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Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK...

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[email protected] 1 (877) 438-9763 HRdownloads.com Templates and online services from HRdownloads are provided for clients of our service. Clients may use HRdownloads’ products as they are, or as a starting point for their own initiatives. HRdownloads assumes no responsibility for the enforcement or effectiveness of its templates and online products. Our human resources information and recommendations are based on seasoned, best practice field experience and should not be construed as legal advice.HRdownloads’ Online Training is developed by experts and intends to meet compliance and industry requirements. In addition to the instructional information provided by HRdownloads’ Online Training, it may be necessary to provide hands-on training or additional training to meet the standards and requirements of particular workplaces, tasks, responsibilities, and jurisdictions.. EMPLOYEE SATISFACTION SURVEYS Employee Satisfaction Survey 2 Benefits Satisfaction Survey 18 Employee Engagement Survey 32 Human Resources Satisfaction Survey 41 Employee Motivation Survey 50 Salary Satisfaction Survey 53 PERFORMANCE AND DEVELOPMENT SURVEYS 360 Employee Feedback Survey 66 360 Manager Feedback Survey 77 Succession Plan Survey 79 Training Needs Survey 96 Employee Attitude Survey 99 HEALTH AND SAFETY SURVEYS Health and Safety Satisfaction Survey 114 Employee Pre-Risk Assessment Survey (Violence) 122 EMPLOYEE LIFECYCLE SURVEYS New Hire Satisfaction Survey 128 Exit Interview Survey 145 Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific Survey 179 Project Status Survey 181 Charity Event Planning Survey 183 Customer Satisfaction – Website Feedback Survey 185 BUSINESS INTELLIGENCE SURVEYS Customer Satisfaction Survey 186 Survey Architect - Previews
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Page 1: Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific

[email protected] 1 (877) 438-9763 HRdownloads.com

Templates and online services from HRdownloads are provided for clients of our service. Clients may use HRdownloads’ products as they are, or as a starting point for their own initiatives. HRdownloads assumes no responsibility for the enforcement or effectiveness of its templates and online products. Our human resources information and recommendations are based on seasoned, best practice field experience and

should not be construed as legal advice.HRdownloads’ Online Training is developed by experts and intends to meet compliance and industry requirements. In addition to the instructional information provided by HRdownloads’ Online Training, it may be necessary to provide hands-on training or additional training to meet the standards and requirements of particular workplaces, tasks, responsibilities, and jurisdictions..

EMPLOYEE SATISFACTION SURVEYS Employee Satisfaction Survey 2

Benefits Satisfaction Survey 18

Employee Engagement Survey 32

Human Resources Satisfaction Survey 41

Employee Motivation Survey 50

Salary Satisfaction Survey 53

PERFORMANCE AND DEVELOPMENT SURVEYS 360 Employee Feedback Survey 66

360 Manager Feedback Survey 77

Succession Plan Survey 79

Training Needs Survey 96

Employee Attitude Survey 99

HEALTH AND SAFETY SURVEYS Health and Safety Satisfaction Survey 114

Employee Pre-Risk Assessment Survey (Violence) 122

EMPLOYEE LIFECYCLE SURVEYS New Hire Satisfaction Survey 128

Exit Interview Survey 145

Employee Retention Strategy Survey 153

QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177

Customer Satisfaction – Product-Specific Survey 179

Project Status Survey 181

Charity Event Planning Survey 183

Customer Satisfaction – Website Feedback Survey 185

BUSINESS INTELLIGENCE SURVEYS Customer Satisfaction Survey 186

Survey Architect - Previews

Page 2: Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific

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Employee Satisfaction

Introduction

How long have you worked for the organization? A) Less than 1 year

B) 1 year to 3 years

C) 3 years to 5 years

D) 5 years to 10 years

E) More than 10 years

F) Prefer not to answer

Which of the following best describes your level of responsibility at the organization?

A) I do not have any supervisory duties

B) I supervise other employees

C) I am responsible for a department/area that does not include supervision over any other employees

D) I supervise both an area and other employees

E) I supervise supervisors/managers

Which of the following best describes the area or department you work in? A) Sales

B) Customer service

C) Warehousing/ manufacturing

D) Health and safety/ maintenance/ repair

E) Administration/ finance/ operations

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Employee Satisfaction

Senior Management or Owner Effectiveness

In my organization, the senior management demonstrates strong leadership skills.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Senior management communicates effectively so that employees understand the organization’s strategic goals.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Senior management generally understands the problems employees face in their jobs.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Senior management institutes practices and policies to ensure that the workplace is balanced and fair.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

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Employee Satisfaction

Senior Management or Owner Effectiveness

Senior management is open and transparent about the future of the company. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Please provide comments about the overall effectiveness of senior management in your company.

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Employee Satisfaction

Supervisor Effectiveness

My supervisor is an effective leader for my department/team. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

My supervisor handles complaints and resolves questions directly. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

My supervisor provides assistance, training, and guidance so that I can improve my performance.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

The job duties that I need to complete every day constitute a reasonable volume of work that I can accomplish within my shift so that overtime is not required.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

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Employee Satisfaction

Supervisor Effectiveness

I understand what my supervisor expects from me and their expectations for my performance are reasonable.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

My supervisor is consistent in their dealings with all employees. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Please provide any general comments about the effectiveness of your direct supervisor.

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Employee Satisfaction

Teamwork in the Organization

My team or department works well together, and we accomplish our assigned tasks.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

In my team, we are encouraged to exchange our ideas and opinions. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

My team is invested in the organization and cooperates well with other departments in the organization.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

The morale in my team/department is good. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Page 8: Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific

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Employee Satisfaction

Teamwork in the Organization

Please provide any general comments about the effectiveness of your department/team.

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Employee Satisfaction

Recognition, Feedback, and Goal-Setting

My supervisor provides useful and constructive feedback to help me improve my performance.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

I am recognized and praised for the good work I do. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

I am encouraged to participate in the goal-setting process in my organization. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Employee performance evaluations are fair and consistent. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Page 10: Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific

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Employee Satisfaction

Recognition, Feedback, and Goal-Setting

Please provide any general comments about feedback and recognition at your organization.

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Employee Satisfaction

Job or Career Advancement Opportunities

I have room to grow professionally in my organization. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

The organization encourages and supports my career development. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

I can accomplish my career objectives by remaining with the organization. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

The process used for promotions in my organization is fair and balanced. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Page 12: Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific

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Employee Satisfaction

Job or Career Advancement Opportunities

Please provide any general comments about job or career advancement opportunities.

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Employee Satisfaction

Work–Life Balance

My hours of work are agreeable. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

My organization tries to make sure that I have a balance between my work and home life.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Please provide any general comments about work–life balance and how it could be improved.

Page 14: Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific

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Employee Satisfaction

Compensation and Benefits

I am paid fairly for the work I do. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

In my organization, work that exceeds performance expectations is rewarded adequately.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Please choose the statement below that best corresponds to your organization’s method of determining pay increases.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Please select the answer below that best summarizes your organization’s benefits program.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

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Employee Satisfaction

Compensation and Benefits

Please provide any general comments about your organization’s compensation and benefits.

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Employee Satisfaction

Job Satisfaction

My job is meaningful and gives me a personal sense of satisfaction. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

I feel challenged in my current role. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

I feel confident in my job security as long as I complete my job duties to the best of my abilities.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

I feel that working conditions in my organization are healthy and safe for everyone.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Page 17: Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific

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Employee Satisfaction

Job Satisfaction

I understand how my work directly contributes to the overall success of the organization.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

I am proud to work for this organization and would encourage others to work here.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

I rarely think about leaving the organization. Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Please provide any general comments about working conditions at your organization.

Page 18: Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific

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Benefits Satisfaction

General Please evaluate the overall effectiveness of your company-provided benefits plan in meeting your needs.

Company benefits plans are easily understood. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The company does a good job of keeping employees informed of the total cost of salary and benefits provided as opposed to just salary.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The overall cost of benefits coverage is reasonable and affordable. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Claim and reimbursement forms are understandable and easy to file. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Page 19: Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific

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Benefits Satisfaction

General Please evaluate the overall effectiveness of your company-provided benefits plan in meeting your needs.

Reimbursement of insurance claims is received in a timely manner. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Someone is available to answer questions about benefits. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Page 20: Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific

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Benefits Satisfaction

Health Plan Please evaluate the overall effectiveness of the company provided health benefits.

The company-endorsed supplemental medical insurance plan meets my expectations.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The prescription coverage offered by the benefits plan is adequate and meets my expectations

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The vision care portion of the plan is suitable for my needs. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Extended health coverage such as psychologist, chiropractor, physiotherapist is/would be more beneficial for me than some of the other benefits provided.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Page 21: Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific

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Benefits Satisfaction

Health Plan Please evaluate the overall effectiveness of the company provided health benefits.

Access to an employee assistance plan is important to me.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

If there was one category of benefits to be enhanced, I would select health STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Page 22: Surveys | HRdownloads - Survey Architect - Previews...Employee Retention Strategy Survey 153 QUICK PULSE CHECK SURVEYS Holiday Party Planning Survey 177 Customer Satisfaction – Product-Specific

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Benefits Satisfaction

Dental Plan Please evaluate the overall effectiveness of the company-provided dental benefits.

The company-endorsed dental plan meets my expectations. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Dental plan deductibles, if any, are reasonable. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Co-payments, if any, are reasonable. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Dental pre-determination costs are provided promptly. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Benefits Satisfaction

Dental Plan Please evaluate the overall effectiveness of the company-provided dental benefits.

If optional dental benefits were available, I would be willing to pay a small premium to enhance my plan.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

If there was one category of benefits to be enhanced, I would select dental. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Benefits Satisfaction

Life Insurance Please evaluate the overall effectiveness of the company-provided life insurance benefits.

Employee life insurance coverage is adequate. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Employee life insurance coverage is affordable. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Optional life insurance is important to me. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Dependent life insurance coverage is important to me. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Benefits Satisfaction

Life Insurance Please evaluate the overall effectiveness of the company-provided life insurance benefits.

Accidental death and dismemberment (AD&D) coverage offered through my employer meets my needs.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

If there was one category of benefits to be enhanced, I would select life insurance.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Benefits Satisfaction

Disability Insurance Please evaluate the overall effectiveness of the company-provided disability benefits.

The company disability insurance plans meet my expectations. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The premium cost for disability coverage is acceptable to me. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Disability benefits received, if applicable, were timely and met my expectations. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I have a good understanding of the benefits that would be provided if I ever have to claim for a disability.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Benefits Satisfaction

Disability Insurance Please evaluate the overall effectiveness of the company-provided disability benefits.

Disability benefits are not important to me. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I would like to see an employee fitness benefit or wellness program offered by my employer.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Benefits Satisfaction

Retirement Benefits Please evaluate the overall effectiveness of the company-provided retirement benefits.

The company-endorsed retirement savings/pension plan meets my expectations.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

There is enough flexibility with the retirement benefits that I feel I am in control of my retirement.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Retirement counselling or information provided through my employer has been very helpful in planning for the future.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I have a good understanding of the retirement savings/pension plans provided by my employer.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Benefits Satisfaction

Retirement Benefits Please evaluate the overall effectiveness of the company-provided retirement benefits.

I have a good understanding of the benefits I will receive upon retirement and what the projected monthly payment will be at that time.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I would prefer to reduce the coverage of health or dental benefits in exchange for additional retirement benefits.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Benefits Satisfaction

Paid Time Off Please evaluate the overall effectiveness of the company-provided benefits with regards to paid time off.

The vacation entitlement policy is reasonable and fair. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Paid time off for sick leave is adequate. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Paid time off for personal days/bereavement/emergencies is adequate. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

It is never an issue to take planned time off. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Benefits Satisfaction

Paid Time Off Please evaluate the overall effectiveness of the company-provided benefits with regards to paid time off.

There is enough flexibility in my job to allow me to achieve work-life balance. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I would prefer to reduce the coverage of health or dental benefits in exchange for additional paid days off.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Engagement

Organizational

How long have you worked for the organization?

My organization has a long-term purpose and direction. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I understand how my work directly contributes to the success of the organization.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Senior management understands the issues employees face. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

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Employee Engagement

Organizational

Working conditions are safe. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I am proud to work at this company. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Engagement

Job-Specific

The expectations of me are reasonable and clear. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I have the materials, resources, and equipment I need in order to succeed at my job.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I know how I am evaluated and what is required to be successful within my role. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My hours of work are agreeable. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Engagement

Job-Specific

My job gives me personal satisfaction. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Engagement

Teamwork

My colleagues are supportive of the work that I do. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Everyone is treated fairly and consistently. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I have friends at work. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The morale in my team/department is good. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Engagement

Communication/ Feedback

I am encouraged to offer my opinions and feedback. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

In the last month, I have received positive feedback on my performance. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I am provided timely, useful, and constructive feedback to help improve my performance.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Organizational changes, successes, and challenges are clearly communicated. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Engagement

Communication/ Feedback

Commitments and promises made by the organization are kept. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Engagement

Growth

My job motivates me to do my best every day. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I am given opportunities to learn and grow. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The compensation I receive motivates me to perform at a high level. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I rarely consider leaving the organization to pursue other opportunities. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Engagement

Growth

I am encouraged to develop my skills. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Human Resources Satisfaction

Services Using the questions below, please give us your opinion on the overall effectiveness of the Human Resources Department.

HR responds quickly to my operational needs. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR works effectively in a reactive manner. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR works effectively in a proactive manner. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR is a valuable business partner. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Human Resources Satisfaction

Services Using the questions below, please give us your opinion on the overall effectiveness of the Human Resources Department.

Transactional services are attended to in a timely and accurate manner. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR provides useful strategic insight that creates an improved workplace. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The HR department offers fast, accurate, friendly, and knowledgeable services. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The HR department makes their services readily available. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Human Resources Satisfaction

Services Using the questions below, please give us your opinion on the overall effectiveness of the Human Resources Department.

The HR department handles all requests for information, services, and projects in a professional manner.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR provides useful and accurate legal advice. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR adds value to my department. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR provides expert advice on employment issues. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Human Resources Satisfaction

Services Using the questions below, please give us your opinion on the overall effectiveness of the Human Resources Department.

HR provides expert advice on health and safety. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR provides expert advice on employment legislation. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR provides expert advice on employee relations. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR provides expert advice on recruitment and selection. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Human Resources Satisfaction

Services Using the questions below, please give us your opinion on the overall effectiveness of the Human Resources Department.

HR provides expert advice on training and development. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR provides expert advice and accurate information regarding payroll functions, including various forms of leave, overtime, hours, and rate of pay.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR provides clear policies and procedures that assist in the effective management of the company.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR policies ensure a clear understanding by managers and staff of both their individual and corporate responsibilities.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Human Resources Satisfaction

Services Using the questions below, please give us your opinion on the overall effectiveness of the Human Resources Department.

HR policies are updated and revised in a timely manner to reflect changes in the workplace and legislation.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR employs effective hiring methodologies, and ensures that qualified and appropriate staff are provided to departments as required.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR ensures that staffing levels are appropriate. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR provides efficient and effective employee training, development, and new-hire orientation.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Human Resources Satisfaction

Services Using the questions below, please give us your opinion on the overall effectiveness of the Human Resources Department.

HR handles all disciplinary actions and terminations in a fair and consistent manner.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

HR ensures that employee benefits are reasonably priced, attractive, and easy to use.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Human Resources Satisfaction

Part II - Qualitative Employee Benefit Satisfaction Survey Please answer the following questions honestly and to the best of your ability.

What can the (Company Name) HR department do to make your employment more satisfying?

What additional services would you like to see?

Do you feel the (Company Name) HR department listens to employee needs and reacts appropriately?

Should Human Resources provide more comprehensive health and wellness promotion?

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Human Resources Satisfaction

Part II - Qualitative Employee Benefit Satisfaction Survey Please answer the following questions honestly and to the best of your ability.

Is there anything else that you believe needs change or to improve in Human Resources?

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Employee Motivation

Years of Service

Please select the checkbox which indicates your years of service with the Company.

Less than one year of service

More than one year and less than three years

More than three years and less than five years

More than five years and less than ten years

More than ten years and less than fifteen years

More than fifteen years

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Employee Motivation

Motivation

Please choose three of the items on the list that motivate you the most to complete work. If the items are not on the list, you may add them in the space provided, along with any comments.

Work that is satisfying

Work that is stimulating/ challenging/ interesting

Completing tasks

Performing tasks that are meaningful

The chance to offer suggestions for improvements/ being consulted

Observing visible progress in the completion of assigned duties

Job security/safety

Feeling like the work you do is noticed by management

Verbal and/or written recognition among peers and/or management

The mission of (Company Name)

Yearly salary

Monetary (cash) rewards/merit bonuses

Health/dental benefits

Days off with pay

Loyalty to (Company Name)

Loyalty to other employees/team dynamics

A climate of trust in the workplace

Opportunity for advancement

Status (job title, etc.)

Interpersonal support for problems/issues

Fair/unbiased decision-making

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Employee Motivation

Motivation

Please choose three of the items on the list that motivate you the most to complete work. If the items are not on the list, you may add them in the space provided, along with any comments. (Continued)

Clear goals

Fear of being reprimanded

Autonomy/ability to make judgement calls

Clear expectations and directives provided by management

Competitiveness

Satisfying the customer/supplier/client

Adequate resources (technical support, tools to adequately perform the tasks)

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Salary Satisfaction

Job Information

What is your job title?

How many employees work at your location?

Population of area(s) serviced:

Total number of clients managed at your location:

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Salary Satisfaction

Job Information

Total number of job titles at your location:

Number of employees in each job title:

Total funding received (government sources):

Total funding received (fundraising):

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Salary Satisfaction

Job Information

Does your location provide cost-of-living allowances or scheduled increases?

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Salary Satisfaction

Benefits Information Are Benefits paid by the Organization, or employer/employee shared cost? Please provide details.

How are you paid?

Amount of life insurance. Please specify in the space provided.

Rx drug plan: Yes

No

Co-insurance amount. Please specify in the space provided.

Deductible group. Please specify in the space provided.

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Salary Satisfaction

Benefits Information Are Benefits paid by the Organization, or employer/employee shared cost? Please provide details.

Life or yearly maximum. Please specify in the space provided.

Vision care: Yes

No

Rx glasses: Yes

No

Rx glasses amount. Please specify in the space provided.

Dental plan: Yes

No

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Salary Satisfaction

Benefits Information Are Benefits paid by the Organization, or employer/employee shared cost? Please provide details.

ODA schedule: Year

Current

Restorative: Yes

No

Restorative amount. Please specify in the space provided.

Ortho: Yes

No

Ortho amount. Please specify in the space provided.

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Salary Satisfaction

Benefits Information Are Benefits paid by the Organization, or employer/employee shared cost? Please provide details.

Ortho maximum. Please specify in the space provided.

Sickness and accident: Yes

No

Weekly amount. Please specify in the space provided.

Maximum number of weeks. Please specify in the space provided.

LTD: Yes

No

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Salary Satisfaction

Benefits Information Are Benefits paid by the Organization, or employer/employee shared cost? Please provide details.

Maximum monthly amount. Please specify in the space provided.

Pension:

Type (defined or contributory benefit):

Company contribution:

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Salary Satisfaction

Benefits Information Are Benefits paid by the Organization, or employer/employee shared cost? Please provide details.

Employee contribution:

Unreduced pension at age:

Unreduced pension at years of service:

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Salary Satisfaction

Employee Job Profiles

Job title:

Yearly salary:

Hourly salary:

Benefits / non-cash compensation received:

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Salary Satisfaction

Employee Job Profiles

Do employees pay towards the cost of benefit plans? Yes

No

How much per week or month?

Which benefits do they pay towards?

Please select type:

Duration of tenure in current job title:

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Salary Satisfaction

Employee Job Profiles

How much per week or month?

Which benefits do they pay towards?

Please select type:

Duration of tenure in current job title:

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Salary Satisfaction

Employee Job Profiles

Highest level of education completed:

Licences, diplomas, professional designations, or certifications held:

Number of vacation days allotted:

Comments

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360 Feedback

Employee’s Information

Employee’s Name:

Title:

Supervisor’s Name:

Date of Review:

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Leadership

Motivates me and fellow employees. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Shows a consistent approach to issues. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Can be persuasive and inspiring. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Is fair and impartial. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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People/Performance Management

Establishes clear performance expectations. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Handles performance issues directly and tactfully. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Delegates responsibilities. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Gives appropriate authority and responsibility. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Communication

Communicates clearly and consistently. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Delivers both good and bad news directly. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Listens well. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Coaching and Development

Provides coaching and guidance on a regular basis. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Shows a good understanding of my challenges. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Recognizes both my strengths and weaknesses. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Rewards hard work and positive results. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Coaching and Development

Creates clear development goals. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Gives attention to questions and suggestions. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Innovation

Supports the ideas of others. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Encourages innovation. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Allows for differences in approach and style. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Interpersonal Skills

Seeks out constructive criticism. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Is approachable. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Is flexible and open-minded. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Works well with others. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Dependability

Completes work and meets commitments. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Accepts accountability. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Stays focused under pressure. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Problem Solving/Analysis

Can simplify and process complex issues. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Understands the difference between critical details and unimportant facts. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Considers multiple solutions. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Expertly handles obstacles. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Planning and Goal Setting

Aligns plans with company goals. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Balances short- and long-term goals. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Develops challenging yet realistic plans. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Plans for and manages resources. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Leadership Please comment on the overall effectiveness of your direct Manager based on your personal dealings with him/her. You can select one or more options of those given to support your comments.

My supervisor is an effective leader for our department/team: Provide training on communication, leadership and management skills for all managers/supervisors in the organization.

Communicate goals and results for all levels of the organization so that workers can see managers/supervisors are held accountable for achieving results.

Provide workers with an opportunity to give feedback on their supervisor as part of the performance evaluation process.

My supervisor handles complaints and resolves problems effectively: Increase communication between employees and supervisor to ensure issues are managed in a timely manner.

Provide supervisors with training on effective conflict resolution to effectively deal with issues before they escalate.

Implement tools to assist with effective coaching technique.

My supervisor has enough authority to make changes that impact our department/team and considers employees' suggestions:

Identify where the lack of decision-making authority is causing issues. Procedures may be too restrictive to allow for efficient and effective problem-solving.

Empower supervisors to make more decisions and encourage employee input to increase commitment to plans.

Introduce an employee suggestion box to solicit ideas from employees. A reward for the best idea of the month or quarter often increases participation.

My supervisor provides assistance, training and guidance so that I can improve my performance:

Implement tools to assist with effective coaching techniques.

If employees feel that more training is required, conduct a needs assessment to identify gaps and offer appropriate training to improve performance.

Suggest that supervisors promote an 'open door' policy so that employees feel comfortable asking for help.

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Leadership Please comment on the overall effectiveness of your direct Manager based on your personal dealings with him/her. You can select one or more options of those given to support your comments.

My supervisor's expectations for me are reasonable: Implement procedures for supervisors to work with HR or higher level management when dealing with employee performance issues to ensure consistency.

Implement tools for use in coaching and performance management that will ensure consistency within the team and throughout the organization.

Provide workers with an opportunity to give feedback on their supervisor as part of the performance evaluation process to identify issues and seek timely resolutions.

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Succession Plan

Employee Information

Gender (Please check one):

Age (please select the most appropriate choice):

Length of employment at (Company Name):

How long have you been in your current position?

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Education These questions measure the current and future levels of education.

Please check all forms of education completed: Grade school (grades 1-8)

High school diploma / GED

Vocational training

Some college

Two-year college degree

Four-year college degree

University degree

Master's degree

Doctoral degree

Professional degree

Other (please specify in the space provided)

Have you considered pursuing additional training or education? If yes, what form of training or education would you like to pursue and why? Please specify in the space provided.

Yes

No

Comments

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Appeal of Leadership at (Company Name) Please evaluate the following statements

My role is dynamic, and provides new and satisfying challenges. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My current role provides me with a high level of job satisfaction. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The workplace culture promotes, recognizes, and rewards success. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The workplace is a collegial and team-oriented environment. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Appeal of Leadership at (Company Name) Please evaluate the following statements

I would like to take a leadership or management position. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

(Company Name) is involved in community and charity. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Motivation Please indicate which of the following factors provide motivation to advance and/or continue your career progression within (Company Name).

Compensation. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Benefits. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Higher levels of responsibility. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Ability to increase decision-making abilities. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Factors Impeding Career Advancement Please indicate which of the following factors create impediments or barriers in the advancement and/or continuation of your career within (Company Name).

Restrictive policies and procedures. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Lack of necessary educational or training requirements. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Lack of available resources for training or development. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Job evaluation. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Factors Impeding Career Advancement Please indicate which of the following factors create impediments or barriers in the advancement and/or continuation of your career within (Company Name).

Time and demands of responsibility. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Personal priorities. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Stress. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Management. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Factors Impeding Career Advancement Please indicate which of the following factors create impediments or barriers in the advancement and/or continuation of your career within (Company Name).

I do not have time to attend training/development activities. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I am not aware of information regarding training/development activities. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The training/development activities that I want are unavailable. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Other (Please Specify):

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Mobility Please answer the following questions in the appropriate format

Do you plan on retiring from active duty at (Company Name)?

When do you plan on retiring?

In the next three (3) years, do you see yourself leaving (Company Name) for any reason other than retirement?

If you answered “Yes” or “Possibly” to the previous question, please indicate which of the following options correspond to your future work preferences or endeavours.

Seek a management role

Seek a senior leadership role

Move to a different town/city

Change of career

Attend school full-time

Retirement

Other (please specify):

If “Other”, please specify:

Comments

Comments

Comments

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Personal Satisfaction Are you happy in your current role? Do you see yourself at the company long term? Is there a clear path for career progression? Are you paid properly for your work?

I enjoy the day-to-day activities of performing my job. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I see myself at (Company Name) long-term. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I am efficient in performing my job. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The work I produce is high-quality. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Personal Satisfaction Are you happy in your current role? Do you see yourself at the company long term? Is there a clear path for career progression? Are you paid properly for your work?

I have to go through a lot of 'red tape' to get my job done. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My job gives me a personal sense of satisfaction. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Our company does a good job of meeting my needs as an individual. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Overall, I am satisfied with this organization. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Personal Satisfaction Are you happy in your current role? Do you see yourself at the company long term? Is there a clear path for career progression? Are you paid properly for your work?

I have a clear path towards job progression. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I have clear expectations and understanding of my job duties and what is required of me.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I receive proper praise and recognition when I perform my job beyond expectations.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Compensation and Opportunities Does the company pay you adequately? Is there opportunity for long term career progression? Do you understand your pay rise procedure? Are there clear benchmarks towards career progression?

I am paid fairly for the work I do. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I understand how my pay is determined. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I am satisfied with how pay raises are determined. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I feel that the benefits package I receive at (Company Name) is fair and competitive.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Succession Plan

Compensation and Opportunities Does the company pay you adequately? Is there opportunity for long term career progression? Do you understand your pay rise procedure? Are there clear benchmarks towards career progression?

In comparison with other people in similar jobs at (Company Name), I feel my pay is adequate.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Qualified employees are usually allowed to transfer to better jobs. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The individuals who do receive promotions usually deserve them. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I can be sure of a job with (Company Name) as long as I do good work. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Succession Plan

Compensation and Opportunities Does the company pay you adequately? Is there opportunity for long term career progression? Do you understand your pay rise procedure? Are there clear benchmarks towards career progression?

There is an opportunity for long-term career progression. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I have the chance to achieve my goals at work. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Succession Plan

Short Answer Questions Please answer the following questions honestly and to the best of your ability.

What can the company do to make your job more satisfying?

What can the company do to support your career goals?

What tools, resources, and abilities can the company provide to make your job easier?

What forms of training, development, or succession planning programs would help you in the advancement of your career?

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Succession Plan

Short Answer Questions Please answer the following questions honestly and to the best of your ability.

Do you feel that the company offers meaningful career development and progression opportunities? What can we do better?

What can the company do to ensure that you stay with us for the long term?

Would you recommend our company as an employer to your friends and family? Why or why not?

Is there anything else that you believe needs change or improvement in the company?

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Training Needs

Training Needs

List the training you have received from the company (regarding position, qualification, etc.).

In what areas do you feel you could use more training, either for your current position or to grow within the company.

Is there a new technique or program in your field that you think should be explored as a potential training opportunity

Are there skills that you had to learn on the job that (Company Name) could provide through training to new employees?

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Training Needs

Training Needs

What do you think is the most effective training delivery system and why?

Who do you think should be responsible for training delivery?

What generally are your goals when you attend training sessions?

What do you think makes a good training session?

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Training Needs

Training Needs

What do you think makes a bad training session?

How has (Company Name) supported you after training?

What do think (Company Name) could do to make training more effective?

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Employee Attitude

Fairness

My manager treats all his/her employees fairly. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The organization's policies for promotion and advancement are always fair. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Favouritism (special treatment) is not an issue in raises or promotions. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My manager is always consistent when administering policies concerning employees.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

Fairness

I am always treated fairly by my manager. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Everybody is treated fairly in this organization. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

My work is rewarding. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My work is stimulating. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My work is challenging. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I have a mentor at work. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

I am encouraged to learn from my mistakes. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My manager encourages and supports my development. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I receive the training I need to do my job well. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

Opportunities for Growth

I have adequate opportunities for professional growth in this organization. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My manager is actively interested in my professional development and advancement.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

Work-Life Balance, Stress, and Work Pace

The environment in this organization supports a balance between work and personal life.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My manager understands the importance of maintaining a balance between work and personal life.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I am able to satisfy both my job and personal responsibilities. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I am not forced to choose between job and personal obligations. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

Work-Life Balance, Stress, and Work Pace

The pace of the work in this organization enables me to do a good job.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The amount of work I am asked to do is reasonable. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The organization has reasonable expectations of its employees. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My job does not cause unreasonable amounts of stress in my life. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

Respect

I respect the senior leaders of this organization.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I respect my manager as a competent professional. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The leaders of this organization know what they are doing. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Our senior managers demonstrate strong leadership skills. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

Respect

I am satisfied with my manager.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My manager always treats me with respect. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My manager listens to what I'm saying. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

This organization respects its employees. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

Respect

My manager values my talents and the contribution I make. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The organization values the contribution I make. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My talent is valued at work. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My co-workers care about me as a person. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

Teamwork

Teamwork is encouraged and practiced in this organization. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

There is a strong feeling of teamwork and cooperation in this organization. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I like working with the other members of my work group. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

There is emphasis on teamwork in this organization. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

This organization has a real interest in the welfare and satisfaction of those who work here.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

This organization is a good place to work. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

People in this organization are treated with dignity and respect, regardless of their job level.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Management acts as if it believes that employees are this organization's most important asset.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

If a good friend were offered a job here, it is likely that I would tell him or her to take the job.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My work environment contributes to my ability to perform my job well. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

My company is a market leader. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Our products and services deliver on their promises. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I trust the decisions that company management makes. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I understand the decisions that upper management makes. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Employee Attitude

Pride

I am happy to talk about my role to friends and family. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My role is important for the efficient functioning of the company. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I feel like a valuable member of my company. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Health and Safety Satisfaction

Employer Please comment on the overall impact of Management in regards to Health and Safety.

My employer visibly demonstrates an interest in the Health and Safety of employees.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My immediate supervisor makes Health and Safety a priority for all work including their own.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My department is flexible in adjusting work assignments according to employee safety considerations.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

If I have a concern about Health and Safety, and my supervisor is not available, I know whom to contact.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Health and Safety Satisfaction

Employer Please comment on the overall impact of Management in regards to Health and Safety.

My supervisor often observes my work practices for the purpose of protecting my Health and Safety.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor/department conducts periodic and effective safety meetings/checks.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Health and Safety Satisfaction

Training Please comment on the overall effectiveness of the Health and Safety Training efforts in your company.

The proper personal protective equipment PPE (I.e. safety glasses, gloves, etc.) for my job is always available.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The Health and Safety rules of this organization have been clearly explained to me.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The ongoing Health and Safety training program offered by my organization meets my needs.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I know what to do in case of an emergency (i.e. fire, tornado, chemical spill, etc.). STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Health and Safety Satisfaction

Training Please comment on the overall effectiveness of the Health and Safety Training efforts in your company.

All new employees are properly trained in Health and Safety rules and work practices.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Safe operating procedures (SOP's) for using equipment/machines are reviewed and revised as necessary.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Health and Safety Satisfaction

Joint Health and Safety Committee/Representative Please comment on the overall effectiveness of the Health and Safety reporting processes in your company.

Identified Health and Safety concerns or hazards are addressed or corrected in a timely manner.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Workplace accidents and/or near misses are always reported. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The Health and Safety Committee is an active and results- oriented group. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I know the name of my organization's safety coordinator and how I can contact him or her.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Health and Safety Satisfaction

Joint Health and Safety Committee/Representative Please comment on the overall effectiveness of the Health and Safety reporting processes in your company.

Reported concerns and hazards are communicated to minimize the opportunity for repeat incidents.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

If I saw another employee committing an unsafe practice, I would say something directly to him or her.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Health and Safety Satisfaction

Employee Please comment on the overall effectiveness of the Health and Safety efforts in your company.

I report every workplace injury or illness to my supervisor that I sustain, regardless of severity.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Health and Safety is a high priority when I am performing my job responsibilities. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I have opportunities to provide input into the Health and Safety program. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Health and Safety inspections of my work area/department are conducted at regular intervals.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

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Health and Safety Satisfaction

Employee Please comment on the overall effectiveness of the Health and Safety efforts in your company.

Rewards and positive feedback are implemented adequately and consistently to achieve H&S goals and increase Health and Safety awareness levels.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My opinion is sought when H&S controls are being implemented, adapted or considered.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments about the overall effectiveness of Health and Safety Programs in your company.

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Pre Risk Assessment

Pre-Risk Assessment Please be sure to report all incidents of violence and/or aggression in the workplace by completing an incident report.

Please state the department you work in:

Please state your role at the company:

Have you personally experienced the following at (Company Name)? Please check all that apply.

Assault

Harassment

Near miss

Physical attack

Sexual abuse

Sexual assault

Threat

Verbal abuse

I have not personally experienced any of the above

Comments

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Pre Risk Assessment

Pre-Risk Assessment Please be sure to report all incidents of violence and/or aggression in the workplace by completing an incident report.

Have you personally witnessed the following at (Company Name). Please check all that apply.

Assault

Harassment

Near miss

Physical attack

Sexual abuse

Sexual assault

Threat

Verbal abuse

I have not personally experienced any of the above

If you have experienced or been witness to any of the above, have you lost time from work as a result?

Do you feel physically safe at (Company Name)?

Are you prepared to handle a violent situation or threat or be responsive to escalating behaviours exhibited by co-workers/others while at work?

Yes

No

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Pre Risk Assessment

Pre-Risk Assessment Please be sure to report all incidents of violence and/or aggression in the workplace by completing an incident report.

If you have experienced or witnessed violence, threats or aggression, who initiated the incidents?

Visitors

Family

Staff

Volunteer

Contractor

I have not experienced/ witnessed the above

Have you read the (Company Name) Workplace Anti-Violence Policy? Yes

No

Do you know where to find the (Company Name) Workplace Anti-Violence Policy?

Yes

No

Have we provided you with every necessary control and measure to protect your safety at work? If no, please complete what could we do in the space provided.

Yes

No

Comments

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Pre Risk Assessment

Pre-Risk Assessment Please be sure to report all incidents of violence and/or aggression in the workplace by completing an incident report.

Are there any improvements required in the following areas that would make your workplace safer?

Lighting

Secure restrooms

Secure parking lot

Restricted public access to work areas on your unit

Cameras

Communication of care plan

Flagging of violent patients

Other (please specify in the space provided)

How would you rate the quality of information about the security devices in our workplace?

Excellent

Very Good

Good

Poor

Very Poor

I have not been given any information about security devices

Comments

Comments

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Pre Risk Assessment

Pre-Risk Assessment Please be sure to report all incidents of violence and/or aggression in the workplace by completing an incident report.

Have any of the following safety supports been offered to you when you have raised a concern for your safety and/or as part of a post incident plan? (check all that apply).

The assistance of a buddy to escort you on/off property

The assistance of a security guard to escort you on/off property

The assistance of police support in high risk situations

A personal alarm when needed

Timely assistance when you request it

EAP support for staff directly or indirectly involved in the events of workplace violence

Other (please specify in the space provided)

Are you aware that (Company Name) can work with you to create a plan to ensure your personal safety at work should there be potential for domestic violence to occur at the workplace?

Yes

No

If you witnessed or experienced workplace violence, were you offered the opportunity to express your thoughts about the incident and to learn about normal stress reactions and available services through debriefing or counseling?

Do you know how to report an incidence of violence, threat or aggression and who to report it to?

Yes

No

Are you required to report threats, violence and aggression? Yes

No

Comments

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Pre Risk Assessment

Pre-Risk Assessment Please be sure to report all incidents of violence and/or aggression in the workplace by completing an incident report.

Are you aware that the Occupational Health and Safety Act places a legal obligation on a worker to report the existence of violence hazards?

Yes

No

Can you report violence hazards without the fear of reprisal? Yes

No

Does the supervisor or manager of the unit investigate incidents without undue delay?

Yes

No

Does the supervisor or manager of the unit take suitable corrective action without undue delay?

Yes

No

When an incident of workplace violence has resulted in you seeking medical attention or losing time from work, has (Company Name) reported the incident to WSIB?

What controls, measures and procedures could be taken to make your workplace safer?

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Organizational New employees must judge the overall effectiveness of the company. Does your company look out for the new employees? Are you proud to work at (Company Name)? Would you recommend working at (Company Name)?

I have been well-received into the company, and made to feel like part of the team.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

In my judgement, this organization is well-managed. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Orientation provided a strong impression of the company and provided useful information.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Organizational New employees must judge the overall effectiveness of the company. Does your company look out for the new employees? Are you proud to work at (Company Name)? Would you recommend working at (Company Name)?

Training was informative and relevant. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Management is interested in the welfare of its employees. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I feel management generally understands the problems we face in our jobs. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Organizational New employees must judge the overall effectiveness of the company. Does your company look out for the new employees? Are you proud to work at (Company Name)? Would you recommend working at (Company Name)?

I am proud to work for (Company Name). STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My job duties have been clearly defined, and are appropriate. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I would recommend employment at (Company Name) to my friends. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Supervisor Evaluation Please evaluate your direct supervisor based on your personal dealings with him/her. Does the supervisor act ethically and fairly in day to day operations? Are deadlines met consistently? Does your supervisor lead by example and provide guidance for you?

I am satisfied with my supervisor. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor is consistent in his/her dealings with all of us. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor listens to our suggestions and problems. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Supervisor Evaluation Please evaluate your direct supervisor based on your personal dealings with him/her. Does the supervisor act ethically and fairly in day to day operations? Are deadlines met consistently? Does your supervisor lead by example and provide guidance for you?

My supervisor gives me credit for work well done. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I feel free to express my honest opinions to my supervisor. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor has confidence and trust in my abilities. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Supervisor Evaluation Please evaluate your direct supervisor based on your personal dealings with him/her. Does the supervisor act ethically and fairly in day to day operations? Are deadlines met consistently? Does your supervisor lead by example and provide guidance for you?

My supervisor encourages me and my colleagues to give their best effort. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor provides me with adequate help, training, and guidance so that I can improve my performance.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I have trust and confidence in my supervisor. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Supervisor Evaluation Please evaluate your direct supervisor based on your personal dealings with him/her. Does the supervisor act ethically and fairly in day to day operations? Are deadlines met consistently? Does your supervisor lead by example and provide guidance for you?

I am satisfied with how my supervisor takes care of complaints. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor expects too much from me. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor has enough authority to make changes for the better. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Supervisor Evaluation Please evaluate your direct supervisor based on your personal dealings with him/her. Does the supervisor act ethically and fairly in day to day operations? Are deadlines met consistently? Does your supervisor lead by example and provide guidance for you?

My supervisor is a good listener. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

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Personal Satisfaction Please evaluate your overall satisfaction. Are you happy in your current role? Do you see yourself at the company long term? Is there a clear path for career progression? Are you paid properly for your work?

I enjoy the day-to-day activities of performing my job. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I see myself at this company long-term. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I am efficient in performing my job. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Personal Satisfaction Please evaluate your overall satisfaction. Are you happy in your current role? Do you see yourself at the company long term? Is there a clear path for career progression? Are you paid properly for your work?

The work I produce is high-quality. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I have to go through a lot of 'red tape' to get my job done. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My job gives me a personal sense of satisfaction. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Personal Satisfaction Please evaluate your overall satisfaction. Are you happy in your current role? Do you see yourself at the company long term? Is there a clear path for career progression? Are you paid properly for your work?

I have a clear path towards job progression. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Our company does a good job of meeting my needs as an individual. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Overall, I am satisfied with this organization. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Personal Satisfaction Please evaluate your overall satisfaction. Are you happy in your current role? Do you see yourself at the company long term? Is there a clear path for career progression? Are you paid properly for your work?

I have clear expectations and understanding of my job duties and what is required of me.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I receive proper praise and recognition when I perform my job beyond expectations.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

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Compensation and Opportunities Does the company pay you adequately? Is there opportunity for long term career progression? Do you understand your pay raise procedure? Are there clear benchmarks towards career progression?

I am paid fairly for the work I do. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I understand how my pay is determined. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I am satisfied with how pay raises are determined. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Compensation and Opportunities Does the company pay you adequately? Is there opportunity for long term career progression? Do you understand your pay raise procedure? Are there clear benchmarks towards career progression?

I feel that the benefits package offered by [company name] is attractive. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I can be sure of a job with (Company Name) as long as I do good work. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

There is an opportunity for long-term career progression. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Compensation and Opportunities Does the company pay you adequately? Is there opportunity for long term career progression? Do you understand your pay raise procedure? Are there clear benchmarks towards career progression?

I have the chance to achieve my goals at work. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

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Working Conditions Please rate your working conditions. Are working conditions safe? Are you overworked? Are the hours of work agreeable?

The hours of work are agreeable. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Working conditions around my job are good. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The workload is fairly distributed. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Working Conditions Please rate your working conditions. Are working conditions safe? Are you overworked? Are the hours of work agreeable?

Work is well-organized at (Company Name). STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Too much work is expected of employees in my area. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Working conditions here are safe. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Exit Interview

Organizational Details

Please enter your name:

What is your role in our organization?

How long have you been employed with our company?

A) Less than 1 year

B) 1-5 years

C) 6-10 years

D) 11-20 years

E) More than 20 years

F) Prefer Not To Answer

In the space provided below, please explain your reasons for leaving your current

position.

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Exit Interview

Job Duties

Were you satisfied with the job duties you were required to perform in your position?

Extremely satisfied

Satisfied

Neither satisfied or dissatisfied

Dissatisfied

Extremely dissatisfied

Do you feel you received enough training to perform your duties effectively?

What would you change about your job?

Do you feel that your job contributed to the company’s success?

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Exit Interview

Opportunities for Advancement

Were you satisfied with the opportunities for career advancement within our

organization?

Extremely satisfied

Satisfied

Neither satisfied or dissatisfied

Dissatisfied

Extremely dissatisfied

Do you feel the organization made the best use of your knowledge and skills?

Was your performance or advancement hindered by any company policies or

procedures?

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Exit Interview

Compensation and Benefits

Please indicate your level of satisfaction with the following components of our

compensation and benefits package.

Extremely satisfied Satisfied Neither Satisfied

or dissatisfied Dissatisfied Extremely Dissatisfied

Salary or wages

Short or long-term disability

Sick time

Vacation time

Dental benefits

RRSP pension plan

Extended health benefits

Commissions

Bonuses, profit-sharing, merit pay

Stock options

Salary or wages

Sick time

Please provide any suggestions you have for improving the company’s compensation and benefits package.

Do you feel you were appropriately recognized or rewarded for the work

accomplishments or contributions you made while working for our company?

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Exit Interview

Relationships with Supervisors and Co-workers

Were you satisfied with your supervisor or quality of supervision?

Extremely satisfied

Satisfied

Neither satisfied or dissatisfied

Dissatisfied

Extremely dissatisfied

Please expand on your level of satisfaction with your supervisor or the quality of

supervision.

How could your supervisor improve their leadership style?

How would you rate your level of satisfaction regarding your relationships with your co-

workers?

Extremely satisfied

Satisfied

Neither satisfied or dissatisfied

Dissatisfied

Extremely dissatisfied

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Exit Interview

Relationships with Supervisors and Co-workers

Please provide any suggestions you have for improving the company’s compensation

and benefits package.

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Exit Interview

Working Conditions

Please rate your level of satisfaction with your working conditions. (For example, the

physical environment, physical demands, hours of work, workload.)

Extremely satisfied

Satisfied

Neither satisfied or dissatisfied

Dissatisfied

Extremely dissatisfied

Please explain your level of satisfaction with your working conditions.

Are there any working conditions at this company that you feel are detrimental? Please

explain your answer in the space provided.

Please provide suggestions for improving the working conditions in our company.

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Exit Interview

Conclusion

Overall, how would you rate your level of satisfaction working for our organization.

Extremely satisfied

Satisfied

Neither satisfied or dissatisfied

Dissatisfied

Extremely dissatisfied

Please provide any additional comments you have about your experience with our

company.

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Employee Retention

Company Employees must judge the overall effectiveness of the company. Does your company look out for the employees? Are you proud to work at (Company Name)? Would you recommend working at (Company Name)?

Management is interested in the welfare of its employees. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

This organization is well managed. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I feel management generally understands the problems we face in our jobs. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Company Employees must judge the overall effectiveness of the company. Does your company look out for the employees? Are you proud to work at (Company Name)? Would you recommend working at (Company Name)?

I am proud to work for (Company Name). STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I would recommend employment at (Company Name) to my friends. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

This survey is a good way to find problems that need to be solved. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Departmental Effectiveness Does your department complete work on time and to the expected level? How does your department deal with challenges and tasks? Is communication effective between department employees?

My department's overall performance and effectiveness are good. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My work department makes good decisions and solves problems well. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

There is cooperation between my department and other departments. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Departmental Effectiveness Does your department complete work on time and to the expected level? How does your department deal with challenges and tasks? Is communication effective between department employees?

I have confidence and trust in my departmental co-workers. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My department produces the amount of work that is expected. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My department is encouraging and works together as a team. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Departmental Effectiveness Does your department complete work on time and to the expected level? How does your department deal with challenges and tasks? Is communication effective between department employees?

The exchange of ideas and opinions is encouraged in our department. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My department is efficient in doing its required work. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My department plans and co-ordinates work effectively. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Departmental Effectiveness Does your department complete work on time and to the expected level? How does your department deal with challenges and tasks? Is communication effective between department employees?

People in my work area work well together. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The department morale is good. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The people I work with help each other out when someone falls behind. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Supervisor Evaluation Please evaluate your direct supervisor based on your personal dealings with him/her. Does the supervisor act ethically and fairly in day to day operations? Are deadlines met consistently? Does your supervisor lead by example? and provide guidance for you?

I am satisfied with my supervisor. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor is consistent in his/her dealings with all of us. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor listens to our suggestions and problems. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Supervisor Evaluation Please evaluate your direct supervisor based on your personal dealings with him/her. Does the supervisor act ethically and fairly in day to day operations? Are deadlines met consistently? Does your supervisor lead by example? and provide guidance for you?

My supervisor gives me credit for work well done. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I feel free to express my honest opinions to my supervisor. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor has confidence and trust in my abilities. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Supervisor Evaluation Please evaluate your direct supervisor based on your personal dealings with him/her. Does the supervisor act ethically and fairly in day to day operations? Are deadlines met consistently? Does your supervisor lead by example? and provide guidance for you?

My supervisor encourages me and my colleagues to give their best effort. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor provides me with adequate help, training, and guidance so that I can improve my performance.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I have trust and confidence in my supervisor. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Supervisor Evaluation Please evaluate your direct supervisor based on your personal dealings with him/her. Does the supervisor act ethically and fairly in day to day operations? Are deadlines met consistently? Does your supervisor lead by example? and provide guidance for you?

I am satisfied with how my supervisor takes care of complaints. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor expects too much from me. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My supervisor has enough authority to make changes for the better. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Supervisor Evaluation Please evaluate your direct supervisor based on your personal dealings with him/her. Does the supervisor act ethically and fairly in day to day operations? Are deadlines met consistently? Does your supervisor lead by example? and provide guidance for you?

My supervisor is a good listener. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

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Employee Retention

Personal Satisfaction Please evaluate your overall satisfaction. Are you happy in your current role? Do you see yourself at the company long term? Is there a clear path for career progression? Are you paid properly for your work?

I enjoy the day-to-day activities of performing my job. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I see myself at this company long-term. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I am efficient in performing my job. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Personal Satisfaction Please evaluate your overall satisfaction. Are you happy in your current role? Do you see yourself at the company long term? Is there a clear path for career progression? Are you paid properly for your work?

The work I produce is high-quality. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I have to go through a lot of 'red tape' to get my job done. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

My job gives me a personal sense of satisfaction. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Personal Satisfaction Please evaluate your overall satisfaction. Are you happy in your current role? Do you see yourself at the company long term? Is there a clear path for career progression? Are you paid properly for your work?

I have a clear path towards job progression. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Our company does a good job of meeting my needs as an individual. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Overall, I am satisfied with this organization. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Personal Satisfaction Please evaluate your overall satisfaction. Are you happy in your current role? Do you see yourself at the company long term? Is there a clear path for career progression? Are you paid properly for your work?

I have clear expectations and understanding of my job duties and what is required of me.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I receive proper praise and recognition when I perform my job beyond expectations.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

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Employee Retention

Compensation and Opportunities Does the [company] pay you adequately? Is there opportunity for long term career progression? Do you understand your pay rise procedure? Are there clear benchmarks towards career progression?

I am paid fairly for the work I do. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I understand how my pay is determined. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I am satisfied with how pay raises are determined. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Compensation and Opportunities Does the [company] pay you adequately? Is there opportunity for long term career progression? Do you understand your pay rise procedure? Are there clear benchmarks towards career progression?

I feel that the benefits package I receive from (Company Name) is fair and competitive.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

In comparison with other people in similar jobs at (Company Name), I feel my pay is adequate.

STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Qualified employees are usually allowed to transfer to better jobs. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Compensation and Opportunities Does the [company] pay you adequately? Is there opportunity for long term career progression? Do you understand your pay rise procedure? Are there clear benchmarks towards career progression?

The individuals who do receive promotions usually deserve them. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

I can be sure of a job with (Company Name) as long as I do good work. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

There is an opportunity for long-term career progression. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Compensation and Opportunities Does the [company] pay you adequately? Is there opportunity for long term career progression? Do you understand your pay rise procedure? Are there clear benchmarks towards career progression?

I have the chance to achieve my goals at work. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

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Employee Retention

Working Conditions Please rate your working conditions. Are working conditions safe? Are you overworked? Are the hours of work agreeable?

The hours of work are agreeable. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Working conditions around my job are good. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

The workload is fairly distributed. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Working Conditions Please rate your working conditions. Are working conditions safe? Are you overworked? Are the hours of work agreeable?

Work is well organized at (Company Name). STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Too much work is expected of employees in my area. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Working conditions here are safe. STRONGLY AGREE- Consistently exceeds expectations

AGREE- Often exceeds expectations

NEITHER AGREE NOR DISAGREE- Performs at a satisfactory level

DISAGREE- Occasionally fails to meet expectations

STRONGLY DISAGREE- Consistently fails to meet expectations

Comments

Comments

Comments

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Employee Retention

Part II Qualitative Employee Satisfaction Survey Please answer the following questions honestly and to the best of your ability.

What can (Company Name) do to make your job more satisfying?

What can (Company Name) do to support your career goals?

Does (Company Name) meet your expectations as an employer?

What tools, resources, and abilities can (Company Name) provide to make your job easier?

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Employee Retention

Part II Qualitative Employee Satisfaction Survey Please answer the following questions honestly and to the best of your ability.

Do you feel that (Company Name) listens to employees and reacts appropriately?

Do you feel that (Company Name) offers meaningful career development and progression opportunities? What can we do better?

Are there any aspects of work at (Company Name) that cause you to consider leaving?

What can (Company Name) do to ensure that you stay with us for the long term?

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Employee Retention

Part II Qualitative Employee Satisfaction Survey Please answer the following questions honestly and to the best of your ability.

Would you recommend (Company Name) as an employer to your friends and family? Why or why not?

Is there anything else that you believe needs change or improvement in the company?

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Holiday Party Planning

Holiday Party Planning Please fill out the following questions. Your feedback is appreciated!

How likely would you be to attend a staff holiday party? Count me in!

Very likely

Somewhat likely

I would not attend

Where would you like the holiday party to be held? In the workplace

At an external venue, such as a banquet hall

At a restaurant

A place where employees can participate in an activity or sporting event

How much would you be willing to pay for a ticket to a holiday party? The cost of the ticket would cover the meal, the rental of the venue, and small door prizes.

$0

$1 to $10

$11 to $20

$21 to $30

$31+

Whom would you like included in the holiday party? Just company employees

Company employees and clients

Company employees plus one

Company employees and their family (plus one, and children)

Comments

Comments

Comments

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Holiday Party Planning

Holiday Party Planning Please fill out the following questions. Your feedback is appreciated!

Do you have any suggestions that would help us plan a fantastic holiday party? If so, please share them!

Comments

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Customer Satisfaction- Product Specific

Customer Satisfaction Please provide feedback on the item you purchased.

What product did you purchase?

How satisfied are you with the quality of the product you purchased? Extremely satisfied

Satisfied

Neither satisfied nor dissatisfied

Dissatisfied

Extremely dissatisfied

How satisfied are you with the price? Extremely satisfied

Satisfied

Neither satisfied nor dissatisfied

Dissatisfied

Extremely dissatisfied

Considering the experience you had today, would you buy a similar product here again?

Yes

No

Comments

Comments

Comments

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Customer Satisfaction- Product Specific

Customer Satisfaction Please provide feedback on the item you purchased.

Please provide any additional feedback you may have on the product.

Comments

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Project Status Survey

Project Status This survey will be used to gauge the current status of the project and determine possible impediments to its success.

Do you feel that you have been provided with the tools, resources, and information necessary to achieve your goals and objectives related to the project?

Yes

No

What do you feel is the largest hurdle facing the project? Inadequate allocation of personnel

Lack of knowledge or experience

Insufficient resources

Time constraints

Unrealistic goals or expectations

Other

There are no significant hurdles present

In your opinion, what is the probability that the project will be completed on time and within the established budget constraints?

Very high

High

Moderate

Low

Very low

Are you confident your team/unit/group/department can overcome any possible obstacles?

Yes

No

Unsure

Comments

Comments

Comments

Comments

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Project Status Survey

Project Status This survey will be used to gauge the current status of the project and determine possible impediments to its success.

Please share any additional feedback you have on the project.

Comments

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Charity Event Planning

Charity Event Planning Survey Please provide your input on charity events you would like to see our company support or organize.

Have you participated in any company-sponsored or organized charity events in the past?

What types of charity events would you like to see our company organize or support? Please select your three preferred options.

Run, walk, or other fitness activity

Car wash

Concert or talent show

Bake sale

Volunteering opportunities

Funding drive

Silent auction

Raffle

Team participation in a charity event

Other

Would you be willing to commit time to support a charity event outside of normal work hours?

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Charity Event Planning

Charity Event Planning Survey Please provide your input on charity events you would like to see our company support or organize.

Considering your work schedule and family or personal commitments, what days are best for you to participate in charity events? Please check all that apply.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Please provide any additional information that you feel will help us organize charity events.

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Customer Satisfaction- Website Feedback

Customer Satisfaction – Website Feedback Survey This quick survey will help us improve our website and provide our customers with an even better shopping experience.

How satisfied were you with the design and functionality of our website? Extremely satisfied

Satisfied

Neither satisfied nor dissatisfied

Dissatisfied

Extremely dissatisfied

Were you able to quickly and easily find what you were looking for?

Did the website provide you with all of the information you were looking for (price, product details, availability, etc.)?

Considering your experience today, would you use our website again?

Please provide any additional input you feel may be helpful for improving our website. We appreciate your comments!

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Customer Satisfaction

Please take this brief survey to help us improve our products and services.

How likely are you to recommend (Company Name) to your friends and family?

0 10

Please rate your satisfaction with each of the following aspects of our products and services:

Very satisfied

Somewhat satisfied

Neither Satisfied or dissatisfied

Somewhat dissatisfied

Very dissatisfied

Your custom requests

Our company saving you time with your tasks and business processes

The quality of products and services available from our company

The quality of the product you purchased

Our pricing of products and services

The level of knowledge of our experts

The responsiveness of our customer service

How our customer service representatives answer your questions and requests

Our company as a strategic partner that provides you with complete solutions

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Customer Satisfaction

Please indicate how likely you are to use each of the following words or phrases to describe our products and services.

Very likely Somewhat likely Neither likely nor unlikely Somewhat likely Very unlikely

Affordable

Good value

High quality

Honest

Practical

Reliable

Responsive

Simple

Time saving

Useful

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Customer Satisfaction

How long have you been a customer with us? This is my first purchase

Less than six months

Between six months and one year

Between one and two years

More than two years

Approximately how much did you spend on your most recent purchase from us? Less than $50

Between $50 and $100

Between $100 and $500

Between $500 and $1000

More than $1000

How likely are you to continue using our products and services in the future? Very likely

Somewhat likely

Neither likely nor unlikely

Somewhat likely

Very unlikely

Considering the experience you had today, would you buy a similar product here again?

Yes, definitely

Maybe/ Not sure

No, definitely not

Did you make your most recent purchase from our website?

Yes

No

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Customer Satisfaction

How satisfied were you with the design and function of our website? Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

How easy was it to find the products you purchased? Very easy

Somewhat easy

Neither easy nor difficult

Somewhat difficult

Very difficult

How would you describe the availability of relevant product information (price, product description, availability, etc.)?

I found all of the information I needed

I found most of the information I needed

I found some of the information I needed

I found little of the information I needed

I found none of the information I needed

How easy was the information to find? Very easy

Somewhat easy

Neither easy nor difficult

Somewhat difficult

Very difficult

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Customer Satisfaction

Did you purchase from our company as an individual or on behalf of a company?

Please provide any additional comments on how we can serve you better?


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