General Department Information

Number of teachers in science department

Number of teachers with safety training

Number of teachers with first-aid training, and type of training

Number of science laboratories

Number of science classrooms

Number of combined science classrooms/laboratories

Classroom information – choose one of the rooms that you will be working in and answer the following questions.

Safety and laboratory rules posted

Student safety contracts on file

Phone or other type of access to emergency help accessible

Accident/Incident reporting procedure posted or well documented that all teachers know protocol.

Recommended student capacity

Actual student capacity

Number of exits per laboratory

Locate exits by layout diagram – attach a diagram of classroom.  With approximate scale and/or dimensions.  You will be asked to identify location of several different things on this diagram.

Are exits properly marked?

Yes

No

Fire Safety

Number of fire extinguishers (total)*

*Mark locations on classroom diagram

Number of fire extinguishers  - CO₂

Number of fire extinguishers  - Soda Acid

Number of fire extinguishers - BC

Number of fire extinguishers - ABC

Number of fire extinguishers - Water

Number of back up extinguishers in storage

Last inspection date for fire extinguishers or when last tested.  Level of charge for each fire extinguisher – if appropriate gage is attached.

Number of sand buckets w/sand*

*Mark locations on classroom diagram

Number of approved fire blankets*

*Mark locations on classroom diagram

Number of gas burners

Number of alcohol burners

Number of candles, if used

First Aid Kits

Number of first aid or emergency charts*

*Mark locations on classroom diagram

Number of first aid kits w/supplies*

*Mark locations on classroom diagram

Inventory a typical kit found in laboratory and list the materials provided?

Do a quick inventory of other kits – do they seem complete or what types of things are they missing?

Safety Showers

Number of safety showers*

*Mark locations on classroom diagram

Are they operational? 

How often are they tested?

Industrial type

Hand or portable type

Eye Wash Stations

Installed with plumbing aerifier*

*Mark locations on classroom diagram

Squeeze bottle type*

*Mark locations on classroom diagram

Other*

*Mark locations on classroom diagram

Are they checked regularly to determine operability?

Yes

No

Eye, Face and Body Protection

Number of approved safety goggles w/full side shields

Number of approved safety chemical goggles

Number of approved plastic face shields

Number of demonstration safety shields

Does each student have his/her own personal eye protection device?

Yes

No

If answer is “No” is there a maintenance and cleaning program/policy?  Location of UV sterilizing cabinet – marked on map

Yes

No

Number of rubber gloves (pairs)

Number of asbestos gloves (pairs)

Number of rubber/plastic/cloth aprons

Number of lab coats

Electrical/Water/Gas/Ventilation Facilities

Number of electric outlets (110-120 with ground)*

*Mark locations on classroom diagram

Number of electric outlets (110-120 without ground)*

*Mark locations on classroom diagram

Is provision made for proper grounding of all electrical devices?

Yes

No

If no please describe…

Is there a master cut off for electricity?

Yes

No

Do you know where it is?

Yes

No

Is it accessible?

Yes

No

Number of compressed gas cylinders

Types of compressed gas cylinders – contents

Are they properly secured to prevent tipping?

Yes

No

Number of gas outlets*

*Mark locations on classroom diagram

Is there a master cut off for gas?

Yes

No

Do you know where it is?

Yes

No

Is it accessible?

Yes

No

Number of sinks*

*Mark locations on classroom diagram

Is there a master cut off for water?

Yes

No

Do you know where it is?

Yes

No

Is it accessible?

Yes

No

Number of fume hoods

Rates exhaust velocity-cfm if known

Is fume hood rated explosion proof?

Yes

No

Number of exhaust fans

Rates exhaust velocity-cfm if known

Storage and Waste Disposal

Number of waste receptacles for glass*

*Mark locations on classroom diagram

Number of waste receptacles for dry chemicals/reagents*

*Mark locations on classroom diagram

Number of waste receptacles for liquid chemicals/reagents*

*Mark locations on classroom diagram

Number of containers designed to transport dangerous reagents or chemicals*

*Mark locations on classroom diagram

Are all waste receptacles properly marked?

Yes

No

Are all waste receptacles easily located?

Yes

No

Number of securable storage spaces for chemicals w/forced ventilation

Number of securable storage spaces for chemicals without forced ventilation

Are chemicals stored following accepted guidelines?

Number of special cabinets to store hazardous or flammable chemicals

Location of MSDS forms

Number and location of biohazards waste disposal containers

Location and type of autoclave

Additional Facilities/Equipment/Practices

Number of electric refrigerators

Briefly describe what type of materials are stored in these units, such as reagents, food, etc.

Number of drinking fountains in classroom

Is food preparation/consumption/storage permitted in laboratory

Yes

No

Are the floors non-skid

Type of floor covering

Is there sharp edged furniture in lab

Are animals used in the classroom?

Are there proper facilities to handle them and maintain them?  Describe…

Are biohazards involved in animal handling posted and understood by all responsible?

Are experiments conducted using biologic fluids?

What is the source?

Is there a biohazards kit accessible?*

*Mark locations on classroom diagram

Are students permitted to handle pathogens?

Yes

No

Policy and procedure for handling pathogens

Describe facilities available to accommodate handicapped students

Is there a documented procedure for field trips – location of manual?