Safety Compliance Checklist Template - Free Download | Page 2
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STANDARD
EVALUATION
Emergency Procedures (Safe
School Plan, Volume 2)
Other Factors:
Notes:
Score:
Adequate water supply (1.5 gal./pp)
First-aid kits (1/400)
SEMS Training
Emergency drills
Seismic bracing
Annual emergency hazard assessment
Designated command post
Toilet and Search and Rescue Supplies
Others
Facilities and Equipment
Maintenance
Other Factors:
Notes:
Score:
Landscaping
Broken windows
Carpet condition
Salvage disposal
Electrical equipment guarding
Refuse bins
Ceiling tile
Playground equipment
Others
Fire/Life Safety
Other Factors:
Notes:
Score:
Exit signs illuminated
Marked fire lane
Fire extinguisher training
Posted emergency routes
Emergency lighting
Exits unlocked & operable in single action
Occupant signs posted in assembly area
Fire alarms tested monthly
Combustible materials
Equipment Clearance
Trip/Fall Hazard
Others
Page 2 of 5
OEHS School Safety Compliance Checklist
SSCC Worksheet v. 2 September 2007
-
Threshold Questions
YES
NO
Are emergency procedures current and readily available
Are staff familiar with their designated responsibilities [Review staff training documents].
Was a completed ''Safe School Plan, Volume 2 - Emergency Procedures'' with all components submitted to OEHS on or before the
required date of October 1st of the current school year
Are emergency supplies and equipment adequately stocked, properly maintained, and stored in designated locations [Review
supplies and equipment in earthquake bin and designation locations. Refer to supply inventory listed in Reference Guides 801 and
802.]
Is dedicated storage provided for emergency supplies
Threshold Questions
YES
NO
Are facilities and equipment maintained in good repair
Have trouble calls been placed for necessary repairs
Are proper housekeeping practices followed in classrooms and on campus
Threshold Questions
YES
NO
Are fire extinguishers checked monthly and serviced annually, clearly marked, and easily accessible
Are all exits and exit corridors free of obstructions
Are exits properly marked
Does each classroom equipped with security grills have at least one with a releasable latch in compliance with District policy [Per
Board of Education Report #15]
source: achieve.lausd.net
