모든 템플릿
Industry-Specific

Mine Site Safety Culture & Incident Reporting Assessment

Measures safety climate perceptions, incident/near-miss reporting behaviors, and barriers to reporting among mine-site personnel. Designed to identify risk gaps and prioritize safety-culture interventions across shifts, roles, and work environments.

샘플 질문

템플릿에 포함된 내용을 미리 확인해 보세요. 모든 질문은 설문 공개 전에 자유롭게 수정할 수 있습니다.

질문 27개 · 약 12분
Q01
메시지

Welcome to the Mine Site Safety Culture Survey. This survey takes approximately 12 minutes. Your responses are confidential, anonymized, and reported only in aggregate to improve safety practices at this site. There are no right or wrong answers—we want your honest experience from the past 30 days. Participation is voluntary, and you may stop at any time. Please tap 'Next' to begin.

Q02
객관식

Are you currently working at or regularly visiting a mine site?

  • Yes
  • No
Q03
의견 척도

Over the past 30 days, safety was prioritized over production on my crew.

척도: 17
최소:Strongly disagree최대:Strongly agree
Q04
객관식

How do you usually report hazards, near misses, or incidents on this site? Select all that apply.

  • Tell supervisor in person
  • Paper or card
  • Radio/phone call
  • Mobile app
  • Computer kiosk/terminal
  • Safety hotline
  • Toolbox talk/team meeting
  • Other (please specify)
Q05
객관식

What, if anything, makes reporting harder on your site? Select all that apply.

  • Unclear what should be reported
  • Takes too much time to complete
  • Fear of blame or negative consequences
  • Little or no feedback after reporting
  • Reporting system is difficult to use
  • Belief that minor issues don't matter
  • Lack of supervisor support
  • Language or communication barriers
  • None—I don't experience barriers
  • Other (please specify)
Q06
의견 척도

In the past 30 days, I could report safety issues without fear of blame or punishment.

척도: 17
최소:Strongly disagree최대:Strongly agree
Q07
AI 인터뷰

We'd like to learn a bit more about your safety reporting experience. An AI moderator will ask you 1–2 brief follow-up questions based on your responses.

Q08
드롭다운

What is your primary job role on this site?

  • Operator/Production
  • Maintenance/Trades
  • Supervisor/Foreman
  • Safety/Health
  • Engineer/Planner
  • Other
Q09
메시지

Thank you for completing this survey. Your input is valued and will be used to strengthen safety practices and reporting at this site.

Q10
의견 척도

Over the past 30 days, my supervisor consistently demonstrated a commitment to safety.

척도: 17
최소:Strongly disagree최대:Strongly agree
Q11
드롭다운

When a hazard or near miss occurs, how often do you personally report it? (past 30 days)

  • Every time
  • Most times
  • About half the time
  • Occasionally
  • Never
  • Not applicable (no issues observed)
Q12
순위 매기기

Please rank the following motivations for reporting from most to least important to you.

  1. Protect coworkers and myself
  2. Fix hazards quickly
  3. Company expects it
  4. Regulatory compliance
  5. Recognition for reporting
  6. Option to report anonymously
드래그하여 순위 지정
Q13
의견 척도

In the past 30 days, I clearly understood what safety issues should be reported and how to report them.

척도: 17
최소:Strongly disagree최대:Strongly agree
Q14
장문형

Based on your responses in this survey, what would make safety reporting easier or more effective at this site? Please share any additional thoughts.

Q15
드롭다운

What is your employment status?

  • Employee
  • Contractor
  • Visitor/Temporary
  • Other
Q16
의견 척도

Over the past 30 days, my coworkers looked out for each other's safety.

척도: 17
최소:Strongly disagree최대:Strongly agree
Q17
드롭다운

How many near-miss events did you personally observe in the past 30 days?

  • 0
  • 1–2
  • 3–5
  • 6–10
  • More than 10
Q18
의견 척도

In the past 30 days, I received meaningful feedback after submitting a safety report.

척도: 17
최소:Strongly disagree최대:Strongly agree
Q19
드롭다운

What shift do you typically work?

  • Day
  • Night
  • Rotating
  • Other
Q20
의견 척도

Over the past 30 days, safety information and updates were communicated clearly to my crew.

척도: 17
최소:Strongly disagree최대:Strongly agree
Q21
객관식

Which of the following have you reported in the past 30 days? Select all that apply.

  • Near miss
  • Minor injury (first aid)
  • Recordable injury
  • Unsafe condition/housekeeping
  • Equipment damage/failure
  • Environmental spill/release
  • Vehicle incident
  • None of the above
  • Other (please specify)
Q22
드롭다운

How long have you worked in mining?

  • Less than 1 year
  • 1–3 years
  • 4–9 years
  • 10–19 years
  • 20 or more years
Q23
의견 척도

Over the past 30 days, I received adequate training to perform my tasks safely.

척도: 17
최소:Strongly disagree최대:Strongly agree
Q24
드롭다운

On average, how many minutes does it take you to complete a typical safety report?

  • Less than 5 minutes
  • 5–10 minutes
  • 11–20 minutes
  • 21–30 minutes
  • More than 30 minutes
  • I have not filed a report
Q25
드롭다운

How long have you worked at this specific site?

  • Less than 1 month
  • 1–6 months
  • 7–12 months
  • 1–3 years
  • More than 3 years
Q26
드롭다운

What is your primary work environment?

  • Surface
  • Underground
  • Both
  • Other
Q27
드롭다운

Which region do you primarily work in?

  • North America
  • South America
  • Europe
  • Africa
  • Asia
  • Australia/New Zealand
  • Other

포함된 기능

  • AI 후속 질문

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  • 주의력 확인 장치

    성의 없는 답변과 저품질 응답자를 걸러내는 내장 안전장치입니다.

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  • 자동 리포트

    응답이 모이면 주요 주제, 인용문, 이해하기 쉬운 요약이 자동으로 작성됩니다.

자주 묻는 질문

“Mine Site Safety Culture & Incident Reporting Assessment” 템플릿에는 어떤 질문이 포함되어 있나요?

바로 사용할 수 있는 질문 27개가 포함되어 있으며, 처음 질문은 다음과 같습니다: “Welcome to the Mine Site Safety Culture Survey. This survey takes approximately 12 minutes. Your responses are confident…” · “Are you currently working at or regularly visiting a mine site?” · “Over the past 30 days, safety was prioritized over production on my crew.”. 전체 질문은 위에서 미리 볼 수 있고 모두 수정 가능합니다.

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