ActivitiesCheclist08-09_0

8/8/2019 ActivitiesCheclist08-09_0

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PROGRAM CONTACT PERSON LIST

Asbestos Management........................................................Mitch Hoard

AED.......................................................................................N/A

AWAIR.....................................................................Sr. Kathy Kuchar

Bleacher Safety............................................................... Mitch Hoard

Bloodborne Pathogens..................................................Sr. Kathy Kuchar

Community Right-to-Know..................................................Mitch Hoard

Compressed Gas Safety......................................................Mitch Hoard

Confined Space Entry........................................................Mitch Hoard

Emergency Action Planning..................................................Mitch Hoard

Employee Right-to-Know/Hazard Communication......................Mitch Hoard

Facilities Safety Management..........................................Sr. Kathy Kuchar

First Aid/CPR ............................................................Sr. Kathy Kuchar

Hazardous Waste Management.............................................Mitch Hoard

Hearing Conservation........................................................Mitch Hoard

Indoor Air Quality.............................................................Mitch Hoard

Integrated Pest Management...............................................Mitch Hoard

Laboratory Standard/Chemical Hygiene Plan.......................................N/A

Lead Management............................................................Mitch Hoard

Lockout/Tagout ..............................................................Mitch Hoard

Machine Guarding ............................................................Mitch Hoard

Personal Protective Equipment............................................Mitch Hoard

Playground Safety............................................................Mitch Hoard

Radon Gas Safety.............................................................Mitch Hoard

Respiratory Protection.......................................................Mitch Hoard

USTs/ASTs...............................................................................N/A

Welding Cutting Brazing...............................................................N/A


2/21

Checklist of E/OHS Activities for Asbestos Management

Program Contact Person: Mitch Hoard

Is the Asbestos Management Plan in place? Yes No N/A

Is the Plan current for all buildings? Yes No N/A

Has the Plan (or Plans) been reviewed this school year? Yes No N/A

The Plan is located at affected building: yes, principals office .

Training for Asbestos Awareness was conducted: 3-26-07

New PT employees received training on N/A (date)

Annual written notification has been prepared; fall, 2007

(date)

Notification appeared in the following publication(s):

Name of publication Date Fall newsletter

Three-year re-inspection Surveillance was conducted: 5-14-2008 .

6-month Periodic Surveillance was conducted: 3-26-07 10-3-2007(first date)

10-08-08 (second date)

All caution labels have been posted.Label locations:

Are supplies of repair materials adequate to meet the requirements ofmaintenance and repair of ACM? Yes NoN/A


3/21

Note: All repairs and removals are outsourced.

Asbestos Maintenance Supplies on Hand

Is documentation of Operations and Maintenance available?

Location:

Status of the Asbestos repair and maintenance Work Order System: N/AEstablished,

PendingComments:

**For information regarding the medical review and questionnaire, see theRespiratory Protection Program.**


4/21

Checklist of E/OHS Activities for AWAIR

Program Contact Person:Sr. Kathy Kuchar

Is the AWAIR Plan in place? Yes No N/A

Is the Plan current? Yes No N/A

Has the Plan been reviewed this school year? Yes No N/A

Is the Safety Committee organized? Yes No N/A

How often are meetings held? Concurrently with the Building and GroundsCommittee.

Are minutes of the meeting maintained?

Location: Main office , Buildings and Grounds binder.

Posted: Main office

How is the program communicated to employees? Staff development meetings

Who is the Contact Person for OSHA 300? Sr. Kathy Kuchar, OSB

Is the OSHA 300A Log completed for the previous calendar year? No

Have the Logs been maintained for five (5) years? No

Location: Activity Manual

Is the Log posted from February 1 until April 30? Yes,

The location/s of the posted log: Main office and School Kitchen

Is information on injuries recorded on the Log within five (5) working days? YesNo N/A


5/21

Safety Committee Meeting Schedule

Date Location Time

.

.

District Safety Committee Members

Member Position BuildingArt Heinze Parishioner Elementary (K-6)

Fr. Tim McGee Pastor-Superintendent

Elementary (K

Dan Baumgarter Parishioner Elementary (K

Mitch Hoard Head Custodian Elementary (K

Roger Reuter Parishioner Elementary (K

Hillary Stoltman Parishioner Elementary (K

Jim Fisher Parishioner Elementary (KBernie Huot Parishioner Elementary (K

Joan Lubitz Parishioner Elementary (K


6/21

Checklist of E/OHS Activities for Bloodborne Pathogens


Is the Bloodborne Pathogens Written Plan in place? Yes No

Has the Plan been reviewed this school year? Yes No

List job categories that may be at risk to exposure: All-staff are considered atrisk of coming in contact bodily fluids.

What is this schools policy regarding Hepatitis B vaccinations for employeesconsidered at risk versus employees considered not at risk in the ExposureControl Plan? Staff may use their wellness benefits through Blue Cross & BlueShield to receive the vaccination series.

Is training provided at this school on methods and techniques to reduceexposure incidents? Training is provided during all-staff development dayseither by use of a video tape or hired consultant.

New Employees: Trained during fall staff development days.

Have the employees identified as first aid responders been given at a minimumRed Cross First Aid Training? Yes No N/ANote: Those that wished , went for a refresher course at Northwest MedicalCenter, fall, 2006.

Are Exposure Control Kits available to staff? Yes No N/A

Location(s): In each classroom and the Main Office.

Status of Declination forms:

How are blood or bodily-fluid-containing materials handled at this facility?

Policy regarding cleanup: Custodians are considered first to respond toevents. Only in the absence of custodial staff are teaching staff required toclean spills.

Location of biohazard bags at school: Each classroom and Main Office


7/21

Approved disposal location for biohazard waste:


8/21

Checklist of E/OHS Activities for Confined Space Entry


Is the Confined Space Entry Plan in place? YesNo N/A


Has the Plan been reviewed this school year? YesNo N/A

Have confined space areas been identified? YesNo N/A

Have measurements to include CCI/ft been completed? Yes No N/A

Are permit entry forms in place? YesNo N/A

Location: Activity Manual

Are confined space labels in the proper locations? YesNo N/A

Is a list of employees eligible to enter confined spaces complete? YesNo N/A

Has training for affected employees completed? Yes No

Date of completion: October 3, 2007


9/21

Confined Space Inventory

Building: St. Bernards School

Building Contact: Mitch Hoard Program Contact: Lee Carlson

Completed By: _Lee Carlson Date: 5-14-2008

RoomIdentificationName Given Space

OpeningDimension

DimensionOf ConfinedSpace

PotentialHazards

Permit/Non-Permit

Labeled PhotoID #

Mens lavatory 3X2 12X24X12 Limited entry Non-Permitrequired

No

Pipe chase(basement)Janitors closet 24X30 20X3X80 LE, Asbestos. Non-

Permitrequired

No

Pipe Chase1st floorcustodial

Elevator pit 7X3 4X8X8 Entrapment,energy,

Permitrequired

No

1st Floor


10/21

Checklist of E/OHS Activities for Emergency Action Planning


Is the Emergency Action Planning program in place and as outlined in theMinnesota Executive Order 93-27 and Model Crisis Management Plan? Yes No

Is the Plan current? Yes No


Are information maps posted to indicate travel routes in the event of fire,tornado shelter locations, and procedures during lockdown? YesNo

Located where? Maps are located in each classroom.

Are all drills timed and recorded? Yes No

Responsible person: Sr. Kathy Kuchar

Location of records: Main Office Activities Manual

Forms provided: Yes No

Does this school coordinate drills with local government authorities to assuresheltering in school, evacuating to their homes or use of congregate carecenters? Yes No N/A

Has this school completed the Fire Marshall required Fire Safety and EmergencyEvacuation Plan? Yes No N/A

Training provided for affected staff? Yes No N/A

Note: Training is typically provided during staff development days.


11/21

Checklist of E/OHS Activities for Employee Right-to-Know/HazardCommunication


Is the Employee Right-to-Know/Hazard Communication Plan in place? Yes No



Has the chemical inventory been completed for the following functional areas?

Location of Chemical InventoryForm

Art Instruction Yes No N/A

Custodians Yes No N/A Main Office

Food Service Yes No N/A Kitchen office/Main Office

Science Rooms Yes No N/A

Shop (metals, wood, auto) Yes No N/A

Are MSDS available and located with the chemical inventory? Yes No

Do the MSDS concur with the chemical inventory? Yes No

Has training been provided for the following staff?

Art Instructors Yes No N/A Science Yes No N/A

Custodians Yes No N/A Shop Yes No N/A

Food Service Yes No N/A Transportation Yes No N/A


12/21

Checklist of E/OHS Activities for Facilities Safety Managementand Fire Safety in Schools

Program Contact Person: Sr. Kathy Kuchar

Is the Facilities Safety Management program in place? Yes No

Does this school use contracted services for the Management AssistantProgram? Yes No N/A

If no, who is the designated person or persons? Lee Carlson

Fire and Life Safety in Schools


Is the Fire Marshal approved Emergency Evacuation Plan in place for eachdistrict building? Yes No

Most recent date of sprinkler electronics inspection:_________ N/A

Most recent date of alarm inspection: June, 2008_______ N/A

Most recent inspection of fire extinguishers: June ,2008___________ N/A

Most recent inspection of fume hoods with fire suppressant:________ N/A

Are emergency lights tested at least biannually? Yes No N/A

Science safety Checklist completed? Yes No N/A

Note: There is no fire suppression system in the fume hoods located in thebasement kitchen. No grease laden foods are cooked in that area. The buildingdoes not have a sprinkler system.


13/21

Facilities Safety Review

Building: St. Bernards Parochial School

Mock-OSHA ReviewArea

Date ReviewCompleted N/A Recommendations

Art X

Dark Room X

Wood Shop X

Kitchen 1-22-08 See Facility Safety Report and photos

Metal Shop X

Halls, Gym, etc. 1-22-08 See Facility Safety Report and photos

Graphic Arts X

Maintenance/Custodial

1-22-08 See Facility Safety Report and photos

Transportation X

Grounds/Garage 1-22-08 See Facility Safety Report and photos

Chemistry/LifeScience

X


14/21


15/21

Checklist of E/OHS Activities for Indoor Air Quality


Is the IAQ Plan in place? Yes No



Has an IAQ Committee beenestablished?

Have the program and goals been approved by the School Board for the current

school year? Yes No

Has the annual cursory walk-through been conducted? Yes No

Havethedistrictskeybuilding systems been evaluated? Yes No

When was the evaluation completed?

Who conducted the evaluation?

Wereoccupied areas of the district evaluated using the EPAs Tools For Schoolscheck list or equivalent?

Teachers check list? An information fact sheet was provided all staff.# of forms distributed # of Forms returned:

Building maintenance checklist?

Building ventilation checklist?

Training conducted(date)

Training has been scheduled for _______________.(date)

Has the District determined the mechanical ventilation rate of each occupiedspace? Yes No.

Supportive technical services were conducted on: _________________.(date)


16/21


17/21

Checklist of E/OHS Activities for Lead-in-Water Management


Is the Lead-in-Water Management Plan in place? Yes No



This school completed testing of water supply taps __3-14-03.(date)

Is a map of all potable water taps available for review? Yes No N/A

Checklist of E/OHS Activities for Lead-in-Paint Management


Is the Lead-in-Paint Management Plan in place? Yes No



Testing for lead in paint on playground equipment: Note: All playgroundequipment has been replace with lead free.

Date completed: N/A

Yet to be tested: N/A

Results of evaluation for paint condition in rooms K-1:Building constructed post-1978; facility not applicableBuilding constructed prior to 1978; paint determined to be in

___good___________ condition


18/21

Checklist of E/OHS Activities for Lockout/Tagout


Is the Lockout/Tagout Plan in place? Yes No N/A



Is LO/TO equipment available? Yes No N/A

Is the equipment appropriate for application? Yes No N/A

If available, where is the equipment located? _________________________

Is the equipment maintained in an orderly and readily usable condition? Yes NoN/A

Have affected personnel been trained as to methods and technique of use? YesNo N/A

Are written procedures available for affected staff? Yes No N/A

If available, the procedures are located where? Activities Manual

Has the annual audit of energy control procedures been completed? Yes No

Date or dates of completion:


19/21

Checklist of E/OHS Activities for Playground Safety


Is the Playground Safety program in place? Yes No



Surfacing:

The equipment has adequate protective surfacing under and around itand the surfacing materials have not deteriorated

Loose-fill surfacing materials have no foreign objects or debris

Loose-fill surfacing materials are not compacted and do not havereduced depth in heavy use areas such as under swings or at slide exits

Note: Pea rock was noted thin in some locations 5-13-08General Hazards:

There are no sharp points, corners, or edges on the equipment

There are no missing or damaged protective caps or plugs

There are no hazardous protrusions and projections

There are no potential clothing entanglement hazards, such as open S-hooks or protruding bolts

There are no pinch, crush, and shearing points or exposed moving parts

There are no trip hazards, such as exposed footings on anchoringdevices and rocks, roots, or any other environmental obstacles in theplay area

Deterioration of the Equipment:

The equipment has no rust, rot, cracks, or splinters, especially whereit comes in contact with the ground


20/21

There are no broken or missing components on the equipment (e.g.,handrails, guardrails, protective barriers, steps, or rungs on ladders)and there are no damaged fences, benches, or signs on the playground

All equipment is securely anchored

Security of Hardware:

There are no loose fastening devices or worn connections, such as S-hooks

Moving components, such as swing hangers or merry-go-round bearings,are not worn

Drainage:

The entire play area has satisfactory drainage, especially in heavy useareas such as under swings and at slide exits

Leaded Paint:

The leaded paint used on the playground equipment has notdeteriorated as noted by peeling, cracking, chipping, or chalking

There are no areas of visible leaded paint chips or accumulation oflead dust

General Upkeep of Playgrounds:

The entire playground is free from miscellaneous debris or litter suchas tree branches, soda cans, bottles, glass, etc.

There are no missing or full trash receptacles

Note: the playground was checked on 5-14-08 and found to meet standards ofthis program.


21/21

Checklist of E/OHS Activities for Personal Protective Equipment


Is the Personal Protective Equipment Plan in place? Yes No N/A



Has a survey of potential workplace hazards been completed? Yes No N/A

Date(s) activity was conducted: Oct 3, 2007

Have recommendations been completed for appropriate equipment? Yes No

Has training been completed for the following departments?

Art and Photo Yes No N/A

Custodial Yes No N/A

Grounds keeping/Garage Yes No N/A

Kitchen Yes No N/A

Maintenance Yes No N/A

Science Laboratories Yes No N/A

Technical Education Yes No N/A

Transportation Yes No N/A

ActivitiesCheclist08-09_0

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