(Likert-Scale Survey)
WORKPLACE VIOLENCE/EMPLOYEE SECURITY SURVEY
This survey is designed to illuminate Workplace Violence/Employee Security issues in your workplace. Please provide your response to the following statements and return the Survey (ANONYMOUSLY) to Randy Blum by April 21, 2003, using the enclosed SASE. Thank you.
What is you job title: _____________________ SHIFT 1 2 3
What is your gender: Male Female
What is your age: 16-21; 21-30; 40-50; 50+
To what degree are the following statements representative of your organization? (Circle the number that applies for each statement)
(1) Strongly Disagree (2) Disagree (3) No Opinion (4) Agree (5) Strongly Agree
When it comes to management commitment and employee involvement:
1. Management supports a Workplace Safety Program 1 2 3 4 5
2. Supervisors view safety as a priority 1 2 3 4 5
3. Employees are comfortable communicating with
supervisors about safety issues 1 2 3 4 5
4. Employees feel safe when they are at work 1 2 3 4 5
5. Management communicates to employees when incidents
of workplace violence arise 1 2 3 4 5
6. Employees are familiar with the company violence
prevention policy 1 2 3 4 5
7. Management has a written Workplace Violence
...