Safety Reporting Self-Assessment Questionnaire
Evaluate your organization's approach to safety reporting. Please answer all questions to the best of your knowledge.
How easy is it for employees to report safety incidents in your organization?
*
Very Difficult
1
2
3
4
Very Easy
5
1 is Very Difficult, 5 is Very Easy
How confident are you that reported safety issues are addressed promptly?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
How would you rate the effectiveness of your current safety training programs?
*
1
2
3
4
5
Which of the following best describes your organization's leadership support for safety reporting?
*
Highly supportive
Somewhat supportive
Neutral
Somewhat unsupportive
Not supportive
How frequently are safety reporting procedures reviewed and updated?
*
Quarterly
Biannually
Annually
Less than once a year
Never
How comfortable do employees feel about reporting near-misses or potential hazards?
*
Very uncomfortable
1
2
3
4
Very comfortable
5
1 is Very uncomfortable, 5 is Very comfortable
Please indicate your level of agreement with the following statements:
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Safety reporting is encouraged at all levels
1
2
3
4
5
Feedback is provided after an incident is reported
6
7
8
9
10
Reporting systems are easy to access
11
12
13
14
15
How likely are employees to provide suggestions for improving safety?
*
Very unlikely
1
2
3
4
Very likely
5
1 is Very unlikely, 5 is Very likely
Which methods does your organization use for safety reporting? (Select all that apply)
*
Online portal
Paper forms
Mobile app
Direct supervisor
Anonymous hotline
Other
What is one improvement you would recommend for your organization's safety reporting process?
*
Submit Assessment
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