NJSBAIG ANNUAL SAFETY SELF-AUDIT SCORE SHEET

NJSBAIG ANNUAL SAFETY QUESTIONNAIRE SCORE SHEET District: Date Completed: A. MANAGEMENT LEADERSHIP ELEMENT Score E. TRAINING & INFORMATION Score A1. Safety Manual E1. Safety Program/Policy Awareness A2. School Board Policy E2. Employee Job Hazard Training A3. District Safety Coordinator E3. Evacuation Procedures Training A4. Safety Committee Total this element: Total this element: F. EVALUATION OF SYSTEM EFFECTIVENESS B. EMPLOYEE INVOLVEMENT F1. Benchmarking B1. Safety Awareness F2. NJSBAIG Safety Audit: Total this element: Total this element C. HAZARD IDENTIFICATION & ASSESSMENT G. EMERGENCY RESPONSE C1. Loss Run Review G1. Emergency Plans C2. Self Inspection G2. Alarm System C3. PEOSHA-300 Log G3. Fire Extinguishers Total this element: G4. Sprinkler System G5. First Aid/CPR D. HAZARD PREVENTION & CONTROL Total this element: D1. Engineering Control H. LOSS CONTROL D2. Administrative D3. Personal Protective Equipment H1. Managed Care for Injuries D4. Accident Reporting H2. Restricted Duty D5. Investigation H3. Pre-Employment Screening D6. Non-Routine Activity Planning H4. WeTip Implementation Total this element: Total this element: Grand Total: Targets for Improvement (i.e., A1, B1 or C3): Completed By: 6/14/07 NEW JERSEY SCHOOL ...