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Home / Safety Culture Assessment Questionnaire

Safety Culture Assessment Questionnaire

Thank you for completing the questionnaire. We will respond to you shortly.

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Section A

Please indicate your department / workgroup

Please select the type of work you most frequently perform

Office Work

Plant Work

Field Work

Do you hold a management / supervisory position?

Yes

No

How long have you been working in the company?

1 – 5 Years

6 – 10 Years

11 – 15 Years

16 – 20 Years

21 – 25 Years

26+ Years

Section B – Accountability & Responsibility

My direct supervisor helps resolve difficult issues between teams

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

We have enough authority to perform our work safely

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Safety responsibilities are clearly defined

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

We accept ownership for safety

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Safety expectations and rules are clearly defined

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I understand my own health and safety responsibilities in the workplace.

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I understand my rights and responsibilities concerning safety at my workplace.

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I voluntarily carry out tasks or activities that help improve safety

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Section B – Attitudes & Behavoural

I feel free to stop work when uncertain or feel unsafe

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I promote the safety program within the organization

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I use the correct safety procedures for carrying out my job

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

If I see someone breaking safety procedures I confront them

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I break rules due to management pressure

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I encourage fellow workers to work safely

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I ignore safety regulations to get the job done

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Overall, I feel safe at my workplace.

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Section B – Communication

I feel free to ask questions about any issue

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

My direct supervisor encourages open discussion within the team

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

The overriding priority of safety is clearly communicated

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our management communicates effectively about safety

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our management encourages open discussion

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Information is effectively communicated across teams

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

There are regular conversations about safety related matters between employees and managers.

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

There is regular exchange about safety related issues between employees and management.

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Section B – Compliance and Procedural

Contractors are held to the same standard as other employees

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Physical working conditions are good

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Poor working conditions are not tolerated

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our housekeeping standards are high

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Safety assessments help us improve

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Safety rules and procedures are followed in my organisation

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Policies and procedures are in place and communicated to address safety in the workplace.

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

The organisation has safety champions

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Section B – Involvement, Participation and Inclusiveness

Contractors actively participate in safety programs

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Contractors are involved in safety discussions

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Contractors follow our safety practices

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

People support each other

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

My direct supervisor involves us when making decisions

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

People work together effectively to solve common problems

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I can always get help from others in this organization

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our suppliers are required to follow our safety policies when on site

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Section B – Management Commitment

Our decisions reflect safety as the overriding priority

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our response to safety concerns shows that safety is the overriding priority

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

People are recognized for safety conscious behaviors

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our management is visibly present in the workplace

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our management makes safety the overriding priority

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

My manager shows their commitment to health and safety by leading by example.

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Leaders actively promote safety culture

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Management allocate adeqaute resources for safety

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Section B – Organisational Learning

Company values includes safety as one of the key pillars

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our work is well planned

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Work plans are realistic

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our management ensures that leadership skills are systematically developed

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

We use operating experience to improve

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I am likely to recommend my friends and colleagues to work with in my organisation

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

The company has disaster recovery plans and a designated team tasked with its implementation

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

In most recent years, summary of work related injuries and illnesses are posted so that employees can easily review them

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Section B – Reporting and Responsiveness

I feel free to report mistakes

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our incident investigations are effective

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

It is easy to report safety issues

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our corrective actions are effective

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our safety performance indicators help us to improve

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Our management is responsive to safety concerns

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

All incidents are investigated quickly in order to improve safety at the workplace as soon as possible

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Trends in safety incidents are tracked and analysed

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Section B – Training, Competency & Knowledge

Our training program helps us improve

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

We have regular opportunities to develop our skills

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

We have access to the training we need

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

We understand our assigned tasks

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I have a good understanding of my company’s health and safety policies

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Every employee in my working area is aware of the building’s emergency evacuation plan

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Every empoyee in my work area know the location of the building’s emergency utensils (such as fire extinguishers or first aid kits)

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Every employee in my work area is well informed about possible safety hazards at the workplace

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Section B – Trust and Respect

There is a high level of trust between workgroups

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

There is a high level of trust between management and employees

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I feel free to question decisions

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

I have confidence and trust on the people appointed to taking care of our workplace safety

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

There is a high level of trust between my supervisor and my workgroup

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

There is a high level of trust within my workgroup

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

People are treated with respect

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

Employees have trust on how the organization manages change

1 – Strongly Disagree

2 – Disagree

3 – Neutral

4 – Agree

5 – Strongly Agree

6 – Not Sure

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