Title Page
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Client / Site
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Conducted on
Details and Location of School
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Name
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Location
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Number of school staff (approx)
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Number of students currently enrolled (approx)
Proximity to Hospital for major injuries
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Nearest Hospital
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Address
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Distance
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Approx time for ambulance response
Proximity to Medical Centre or Doctors for moderate injuries
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Name of medical facility/doctors
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Address
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Distance
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Approx time to drive
On campus Medical Facilities for minor injuries
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Describe the Medical Facilities available on campus
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Name of First Aid Officer
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Qualifications of First Aid Officer
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Hours worked by First Aid Officer
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Name of Deputy First Aid Officer
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Number of First Aid boxes available
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Number of Portable First Aid kits available
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Number of EPI PENS available on campus
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Number of DEFIBRILLATORS available
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Number of staff holding a current First Aid qualification
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Number of staff holding a current CPR qualification
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What is the ratio of staff with first aid qualifications to students enrolled?
Accident Risks
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List major accident risk activities
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Number of accidents involving STUDENTS reported in previous year:
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Number of accidents involving STAFF reported in previous year
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Number of NOTIFIABLE INCIDENTS reported in previous year
Safety Measures
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Are eye wash baths and deluge showers available in areas where hazardous chemicals are present?
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Is adequate Personal Protective Equipment available to staff/students conducting high risk activities?
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Are regular safety checks conducted in high risk areas?
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Are Risk Assessments submitted and approved PRIOR to high risk activities and/or events?
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Does the school have an effect Concussion Policy and procedures?
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Does the school have an effective Infectious Diseases Control policy and procedures?
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Does the school have an effective Anaphylaxis Policy and processes in place?
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Is an Accident Analysis performed to monitor any accident risk trends?
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Is the ratio of students enrolled to each staff member with first aid qualifications less than 50:1?
Risk Grade
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Evaluate the risk of serious injury to staff and students WITHOUT any safety controls in place:
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Evaluate the risk of serious injury to staff and students AFTER all safety controls are taken into account: