Workplace Health Culture Survey

A. Departmental Information

1. Please provide the following information:

Name of Department/Unit

Contact Person (Department Head/Manager)

B. Work Climate

2. Sense of Community

Please indicate your level of agreement with the following statements, using the scale below:

Strongly Agree Agree Neutral Disagree Strongly Disagree

I have gotten to really know my coworkers (more than just knowing the jobs they do)

I feel as if I belong here

I feel coworkers would care for me in a time of need

I trust the people I work with

In my work group, I never hear demeaning comments or jokes that relate to race, ethnicity, gender, age, sexual orientation, religious tradition, disability, physical appearance, or other defined areas of social discrimination

In my work unit, all employees, regardless of cultural or socio-economic background, are welcome and respected

In my work group, employees are comfortable working with people of diverse cultures and lifestyles

(if applicable) In my work group, there is adequate interpreter services for people with limited English proficiency

3. Shared Vision

Please indicate your level of agreement with the following statements, using the scale below:

Strongly Agree Agree Neutral Disagree Strongly Disagree

In my workgroup, we have a clear sense of what each member does

I feel comfortable saying what is on my mind to my coworkers

In my workgroup, we spend time talking about how we work together and how we can work together more effectively

In my workgroup, people follow through on commitments

I share common values with my coworkers

I see my work group as having a clear and consistent direction

My supervisor asks for my input on major decisions affecting my work

I feel comfortable expressing my opinions to my supervisor

I recognize how my own day-to-day activities contribute to the University's mission

4. Positive Outlook

Please indicate your level of agreement with the following statements, using the scale below:

Strongly Agree Agree Neutral Disagree Strongly Disagree

I am proud of the contribution my department is making

In my department, group or team achievements are celebrated

In my workplace, conflicts are resolved in positive ways

The people I work with tend to bring out the best in me

I feel optimistic about the future of this University

I treat difficult assignments not as problems but rather as special challenges and opportunities

I have a ''can do'' attitude

Overall, I find my work inspiring

My contribution to the University is recognized

I cope with stress in positive ways

C. Health Norms

5. Please indicate your level of agreement with the following statements, using the scale below:

Strongly Agree Agree Neutral Disagree Strongly Disagree

My immediate supervisor models a healthy lifestyle

My work unit demonstrates its commitment to supporting healthy lifestyles through its use of resources, such as flex time

In my work unit, people are rewarded and recognized for efforts to live a healthy lifestyle

In my work unit, participation in healthy activities is a primary way to renew friendships and meet new people

In my work unit, unhealthy behaviors are discouraged and confronted

D. Organizational Support

6. Please indicate your level of agreement with the following statements, using the scale below:

Strongly Agree Agree Neutral Disagree Strongly Disagree

I am not expected to take on more responsibility than is required by my job description

In my work group, excessive overtime is discouraged

In my workgroup, I feel supported in dealing with personal and family circumstances such as childcare issues, aging parents, etc. through the availability of resources such as flex time

In my work group, I am encouraged to take advantage of staff development and wellness program opportunities

In my work group, I feel supported when needing to request reasonable accommodations due to pain, illness, injury, or disability

E. Physical Environment

7. Please indicate your level of agreement with the following statements, using the scale below:

Strongly Agree Agree Neutral Disagree Strongly Disagree

Adequate lighting is provided in my work area

My work station is comfortable

The noise level in my work area is acceptable

There is adequate ventilation in my work area

My work area is free of nuisance odors

I feel adequately protected from exposure to chemicals in my workplace

I work in an uncluttered area that allows for easy exit in case of an emergency

The floors, steps, and walkways in my work area are well maintained and free of slipping/tripping hazards

My work area is not too warm in the summer

My work area is not too cold in the winter

F. Comments/Suggestions

8. Please help us improve this survey.

Thank you for taking the time to complete this survey. Select Submit Survey now to send your responses to us.

This questionnaire was created by Perseus SurveySolutions for the Web.

Name of Department/Unit
Contact Person (Department Head/Manager)

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
I have gotten to really know my coworkers (more than just knowing the jobs they do)
I feel as if I belong here
I feel coworkers would care for me in a time of need
I trust the people I work with
In my work group, I never hear demeaning comments or jokes that relate to race, ethnicity, gender, age, sexual orientation, religious tradition, disability, physical appearance, or other defined areas of social discrimination
In my work unit, all employees, regardless of cultural or socio-economic background, are welcome and respected
In my work group, employees are comfortable working with people of diverse cultures and lifestyles
(if applicable) In my work group, there is adequate interpreter services for people with limited English proficiency

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
In my workgroup, we have a clear sense of what each member does
I feel comfortable saying what is on my mind to my coworkers
In my workgroup, we spend time talking about how we work together and how we can work together more effectively
In my workgroup, people follow through on commitments
I share common values with my coworkers
I see my work group as having a clear and consistent direction
My supervisor asks for my input on major decisions affecting my work
I feel comfortable expressing my opinions to my supervisor
I recognize how my own day-to-day activities contribute to the University's mission

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
I am proud of the contribution my department is making
In my department, group or team achievements are celebrated
In my workplace, conflicts are resolved in positive ways
The people I work with tend to bring out the best in me
I feel optimistic about the future of this University
I treat difficult assignments not as problems but rather as special challenges and opportunities
I have a ''can do'' attitude
Overall, I find my work inspiring
My contribution to the University is recognized
I cope with stress in positive ways

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
My immediate supervisor models a healthy lifestyle
My work unit demonstrates its commitment to supporting healthy lifestyles through its use of resources, such as flex time
In my work unit, people are rewarded and recognized for efforts to live a healthy lifestyle
In my work unit, participation in healthy activities is a primary way to renew friendships and meet new people
In my work unit, unhealthy behaviors are discouraged and confronted

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
I am not expected to take on more responsibility than is required by my job description
In my work group, excessive overtime is discouraged
In my workgroup, I feel supported in dealing with personal and family circumstances such as childcare issues, aging parents, etc. through the availability of resources such as flex time
In my work group, I am encouraged to take advantage of staff development and wellness program opportunities
In my work group, I feel supported when needing to request reasonable accommodations due to pain, illness, injury, or disability

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Adequate lighting is provided in my work area
My work station is comfortable
The noise level in my work area is acceptable
There is adequate ventilation in my work area
My work area is free of nuisance odors
I feel adequately protected from exposure to chemicals in my workplace
I work in an uncluttered area that allows for easy exit in case of an emergency
The floors, steps, and walkways in my work area are well maintained and free of slipping/tripping hazards
My work area is not too warm in the summer
My work area is not too cold in the winter