Information

  • Add media

  • District Nane

  • Address
  • Conducted on

  • Auditor Name

  • Health and Safety Contact

  • This is a paperwork Audit.
    Its intention is to inform the audited districts on the necessary paperwork that might be asked for by an auditor from a government agency.
    An in depth field audit would further ensure compliance with the requirements. Some responses are based solely on the feedback from the H&S contact person.

  • Rating Scale for Each Program Area
    5 is excellent
    1 is poor

Blood Born Pathogens

Blood Born Pathogens

  • Does the school have a Exposure Control Plan

  • Does school have a readily available printed copy of the Exposure Control Plan

  • Has the Exposure Control Plan been recently evaluated? 5 - Evaluated within the last year 4 - Evaluated over a year ago 3 - Evaluated over two years ago 2 - Evaluated over three years ago 1 - Evaluated over four or more years ago

  • Deduction Bypass -6

  • Is H&S Contact believes compliance with staff immunization program requirements for Hepatitis B are up to date 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Record Storage Location

  • Pertinent staff have received the annual refresher 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Medical Waste bags are available for use by nurse and other trained employees

  • Procedure is in place for safe and legal disposal of medical waste in a timely fashion

  • Post Exposure Evaluation and Follow Up Procedures are Established

  • Additional Notes

Confined Space Entry

Confined Spaces Entry

  • District has Confined Space Entry Plan

  • District has printed Confined Space Entry Plan readily available

  • Has the Confined Space Entry Plan been recently evaluated? 5 - Evaluated within the last year 4 - Evaluated over a year ago 3 - Evaluated over two years ago 2 - Evaluated over three years ago 1 - Evaluated over four or more years ago

  • Deduction Bypass -6

  • Confined Spaces have been labelled appropriately 5 - 100% 4 - 85% 3 - 75% 2 - 50% 1 - Less then 50%

  • Additional Notes

Emergency

Emergency Preparedness

  • Does District Have a SAVE Emergency Preparedness Plan?

  • District has printed Emergency Preparedness Plan readily available

  • Has the Emergency Preparedness Plan been recently evaluated? 5 - Evaluated within the last year 4 - Evaluated over a year ago 3 - Evaluated over two years ago 2 - Evaluated over three years ago 1 - Evaluated over four or more years ago

  • Deduction Bypass -6

  • District completed the required emergency drills for sheltering and early dismissal during the previous school year. 5 - 100% 4 - 85% 3 - 75% 2 - 50% 1 - Less then 50%

  • Administrators have ICS Training 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • H&S Contact feels District Emergency Procedures are know by staff 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Additional Notes

AED's

  • The District has a signed PAD Agreement

  • District has an AED available in each required building. 3 - All buildings 2 - Most buildings 1 - Few Buildings 0 - No Buildings

  • The H&S Contact believes that the district has adequate staff trained to use the AED for emergencies with all student age groups 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Signs indicating the location of AED's are posted at all main entrances

  • Additional Notes

Fire Inspections

Fire Inspections

  • H&S Contact believes a current certificate of occupancy is posted in all buildings 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • H&S Contact believes Exit Doors and Windows are kept clear year round 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • H&S Contact believes Emergency Lighting and Exit Signs are illuminated year round. 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Additional Notes

Hazard Communication/Right-to-Know

Hazard Communications/Right-to-Know

  • The H&S Contact believes efforts are made to keep the district's written inventory of chemical products current 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • The H&S Contact has attendance sheet for refresher training dated within the last year.

  • The H&S Contact believes that efforts to collect Safety Data sheets for the areas in the district where chemical products are used. 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • The H&S Contact believes records of chemical disposals are accurately kept 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Location where chemical records are kept

  • The H&S Contact believes that Secondary labels are properly maintained 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Additional Notes

Asbestos

Asbestos

  • The 3 Year AHERA asbestos inspection was completed

  • District has printed AHERA Management Plan readily available

  • Has the AHERA Management Plan been recently evaluated? 5 - Evaluated within the last year 4 - Evaluated over a year ago 3 - Evaluated over two years ago 2 - Evaluated over three years ago 1 - Evaluated over four or more years ago

  • Deduction Bypass -6

  • All custodial and maintenance workers who work around asbestos have completed initial and annual refresher 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Have all Subcontractors been Given Notice of Asbestos Locations and Signed Documentation Stating that this information was made available to them. 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Additional notes

Bulk Petroleum Storage Tanks

Bulk Petroleum Storage Tanks

  • Tanks are registered

  • H&S Contact believes Printed copy of tank registration is posted near the tank

  • H&S Contact believes that tightness testing and leak detection checks are preformed as required 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • H&S Contact believes that Inventory control by proper record keeping is being completed 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • H&S Contact believes that Monthly monitoring of above ground tanks is being completed and documented 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Additional Notes

Chemical/Pestesides

Chemical Hygiene Plan

  • District has a completed Chemical Hygiene Plan

  • Printed copy of Chemical Hygiene Plan is readily available

  • Has the Chemical Hygiene Plan been recently evaluated? 5 - Evaluated within the last year 4 - Evaluated over a year ago 3 - Evaluated over two years ago 2 - Evaluated over three years ago 1 - Evaluated over four or more years ago

  • Deduction Bypass -6

  • H&S Contact believes Science staff have been appropriately trained regarding the plan 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • H&S Contact believes that Science rooms are neat and orderly 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Additional Notes

Pesticides

  • District has pesticide business license and certified applicatiors.

  • H&S Contact believes that Safety Data Sheets and Product labels are on file

  • H&S Contact believes that district is in compliance with requirements of the Neighbor Notification Law and has documentation on file.

  • H&S Contact believes that pesticide reports and record keeping are completed routinely 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • H&S Contact believes that District applicators annually submit reports to DEC

  • Additional Notes

Hearing Conservation

Hearing Conservation

  • District has a Hearing Conservation Plan

  • District has a printed Hearing Conservation Plan readily available

  • Hearing Conservation Plan has been recently evaluated 5 - Evaluated within the last year 4 - Evaluated over a year ago 3 - Evaluated over two years ago 2 - Evaluated over three years ago 1 - Evaluated over four or more years ago

  • Deduction Bypass -6

  • Equipment has been evaluated for sound levels periodically 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • H&S Contact believes that effected employees have received training, have annual hearing tests, and wear hearing protection when needed or exposure time to loud noises are limited. 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Additional Notes

Lockout/Tagout Program/Electrical Pratitions

Lockout/Tagout Program

  • District has a written Lockout/Tagout Plan

  • District has a printed Lockout/Tagout Plan readily available

  • Lockout/Tagout Plan has been recently evaluated 5 - Evaluated within the last year 4 - Evaluated over a year ago 3 - Evaluated over two years ago 2 - Evaluated over three years ago 1 - Evaluated over four or more years ago

  • Lockout/Tagout Plan includes Elevators, RTU's, Fan units, Hydraulic forces, and Steam systems. 1 point given for each of the above categories being Complete

  • Deduction Bypass -11

  • H&S Contact Believes that necessary areas are properly labeled 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • H&S Contact believes supervisors document employees use of the Lockout/Tagout system 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Additional Notes

Electronic Partitions

  • The H&S Contact believes all Electronic Partitions have been upgraded according to SED approved specifications or rendered inoperable

  • The H&S Contact believes signs describing safe operation and supervision are posted on both sides of partition adjacent to operating mechanism

  • The H&S Contact believes Staff training records are current 5 - Evaluated within the last year 4 - Evaluated over a year ago 3 - Evaluated over two years ago 2 - Evaluated over three years ago 1 - Evaluated over four or more years ago

  • The H&S Contact believes Electronic Partition inspection records are on file.

  • Additional Notes

Personal Protective Equipment

Personal Protective Equipment

  • District has a Personal Protective Equipment Plan

  • District has a printed Personal Protective Plan readably available

  • Personal Protective Equipment Plan has been recently evaluated 5 - Evaluated within the last year 4 - Evaluated over a year ago 3 - Evaluated over two years ago 2 - Evaluated over three years ago 1 - Evaluated over four or more years ago

  • Deduction Bypass -6

  • H&S Contact believes that necessary personal protective equipment has been purchased 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • H&S Contact believes that appropriate staff have been trained in the use of PPE and training has been documented 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

Reparatory Protection Plan

  • District has evaluated the need for Respiratory Protection Plan

  • District has a printed Respiratory Protection Plan readably available

  • Respiratory Protection Plan has been recently evaluated 5 - Evaluated within the last year 4 - Evaluated over a year ago 3 - Evaluated over two years ago 2 - Evaluated over three years ago 1 - Evaluated over four or more years ago

  • Deduction Bypass -6

  • District Staff Requiring respirators for personal protection have been fit tested within the last 12 months

  • H&S Contact believes that district staff has had a physical in the last 12 months

  • The H&S Contact Believes that Respirators are properly Stored by employees

Regulations

Pool Regulations

  • The District's Pool Permit & Pool Plan are updated annually

  • H&S Contact believes that Life Guards have 1st Aid, AED, and CPR cards up to date. 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Additional Notes

Backflow Preventers

  • The Districts Backflow preventers have been tested

  • The Districts Backflow test records have been sent to DOH and water suppliers

  • Additional Notes

Cafeteria and Concessions

  • The Districts Cafeteria's & Concession stands have DOH Permits

  • H&S Contact believe Cafeteria workers have had safe food handling training 5 - 90% or better 4 - 80% 3 - 60% 2 - 50% 1 - Less then 50%

  • Additional Notes

RESCUE ( Comprehensive Public School Building Safety Act)

  • The District has a Health and Safety Committee which reviews health and safety complaints reported to administration

  • Building condition surveys and annual visual inspections reports for all occupied buildings have been filed with the SED

  • The Preventive Maintenance Plan is current 5 - Evaluated within the last year 4 - Evaluated over a year ago 3 - Evaluated over two years ago 2 - Evaluated over three years ago 1 - Evaluated over four or more years ago

  • The Five Year Capital Facilities Plan is current 5 - Evaluated within the last year 4 - Evaluated over a year ago 3 - Evaluated over two years ago 2 - Evaluated over three years ago 1 - Evaluated over four or more years ago

  • Printed copy of the FIve Year Capital Facilities Plan is readily available

  • Additional Notes

SOSHA

  • The H&S Contact believes the DOSH-908 Poster Identifying Employee Rights and Responsibilities for Job Safety is currently posted in each building

  • The H&S Contact believes the DOSH-900 Occupational Illness/Injury Log is maintained in each facility

  • The H&S Contact believes the summary of DOSH-900 was posted in each facility from Feb-April as required and is currently on file

  • Additional Notes

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