Introduction: In the interaction between man and machine, the human behavior plays a key role in the accidents occurrence and the risks. Safety culture models can be a base to safety culture assessments and may lead scientists toward effective aspects of organization safety. The aim of present study was to develop and offer a specific questionnaire for safety culture assessment according to the customized model in an automotive industry.

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Material and Method: In this cross-sectional analytical study, a questionnaire including 16 items and 37 questions was developed based on management, individual, and organizational factors. Then, the reliability and validity of the developed questionnaire, it were studied among 30 employees of an automotive company.

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Result: Concerning the reliability of the questionnaire, the Cronbach’s alpha was 0.855. In the context of validity of the questionnaire, the simplicity and clarification of contents were investigated by means of Expert Analysis. Moreover, in terms of the integral components of culture, according to the factorial analysis, this evaluation regarded to have ten main components.

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Conclusion: So far, there was no exclusive tool for evaluating safety culture based on a customized model. The findings of the present study showed that evaluating safety culture using the administered questionnaire is valid and reliable in the understudied industry.