Customized Contractual Education Survey

Listed below are 13 areas of assessment for the employee Workplace Safety Audit. This initial classification is intended to stimulate thinking relating to issues that impact the workplace. Please consider your work environment in average or usual situations as you respond.

Response Options:

Never: this is never the situation in the work environment

Almost Never/Infrequently: this may be the situation in the work environment, but it is unlikely

Sometimes: this is the situation on occasion in the work environment

Almost Always/Frequently: this is the situation on a regular basis in the work environment

Always: this is the routine situation in work environment


#1: Employees face conflict with co-workers in the workplace.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   
#2: Employees face conflict with customers in the workplace.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   
#3: Employees respond to conflicts in the most appropriate manner to prevent further escalation of a situation.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   
#4: Employees interact with customers and co-workers professionally and with the utmost respect.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   
#5: Employees adhere to relevant policies and properly manage confrontations and disruptions in the workplace.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   
#6: When confronted by a customer or co-worker, employees tend to personalize the situation and contribute to the problem escalating.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   
#7: In stressful situations with customers or co-workers, employees consider the perspectives of others to achieve effective problem resolution.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   
#8: Employees demonstrate appropriate listening skills with customers and co-workers who are upset.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   
#9: Employees pay attention to, and appropriately adjust, their verbal tone and body language when dealing with customers and co-workers.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   
#10: Employees are aware of and respond appropriately to the verbal tone and body language exhibited by others in the workplace.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   
#11: Dangerous situations which have occurred in my workplace, could have been prevented if employees had better developed skills in responding to and de-escalating challenging situations.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   
#12: Employees become frustrated or frightened when faced with conflict or disruptions in the workplace.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   
#13: Employees respond confidently to implement organizational procedures in responding to physically violent situations in the workplace.   
 Never
 Almost Never/Infrequently
 Sometimes
 Almost Always/Frequently
 Always   

Complete the information below to obtain your audit results, including a summary, comments, and basic recommendations.

These audit results will be saved with your contact information for future reference.

Please be assured your contact information will be used for confidential audit retrieval and consultation at your request, and will not be shared or distributed.

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Last Name: *       
Organization:       
Email Address: *       
Phone Number:       
Fax Number:       
     

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