Safety Culture Survey

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Safety Culture Survey

Full Name of Employee:______________________________________Date Submitted:___________

Employee ID Number:__________________________Position:_______________________________

Department:_______________________________Gender:_________________________Age:_____

The purpose of this survey is to evaluate the strengths and weaknesses of the company in implementing safety culture towards its employees. You can rate the question according to the categories provided. Mark check on the scales which you prefer suits your answer. Mark check on strongly disagree if you extremely disagree with the statement. Mark check on the disagree option if you just merely disagree. Mark check on neutral if you think you are undecided. Mark check on agree if you just agreed to the statement. And mark strongly agree if you firmly agree to the statement. 

QUESTION	STRONGLY DISAGREE	DISAGREE	NEUTRAL	AGREE	STRONGLY AGREE
A. GENERAL
1. The company values the security and protection of its employees.
2. The company cares and prioritizes the employees health and security conditions.
3. The company is strict in implementing safety culture.
4. The company provides emergency situation training such as fire drill, earthquake drill, and other emergency scenarios.
5. The company has a solution when an emergency situation occurs.
6. [Insert your question here.]
B. LEADERSHIP
1. The manager appointed an emergency coordinator.
2. The manager looks after the health and safety of the employees.
3. The manager, HR Department, and the Administration crafted a Safety Culture Policy or pertaining to it.
4. The management respects culture, tradition, and doesn’t tolerate any bullies.
5. The management has securities outside and inside the building premises.
6.  [Insert your question here.]
C. EMPLOYEE
1. I am comfortable with my colleagues.
2. I am comfortable with my boss.
3. I am comfortable expressing myself at work.
4. I am aware of the health, security, and safety culture policy.
5. I feel safe working in the company.
6.  [Insert your question here.]

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