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Hawthorn Academy

West Jordan

EMERGENCY RESPONSE,

EVACUATION,

AND SAFETY PLAN

2018-2019

TABLE OF CONTENTS

APPROVAL STATEMENT 4

HOMELAND SECURITY CHECKLIST 5

INTRODUCTION 7

PURPOSE & SITUATION 7-8

DIRECTION & CONTROL 8-10

PLAN DEVELOPMENT & MAINTENANCE 10

TRAFFIC PLAN (drop-off & pick up policy) 11

VISITORS ON CAMPUS 12

MEDIA 13-14

EMERGENCY SAFETY POLICIES

ASSAULT 1 FIGHTS 15

BOMB THREAT 16

BOMB THREAT CHECKLIST 17

COMMUNICATION 18

EARTHQUAKE 19

EVACUATION 20

EVACUATION MAP 21

EVACUATION (REVERSE) 22

FIRE 23

GAS LEAK 24

GENERAL EMERGENCY 25

HAZARDOUS MATERIALS EVENT 26

INTRUDER / HOSTAGE 27

LOCKDOWN / SHELTER IN PLACE 28

SERIOUS INJURY OR DEATH 30

SHELTERING PROCEDURES 31

STAFF RESPONSIBILITIES 32

STUDENT UNREST 33

SUICIDE 34-35

TERRORIST EVENT 36

WEAPONS 37

WEATHER 38

APPENDICES AND ATTACHMENTS

1

EMERGENCY PHONE NUMBERS 39

FACULTY / STAFF ROSTER (emergency phone numbers) 40

MASTER SCHOOL SCHEDULE 41

NOTICE OF FIRST-AID CARE 42

RESOURCE INVENTORY 43

SAMPLE LETTERS NOTIFYING ABOUT EMERGENCY 44-45

SEARCH & RESCUE TEAM FORM 46

SITE PLAN 47

SITE STATUS REPORT 48

STAFF SKILLS SURVEY & INVENTORY 49-50

STUDENT ACCOUNTING FORMS 51

STUDENT RELEASE FORM 52

STUDENT ROSTER (with parent phone numbers) 58

ROOM NUMBER MAP………………………………………………………………………59

UPDATE REPORTS 60

2

Approval Statement

The School Safety Plan for Hawthorn Academy has been reviewed and found to comply with the Local

City Emergency Response Plan, minimum and/or recommended requirements.

_____________________ ______

Administrator Date

_________________ ______

Board President Date

_____________________ ______

____________ City Police Date

_________________ ______

_________ City Fire Authority Date

3

HOMELAND SECURITY CHECKLIST

Use this checklist to determine if your emergency response plan complies with Utah Homeland

Security requirement. The elements of the minimum requirements are listed below. Your plan must

contain each listed element to be in compliance. This checklist can assist you in conducting your

annual review.

Y N UNK INTRODUCTION

� � � Table of contents

� � � Approval statement and dated signatures of Administrator and appropriate school official

PURPOSE

� � � State the purpose of the emergency response plan

SITUATION

� � � State the size and location of your facility in acres and the number, general size, and use of each of

the buildings

� � � State the number of students and employees normally on hand, and any scheduled daily differences

in population

DIRECTION AND CONTROL

� � � Create a management system which will include a chain of command and alternates to carry out the

plan

� � � Designate a primary and alternate on-site Command Post

� � � Identify persons, by title and agency, who will be notified during an emergency

� � �

Describe the warning signals or commands that alert staff and students to emergency responses:

1. Evacuation

2. Reverse Evacuation

3. Drop, cover, hold

4. Lockdown

5. Shelter in place

� � � Designate primary and alternate evacuation routes and assembly areas

� � � Describe how disabled and/or non-English-speaking children will be provided for

� � � Provide a resource inventory of emergency items available—communication equipment, first aid,

medical, fire fighting equipment, lighting, etc.

� � � Post a classroom Emergency Response Guide in each room or assembly area for students and staff

� � � Each School should have a battery powered radio in case of power failure

� � � Make provisions for off campus emergencies (field trips, etc.)

PLAN DEVELOPMENT AND MAINTENANCE

� � � Provide an annual review of plan, attachments, responses, and needs, and update when necessary

� � � Annually train staff regarding warning/response signals, evacuation routes, assembly areas,

emergency procedures, and chain of command

� � � Review current management system or Incident Command System annually with staff and train

those who have assigned responsibilities

� � � Annually practice response drills with students

1. Evacuation

4

6. Reverse Evacuation

7. Drop, cover, hold

8. Lockdown

2. Shelter in place

� � � One school employee will participate in training annually

� � � Overview of plan explained and distributed to parents

APPENDICES AND ATTACHMENTS

� � � Management system or ICS structure and responsibilities

� � � Student roster with parent phone numbers

� � � Master schedule

� � � Faculty/staff roster with emergency phone numbers

� � �

Community emergency numbers:

1. General emergency number – 911

2. Ambulance

3. Poison Control Center

4. Local hospital

5. Police Dept/Sheriff/State Police

6. Fire Dept

� � � Map of evacuation route(s) and assembly areas, student release gate, command post(s)

� � �

Site plan or blueprint of the facility and floor plan(s) of the building(s) showing location of water and

gas shut off points, heat plants, boilers, generators, flammable liquid storage, other hazard materials

storage, fire fighting equipment placement, first aid facilities, exits, etc.

� � � Lists with the name, title, address, telephone number, and organizational responsibilities for

emergency operations

� � � Sample statements/letters for use in notifying faculty, students, parents, and media about emergency

� � � Student accountability/release forms

Area Comments

5

INTRODUCTION

What is an Emergency?

A duly proclaimed existence of conditions of disaster or extreme peril to the safety of persons or

property caused by air pollution, fire, flood or flood water, storm, epidemic, riot, earthquake, intruder or

other causes. This may be beyond the control of the services, personnel, equipment and facilities of the

site am school and require the combined efforts of the State or other political subdivisions. School

facilities must be prepared to respond to an emergency or traumatic event in an organized and timely

manner so that students and staff can continue to function effectively without additional trauma or the

development of additional emergencies.

School emergencies can be small and easily managed, or they can be large and difficult to manage. Every

school emergency must be managed in a way that ensures the safety of everyone involved. In order to

provide a safe and secure teaching and learning environment, personnel must plan for the management of

emergency events that cannot be predicted or prevented. This plan is designed to help you do that.

PURPOSE / SITUATION:

A. To effectively handle an emergency, a comprehensive Emergency Operations Site Plan must be

developed and an Emergency Response Team must be organized before an emergency occurs.

Our school's Emergency Operations Plan must be organized and all staff members trained in

order to effectively prepare for maximum safety, efficiency and communication in the event of an

emergency.

B. The Incident Command System (ICS) will be used to manage all emergencies that occur within

the school. ICS will be used to perform non-emergency tasks to promote familiarity with the

system. All school personnel will be trained in ICS.

C. Students and parents must also understand that contingency preparation and procedures are

necessary and are conducted for their safety and well-being.

D. Planning, preparation, and training will help staff personnel learn the proper course of action in an

emergency. This manual will provide step-by-step guidelines to help deal with emergencies that

may occur. This manual cannot foresee all possible circumstances of an emergency. Staff must

be prepared to evaluate all the circumstances and make sound judgments based on the situation.

E. A committee will be established consisting of local law enforcement, fire/EMS, emergency

management, and site personnel to develop the Emergency Operations Plan. The committee

should consist of site staff from the following disciplines at a minimum:

Administrator Maintenance/Custodian

Office staff Teachers

School Counselor Parent Volunteers

6

Procedures will be developed to provide for disabled and non-English speaking students and staff.

F. This plan shall be reviewed annually by the above committee and updated to maintain up to date

procedures.

G. Drills will be conducted periodically to test the effectiveness of the plan. A debriefing shall be

conducted after each drill to receive feedback from all participants on the effectiveness of the

plan.

During a Disaster: Step by Step is Right Here

The greatest mistake Administrators, teachers and staff make in crisis come from not knowing what steps

to take and in what order in a given situation. Planning, training and drills will help prevent those mistakes.

In a crisis it helps to know where to turn for help. This manual provides specific sequential steps to take.

These steps are guidelines to inform you of the most likely steps to take. The most likely incidents have

been addressed to help you in an emergency. It is critical to evaluate the circumstances and determine the

most appropriate course of action.

The following manual outlines various school emergencies and the plans in place to address them. All

school safety policies and procedures shall be implemented in accordance Utah Code 53A-3-402.

Site

Hawthorn Academy West Jordan is a K-9 Charter School located at approximately 2200 W. 9062 S. West

Jordan, UT. The procedures outlined in this safety plan will provide a standardized, efficient approach to

safety management within the school. The site consists of one building. There is an Average Daily

Membership of 850 students and 54 staff members.

DIRECTION & CONTROL:

The Administrator has the primary responsibility for implementing the site Emergency Operations Plan.

The Administrator has the responsibility of executing policies developed by the school.

Site personnel and/or local fire and law enforcement agencies handle most emergencies on site.

In case of an emergency that is beyond the capabilities of the site to handle, site personnel will

coordinate with local emergency response agencies. This may include having a member or members

act as liaison with responding agencies.

7

SITE ASSIGNMENTS AND STAGING AREAS

On Site Locations and Staging Areas

Primary Alternate

On Site Command Post Main Office Gym

Student Care Library Classrooms

First Aid Learning Center Classrooms

Student Request Front Door Side Gate

Student Release Front Door Side Gate

Media Staging Cafeteria Classrooms

Law Enforcement Staging Gym Classrooms

Fire Staging Gym Classrooms

Public Works Staging Gym Classrooms Utilities Staging Gym Classrooms

Student Relocation Center LDS Church

9750 S. 2200 W

LDS Church

1945 W. 9000 S.

Off-Site Locations and Staging Areas

Primary Alternate

Off-Site Command Post Church of Jesus Christ of Latter

Day Saints

Church of Jesus Christ of Latter

Day Saints

Student Care 9750 S. 2200 W. 1945 W. 9000 S.

First Aid Church of Jesus Christ of Latter

Day Saints


Day Saints

Student Request 9750 S. 2200 W. 1945 W. 9000 S.

Student Release Church of Jesus Christ of Latter

Day Saints


Day Saints

Media Staging 9750 S. 2200 W. 1945 W. 9000 S.

Law Enforcement Staging Church of Jesus Christ of Latter

Day Saints


Day Saints

Fire Staging 9750 S. 2200 W. 1945 W. 9000 S.

Public Works Staging Church of Jesus Christ of Latter

Day Saints


Day Saints

Utilities Staging 9750 S. 2200 W. 1945 W. 9000 S.

8

ICS ASSIGNMENTS

POSITION 1st (Primary) 2nd

(Alt) 3rd (Alt)

I/C

SAFETY Assistant Principal:

Ellinger Assistant Principal: Kunz Lead Director: Swensen

LIAISON Lead Director: Swensen Principal: Kristi Kunz Assistant Principal: Ellinger

INFORMATION OFC Lead Director: Swensen Principal: Kristi Kunz Assistant Principal: Ellinger

OPERATIONS

RECORDER Secretary: Brockbank Secretary: McDevitt Aide: Combes

SECURITY Assistant Principal

Ellinger Aide: Mikkelson Aide: Lence

SEARCH/RESCUE Counselor: Robinson Assistant Principal:

Ellinger

Assistant Principal: Kristi

Kunz

SAFETY/DAMAGE Assistant Principal:

Kristi Kunz

Assistant Principal:

Ellinger Counselor: Robinson

MEDICAL Teacher: Coletti Teacher: Boom Teacher: White

STUDENT REQUEST Secretary: McDevitt Secretary: Brockbank Librarian: Clark or Lenz

STUDENT

SUPERVISION Grade Level Teachers Grade Level Teachers Grade Level Teachers

STUDENT RELEASE Librarian: Clark or Lenz Aide: Combes Secretary: McDevitt

RUNNERS Specialist: Hansen Specialist: Lizano Aide: Merrill

Notes:

PLAN DEVELOPMENT & MAINTENANCE:

The school’s safety committee will review the plan each year, update information, and suggest any

changes that may be necessary to maintain the plan’s usefulness.

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10

TRAFFIC PLAN

❑ Between the hours of 8:00-8:45 AM and 3:00-3:45 PM vehicles MUST enter the school ground from

2200 W. and exit RIGHT onto 2200 W.

❑ For safety reasons, you must drop-off and pick-up your students in the designated drop-off and

pick-up zones at the school.

❑ You may drop-off your students between 8:00-8:15 AM. The school bell will ring at 8:20 AM. You

may not drop your students off prior to 8:00 AM as they will not be supervised until this time.

❑ Please have your students ready to exit the car as soon as you move into the drop-off zone to help

expedite a quick drop-off period and to alleviate congestion. If your student is unprepared to exit the

car please pull through the drop-off zone when directed to do so and come around again.

❑ When entering the Drop-off Zone please pull as far forward in the Drop-off zone as possible and

follow the directions of the safety officers.

❑ If you arrive at the school after 8:20 AM you will need be sure your students get into the building

safely as there will be no supervision outside the school. If you arrive after 8:25 AM you will need to

sign them in at the front office as roll may already have been taken in class.

❑ Pick-up will begin at 3:05 PM when students are released from class. You must arrive at the school

to pick-up your students no later than 3:20 PM.

❑ Students who have not been picked-up by the time the drive thru has been cleared will wait by the

front door of the school. If you have an emergency and will be late in picking up your students you

must call the main office to notify the administrators.

❑ Students will be escorted from the building after the final bell by their teachers with their class.

Students will be required to go immediately to the Pick-up area and stay in that area until they have

been picked-up. Students will need to use the bathroom, meet with their teachers and all other

"things" prior to the final bell. A single student missing from the pick-up area can throw off the entire

pick-up system.

❑ If a student does not come to their car when all other cars are ready to move from the Pick-up zone,

this car will need to move out of the pick-up zone with the other cars and circle back through the zone

again so as not to hold up the entire system.

❑ Teachers and school administrators will oversee the Drop-off and Pick-up each day, serving as safety

officers.

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Safe Walking Policy

For those students who would like to walk or ride bikes to school, they should be aware of the following

things. Please review them with your children.

❑ The School cannot assume-responsibility for students unless they are on school

grounds. Parents, please review your children's walking/biking route with them and teach them

to be safe!

❑ Crossing guards at 9000 S. and 2200 W. will be on duty every school day from 8:00-8:30 &

3:15-3:35. Please do not cross earlier than 8:00a.m. without the crossing guard, as

students are not allowed on school grounds before 8:00 a.m. Also, please keep in mind

that school starts at 8:20.

❑ All pick-up and drop-off will be through the west entrances during pick up and drop off times.

❑ There are no crossing guards in the middle of the day to cross Kindergarteners!

❑ Please wait until the crossing guard is in the middle of the street and signals that it is okay to

cross. Do not cross without the crossing guard! Please walk your bike across the street, and do

not run.

❑ Your route to school may have stretches with no sidewalk, and/or intersections with no crossing

guard. Please use caution, stay well off the street, and cross only after looking both ways.

Bikers, remember to wear a helmet and stay to the far right side of the street.

❑ Please do not walk/bike alone if possible. Avoid talking to strangers, and never approach their

cars. Scream and run away if you feel you are in danger, and tell a crossing guard, another

mother with kids, or your teacher at school what happened.

❑ Once on school grounds, please walk your bike, staying on sidewalks. The school bike rack is

available on the east side of the building near 2200 W.

Thank you for your cooperation! Let's have a safe year!

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VISITORS ON CAMPUS

90% of school safety deals with controlling who comes on the campus and what they bring with them. With

this as a foundation, the school will be vigilant in requiring all visitors to enter through the front entrance and

sign in at the office. The front office must have an accurate accounting of everyone on the campus. If the

building caught fire, for example, the fire chief will ask the principal, “Who is still in the building?” If a person

who hasn’t signed in was trapped inside and needed help, the office would be unaware of their presence on

campus.

❑ Authorized Visitors appropriately register their presence with the school office staff, wear

school-issued badges, and comply with school procedures to conduct campus business.

❑ Unauthorized Visitors do not register in the office but their presence is still perceived as

non-threatening. These persons, when approached, will comply with campus visitation procedures

immediately.

❑ Intruders are unauthorized visitors who do not cooperate with school staff or administration to

comply with visitation procedures and whose presence is perceived as hostile or threatening to

students or staff.

❑ ANYONE seen on campus without a visitor badge or volunteer button will be asked about his or

her presence. “May I help you?” is a common question heard when greeting someone without a

name-tag. This is YOUR campus too. Parents and volunteers have the right to ask about

someone’s presence too. We all have to work as a team.

❑ Should someone not have a volunteer or visitor sticker displayed, they should be directed to the

front office for proper sign in.

❑ Parents need to sign in all younger children and infants who may be with them. Again, the office

must be able to account for EVERYONE.

❑ Visitors who sign in and wear a nametag may become a campus “intruder” depending on their

actions while on campus. If you are visiting campus, please state your business in the sign in book.

Straying from campus business can be a disruption to classroom instruction and should be

avoided.

❑ Always SIGN OUT when you leave campus.

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MEDIA

All staff must refer media to site or school spokesperson.

The Administrator and Law Enforcement assume responsibility for issuing public statements

during an emergency.

❑ The Administrator serves as the school spokesperson unless he/she designates another

spokesperson. If spokesperson is unavailable, an alternate assumes responsibilities.

School spokesperson: Lead Director: Deborah Swensen (801) 865-2585

Alternate School spokesperson: Principal: Ryan Dubois (801) 282-9066

❑ School Public Information person acts as contact for emergency responders and assists school

spokesperson with coordinating media communications. If Public Information person is unavailable,

an alternate assumes responsibilities.

School Public Information person:

Name: Dr. Deborah Swensen Room #

Alternate Public Information person:

Name Kristi Kunz Room #

During an emergency, adhere to the following procedures:

❑ Incident Commander relays all factual information to Administrator.

❑ Administrator may ask school Public Information designee to prepare a written statement to media.

❑ Establish a media information center away from school.

❑ Update media regularly. Do not say "No comment".

❑ Do not argue with media.

❑ Maintain log of all telephone inquiries. Use scripted response to inquiries.

Media statement

❑ Create a general statement before an incident occurs. Adapt statement during crisis.

❑ Emphasize safety of students and staff first.

❑ Briefly describe school's plan for responding to emergency.

❑ Issue brief statement consisting only of the facts.

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❑ Respect privacy of victim(s) and family of victim(s). Do not release names to media.

❑ Refrain from exaggerating or sensationalizing crisis.

Public Information Release Form

Check (_) as appropriate: School

Date: Time:

NOTE: If this is used as a script, read only those items checked. Make no other comments.

(Check off, fill in, and cross off as appropriate.)

________________________has just experienced a(n) _________________________________

_ The (students/employees) [(are being) or (have been)] accounted for.

_ No further information is available at this time.

_ Emergency medical services [(are here) or (are on the way) or (are not available to us)].

_ Police [(are here) or (are on the way) or (are not available to us)].

_ Fire Dept. /paramedics [(are here) or (are on the way) or (are not available to us)].

_ ______________________________ [(are here) or (are on the way) or (are not available to us)].

_ Communication center(s) for parents (is/are) being set up at

To answer questions about individual students.

_ Communication center(s) for families (is/are) being set up at to answer questions about individual

employees.

_ Injuries have been reported at__________________________and are being treated at the site by

(Staff/professional medical responders). (#)________reported injured.

_ Students have been taken to a safe area,(location) , and are with [(classroom

teachers/staff or [(alternate staff with students)].

_ (#) Students have been taken to the local emergency room for treatment of serious injury. Parents of

injured students should go to the emergency room at

15

_ (#) Confirmed deaths have been reported at _______________________________________.

Names cannot be released until families have been notified.

_ Structural damage has been reported at the following sites:

Release restrictions _______ No _______ Yes

If yes, what?

Released to the public as Public Information Release #

Date/Time: ________________________

16

EMERGENCY SAFETY POLICIES

ASSAULT / FIGHTS

❑ Ensure the safety of students and staff first.

❑ Notify office. Call 911, if necessary.

❑ Notify CPR/first aid certified persons in school building of medical emergencies (names of CPR/first

aid certified persons are listed in Crisis Team Members section).

❑ Notify Incident Commander. Incident Commander assembles Crisis Team Members.

❑ Seal off area where assault took place.

❑ Defuse situation, if possible.

❑ Incident Commander notifies police if weapon was used, victim has physical injury causing substantial

pain or impairment of physical condition, or assault involved sexual contact (intentional touching of

anus, breast, buttocks or genitalia of another person in a sexual manner without consent. This

includes touching of those areas covered by clothing).

❑ Incident Commander notifies Administrator and parents of students involved in assault.

❑ Document all activities. Ask victim(s)/witness(es) for their account of incident.

❑ Assess counseling needs of victim(s) or witness(es). Implement post-crisis procedures.

17

BOMB THREAT

Upon receiving a message that a bomb has been planted in school:

❑ Use bomb threat checklist.

❑ Ask where the bomb is located, when will the bomb go off, what materials are in the bomb, who is

calling, why is caller doing this.

❑ Listen closely to caller's voice and speech patterns and to noises in background.

❑ After hanging up phone, immediately dial *69 to trace call.

❑ Notify Incident Commander or designee.

❑ Incident Commander orders evacuation of all persons inside school building(s).

❑ Incident Commander notifies police (call 911) and Administrator. Incident Commander or

Administrator must report incident to police.

Evacuation procedures:

❑ Incident Commander warns students and staff. Do not mention "Bomb Threat". Use standard fire drill

procedures.

❑ Direct students to take their belongings.

❑ Students and staff must be evacuated to a safe distance outside of school building(s). After

consulting with Administrator, Incident Commander may move students to the LDS church located

at 9750 S. 2200 W. if weather is inclement or building is damaged.

❑ Teachers take roll after being evacuated.

❑ No one may re-enter the building(s) until fire or police personnel declare them safe.

❑ Incident Commander notifies students and staff of termination of emergency. Resume normal

operations.

18

BOMB THREAT CHECKLIST

Description Detail Report Callers Voice - Circle as applicable:

Questions to ask: • Calm • Nasal

• Angry • Stutter

1) When is the bomb going to explode? • Excited • Lisp

• Slow • Raspy

2) Where is it right now? • Rapid • Deep

• Soft • Ragged

3) What does it look like? • Loud • Clearing Throat

• Laughter • Deep Breathing

4) What kind of bomb is it? • Crying • Cracked Voice

• Normal • Disguised

5) What will cause it to explode? • Distinct • Accent

• Slurred • Familiar

6) Did you place the bomb?

If voice is familiar, whom did it sound like?

7) Why?

8) What is your address?

Background Sounds:

9) What is your name?

• Street Noises • Factory Machinery

Exact wording of the threat: • Animal Noises • Voices

• Clear • PA System

• Static • Local Call

• Music • Long Distance

• House Noises • Phone Booth

• Motor • Office Machinery

Sex of Caller: Race: • Other

Length of call: Age:

19

Date: Time:

Number at which call was received:

Threat Language:

- Well Spoken (educated)

- Incoherent

- Foul

- Taped

- Message read

- Irrational

20

COMMUNICATION (EMERGENCY)

When an emergency condition exists, the Incident commander (Administrator) will notify personnel to

respond to their area of assignment. The methods of communication listed below will be used. Notifications

will be given in plain language. Code words shall not be used.

❑ Intercom

❑ Radio

❑ Telephone

❑ Runners

❑ Ham Radios

21

EARTHQUAKE

When an earthquake strikes:

❑ Assume the preferred defensive position: kneeling under a desk or table, while holding tightly to its

legs.

❑ If it is not possible to respond in the preferred manner, an appropriate defensive position may be up

against a wall or in a doorway, squatting and covering one's head.

❑ If possible, stay away from windows.

❑ Remain in these positions until you are reasonably certain the quaking has stopped or until further

instructions have been given from the school office.

❑ Evacuate the school building when it has been deemed safe and appropriate as predetermined

evacuation procedures.

❑ Once outside, stay clear of building, trees, poles, and power lines.

❑ Assemble in predetermined areas and account for all students.

❑ Remain in assembly areas until situation is assessed and further directions are given.

❑ Incident Commander notifies police and fire (call 911) and Administrator.

❑ After consulting with Administrator, Incident Commander may move students to 9750 S. 2200

W. if weather is inclement or building is damaged.

❑ No one may re-enter building(s) until fire or police personnel declare entire building(s) safe.


operations.

22

EVACUATION

In some emergency scenarios, it may be necessary for the campus to evacuate. Evacuation will be

practiced at least twice per year in conjunction with fire drills or earthquake drills. Emergencies can and do

occur which require the evacuation of students from the school. Teachers and our student body practice

emergency drills. In case of an emergency evacuation, students will be excused to person's names on our

copy of the emergency card. It is the parents' responsibility to keep the emergency cards updated.

1. Evacuation

❑ Incident Commander (IC) issues evacuation procedures.

❑ I/C to determine if students and staff should be evacuated outside of building (primary) or to 9750

S. 2200 W. (secondary)

❑ Incident Commander notifies relocation center 801-562-8260 of Secondary Location

❑ Direct students and staff to follow evacuation drill procedures and route. Follow alternate route if

normal route is too dangerous.

❑ Close all doors and windows.

❑ Turn off lights, electrical equipment, gas, water faucets, air conditioning and heating system.

❑ Office Personnel place evacuation sign in window.

❑ Lock doors.

2. Relocation Centers

❑ Primary Relocation Center – 9750 S. 2200 W.

❑ Secondary Relocation Center – LDS Church 1945 W. 9000 S.

3. Teachers

❑ Direct students to follow normal evacuation drill procedures unless I/C alters route

❑ Take classroom roster and emergency kit.

❑ Close classroom doors and turn out lights.

❑ When outside building, account for all students. Inform Administrator immediately of missing

student(s).

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❑ Teachers will travel to evacuation site with their students. Take roll again when you arrive at

the relocation center.

4. Parents

❑ Parents should not drive to the school if an evacuation is announced. Roads must be kept clear

for emergency vehicles.

❑ When allowed, parents will be asked to sign their children out. Parents / those allowed to pick

up the student should bring a photo-bearing identification card. Those allowed to pick up

student are on the student's emergency card.

24

EVACUATION MAP

*Please see specific classroom plans for evacuation routes.

❑ Primary evacuation routes

❑ Alternate evacuation routes

❑ Handicap evacuation areas

❑ Utility shut-off for

❑ Gas

❑ Water

❑ Electricity

❑ HVAC System

❑ Site assignments and Staging Areas

identified on page 2

❑ Haz Mat storage areas

❑ Heat plants/boilers

❑ Room numbers

❑ Door/window locations

❑ Any other information deemed appropriate by

your planning

25

REVERSE EVACUATION

Reverse Evacuation/Shelter-in-place provides refuge for students, staff and public within school buildings

during an emergency. Shelters are located in areas that maximize the safety of inhabitants. Safe areas may

change depending on the emergency. Be prepared to go into lockdown once inside.

❑ Identify safe areas in each school building.

❑ Incident Commander warns students and staff to assemble in safe areas. Bring all persons inside

building(s). The code word is soft, soft, soft.

❑ Teachers take class roster.

❑ Close all exterior doors and windows.

❑ Turn off any ventilation leading outdoors.

❑ Cover up food not in containers or put it in the refrigerator.

❑ If advised, cover mouth and nose with handkerchief, cloth, paper towels or tissues.

❑ Teachers should account for all students after arriving in the safe area.

❑ Office personnel must contact each teacher/classroom for a headcount through email.

❑ All persons must remain in safe areas until notified by Incident Commander or emergency responders.

26

FIRE

In the event a fire or smoke from a fire has been detected:

❑ Activate fire alarm.

❑ Evacuate students and staff to a safe distance outside of building.

❑ Follow normal fire drill route. Follow alternate route if normal route is too dangerous.

❑ Teachers take class roster. Teachers will notify I/C of missing students or personnel.

❑ Incident Commander notifies police (call 911) and Administrator. Incident Commander or

Administrator must report incident to Fire Marshal.


❑ After consulting with Administrator, Incident Commander may move students to Churches at

9750 S or 9000 S. if weather is inclement or building is damaged.

❑ No one may re-enter building(s) until entire building(s) is declared safe by fire or police personnel.


operations.

27

GAS LEAK

If gas odor has been detected in the building:

❑ Evacuate students and staff to a safe distance outside of building.

❑ Follow normal fire drill route. Follow alternate route if normal route is too dangerous.


❑ Incident Commander notifies police and fire (call 911) and Administrator.


❑ After consulting with Administrator, Incident Commander may move students to the church on

9000 S. if weather is inclement or building is damaged.



operations.

If gas odor has been detected outside the building:

❑ Incident Commander notifies police and fire department (call 911) and/ Incident Commander or

Administrator must report incident to Fire Marshal.

❑ Incident Commander determines whether to shelter in place or evacuate. Fire personnel will assist with

decision.

❑ After consulting with Administrator, Incident Commander may move students to 9750 S. 2200

W. if weather is inclement or building is damaged.



operations.

28

GENERAL EMERGENCY

❑ Notify 911 (if necessary) and the Incident Commander. Incident Commander notifies Administrator.

❑ Notify CPR/first aid certified persons in school building of medical emergencies, if necessary. Names

of CPR/first aid certified persons are listed in Crisis Team Members section.

❑ Seal off high-risk area.

❑ Take charge of area until incident is contained or relieved.

❑ Assemble Crisis Team

❑ Preserve evidence. Keep detailed notes of incident.

❑ Refer media to Administrator

29

HAZARDOUS MATERIALS EVENT

Incident occurred in school:

❑ Call 911.

❑ Notify Incident Commander.

❑ Incident Commander notifies Administrator.

❑ Seal off area of leak/spill.

❑ Take charge of area until fire personnel contain incident.

❑ Fire officer in charge will recommend shelter or evacuation actions.

❑ Follow procedures for sheltering or evacuation.

❑ Notify parents if students are evacuated.

❑ Resume normal operations after consulting with fire officials,

Incident occurred near school property:

❑ Fire or police will notify Administrator.

❑ Fire officer in charge of scene will recommend shelter or evacuation actions.

❑ Follow procedures for sheltering or evacuation.

❑ Notify parents if students are evacuated.

❑ Resume normal operations after consulting with fire officials.

30

INTRUDER / HOSTAGE

Intruder: An unauthorized person who enters

school property:

❑ Notify Administrator (IC).

❑ Ask another staff person to accompany you

before approaching guest/intruder.

❑ Politely greet guest/intruder and identify

yourself.

❑ Ask guest/intruder the purpose of his/her visit.

❑ Inform guest/intruder that all visitors must

register at the main office.

❑ If intruder's purpose is not legitimate, ask

him/her to leave. Accompany intruder to exit.

If intruder refuses to leave:

❑ Warn intruder of consequences for staying on

school property.

❑ Notify Administrator and school resource

officer if intruder still refuses to leave. Give

SRO full description of intruder. (Keep

intruder unaware of call for help if

possible)

❑ Walk away from intruder if he/she indicates a

potential for violence. Be aware of intruder's

actions at this time (where he/she is located in

school, whether he/she is carrying a weapon or

package, etc).

❑ Maintain visual contact with intruder from

a safe distance.

❑ Administrator (IC) may issue

lock-down procedures (see

Lock-Down Procedures section).

Hostage:

❑ If hostage taker is unaware of

your presence, do not

intervene.

❑ Call 911 immediately. Give

dispatcher details of situation;

ask for assistance from hostage

negotiation team.

❑ Seal off area near hostage scene.

❑ Notify Administrator (IC).

❑ Give control of scene to police and

hostage negotiation team.

❑ Keep detailed notes of events.

If taken hostage:

❑ Follow instructions of hostage taker.

❑ Try not to panic. Calm students if they are

present.

❑ Treat the hostage taker as normally as

possible.

❑ Be respectful to hostage taker.

❑ Ask permission to speak and

do not argue or make

suggestions.

31

LOCKDOWN / SHELTER-IN-PLACE

Lock-down procedures may be issued in situations involving dangerous intruders or other incidents that

may result in harm to persons inside school building. The school will practice lock-down drills.

❑ Incident Commander (IC) will issue lock-down order by announcing a warning over PA system,

sending a messenger to each classroom or other alternate method.

❑ Direct all students, staff and visitors into classrooms.

❑ School administration will call 911 if campus safety reaches a level where students, staff and visitors

are in direct danger.

❑ Campus visitor, faculty and staff members are not to use cell phones or other communication devices

to contact the outside during a lock-down. School emergency information must come from designated

school officials.

❑ Lock classroom doors.

❑ Cover windows of classrooms.

❑ Move all persons away from windows and doors.

❑ Have all persons get down on the floor.

❑ All students remain silent during hard lockdown.

Allow no one outside of classrooms until the Incident Commander gives the “all-clear” signal.

32

SERIOUS INJURY / DEATH

If incident occurred in school:

❑ Call 911.

❑ Notify CPR/first aid certified persons in school building of medical emergencies (names of

CPR/first aid certified persons are listed in Crisis Team Members section).

❑ If possible, isolate affected student/staff member.



❑ Activate school crisis team. Designate staff person to accompany injured/ill person to hospital.

❑ Incident Commander notifies parent(s) or guardian(s) of affected student.

❑ Direct witness(es) to school psychologist/counselor. Contact parents if students are sent to

psychologist/counselor.

❑ Determine method of notifying students, staff and parents.

❑ Refer media to Dr. Deborah Swensen (801) 865-2585

If incident occurred outside of school:

❑ Activate school crisis team.

❑ Notify staff before normal operating hours.

❑ Determine method of notifying students and parents. Announce availability of counseling

services for those who need assistance.

❑ Refer media to Dr. Deborah Swensen (801) 865-2585

Post-crisis intervention:

❑ Meet with (school counselor) and (school Administrator) to determine level of intervention for staff and

students.

❑ Contact the Lead Director and school counselor to mobilize the Counselor Charter Crisis

33

team.

❑ Designate rooms as private counseling areas.

❑ Escort affected students, siblings, close friends, and other “highly stressed” students to counselors.

❑ Debrief all students and staff.

❑ Assess stress level of all students and staff.

❑ Recommend professional counseling services to overly stressed students and staff.

❑ Follow-up with students and staff who received counseling.

❑ Designate staff person(s) to attend funeral.

❑ Allow for changes in normal routines or test schedules to address injury or death.

34

SHELTERING PROCEDURES

Sheltering provides refuge for students, staff and public within school building during an

emergency. Shelters are located in areas that maximize the safety of inhabitants. Safe areas may

change depending on the emergency.

❑ Identify safe areas in each school building.

❑ Incident Commander warns students and staff to assemble in safe areas. Bring all persons inside

building(s).


❑ Close all exterior doors and windows.

❑ Turn off any ventilation leading outdoors.

❑ Seal doors, windows, and vents with plastic sheets and duct tape.

❑ Cover up food not in containers or put it in the refrigerator.

❑ If advised, cover mouth and nose with handkerchief, cloth, paper towels or tissues.

❑ Teachers should account for all students after arriving in safe area.

❑ All persons must remain in safe areas until notified by Incident Commander or emergency responders.

35

STAFF RESPONSIBILITIES

Incident Commander (Administrator or designee):

❑ Verify information.

❑ Identify Command Post

❑ Call 911 (if necessary).

❑ Seal off high-risk area.

❑ Convene crisis team and implement crisis response procedures.

❑ Notify Administrator.

❑ Notify students and staff (depending on emergency; students may be notified by teachers).

❑ Evacuate students and staff if necessary.

❑ Refer media to school spokesperson (or designee).

❑ Notify community agencies (if necessary).

❑ Implement post-crisis procedures.

❑ Keep detailed notes of crisis event.

Teachers:


❑ Lock classroom doors, unless evacuation orders are issued.

❑ Warn students, if advised.

❑ Account for all students.

❑ Stay with students during an evacuation. Take class roster.

❑ Refer media to school spokesperson (or designee).

❑ Keep detailed notes of crisis event.

36

STUDENT UNREST

❑ Notify police, if necessary.

❑ Ensure the safety of students and staff first.

❑ Contain unrest. Seal off area of disturbance.


❑ Incident Commander notifies Chief Administrative officer.

❑ Warn staff. Incident Commander may issue lock-down (see Lock-Down Procedures section).

❑ Shut off bells.

❑ Move students involved in disturbance to an isolated area.

❑ Meet with student representatives to address issues.

❑ Document incidents with phone or take detailed notes.

Teachers:

❑ Keep students calm.

❑ Lock classroom doors.

❑ Do not allow students to leave the classroom until you receive an all-clear signal from Incident

Commander.

❑ Make a list of students that are absent from classroom. Document all incidents.

37

SUICIDE

Suicide Attempt in School:


❑ Call 911.

❑ Notify school counselor and Incident Commander (school Administrator)

❑ Incident Commander notifies parent(s) or guardian(s) if suicidal person is student, Incident

Commander may schedule meeting with parents and school counselor to determine course of

action.

❑ Calm suicidal person.

❑ Try to isolate suicidal person from other students.

❑ Ask suicidal person to sign a “no suicide contract”.

❑ Stay with person until counselor or parent arrives. Do not leave suicidal person alone.

❑ Determine method of notifying staff, students and parents. Hold daily staff debriefings

before and after normal operating hours as needed.

❑ Activate school crisis team to implement post-crisis intervention. Determine level of

intervention.

Suicidal Death/Serious Injury:


❑ Activate school crisis team and Lead Director contact Charter network crisis team for additional

support.


❑ Notify staff in advance of next school day following suicide or attempted suicide.

❑ Determine method of notifying students and parents. Do not mention “suicide” or details about death

in notification. Do not hold memorials or make death appear heroic. Protect privacy of family.

❑ Implement post-crisis intervention.

Post-crisis Intervention:

38

Meet with school counselor and school Administrator to determine level of intervention and activation for

staff and students.

❑ Contact school counselor and Lead Director to initiate contact with the school crisis team in the area to

aid in debrief students and staff

❑ Designate rooms as private counseling areas.

❑ Escort siblings, close friends, and other “highly stressed” students to counselors.

❑ Assess stress level of staff. Recommend counseling to overly stressed staff.

❑ Refer media to designated individual. Do not let media question students or staff.

❑ Follow-up with students and staff who received counseling. Resume normal routines as soon as

possible.

39

TERRORIST EVENT

Weapons of mass destruction likely to be employed by terrorists fall into four basic categories: Nuclear,

Biological, Chemical, and Conventional. The below outlined procedures will protect students and staff

should such attacks occur.

Nuclear:

Defense against nuclear weapons depends primarily on distance from the point of detonation. If time

permits:

❑ Move students and staff to specifically identified basement or lower level rooms. Interior hallways

may be used as an alternate.

❑ Close all doors leading into hallways to minimize flying glass.

❑ All people assume the duck, cover and hold position on the ground.

❑ Shut down all utility systems to the building. (Gas and electricity are the priorities)

❑ Shelter in place to protect from fallout if attack is far enough away.

❑ Keep students and staff inside buildings. Allow parents to pick up their children at their own

discretion once cleared to do so by public safety, emergency management, or military

authorities

Biological:

Defense against biological attacks is difficult. Awareness of an attack is usually not possible for days or

weeks. The first signs may emerge as personnel notice a higher than usual incidence of various

symptoms. Should an attack be discovered while in progress the school should:

❑ Reverse-evacuate all people into school buildings.

❑ Shelter in place. (Do not use basements or low lying areas)


❑ Shut down the HVAC system. (Limit airflow from outside)

❑ Seal doors, windows, and vents with plastic and duct tape.


discretion once cleared to do so by public safety, emergency management, or military

authorities.

Chemical:

❑ Reverse-evacuate all people into school buildings.

❑ Shelter in place. (Do not use basements or low lying areas)


❑ Shut down the HVAC system. (Limit airflow from outside)

❑ Seal doors, windows, and vents with plastic and duct tape,

❑ Be prepared to treat students and staff who experience a reaction to the chemical agent.

❑ The decision to evacuate should be made after consulting with public safety, emergency

management, or military authorities.

Conventional:

The danger from the blast effect of conventional explosive devices is similar to nuclear devices with a

higher rate of survivability. If responding to the threat of a imminent blast nearby:

40

❑ Move students and staff to specifically identified basement or lower level rooms. Interior hallways

may be used as an alternate.

❑ Close all doors leading into hallways to minimize flying glass.

❑ All people assume the duck, cover, and hold position on the ground.

❑ Shut down all utility systems to the building. (Gas and electricity are the priorities)

❑ Shelter in place to protect from fall out if attack is far enough away.


discretion once cleared to do so by public safety, emergency management or military authorities

41

WEAPONS

❑ Notify office. Administrator will call police if a weapon is suspected to be in school.

❑ Ask another staff member or school resource officer (SRO), if applicable, to join you in questioning

suspected student or staff member.

❑ Accompany suspect to private office to wait for police.

❑ Conduct search with police or SRO.

❑ Have SRO or police Inform suspect of his/her rights and why you are conducting search.

❑ Keep detailed notes of all events and why search was conducted.

❑ Notify parent(s) or guardian(s) if suspect is a student. Explain why search was conducted and

results of the search.

❑ If suspect threatens you with a weapon, do not try to disarm them. Back away with your arms up.

Remain calm.

42

WEATHER

Severe Weather Watch has been issued in an area near school

❑ Monitor Emergency Alert Stations (see EAS section) or NOAA Weather Stations (National Weather

Service, Weather Channel).

❑ Bring all persons inside building(s).

❑ Close windows and blinds.

❑ Review severe weather drill procedures and location of safe areas. Severe weather safe areas are

under desks and in hallways away from windows and large rooms.

❑ Review "drop, cover and hold" procedures with students.

Severe Weather Warning has been issued in an area near school or severe weather has been

spotted near school

❑ Shut off gas.

❑ Move students and staff to safe areas.

❑ Remind teachers to take class rosters.

❑ Ensure that students are in "drop, cover and hold" positions.

❑ Account for all students.

❑ Remain in safe area until warning expires or until emergency personnel have issued an all-clear

signal.

43

REUNIFICATION PLAN

❑ Parents will pick up their students at the designated location. Depending on the needs of the

situation, possible locations include school building or back field (primary location), the LDS Church

located at 9750 S 2200 W (secondary location ) or the LDS church just east of the school on 1945

West 9000 South.

❑ If reunification occurs inside the school, parents and guardians will enter via the front doors. If

reunification occurs on the back field, parents and guardians will enter at the south gate. If

reunification occurs at the secondary location, parents and guardians will enter at the front doors of

the church building. If reunification occurs at the tertiary location, parents and guardians will enter

at the front doors.

❑ Parents and guardians must present their identification at the designated reunification station setup

by the staff. Staff will be designated as scribes. (In the event a parent or guardian is not available

to pick up a student, emergency contacts as designated in Aspire may also pick up student. The

school will maintain paper copies of student contact information).

❑ Scribes will record all required information on the Student Release Form located in this document.

❑ Designated runners will verify the student’s information matches the information on the student

release form.

❑ Runners will retrieve students from their location and reunite them with their parents.

❏ Students not picked up after 6 hours will have parents contacted. If parents cannot be contacted,

emergency contacts will be notified to pick up student. Notes will be taken on who was contacted

and who picked up the student if the emergency contact picked up the student.

44

APPENDICES & ATTACHMENTS

EMERGENCY CONTACT NUMBERS

Public Safety Agencies

Numb

Number

General Emergency 911

Police/Sheriff/Fire 911

Poison Control 801-222-1222

Hospital Jordan Valley: 801-561-8888

Lone Peak: 801-545-8000

Health Department 801-538-6003

Mental Health 801-538-3939

City Police Dispatch 801-569-6100

Fire Chief 801-260-7300

Other Agencies

Administrator Dr. Deborah Swensen

(801) 865-2585

Applied Technology College (801) 256-5900

Public Transportation 801-743-3882

Emergency Management Director Ryan Dubois

(801) 282-9066

Gas Company (for gas shut off) (801) 324-5111

Public Utility (for water shut off) (801) 254-3742

PacifiCorp (for electricity shut off) (888) 221-7070

Division of Child and Family Services 1-855-323-3237

Child abuse and foster care after hours and holidays 1-855-323-3237

45

Calling Tree for Emergency Notifications

• Lead Director (Debbie Swensen)

• School Board

• Principal (Ryan Dubois)

• Lead Secretary (Lori Brockbank)

• Team Leads

• Team Members

• Grade TA

• Kitchen Manager (Kirsten Dalpaiz)

• Kitchen

• Nelly

• Assistant Principal (Kristi Kunz)

• Special Ed Teachers

• Sp Ed TA's

• Secretary (Tiffanie McDevitt)

• Specialists & Library Staff

46

47

48

NOTICE OF FIRST-AID CARE FORM

DATE: ________________________

SCHOOL: _______________________

Dear Parent:

____________________________ was injured at school and has been given first aid. If you feel further

care is necessary, please consult your family physician.

Destination: (If not presently on site) ________________________________________________________

Transporting Agency: (if not presently on site) ________________________________________________

Time: ________________________

Remarks:

Please sign and return one copy to school. Retain a copy for your records.

___________________________________ ____________________________________________

PARENT'S SIGNATURE SCHOOL REPRESENTATIVE’S SIGNATURE

Note: 1 copy goes home with student

1 copy stays with teacher or medical treatment team records

49

RESOURCE INVENTORY

❑ Communications equipment

❑ Walkie Talkies (6)

❑ First aid supplies

❑ First aid kits (27)

❑ Fire fighting equipment

❑ Extinguishers as per code

❑ Lighting

❑ Flashlights (27)

❑ Classroom emergency kits

❑ Water & Granola kit (27)

50

SAMPLE - EMERGENCY LETTER FOR PARENT

[Date]

Dear Parents:

Should an emergency or disaster situation ever arise in our area while school is in session, we want you to

be aware that the school has made preparations to respond effectively to such situations. In fact, public

schools in Utah are built to meet stringent construction standards, and they may be safer than your own

home in the event of a disaster.

Should we have a major disaster during school hours, your student(s) will be cared for at this school,

The school has a detailed disaster plan which has been formulated to respond to a major catastrophe.

Your cooperation is necessary in any emergency.

1. Do not telephone the school. Telephone lines may be needed for emergency communication.

2. In the event of a serious emergency, students will be kept at the school until they are picked up by an

identified, responsible adult who has been identified as such on an emergency card which is required

to be filled out by parents at the beginning of every school year. Please be sure you consider the

following criteria when you authorize another person to pick up your child at school:

■ He/she is 18 years of age or older.

■ He/she is usually home during the day.

■ He/she could walk to school, if necessary.

■ He/she is known to your child.

■ He/she is both aware and able to assume this responsibility.

3. Turn your radio to 1160am for emergency announcements. If students are to be kept at school, radio

stations will be notified. Impress upon your children the need for them to follow the directions of any

school personnel in times of an emergency.

Students will be released only to parents and persons identified on the School Emergency Card. During an

extreme emergency, students will be released at designated reunion gates located on school grounds.

Parents should become familiar with the School Emergency Disaster Plan and be patient and

understanding with the student release process. Please instruct your student to remain at school until you

or a designee arrives. Because local telephone service may be disrupted, also list an out-of-state contact

on the emergency card, as calls may still be made out of the area while incoming calls are affected.

51

The decision to keep students at school will be based upon whether or not streets in the area are open. If

this occurs, radio stations will be notified.

In case of a hazardous release event (chemical spill) near the school area, Shelter-in-Place procedures will

be implemented to provide in place protection. All students and staff will clear the fields, report to their

rooms and all efforts will be made to prevent outside air from entering classrooms during the emergency.

"Shelter-in-Place" signs will be placed in classroom windows or hung outside classroom doors during a drill

or emergency. Students arriving at school during a Shelter-in-Place drill or event should report to the school

office or to a previously designated area at the school because classrooms will be inaccessible. When the

dangerous incident has subsided, an all-clear signal will be given.

Please discuss these matters with your immediate family. Planning ahead will help alleviate concern during

emergencies.

Sincerely,

______________________________

Administrator

52

NAMES Ra

di

o

Key

s

Har

d

H

at

Go

g

gl

e

s

Buc

k

et

Ves

t

Clip

B

oa

rd

Bac

kp

ac

k

S & R TEAM #1

NOTES:

S & R TEAM #2

NOTES:

53

S & R TEAM #3

NOTES:

S&RTEAM#4

NOTES:

S & R TEAM #5

NOTES:

SEARCH AND RESCUE TEAM FORM

SEARCH AND RESCUE (S & R) TEAM LEADER: ___________________________________________

Note: Number of teams will vary depending on size of campus.

54

■ Assign teams based on available manpower; minimum 2 persons. Attempt to place one experienced

person on each team.

■ Perform visual check of outfitted team leaving Command Post (CP); include radio check. Advice

teams of known injuries.

■ Remain at Command Post table.

■ Be attentive to all S&R related communications.

■ Utilize boxes above to record location of injured students. Example: report of 2 injured students in

Room 20 would be recorded as “S/2 = RM 20” in box under team #3.

■ Utilize manpower pool to aid S&R (i.e., request for backboard and carryout or request for rescue

equipment).

55

SITE PLAN

56

SITE STATUS REPORT

TO: FROM: (name) LOCATION:

DATE: TIME: PERSON IN CHARGE AT SITE:

Message via: 2-way Radio Telephone _________ Messenger

EMPLOYEE/STUDENT STATUS

Absent Injured # Sent to

Hosp./med

Dead Missing Unaccounted for

(Away from site)

# Released

To parents

# Being

supervised

Students

Site

Staff

Others

STRUCTURAL DAMAGE Check damage/problem and indicate location(s).

Check Damage/Problem Location(s)

Gas leak

Water leak

Fire

Electrical

Communications

Heating/cooling

Other (list):

MESSAGE: (include kind of immediate assistance required; can you hold out without assistance/how

long? overall condition of campus, neighborhood & street conditions; outside agencies on campus &

actions; names of injured, dead, missing and accounted for ASAP)

57

STAFF SKILLS SURVEY AND INVENTORY

Name & School / Room

Name School

During any disaster situation, it is important to be able to draw from all available resources. The special

skills, training and capabilities of the staff will play a vital role in coping with the effects of any disaster

incident. These will be of paramount importance during and after a major or catastrophic disaster. The

purpose of this survey/inventory is to pinpoint those staff members with equipment and the special skills

that might be needed. Please indicate the areas that apply to you and return this survey to your

administrator.

PLEASE CHECK ANY OF THE FOLLOWING IN WHICH YOU HAVE EXPERTISE & TRAINING. CIRCLE

YES OR NO, WHERE APPROPRIATE.

_______ First Aid (current card y/n) _______ CPR (current y/n) _________ Triage

_______ Running/jogging _______ Emergency planning _______ Emergency Management

_______ Search & Rescue _______ Law Enforcement _______ Mechanical Ability

_______ Shelter Management _______ Survival Training & Techniques _______ Food Preparation

_______ Ham Radio Operator _______ CB Radio _______ Journalism

_______ Camping _______ Waste Disposal _______ Recreational Leader

_______ Structural Engineering _______ Bus/Truck Driver (class 1 or 2 license y/n)

_______Construction (electrical, plumbing, carpentry, etc.) _______ Firefighting

_______ Bi/Multi-lingual (what language(s) ________________________________________________

DO YOU KEEP A PERSONAL EMERGENCY KIT? in your car? in your room?

DO YOU HAVE MATERIALS IN YOUR ROOM THAT WOULD BE OF USE DURING AN

EMERGENCY? (i.e., athletic bibs, traffic cones, carpet squares) _________Yes _______ No

DO YOU HAVE EQUIPMENT OR ACCESS TO EQUIPMENT OR MATERIALS AT YOUR SCHOOL

SITE THAT COULD BE USED AN IN EMERGENCY? _______YES _______ NO P

PLEASE LIST EQUIPMENT AND MATERIALS.

_____________________________________________________________________________________

_____________________________________________________________________________________

58

_____________________________________________________________________________________

COMMENTS __________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

WHAT WOULD MAKE YOU FEEL MORE PREPARED SHOULD A DISASTER STRIKE WHILE YOU

WERE AT SCHOOL?

_________________________________________________________________________________

_________________________________________________________________________________

59

STUDENT ACCOUNTING FORM

Room No: Date:

Enrolled per register: Reported by:

Not in school today: Received by:

Present now: ___________________________________

1. Students or classroom volunteers elsewhere (off campus, left in room, other location, etc.)

Name Location Problem

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

2. Students on playground needing more first aid than you can handle:

Name Location Problem

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Additional comments: (report fire, gas/water leaks, blocked exits, structural damage, etc.)

60

STUDENT RELEASE FORM

(To be taken by Runner)

Please Print

Student's Name

Teacher Grade

Requested By

********************************************************************************************

To be filled in by Request Gate staff

Proof of I.D. Name on Emergency Card _______________________________

(yes) (no)

********************************************************************************************

Student's Status

To be filled in by teacher

Sent with Runner Absent First Aid Missing __________________

*******************************************************************************************

To be filled in by Request Gate staff

Proof of I.D. Name on Emergency Card ________________________________

(yes) (no)

*********************************************************************************************

To be filled in by Requester

At Release Gate

Requester Signature _____________________________________________________________

Destination:

Date: ____________________________

Time: ____________________________

*********************************************************************************************

Notes:

61

UPDATE REPORTS

Update Report

Name

Time

___________________________

_________# children remaining

at school

_________# staff members

remaining to care for children

Assistance required: water

food blankets

# people to help

Update Report

Name

Time

__________________________

__________# children remaining

at school

__________# staff members

remaining to care for children

Assistance required: water

food blankets

# people to help

Update Report

Name

Time

__________________________

62

__________# children remaining at school

__________# staff members remaining to care for children

Assistance required: water food blankets . # people to help

Update Report

Name Time __________________________

__________# children remaining at school

__________# staff members remaining to care for children

Assistance required: water food blankets # people to help

63

Documents

Hawthorn Academy - Amazon Web Services