Template No.: T289 Template Title: Internal Survey Template (Staff / Volunteer Perception) – Anonymous

 THE HSWAGATA BUDDHA TOOTH RELIC PRESERVATION MUSEUM

FOR INTERNAL USE ONLY

Template No.: T289

Template Title: Internal Survey Template (Staff / Volunteer Perception) – Anonymous

Related Research Case IDs / Cluster: _______

Linked Templates / Policies: _______________

Date of form: ____ / ____ / ______

Prepared by / Role: _______________________

Office / Unit: ____________________________

Country / Location: _______________________

Confidentiality Level:

Internal only [ ] Restricted [ ] Sacred-Restricted / Sensitive

Use of this form (tick):

New case / action [ ] Follow-up [ ] Annual review [ ] Archive only

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T289 – Internal Survey Template (Staff / Volunteer Perception)

1) Purpose

This is a standard anonymous survey to understand staff and volunteer views on:

• ethics and fairness

• workload and wellbeing

• safety and safeguarding

• leadership and communication

We use results to improve systems, training, and support.

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2) Anonymity and consent (must show at the start)

Tick one:

• I agree to take this survey. I understand it is anonymous. [ ]

• I do not agree. [ ] (Stop here)

Anonymity note (read):

• Do not write your name or other details that can identify you in comment boxes.

• Only summary results will be shared (group level, not person level).

• If you report a serious safety concern, you may also use the Concern Reporting Form (T285).

If you need urgent help now (internal):
Contact (role/name): ____________________ Phone/Email: ____________________

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3) Response scales

Scale A (Agreement):
1 = Strongly disagree 2 = Disagree 3 = Not sure 4 = Agree 5 = Strongly agree

Scale B (Frequency):
1 = Never 2 = Rarely 3 = Sometimes 4 = Often 5 = Always

Scale C (Safety):
1 = Very unsafe 2 = Unsafe 3 = Not sure 4 = Safe 5 = Very safe

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4) Background (non-identifying only)

(Choose one per question. Skip if you feel it may identify you.)

1. Your role: Staff [ ] Volunteer [ ] Intern [ ] Contractor [ ] Other: ______

2. Your main area: Admin [ ] Conservation [ ] Security [ ] Education [ ] Visitor service [ ] Research [ ] Other: ______

3. Time with HSWAGATA: < 3 months [ ] 3–12 months [ ] 1–3 years [ ] 3+ years [ ]

4. Work pattern: Full-time [ ] Part-time [ ] Occasional [ ]

5. Site/location (if more than one): ___________________________ (optional)

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5) Survey questions

A) Ethics and integrity (Scale A)

A1. I understand the Code of Conduct. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
A2. People here act with honesty. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
A3. Rules apply fairly to everyone (staff, volunteers, leaders). 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
A4. Gifts and donations are handled clearly and ethically. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
A5. I have seen or heard pressure to hide problems. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ] (If high, explain in comments without names.)

B) Workload and wellbeing (Scale A)

B1. My workload is reasonable. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
B2. I can take breaks when needed. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
B3. I feel respected in daily work. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
B4. I feel comfortable asking for help. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
B5. Work stress is managed well by the unit. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]

C) Safety and safeguarding (Scale C or Scale A as marked)

C1. I feel physically safe at work. (Scale C) 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
C2. I know what to do in an emergency. (Scale A) 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
C3. I know how to report safeguarding concerns. (Scale A) 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
C4. I believe reports are taken seriously. (Scale A) 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
C5. Safety equipment and facilities are in good condition. (Scale A) 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]

D) Leadership and communication (Scale A)

D1. Leaders communicate clearly about decisions. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
D2. I understand my responsibilities and limits. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
D3. Leaders listen to staff/volunteer feedback. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
D4. Problems are handled calmly and fairly. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
D5. I trust leadership to protect people and sacred objects. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]

E) Team culture and inclusion (Scale B)

E1. People treat each other with respect. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
E2. I see bullying or harsh speech. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
E3. Different backgrounds are welcomed. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
E4. Conflicts are solved without gossip and blame. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]

F) Training and support (Scale A)

F1. I received the training I needed for my role. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
F2. I know the basic rules for sacred space and relic care (as relevant to my role). 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
F3. I know the basic rules for privacy/confidentiality. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
F4. Refresher training happens often enough. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]

G) Speaking up and protection (Scale A)

G1. I know how to report concerns (T285 or other channel). 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
G2. I believe I will be protected if I report in good faith. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
G3. I fear negative consequences if I report a concern. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]
G4. Follow-up is clear after a report is made. 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ]

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6) Open comments (optional)

(Do not write names. Use roles like “a supervisor” or “a colleague”.)

1. One thing that works well at HSWAGATA:

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2. One thing that does not work well / needs improvement:

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3. Safety or safeguarding improvements you suggest:

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4. Workload / wellbeing improvements you suggest:

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5. Leadership / communication improvements you suggest:

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6. Any other comments:

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7) Submission details (for the survey organiser)

• Survey method: Paper box [ ] Online form [ ] Interview-assisted [ ] Other: ______

• Survey open date: ____ / ____ / ______ Close date: ____ / ____ / ______

• Who receives raw responses (role/unit): ______________________________

• Where data is stored (folder/path): _________________________________

• Minimum group size for reporting results (to protect anonymity): ________ people

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FOR OFFICE USE ONLY (summary after collection)

• Total responses received: ________

• Groups reported (without identifying small groups): __________________________

• Key themes (top 5):

  1. ____________________ 2) ____________________ 3) ____________________ 4) ____________________ 5) ____________________

• Actions agreed (link to owner and date):

  1. __________________________ Owner: ________ Due: //______

  2. __________________________ Owner: ________ Due: //______

  3. __________________________ Owner: ________ Due: //______

Prepared by: _______________________ Signature: ______________ Date: ____ / ____ / ______
Reviewed by: _______________________ Signature: ______________ Date: ____ / ____ / ______