Optional Information
Name of school: 
Date of inspection:
Career-Technical program/course/room:
Signature of inspector: 


Environmental and Occupational
Safety and Health Plan
Self Inspection Checklist


Guidelines: This checklist covers the recommended general elements of an environmental and occupational safety and health plan that should be present in any school district. No Federal regulations or laws that require these elements. Individual States, however, may have regulations that apply. Additional written documentation may be needed for specific occupational safety and health areas (e.g., respiratory protection and hearing protection). Definitions of underlined terms are provided at the end of the checklist to help you understand some of the questions.

     Please Circle  

  1. Does your school district have a written environmental
    and occupational safety health plan adopted by the
    district board of education, agency, or institution?
 Y   N   N/A   ?? 

  1. Does the written plan include the following general elements:

    1. objectives?

    2. a statement of general policies?

    3. a defined organizational structure for program
      implementation?

    4. designated persons or groups with clear lines of
      responsibility?

    5. procedures to implement the plan?

    6. a time table for plan implementation and periodic
      review?

    7. a mechanism to evaluate the effectiveness of the
      plan and the program?


 Y   N   N/A   ?? 

 Y   N   N/A   ?? 

 Y   N   N/A   ?? 


 Y   N   N/A   ?? 


 Y   N   N/A   ?? 

 Y   N   N/A   ?? 


 Y   N   N/A   ?? 

  1. Does the written plan include the following more specific elements:

    1. a hazard analysis for each career-technical course?

    2. environmental and occupational safety and health
      practices and precautions for each career-technical course?

    3. a plan and procedures for periodic inspections and
      maintenance of facilities and equipment, including
      personal protective equipment?

    4. a plan and procedures to eliminate hazards?

    5. emergency procedures?

    6. methods to provide environmental and safety and
      health education to pupils and teachers, including
      methods for incorporating the results of the hazard
      analysis      ?

    7. procedures and methods to document and assess
      pupils' and teachers' knowledge of environmental
      and occupational safety and health practices and
      procedures?

    8. a system (that may include disciplinary action and
      positive motivational actions) to ensure that pupils
      and teachers comply with environmental and
      occupational safety and health practices?

    9. procedures to ensure that all new staff and pupils
      receive initial environmental and occupational safety
      and health training before starting any course or
      program?

    10. procedures to ensure that all staff and pupils receive
      followup refresher environmental and occupational
      safety and health training when needed?

      Note: Refresher training should be provided
      annually and whenever evidence shows that training
      is needed.

    11. procedures to report and investigate injuries and
      illnesses related to career-technical courses?


 Y   N   N/A   ?? 

 Y   N   N/A   ?? 


 Y   N   N/A   ?? 



 Y   N   N/A   ?? 

 Y   N   N/A   ?? 

 Y   N   N/A   ?? 




 Y   N   N/A   ?? 




 Y   N   N/A   ?? 




 Y   N   N/A   ?? 




 Y   N   N/A   ?? 







 Y   N   N/A   ?? 

  1. Does your school district have a designated person(s) who
    is responsible for developing the plan and implementing the
    program?
 Y   N   N/A   ?? 

  1. Has your school district implemented its plan?
 Y   N   N/A   ?? 

  1. Does your district have a board-approved written curricula
    for all students that includes environmental and
    occupational safety and health?
 Y   N   N/A   ?? 

  1. Does your district perform an annual inspection of buildings
    to insure adherence to environmental and occupational
    safety and health laws?
 Y   N   N/A   ?? 

  1. Do written policies and procedures exist to cover
    1. notification of parents or guardians of students
      needing further immediate medical care?

    2. safe and sanitary operation and maintenance of
      school buildings and grounds?

    3. supervision of pupil safety in the school district
      associated with safe storage and use of hazardous
      materials on school property?

    4. supervision of pupil safety in the school district
      associated with preventing accidents, panic, and fire?

    5. supervision of pupil safety in the school district
      associated with providing for and maintaining
      suitable and safe equipment?


 Y   N   N/A   ?? 


 Y   N   N/A   ?? 


 Y   N   N/A   ?? 



 Y   N   N/A   ?? 


 Y   N   N/A   ?? 

  1. Are all employees informed at the beginning of each school
    year of the environmental and occupational safety and
    health policies and procedures?
 Y   N   N/A   ?? 




Definitions:

Hazard analysis: a method of reviewing career-technical program equipment, materials, and procedures to identify potential causes of injury or illness.

Plan: a written document outlining how an environmental and occupational safety and health program will be implemented.

Program: the steps being implemented to ensure a safe and healthful workplace and environment.



Comments/Corrective action:




















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National Institute for Occupational Safety and Health