Information
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Site conducted
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Document No.
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Polk School District
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Conducted on
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Prepared by
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Location
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Personnel
Parking lots:STF
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Does the parking lot have proper lighting?
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Are the surfaces smooth and free from potholes?
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Are the parking lot walkway routes marked off?
Outdoor walkways: STF
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Are the surfaces level ?
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Do surfaces have proper drainage?
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Are walkways properly illuminated?
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Are walkways free of debris?
Indoor walkways:
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Are the floor surfaces level and free of cracks/bulges/breaks/tears?
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Are the carpets firmly fastened in place and free of gaps?
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Are the entryway mats in place during rain or snow conditions?
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Are the floor surfaces free of debris?
Ramps:
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Are the floor surfaces treated with non-slip materials?
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Are the ramps equipped with handrails?
Stairways:
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Are the steps uniform and well maintained with no broken edges?
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Are handrails provided and secure?
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Are the stairways and landings well illuminated?
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Are the landings and stairways free of debris?
Restrooms:
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Are the floor surfaces free of irregularities?
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Are the floor surfaces free of water?
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While floors are wet mopped, are the areas barricaded or signs in places?
Classrooms
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Are the floor surfaces level and free of cracks/bulges/breaks/tears?
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Are the carpets firmly fastened in place and free of gaps?
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Are floors in good condition and not slippery?
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Are potential hazards such as uncovered extension cords/ cables across aisles?
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Are there any other potential trip hazards in the classroom?
Fire and Life Code Safety:
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Are the fire alarm pull stations accessible at all times?
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Are the evacuation diagrams posted at primary exit door(s)?
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Is there adequate aisle space is provided for egress to all primary and<br>secondary exits?<br>
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Are the fire extinguishers accessible and mounted on hangers or brackets?
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Have the fire extinguishers been inspected monthly/yearly?
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Artwork in classrooms is there more than 50% of any wall covered with art and/or<br>teaching materials? <br>
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Artwork in corridors is there more than 20% of any wall covered with art and/or<br>teaching materials?
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Are all “EXIT” signs are illuminated?
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Is the door panic hardware in good working order, and free from chains, padlocks or<br>any other locking device? <br>
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Are flammable/combustible liquids, such as paint and glue are stored<br>properly? <br>
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Is there any door stops being used on fire doors?
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Are emergency lights in proper working order?
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Are all emergency exits free of all obstructions?
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Is storage allowed under the stairs?
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Are 1st Aid kits available and up to date?
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Ceiling clearance, is storage 2 foot or more for non-sprinklered and 18 inches for sprinklered areas?
Electrical Safety:
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Do all electrical panels have 36 inch clearance?
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Do all electrical switches and receptacles all have cover plates?
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Is there any extension cords being used as permanent wiring?
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Are power strips used with the proper application ( not daisy chained or overloaded)?
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Do all power and extension cords have ground prongs?
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Are all electrical rooms and mechanical/air handling rooms free of any storage.?
Chemical Safety-Hazcom
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Are the Safety Data Sheets (SDS) up to date with inventory listed?
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Do the staff know how to access material Safety Data Sheets (SDS)?
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Are all chemicals properly labeled?
Custodial Services/Housekeeping
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Are all areas kept clean, orderly and sanitary?
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Are areas around mop sinks dry and slip free?
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Are blood borne spill kits provided and accessible?
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Are cleaning materials properly and is the door to the custodial rooms locked?
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Are "WARNING" signs placed around wet floor areas?
Additional information:
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Comments:
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Additional pictures:
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Required