Safety Compliance Checklist Template - Free Download | Page 5
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STANDARD
EVALUATION
Restroorn Facilities
Notes:
Other Factors:
Score:
Restroom designation
Restroom ventilation
Fixtures operating properly
Adequate number of toilets/urinals
Others
Science Lab Safety [Secondary
Schools Only]
Other Factors:
Notes:
Score:
Incompatible storage
Eyewash/showers
Personal Protective Equipment
Fume hoods
Outdated chemicals
Over-accumulation of reagents
Spill Kits
Others
Traffic and Pedestrian Safety
Other Factors:
Notes:
Score:
Accident reporting
Adequate crossing guards
Crosswalks adequately marked
Traffic enforcement
Others
Page 5 of 5
OEHS School Safety Compliance Checklist
SSCC Worksheet v. 2 September 2007
-
Threshold Questions
YES
NO
Are all restrooms available for use
Are all restrooms adequately stocked (toilet paper, soap, and paper towels); and maintained in sanitary condition [Evaluation
should be based on visual inspection and review of Contact Log.]
Are restroom inspections conducted regularly [At least twice daily
Threshold Questions
YES
NO
Is the Chemical Hygiene Plan kept in a designated location, readily available and are staff aware of their responsibilities
Has a Chemical Safety Coordinator been assigned by the Principal
Is a laboratory chemical inventory kept in a designated locations and readily available
Are MSDSs readily accessible for all laboratory chemicals listed on the inventory [MSDSs should be kept in a centralized location
known to all science staff.]
Is safety equipment adequate, available, and maintained in good condition
Are laboratory chemicals properly stored, secured and disposed of
Are all laboratory chemicals used at the school District approved
Threshold Questions
YES
NO
Have ''Safe Routes'' to school been designated [Safe routes should be posted and distributed to parents.]
Are drop-off and pick-up points designated and supervised [Drop-off and pick-up points should be posted and distributed to
parents.]
Are there recurring complaints, observed hazards, or a history of student injuries [Evaluation should be based on staff interviews,
field observations, and review of Contact Log and School Police accidents records.
Scorecard Rating:
source: achieve.lausd.net
