Safety Manual

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Table of Contents Introduction .................................................................................................................................................. 6

Phoenix Children’s Academy’s Occupational Health and Safety Policy Statement ........................ 7

Health and Safety Policy ........................................................................................................................... 8

General Safety .......................................................................................................................................... 11

Facility Inspections ................................................................................................................................... 13

Safety and Health Training ..................................................................................................................... 14

Basic Safety Procedures: ........................................................................................................................ 15

Emergency Procedures and Preparedness ......................................................................................... 17

Emergency Preparedness Team ........................................................................................................... 18

Emergency Preparedness Plan for Early Care and Education Centers .......................................... 20

Emergency Notification ........................................................................................................................... 23

Evacuation Away from the Center ......................................................................................................... 29

Medical Emergencies .............................................................................................................................. 31

Fire .............................................................................................................................................................. 34

Hazardous Materials ................................................................................................................................ 35

Random Acts of Violence ........................................................................................................................ 36

Missing Child ............................................................................................................................................. 38

Suicide Intervention ................................................................................................................................. 38

Emergency Lockdown or Unwanted Intruder ....................................................................................... 39

Media Guidelines ...................................................................................................................................... 40

Emergency Phone Numbers .................................................................................................................. 41

Emergency Evacuation Plan .................................................................................................................. 42

Emergency Kits and Supplies ................................................................................................................ 43

Guidelines on Handling Medical Emergencies .................................................................................... 44

Procedures for Conducting a Fire Drill .................................................................................................. 45

Bomb Threat Report ................................................................................................................................ 46

Organizational Roles and Responsibilities ........................................................................................... 47

Emergency Drill Log ................................................................................................................................. 49

Fire Safety Plan ...................................................................................................................................... 50

Safety Coordinator’s Fire Drill Log ......................................................................................................... 51

Fire Preventative Measures .................................................................................................................... 52

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Fire Drills .......................................................................................................................................... 53

Fire Extinguishers ............................................................................................................................ 54

Fire Drill Log .............................................................................................................................................. 55

Role of the Safety Coordinator ............................................................................................................... 57

Safety Coordinator Policy ....................................................................................................................... 59

Safety “What-To-Dos” .............................................................................................................................. 60

Short Employee Safety Meetings .......................................................................................................... 61

12 Rules of Successful Safety Meetings .............................................................................................. 62

Establishing an Effective Safety Committee ........................................................................................ 65

Plan Before an Accident Occurs ............................................................................................................ 67

Teacher’s Classroom Safety/Sanitation Checklist .............................................................................. 68

Safety Sanitation Inspection Checklist .................................................................................................. 70

Safety Inspection ...................................................................................................................................... 73

Setting Up a Safety Incentive Program ................................................................................................. 76

Safety Program ................................................................................................................................. 78

Promoting the Safety Incentive Program .............................................................................................. 87

Employees Safety Suggestions ............................................................................................................. 88

Safety Coordinator – Agendas ............................................................................................................... 89

Safety Awareness Ideas ......................................................................................................................... 90

Injury Prevention....................................................................................................................................... 92

Ready, Set Lift Skills ................................................................................................................................ 92

Skills to Master ......................................................................................................................................... 92

Preventing Slips and Falls Through Effective Floor Care .................................................................. 97

Basic Fall Incident Analysis Spreadsheet .......................................................................................... 103

Maintenance Log .................................................................................................................................... 105

Quarterly Maintenance Checklist ......................................................................................................... 106

General Maintenance Reporting .......................................................................................................... 107

Daily Van Maintenance Checklist ........................................................................................................ 108

Daily Bus Maintenance Checklist ........................................................................................................ 109

Playground Safety .................................................................................................................................. 112

Regional Playground Safety Check Report ........................................................................................ 113

Playground Safety Checklist ................................................................................................................. 114

Teacher / Child Interaction .................................................................................................................... 115

Seasonal Inspection List for Childcare Outdoor Settings................................................................. 116

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Playground Maintenance Reporting .................................................................................................... 118

Staff Responsibilities ............................................................................................................................. 119

Playground Pre-check ........................................................................................................................... 123

Daily Playground Log ............................................................................................................................. 124

Heat Illness Prevention Plan ................................................................................................................ 126

Worker’s Compensation and General Liability .................................................................................. 131

Employer’s School ................................................................................................................................. 131

Employer’s Guide to Workers’ Compensation ................................................................................... 132

Telephone Reporting ......................................................................................................................... 133

Claims Investigation .......................................................................................................................... 138

Accident Investigation ............................................................................................................................ 140

Accident Investigation Report Form .................................................................................................... 141

Activities When an Illness or Injury Occurs ........................................................................................ 146

Transitional Duty..................................................................................................................................... 148

Transitional Duty Progress Form ......................................................................................................... 150

Modified Duty Assignment Orientation Acknowledgement .............................................................. 152

Claim Case Management – Bringing Claims to Closure .................................................................. 153

General Liability Claims ......................................................................................................................... 155

Introduction .............................................................................................................................................. 155

Incident Accident Report ....................................................................................................................... 158

Motor Vehicle Procedures ..................................................................................................................... 160

Daily Van Maintenance Checklist ........................................................................................................ 162

Daily Bus Maintenance Checklist ........................................................................................................ 163

Motor Vehicle Policies and Procedures .............................................................................................. 165

MVR Instructions .................................................................................................................................... 166

Motor Vehicle/Bus Accidents ................................................................................................................ 172

Student Liability ...................................................................................................................................... 176

Summer Time Safety Tips .................................................................................................................. 176

Dealing with Divorce and Custody Issues .......................................................................................... 179

Americans with Disabilities Act ............................................................................................................ 180

Student Liability Insurance ............................................................................................................. 181

Student Accident Helpful Hints ............................................................................................................. 182

Chartis Claim Form Instructions ........................................................................................................... 183

Laundry Room Safety ............................................................................................................................ 189

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Fire Protection......................................................................................................................................... 189

Food Preparation .................................................................................................................................... 192

Safety in the Kitchen .............................................................................................................................. 193

Food Preparation .................................................................................................................................... 198

Hand Washing ............................................................................................................................... 199

Forms ....................................................................................................................................................... 201

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Introduction

It is the policy of Phoenix Children’s Academy (PCA) that prevention shall be considered of primary importance in all phases of operation and administration. This is a program that we expect Regional Directors and Directors to promote and manage in each of their locations. It is the intention of the Company’s Top Management to provide safe and healthy working conditions and to establish and insist upon safe practices at all times with and by all team members. The prevention of accidents is an objective affecting all levels of the Organization and its activities. It is a basic requirement that each Director make the Safety of Employees an integral part of their regular management functions. It is equally the duty of each employee to accept and follow the established safety regulations and procedures. Every effort will be made to provide adequate training to employees. However, if an employee is ever in doubt about how to do a job safely, it is their duty to ask a qualified person for assistance. Likewise if a Director and/or Supervisor witnesses an employee doing their job wrong and they are at risk of injury, they must help the employee immediately and teach them the correct procedure and the policy on the item they saw them doing incorrectly. Any injury, which occurs on the job, must be reported to management as soon as possible. Under no circumstances, except an emergency, should an employee leave a shift without reporting an injury. Management must then notify Human Resources of the injury. When you have an accident, everyone loses; you, your family, our fellow workers and the Company. Working safely is the only option in our schools – we want to give our employees the safest and best place to work! The Purpose of this Book: This book is your go-to guide for anything related to Safety. This manual must be kept in a visible position where the Director and Safety Coordinator (as well as anyone who may find it useful) know where to find it at any time. This manual will walk you through reporting procedures, forms needed to report, training materials and everything you need to keep your school safe.

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Phoenix Children’s Academy’s Occupational Health and Safety Policy Statement

Policy Statement: Phoenix Children’s Academy (PCA) believes in its people and is vitally interested in the Health and Safety of its employees, children, families, visitors and the general public. In order for our employees to provide excellent quality care to the families they serve, everyone must play an integral part in ensuring that the environment in which they work is free from Health and Safety Hazards. PCA places the safety and health of our team members and students as the first consideration in operating our school system. A “Safety Program” policy has been adopted by PCA and this policy along with additional safety procedures is set forth in this manual. While no program guarantees an accident-free workplace, following these safety procedures will significantly reduce the risk of danger to you and your co-workers. Philosophy: PCA believes that all workers are entitled to a safe workplace. The safety of team members, students, patrons, and the general public are of paramount importance. It is the desire of PCA to provide safe and healthy working conditions, safe equipment, proper materials, and to establish and insist upon safe methods and practices at all times by all team members. Accident prevention shall be considered of primary importance in all phases of operation and administration. It is the intent of PCA to comply with all safety and health laws and ordinances relating to the operation of the school. It is the objective of PCA to implement a safety and health program that will reduce the possibility of accident occurrence and occupational-related illness. PCA believes that most, if not ALL, accidents are preventable. To Give Effect To This Program:

1. Management along with the Safety Coordinator must be committed to ensuring that all possible hazards are eliminated. This is done through a daily visual inspection and monthly inspections. Continuous follow up on Health and Safety Committee recommendations, ongoing and new team member training, evaluation of job tasks and communication with the employees.

2. A safe environment must be maintained through a comprehensive and effective maintenance and education program. This ensures that when hazards arise that they are dealt with promptly.

3. It is the responsibility of all team members to report to their Director and/or Assistant Director any illnesses, injuries or any known or potential hazards in the workplace. It is also the responsibility of the team members to work within the guidelines and practices that are determined by PCA for the health and safety of all employees.

4. It is the responsibility of all Directors, Assistant Directors and the Safety Coordinator to ensure that all job tasks are safe for the employees to perform, that safe and healthy work conditions are maintained and to educate all team members on how to identify potential hazards and the way in which to avoid them.

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Health and Safety Policy Team Member Roles and Responsibilities: Role: It is the responsibility of the Team Members to report to their Director and/or immediate supervisor (including the Safety Coordinator) any illnesses, injuries or any known or potential hazards in the workplace. It is also the responsibility of each team member to work within the guidelines and practices that are determined by Phoenix Children’s Academy (PCA) for the health and safety of team members. RESPONSIBLITIES:

1. Team Members are responsible for becoming familiar with the Occupational Health and Safety Act and appropriate legislation and working in compliance of its said provisions.

2. Team Members are responsible for the reporting of any unsafe practice, procedure or

device to their immediate supervisor.

3. Team Members are responsible for attending any educational workshops conducted in the workplace.

4. Team Members are responsible for ensuring prompt reporting of any injury, illness and/or any accident/incident to their Director/Supervisor (or Safety Coordinator).

5. Team Members are responsible when performing the duties of the work required taking into account all safe working practices and conditions set forth by PCA and appropriate legislation.

6. Team Members are responsible for assisting the Safety Coordinator in obtaining and discussing any necessary information for completion of the monthly calendar inspections.

7. Team Members are responsible for learning the policies and procedures, including the evacuation procedure and any other safety measures listed or set out in the provided manuals.

8. Team Members are responsible for wearing any protective equipment, device or clothing necessary as supplied and directed by PCA.

9. Team Members are responsible for following PCA guidelines for the proper lifting techniques.

10. Team Members are responsible for following the smoking guidelines as set out by PCA and appropriate legislation.

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Communication: It is PCA’s policy to maintain open communications between management and team members on matters pertaining to safety. Your thoughts regarding safety are considered important and we encourage your active participation in our Company’s Safety Program. Please feel free to express any of your concerns or suggestions during safety meetings, to your Director, Assistant Director or the Safety Coordinator. If preferable this may be done in writing on the Safety Suggestion Form (this will allow for you to remain anonymous but will make it difficult to provide you special recognition before your suggestion is put into action). In turn, the Company will provide current safety information, guidelines, signs, posters and a place to post documents for all employees to see. Also, regular safety meetings will be held so that all employees have an opportunity to receive safety training and voice personal observations regarding safety.

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SAFETY 101

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General Safety

Rules: For the protection and safety of all team members, we have established the following rules designed to prevent accidents and injuries. Compliance with these rules is mandatory.

1. All accidents and injuries must be reported to the Director or Assistant Director at the time of the occurrence and reported to the appropriate agency; as well as to Human Resources.

2. All spilled water, oil, paint, other liquids and food spills must be wiped up immediately. Regardless of who did the accident anyone who sees is responsible to clean it up immediately.

3. Any obstacles, toys or potentially hazardous objects must be picked up and put in their proper place immediately.

4. Any defective equipment must be immediately reported to the Director or Assistant Director. Approval to replace the equipment must be done by the Regional Manager.

5. Machines or equipment shall not be operated until you have received proper training and instructions on how to operate the equipment.

6. Failure by any employee to comply with the safety rules will be grounds for disciplinary action up to and including termination.

Material Handling:

1. Attempting to lift or push an object, which is too heavy, must be avoided. Ask for assistance when help is needed to move a heavy object. NEVER attempt to move anything you are not capable of moving.

2. When carrying material, caution must be exercised in observance of obstructions, loose material, etc. Never carry more material than you can see beyond or that blocks your vision/path.

3. All materials must be stored in proper areas. 4. Materials will not be stored in aisles/hallways. Aisles/hallways must be kept clear at

all times. 5. All Exit doors must be kept clear and accessible per the law.

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Housekeeping:

1. The foundation to all safe schools is housekeeping. 50% of all accidents would not happen with proper housekeeping. This is the number one cause of trips and falls.

2. Materials and equipment will be kept out of hallways. Materials will not be stored against doors, exits or fire extinguisher stations.

3. Tools, cleaning supplies and other equipment will be returned to the proper storage area immediately after use.

4. Tools will be kept dry, spilling of goods will be avoided, and all spills will be wiped up immediately. Walking by a spill is against the Company’s Safety Policy. Everyone must work together to ensure that proper housekeeping is a priority in their school.

5. Trash and scraps will be thrown in waste containers. A messy classroom is an accident waiting to happen. Take time to clean after projects, lunch, playtime, etc.

6. Good housekeeping practices will be exercised within each employee’s work area. As well as the Company expects all employees to work as a team ensuring a safe school and playground for all.

Chemicals:

1. Chemicals meeting the definition of “Hazardous Material”, as defined by the OSHA Safety and Health Regulations, will not be purchased and/or brought into the school for usage without:

a) Material Safety Data Sheets (MSDA for OSHA-20) or equivalent on file and b) Expressed consent or approval of the designated School Safety Coordinator.

2. All containers must be clearly labeled with their contents. Fire Emergency:

1. All fires must be reported immediately. Fire Emergency Numbers will be called and locations given.

2. All Employees must know the location of and how to use a fire extinguisher. 3. Tampering with fire extinguishers is against Company Policy and will result in

disciplinary action up to and including termination. 4. Fire extinguishers, fire pulls and fire exits will not be blocked by supplies or equipment at

any time. 5. Smoking is not permitted at any facility or on school property.

Medical Emergency:

1. All medical emergencies must be reported immediately. Medical Emergency numbers will be called and location of emergency given.

a) If the emergency is related to Workers’ Compensation or to Student Liability, Human Resources must be alerted to the accident as soon as possible.

b) Forms are provided in this manual for those accidents (see specific section as well as forms section in back of manual. Forms are also located on the Intranet).

c) Any questions regarding a Workers’ Compensation, General Liability or Student Liability Accident should be referred to Human Resources.

2. The person reporting the emergency must stay on the telephone line until released by the answering party.

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Facility Inspections

Weekly inspections are to be conducted by the School Director/Principal working with their Safety Coordinator and the daily calendar. All items that need to be replaced are to be written on the maintenance log and discussed with the assigned Maintenance Person (or a person will be called in to do the job with the approval of the Regional Director). Repairs that fall out of the scope of “normal maintenance” are to be addressed with your Regional Director. Results of the inspections will be reviewed with the Safety Coordinator and addressed according to priority. Problems identified by each inspection will be corrected immediately or by a specific date and time as directed by the Safety Coordinator. All daily, weekly and monthly inspection results will be discussed during Company Safety Meetings. Employees are encouraged to discuss and bring forward their ideas and thoughts regarding any safety items mentioned or of concern to them. A record of all safety inspections will be kept at the school site and a copy sent to the Regional Director and Human Resources at the Corporate Office. An accident investigation report will be completed by the Director or Safety Coordinator (if available) on EVERY accident occurring at the site and a copy forwarded to the Regional Director and Human Resources once complete. An annual report of accidents and a claims analysis shall be completed and maintained by the School Director or Safety Coordinator. Records will be maintained on each accident, injury, or occupational-related illness requiring medical treatment in accordance with the requirements of the Occupational Safety and Health Act (OSHA). A summary of all reported injuries or illnesses will be posted for one month no later than February 2 of each year on OSHA Form 300, and the records will be maintained for five years from the date of preparation. This will be done once they are sent into the office and will be maintained on a secure computer file. The Safety Coordinator will maintain records of all required employee training, hazards, identifications, abatements, and accident investigation reports. The Safety Coordinator is responsible for obtaining a file of Material Safety Data Sheets (MSDS) on potentially hazardous materials. Vehicle and Power Equipment Inspections All Company vehicles and individual power machinery will be inspected daily by its operators. Inspection forms are available from the Safety Coordinator for documenting inspections of all Company vehicles inspections include: brakes, lights, tires, turn signals, safety belts and wind- shield wipers.

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Safety and Health Training

All new employees must undergo an initial orientation on Safety in order to be instructed in:

• General Company Safety Rules and Policies o Results of not following the Rules and Policies

• Safe Work procedures All employees will be required to take quizzes after covering certain subjects and copies will be kept in their files. Any violations of Safety Rules and Policies will result in additional training or Disciplinary Action up to and including termination. In addition, other work related education is included in the Orientation process. Full written instructions are provided in the Company Employee Handbook, job descriptions, daily operating guidelines, on the Intranet and other documentation as deemed necessary. The Safety Training Program for all new employees will consist of:

1. An initial training period which will include individual instruction on the safe use of equipment to be used and operated, accident reporting procedures, worksite and all other miscellaneous safe work practices.

2. Routine reinforcement of safe performance of individual work assignments. a) Violations could result in Disciplinary Action.

3. Proper use and care of required protective equipment (such as gloves). a) Violations could result in Disciplinary Action.

4. Hazard communication when hazardous chemicals are to be used. 5. Safe lifting techniques.

The Safety Training Program is also intended to provide general and specific job safety training to existing Company personnel. To insure that all employees receive appropriate job safety training, all Company employees will participate in:

• Scheduled Staff Meetings, which include safety meetings. • Additional training as job duties or work assignments are expanded or changed.

o Also additional training may be assigned dependent upon the situation. Further training will be provided whenever employees are exposed to a new process or when previously unrecognized hazards will have an effect on their safety and health. Records of all of the above training will be kept in the Employee’s Personnel file and checked monthly by the Safety Coordinator and quarterly by the Regional Managers.

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Basic Safety Procedures: 1. GET PROPER TRAINING. Ask questions. Doing the job right = doing the job safely. 2. USE YOUR HEAD (not literally). Concentrate on what you are doing and good judgment

will prevent accidents. 3. DRESS RIGHT. Loose or torn clothing, jewelry, long hair, improper shoes and some

types of fabrics can be dangerous in certain situations. Follow the School’s dress code. 4. FOLLOW ALL SAFETY RULES. These rules are a part of your job and part of the

Company’s Policies and Procedures. To not follow them could result in Disciplinary Action up to and including termination.

5. LIFT CORRECTLY. Back injuries can be painful, costly, and cause permanent disability. 6. KNOW ALL ABOUT TOXIC MATERIALS. Request “Material Safety Data Sheets” from

your supervisor on any toxic materials you are exposed to. Read labels for all products you use.

7. USE PERSONAL PROTECTION. Always use appropriate protection for eyes, lungs, head, skin, heating, etc.

8. KEEP YOUR AREA CLEAN. Prevent slips, trips, falls and fires. 9. USE THE RIGHT TOOLS. Never use defective tools or equipment. 10. KNOW EMERGENCY PROCEDURES. Know what to do before an emergency occurs. 11. REPORT ALL INJURIES. Immediately report all work-related injuries to your

Supervisor. Only work-related injuries are covered by “Workers’ Compensation”. If the injury or illness did not occur as a result of the job, it is not covered by Workers’ Compensation.

a. However regardless of where the injury occurred we do require all team members to bring a Doctor’s not showing their restrictions. It is up to the Regional Director and Director as to whether or not we can accommodate the injured worker’s restrictions.

12. WORK SAFELY. When you have an accident, everyone loses you, your fellow workers and the Company.

Safety Communication It is the Company’s policy to maintain open communication between Management (including but not limited to Directors, Assistant Directors and Regional Managers), Employees and Human Resources on matters pertaining to Safety. Your thoughts regarding safety are considered important, and we encourage your active participation in the Company’s Safety Program. Please feel free to express any of your suggestions, concerns and/or ideas during Safety Meetings, or to your Director and/or Assistant Director. If you are not comfortable with discussing an issue with your Director and/or Assistant Director you can contact Human Resources where it will be kept confidential. If you do want it to remain confidential it will be difficult to provide you special recognition before your suggestions is put into action. Be assured that all Safety Suggestions will be given serious consideration and that each will receive a response. In turn, The Company will provide current Safety News and activities, Safety Reading Materials, Signs, Posters and a bulletin board for easy access to them all. Also, regular Safety Meetings will be held so that all employees have the opportunity to receive Safety Training and voice personal options regarding safety.

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CRISIS

MANAGEMENT POLICY &

PROCEDURES

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Emergency Procedures and Preparedness

Emergency Preparedness Overview: The key to successfully handling any emergency situation is to be prepared!! This section includes a comprehensive plan which gives each center the tools to be prepared to handle an emergency.

1. It is imperative that every center prepare and practice an “Emergency Response Plan”. 2. All information in this section must be filled out by the Director or Assistant Director (see

following pages) and reviewed at an “All Staff” meeting so everyone understands their roles and responsibilities.

3. Create an “Emergency Team”, decide who will be responsible for: a) Overall direction (Director), analyze type activity required. b) Food Supply (Cook), assess quantity, preparation, conservation, special needs. c) Communication (Director and Assistant Director) contacting local authorities,

Regional Director and parents. d) First Aid (Safety Coordinator) responsible for securing children’s medication and

first aid kit(s). e) Building control (Director), someone to be prepared to direct emergency vehicles

to proper entrance/exit of building, check building for security. 4. Ensure the center has updated phone numbers for all parents including emergency

contact numbers. 5. Ensure all information is updated weekly in the Emergency Contact Binder. 6. Ensure your First Aid Supplies are replenished and available. 7. Ensure each and every room has the Emergency Information procedures posted above

the Fire Extinguishers. 8. PRACTICE! PRACTICE! PRACTICE!

a) Building evacuation (your fire drills). b) “Shelter in Place” (your tornado drills). c) Each room should compile an “Emergency bag” with extra diapers, containers for

baby bottles, flashlights, etc. 9. Obtain information of a nearby building to be used as an evacuation site as well as

written permission. Include written directions to site. 10. Prepare a written Emergency Evacuation Transportation Plan which includes the name

of the evacuation site to be signed by parents.

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Emergency Preparedness Team NOTE: Each position should have two (2) different people appointed in cases where one individual might be absent/away from the center during a crisis. The two (2) individuals should plan and act as one.

1. Operations Management a. Team Leader/Alternate b. Members

i. Determine appropriate actions for students, i.e. evacuate school buildings, lock down, etc. Collect, analyze information; provide overall direction for all activities that occur during an emergency.

1. Name: ______________________________________________

2. Name:_______________________________________________

2. Communications a. Team Leader/Alternate b. Members

i. Maintain communications with local authorities, local news and communicate with all parents.

1. Name: ______________________________________________

2. Name: ______________________________________________

3. First Aid a. Team Leader/Alternate b. Members

i. Determine need for, request assistance, provide overall direction for emergency functions as appropriate. Collect all information concerning injuries, facility damage, assessment, etc. report to the Director.

1. Name: _______________________________________________

2. Name: _______________________________________________

4. Food, Water and Supply Management a. Team Leader/Alternate b. Members

i. Assess food preparation, adequacy of available water, food, blankets, other supplies.

ii. Control conservation of water. iii. Establish list and determine needs. Report to Director.

1. Name: ______________________________________________

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2. Name: ______________________________________________

5. Building Control a. Team Leader/Alternate b. Members

i. Check building, determine safety of exit/entrance, and report to the Director.

ii. Be prepared to direct emergency vehicles to proper entrance for access.

1. Name: _______________________________________________

2. Name: _______________________________________________

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Emergency Preparedness Plan for Early Care and Education Centers Introduction: The intent of this plan is to assist the Child Care Director and Staff in responding to emergency situations, provide information that can be used with family members concerning emergency planning, and provide a basis for restoration of services. The Director and staff of each Center are considered responsible for the Safety of the Children and will coordinate actions and/or requirements with community public safety officials, Sponsor or Landlord’s security and facilities, and families/guardians. Note: if location licensing regulations require more than this Emergency Response Plan, the licensing requirements will prevail. In addition, Sponsor emergency plans take the place of this plan where applicable. Emergency Response Organization Where applicable the Center’s Emergency Response Plan is integrated into the Sponsoring Organization/Landlord’s Emergency Response Plan (i.e. if you are in a center with other vendors surrounding you). Emergency instructions and directions will be taken from the Sponsoring Organization/Landlord and/or the local emergency agency at event scenes at or near the Center. In the event of an emergency, the Director will oversee the situation at the Center. The roles have been divided in an earlier part of this section, all teams report to the Director and/or Assistant Director in the Director’s absence. The Emergency Response Plan shall be reviewed periodically for modifications to the procedures, changes of key personnel or other resources, and additions of new emergency management information. The Emergency Response Plan shall be controlled by the Center Director along with help from the Safety Coordinator to ensure appropriate updates, changes, and reviews are incorporated in all distributed copies of this plan. A copy of the plan shall be maintained by the following:

1. Center Director’s Office 2. Center’s Assistant Director 3. Center’s Staff Room 4. Safety Coordinator 5. Sponsor Liaison or Landlord 6. Additional Sponsor Representative

The following situations will be covered by this policy:

1. Evacuation Procedures and Process 2. Sheltering/Sheltering Place 3. Medical Emergencies 4. Natural disaster, hurricane, tornado, severe storms 5. Utility disruption 6. Fire/smoke emergencies 7. Hazardous materials 8. Bomb threat 9. Suspicious Articles

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10. Potentially Violent Situations 11. Random Acts of Violence 12. Disgruntled Impaired Parents/Guardians, or Parent’s/Guardian’s Authorized

Representatives 13. Hostage situations 14. Missing Child

*For earthquake information, please refer to specific state requirements. Overall Operational Crisis/Emergency Roles & Responsibilities In the event of an emergency situation, the Center Director shall declare an Emergency Situation and institute the appropriate response actions. In the event the Director is not available, the Assistant Director or Safety Coordinator will take over. Center Director: ______________________ Safety Coordinator: ______________________

1. Work with Sponsor/Landlord and local emergency agencies to arrange for evacuation locations and transportation away from the Center (ONLY if necessary and part of your Emergency Plan).

2. Familiarize all staff with the crisis/emergency response plan and ensure effective implementation.

3. Ensure that the Center’s practice drill program is implemented and documented. 4. Ensure supplies and equipment are present and checked at least monthly. 5. Review each crisis/emergency situation to ensure that proper reports are completed and

appropriate action is taken to prevent repetition of any ineffective efforts. 6. Act as a Team Leader in a crisis/emergency situation. Identify the emergency situation

and determine the course of action. 7. Activate contact with Sponsor Security and/or other local authorities to inform Center of

potential or existing crisis/emergency situation. Assistant Director: ___________________________ The responsibilities of the person Next in Charge (a.k.a. Assistant Director of Safety Coordinator) are to assist the Director during an emergency, and in the absence of the Director, assume all responsibilities.

1. Become familiar with the Crisis/Emergency Response Plan. 2. Provide complete crisis/emergency response training to employees on a regular basis

and updates as necessary. 3. Take the lead in planning, implementing, and tracking all training to update and check

the accuracy of current crisis/emergency response procedures. 4. Work with the Center Director to investigate and evaluate each crisis/emergency

situation to prevent repetition of the ineffective efforts. 5. See that all injuries and issues are attended to immediately and referred to the Center

Director to determine if contact with Sponsor or other authorities is necessary. 6. Coordinate a regular plan of inspection of work areas to detect unsafe conditions and

work practices. 7. Act as team leader in a crisis/emergency situation. Identify the emergency situation and

determine the course of action.

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Employee Responsibilities:

1. Notify the Director and/or Assistant Director of emergency situations as they become aware of them.

2. Follow emergency procedures as outlined and directed by the person in charge. 3. Safety and well being of the children in their care.

Sponsoring Organization/Landlord: Where applicable, the Sponsor or Landlord is responsible for the safety of the building and grounds. The health and safety, security, and facilities procedures established by the Sponsor or Landlord shall be followed by the Center in conjunction with center policies and licensing regulations. For emergencies, the Director shall immediately notify the Sponsor or Landlord after calling 911 for medical, fire, or security emergencies. They will notify appropriate Sponsor or Landlord response of personnel as necessary. Sponsor/Landlord Emergency Contact Numbers: Name Title Phone Number Work:

Cell: Work:

Cell: Work:

Cell: Emergency Numbers, Systems and Locations Use Emergency Numbers list (see Attachment A); post by all phones and attach a copy to this plan. All classroom and common areas should have a floor plan outlining the evacuation route from that location as well as denoting the location of all fire extinguishers (red dots) and pull stations (blue squares). Unless otherwise required by your state licensing agency, these should be used as your posted evacuation plans through the center. In addition to the floor plan, complete the following: System Yes No Location Central Alarm Control Box Main Telephone Panel Central Sprinkler Shut Off Gas Shut Off Furnace Shut Off Emergency Power Source Water Shut-off

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Emergency Notification Introduction: The center response for most emergencies generally involves sheltering in our evacuation location. The exception to this is providing emergency medical care and use of a fire extinguisher for small, localized fires. Protocol for Notifying Emergency Personnel and Other External Parties All emergencies shall be reported as follows: Emergency Event Initial Notification Secondary

Notification Actions

Fire Alarm, smoke, noxious/toxic fumes

Pull Fire Alarm 911 Sponsor Security (Number )

Evacuate the Building.

Telephone Bomb Threat to Center, Security Issues

Call 911 Sponsor Security (Number)

Gather information from caller. Evacuate the building.

Suspicious item left in the Center

Sponsor Security (number) Call 911

Sponsor Security (Number)

Follow instructions from Security/911. Evacuate the building.

Suspicious package delivered to the center

Sponsor Security (number) Call 911

Sponsor Security (Number)

Follow instructions from Security/911. Evacuate the building.

Medical Emergencies Call 911 Sponsor Security (Number)

Follow instructions from the 911 Operator.

Security Incidents (intrusion alarm, disgruntled person, break-in, etc.)

Call 911 Sponsor Security (Number)

Follow instructions from Security/911 Operator.

Post Natural Disaster (building unsafe)

Sponsor/Security Call 911

Call 911 Follow instructions from Security/911. Evacuate the building.

SPONSOR Directed Intercom (pull fire alarm)

N/A

City FD/PD Directed Intercom (pull fire alarm) Sponsor/Security (number).

N/A

The Sponsor’s/Landlord’s Security shall notify the Center Director of emergency situations that may impact the facility and/or occupants. Once the situation is under control, the Center Director shall contact their immediate supervisor (where applicable) to inform him/her of the situation and current status.

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Signs and Postings

• A floor plan/diagram should be posted in all classroom and common areas indicating the primary and secondary routes for exit from each area. The diagram will also identify the building’s shelter locations and evacuation assembly areas.

• Emergency phone numbers shall be prominently displayed by all telephones in the Center.

• The Center approved shelter areas are identified by a placard containing a tornado symbol over the door to shelter (for those centers in tornado prone areas only).

• The emergency shut off for the HVAC system, water supply, and electric service supply shall have a sign placed by the control identifying it as the primary disconnecting/shutoff means. This information will be available at all times in the Director’s office.

Center Evacuation Sites Plans should be well thought out with regard to immediate area threats and more widespread area threats prior to designation. Provide information on where the center plans to evacuate for families. This information should be provided in an annual notice to families (see Attachment B Emergency Evacuation Plan).

1. Immediate Area Threat (i.e. bomb threat, fire, flood, other major building problems, etc). a) Leave the building and gather in a predetermined location. This should be a safe

place within walking distance; consider whether or not the area will be safe in all circumstances, i.e., rain, snow, etc. Seek permission if using a building or area for emergency use and determine if it is always available and suitable.

2. More Widespread Threat (i.e. Sponsor evacuation, chemical spill, widespread fire, etc.) a. Leave the building, Sponsor campus and/or neighborhood, pick a safe accessible

spot, and seek permission of the owner, manager, principal, etc. The method of transportation should be addressed in anticipation of a situation. Decide what method of transportation you are using BEFORE a situation occurs. While it is not recommended that teachers transport children, if the situation arises where children need to be in cars and transported immediately to another location, using staff transportation must be considered and planned for.

3. Mass Ordered Evacuation (i.e. declared state of emergency) a. Leave the building and evacuate to a mass shelter as determined by the Red

Cross. Emergency personnel will want to know if you need transportation. b. Emergency personnel (Sponsor, local police department) should have a copy of

your evacuation plan on file. Evacuation Area

• The designated evacuation areas for the Center are the farthest points from the building within the fenced outside playgrounds and the center parking areas. If the Center Director determines that the designated evacuation areas do not provide adequate protection for the children, a previously determined alternate evacuation assembly area will be utilized.

• The designated transportation will be sent to the Center for assisting in the transportation of the children.

• Sponsor security or the emergency response team will assist in the orderly evacuation of the Children.

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• If an evacuation is ordered by the city emergency response organization, the Incident Commander for the City will identify the route and location of the nearest evacuation shelter.

Evacuation Planning It is critical to conduct evacuation drills in order for children and staff to understand how to respond in the event of an emergency. Centers should hold drills monthly, or more frequently if required by the state licensing agency. Two of the drills should be held at naptime. In addition, if the Center is open more than twelve hours, two of the drills should be held during off-peak hours, i.e., very early morning and/or during evening hours. Sheltering In Areas In the event of a natural emergency (i.e. tornado, severe storms, or hazardous airborne chemicals incident outside the Center facility) the children and other occupants of the building will shelter in place in the prearranged designated areas as necessary. All Centers should have a plan in place for the following:

• Evacuation Assembly area within walking distance • Evacuation area at a distance for secured evacuation:

o ________________________________________________________________

• Evacuation away from center (name, address, contact person, and telephone number of

the facility that agrees to serve as short-term host facility until children are picked up):

o ________________________________________________________________

o Transportation arrangements: ________________________________________________________________

o Shelter (in-place) ________________________________________________________________

In the event of an emergency requiring an evacuation away from Center premises, the Center shall coordinate necessary provisions for the transportation and continued care of children until parent/guardian or an authorized individual picks up the child. Center Evacuation Procedures The following measures should be taken during an evacuation:

1. Check attendance and compile an accurate attendance list. Use list during evacuation and take it along during transport to host facility.

2. Account for all children, staff, and visitors during the evacuation process. 3. Transport all necessary medications, supplies, records, emergency numbers, and cell

phones. 4. Coordinate all actions with community public safety and/or emergency management

officials. 5. Confirm required transportation resources and arrival time.

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6. Determine host facility based on situation. 7. Pre-determine assembly area nearby requiring short walk or transportation.

a) Transportation to host facility some distance away. 8. Contact host facility with estimated time for arrival of children and staff. 9. Notify families of evacuation and host facility information, if possible. 10. Make arrangements for support of children at host facility until reunited with families or

returned to evacuated facility. 11. After evacuations use attendance sheets to ensure that all children are safe and with

their group. Specific Duties and Responsibilities for Evacuation or Drills Definitions of people responsible during an evacuation:

1. Emergency Assembly Area – An area outside the Center building that is designated for assembly of the building occupants in the event of an emergency.

2. Evacuation Chief (normally the Director or Safety Coordinator) – the person responsible for the evacuation to Center building occupants.

3. Searcher (normally the Director and Assistant Director, however in large centers with Program Coordinators or Head Teachers, etc. these people may be designated as Searchers and assigned these responsibilities) – the person(s) responsible for checking that all occupants have evacuated the Center building.

The Director/Safety Coordinator and any other Center employees not counted in ratio will assist in all duties and responsibilities as designated by the Director/Safety Coordinator. The Center Director (Evacuation Chief) is responsible for notifying building occupants to initiate evacuation of the building, ensuring that the building has been safely evacuated, and for ensuring accountability for all occupants. Pre-evacuation duties:

• To assure evacuation assembly areas and routes are posted in all areas. • Ensure that all assigned employees are knowledgeable of how, when and where to

evacuate when necessary. Evacuation duties:

• Initiate evacuation procedure by either pulling the fire alarm box and/or notifying building occupants through the intercom system, if available.

• Notify Sponsor’s security of evacuation initiation. • Report to the designated assembly area. • Ensure searchers carry out their assignments. • Ensure accountability of building occupants through the reports of the coordinators. • Determine if evacuation area provides adequate safety of children. Initiate further

evacuation to other facility if necessary. • Coordinate with the City emergency response personnel as needed.

The Assistant Director’s/2nd in charge primary responsibility is to ensure that all Center occupants assigned to their area are evacuated when necessary and accountability is reported to the Director (Evacuation Chief).

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Pre-evacuation duties:

• To be knowledgeable of the duties of the Evacuation Chief and Searchers. • To have access to a list of all occupants in their area for accountability purposes. • To ensure all exits are marked, unobstructed, and signs are lit (if applicable). • To check that all evacuation signs are posted and are accurate.

Evacuation Duties:

• Maintain order during the evacuation. • Ensure the searchers perform their duties as assigned. • Provide accountability for all occupants in their assigned areas and report results to the

Evacuation Chief. • Stay with the evacuated group until notified by emergency response personnel.

Any Center employees other than the Director, Assistant Director and Safety Coordinator who are not counted in ratio at the time (Searchers) are appointed by the Director (Evacuation Chief) and are responsible for ensuring that all occupants in their assigned areas safely and properly evacuate to their designated assembly areas. Pre-evacuation duties:

• Pre-plan all areas that require searching in the event of an emergency (i.e. restrooms, closets, structures on playground areas, etc.

• Be knowledgeable of the responsibilities of Searchers. Evacuation Duties:

• Upon notification of an evacuation, all employees should begin assisting with the orderly evacuation of occupants.

• A staff member from each classroom should conduct a thorough search of assigned areas when occupants have evacuated, reporting findings to the Evacuation Chief for their area. Where possible, employees not assigned to a classroom should be assigned this responsibility.

• Assist the Director and Assistant Director as necessary. Evacuation Process The decision to evacuate the Center/Building will be made by the Director/Designee. When the decision is made to evacuate the Center/Building, The Director (Evacuation Chief/Designee) will make the announcement in the most expeditious way possible that all persons are to evacuate to their assigned assembly area and await further instructions and/or activate the building fire alarm. The Director will notify appropriate personnel. Center staff will evacuate their children as follows: Infants Put up to four non-mobile babies in an evacuation crib and move children to the evacuation assembly area. Take attendance sheets, child rosters, and information sheets. For inclement weather, if possible, take appropriate supplies to protect the infants.

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Toddlers and Preschool Gather children in a group and supervise an orderly evacuation to the designated assembly area. Take attendance sheets, child rosters, and information sheets. For inclement weather, if possible, take appropriate supplies to protect the children. Center Searchers will assist the staff with the evacuation and then proceed to perform their assigned duties. Note: Under no circumstances are staff members to stop for any of their own or children’s personal belongings, including jackets, shoes, etc. Center Accountability Process In the event of an evacuation, if it is available, the Evacuation Chief will take a printout of the children and employees logged into the Center and a list of the visitors in the building. These lists will be taken to the designated assembly areas and attendance will be taken. The Evacuation Chief will notify appropriate authorities (i.e. City Fire Department, Police Department, and Sponsor’s Security) of the results and report any missing children, staff or visitors, providing information as to possible locations.

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Evacuation Away from the Center

Procedures at Evacuation Location Site There are five (5) essential jobs to be covered during a Center evacuation (assume responsibilities if possible during an emergency):

1. Evacuation Chief 2. First Aid 3. Communications 4. Play space operations 5. Child pick-up point

Before an emergency occurs, a person and alternate should be assigned to each of these jobs:

1. Evacuation Chief: Director Alternate: Asst. Director or 2nd in Charge a) Make sure all children are accounted for. b) Determine the safest location for continued operations until children can be

picked up and the safest path for all staff and children to get there. c) Activate the parent/guardian pick-up point assignment. This should be the best

location away from the play space areas and first aid station. d) Activate the communications assignment and provide specific phrases for the

caller and information about the parent/guardian pick-up point – when possible, be the one to make contact with those families whose children are injured as a result of the event.

e) Inform Sponsor/Landlord of your circumstances as soon as you are able.

2. First Aid Assignment a) Administer First Aid as necessary. b) Key materials: Complete First Aid Kit, flashlights, batteries, cell phone, and radio,

contained in a bright, labeled bag.

3. Communication Assignment: a) Check with Evacuation Chief about exact info to give to families when calling

(emphasis should be placed on the child’s condition and the pick-up location). b) Locate nearest phone and collect the emergency information from the

Evacuation Chief with family phone numbers. c) Discuss with the Evacuation Chief, the exact wording to offer families whose

children have been injured in some way by the event. d) Report back to the Evacuation Chief with updates, needs, and problems during

his/her rounds.

4. Play Space Assignment: a) Determine where to set up different groups of children. b) If possible, use blankets, tables, and chairs to define areas. c) Determine the nearest and safest bathroom and arrange for supervision.

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d) Report back to the Evacuation Chief with updates, needs, and problems during his/her rounds.

e) Key Materials: i. Prepared Emergency Evacuation Kit (see Emergency Kits and Supplies,

Attachment C) including some play materials.

5. Pick-Up Assignment: a) Establish an area away from the primary play area and first aid areas to control

access. b) Collect all the sign-in sheets to monitor family pick-ups. c) Select a staff member to collect children and bring them to the pick-up point. d) Report back to the Evacuation Chief with updates, needs, and problems during

his/her rounds. e) Key Materials: Sign-in sheets, marker/pens and paper; highly visible cap.

Sheltering/Sheltering in Place Sheltering is conducted in response to tornadoes and severe storms. Sheltering in lace is defined as moving people into the building and isolating the building environment from the outside. Emergency response personnel will shut down air handling (HVAC), water, and electrical systems, as required, however, many air handling systems will shut down automatically. Sheltering in place is conducted in response to hazardous materials incidents as well. Sheltering: Any sheltering area should be identified on the center plan.

• Identify shelter areas that provide the most structural resistance from collapse. • Shelter areas within the facility will be appropriately marked. • Shelter areas will be free of items that may fall on sheltered people. • Shelter areas will have a flashlight or emergency light available. • Shelter areas will have blankets available. • A primary and alternate staff member will be assigned for shutting off systems as

directed. These members will be trained by the Center or Sponsor maintenance and utility personnel in the proper procedures.

Sheltering in place: Shelter in place involves keeping all windows and doors closed and covering all air intake vents to provide protection from airborne hazardous materials.

• Ensure all Center staff and children are in the building (outside playground areas are unoccupied).

• Ensure all doors and windows are closed and secured. • If necessary, emergency response personnel will shut off all HVAC systems to isolate

the outside air from the building if the system has not already shut down. • Remain in the building until notified by the emergency response authorities that the

situation has been resolved or that an evacuation has been ordered.

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Medical Emergencies Life Threatening Medical Emergency means that the patient requires immediate medical intervention to stabilize and prevent the medical condition from deteriorating. Examples of life threatening medical emergencies are: compound fractures; sever lacerations; internal bleeding; severe burns; difficulty in breathing; heart problems; shock; severe allergic reactions to insect bites/foods, medications; poisonous plant contact or animal bites; ingestion of chemicals/poisoning; and unconsciousness. Procedure for Life Threatening Emergencies: Person finding injury shall:

• Remain calm, render first aid, and call for help. Do not move the injured or sick person unless his/her safety and health are at risk.

• Call 911 for emergency medical services and report the incident or request someone else to call. Stay on line with the dispatcher and provide information as requested.

Center Director or Designee shall:

• Report the incident to Sponsor Security, or call 911 if they have not already been called. • Assign an individual to meet the emergency medical personnel to guide them to the

location. • Pull the medical release form of the injured from the files and provide it to the emergency

medical personnel upon arrival. • Assign a staff member to accompany the patient to the hospital. • Make notification to applicable emergency contacts of the patient. • Insure that the appropriate paperwork is completed. • Contact the following to report the incident:

o Licensing Representative, if necessary. o Sponsor Liaison or immediate supervisor.

• Maintain communications with staff member assigned to stay with the patient for progress reports.

For more information on general guidelines, see Attachment D – Guideline for Handling Medical Emergencies. Snow and Ice Storms Monitor winter storm watch, warnings, blizzard warnings or travel advisories. Check the status of battery powered radios, flashlights, back-up lighting, power, heat, and cell phones. Consider pre-storm closing (night before) or early closing depending on conditions (secure Sponsor approval, if necessary). Release non-essential staff in accordance with center closing procedures. Arrange for snow and ice removal as well as possible debris removal such as fallen trees and utility lines.

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Tornado A tornado watch means that a tornado is likely over a large area. A tornado warning means that a tornado has been sighted or is indicated on weather radar in a specific area. Monitor tornado watch, warnings, or severe thunderstorm watch/warning. Tornado Cover – Administrative Procedures Take Cover Announcements are issued by the Director when one or more of the following conditions exist:

• A tornado is sighted. • A tornado siren is heard. • A tornado warning is issued that affects the Center. • High winds at or exceeding 60 miles per hour. • Golf ball size hail or larger. • Rapidly dropping pressure; dark greenish clouds. • Watch Conditions are issued by the national Weather Service for the area. • Tornado spotters are alerted. • Radios should be monitored at the Center office. • All teachers should be notified of the watch. • Tornado shelters should be visited by an administrator to ensure that they are clear.

When the announcement to take cover is given, the Director and other management take the emergency information (children and staff emergency contact numbers) and assist in the cover procedures in rooms with infants and non-ambulatory children first. If more than one administrator is present, divide the building into sections and move to assist. Director and other management need to check all areas for “hidden” children. When security/other authorities give the all-clear sign, check with the teachers from each room to make sure all children are accounted for. If there is any question about damage to the Center, do not re-enter the building until security or other emergency personnel have surveyed the building. Inform all the teachers of any facility hazards. Determine if any areas or routes must be closed from access and inform staff. If it is unsafe to remain at the Center, assess whether the Alternate Site is a safe back-up and evacuate the children to this location. Classroom Tornado Procedures Each classroom teacher should be assigned the following responsibilities in anticipation of being instructed to take cover in the event of a tornado warning. Designated Teacher 1

• Begin evacuating all children to the designated tornado shelter. • Avoid windows and glass doorways. • Close doors to the outside rooms. • Protect the heads of staff and children with blankets.

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Designated Teacher 2

• Take the attendance. • Take the first aid kit. • Last check for children in “hidden” areas. • Evacuate any remaining children and close the shelter door.

Note: when you are the only staff person in the classroom, you will be responsible for the roles of teacher 1 & 2. Remain in the shelter areas until given further instruction by Security or Center Administrative Personnel. Hurricane

• Monitor Hurricane Watch and Warnings. • Secure outside equipment. • Check status of battery powered radio and alternate light sources. • Remain indoors until storm passage is confirmed. • Prepare to evacuate. If necessary, evacuate children and staff to a more secure facility

depending on road and safety conditions. Provide information on where the center plans to evacuate for families.

Flooding

• Monitor announcements of Flood Watch or Warnings. • Close or evacuate facility if needed. Heed evacuation order from public safety officials.

Utility Disruption (water, heat, electricity) If utilities are disrupted in the Center, the Center will make every effort to remain open. The decision to close the Center or delay its opening will be based on the following factors:

• The amount of natural light in the Center. • The temperature in the Center. • The ability and necessity of heating food and formula. • The risk to the health and well being of children and staff.

Note: Check state licensing regulations concerning the procedure of utility disruption. Some states may require the school to close. The staff will begin calling parents/guardians to inform them of the situation after one (1) hour of disrupted service. Infant families will be called first and may need to be called sooner depending on how much disruption has occurred to basic care-giving routines. This time period will allow the Center to assess the situation and provide families with as much accurate information as is available. Notify your state licensor of the situation, if applicable. The Center may close or delay opening (confirm with the Sponsor and/or immediate supervisor) if the following conditions are present:

• The temperature of the Center thermostats register 64 degrees or below, or 85 degrees or higher for one hour, unless otherwise noted by the local state licensing agency, with

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no expectation of heat/air conditioning restoration within the next one to two hours, and/or the room conditions prevent adequate ventilation and breathing.

• The natural light in the Center is diminished to the point that children and staff are at risk. • The main phone line will be inoperable for more than one hour, and no auxiliary cellular

phones are available. • The nutritional needs of the children cannot be met. • Live wires will require the immediate closing of the Center and the transfer of the

children. • Loss of water that disrupts appropriate diapering, hand washing, and toileting with clean

running water for more than 1 hour. Reporting Facility System Emergencies In the event that any of the critical systems for the Center become inoperative, the Director/2nd in Charge shall immediately notify their immediate supervisor and/or the Sponsor’s or Landlord’s Facilities Manager. The Facilities person will assess the situation and provide the necessary resources to correct the problem. Facilities will arrange for temporary services (i.e. electrical power, portable toilets, drinkable water, etc.) if possible, if the problem cannot be corrected in a timely manner. If support is not available to the center, the Director shall make contact with the appropriate repair personnel and arrange for the necessary resources to correct the problem. The Center Director/Designee shall communicate with Sponsor or Landlord’s Facilities to estimate the duration of the event. If the duration of the event is likely to pose a sanitary or safety threat, or if the disruption would make the facility environment untenable, the Center may need to close early at the direction of the Center Director/Designee, and appropriate Sponsor personnel. In the event of a major incident involving a critical system (i.e. explosion, building collapse, electrical sparking, etc.) call 911 and order an evacuation of the center.

Fire Fire procedures Each facility should have a fire emergency plan including an evacuation procedure, marked exits, fire/smoke detectors, fire extinguishers, safe storage and use of flammable materials, and fire safety training and fire drills. The fire plan should specify when and how to evacuate in case of fire and under which conditions staff should attempt to control a fire using extinguishers. Check with fire officials to remain current on fire safety such as regular inspections and use of fire extinguishers, detectors, and alternate heating sources. Conduct regular fire safety training and fire drills. Refer to Attachment E Procedures for Conducting a Fire Drill. Fire Emergencies All Center staff is to familiarize themselves with the fire emergency procedures and maintain their areas free from the accumulation of combustible materials. The staff is responsible for ensuring that all fire extinguishers, alarm boxes, exits, and paths to exits are unobstructed at all times.

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Response to Fires:

• If fire/smoke is discovered, immediately activate the nearest pull station/call 911 and, if available, activate the duress button to report the fire and begin the evacuation per the evacuation procedure.

• If the fire is small (waste paper basket size) extinguish the fire by using water, blanket, fire extinguisher, etc. DO NOT TAKE RISKS. Personal safety and that of the children come first.

• If the fire is larger, or if the smoke makes it difficult to determine the fire location, evacuate and report to the evacuation area.

• When possible, the Center Director/Designee shall notify Sponsor Security of the situation.

Hazardous Materials Hazardous materials are substances that are flammable, combustible, explosive, toxic, noxious, corrosive, oxidizable, an irritant or radioactive. If hazardous material accidents occur within close proximity of your Center, notify the fire department and follow safety directions. Be prepared to evacuate or shelter-in-place. Bomb Threats, Threatening Call or Threatening Message Calls of a threatening nature should be recorded as accurately as possible and reported to the police. Depending on the nature of the call, appropriate action should be taken to protect lives and property, including evacuation. If possible, record the threatening message carefully with attention to details. If caller ID is operational, record telephone number. Notify police immediately. Get advice from your local police to help determine how to handle the situation. See Attachment F – Bomb Threat Report Form. Suspicious Article Evidence of a suspicious article, package, or letter should be reported to the Center Director immediately. Communication to security or police is advised. Do not touch or attempt to move the article unless instructed by police. Follow advice of police to determine appropriate procedures to take within the center. Potentially Violent Situations A potentially violent situation (i.e. hostage situation, disgruntled person, unstable custody) may be cause for a selective evacuation procedure. The premise behind a selective evacuation is that it enables large numbers of children and staff to move out of harm’s way when an individual is on-site who is potentially violent. If a potentially violent individual gains access to your facility and leaves:

1. Immediately call 911/Police and notify Security. 2. Indicate to security and another Center administrator that you may have a condition for a

selective evacuation (this may be within the building if the potentially violent person does not leave the area). If you have any reason to believe the individual has a weapon, order a selective evacuation from non-affected areas (this may be another room within the facility).

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3. If the individual cannot be isolated and chooses to leave the premises, allow them the freedom to exit making sure to note their car make and model, license plate, and the direction of their travel. Communicate this immediately to the 911 dispatcher.

Note: if the individual is leaving and taking a child or staff member, it is still better to let the individual leave than to prompt a confrontation that could increase the risk of injury. If potentially violent individual gains access to your facility and remains:

• Immediately call 911/Police and notify Security and seek advice on how to handle the situation.

• Indicate to Security and another Center administrator that you may have a condition for a selective evacuation. If you have any reason to believe the individual has a weapon, order a selective evacuation, if possible.

• Try to isolate the potential aggressor from as many adults and children as possible. Seek to draw the individual(s) to the office, break room, conference room or other less populated space. If the individual has entered a classroom, seek to draw him into the least utilized portion of the room.

• If comfortable doing so, engage the potential aggressor in agreeable conversation to de-escalate the situation.

• Remain calm and polite. • Do not physically restrain or block their movements. • While you are engaging the potentially violent individual, other available persons should

direct unaffected classrooms to move to locations around the facility that are farthest from the incident point. This selective evacuation should precede room-by-room and as orderly and quietly as possible, being careful to use routes not visible to the incident point.

• The other administrator should also make sure no other individuals, other than emergency personnel, enter the space where you have isolated the potentially violent individual.

• Once the police arrive they will take over the situation, negotiate and dictate further movements.

• If a decision is made to relocate to the alternate site while negotiations go on, follow the appropriate evacuation procedures.

Random Acts of Violence If the Center is affected by random acts of violence (i.e. drive by shooting), implement the following:

• Remain Calm. • Activate the duress button and/or immediately call 911 and Security. • Staff members will alert other staff personnel of the problem. • Alerted staff members will close the doors of their areas of responsibility and have the

children lay on the floor. • Brief Security of the problem once they arrive. • Report the incident to the Sponsor, and immediate supervisor.

Disgruntled Employees, Parent/Guardians, or Parent’s Guardian’s Authorized Representatives In the event of having to deal with Disgruntled Employees, Parents/Guardians, or Parent’s/Guardian’s Authorized Representatives, implement the following:

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• Remain Calm. • Remain Polite. • Activate the duress button and/or immediately call 911 or Sponsor Security. • Staff members who observe the problem will go to the nearest telephone and call

Security (back-up call). • Staff members will alert other staff personnel of the problem. • Alerted staff members will close the doors of their areas of responsibility. • If the disgruntled individual’s child is immediately known, move the child to another

room, out of sight. • Turn the child over to parent/guardian or authorized representative in accordance with

center procedures. • Report the incident to the Sponsor, and immediate supervisor.

Impaired Employees, Parent/Guardians or Parent’s/Guardian’s Authorized Representatives If you have reasonable cause to suspect that any person picking a child up is under the influence of alcohol or drugs, or is physically impaired in any way and may endanger a child, you may have cause to refuse to release the child. If so, request that another adult be called to pick up the child or call the numbers listed on the Child Release Form. In the event of having to deal with employees, parents/guardian, or parent’s/guardians authorized representative, implement the following:

• Remain calm. • Remain polite. • If the person becomes agitated and/or confrontational, activate the duress button and/or

immediately call 911 and Sponsor/Security. • Staff members who observe the problem will go to the nearest telephone and call

Security (back-up call). • Staff member will alert other staff personnel of the problem. • Alerted staff members will close the doors of their areas of responsibility. • Turn the child over to the other parent/guardian or alternate authorized representative in

accordance with center procedures. • Report the incident to the Sponsor Liaison and immediate supervisor.

Hostage Situations Although considered improbable, the Center may be subject to hostage situations either from disgruntled employees, parents/guardians, parents/guardian’s authorized representative, or other people. In the event of a hostage situation:

• Remain calm. • Remain polite. • Follow the hostage takers instructions. • Do not resist. • ANY available staff member will activate the duress button and/or immediately call 911

and Security. • Staff members will alert other staff of the problem if time permits. DO NOT PUT

YOURSELF IN DANGER! • Alerted staff members will close the doors to their areas of responsibility.

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• If staff members believe it is safe, evacuate the children from the Center moving in the opposite direction from the incident. Report your location to Security immediately.

Perimeter Issues Administrative Procedures for Playground Clearance (i.e. protest/riot adjacent to facility, toxic spill, sniper, suspicious parked vehicles and loiterers):

• Call Security or local authorities to investigate the situation and consult with them to determine the level of potential crisis.

• If the situation is of marginal concern or greater, require that the entire Center remain inside. Immediately require any groups outside to come inside.

• Lower blinds to further obscure visibility and consider bringing those classrooms in the direct line of the site into the “core” play space or another classroom/area until the situation is resolved.

• Be prepared to fully evacuate the facility should Security or other Emergency services make this request. Consider whether existing evacuation routes will suffice or if an alternate route must be taken due to the location of the incident. Make staff aware of any changes to their evacuation routes if necessary.

• Coordinate your actions with Security and other support services (i.e. police, fire department, bomb squad, etc) based on the nature of the incident.

Missing Child

• Immediate notification of the Police and Security should be made once an initial search of the facility has been made and rapid attempts have been made to confirm whether or not a family member may have picked up the child.

• Conduct a search of all areas of the facility, including closets, cabinets, etc., and the immediate surrounding area.

• Make all other required notifications. • Continue searching while waiting for the Police/Security to show. • The Director is to remain at the center as the point person and to gather

information/description of the child to share with authorities.

Suicide Intervention If there is a reason to believe that a student or a team member is in any danger of harming him/herself, the situation should be reported immediately. Steps of Action:

1. Notify Director, Assistant Director and Regional Director. 2. Do not leave the student and/or team member alone. 3. Crisis counseling techniques will be used as appropriate. 4. Do not allow the student and/or team member to go home unsupervised. A

parent/guardian or other adult must assume direct responsibility for the student and/or team member before allowing them to leave the school.

5. If it is determined that it is not in the best interest of the student and/or team member to release them to the parents or other adult should be called. They will transport to the facility deemed most appropriate.

6. Police can arrange for hospitalization up to 72 hours if suicidal student’s and/or team member’s parents/guardians or other adult cannot be reached.

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Follow-up Steps 1. The Regional Director and Director will meet to evaluate the situation and define the

appropriate role for the school in future assistance to the student and/or team member. 2. A counselor will be appointed to remain in close contact with the student and will serve

as the liaison between student, parent/guardian, school, and any involved community agencies.

3. Confidentiality will be maintained throughout these procedures unless the safety of the student is at stake.

Emergency Lockdown or Unwanted Intruder Unfortunately, no public place, including the schools, is immune from unwanted intruders who might be a security risk to those around them. The following procedure will be used if a potentially serious security threat is suspected. When a potential security threat is recognized, office personnel and designated employees will make notification according to the following procedure. Steps of Action

1. The principal/Director or other designated person (i.e. Safety Coordinator) will make the announcement “Sorry to interrupt; the meeting with the Mayor is going to be in room __________.” (The room number given is where the intruder is). This will alert all classroom teachers to lock their door according to building procedures. Classroom lights should be turned off. Designated personnel will determine whether to lock outside doors according to building procedure. Students should be kept out of the line of sight from a school window or door window.

2. Designate people who will call police giving them as much information as possible about the intruder (clothing, gender, race, etc.).

3. Designated teacher located near restrooms will check for students and direct them to their class, of if deemed necessary to the nearest classroom.

4. Students in open unsecured areas such as gyms, hallways, etc. will be taken to the nearest secured room.

5. Everyone will stay in a secured area with rooms locked until directed by administration to resume normal activities.

Personnel Roles: Principal or Director

• Announce warning signal. Ensure all other steps are being taken. Assistant Principal/Director

• Call Sheriff’s office or Police Department. Notify Regional Director. Turn bell of until danger passes.

Teacher

• Stay with students and lock classroom doors. • Lock outside doors to which each has been assigned.

Care should be taken during lock down procedures to move quickly and orderly, and in a way not to cause unnecessary alarm to the Students. Students should not be given any information unless the situation warrants, except that a security drill is being conducted.

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Media Guidelines Suggested Guidelines for responding to the media The following list of suggestions for working with the media will assist in minimizing the disruption during a school crisis and in informing the public about a newsworthy event. These will help avoid confusion in times of crisis and ensure consistency of information given to the media.

1. Initially, all media inquiries are to go to the Regional Director and they will notify the COO. In their absence the Director will be assigned to deal with the media. After the initial contact with the media, they will make any additional calls as deemed necessary (i.e. to Marketing Department for press release, etc.).

2. The Regional Director (a.k.a. Spokesperson) needs to respond to the media in a timely and professional manner. Avoid being defensive. Do not treat the interviewer as an adversary. Acknowledge the difficulty of the media’s role and take a position of helpfulness.

3. The Regional Director (a.k.a. Spokesperson) should prepare a written statement or notes with points to be made for quick reference (this can be done with the help of our Marketing Department). If the answer to a question is not known, a return call with the information may be made. Release factual information only. Do not make assumptions.

4. Personal information about any staff member or student should not be disclosed. Such information should be released only at the discretion of family and from the family.

5. The Regional Director (a.k.a. Spokesperson) should emphasize what is being done by the school and the academy to contain and resolve the crisis.

In a crisis, the site Director should continually phone in updated information to the Regional Director. Updates will be given to the media and to other school offices as deemed necessary by the Regional Director and the COO.

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Attachment A

Emergency Phone Numbers Name/Company Contact/Town Telephone Number

Director Ambulance Fire Poison Control Police Human Resources 866-607-7552 ext. 13180 Local Health Department Building Inspector Sponsor Liaison Sponsor of Security Dept. of Social Services Health Consultant State Licensor Air Conditioning Appliance Repair Cleaning/Maintenance Copy Machine Electric Company Electrician Glass Company Heating Company Locksmith Plumber Snow Removal Taxi Trash Removal Water Department

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Attachment B

Emergency Evacuation Plan In the event of an emergency situation that requires an evacuation of ____________________, one of the following plans shall be implemented. In all situations, the caregiver in charge when evacuating shall:

• Take an accurate attendance list. • Account for all children and staff as they board/depart vehicles. • Bring any necessary medications/supplies and emergency records. • Take a cellular phone if available to be used for emergency situations.

1. If the emergency environment is confined to the immediate area of the child care facility (i.e. fire

or toxic fumes) and the children cannot stay on the premises the children will be brought to _____________________________ by _______________________ where they will remain accompanied by caregivers while family/guardian/emergency contacts are notified of the situation and arrangements are made for either the transporting home or care taking for the remainder of the day. The place of safety should be close by and within walking distance if appropriate.

a. In the event of exposure to toxic materials or gases and a physical examination is recommended, children will be transported by __________________________ to _________________________ where they will be examined and family/guardian/emergency contacts will be notified.

2. If the emergency is more widespread and encompasses a larger area such as a neighborhood

or several homes, due to non-confined environmental threat (i.e. toxic fumes from a spill, floodwater, brush fires, etc.) and the children cannot remain in the area, the children will brought to ________________________, by (method of transportation) __________________ where they will remain accompanied by caregiver(s) while family/guardian/emergency contacts are notified and arrangements for either transportation home or a continuation of care are made.

3. In the event of a major environmental hazard that necessitates a larger area of evacuation such

as several neighborhoods, a city/town or a geographical area, due to a large non-confined hazard (i.e. a nuclear incident, earthquake, hurricane, etc.) children will be transported to a Red Cross designated mass shelter by ____________________________ where they will remain accompanied by caregiver(s) while family/guardian/emergency contacts are notified and arrangements are made for their pick up.

a. Those childcare programs in Nuclear Power Plant Evacuation Areas should

follow the procedures established by the State Emergency Management Agency. Those procedures should be shared with all family/guardian of children enrolled.

Staff will remain with and care for the children at all times during an event. Attendance will be checked whenever children are moved. Staff will bring any necessary medications, supplies and emergency needs.

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Attachment C Emergency Kits and Supplies This list contains the minimum items you should have in your center in case of an emergency. Please check your licensing regulations to determine if your state requires any additional items. Center Emergency Kit; This should be packed in a backpack or other container that is mobile in the event of an evacuation and be located in a central and easily accessible location.

• Copies of all contact list o For families AND staff, include the name, phone number, and email as well as

information for someone preferably out-of-state, at least out of the immediate area.

o Phone numbers and emails for your Sponsor Liaison (Property Manager) and/or Immediate Supervisor.

• Flashlights with extra batteries o Long-life, emergency flashlights

• Battery-operated radio and extra batteries o AM/FM, weather band/TV band

• Manual can-opener • First Aid Kit

o Add gloves and Kleenex • Notepad and pens/pencils • Scissors • Hand-sanitizer and cleansing agent/disinfectant • Whistle • Disposable Cups • Wet wipes

In the Center in General:

• Charged Cell Phone • One gallon of water for every four children and staff • Disposable cups • Non-perishable food items like soft granola bars, cereal, cheese and crackers, cans of

fruit, and special infant items, etc – these should be nut free in the case of allergies • Extra supplies of critical medication such insulin, epi-pens, etc. for children and staff

Each Child Should Have:

• A change of seasonally appropriate clothing • A blanket • Extra diapers (one-day supply as space allows) • Extra formula (one-day supply as space allows)

Location of Emergency Kits: _____________________________________________________ Location of Additional Emergency Supplies: _________________________________________

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Location of Cell Phone: _________________________________________________________ Attachment D Guidelines on Handling Medical Emergencies The following is provided as a quick reference to help you make decisions in a stressful emergency situation. This information is by no means intended to substitute for adequate first aid training. Staff involved in the direct care of children should maintain current certification in First Aid and CPR for infants and children. By applying standard principles of action in every medical situation, staff can prevent further harm and avoid overlooking factors that may affect a child. It is important for staff to recognize signs and symptoms requiring immediate action and ambulance transport to the nearest hospital emergency department, as opposed to those that are not emergencies and can be treated at the Center and/or while waiting for the child to be picked up. The teacher who is with the child should provide first aid according to the principles of emergency action. Medical Emergency Conditions Listed below are some examples of conditions that are considered serious medical emergencies requiring immediate medical care by a health care professional. Call an ambulance and notify the child’s parent/guardian immediately for any of the following:

• Semi-consciousness (able to arouse but extremely lethargic) or unusual confusion. • Breathing difficulties including:

o Rapid, noisy breathing (barking, gurgling or crowing sounds, severe wheezing). o Labored breathing (takes so much effort that the child cannot talk, cry, drink, or

play. • Severe bleeding (large or multiple wound that cannot be controlled with direct pressure. • Unequal pupils (black centers in eyes). • First-time seizures or seizures lasting more than 15 minutes in a child known with

seizure disorder. • Injury that causes loss of consciousness. • Neck or back injury. • Continuous clear drainage from the nose or ears after a blow to the head. • Non-Injury-Related severe headache, stiff neck, or neck pain when the head is moved. • Hives (a rash that looks like welts) that appear quickly, especially if hives involve face,

lips, tongue and/or neck. • Very sick-looking or sick-acting child who seems to be getting worse quickly. • Repeated forceful vomiting after eating in an infant under four months of age. • Severe abdominal pain without vomiting or diarrhea following a recent blow to the

abdomen or a hard fall. • Possible broken bones, especially if the child shows symptoms of shock or the body part

cannot be adequately splinted or otherwise immobilized for transport by parent/guardian. The teacher should apply appropriate first aid measure for all medical emergencies and minor illnesses or injures as outline in Red Cross Pediatric First Aid. Keep a copy of this section in the first aid kit. Notifying a Parent/Guardian The parent/guardian of a sick or injured child should be contacted by telephone immediately. The Center Director or staff member should continue to try to reach a parent/guardian or

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emergency contact. However, whether or not he or she is able to contact a parent/guardian, the child should still be taken to the hospital whenever a medical emergency exists. Attachment E Procedures for Conducting a Fire Drill

1. Inform the staff in advance. The Center Director informs the staff that there will be a fire drill later in the day/week.

2. Staff Members talk to the children about the drill. Teachers talk to the children in their classroom about the bell/alarm rules, and procedures for vacating the building.

3. Evacuate the building when the alarm goes off. a. Evacuating Infants and Toddlers: The designated member of the management

team goes to the infant/toddler area. i. Children who are not walking are placed in an evacuation crib (four to a

crib) and the crib is wheeled outside to the designated area. ii. Toddlers (walkers) proceed immediately with staff to the outside-

designated area. b. Teachers count their children and take attendance sheets with them. No one can

stop for coats or any other personal items. c. Evacuating All other children: Teachers count their children and leave the

building in groups, taking attendance sheets with them. No one can stop for coats or any other personal items. Everyone should go to his or her designated place on the playground or other space. Once outside, teacher recount their children.

d. The Center Director or designee checks bathrooms, closets, and “hiding places” for “lost children” and for possible sources of smoke or fire during a real alarm.

4. Retrieve files of parent/guardian names and phone numbers. The Center Director retrieves the files of all parent/guardian names and telephone numbers and takes them outside.

5. Time the drill. The Center Director times how long it took to vacate the building and checks with each group to verify an accurate recount of all persons.

6. Verify accurate recount of all persons. The Center Director or designee checks with each group to verify an accurate recount of all persons.

7. Return to the building. The Center Director or designee givers approval to reenter the building. The Center Director or designee helps with infants and toddlers.

8. Document the Completed Fire Drill. The Center Director completes written documentation that contains the specifics of the drills: date, time to vacate building, weather conditions of the fire drill.

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Attachment F Bomb Threat Report Directions: If you receive a bomb threat remain calm, listen carefully and do not interrupt the caller. By discreet prearranged signal, alert a second person. Complete as much of the information below as possible to keep the caller on the phone and prolong the call. Date: Time: Time Call Ended: Questions: Answer: When is the bomb going to explode?

What kind of bomb is it?

Where is the bomb right now?

What does the bomb look like?

Why did you place the bomb?

Where are you calling from?

Caller’s Identity Circle the ones that apply: Age: Male Female Adult Juvenile Language: Good Poor Foul Slang Accent: Local Not Local Foreign Tone of Voice: Raspy Pleasant Loud Soft

High Intoxicated Deep Pitched High Speech Pattern: Distinct Fast Slow Nasal

Lisp Slurred Stutter Manner: Coherent Incoherent Calm Angry

Rational Irrational Laughing Deliberate Emotional Other:

Background Noise: Voices Bedlam (trains, Factory Machines, Animals) Traffic Airplanes Quiet

Was the voice familiar? Yes No If yes whose?

Exact words of the caller:

Did the caller use familiar terms? Yes No If yes, describe:

Person Receiving Call: Name: Receiving Telephone Number: Number Called:

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Immediately after call notify your Director and Security. Talk to no one else, unless instructed to do so. Attachment G Organizational Roles and Responsibilities List all staff names, address, and phone numbers (regular and emergency) as well as position in the program. For each person, list whom that person reports to, in order of responsibility. Be able to show at a glance who is in charge if someone above them is unable to respond. STAFF Name: Address Phone Numbers Reports to: Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Answer the questions:

• Who will provide first aid? _________________________________________________ • Who will take medication? _________________________________________________ • Who will take the first aid kit? ______________________________________________ • Who will take emergency information on each child? ____________________________ • Who will call for help? ____________________________________________________ • Who will carry the cellular phone? ___________________________________________ • Who will carry the emergency kits? __________________________________________ • Which groups of children go with which staff? __________________________________ • Who makes sure everyone is out of the building? _______________________________

Share the list with the staff and discuss it so there is no surprise during an emergency. Everyone should know their primary and back up responsibilities. Maintain an attendance list at all times; do not put children, staff, visitors, or emergency personnel at risk by not knowing these three things:

1. Who is in the building? 2. When did they arrive? 3. When did they leave?

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Have emergency information with attendance list. Make sure you know health information and have permission for emergency medical treatment and know of any special requirements or medications for children and staff. References: www.ready.gov Federal Emergency Management Association’s Official Website for emergency preparedness. This website specifically directs parents to consult with their child’s school/child care facility about the emergency plans. Emergency Management Guide for Business and Industry, ARC 5025, November 1993. Coping with Children’s Reactions to Hurricanes and Other Disasters, FEMA 184, October 1989. Helping Children Cope with Disaster, FEMA L-196, February 1993.

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Emergency Drill Log Center Number: ___________________________ Year: ________________________ Director Name: ____________________________

Date Time # of

Children Present

# of Adults Present

“Type” of Emergency Practiced

Length of time to complete

Management Signature

1st Quarter

2nd Quarter

3rd Quarter

4th Quarter

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Fire Safety Plan

1. In case of an Emergency, sound the fire alarm immediately, and contact the Fire Department using the Emergency Number List.

2. The Director or person in charge will see that all classrooms are being evacuated using

the fire evacuation procedures outline and posted in each classroom.

3. It is the responsibility of the Director or Person in Charge to make sure all Occupants have evacuated the building.

4. The Last Person exiting the room shall ensure that all lights are turned off, all windows are closed and all internal and external classroom doors are closed.

5. The Designated Safety Coordinator will assist the Director or Person in Charge in ensuring all persons have evacuated the building and all doors have been closed. It is the responsibility of the Safety Coordinator to bring the Evacuation Bin and Parent Emergency Contact cards when leaving the building.

6. The Director or Person in Charge is responsible for leading all evacuated parties to their safety shelter as set out in the Crisis Management Policy.

7. Once everybody has arrived at their safety shelter the Director or Person in Charge is responsible to return to the Center in order to assist the Fire Department with any information required.

8. The Director shall designate someone to be in charge of all Children and Staff while she is away from the Center.

9. Fire Drills shall be held on a Monthly basis by the Safety Coordinator or Person in Charge and logged in a book noting the date, how long the evacuation took, and any concerns to be addressed prior to the next drill and verify that all extinguishers are charged (monthly).

10. All Fire Alarms and Extinguishers will be maintained on an on-going basis to ensure they are in good working order.

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Safety Coordinator’s Fire Drill Log Date: How Long Did the Drill

Take: Concerns to be addressed before next drill:

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Fire Preventative Measures

1. Keep storage areas as clean as possible. Don’t let debris accumulate anywhere, especially in the Kitchen Area.

2. Check for grease build-up in the vent hood regularly and clean regularly.

3. Make sure Smoke Detectors are working. Check on a monthly basis (if applicable).

4. Check all electrical cords on appliances to make sure they are not worn or frayed. Use

of extension cords is not encouraged.

5. Never store flammable liquids indoors.

6. Have maintenance check your heating source prior to start up in the fall. Also, check and clean the filters regularly.

7. Don’t leave the Kitchen Area unattended while cooking food.

8. Don’t overload any electrical outlet with too many appliances. This can result in overheating and possibly shorting out the circuit.

9. Don’t leave matches or other sources of ignition within the reach of Children.

10. Clean lint from dryer screen at each use.

11. Have dryer vent cleaned on a monthly basis.

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Fire Drills Fire drills must be practiced each month. Management should indicate the date of the fire drill on the monthly calendar. Fire drills are mandated by Phoenix Children’s Academy and Licensing Agencies. Management should ensure all exit routes are clearly posted in each classroom. Exit lights should be checked monthly. Management must keep a Fire Drill Log of time allotted for the drill, problems encountered during the drill and action taken to eliminate the problem. Teachers should be instructed in following proper routes during an evacuation (see instructions in each classroom). Teachers should also be instructed to bring their classroom roll sheets with them. The Fire Alarm can be activated in three ways:

1. Emergency Pull Stations at Exit Doors. 2. Smoke detectors in ceiling 3. Sprinkler system activation

The system is directly connected to a 24 hour monitoring station and to the police and fire department. Any of the above equipment will send a signal to the monitoring station and the fire department. In conducting a fire drill, the monitoring station should be notified that a test will be conducted, the time of the test, and when the test is complete. Evacuate the building, noting the time required to evacuate all children and staff. Note any problems the staff may have in getting all the children away from the building to a safe area as far away as possible from the building. Should the drill exceed a reasonable length of time, classes should be assigned “practice runs” until everyone is comfortable with their abilities. The charge on each Fire Extinguisher should be checked monthly and noted on the maintenance hang tag located on the extinguisher. At least one drill per year should take place during Nap Time.

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Fire Extinguishers There are three (3) basic types of fire extinguishers. You should be aware of which kind your school uses as you could potentially be around all three. Halon: used around electrical equipment, it starts automatically once triggered oxygen is replaced with Halon, a gas, extinguishing the fire. An alarm will sound when Halon is activated; anyone near this should leave the area immediately as there will be no breathable air (not likely to be found in our schools). CO: replaces oxygen in non-electrical environments. Like Halon, an alarm will sound when activated, requiring all personnel to leave the area immediately. ABC: dry chemical, hand-held. This is a good multipurpose extinguisher. It works on 3 of the 4 classes of fire:

1. Combustible 2. Chemical 3. Electrical 4. Flammable when Solid, dangerous when wet. ABC is not normally used for this type of

fire. How to use a Fire Extinguisher Remember P.A.S.S. Pull the pin Aim at the base of the fire Squeeze the handle Sweep from side to side Do not try to be a hero. If you are unsure how to operate a fire extinguisher let someone else do it!

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Fire Drill Log Center Number: ___________________________ Year: ________________________ Director Name: ____________________________

Date Time # of

Children Present

# of Adults Present

Length of Time to Evacuate

Management Signature

Fire Extinguisher Inspection Date

January

February

March

April

May

June

July

August

September

October

November

December

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Safety coordinator

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Role of the Safety Coordinator Your Safety Coordinator is the nucleus of your Managed Care Program, coordinating all of its components. The Safety Coordinator is the contact between all involved parties in an effort to support the team member in their time of injury and return to work efforts.

The involved parties may include:

• Employee • Medical Provider • Claim Handler • Manager/Supervisor • Senior Management • Safety/Loss Control

It is critical to the success of the program that the Safety Coordinator is able to respond to all concerns and situations that arise. The incumbent must also periodically assess the effectiveness of the process and program results, and voice concerns/issues with both internal management and external management (i.e. Regional Director or Human Resources). The functional areas of concentration for this individual are:

• Planning and implementing Safety Meetings • Planning and implementing Safety Incentive Programs (including games and prizes). • Update Safety Calendar Daily. • Work with the School’s Director to ensure all maintenance checklists, cleaning

checklists, safety checklist and orientation checklists are complete. Implementation and maintenance of the Managed Care Program.

• Ensure proper and timely treatment of injured workers. • Implementation and management of the Transitional Duty Program (a.k.a. Return to

Work Program). Finally, the Safety Coordinator is responsible for maintaining contact with out-of-work employees. Immediate and on-going contact keeps the injured worker connected to the work team (also part of the Transitional Duty Program).

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Contact should be personal and frequent, regardless of the estimation of disability.

• In all situations work with the Director to get the employee to return to work as soon as possible.

• Work with their Doctor’s restriction; change classrooms, have them help with paperwork, update files, etc. Just get them back to work!

• Try, if medically appropriate, to get the employee to visit the workplace as often as possible.

• Share news about the workplace. • Monitor the employee’s emotional state: ask if they are satisfied with the doctor and

treatment plan. • Ensure that scheduled disability payments are being received. • Encourage the Director to stay in touch throughout the recovery. • Once the employee has returned to work, check periodically to make sure no further

problems arise. .

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Safety Coordinator Policy The Safety Coordinator will make sure the Company’s team members assume their respective responsibilities included, but will not be limited to:

1. Review Safety Policies and Procedures; become familiar with functions and responsibilities of supervision and the interrelationships with other departments.

2. Develop a sound technical knowledge of all-applicable OSHA Safety Orders and

Regulations; also stay current with the requirements made by other government agencies.

3. Maintain an occupational training program covering hazards basic to all types of employment and those unique to each worker’s job assignment.

4. Correct unsafe and unhealthy work practices in a timely manner. Follow Safety Calendar Daily.

5. Schedule and conduct regular safety training meetings with all employees.

6. Perform first aid duties required, which will include maintaining appropriate first aid supplies, dissemination of emergency procedures, and providing first aid training.

7. Keep record of all employees training, correction of unsafe conditions, dates and results

of workplace inspections. Submit all documentation to the Director so she/he can place in employee file.

8. Work with Director in any Crisis Situation.

In addition, Supervisors of this Company will be responsible for ensuring that all employees adhere to all Company Rules and Policies. This may include employee incentives, retraining and any necessary disciplinary actions for negligence.

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Safety “What-To-Dos” Meet Regularly The holding of regularly scheduled safety meetings gives team members an opportunity to discuss hazards and ways to correct them, accident frequency rates, injuries that have occurred, recommendations and program plans. A well-organized meeting is the most common ground on which workers and management make their reports and arrive at the decisions that give life to the accident prevention program. Inspect Regularly Regular inspections make possible early discovery of hazardous conditions which have developed or which may develop. Supervisors and workers knowing that regular inspections are being made will strive to eliminate conditions that might be hazardous. Investigate Accidents Accidents result from failures mechanical, material or human. When an accident occurs, the Directors and/or Safety Coordinators should investigate carefully in order to find and correct the cause. This experience helps them to make more valuable recommendations. Also, the combined efforts of the Director and Regional Manager may bring to light important items that would otherwise be overlooked. Develop Accident Data By compiling and analyzing accident reports, we determine how many injuries occurred, when they occurred, and what the main causes were. We can use this information to determine which phases of the safety program need to be emphasized or modified. Safety, First Aid Training and Emergency Procedures Safety, first-aid training and emergency procedures not only give workers and supervisors an opportunity to learn more about these subjects, but also are an excellent means of arousing and maintaining their interest in them. See that adequate First-Aid Facilities are provided In addition to sponsoring first-aid training, the Safety Coordinator should see to it that there is a centrally located first-aid station, even if the size of the station warrants only a box or locker of bandages and other supplies, rather than a separate, well-equipped room. The Director should make certain that responsibility for maintaining the first-aid station has been clearly assigned. Plan Special Features By featuring one phase of accident prevention each month, The Safety Coordinator can concentrate their efforts and heighten the safety awareness factor one idea at a time. Good housekeeping, safely kept floors and aisles, correction of machine hazards, tools, and correct ways to handle materials are excellent subjects for this type of plan.

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Short Employee Safety Meetings Once the busy season is underway and everyone is working at full capacity, the points made about safety in the orientation discussion may be forgotten. Unsafe work choices that are being made may begin to creep in. Tiny things get overlooked that could help control safety costs and team member accidents. Or sometimes people are just too lazy to care (NOT our team members!). The way we help to remind our team members is with Safety Meetings. Some Pointers:

• Keep them very short, 5 to 10 minutes (AT Staff Meetings).

• Cover one subject only.

• Demonstrate an object to focus attention. Hold it in your hand, if possible, or gather the employees around it.

• Get employees to participate in the talk, to arouse their interest and show that they understand.

• Give team members a short quiz (they need to complete) and gather after the meeting (make sure their names are clearly written so you can file in their file). Use this as an assessment of how well the training went, if they listened and if they learned anything.

o If they scored badly work with Management/Human Resources to set up a Power Point Presentation on this topic so that they can read and take the quiz again. Anything under 75% should result in a re-take.

• Document the meeting. This may be needed later on, in a disciplinary situation or if you are visited by a compliance office from OSHA. Most importantly, it shows who may have been absent and will have to be spoken to individually later on.

• Schedule the meetings and stick to the schedule, otherwise they are likely to be postponed or forgotten about. In a short, intense season, you may need meetings on a weekly basis.

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12 Rules of Successful Safety Meetings Rule #1: Start the meeting on time. If you run late, they start looking at the clock. Such distraction can ruin a carefully prepared presentation. Rule #2: End the meeting on time. If you promised to keep it brief, keep it brief. If you promised to end by a certain time, end at that time. Understand that your audience wants to get back to work. Their time and patience is limited. Rule #3: Observe the KISS rule. Keep It Straightforward and Simple. Zero in on just a few key points and don't bore your audience by reviewing the whole safety manual in a single session. When it comes to safety training sessions, less is more! Rule #4: Stick to your agenda. Control the meeting and don't let it turn into a social hour or a beef session. You should be flexible enough to respond to concerns expressed during the session but still keep to the topic. Rule #5: Encourage questions. Remind participants that there's no such thing as a dumb question. Questions enable you to make important points and get a sense of whether your message has gotten through. Repeat questions in your own words to make sure you understood and that everybody in the audience heard the question. Rule # 6: You don't have to have all the answers. If a question comes up that you can't answer, don't fake it. Promise to look into the matter and report back at the next safety talk. Better yet, direct the question to your audience to see if any of the participants have an answer. Rule #7: Find ways to involve participants. For example, ask them for examples of hazards and safeguards related to the topic. Another good idea is to have audience members pick a partner with whom they can take turns practicing the safety technique being discussed. Devices like these maintain audience interest and promote retention of the discussion. Rule #8: Use Humor. This is another way to keep the attention of your listeners and help them remember what's been discussed. Rule #9: Show interest in your topic. You can't keep an audience engaged when the speaker appears bored with the topic. So be as animated as you can without resorting to acting or behavior that is unnatural for you. Rule #10: Treat your audience with respect. Keep in mind that your participants may include workers who have years of experience on the job. Draw on the collective wisdom in the room. Invite them to comment or demonstrate techniques. If the topic is familiar to your audience, treat it as a review. At the same time, guard against complacency. Remind participants that even experienced workers develop unsafe habits.

Rule #11: End your meeting on a positive note. Sum up the key points that are outlined on your copy of the talk along with any further action that you want workers to take to follow up on the safety meeting. Thank the audience for taking the time to participate in the session.

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Rule #12: Honor your promises. If you promise to follow up on a safety concern for an upcoming meeting, make sure that you do. There is no surer way to lose both credibility and respect than making promises you don't keep.

Safety Meetings are an excellent way to keep in touch with current safety concerns in your workplace. They're also an excellent way of emphasizing any safety accomplishments that have been gained by the group.

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EMPLOYEE SAFETY MEETING

Date: ______________________________ Time:_____________________ a.m./p.m.

Conducted by: _______________________________________________________________ Title: ________________________________________________________________________ Subject Discussed: ____________________________________________________________ Employees in Attendance (please write legibly) _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________

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Establishing an Effective Safety Committee Your Safety Committee has a most important job in communicating safety, and advising on the entire safety effort. The Committee enables representatives to participate in open discussion on the formulation of policy and programs for the organization. The Committee is a valuable part of loss control efforts. It is especially important in communicating problems and their possible solutions to both upper management and front-line supervision. The Committee must work to maximize the involvement of all employees at all levels in the safety effort. Authority The Safety Committee, with management representation (the Safety Coordinator) and leadership from the operations side of your organization, has the authority to recommend improvements in the organization’s safety management system. In some instances a cross-functional Committee, representing major departments in the organization, can help to eliminate many of the barriers that could arise when implementing and leading safety improvement strategies across the organization. However, line management must be responsible for implementing the changes. Building Safety into Line Operations Once your organization makes the commitment to establish safety as a major priority, there are three critical steps that you can take to build safety into line operations:

1. Establish an accountability system for safety that encompasses the entire organization. 2. Provide training at all levels. 3. Continuously improve your focus: work towards the goal of zero accidents.

What Are the Safety Committee’s Main Areas of Responsibility? The Safety Committee is an important vehicle for communicating the importance of safety to all workers.

• Serves as a means of safety communication • Analyzes accidents and trends • Designs and manages safety incentive program • Coordinates education programs • Coordinates and allocates resources for prevention • Creates and maintains an active interest in safety

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Who Participates on Your Safety Committee? A broad membership that draws on line supervisors and line workers is essential. The chairperson is the Safety Coordinator. Total membership should be limited to 5 people (this may vary based on employee population). Appointment to the Committee should be viewed as a positive event. Members should be drawn from:

• Senior Management • Department Heads • Directors and Assistant Directors • Team Members

Any departments at risk for injury should participate. Membership should be for a specific time period and on a rotating basis. This ensures widespread awareness and support for the Committee and avoids falling into an ineffective routine. How does the Safety Committee Work? The Committee should meet regularly, probably once a month. The agenda should be established in advance and include the following:

• Review of old business, especially making sure appropriate follow-up has been take to correct identified hazards.

• Review of main focus items. • Accident analysis and corrective actions. • Safety incentive programs. • Inspection tours. • Safety education programs. • Safety focus areas, guest speakers or supplemental training.

Following the establishment of a Safety Committee, loss experience results should be shared among the Committee in order to understand trends in loss experience. This enables all “stake-holders” to understand how their efforts can have a positive impact on the bottom line.

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Plan Before an Accident Occurs

This can save lives and money!!

1. Establish an Emergency Action Plan a. Emergency telephone numbers should be posted by all outgoing phones. A map

showing the nearest health care facility should also be posted in a central location. In emergency situations, the nearest facility that can handle the injury should be used (if you don’t have these please contact the Human Resources Department).

b. The name and location of the health care provider designated by the employee should also be posted if it is different from the nearest location. Employees should go to this medical provider for all injuries, except, in emergency situations where another qualified medical provider is closer. When job locations change, the nearest ambulance and hospital locations, and emergency phone numbers should be updated.

c. Team Members should be instructed as to what to do if an accident happens. Responsibility for phoning, transporting and caring for injured employees should be pre-determined.

2. Maintain an Adequate Supply of First-Aid Materials

a. The amount and type of first-aid supplies available should be appropriate to the number of employees and the types of hazards they are exposed to. A Doctor is a good source to consult to make sure amounts and types of supplies are available.

b. The Safety Coordinator is responsible for routinely checking to make sure first-aid supplies are properly maintained and are in adequate supply.

c. Each separate job location must maintain a supply of first-aid materials. A first-aid manual should also be available at each school.

3. Provide First-Aid Training to Employees a. Phoenix Children’s Academy makes first-aid training available to employees.

The number of employees trained, and the degree of their training, should be appropriate to the hazards of the job and the remoteness of the work location.

b. Information on first-aid and CPR is available from the Safety Coordinator.

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Teacher’s Classroom Safety/Sanitation Checklist

CLASSROOM: DATE: INSPECTED BY: CLASSROOM ISSUES YES NO COMMENT

1 Floor clean and in good repair? 2 Walls clean and in good repair? 3 Windows clean and in good repair? 4 Carpet clean and in good repair? 5 Trash containers with lids, emptied

appropriately?

SANITATION ISSUES

1 Good hygiene practices? 2 Proper Diaper Changing/Toilet

Procedures

3 Adult hand washing practices correct? 4 Children’s hand washing practices

correct?

5 Gloves in use? 6 Toys sanitized properly and frequently? 7 Changing tables sanitized properly? SAFETY ISSUES

1 Adult items out of reach? 2 Approved classroom chemicals only? 3 Chemicals labeled (bleach, water, etc.)

properly?

4 Chemicals out of reach? 5 Outlets covered? 6 Electrical cords out of reach? 7 Toys appropriate and safe? 8 Fire Safety 9 Doors not blocked?

10 Evacuation notice properly displayed? 11 Evacuation cribs identified? 12 Safety belts in baby chairs? 13 Room free of hazards? 14 Classroom equipment in good repair? 15 Chairs not stacked on tables while room

is occupied?

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ACCIDENTS WITHIN THE PAST MONTH DATE TIME

TYPE

1

2

3

4

5

6

7

8

9

10

Additional Notes for Next Safety Meeting: ______________________________________________ ______________________________________________________________________________ _______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _________________________________________________________________________________ ______________________________________________________________________________

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Safety Sanitation Inspection Checklist Center: _____________________________ Director: ____________________________ KEY INSPECTION ITEMS DEFICIENCY COMMENTS 1. Health Practices Regarding

Children

Hygienic Practices Diaper Changing Disposable Wipes Diaper Proper Handling 2. Site Free of Hazards Outdoor Play Areas Protected Water Hazards Fencing intact, good shape Insect, Vermin/Animal Control

3. Facility Lighting – all lights operational

Clean Surfaces Floors Walls

Electrical Openings Protected Safety Glass/Decals Storage of Harmful Items Gates Handrails, Barriers Clean, Safe Interior Clean Safe Exterior Ceilings

4. Safety of Equipment Physical Building Furnishings, Toys

Cribs, Playpens, Feeding Chairs Safety Barriers Microwave Ovens

Non-toxic Materials Stored Room Temperature First Aid Supplies Playground Equipment

5. Bathrooms

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Toilets/Lavatories Step Stools Training Equipment Ventilation Clean Good Repair

KEY INSPECTION ITEMS DEFICIENCY COMMENTS Water Temperature Soap Individual Towels Easily Cleanable Walls

Easily Cleanable Receptacles 6. Water Supply

Source, Supply, Pressure Drinking Fountain

7. Waste Disposal Water Tight Containers Garbage, Solid Waste Liquid Waste / Sewerage Soiled Diapers

Proper Cleaning Procedures 8. Preparation, Serving,

Storage of Food / Protection of Supplies

Hand washing facilities Protected/Stored Properly Handled Properly

Single Serve Articles Stored, Used Properly

Common Drinking Cups Personal Health Personal Hygiene of Staff Hazardous Foods Properly Prepared

Adequate Temperatures Special Foods Labeled Source, Sound Condition No Spoilage Stored Food Properly Labeled

9. Cleaning, Storage, Handling of Utensils, Equipment

Washing, Rinsing, Sanitizing

Food Contact Surfaces Sanitizing Test Kits Storage of Utensils

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Handling of Utensils Kitchen Hood Clean Refrigeration/Freezer compartments clean

Floor Condition KEY INSPECTION ITEMS DEFICIENCY COMMENTS 10. Teacher Training

CPR 1st Aid Safety Issues

Comments: Signed: _______________________________________________ Date: __________________________________________

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Safety Inspection School: __________________________ Director: _____________________________ Date: _________________ Discussed with Safety Coordinator on date: ______________________________________________________ YES NO INJURY, ILLNESS AND PREVENTION PLAN Floors are smooth and have non-skid surfaces. Rugs are skid proof. Doors that children can access are easily opened by children and adults. Doors in children’s areas have see-through panes for easy visibility for anyone opening

the door. Doors have slow closing devices and/or rubber gaskets on the edges to prevent finger

pinching. Windows cannot be opened more than 6 inches from the bottom. All windows have closed permanent screens. Bottom windows are lockable. Walls and ceilings have no peeling paint or cracked plaster. The childcare setting is free of toxic or lead paint and or crumbly asbestos. Safety covers are on all electrical outlets. Electrical cords are out of children’s reach. Covers of guards for fans have openings small enough to keep fingers out. Freestanding space haters are NOT used. Nobody smokes or has lighted cigarettes, matches or lighters around children. Tap water temperature is 120 degrees to 130 degrees Fahrenheit or lower. All trash containers are covered at all times. All furniture has cushioned edges. Emergency lighting equipment works. Children are always visible in all areas. Poisonous plants are not present indoors or outdoors in the child care area. All adult handbags are kept out of children’s reach. All cleansers, cleaners, medicine and paint are kept out of children’s reach and kept in

locked cabinets. Pesticides are not used during normal operation of the childcare setting. A certified pest control operator applies pesticides. Children are never left alone in infant seats on tables or other high places. Teaching aids such as the TV and VCR’s are put away when not in use. YES NO TOYS AND EQUIPMENT Toys have no sharp edges or points, small parts or pinch points. All toys are painted with lead-free paint. Toys are put away when not in use. Toys that are mouthed are washed after every use. Children are not allowed to play with any type of plastic bag or balloon. Toys are too large to fit into child’s mouth. Infants and Toddlers are not permitted to eat foods that they can easily choke on (i.e.

hot dogs, grapes, hard candy, popcorn, etc.). Toy chests have air holes and a lid support or have no lid. Shooting and Projectile toys are not present.

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YES NO TOYS AND EQUIPMENT All commercial art materials are stored out of children’s reach. Rugs, curtains, pillows, blankets and cloth toys are flame resistant. Cribs, playpens and highchairs are away from electrical cords and wires. Toys are not hung across cribs of infants who can sit up. Rattles, pacifiers or other objects are never hung around an infant’s neck. YES NO PLAYGROUND The playground offers a wide range of parallel and interactive activities. All surfaces underneath play equipment are covered with 10 to 12 inches of impact-

absorbing materials such as sand, wood chips, or pea gravel. YES NO VEHICLES All vehicles work well. Staff helps to buckle and unbuckle children at drop-off and pickup. All vehicles are locked when not in use. The caregiver has current emergency contact information when driving children. Trip plans include how to manage emergencies. Children wear identification when transported. Pickup and drop-off points are away from traffic. Driver knows where children are before putting vehicle in reverse. All children that do not meet the age or weight requirements for your State must be in a

car seat (Check you State specific current law). Bicycles and other riding toys are stable, well-balanced and of the appropriate size. YES NO HALLWAYS AND STAIRS Handrails are securely mounted at Child’s height. Doorways to unsafe or unsupervised areas are locked unless used as an emergency exit. Emergency Exit Doors have easy open latches. Safety glass is used in all areas of potential impact. Caregivers can easily monitor all entrances and exits to keep out strangers. Stairways and hallways are clear of objects that can cause a fall. YES NO KITCHEN AND FOOR PREPARATION AND STORAGE AREAS Caregivers always wash their hands before handling food. Caregivers always wash children’s hands before mealtimes. Trash is always stored away from food preparation and storage areas. All perishable foods are stored in covered containers at 40 degrees Fahrenheit or

lower. Pest strips are not used. Cleansers and other poisonous products are stored in their original containers, away

from food and out of reach of children. Non-perishable food is stored in labeled, insect-resistant metal or plastic containers

with tight lids. Refrigerated medicines are kept in closed containers to prevent spills that would

contaminate food. Food preparation surfaces are clean and are free of cracks and chips. Appliances and sharp hazardous cooking utensils are stored out of children’s reach. A fire extinguisher is securely mounted on the wall near the stove. All Caregivers are trained in proper handling of fire extinguishers. Trash is stored away from the furnace, stove and hot water heater.

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YES NO KITCHEN AND FOOR PREPARATION AND STORAGE AREAS Kitchen area is not accessible to children without constant adult supervision. Caregivers do not cook while holding a child. Hot food and liquids are kept out of children’s reach. Stable step stools are used to reach high places, not chairs. YES NO BATHROOMS Stable step stools are available where needed. Electrical outlets have safety covers or are modified to prevent shock. Cleaning products and disinfectants are locked in a cabinet out of children’s reach. Toilet paper is located where children can reach it without having to get up from the

toilet. If potty-chairs are used, they must be easily cleaned with a bleach solution. There are enough toilets so children do not have to stand in line. Caregivers and children always wash hands after toileting and diaper changing. The changing of diapers or soiled underwear is done in a special, separate area away

from food and play. The diapering or changing table has rails to keep the child from rolling off. Trash cans for diapers, tissues and other materials that come in contact with body

fluids can be opened with a step pedal and are lined with a plastic bag, emptied daily and kept clean.

Paper towels and liquid soap are readily available at the sink. Children are never left alone on a changing table, bed or any other elevated survace. Children are never left unsupervised in or near water. YES NO EMERGENCY PREPAREDNESS All Caregivers share roles and responsibilities in case of fires, injuries, or other

disasters. One or more Caregivers who is certified in first aid and infant CPR is always present. All first aid kits have the required supplies, and are stored where Caregivers can easily

reach them in an emergency. Gloves are used when necessary to clean up injuries. Each room and hallway has a fire escape clearly posted. Emergency Procedures and telephone numbers are posted near a phone and can easily

be taken along in case of an emergency. Emergency procedures include the following:

1. How to phone emergency medical services (EMS). 2. Transportation to an emergency facility. 3. Notification of parents. 4. Where to meet if the child care setting evacuated. 5. All emergency exits are posted. 6. Plans for an adult to care for the child while a Caregiver stays with the inured

children. 7. How to escort children to Emergency Medical Care.

All exits are clearly marked and free of clutter. Doors and gates open for easy exit. Children are taught to tell if they or anyone is hurt. Monthly Fire Drill is conducted and logged on fire drill sheet in the handbook, including

time spent exiting and the date.

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Setting Up a Safety Incentive Program Who should set up a Safety Incentive Program at their school?

• All School Director’s/Principals with the help of the Safety Coordinator should have some

form of an incentive program that fits their State and Schools specific requirements. The Safety Coordinator will be in charge of ensuring the program is run and is running efficiently.

1. Prevention of work place injuries is a requirement of all Supervisors and the Company that they represent. An incentive program can cost minimal dollars in comparison to a costly work related injury. It can prevent a team member from receiving an injury that could affect them for the rest of their life and a compensation package that no Company wants to have to pay out through increased Workers’ Compensation Premiums.

How do I set up an Incentive Program at my school?

• There are a wide variety of accident prevention promotional activities that have been proven successful by employers who have gained outstanding safety records by utilizing these strategies. Some Companies implement programs that can cost thousands of dollars to encourage team members to work safer and other Companies like ourselves can obtain the same results with creative ideas that are affordable to our School and type of business.

What factors should I consider when setting up a Safety Incentive Programs?

• What some people find interesting and rewarding varies considerably according to school and locale. Here are some activities to consider when you set-up your program:

1. Special meetings with presentation of awards, announcements of safety policy or practice, or purchase of safety equipment. Contests for Safety Record Improvement or Safety Poster Design. Safety Displays, Safety Suggestions, systems, and signs showing days worked without a lost-time accident.

2. Making these activities successful, means changing the activity to fit each individual situation. What stirs people to action varies considerably depending on their motives, emotion, attitudes and background. When developing promotional activities involve the team members. If the activity interests them and helps you meet your accident prevention goals, ALL BENEFIT.

3. Keep changing your promotional activities to fit your schools need. Even a good thing gets stale. Change or vary your promotional activities when interest lags. Later, you can rerun the more successful activities if you do not use up their usefulness.

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Ideas for a Safety Incentive Program DANGER! DANGER! DANGER! 1) Initial Two Hour Training: DANGER! DANGER! DANGER!

a) Setting the Scene b) Sample Training Packets & Sample Meeting Agenda c) PCA Phoenix Squares Game d) Safety BINGO e) Introduce Safety Coordinator Position f) Incentive/Reward Programs

2) Safety Incentive Game

a) Ongoing Safety BINGO Game i) Sample Game Cards ii) Reward Examples

3) Rewards/Incentives

a) Short term and long term rewards 4) Supporting and Promoting the Program

a) Monthly Staff Meeting Agenda Topic b) Posting the Winners c) Safety Coordinator Position

Setting the scene

DANGER! DANGER! DANGER!

A. Use yellow caution tape to hang from doorway as staff enters room. B. Decorate tables with white table cloths and use yellow caution tape to make bows or

wrap around tables. C. Give all staff a plastic yellow hard hat as they enter the meeting. These can be found at

most party stores, Oriental Trading Company, etc. Children’s party hats! Of course if you have real ones that would be a nice touch.

D. Decorate the meeting with props like Wet Floor Signs, Saw Horses, Danger Signs, etc. E. The Director and Assistant Director could wear fluorescent orange shirts and safety

vests – the kind construction or road workers wear. Encourage all staff to wear orange and yellow attire to the meeting.

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Safety Program Date: _________________________ School: _______________________________ 1) Initial Two Hour Training on DANGER! DANGER! DANGER!

a) Setting the scene: Staff Meeting Decorations i) White Table Clothes with yellow flowers and Yellow Caution Tape ii) All Employees are given yellow & white hard hats as they walk in to the meeting. iii) BINGO Cards at each seat.

b) Teach them the DANGER! DANGER! DANGER! Cheer and practice it as a 3 part round. c) Play BINGO throughout the meeting! This will introduce the SAFETY BINGO

INCENTIVE game (explained later in this chapter). d) Play the “Phoenix Children’s Academy Squares” Safety Game – Based on the

Hollywood Squares TV Game Show. e) Hand out the DANGER! DANGER! DANGER! Packets to all staff.

i) Review all Company Safety Procedures from the Safety Binder. ii) Examples:

(1) Basic Safety Principals (2) General Safety Rules (3) Coaching Counseling Form (4) Safety Program as written in Employee Handbook (5) Signed Acknowledgement Form for Safety Practices and Employee Safety (6) Copy of Classroom Inspection Forms

f) INTRODUCE SAFETY BINGO GAME (Short term & Long term Incentives) i) Introduce with everyone singing the Safety BINGO song.

(1) Yes it is corny but you’ve got to be the kind of Director, Cheerleader that can pull this program off successfully.

ii) $50.00 Gift Certificate to the winner. iii) Review the rules of the game

g) Additional Incentives Programs: (Long Term Incentives) i) 90 working days without an accident – pizza party for staff ii) 1 year – Luncheon and T-Shirt

(1) Recognition Banner Posted in the lobby or outside iii) 2 years – Luncheon, Polo Shirt with Logo, Gift bag, Director will wear a costume

for the day (i.e. Hotdog, Big Bird, Dinosaur, etc).

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The Safety Squares Game Show Preparations: 9 Large Yellow Post Board Cards Marked with a LARGE “X” on one side

and a large “O” on the other side. Set-Up: Set-up chairs in three rows of three chairs with a set of “X” & “O” Cards

on each seat. Set up small table that will seat two contestants. Decorate the table as the Safety Squares and designate one seat as the

”X” Contestant and the other set as the “O” Contestant. Select: Select 9 Volunteers to sit in the Safety Squares Chairs Select 3 Volunteers to be the Contestants The Director and/or Safety Coordinator is the Game Show Host Object of the Game: Contestants compete to win prizes by getting a Tic Tac Toe with three in

a row of “X’s” or “O’s” Directions: Contestant “X” picks a person in the Safety Squares and the host will ask

that person a pre-selected question. Contestant “X” must either agree or disagree with the person’s answer to the question. If they are correct then they get to put an “X” in that spot (the person holds up the “X” Card).

Contestant “O” goes next and the host will ask this person a pre-selected

question. Contestant “O” must either agree or disagree with the person’s answer to the question. If they are correct then they get to put an “O” in that spot. They then take their turn and possibly play to win.

When any contestant gets a Tic Tac Toe they win a prize (gift cards to

Wal-Mart, Target and other stores that are used regularly are great incentives). The Losing Contestant also receives a prize for participation (make this a smaller amount of a gift card and/or something else from the school). The nine volunteers all receive a candy bar (prize) for playing. Select another 9 players and 2 contestants to play a new game, if you have the time.

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Safety Square Sample Questions

1. What was the average cost of our Workers’ Comp Claims for last May 2011 – May 2012?

a. $1,629 b. $867 c. $2,745

i. ANSWER is C

2. How much did the largest claim total after all medical expenses, missed time and rehabilitation cost for May 2011- May 2012?

a. $66,234 b. $78,884 c. $109,165

i. ANSWER IS C – all of these are actual claim amount numbers that the Company paid for last year for ONE accident

3. What was the cause of this large accident?

a. Lifting wrong b. Slip or fall c. Hit with a flying object

i. ANSWER is B

4. What % of Workers’ Comp Claims was caused by carelessness or failure to follow appropriate safety standards?

a. 75% b. 89% c. 100%

i. ANSWER is 100% - all claims can be avoided when safety rules are followed

5. When trying to reach high places, step stools, ladders, sturdy tables are acceptable to

use? a. True b. False

i. ANSWER is False

6. Where is the Maintenance Log Kept?

Answer ________________________________________________________________

7. How many fire extinguishers are in the school and where are they located: Answer ________________________________________________________________

8. What could happen to an employee who fails to comply with Phoenix Children’s

Academy Safety Rules:

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Answer: Written documentation up to and including termination.

9. Which of the following causes trips and falls? a. Tripping over a child behind you b. Toys left on the floor c. Spills/food left on the floor and not cleaned up d. All of the above

i. ANSWER is D

10. Cleaning/Spray Bottles must be labeled with the type of contents inside? a. True b. False

i. ANSWER is True

11. The leading cause of fires in the school setting is? a. Kitchen Fires b. Janitor’s Closet Fires (washer, dryer, hot water heaters) c. School-agers playing with matches

i. ANSWER is B

12. What is the appropriate footwear for Phoenix Children’s Academy Employees?

Answer: ___________________________________________________________________ 13. What is the name of the Government Agency that regulates Safe Working Conditions

for Employees? i. ANSWER is OSHA (Occupational Safety and Hazard Agency)

14. In the Child Care Industry what it the leading MOST EXPENSIVE cause of work related

injuries? Answer: Lifting/back Injuries; 2nd is trips and falls

15. Under what circumstances can an employee leave their shift without reporting an injury

to their supervisor? ANSWER: NEVER

16. What is the MSDS Log?

ANSWER: Material Safety Data Sheets

17. All cleaning supplies must be kept on the sink counter out of the reach of children? a. True b. False

i. ANSWER is False – must be kept locked in a cabinet out of reach of children

18. A child suffers an injury to the head and is bleeding profusely from a large cut on the

forehead what is your first course of action? i. ANSWER is Glove Up

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19. It is ok to stand on an adult chair to staple a bulletin board but it is never ok to stand on a

child’s chair? a. True b. False

i. ANSWER is False – Chairs are made for sitting and not standing on

20. When is it appropriate to leave a spill/liquid on the floor? a. Juice when it is under the table because it is out of the walkway b. Urine on the floor in the bathroom because it is the Janitor’s job to clean it up c. Water around the sink area because you just don’t have enough time to clean

with 24 children d. None of the above

i. ANSWER is D

21. It is ok to leave boxes, strollers, play equipment, etc in the hallway until a member of management moves it?

a. True b. False

i. ANSWER is B – we are all responsible for keeping our schools as safe as possible and that means clearing hallways and moving items so that no one gets hurt

22. When using a Fire Extinguisher – what does the P.A.S.S. method stand for?

i. ANSWER is Pull, Aim (at the base of the fire), Squeeze and Sweep

23. You’re working hard on your bulletin board and you don’t want to set your scissors down at a child’s level, it is acceptable to put them in your pocket or smock pocket?

a. True b. False

i. ANSWER is False – cut as much as you can before putting items on a bulletin board, if scissors are needed get down and use them then put them back in safe spot.

24. When diapering or potty training, it’s correct policy to change gloves between each child

therefore not needing to wash hands between each child? a. True b. False

i. ANSWER is False – you must wash your hands between each change regardless of the conditions (urine or poop) and even though you are using gloves. Bacteria can and still will get on your hands.

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Safety Bingo Rules of the Game:

1. For each day your school goes without an injury, one BINGO number will be pulled and posted on the BINGO Board. Play will continue each day until someone gets a BINGO.

2. If someone is injured on the job, then the game is immediately stopped and a new game

will begin on the first of the next month.

3. If management observes a staff member not following a Safety Policy and/or Guideline or using poor judgment, then they will post the Safety Violation and NO BINGO number will be pulled for that day.

4. If there is a tie, then the prize will be split between the winners.

5. Have FUN!! Get BINGO and WIN a $50.00 Gift Certificate.

WORKING SAFE….PLAYING SMART Remember: DANGER! DANGER! DANGER!

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SAFETY BINGO SONG

We have a game to keep us safe

And BINGO is its Name O B-I-N-G-O B-I-N-G-O B-I-N-G-O

And BINGO was its Name O

We’ll work and teach and keep us safe And BINGO is its name O

B-I-N-G-O B-I-N-G-O B-I-N-G-0

And BINGO is its name O

Win the game and get a gift card And Target is its Name O

B-I-N-G-O B-I-N-G-O B-I-N-G-O

And BINGO is its Name OOOOOOOOOOO

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Sample of BINGO cards you can get off the Intranet

B I N G 0 5 13 47 29 10

37 22 3 45 30 17 1 FREE

SPACE 27 11 8 16 24 18 28

48 19 12 25 36 31 16 36 42 2

B I N G 0 12 39 48 23 1 7 16 23 45 10

17 22 FREE SPACE 33 44

15 29 46 30 4 9 19 31 25 38

31 32 36 42 2

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Use Numbers to cut out for SAFETY BINGO (also on the Intranet)

1 2 3 4 5 6 7 8 9 10 11 12

13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48

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Promoting the Safety Incentive Program

A. Make sure that Safety BINGO is done every day and follow through on all winnings immediately.

a. Post the game in the staff lunch room or other central areas. b. Post any violations. c. Post ALL winners and make it special.

B. Monthly Staff Meetings

a. Health and Safety Program on EVERY Agenda. b. Safety Program is the first item on the Agenda. c. Make the monthly topic meaningful with handouts, videos or demonstrations. d. Discuss any Violations of the Safety Policies for that month.

C. Safety Coordinator

a. Support the Safety Coordinator daily. b. Allow the Safety Coordinator to present at Staff Meetings on Safety Topics.

D. Directors and management need to constantly make it a priority every day. It is your

leadership and commitment that will make this successful!!!!

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Employees Safety Suggestions

Name: ___________________________________ Date: ______________________ Supervisor’s Name: ________________________ School # ___________________ Practice or Condition Now: Suggestions: Benefits Expected from Change: Action Taken: Date Acted On: Date of Final Action Notice to Suggestion: Implementation Date:

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Safety Coordinator – Agendas

MONTH THEME SAFETY TALKS POWER POINT PRESENTATION

HANDOUTS POSTERS

January Proper Lifting Techniques

February Emergency Procedures

March First Aid

April Nap room Safety, Walkways, clutter,

stepping over Children

May On the job injury procedures

June Playground Safety Spread out, Sun Safe

Spare the Air Days

July Keep hands and arms clear of doors

August Spills, Entry/Hall Walkways (high traffic

areas)

September Strains, Sprains, proper lifting

October Food Preparation, Spills/Slips lunch area

November Cleanliness and Hygiene

December Classroom Safety Checklist

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Safety Awareness Ideas Here are some quick and easy ways to help employees be more aware of safety every day. These ideas cannot take the place of a fully implemented safety program, but they can help.

1. Give Supervisors More Accountability: Expect supervisors to make regular inspections of work areas, submitting completed inspection checklists to the Safety Director. Any injuries resulting from malfunctioning equipment not identified by the inspection will be the responsibility of the supervisor.

2. Get Workers Involved in Safety Inspections: Choose workers at random to complete daily safety surveys of their own department or work areas. Choose different workers each day (have Safety Coordinator make a list of who has been chosen and who has not). This encourages workers to focus on safety as they perform their surveys. Identified hazards are referred to the appropriate person for corrective action. Make sure hazards are actually corrected!

3. Choose a “Safety Slogan of the Month:” Choose workers at random to come up with the motto for the month. Reward them with a special prize for being creative and being part of the Safety Team.

4. Focus on Work Groups: Complete a review of injury trends by department, and use department meetings to discuss problem areas. Solicit suggestions from team members and issue a challenge to the work group to achieve a reduction in injury rates over a certain time period.

5. Start a Safety Suggestion Program: Let employees give their opinion of things they see that good possibly affect the safety of the employees, children and the school. Make form easily available to employees to complete with suggestions. Have a specific drop off spot for the suggestions (it does not have to be a box can be a mailbox and/or a vase on a desk). Give awards and recognition to the most useful suggestions.

6. Install an “Injury Traffic Signal” at each doorway: The traffic light “turns” yellow for any minor injury and red for any lost time injury. Three days after the incident, the light turns back to green.

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INJURY

PREVENTION

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Injury Prevention Ready, Set Lift Skills Skills to Master Don’t allow a back problem to interfere with your work by mastering the following skills. These strategies are provided to give you the proper direction in lifting items and children. Safe Lifting The “perfect” lift is one where you lower your body down by bending your hips and knees. Your back stays erect, and you hold and lift the item from directly below you. There’s less force on your back, and your hips and legs do all the work – not your back muscles. But most often, you have to bend forward to get the item. This requires timing and coordination between your back and hips as you bend forward to gather ad lift the item. Imagine how you would safely lift a bag of groceries from the back seat or trunk of a car, pick a bulky object off the floor, or grab a trash container from the kitchen cupboard or pantry. The skills listed here are designed to help you gain strength and coordination in your back, hips and buttock muscles so you can keep your back safe when you lift.

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Lifting Infants and Kids Unlike lifting a compact box, children come in all shapes and sizes. They may by lying down, sitting up or flailing their arms, or waiting in a crib. They pose a unique challenge for safe lifting. The key to lifting infants and children is to always apply the concepts of Safe Lifting. Plan ahead. When possible, don’t be in a hurry. Keep your back in the power position as you bend down toward the child, hinging your hips and not hunching your back. Gather the child closely to your chest. Rise up using your hip, buttock and leg muscles. Infant Lifting Technique – “Tripod Lift”

1. Put one foot next to the infant. Keep your back straight, push your buttocks out and slowly lower yourself down onto one knee.

2. Position the infant close to your knee on the floor. 3. Slide the infant from you knee on the floor to mid-thigh, while

keeping your head forward, your back straight, your buttocks out, and lift the infant onto the opposite thigh.

4. Put both of your forearms under the infant with your palms facing upward and hug the infant close to you.

5. Prepare for the lift by looking forward. 6. Lift upwards following your head and shoulders. Hold the infant

close to your body. Lift by extending your legs while keeping your back straight and buttocks out. Remember to breathe as you lift.

Acronym to Remember Use the following acronym as a guide when engaging in child handling procedures: Back Straight Avoid Twisting Close to Body Keep Smooth The Pivot Technique

• Use the Pivot technique for lifts requiring turns. This will help twisting when lifting.

• Properly lift the Infant using the infant lifting technique. • Hold the infant close to your body.

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• Turn your foot 90 degrees towards the direction you wish to move. • Bring your other foot next to the lead foot. Do not twist your body.

Holding Technique

• When holding toddlers, you should avoid placing them on one hip. • When holding or rocking children, use chairs or furniture with upper

back support. • Keep children centered on your body and use both arms to hold. • It is also helpful to teach the children to help you lift by holding onto

your body rather than leaning away from you.

Other Ways to Reduce Risk of Back Injury When Caring for Children

• Store frequently used or heavy items in easily accessible areas and at waist height.

• Avoid bending down at the waist to interact with children. Instead use a squatting or kneeling position.

• If possible when sitting on the floor, sit against a wall, or furniture to support your back.

• Minimize repetitive bending and stooping when cleaning up toys, etc. Rather incorporate this into children’s clean up time.

• Lower the sides of the cribs when lifting/lowering a child. Loading and Unloading a Clothes Dryer Getting clothes in and of a dryer poses challenges to safe lifting. Wet clothes are heavy. And a large load requires repeated motions to get items in and out of the dryer. Using the concept of Safe Lifting can help protect your spine when loading and unloading a clothes dryer. Place washed items in a clothes basket. Use good technique as you place the basket on the floor next to the dryer. To avoid twisting your back, bend down so that you are facing the front of the dryer. Bend from your hips to keep to keep your back in the power position when placing items from the basket into the dryer. Reverse this order when removing items from the dryer.

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Do’s and Don’ts for Safe Lifting DO NOT LIFT WITH YOUR BACK, LIFT WITH YOUR LEGS

Do

• Place your feet and knees at least shoulder width apart or front to back in a wide-step position. This will allow you to bend at the hips, while keeping your back relatively straight.

• Squat with your chest and buttocks sticking out. If you do this correctly, your back will be flat and your neck will balance in a relaxed neutral position.

• Take weight off one or both arms if possible. When you squat down or push back up, use your hand or elbow as support on your thigh or any available structure. This takes some of the compression and strain off of your lower back.

Don’t

• Lift with your feet close together as it can result in poor leverage, instability, and a tendency to round your back.

• Lift with your knees and hops straight. • Tense or twist your neck while lifting. • Lift children that are too heavy for you.

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Do’s and Don’ts When Your Back is Hurting

Sitting Avoid sitting. If you must sit, get up and move around every twenty minutes. Sit with your knees at hip level or slightly higher than your hips. Use a small towel rolled behind your back to add support in the lumbar. Standing Stand with one foot in front of the other with knees slightly bent. Or place one foot on stool. This position will reduce the pressure on your lower back. Lying Use the resting position frequently. Sleep on a firm mattress. The floor is too firm. Sleep on your back with pillows under your knees, or sleep on your side with knees bent and a pillow between your knees. When rising from a lying position, use your arms for support; roll first to your side, and then push yourself up with your arms. Driving Bring your car or truck seat forward to a position where your knees are slightly higher than your hips. Use a towel roll, magazine roll, or backrest for support. Lifting Avoid lifting. If you must lift, put one foot in front of the other. Bend to the floor and keep the object(s) as close to you as possible. Use the strength in your legs instead of your back. Activity Stay as active as possible. Muscles tighten and stay in spasm if they are not allowed to stretch. Walking is good exercise for low back pain.

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Preventing Slips and Falls Through Effective Floor Care Introduction The procedures and products used to clean and maintain floor surfaces are sometimes a direct cause of many “slip and fall” accidents. Maintenance staff may not have proper instruction and training in floor care, may fail to follow manufacture directions when cleaning and applying finish/wax, or may not understand that specific types of floor require specific types of care. Many of the best cleaning and finishing materials can be hazardous when applied improperly, and using the wrong product for a specific surface can create problems. It is critical that the right product be used on the right surface, for the right reasons, and under the right conditions. Primary Errors in floor care procedure include:

• Floors not completely and properly stripped of previously applied finish. • Floors improperly cleaned or scrubbed. • Floor-treating product applied too often. • Surface not properly buffed when buffing is necessary. • Finish applied with improper equipment. • Too much finishing material applied. • Improper finish for type of floor. • Inadequate drying time. • Inadequate cleaning, leaving soap residue on floor. • Inadequate or untimely removal of spills.

Use Floor Products to increase coefficient friction Many floor treatments are available that can be used to increase the coefficient of friction of floor surfaces. These products are made for specific types of floors and work best on the floors for which they are designed. However, the application of any of these products is not effective unless the floor is properly cleaned and maintained. Maintenance staff must follow specific procedures for proper application of these products in order for the treatments to be effective. Follow Maintenance Procedures of specific floor surfaces The following is an overview of various floor types and general recommended maintenance procedures. Regardless of the floor type or the specific product use, however, the two most important factors in proper maintenance of floor are:

1. The use of a specific chemicals and procedures designed for the particular type floor involved;

2. Proper application of the treatment products according to manufactures specifications. Floor types and cleaning procedures This section is to make you aware of the tile in the school and to ensure that it is being cleaned properly and not creating a hazard (check the chemicals used on the tile to ensure they are right for the tile in the school). You may not know the type of tile but by reading the descriptions and directions you will be better informed on how to save the school and staff from slips and falls. Wet tile is always slippery; we all know that, so do not let that be a reason for an accident in the school. None of these tiles will help eliminate accidents without you and your team being proactive. (BTW – there will be no quiz on the types of tiles ). If you have carpet simply cleaning with a vacuum nightly will help to alleviate any unnecessary accidents. If carpet is frayed make sure it is not a safety hazard and have it fixed.

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Ceramic and Quarry Tile Ceramic tile comes in so many different surface variations that they are difficult to distinguish, and it is almost impossible to generalize maintenance procedures for all types. Ceramic tile is available in virgin fired condition or glazes; some have non-slip additives. Virgin Tile, such as quarry tile, has a generally high coefficient of friction; when properly maintained, it offers a relatively safe surface. Virgin tile is often sealed after installation. Many sealants give the virgin tile a ceramic appearance and also a low coefficient of friction. Some tile manufacturers even warn in their literature that their tile product can be dangerous when wet. Glazed Tiles are not appropriate for high use walkway areas because they have low anti-slip coefficient of friction values. Some glazed tiles are manufactured with non-slip implants; however, glazing eliminated the benefits of the friction implants. Ceramic and Quarry Tile floors are designed and intended to offer a natural look. If they are very shiny, they have been improperly treated. Proper maintenance usually involves the use of stone cleaners and the use of “no wax” stone preservers. Use only chemicals designed specifically for natural and stone tile floors. Vinyl Tile Vinyl and Vinyl Asbestos Tile are plastic or plastic-containing floor surfaces (such as asphalt, rubber, plastic, or linoleum). These plastic sheet tile surfaces have very low coefficients of friction. Floor products that combine cleaner and wax are not acceptable for commercial pedestrian traffic areas because of the build-up of residue that naturally occurs with their use. The usual treatment for these resilient floor surfaces is to strip and clean floor periodically, then to apply a non-slip wax or synthetic resin finish, and buff or polish the floor as little as possible, ensuring that the finish does not create a slippery surface. The application of “non-slip” wax dressing without buffing is highly recommended for these floors. This will allow a safe shine of the floor and will be much easier to clean. A non-slip wax dressing also protects the floor surface from wear. Wood Fewer slip and fall accidents occur on wood floor than on other types of floors. Many stained woods provide safe floor surfaces. The customary finishing treatment for wood floors involves sanding, sealing with a penetrating sealer, and then dressing with a wood solvent-resistant combination cleaner and dressing. Wood floors generally become dangerous when unsafe sealants are applied or when they are oiled. The use of oil on wood flooring is not recommended because a slight film of oil may remain on the floor. If oil is used, the floor must be thoroughly wiped and dried. Appropriate commercial products other than oil are recommended; be sure to apply them according to the manufacturer’s instructions.

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Clean Floors Effectively and Safely Several processes involved in cleaning floor have been discussed. Three of the more important concerns that need to be continually addressed for all floor types are:

1. Use soap sparingly. A little soap goes a long way. Too much soap produces dangerous, slippery residue.

2. Remove all traces of soaps and cleaners. If a floor has been cleaned with liquid or powder soap, flush the surface clean with clean water to remove all soap from the floor surface. Thoroughly clean and rinse all mops, sponges, buckets, etc., to remove all traces of soap.

3. Maintain floors properly to limit build-up of residues. A build-up of soap and wax can defeat even the best non-slip flooring. A non-slip floor has usually been treated or impregnated (scandalous!) with a material to increase friction. When a build-up of residue from soap, wax, or other floor preparations is allowed to accumulate, it may increase to the point that the friction-increasing material is actually buried under the accumulated residue, resulting in a slippery surface.

Use Floor Finishes and Waxes Properly Keep the maintenance of a high coefficient of friction in mind during application of any floor finish. Suspended polymers (plastics) are used in some contemporary floor finishes. AS the floor dries, these polymers become interlocked, creating, in essence, a surface comparable to a sheet of plastic. Some of these plastic floor finishes are safe walkway surfaces before they are buffed. However, many of them have very low anti-slip coefficients of friction and are very dangerous. When a wax must be used, care should be taken to use a non-slip wax. Floor products that combine cleaner and wax are not acceptable for commercial pedestrian traffic areas because of the build-up of residue that naturally occurs with their use. When any type of wax is used, be sure that the floor is periodically stripped, cleaned, and sealed (if appropriate for the type of floor), and dressing applied as indicated by the manufacturer. If a floor is not properly cleaned and rinsed, any residue left on the floor will mix with the newly applied floor finish, destroying much of its water resistance. Use Buffing Only as Specified Many floor finish products on the market are not designed to be buffed. High speed buffing can drastically reduce the coefficient of friction. A floor which has been covered with what should be a very safe floor finish may often be buffed into a very slippery floor. Sometimes maintenance personnel use highly abrasive or nylon pads to buff floors to create a high shine. Often, this buffing is done by a buffing machine set at high speeds. This vigorous buffing will seriously lower the coefficient of friction of the floor surface. In fact, many slip and fall accidents occur when retail and commercial establishments first open in the morning, after the night maintenance crews have cleaned and buffed the floors.

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Many floor maintenance personnel do not understand the need to match floor finishing materials with specific buffing speeds and specific types of abrasive pads. If the buffing speed is too high, and/or abrasives of the pad too great, the buffing will create very slippery floor conditions. It is also very important to wipe the buffing pad clean after every use. Take Care of Standing Water and Spills IMMEDIATELY Standing water or spills on a floor create serious slip and fall hazards; a plan for their immediate removal should be in place. Floors, especially those that have been waxed, should never be left wet. Use a “dry mop” procedure to clean up water and/or spills. A dry mop procedure is one where a slightly damp or dry mop (depending on the substance spilled) is used to clean up water or other spills, the point being to remove the spill without leaving the floor wet. A wet mop simply spreads water and most spilled substances, but does not remove them. If water has been spilled on the floor and not immediately removed, it will start to dissolve the finish. A person may slip in a puddle of water and partially dissolved plastic. Standard practice in floor care procedures to handle spills should include the following:

• Have clean water and more than one clean mop available. • Be sure the mops are dried continuously and not left standing in a bucket of water. • Do not use soapy water during business hours unless absolutely necessary, and then

only in a weak solution. Inclement Weather, Rain, Ice and Snow Protect against slips and falls caused by inclement weather. Start on the outside with the timely and effective application of ice melting material on parking lots, sidewalks, and steps to increase traction. Use shovels and clear snow from walkways, paths, steps and overhangs. To guard against slips and falls, and to protect floors, follow this three-stop procedure during inclement weather.

1. Place a touch “scrape” mat just outside the entrance, where pedestrians can scrape ice, snow, and mud off their shoes before they enter. Be sure this mat has high mat bristles with enough space between the bristles to allow water and ice to fall below the bristles and not collect on top. Sweep or clear this mat on a regular basis, depending on snow or ice accumulation.

2. Place a non-slip absorption mat just inside the front entrance to collect water and excess ice, snow, or mud that is tracked in on pedestrian shoes. Change this mat regularly to assure its ability to keep absorbing water. Place signs warning of wet floor conditions where needed.

3. Be sure that two or three dry mops and squeeze buckets are available to mop up excess water as it accumulates. Keep more than one mop available so that one can dry as the other is being used. Use the “dry mop” technique described above.

Use Mats with Caution Mats, if not placed and maintained properly, can create a “trip and fall” hazard. Take care to ensure that mats are:

• In good condition • Laid flat with no upturned corners • Do not raise the height of a step • Are easily distinguished by color from the walking surface or floor

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Have a program for Fall Prevention Your Company’s top management should ensure that floor care and fall prevention methods and practices are uniformly followed by all employees and contractors. Management should assign accountability for this to the Safety Coordinator. However all management will be held accountable for following proper fall prevention methods in their work. The prevention program, at a minimum, should include:

• Investigate Every Fall Incident to Determine Conditions Every fall incident, like every other accident, must be investigated immediately and thoroughly to obtain all pertinent data (such as location, time, prevailing physical conditions of floor, operations at time of accident, etc.). Record names of witnesses and names of employees who can testify as to the condition of the floor, whether or not they witnessed the accident, etc. Take photographs of the area where the fall occurred to show the physical condition of the area at the time of the incident. Promptly report all accidents to the Insurance Company as well as Human Resources.

• Investigate Every Incident to Determine Cause Investigate each accident to identify cause(s). Summarize and analyze all accident data to discover the cause(s) of falls on floors and the areas or locations producing such accidents, so that operating methods or conditions can be improved to prevent similar incidents. Develop monitoring techniques so management can assess the success, or lack of success of their schools fall incident ratio as well as the costs associated with these falls.

• Hold Employees Accountable Be sure that orientation programs for all new employees include basic safety training. Emphasize fall prevention as well as the relationship between improper work procedures and slip and fall hazards. Make sure all employees have been given the “Safety Rules/Code of Safe Practices” and have acknowledged that they have received by signing and keeping a copy in their file. Not following proper safety policies and procedures could result in disciplinary action up to and including termination.

• Hold Contractors Accountable If a contract company does the cleaning, ensure that the Company is aware of, and uses, proper cleaning and finish compounds and proper maintenance procedures. Require Contractors to provide Certificates of Insurance (this is a Company Policy and every Contractor you use – should have a Liability Insurance Certificate on file) evidencing adequate levels of Completed Operations Liability coverage.

• Conduct Periodic Inspections Periodic housekeeping surveys and inspections, conducted by the Safety Coordinator/Committee are important to the entire Safety Program. Inspections can identify unsafe conditions and improper work methods so that corrective steps can be taken. An inspection program can also stimulate satisfactory housekeeping standards. The success of a Safety Program depends upon the timely identification, investigation, and correction of unsafe conditions and practices discovered through housekeeping surveys, employees reports, or other methods.

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Summary Floor care and maintenance is an integral part of an effective slip and fall prevention program. Select floor care procedures carefully, and use materials, cleaners, and other floor care products according to manufacturer’s specifications. Accident investigation and accident trend monitoring are important components of a slip and fall prevention program. To be effective, a slip and fall prevention program must be tailored to the operations and organizational structure of a Company and accountability and responsibility must be assigned to appropriate staff and monitored for results.

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Basic Fall Incident Analysis Spreadsheet

Accident Number

Date/Time

Name of Person

Weather Condition

Slip or Trip

Slip or Trip on What

Type of Floor Surface

Conditions and Comments

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Maintenance Logs

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Maintenance Log For the Month of: ________________________________

DATE CENTER # HOURS WORKED

WORK PERFORMED DIRECTOR’S INITIALS

TOTAL HOURS WORKED: ____________________ COST: ____________________

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Quarterly Maintenance Checklist School: _______________________ Date: ______________________________ Checklist Completed by: _________________________________________________ Director’s Signature: ____________________________________________________ Date Reviewed

Item

Status

Repairs/Corrections

Date Completed

Downspouts/Gutters Clean

Roof-damage/missing shingles

Exterior sprinkler system-timing/damage

Exterior light-timing/bulbs

Playground-fencing-posts brackets

HVAC Units air-flow clear

Dryer exhaust clear

Vent lines – gaskets

Stove-hood vents

Interior flooring-cracks, tears, damages

Interior cover base / base boards damage

Interior Sprinkler System-test

Other Items to Address:

Cold Weather Preparations: Ice melt-containers outside

Sand-containers outside

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General Maintenance Reporting DATE ROOM GENERAL MAINTENANCE PERFORMED DATE

COMPLETED COMMENTS

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Daily Van Maintenance Checklist Name: _____________________________ Vehicle # & Plates: ________________ Mileage: Monday _______ Friday _______ Location: ________________________ Items must be CHECKED DAILY for proper operation Functioning Properly M T W T F Comments Brakes Lights (front) Lights (back) Brake Lights Windshield Wipers Seat Belts Horn Turn Signals Interior Lights Heater / Air Conditioner All Doors / Windows All Emergency Exits Engine / Exterior Check Wiper Fluid Filled Radiator Filled Oil Filled Engine Belts Inspected NO Leak drips Clean exterior Exterior body integrity Tires PROPERLY inflated Interior Check Windshield clean, no cracks Seats secure to floor Interior CLEAN First Aid Kit and Flashlight Emergency cards for riders Car seats secure Fire extinguisher on board Interior Check Vehicle drives appropriately Any issues reported to Supervisor Driver / Inspector Signature: ________________________________ Date: ____________________ Director / Supervisor Signature ______________________________ Date: ____________________

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Daily Bus Maintenance Checklist Name: _________________________ Bus #: __________ PMI Mileage: __________ Today’s Date: ___________________ Today’s Mileage: _______________________ Remaining Days: ________________ Mileage Remaining: _____________________ Note: Within 5 days or 300 miles call for PMI Inspection if required. The daily Inspection list must have an “OK” or if defective place an “X”. DO NOT DRIVE IF THERE IS A DEFECT OR SAFETY ISSUE! ITEM OK NOTES Approaching Bus Fluid pooling under bus Flat ties New body damage Engine Compartment Fluids: oil, water, steering, transmission Battery terminals Fan belts, hoses, leaks on engine Exterior All lights Tires, lugs, side walls, wheel cover, stems, mud flap Fuel cap, secure and present Windshield wipers, present, not cracked or tearing All glass / mirrors secure Lettering / CA# , clear and present Tail pipe, license plate Emergency door / buzzer Capacity / CHP 292 Card Back up buzzer Interior Driver’s seat, belt, mirror, horn, setting All lights, dome, step, dash, monitor Gauges, oil, battery, fuel, water, transmission Heater, defroster Passenger seat belts Windows, latches Walls, padding, ceiling rivets, floor, runners Seats, cushions, modesty panel, hand rail, seat backs Emergency exit, unlock, doors open, buzzer, light Emergency Equipment/Extra Equipment First aid kit Fire Extinguisher Road side reflectors Hand held stop sign

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ITEM OK NOTES Communicable Disease kit Hydraulic Brakes Inspection Hydraulic Test Parking Brake 2 Stops Driver’s Signature: _____________________________________________________________ Maintenance required & Date Complete: ___________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Follow-Up Items: ______________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Director’s Signature: ___________________________________________________________

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PLAYGROUND SAFETY

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Playground Safety Management Responsibilities The Playground Management Checklist is done each day prior to outdoor play (can be part of the Safety Coordinator’s daily duties). At the end of each week, the form is placed in a playground note book after being signed by managers. Each day the manager doing the check list should initial the form in the area provided. Prepare a notebook with tabs for each classroom in your building. This notebook will be kept by the playground door for easy reference and use upon entering the playground. A First Aid Bag such as a back pack or container should be placed with notebook by playground door so that it is easily available to staff. This should be checked each day. A suggestion would be to have a hook out of reach on the inside and outside of the door that the bag can be moved easily from one to the other. In the bag should be all required first aid supplies and added items such as Kleenex, wipes, accident report forms, etc. Zone signs should be laminated and posted on every playground door and placed in the playground note book kept by the playground door. Each morning when doing the management check list, the playground note book should be reviewed from the day prior to ensure that teachers did their playground checks. Management should ensure that each week new forms are available in the note book. Walkie Talkies are an addition you can consider for additional safety. Each morning one Walkie Talkie will be placed with the notebook after it has been charged each night. Management’s Walkie Talkie will be turned on and kept within earshot of manager throughout the day. If a staff member needs support on the playground they can use the Walkie Talkie to contact the office. Possible uses would be:

• A child is hurt and needs more first aid than the emergency playground bag can offer. • A teacher must leave the play area and needs to support to remain in ratio.

At the end of each day the last class to use the play area must return the Walkie Talkie to the charger. Management must ensure that all needed items are available for extra daily activities. A suggestion is to lace items in a net mesh bag using a different color for each day of the week. See link at the end of instructions for bag purchase. The bags can be marked with the appropriate day and placed in an accessible place each morning for that days use.

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Regional Playground Safety Check Report Date: _____________________ Regional Director: ____________________________ School # Playground Safety Synopsis Plan of Correction

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Playground Safety Checklist Date Time Location Age

Group Number of Students

Number of Teachers

Student/ Teacher Ration

Ratio Met

Safety Checklist Yes No Fall Zone Material meets licensing regulations. Yes No Ground cover is in good repair. Yes No Gate latches are in good repair. Yes No Gates are locked. Yes No Landscaping bushes do not have sharp or small objects (i.e. berries) that can be

swallowed. Yes No Wooden dividers, borders of sandboxes, etc. do not contain rough edges or have splinters

exposed Yes No Tricycles are in good repair. Check for missing peddles, handlebar grips, loose parts. Yes No Bike/Trike riding areas is separate from other equipment. Yes No Sandboxes are located in the shade, have smooth frames, and are covered when not in

use. Yes No Sandbox sand is raked and checked weekly. Yes No Fencing is in good repair. (Walk the entire length of the fencing; note any unsafe

condition. Yes No Ground cover is free of any inappropriate materials. Yes No Grass is healthy and no potholes are present (walk the entire grass areas). Yes No Swings are in good repair (check each swing for any unsafe issues). Yes No Ride toys and push toys are in good repair. Yes No First aid supplies are available outside. Yes No Sidewalks are cleanly swept. Yes No Daily sweeping schedule and system is in place. Yes No Drinking fountains are clean and sanitized. Yes No Drinking fountains are in good repair and functioning. Yes No No puddles of water are present in any area of the playground. Yes No All playground equipment meets current licensing regulations. Yes No Exposed concrete or hard anchoring material is covered. Yes No There are no sharp edges, loose connections, exposed nails or bolts present. Yes No Play equipment present is appropriate to the size and development of the children. Yes No All equipment is checked for inappropriate heat before used by children. Yes No Garden hose is contained in an appropriate holder and not left out causing an unsafe

situation for children, parents and staff. Yes No Play equipment is used appropriately by the children & staff (i.e. jump ropes, etc.).

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Teacher / Child Interaction Is there a teacher stationed by all large equipment observing and reminding the children of the rules?

Are teachers located in different areas of the playground supervising all areas of the playground?

Are there any blind spots on the playground? Do you observe any Teachers standing together in conversation?

Do you observe any organized Teacher directed activity available to the children?

Did the teacher(s) conduce a safety pre-check before the children were set free to play?

Are there playground rules posted and present on the playground?

Is role call taken as children arrive on the playground and as they exit the playground?

Are children entering the building without adult supervision?

Are children wearing appropriate footwear for outside play?

Are the teachers monitoring the amount of time that children are outside and how the heat is affecting the children?

What method of water play is used? Wet/Dry tables, buckets, sponges, water balls, hoses or sprinklers?

Can a child fit inside of a bucket you are using for water play?

Are the water toys stored properly when not in use? Where are they stored?

Swimming pools – what is the ratio used? Explain the process for usage?

Explain security system for the gate when not in use?

Any unsafe issues present?

Additional Comments: ______________________________________________________________ _______________________________________________________________________________ Director’s Signature: ____________________________________ Date: ___________________ Regional Director’s Signature: _____________________________ Date: ____________________

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Seasonal Inspection List for Childcare Outdoor Settings Location: ______________________ Date of Inspection: ______________________ Director: _______________________ Signature: _____________________________ Name of Person Checking: ___________________________________________________ Winter (to be completed in November

OK NO Comments Action Needed

Action Taken / Date/ Signature

Gates are free of all obstructions such as ice build up to allow for easy access.

Gates are closed properly.

All Summer play equipment is stored properly.

All Winter Play equipment is checked and added to playground.

Spring (to be completed in March) Gates are checked for frost damage which could lift the gates posts preventing them from closing properly.

Fence posts are checked for frost damage.

Pathways are checked for frost damage causing cracks, pot holes, etc.

All winter play equipment is properly stored.

All summer play equipment is checked and added to the playground.

Summer (to be completed mid June)

Activities planned to accommodate summer weather.

Adequate shade is available. All foliage has been checked in and around playground.

Site is in generally acceptable location.

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Fall (to be completed by Mid-September)

Leaves are raked up as necessary and are swept off pathways, climbers, etc.

All items which received a NO should be attended to without delay.

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Playground Maintenance Reporting

Date Area Maintenance Required Date Completed

Comment / Additional Follow up

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Staff Responsibilities One staff from each classroom must complete teacher check list prior to outdoor play A.M. and P.M. This should be done in the following manner:

1. Upon going to the play ground check all items from the list that can be checked such as first-aid supplies, resources, children’s shoes, etc.

2. Upon entering the play ground the child will always go to a designated areas such as sidewalk or line area.

3. The Teacher will then complete her checklist before allowing the children to play. 4. At the end of each week the check list must be signed by the Classroom Teacher.

Zone guidelines must be noted and adhered to each time your classroom uses the play area. THINK SAFETY – pay close attention to equipment use: are children using it properly, is running area free of hazards such as swings in path, etc. Are there any hidden areas where inappropriate play could happen?

• If one Staff Member is present they must walk entire play area. • If two Staff Members are present split in the zones in half, each walk and monitor 2 zone

areas. • If more than two Staff Members are present all zones are split equally.

Staff Members should use common sense and good judgment when manning zones. If it is not possible for a Staff Member to monitor all zones they must limit children to a limited play area. Any Staff Member not following guidelines must be reported to the Director. The playground first aid bag or container should be placed so that it is easily available to staff. Staff Members must work together to ensure that the extra daily activities are available and encouraged during outdoor time. All items will be placed in a bag or container by management each morning. It is the staff’s responsibility to collect items at the end of the day and place in the provided container. Please refer to outdoor lesson plan for activity resource ideas.

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Playground Supervisor The Playground Supervisor will oversee the daily playground activities as an extension of the indoor classroom, general playground usage, supervision, playground safety and maintenance.

• Perform a daily playground pre-check each morning before children are scheduled to be on the playground, post the Daily Playground Log and review the log from the previous day.

• Oversee the monthly playground inspections as outlined in the Phoenix Children’s Academy Safety Manual.

• Develop and post the playground rules and monitor their enforcement. • Provide supplemental activities on a weekly basis for teachers to introduce and use with

children on the playground. • Ensure the following extensions of the indoor classroom are available for children on the

playground: o Books o Art o Music o Dramatic Play o Fine Motor o Sand Play o Water Play

• Define the areas in which activities are to take place. • Define Playground Zones for supervision and monitor their use. • During the summer months, oversee Water Day activities. • Oversee the cleanup of playground items at the end of the day to include:

o Water jugs being returned to kitchen for sanitation. o General clean up of all toys, bikes parked in designated area, toys return to bins

and bins closed with a lid. o Removal of trash from trash cans. o Sweep of perimeter outside the fence and return of items to the playground.

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STAFF MEETING SCHOOL PLAYGROUNDS Welcome Introduce the Playground Supervisor If possible go to the playground

• Playground Pre-Check o Go through the list step by step and review hot to check appropriately.

• Daily Playground Log o How to record, where it is located.

• Sweeping schedule o Expectations, how to record, where it is located.

• Playground Rules o What they are o How they are enforced

• Playground Zones o What they are

• Playground Learning Centers o What, where, how

• Playground Supervision Policy Questions and Answers Play a game with numerous situations that occur on the playground, all teachers will be involved with answering the questions. Identify the issue and how the teacher should respond. Wrap Up

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PLAYGROUND RULES TAKE TURNS

FEET FIRST

ONE DIRECTION

PLAY SAFELY

PLAY NICE Keep toys in area they belong Put toys away when finished Do not climb on top of equipment

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Playground Pre-check Upon arrival to the playground, the children should remain lined up against the wall while a Teacher performs a playground pre-check. All safety issues must be resolved prior to allowing the children to be released to play.

• Roll has been taken by each child’s name being called and the teacher looking at each child as they respond.

• First aid kit has adequate supplies. • Water and cups are available. • The perimeter is inspected for the following:

o Gates are secured. o Fence line is free from holes both along and under the fence. o No unauthorized individuals are lurking outside fence lines.

• The playground surface should be inspected to ensure the following: o There are no dangerous or foreign objects. o There are no dangerous animals present. o There are no puddles or standing water deeper than 1 inch. o Sidewalks and bike paths are clear from debris.

• Equipment should be inspected for the following: o Inappropriate heat. o Strangulation hazards. o Clear fall zones. o Toys are free from sharp edges, pinching hazards, cracks, splinters, or unsafe

items. o Play equipment is located in the appropriate areas.

• While on the playground if any hazards are noticed, hazards must be resolved immediately. If you are unable to resolve the hazard, report it immediately to Management for assistant.

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Daily Playground Log Your signature on this log indicates that you have performed the indicated task in accordance with the procedures outlined in the Phoenix Children’s Academy Policy and Procedures Manual. Date: _____________________ Playground Supervisor: _______________________ Safety Pre-check – must take place BEFORE children enter playground Class Time Signature

Class Time Signature

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HEAT ILLNESS PREVENTION

PLAN

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Heat Illness Prevention Plan Overview and Objectives Employees, who work in outdoor places of employment or on the job tasks in other areas at those times when the environmental risk factors for heat illnesses is high; need to protect themselves appropriately. The objective of this program is team member awareness regarding heat illness symptoms, ways to prevent illness, and what to do if symptoms occur. This written program is based on the California Code of Regulations, Title 9, and Section 3395. Scope The Phoenix Children’s Academy family of schools Heat Illness Prevention Program applies to control the risk of heat illness occurrence. This is particularly specific to summer time activities on the playground and field trips. Policy It is the policy of Phoenix Children’s Academy that any team member participating in job tasks when environmental risk factors for heat illness are present will comply with the procedures in this document and in the Injury Illness and Prevention Program. Purpose To ensure that all team members working for Phoenix Children’s Academy are protected from heat illness while working on job tasks where environmental risk factors for heat illness are present and to establish the minimum requirement for working in this environment. Definitions The term “acclimatization” means temporary adaptation of the body to work in the heat that occurs gradually when a person is exposed to it. Acclimatization peaks in most people within four to fourteen days of regular work for about two hours per day in the heat. “Environmental risk factors for heat illness” means working conditions that create the possibility that heat illness could occur, including air temperature, relative humidity, radiant heat from the sun and other sources, conductive heat sources such as the ground, air movement, workload severity and duration, protective clothing and personal protective equipment worn by team members. The term “heat illness” means a serious medical condition resulting from the body’s inability to cope with a particular heat load, and includes heat cramps, heat exhaustion, heat syncope, and heat stroke. “Personal risk factors for heat illness” means factors such as an individual’s age, degree of acclimatization, health, water consumption, alcohol consumption, caffeine consumption, and use of prescription medications that affect the body’s water retention or other physiological responses to heat. “Preventative recovery period” means a period of time to recover from the heat in order to prevent heat illness.

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The term “shade” means blockage of direct sunlight. Canopies, umbrellas, and other temporary structures or devices may be used to provide shade. One indicator that blockage is sufficient is when objects do not cast a shadow in the area of blocked sunlight. Shade is not adequate when heat in the area of shade defeats the purpose of shade, which is to allow the body to cool. For example, a car sitting in the sun does not provide acceptable shade to a person inside it, unless the car is running with air conditioning. Responsibilities

1. Environmental Health and Safety (EH&S) is responsible for: a. Preparing and maintaining a written program which complies with the

requirements of applicable OSHA requirements (along with California). b. Assisting with providing training to all potentially impacted employees and their

supervisors on the risks and prevention of heat illness, including how to recognize symptoms and respond when they appear.

2. Directors, Managers and Safety Coordinators are responsible for: a. Identifying all team members who are required to work outdoors where potential

heat illness could occur and identifying the Director or Supervisor of the team members.

b. Assuring that adequate water and shade are available at a job site and/or on playground.

c. Ensuring that all affected team members have received proper training on heat illness preparation.

d. Ensuring that the requirements in this document are followed. e. Contacting Public Safety to request emergency medical services in the event

medical assistance is required. Public Safety will direct emergency medical services to the school.

3. Affected Team Members are responsible for: a. Complying with the provisions of the Heat Illness Prevention Program, as

described in this document and in the training sessions they attend. b. Ensuring they have drinking water available at all times when the environment

risk factors for heat illness are present. c. Ensuring they have access to a shaded area to prevent or recover from heat

related symptoms. d. Reporting heat related illness symptoms to the Director/Supervisor or Safety

Coordinator immediately. Basic Requirements The following basic requirements apply to all employees while working where environmental risk factors for heat illness are present.

1. All Team Members shall be identified who are required to work where environmental factors for heat illness are present.

2. Training shall be provided for all potentially impacted team members working where environmental risk factors for heat illness are present. Training information shall include the topics listed in the training section for this written program. All potentially impacted team members and Directors/Supervisors or Safety Coordinator who supervise these team members must be trained on the risks and prevention of heat illness, including how to recognize symptoms and respond when they appear.

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3. Drinking water in the quantity of One (1) Quart per hour shall be available at all times for

each team member for the duration of the entire shift while working outdoors in the heat. Directors/Supervisors or the Safety Coordinator shall remind team members to drink frequently and this topic will be addressed at Safety meetings.

4. Team members shall have access to a shaded area to prevent or recover from heat illness symptoms and where they can take their rest breaks. The importance of taking rest breaks and recognizing when a preventative recovery period is needed allowing Team Members to cool shall be addressed at Safety meetings.

5. In the event a team member feels discomfort from the heat, a preventative recovery period is needed to allow the employee to cool down and prevent the onset of heat illness.

6. Directors/Supervisors and team members shall carry radios or other means of communication to ensure that emergency services can be called. Verification that the radios or other means of communication are functional at the work site shall be carried out prior to each shift.

Training Levels of Training Training shall be provided for team members working on job tasks where environmental risk factors for heat illness are present, and training for their respective supervisors. Team Members All Team Members working on job tasks where environmental risk factors for heat illness are present shall receive instruction before being assigned to work tasks. Training Topics shall include:

1. Environmental and personal risk factors for heat illness. 2. Procedures for identifying, evaluating, and controlling exposures to the environmental

and personal risk factors for heat illness. 3. Team Members who experience excessive sweating require frequent consumption of

small quantities of water, up to 4 cups per hour when working in extreme conditions of heat.

4. Importance of acclimatization. 5. Different types, signs, and symptoms of heat illness. 6. Importance of immediately reporting symptoms or signs of heat illness in themselves or

in coworkers to their Supervisor. 7. Procedures for responding to symptoms of possible heat illness, including how

emergency medical services will be contacted and provided, should they become necessary.

Directors/Supervisors of affected Team Members Directors/Supervisors and the Safety Coordinator shall receive training on the following topics prior to being assigned to supervise outdoor employees:

1. Information as detailed above in Team Member training requirements. 2. Procedures the Director/Supervisor shall follow to implement the provisions of this

program. 3. Procedures the supervisor shall follow when a team member exhibits symptoms

consistent with possible heat illness, including emergency response procedures.

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Program Audits Responsibility Audits of the Heat Illness Prevention Program shall be performed by Directors/Supervisors or the Safety Coordinator and Environmental Health and Safety. Frequency Audits of the Heat Illness Prevention Program shall be performed annually. Contents

1. The audit shall review the program to ensure that heat illness prevention procedures are in place and are being properly followed.

2. The audit process and findings shall be documented. Records All training, audit, and other records prepared in association with the Heat Illness Prevention Program shall be managed in accordance with the requirements of Phoenix Children’s Academy’s Injury and Illness Prevention Program.

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Workers’

Compensation & General Liability

reporting & procedures

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Worker’s Compensation and General Liability Employer’s School Introduction Phoenix Children’s Academy has partnered with Traveler’s Insurance for all of our Workers’ Compensation Claims.

Travelers, through its state-of-the-art claim and medical systems, provide total integration of all workers' compensation services for you and your employees. They achieve results through the use of the TravComp model on each claim we manage.

Total integration consists of:

• Toll-free Telephone Reporting – 24 hours a day for all industrial accidents.

• Customized medical preferred provider networks (PPN) selected for their ability to provide services at cost-effective levels to you and your employees.

• Claim Case Managers and Medical Nurse Case Managers working together as a team to ensure early recovery and prompt return to work for your injured employees.

• Specialized Claim and Medical expertise to manage serious injury and complex claims before they become “high cost” losses.

• State-of-the-art systems that enable our people to provide quality services to you, your injured employees, and the medical providers who play such a critical role in your workers’ compensation program.

• A strong partnership between you and your Travelers Claim Team. Our willingness to work together to achieve lower costs is a measure of success for both of us.

• Loss Prevention and Engineering services that focus on work-site safety and post-accident evaluation.

Training Goals Workers’ Compensation is a complex and ever-changing field. You cannot be expected to become experts in the details of workers’ compensation. However, an informed and educated employer is one who can have a significant impact on reducing the costs of workers' compensation. Training focuses on two issues:

1. A brief overview of Workers' Compensation and how the employer commitment helps to make a difference in premium costs.

2. Key actions that employers should take that have been shown to make a significant difference in workers’ compensation costs.

3. These actions will focus on: a. Communication with your employees about workers’ compensation b. Claim Management c. Early reporting of accidents and accident investigation

a) the role of the Safety Coordinator at the work-site

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b) immediate referral of injured workers to an approved clinic c) a return to work program utilizing transitional duty d) post-injury follow-up e) claim case management—bringing claims to closure

d. Loss Prevention and Work-Site Safety a) analyzing accidents: supervisor’s role b) establishing an effective Safety Committee c) measuring results going forward

Employer’s Guide to Workers’ Compensation Employers must understand their obligations and rights under Workers’ Compensation laws. Although the laws and regulations can be complicated, a few key elements of a Workers’ Compensation program offer employers essential tools for controlling the return-to-work path for injured employees.

Understanding the Legal Framework Workers’ Compensation is:

Mandatory Insurance Employers must carry workers’ compensation insurance for their employees. The benefit levels are determined by the state legislature. No-Fault This concept was originally developed to eliminate litigation in workers’ compensation. Rather than trying to determine whether and how much the worker or employer was at fault for each accident, now no negligence need be proven. Exclusive Remedy In a trade off for not having to prove employer negligence, employees generally cannot seek additional damages from their employers. They are free, however, to pursue appropriate third-party recovery. Injury on the Job - In the Course and Scope of Employment Employees are covered for all activities performed in the course and scope of employment. They generally are not covered if performing activities that are not work-related. It’s An Accident Most injuries happen through human or mechanical error and are unintentional. The workers’ compensation laws were designed to offer protection for both the employer and the employee.

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Telephone Reporting Travelers: 800-832-7839 Toll free claim reporting

• 24 hours a day/7 days a week

• Claims sent instantly electronically to an experienced claim professional

• It is critical to use Travelers’ toll-free reporting system on the same day of the injury. This ensures that the Travelers’ system comes into play from the earliest possible moment, and that you and the injured worker receive the direct assistance that is needed: If workdays are lost, benefits begin promptly.

• If questions of compensability, fraud, subrogation, or other unusual circumstances arise,

you have immediate support of experts.

• All required reports are filed in a timely manner.

• If questions come up regarding medical treatment, we can direct the injured worker to one of our preferred providers.

Key Facts:

• A 1997 study of 235,000 of Travelers cases in all lines of business has shown the following: Lost time cases reported within 2 days of injury had an average cost of $11,000.

• Lost time cases reported over 10 days of injury had an average cost of $24,000.

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Workers' Compensation Telephone Reporting Guide

Call 800-832-7839 to report a claim Call the Telephone Reporting Center toll-free to quickly and easily report all Workers' compensation injuries. We will be asking you the following questions, so please have the information handy.

Please do not delay in reporting the claim even if you do not have all the necessary information. We will produce and submit the necessary state forms.

Account Information

• Caller's phone number and extension • Caller's name and title • Benefit state • Employer's name and address • Employer's mailing address (if different from above) • Parent company / Insured's name • Location code Nature of business • Policy form and number

Employee Information • Name • Male or Female • Social Security Number • Employee's mailing address • Employee's home address (if different from above) • Marital Status • Employment status (full time or part time) • Number of dependents • Class code • Date of birth • Wage period • Home phone number

Accident Information • Date of Injury • Time of Injury • Date claim reported to employer • Was the accident on employer's premises? • Accident location • Did employee lose any time from work? • Is employee back at work? (If yes, date returned) • Date employee last worked • Was employee paid for last date worked? • Date employee last paid • Date disability began and ended • Is / was employee's salary continued?

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• Was employee's injury related to a company-sponsored event? • Was accident fatal? (If yes, date of death) • Description of accident • Cause of accident (e.g., slip/fall, lifting, chemical) • If motor vehicle accident, driver's license number and state where issued • Contributing factors • Equipment, material or substance involved • Names, addresses and phone numbers of other parties involved • Were safeguards provided? (if yes, describe) • Were safeguards in use at time of accident? • Names, address and phone numbers of witnesses

Injury Information • Part of body injured (e.g., head, neck, arm, leg) • Nature of Injury (e.g., fracture, sprain, laceration) • Previous related condition(s) • Cumulative Injury? (If yes, length of exposure) • Nature of duties • Length of time doing activity • Treatment - Check all that apply • First aid (who, treatment and date of 1

st treatment)

• Hospital/clinic (name, address, treatment, length of stay, date of 1st

treatment) • Physician (name, address, phone number, treatment, specialty, date of 1

st treatment)

Employee Job Information • Occupation when injured • Regular occupation • Date of hire • Schedule (regular work hours, hours per day, days per week) • Wage (hourly, annual, average weekly, overtime/per, additional benefits/per)

State Specific Information

See WORKERS' COMPENSATION - FIRST REPORT OF INJURY - STATE SPECIFIC QUESTIONS for your individual state

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Claims Investigation

Travelers has an extensive investigation program, which is used to ensure that we pay only for claims we owe. However, it is the partnership between Travelers and the employer that is vital to our ability to make good claim decisions and control costs.

Travelers has the experienced, professional resources available to assist you.

Dedicated Investigation Claims Unit

Each office has dedicated claim professionals who will be assigned to your account. Their job is to investigate lost time claims, determine compensability, and assert the customers' legal rights to pay or deny a claim.

Special Investigation Unit

The dedicated claim professional works closely with our Special Investigation Unit. Travelers Investigative Services is a 140-person organization with approximately 120 field investigators. Our investigative staff has a diverse background of law enforcement and claim handling experience. They work closely with local, state, and federal law enforcement agencies as well as state fraud bureaus and the National Insurance Crime Bureau. They provide fraud detection training to employers upon request.

A confidential fraud hotline is available by calling 800-6FRAUD0 (800-637-2830).

Although Travelers has extensive services for assistance, it is you, the employer, who is on the scene and can provide critical information to Travelers. The key to a prompt, accurate investigation is for you to report the injury as soon as possible by using 800-832-7839 and by informing us of any “red flags.”

“Red Flags” – Warning Signs The presence of one or more of the following factors can suggest that a claim may warrant further investigation:

• Employee was recently counseled regarding poor work performance, attendance, tardiness, etc.

• Injured employee is short term or newly hired. • Injury was reported on Monday morning or employee’s first day back to work after

weekend or vacation. • Injury was not witnessed. • Employee has a history of prior Workers’ Compensation or personal injuries, especially if

he/she is familiar with litigation process. • Injury was not immediately reported by the employee.

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• Witnesses offer conflicting versions of incident, or their versions differ from that of injured worker.

• Injury occurred after the employer declined the employee’s request for vacation or personal leave.

Early Intervention Timely intervention and treatment play a crucial role in affecting the cost drivers of workers’ compensation. Data has shown that the longer an injured worker waits to see a doctor, the more likely he/she is to see a lawyer and the longer he/she remains away from work. The focus of Travelers is quick intervention and fast return to work. We promote better-focused and earlier treatment to get employees back to work. The claim professional makes 24-hour three-point contact on lost time cases. Contact is made with:

• The Injured Employee • You, the Employer • The Treating Physician

We have a dedicated return-to-work team of claim professionals whose mission is to:

• Reduce lost time • Reduce average paid costs • Close claims

They accomplish this by teaming up with a registered nurse to coordinate a treatment plan and a return-to-work strategy. The nurse’s responsibilities are to:

• Determine the diagnosis • Determine the treatment plan • Determine appropriateness of the treatment plan • Determine return-to-work status

The registered nurse is co-located in the unit and sits next to the claim professional. Our nurses use state-of-the-art systems to ascertain injuries and appropriate treatment. They also work closely with you, the employer, to formulate a return-to-work program to get the injured worker back to work. Loss Prevention and Work Place Safety Even as you prepare a response system for accidents, you need to maintain an organization-wide focus on safety. Workplace safety should receive high priority from all levels Everybody in the workplace should be responsible for his or her own safety and for employing safety and safe work practices. Working together with your Safety Coordinator you can develop a “safety vision” for your organization.

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Key steps include:

1. Analyzing Accidents: Supervisor’s Role Every accident must be analyzed to determine the root cause. Directors, with their unique knowledge of process and equipment, are ideally situated to perform this analysis. Safety Coordinators should also be trained in this process and help the Directors with their investigations.

a. The accident analysis is the assessment of how an accident occurred. It is based on interviews with the injured employee, witnesses and other workers. The interviews should be completed as quickly as possible, preferably within 24 hours of the accident.

b. Under no circumstances should you delay reporting the accident in order to complete your investigation.

Interviews

• Are held with the injured worker (if possible) and witnesses • Are held one-on-one • Are held in a non-threatening environment • Require open-ended questions • Calm people down and refocus on getting back to work

Corrective Action The supervisor should specify what corrective action is needed and who will perform it. If purchases are required, the Safety Coordinator should facilitate the process. Accident Investigation A thorough accident investigation is one of the best tools available to determine the accident-causing chain of events so that corrective action can be implemented to avoid a reoccurrence. Accident investigation should:

1. Determine ALL causative factors 2. Document the particular facts of the accident. 3. Your investigation should answer the “who”, “what”, “when”, “where”, and “how”

questions. An accident Investigation Report should be completed by the site supervisor and employee where an accident has been reported. This form should be forwarded to the Safety Coordinator and Human Resources.

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Accident Investigation Report Form

Date:________________

Part 1 - (To be completed by the injured employee)

Employee Name: _______________________________________________

Employee Number: ______________________________________________

Address (Street): _______________________________ Home

Phone:__________________________________

City: _________________________________________ Zip Code:_______________________

Position: _____________________________________ Hourly Wage: ____________________

Department or School Site: ______________________________________________________

Date Hired For This Position: ___________________ Hours: From __________ to __________

Site Administrator/Supervisor’s Name: _____________________________________________

Date of Injury: ______________________________ Time of Injury: ___________ a.m. or p.m.

Name of Person Injury Reported To: _____________________________________________

Department or Name of School Where Injury Occurred:

___________________________________________________________________________

Were You Doing Your Regular Job? _____ Yes _____ No

State Fully What You Were Doing At The Time Of The Injury And How The Injury Occurred:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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Nature and Location of Injury (Describe fully exact location of injury, i.e., right or left arm, shoulder, etc.)

___________________________________________________________________________

___________________________________________________________________________

Was Any Other Part of The Body Injured? _____ Yes _____ No

Describe: ___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Was First-Aid Give? _____ Yes _____ No (Describe and list name(s) of person(s) who administered first-aid)

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Was Anyone Else Injured In This Accident? _____ Yes _____ No

Name(s): ___________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Were There Any Witnesses To This Accident? _____ Yes _____ No

Name(s): ___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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Part 2 - (To be completed by site administrator or supervisor)

Name: __________________________________Position: ___________________________

Department or School Site: _____________________________________________________

Date You Were Notified Of Accident: __________________ Time: __________ a.m. or p.m.

Did the Employee Require Medical Treatment: _____ Yes _____ No

If Yes, Where Was Medical Treatment Administered? ________________________________

___________________________________________________________________________

Date Employee Returned To Work: ___________________ Time: ___________ a.m. or p.m.

Was The Employee Performing His Regular Job? _____ Yes _____ No

Was The Employee Properly Instructed On Safe Job Performance? _____ Yes _____ No

Describe: ___________________________________________________________________________

___________________________________________________________________________

Cause of Injury Protective Equipment Type Required In Use? _______Inattention to duties being performed Hard Hat

_______Insufficient instructions Safety Glasses

_______Improper instructions Dust Goggles

_______Inadequate job planning Full Face Shield

_______Lack of knowledge or skill Respirator

_______Improper use of equipment Welding Hood

_______Inadequate or wrong equipment Hearing Protection

_______Fatigue Cutting Goggles

_______Physical disability Other

_______Uncooperative

_______Other

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What Was Defective, In Unsafe Condition, or Wrong With Method Used?

___________________________________________________________________________

___________________________________________________________________________

What Did Employee Do Unsafely?

___________________________________________________________________________

___________________________________________________________________________

What Could Or Should Have Been Done To Prevent Injury?

___________________________________________________________________________

___________________________________________________________________________

What Steps Have Been Or Will Be Taken To Prevent Similar Injuries?

___________________________________________________________________________

___________________________________________________________________________

Was The Employee Instructed To Use Any Special Protective Equipment Or Safety Procedures?

_____ Yes _____ No Explain:

___________________________________________________________________________

___________________________________________________________________________

Did The Employee Follow These Instructions? _____ Yes ______ No Describe:

___________________________________________________________________________

___________________________________________________________________________

Was The Injury The Result Of Failure Of The Employee To Follow Instructions Or Established Safety Rules?

_____ Yes _____ No Explain:

__________________________________________________________________________

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What Action Has Been Or Will Be Taken Because Of This Failure?

___________________________________________________________________________

___________________________________________________________________________

Comments: ___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________ ____________________________________________________________________________ Copy emailed/faxed to Regional Director on Date: ___________________________________ Copy emailed/faxed to Human Resources on Date: __________________________________

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Activities When an Illness or Injury Occurs Immediate and appropriate response to an injury can determine the entire course a claim takes. Planning and preparation is the answer. The Gallup study referred to earlier shows that the longer injured workers need to wait to see a doctor, the more likely they are to see an attorney and the longer they are away from work. The study also states that when workers are seen on the first day, they are more satisfied with their medical care, medical provider, and employer. In fact, in the first moments after an injury, the following is likely to be determined:

• Whether the employee believes that the organization cares about his or her well being. • Whether the employee receives timely and appropriate medical care. • Whether the injury is properly documented. • The response of the employee to an offer of transitional duty. • The ultimate cost of the injury.

The Safety Coordinator and Human Resources need to be notified of the injury immediately, or as soon as possible. They play a key role in ensuring that all of the planning and preparation done prior to an injury is executed at the time of injury. The following is an operational workflow of this process.

Transportation to the Medical Provider Providing timely and appropriate transportation for the injured employee is important for both the physical and psychological well-being of the employee. In addition, it establishes positive control of the claim and provides the employee with immediate access to medical care. Employers need to establish their own list of choices for this transportation. The supervisor always tops this list, since he/she is the everyday source of support for the employee. There is a level of trust and comfort that exists between an employee and supervisor. If possible, it should be used during this time, which may otherwise be confusing and upsetting for the injured worker. If the supervisor is not available to transport the employee, then in order of preference, these are other options.

• Managers • Safety Coordinator • Co-worker

If the injured worker is not escorted to the provider, then they should be informed that a call to the supervisor immediately after seeing the doctor is mandatory. Of course, if the injury requires emergency care, or is of a serious nature, this may not be possible. The Safety Coordinator should also be doing their own follow-up with the provider and the employee.

Communication with the Provider

• The Director/Assistant Director or another designated individual needs to call the provider and inform them that an employee is en route due to an injury or illness. At this time, it is extremely important to remind the provider that you have previously communicated your service expectations. Ideally, the provider maintains written or

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computerized instructions for each employer. If so, instruct them to pull this information and attach it to the front of the employee’s chart for the physician’s review. In any event, spoken reiteration of expectations should be stated during this call. For example, review the Transitional Duty program and your communication policy as well as request a Doctor’s note with injured employee’s restrictions to be faxed to the school. The communication policy lists your point of contact for status, etc. Remind them that they need to adhere to this, and that they must fax or phone you with the employee’s status.

• The Director/Assistant Director or designated individual needs to follow up with the medical provider. Ask the provider to review the employee’s post-injury capabilities and recommend job modification, if necessary and appropriate. Seek, if possible, to have the employee released to full duty. If this is not appropriate, be as flexible as you can to accommodate work restrictions. For example, assign temporary modified, alternative duties, or hours that accommodate the restrictions.

• Maintain communication with the injured employee, medical provider, and Travelers.

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Transitional Duty Transitional Duty is alternate or modified employment for team members not able to perform their full-time regular job. A Transitional Duty/Return to Work program is key to having this work to its potential. It is also a critical component of cost containment. Advantages of Transitional Duty

• Team Member stays in a work routine. • Prevents/limits psychological damage by keeping team members productive and

involved in their own recovery. • Eliminates the “disability syndrome”. • Sends a clear message for all team members. • Enhances productivity. • Reduces indemnity and medical payout.

To be truly effective, transitional duty must be:

• Progressive • Meaningful • Temporary

The Program must also:

• Have a start and end date. • Have a purpose and goal. • Be evaluated weekly. • Provide meaningful work.

It is critical to keep transitional duty assignments as close to the regular job as possible. Therefore the following placements are listed in order of recommended preference:

1. Return to same job, with modifications. 2. Return to work in a different job, same department. 3. Return to work in a different department, same employer.

It is equally important that the team member be a part of this process. In other words, educate the team member about what is happening, and be sure that all of their concerns are addressed. If the team member feels that the employer is treating them fairly and with respect, the team member is less likely to seek an attorney. Because co-workers may feel that the injured team member is receiving special treatment because of the injury, be sure to keep co-workers informed of the situation within reason and without breaking any privacy laws. Uninformed co-workers may develop feelings of unhappiness and unfair treatment. Once an employer becomes aware that an injured worker is returning to transitional duty, all team members within that department should be informed. The Safety Coordinator must follow up with the medical provider after each visit to see if there has been any change in the team member’s work status. The physician or provider should redefine restrictions after every visit. It is the provider’s responsibility to ensure that the transitional duty remains progressive. Once the team member has returned to full duty, the supervisor and safety coordinator should monitor their transition.

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Ask the team member:

• Are you comfortable with your transition to full duty? • Are you having difficulty handling any full duty tasks?

Finally, instruct the employee to inform you of any additional problems.

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Transitional Duty Progress Form The purpose of this form is to help monitor team members working transitional duty. Transitional duty must be temporary and progressive in nature. The Safety Coordinator should use this form to document the physician's updates and the employee's transitional-duty jobs.

Team members should not be on transitional duty more than 30 days. Therefore, if a team member reaches 30 days on transitional duty, call the Case Manager/Adjustor to strategize next steps.

Employee Name: ______________________________ School: __________________ Supervisor’s Name: _____________________________________________________ Transitional Duty Start Date: _______________________________________________ Number of Days Estimated on Transitional Duty: _______________________________ Physician Name: _______________________________________________________ Physician Phone: _______________________________________________________ Original Restrictions: ____________________________________________________ _____________________________________________________________________ ______________________________________________________________________ Date: _____________________________ Job: _______________________________

Updated Restrictions: ____________________________________________________ ______________________________________________________________________ _____________________________________________________________________ Date: _____________________________ Job: _______________________________

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Updated Restrictions: ____________________________________________________ _____________________________________________________________________ ______________________________________________________________________ Date: ____________________________ Job: ________________________________ Date of Return to Regular Duty: ____________________________________________ Doctor’s Note received on date: ____________________________________________ Copy of Doctor’s Note submitted to HR on date: _______________________________ Safety Coordinator Signature: _____________________________________________ Director Approval: _______________________________________________________ *At 30 days call the Travelers Claim case manager

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Modified Duty Assignment Orientation Acknowledgement Name of Employee: Date/Time of

Orientation: /

Name of Manager/Supervisor:

Date/Time Modified Duty Began:

/

Modified Duty Assignment Details: Job Name:

Brief Description of Modified Duty

Assignment

Acknowledgement of Orientation to Modified

Duty Assignment

Yes

No

I acknowledge being trained fully in my new modified duty position prior to beginning my new modified duty assignment. Further, my work restrictions have been fully explained to me, and I agree to comply with these work restrictions.

I do not acknowledge being fully trained in my new modified duty position prior to my beginning my assigned modified duty, and/or do not agree that all aspects of this new work assignment are fully compliant with my work restrictions.

Employee Signature: Date:

Management or Supervisory Report:

Manager/Supervisor Name:

Supervisor’s Orientation

Acknowledgements:

Yes No

Was the orientation completed prior to worker beginning new assignment?

Is the new assignment compliant with work restrictions?

Was the modified duty assignment fully explained to the worker?

Did employee acknowledge that he understood the modified duty assignment, and agreed to follow the work restrictions?

Follow-Up/Additional Comments:

Mgr./Supv. Signature: Date:

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Claim Case Management – Bringing Claims to Closure The primary duty of the case manager is to provide all appropriate benefits timely, with a focus toward case resolution. While workers' compensation benefits are state jurisdictional, nearly all states provide similar benefits: Temporary Disability (TD) Benefits Temporary disability is a benefit paid in lieu of wages when the injury prevents the team member from working. Most states set this figure at 66 2/3% of the injured worker's gross weekly wages, though some may use a different percentage, or a percentage of the net earnings. California, for example, uses 66 2/3% of the gross weekly wage. New Hampshire uses only 60%, whereas, Alaska calculates the TD rate at 80% of the weekly net earnings. Similarly, most states place restrictions on TD rates, with minimum and maximum rates. While a few states place no minimum restrictions on TD rates, all place restrictions on maximum rates. These can range from Mississippi's weekly maximum rate of $279.78, to Iowa's weekly maximum rate of $903.00. (Only the Federal Employee's Compensation Act, or FECA, provides for a higher rate.) The duration of temporary disability also varies by state, though most require the benefit paid for the duration of the disability. With the exception of the Virgin Islands, all have some form of waiting period before temporary disability benefits become due. Some states exempt the waiting period if the injury requires immediate hospitalization. Your Case Manager will work closely with you to coordinate commencement and termination of temporary disability benefits, verify wages, as well as provide you with the correct minimum and maximum rates for your state. Permanent Disability (PD) Benefits Following an industrial injury, an injured worker may be left with permanent residuals. Such residuals may entitle the worker to permanent disability benefits. Permanent disability benefits can be based on total (PTD) disability, or partial (PPD) disability. As with temporary disability, the minimum and maximum rates, duration of payment, and offsets are state jurisdictional. Unlike temporary disability a benefit, which, by its very name, implies that the benefits are temporary, permanent disability benefits can be paid for the life of the injured worker. Each state is different, but most pay for the duration of the disability. Permanent disability may be based on “scheduled” injuries (listed by state and pertaining to loss, or loss of use, of a body member), or based on “nonscheduled” injuries, which are based on a percentage of wage loss. Usually, though not always, the nature and extent of permanent disability is determined by a physician when the injured worker has reached a level of maximum recovery, or the medical condition has remained stable for a period of time. Once this level is achieved, the worker is said to have reached maximum medical improvement (MMI), or become permanent and stationary (P&S). This plateau may or may not coincide with the injured worker's ability to return to work. Very often, the injured worker may be released to return to work, but still require additional medical care.

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Vocational Rehabilitation (VR) Benefits Vocational rehabilitation benefits are provided to injured workers, who, as a result of their industrial injury, are unable to return to their job on a permanent basis. Not all states provide for this benefit (your Claim Case Manager can inform you if you have any liability). Some states permit a portion of funds to be paid back to the employer if accommodations are made to allow the injured worker to return. Some states also require the employer to provide training and job placement assistance to workers who are unable to return to their jobs. As with other workers' compensation benefits, vocational rehabilitation benefits are state jurisdictional. Medical Benefits With the exception of six states (Alaska, Florida, Hawaii, New Jersey, Ohio, and Montana), all states are required to provide full medical benefits, with no time or monetary limitations. Most states permit the injured workers the choice of selecting the physician, either on their own, or from a list provided by the employer or state agency. Some states permit the employer to make the initial choice, while others permit the employer or state agency to maintain control. Depending on the state, medical benefits can range from physician and hospital care to psychiatric and marriage counseling, acupuncture, spiritual treatment, and home remodeling or relocation. Death Benefits All states provide for some form of death benefits to the surviving spouse and dependents, as well as burial expenses. Claim Resolution Again, depending on state jurisdiction, cases may be settled with or without a formal award, by lump or periodic payments, and may include settlement of all benefits or provide lifetime benefits. Some states permit settlement by the parties, while others require approval by a state authority. All permit some sort of appeal process. Your Case Manager will be working with you and your injured workers to coordinate timely provision of benefits, as well as bringing cases to closure. Because of the complexities surrounding state laws and procedures, as well as injury types, some cases do end up in litigation. Should you require representation, Travelers' staff and panel counsel will competently represent your interests, working diligently with you and your Claim Case Manager to achieve equitable resolutions.

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General Liability Claims Introduction Any business that receives visitor’s faces a risk of premises liability. Visitors may include solicitors, sales people, customers or independent contractors who are performing some agreed-upon service (i.e. snow removal, sprinkler system testing, window washing, grounds maintenance, computer maintenance, etc.). Slips and falls tend to be the primary type of incident involving visitors. Unsafe conditions that pose a risk to visitors also threaten the safety of team members. The best way to eliminate general liability claims is to take steps to reduce hazards such as:

• Controlling the flow of visitors to restricted areas, and allowing visitor’s access only when they are accompanied by a representative of the Company.

• Maintain floor, stairways, parking lots and exterior walkways properly, and providing adequate lighting, both inside and outside.

For outside services you employ, be sure your contractual agreement covers issues such as:

• A policy requiring that they adhere to Company Safety Rules. • A Restriction on borrowing Company Equipment. • A Requirement that Contractors have their own Worker’s Compensation and General

Liability Insurance (please discuss with your Regional Directors and they will direct you to the correct person at the Corporate Office to review Insurance Policies).

Since incidents involving visitors can happen even when these safeguards are in place, be sure to have specific guidelines in place for how your team members should responds to reports of injuries to visitors or damage to visitors property. Respond Effectively to Visitor Incidents When responding to an alleged visitor incident, it is critical that you and your employees remain professional at all times, and show genuine concern for the person’s injury or damages. Put yourself in the other persons place; they may be embarrassed and upset following the incident. Make the visitor as comfortable as possible. Arrange for prompt first aid or medical care. Be sure that a copy of Emergency Numbers for Ambulance, Fire and Police are prominently displayed for easy reference by all team members. If injuries allow, take the customer off to the side so that others don’t stare, or crowd around, or otherwise make the situation more stressful and upsetting. Ask the Customer or Visitor what happened, but do not be judgmental or enter into any disputes over the alleged cause of the incident. Just observer and report the facts of the event, and let the claim adjuster worry about whether the claim is justified. It is absolutely critical to avoid making any admission of negligence or responsibility, or even to hold discussions that would imply negligence or responsibility. For Example:

• Never reprimand a team member at the scene of an incident. • Never make statements about how management will handle future costs for medical

treatments or property damages for affected parties. • Never discuss insurance coverage with the visitor.

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• Do not discuss facts of the incident with strangers at the scene, or any time after the incident.

Report All Incidents Team Members should promptly report to management all customer/visitor incidents, accidents or claims. A properly completed incident report will alert management to a potential problem. All completed incident forms must be returned to Human Resources within 24 hours of the accident. Handle and investigate all incidents promptly to help control future liability claim costs. For example, a customer or visitor who, immediately after an incident, states that no injury or damage has been sustained, may discover problems later, or may change his or her story. A well-documented incident report will help to defend against fraudulent liability allegations that omit or alter the real facts of the incident. Record Accident Facts The specific information recorded at the scene of a visitor incident can be critical to the ultimate outcome of any liability claim that may be generated. In addition to recording the time and date of the incident, be sure to document this additional key information:

• Exact Location Be as specific as possible in describing exactly where the incident took place. For example, rather than stating that “the visitor fell at the front of the building,” it is better to stay that “the visitor fell while walking across the rubber mat outside the main entrance on the north side of the building.” Describe locations of incidents inside of the building with references to specific areas, such as a specific hallway, classroom or other identifying point where the alleged incident took place.

• Record Witness Statements Always write down any statements made by the customer/visitor or witnesses. For example, the visitor may state “the reason I fell was that the heel of my shoe broke and caused me to fall.” Or a witness may say that they saw the customer drop a bottle of juice, and then slip in the spilled liquid. These documented comments can play a significant role in providing a defense should the customer later allege that he or she was injured due to some negligence. If the visitor states that they were not hurt, or if they refuse any medical assistance, document this as well.

• Identify Witnesses Record the names and addresses of all witnesses. Employees who saw what happened should fill out a witness report immediately.

• Investigate the Scene At the site of the incident, make a complete inspection of the immediate area and gather as much information as possible that may have a bearing on the claim.

o Note the type and condition of the visitors shoes (for example high heels, smooth leather soles, untied sneakers), especially if the incident involved a slip, trip, or fall.

o Document pertinent weather and lighting conditions, if the alleged incident occurred outside.

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o Describe the lighting area. o Document if the visitor was wearing glasses or using an assistive device (cane,

walker, etc.). o Document whether the visitor was using any equipment at the time of the alleged

incident and note to whom the equipment belonged and the apparent condition of this equipment. Remove any defective equipment from service immediately, tag it with an “out of service” sticker and retain it as possible evidence in the defense of a claim.

o If there are any objects or debris on the floor, try to determine if they were dropped by the visitor or if they came from another source.

• Photograph the Scene Finally, take photographs of the area in question in order to document the exact conditions at the time of the alleged incident.

o Try to take pictures from a number of angles or reference points. o For close ups, put a ruler or other familiar object in the picture to provide a

reference scale. o To capture the time and date, one can place a watch and the front page of a

newspaper in the scene. o Do not permit anyone other than Company Representatives to take photographs

of the scene. o Do not take pictures of injured people, especially if injuries are severe.

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Incident Accident Report

Email or Fax to HR in the Corporate Office

School Name and Number School Address Type of Incident / Accident Date and Time Reported By Description of Incident Description of Damage Description of Injury Vehicle Information (year, make, model, vin number) Name & Address Involved Party

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MOTOR VEHICLE

PROCEDURES

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Motor Vehicle Procedures Introduction Nearly 20.5 million children ages 12 and under of employed parents are in child care in the United States. Three out of four children ages four and under (about 8.7 million); four out of five, five-year-olds (about 2 million), and half of school-aged children younger than 13 (about 9.8. million), with employed parents and caregivers are regularly in non-parental care when they are not in school. Whether in center-based care, home-based care, or before and after-school programs, children often need to be transported in motor vehicles by their child care providers for purposes ranging from pick-ups from school to entertainment and educational pursuits. Regardless of who does the driving, child occupant protection is paramount. Motor vehicle crashes are still the leading cause of unintentional injury-related death among children ages 14 and under, killing approximately 1,700 kids and injuring another 248,000 each year. Facts

• Nearly half (49%) of parents cited that their children were transported by caregivers once a week or more, including more than a third (35%) whose children were transported daily.

• Sixty percent (60%) of children were reported to be cared for in home settings versus 38% in program/center settings. In-home care was defined as care provided in another home, care by a provider in one’s own home or care by a provider in a registered family child care home. Program/center care was defined as care in a licensed child care center, a before or after-school child care program.

• Sixty percent (60%) of children cared for in the home were reported to be cared for by grandparents, 39% of whom were aged 60 and over.

• Forty-six percent (46%) of children from birth to age eight who should have been in child safety seats were reported to be transported in lap belts or lap and shoulder belts. There was significant difference reported according to the age of the child. Twenty-three percent (23%) of parents of children under age five (5) reported that their child’s care provider used a lap-should belt or lap belt when transporting their children as compared to 85% of parents of children ages five to eight.

• More than one-third of parents (37%) of children in program/center child care reported that either their provider had no formal or informal policy on transporting children.

• Two-thirds (65%) of parents whose children use a child safety seat while in child care reported that they had provided the seat to the caregiver.

• Nearly half of parents (49%) whose children use a child safety seat reported that they had installed the seat in the motor vehicle used by the child care provider. Parents of children in home-care settings (55%) were more likely to have installed the child safety seat than those in program/center settings (21%).

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State Child Care Regulations on Child Transportation Policy All fifty states and the District of Columbia have some form of child occupant protection law to which child care providers must adhere. In addition, most states have some form of child care regulation that is designed to ensure the safety and well being of children, including provisions as to how child care providers should or should not transport children in motor vehicles. However, these child care regulations often fail to offer proper guidance to child care providers because they are inconsistent in scope and coverage, and sometimes conflict with existing statewide child occupant protection laws. Specifically, the Campaign’s review revealed that:

• 20 states explicitly defer to or restate a child occupant protection law in their child care regulations. However, these regulation often do not reflect recent upgrades in the state child occupant protection laws.

• 12 states detail their own child care transportation policies that often do not reflect current best practices in child occupant protection.

• 18 states and the District of Columbia either have no evidence of a regulation or the regulations were not easily identified, or have different child restraint policies for transporting children in home care setting versus program/center settings.

• Have an explicit written policy concerning transporting children under your supervision (“Driving Policy Agreement”) and ensure that parents and staff understand all components.

• Restrain every occupant in motor vehicles, regardless of seating position. • Ensure that children ages 12 and under ride restrained in a rear seat. • Make certain that children ages seven (7) and under are transported in child restraints

that are correctly installed and used, according to manufacturer instructions. • Never leave children unattended in or around vehicles. • Take or provide opportunities for staff to attend a child passenger safety training

program. • Post and regularly check all child safety seats used against current child restraint recall

lists from the National Highway Traffic Safety Administration at www.nhtsa.dot.gov and the U.S. Consumer Product Safety Commission at www.cpsc.gov.

• Inspect any vehicles used for transporting children regularly (see “Daily Bus Inspection Checklist”).

• Designate qualified and appropriate drivers to transport children. Send MVR request to Human Resources for completion BEFORE driving children. All Drivers must have MVR’s complete PRIOR to driving any Company vehicles and transporting children.

• Ensure the quality of transportation practices and policy compliance by spot checks and interviews of staff.

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Daily Van Maintenance Checklist Name: _____________________________ Vehicle # & Plates: ________________ Mileage: Monday _______ Friday _______ Location: ________________________ Items must be CHECKED DAILY for proper operation Functioning Properly M T W T F Comments Brakes Lights (front) Lights (back) Brake Lights Windshield Wipers Seat Belts Horn Turn Signals Interior Lights Heater / Air Conditioner All Doors / Windows All Emergency Exits Engine / Exterior Check Wiper Fluid Filled Radiator Filled Oil Filled Engine Belts Inspected NO Leak drips Clean exterior Exterior body integrity Tires PROPERLY inflated Interior Check Windshield clean, no cracks Seats secure to floor Interior CLEAN First Aid Kit and Flashlight Emergency cards for riders Car seats secure Fire extinguisher on board Interior Check Vehicle drives appropriately Any issues reported to Supervisor

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Driver / Inspector Signature: ________________________________ Date: ____________________ Director / Supervisor Signature ______________________________ Date: ___________________

Daily Bus Maintenance Checklist Name: _________________________ Bus #: __________ PMI Mileage: __________ Today’s Date: ___________________ Today’s Mileage: _______________________ Remaining Days: ________________ Mileage Remaining: _____________________ Note: Within 5 days or 300 miles call for PMI Inspection if required. The daily Inspection list must have an “OK” or if defective place an “X”. DO NOT DRIVE IF THERE IS A DEFECT OR SAFETY ISSUE! ITEM OK NOTES Approaching Bus Fluid pooling under bus Flat ties New body damage Engine Compartment Fluids: oil, water, steering, transmission Battery terminals Fan belts, hoses, leaks on engine Exterior All lights Tires, lugs, side walls, wheel cover, stems, mud flap Fuel cap, secure and present Windshield wipers, present, not cracked or tearing All glass / mirrors secure Lettering / CA# , clear and present Tail pipe, license plate Emergency door / buzzer Capacity / CHP 292 Card Back up buzzer Interior Driver’s seat, belt, mirror, horn, setting All lights, dome, step, dash, monitor Gauges, oil, battery, fuel, water, transmission Heater, defroster Passenger seat belts Windows, latches Walls, padding, ceiling rivets, floor, runners Seats, cushions, modesty panel, hand rail, seat backs Emergency exit, unlock, doors open, buzzer, light

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Emergency Equipment/Extra Equipment First aid kit Fire Extinguisher Road side reflectors Hand held stop sign ITEM OK NOTES Communicable Disease kit Hydraulic Brakes Inspection Hydraulic Test Parking Brake 2 Stops Driver’s Signature: _____________________________________________________________ Maintenance required & Date Complete: ___________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Follow-Up Items: ______________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Director’s Signature: ___________________________________________________________

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Motor Vehicle Policies and Procedures All drivers for Phoenix Children’s Academy must have a Motor Vehicle Record Check done on them BEFORE they can drive any Company vehicles. Any employee who is required to do any driving for the company must have an MVR done upon hiring. All of our drivers must have a clean driving record. Our criterion is as follows:

• Must be 21 years of age. • One non-chargeable accident within the past 3 years (no points). • One speeding ticket within the past 3 years. • Must have NO DUI’s or any other illegal substance charges. • Must have a valid Driver’s License from the State where the school is located.

o The only exceptions are for employees who work in a different state than they live. We will accept their driver’s license from their home State as long as the address in our payroll system matches the address on their license.

o A license can also be from another state as long as they are a member of a family who has a member in the military.

Employees must sign the Motor Vehicle Record Policy and the Vehicle Driver Policy Agreement. These must be sent to Human Resources along with a copy of their current driver’s license. Motor Vehicle Records are run once a week. Please do not hesitate to contact Human Resources if you have submitted a request and have not heard back within a week. Also if you need the records run sooner please let Human Resources now and they can rush the report.

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MVR Instructions In order to be a driver with The Company and operate any of the motor vehicles under the school’s name all team members must have their Motor Vehicle Records reviewed. Each team member will sign the Motor Vehicle Record Policy as well as the Driving Policy Agreement. Motor Vehicle Records will be run upon hiring (if your job description requires driving) and each year at insurance renewal. All of our drivers must have a clean driving record. Our criteria are as follows:

• Must be 21 Years of Age. • One non chargeable accident within the past three years (no points). • One Speeding ticket within the past three years. • Must have NO DUI’s. • Must have a VALID Driver’s License from the state where the school is located.

The ONLY exceptions are for employees who work in a different state then they live. We will accept their driver's license from their home state as long as the address in our payroll system matches the address on their license.

Also Military Employees are allowed to have a license from another state. Please have all employees who will be and are driving for Company business sign the Motor Vehicle Record Policy and the Vehicle Driver Policy Agreement (if they have not done so previously). Upon completion of these forms please return to Human Resources along with a clear copy of a valid driver's license. If they refuse to sign they will not be eligible to drive a Company vehicle, we do not check their credit. They do have the option to bring a current Motor Vehicle Report to us however; they are still required to sign the forms. If you have any questions, please contact your Regional Director and/or Human Resources. Attached are copies of the Motor Vehicle Record Policy and Vehicle Driver Policy Agreement.

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MOTOR VEHICLE RECORD POLICY It is the policy of the Phoenix Children's Academy to obtain and review Motor Vehicle Records (MVR) on each prospective employee when driving is part of their job description. Motor Vehicle Records are checked each year with our insurance renewal and when a license is renewed. It is the employee's responsibility to give a copy of their valid driver's license and sign new MVR forms at the time they renew their license. Management of Phoenix Children's Academy will review the Motor Vehicle Record to be sure the employee holds a valid driver's license and their driving record is within the parameters set by company policy. If the employee's driving record does not meet the criteria set by management, remedial training or other disciplinary action may be taken, up to and including removal as a qualified driver. I give Phoenix Children's Academy permission to obtain my Motor Vehicle Records. I understand that my Driving Record will be considered as one of the criteria for employment and continued employment. Print Name Drivers License Number Signature License State Date Date of Birth School #

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Driving Policy Agreement Vehicles owned or leased by this Company are to be used solely for Company business. Unless approved by Regional Director, there shall be no personal use of Company vehicles (including commuting to and from work). Individuals driving Company vehicles may have occasions where an incidental stop is necessary between business stops. Such use shall not be considered to be in violation of this policy. The Company requires that vehicles not in use shall be parked in designated areas on the Company premises. No personal items are to be stored in Company vehicles. Company materials and supplies are to be secured in the trunk, lock boxes or within the Company offices. Keys are to be returned to your Supervisor, or designee, upon the close of business each day. If you are assigned or are using a Company vehicle, we require that it be operated in accordance with the Company’s Vehicle Use Policies as well as prevailing laws and regulations. Only employees who have completed Company Drivers Approval forms are authorized to operate Company vehicles. If you are authorized to operate a motor vehicle for the Company, you acknowledge that under no circumstances will you operate the motor vehicle without being in possession of a valid driver’s license. You must maintain an acceptable driving record and you acknowledge that if your driver’s license should expire, be revoked or suspended, or if you fail to maintain an acceptable driving record you will immediately notify your supervisor and will no longer operate the Company’s vehicle. The Company may, on occasion, conduct a Motor Vehicle record (MVR) verification to ensure compliance with the Driving Policy. Employees driving for the company will be required to sign an authorization for an MVR check. If the employee refuses to sign this authorization, all privileges will be revoked. If the position requires driving to perform the essential functions of the position, refusal to sign the authorization of the MVR check may lead to disciplinary action, up to and including termination. Being an acceptable driver/ an acceptable driving record is defined as:

• Possessing a valid driver’s license issued in the state where you are working. • Being at least 21 years of age. • One non chargeable accident within the past three years (no points). • One speeding ticket/moving violation within the past three years. • No DUI.

The Company requires that: • Drivers must be 21 years or older and have a valid driver’s license in the state they are

driving and as required by law to transport children. • Drivers must be CPR and First Aid Certified prior to operating a vehicle. • Under NO circumstances should any person, other than a child enrolled in the center, or

an adult chaperone be transported in a company vehicle. • Personal use of the vehicle where permitted, is limited to driving to and from work only. • Radios are not to be used in vehicle at any time. • Use of cell phones and/or texting is prohibited. You must stop the vehicle in a safe

location to use the cell phone. Unless a bona fide emergency, you can only use the Company cell phone to make calls. However, the Company reserves the right to investigate a claim of a bona fide emergency.

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Vehicle Drivers are responsible for the following: • Conduct an overall check of the vehicle; check to be sure you have a current Auto ID

insurance. • Review Vehicle Rules with the children on a regular basis. • Safely transporting all children. • Ensure that each child is wearing a seatbelt. • Ensure that all children remain seated with seatbelt until the vehicle comes to a complete

stop. • Wear a seatbelt at all times. • Make sure that all children board and leave the vehicle safely. • Be sure that all people and obstacles are at safe distance before operating the vehicle. • Maintain an accurate “Vehicle Attendance Log” to account for all children (The vehicle

driver must take attendance each time a child enters or exits the vehicle). • Notify the Director immediately if a scheduled child does not get on the vehicle. (The

vehicle driver must not leave school grounds until receiving confirmation that the child is not being picked up).

• Notify your Director if you are not able to operate a vehicle due to illness or it you are taking medication that could impair your judgment or performance.

• Stop the vehicle in a safe location to deal with disciplinary problems. • Do not leave a child UNATTENDED in a vehicle at any time. • Be sure your vehicle is well maintained at all times, and serviced regularly as required and

in coordination with your School Director. • Ensure that the vehicle is operated in accordance with any restrictions on your license. • NO SMOKING, EATING or DRINKING is permitted in the vehicle.

If using a personal auto for company business, the Company does not provide any physical damage reimbursement for your personal auto. If you are in an accident, you must notify your liability insurance company immediately. The above has been discussed with me by my Director. I understand the contents and acknowledge and understand the corrective action required. I also understand the potential consequences of non-compliance. Name Date

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A Summary of Your Rights Under the Fair Credit Reporting Act The federal Fair Credit Reporting Act (FCRA) is designed to promote accuracy, fairness, and privacy of information in the files of every “consumer reporting agency” (CRA). Most CRA’s are credit bureaus that gather and sell information about you – such as if you pay your bills on time or have filed bankruptcy – to creditors, employers, landlords, and other businesses. You can find the complete text of the FCRA, 15 U.S.C. 1681-1681u, at the Federal Trade Commission’s web site (http://www.ftc.gov). The FCRA gives you specific rights, as outlined below. You may have additional rights under state law. You may contact a state or location consumer protection agency or a State Attorney General to learn those rights.

• You must be told if information in your files has been used against you. Anyone who uses information from a CRA to take action against you such as denying an application for credit, or employment – must tell you, and give you the name, address, and phone number of the CRA that provided the consumer report.

• You can find out what is in your file. At your request, a CRA must give you the information in your file, and a list of everyone who has requested it recently. There is no charge for the report if a person has taken action against you because of information supplied by the CRA, if you request the report within 60 days of receiving notice of the action. You also are entitled to one free report every twelve months upon request if you certify that (1) you are unemployed and plan to seek employment within 60 days, (2) you are on welfare, or (3) your report is inaccurate due to fraud. Otherwise, a CRA may charge you up to eight dollars.

• You can dispute inaccurate information with the CRA. If you tell CRA that your file contains inaccurate information, the CRA must investigate the items (usually within 30 days) by presenting to its information source all relevant evidence you submit, unless your dispute is frivolous. The source must review your evidence and report its findings to the CRA. (The source also must advise National CRA’s – to which it has provided the data – of any error) The CRA must give you a written report of the investigation and a copy of your report if the investigation results in any change.

• Inaccurate information must be corrected or deleted. A CRA must remove or correct inaccurate or unverified information from its files, usually within 30 days after you dispute it. However, the CRA is not required to remove accurate data from your file unless it is outdated (as described below) or cannot be verified. If your dispute results in change to your report, the CRA cannot reinsert into your file a dispute item unless the information source verifies its accuracy and completeness. In addition, the CRA must give you notice telling you it has reinserted the item. The notice must include the name, address and phone number of the information source.

• You can dispute inaccurate items with the source of the information. If you tell anyone-such as a creditor who reports to a CRA – that you dispute an item, they may not then report the information to a CRA without including a notice of your dispute. In addition, once you‘ve notified the source of the error in writing, it may not continue to restore the information if it is, in fact, an error.

• Outdated information may not be reported. In most cases, a CRA may not report negative information that is more than seven years old; ten years on bankruptcies.

• Access to your file is limited. A CRA may provide information about you only to people with a need recognized by the FCRA – usually to consider an application with a creditor, insurer, employer, landlord, or other business.

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• Your consent is required for reports that are provided to employers, or reports that contain medical information. A CRA may not give out information about you to your employer, or prospective employer, without your written consent. A CRA may not report medical information about you to creditors, insurers, or employers without your permission.

• You may choose to exclude your name from CRA list for unsolicited credit and insurance offers. Creditors and insurers may use file information as the basis for sending you unsolicited offers of credit or insurance. Such offers must include a toll-free phone number for you to call if you want your name and address removed from future lists. If you call, you must be kept off the list for two years. If you request, complete, and return the CRA form provided for this purpose, you must be taken off the list indefinitely.

• You may seek damages from violators. If a CRA, a user or (in some cases) a provider of CRA data, violates the FCRA, you may sue them in State or Federal Court.

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Motor Vehicle/Bus Accidents All Accidents, even minor, that happen with a Company vehicle must be reported to Human Resources immediately. If the accident involves another person’s vehicle the police must be called and a Police Report filled out. Make sure to document the cause of the accident and get any names of witnesses and / or their statements at the time of the accident (if possible). Exchange insurance information with the other driver and complete the Vehicle Accident Report. The Auto accident deductible is $1000 the Company will pay for any accidents that are lower than this amount the Company will pay directly to the party that was at cause (or fix our own vehicle). When a vehicle is damaged and /or in an accident an estimate must be done by a licensed facility. Often it is good to get a couple of estimates to make sure pricing is comparable or cheaper. After the Vehicle Accident Report is complete send a copy to Human Resources along with details of the accident (this can be done via email). Make sure to include all details when reporting accidents.

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STUDENT LIABILITY

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Student Liability

Summer Time Safety Tips Summer Safety Tips Longer days, lighter nights, and more worrying; yes it is summer! There is something about this season that makes kids run faster and play harder. And like everything else as caregivers we must do all we can to protect the kids. Here are some tips to keep kids safe during this hot weather and the Summer Season:

• Be Sun Savvy. Here’s a summer-bummer: a person’s sunlight exposure during childhood and adolescence is generally considered to increase the risk of melanoma. We’ve heard it all before, but make sure to follow these rules for Summer Sun Safety:

o Apply early and repeat. For kids six months and older (as well as adults), sunscreens with a Sun Protection Factor (SPF) of 15 or greater reduce the intensity of UVR’s that cause sunburns. Apply liberally 15 to 30 minutes before sun exposure so it can absorb into the skin and decrease the likelihood that it will be washed off. Then reapply every two hours after kids swim, sweat, or dry off with a towel. For most users, proper application and reapplication are more important factors than using a product with a higher SPF.

o Cover. Kids should be dressed in protective clothing and hats (remind parents of this if they forget). Clothing can be an excellent barrier of ultraviolet rays. Many light-weight sun-protective styles cover the neck, elbows, and knees.

o Keep Infants out of the sun. Babies younger than six (6) months should be kept out of direct sunlight, dressed in cool, comfortable clothing and wearing hats with brims. The American Academy of Pediatrics (AAP) says sunscreen may be used on infants younger than six (6) months on small areas of skin if adequate clothing and shade are not available.

o Plan early morning play. For kids beyond the baby stage, plan children’s outdoor activities to avoid peak-sun hours (10 a.m. to 4 p.m.) as much as possible (do not cancel recesses – just beware of the power of the sun on the children in your care).

o Beware of shade. Many think sitting in the shade is a simple way out. Shade provides relief from heat but offers a false sense of security about UVR protection. People can still sunburn in shade, because light is scattered and reflected. A fair-skinned person sitting under a tree can burn in less than an hour.

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o Check the weather. Check the ultra-violet (UV) index (on a site like weather.com) when planning outdoor activities, it predicts the intensity of UV light for the following day based on the sun’s position, cloud movements, altitude and other factors. Higher UV index numbers predict more intense UV light during midday of the following day.

Splash Safety If you have a pool you use and/or one at your school you know the rules. Drowning happens quickly and quietly – not with a lot of splashing. Drowning is the leading cause of unintentional injury / deaths in kids one (1) to four (4) years old.

• Stay off Cell Phones (this is against Company Policy). Don’t even allow yourself to get distracted when you have kids in the water. Chatting with other teachers is a distraction; stay alert and make sure all the children in your care are safe.

• Know your skills. Adults and caregivers should refresh their Infant Child CPR certification each year, especially before summer, if there is a pool involved. Kids should never swim alone, and having caregivers know water safety skills is a must.

Beware of Bugs Unfortunately, those blood-sucking critters are a part of summer nights and days.

• Spray and repeat. Caregivers should spray kids’ exposed skin and clothing. Reapply whenever the spray gets washed off or the child starts getting bitten again. For an alternative to sprays, try insect repellent pads that clip on clothes.

• Check for allergic reaction. Some kids react to insect bites more than others. If a child gets bitten and seems to have an allergic reaction to the bite, contact your Director or Safety Coordinator immediately. If the reaction is severe contact emergency services to help the child. Do not wait until it is too late. Follow all the procedures for reporting and caring for an injured child.

• Beware of serious bug-borne illnesses. Most people who contract Eastern Equine Encephalitis (“Triple E”), a mosquito transmitted illness, do not show any symptoms. But here’s the good news: this illness occurs relatively infrequently and mostly in and around swampy areas where human populations are limited. West Nile is another virus that is caused by mosquitoes. Symptoms of either of these illnesses are flu-like. If an instance

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occurs in your area and a child has flu-like symptoms (and muscle-stiffness for West Nile), call the parents immediately. The parents will decide whether or not to seek medical attention.

Prevent Dehydration You may be surprised how much and when kids should drink. To prevent dehydration, kids should drink 12 ounces of fluid 30 minutes before an activity begins and take mandatory fluid breaks. With kids fewer than 90 pounds drinking five ounces of water every 20 minutes during activities and kids over 90 pounds drinking 9 ounces every 20 minutes. Tip: A child’s gulp equals a half-ounce of fluid, so children should drink 10 gulps every 20 minutes of play.

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Dealing with Divorce and Custody Issues Stay Neutral

• Do not take sides (even if there is a good reason to). • Do not even discuss marital or custody issues with parents.

o If they have a request of you (court orders, etc.) simply take the request, read and make sure you understand. Only ask questions about the request and not the situation.

Require Subpoenas

• Do not turn over or create documents without a subpoena. • Do not talk to a parent’s attorney or give a deposition without a subpoena.

o If you are served a subpoena contact your Regional Director immediately. Release Children to Appropriate People

• Get court papers for all divorced or separated parents. This may include temporary orders or permanent orders.

o If these documents exist, release only to parent who has visitation rights on that day. A parent with visitation has the right to authorize someone else to pick up

the child, unless the court documents state otherwise. • Keep a copy of the court documents in the child’s file.

If the parent who does not have visitation tries to pick up the child, tell the parent you are legally obligated to follow the terms of the court documents. You can also tell the parent he or she is free to work out special arrangements with the other parent with visitation.

o If court documents explaining custody and visitation schedules do not exist, you may release the child to: The biological parent or The legal guardian

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Americans with Disabilities Act All children with special needs must be provided with reasonable accommodation to facilitate their participation in our program. Exceptions:

• Undue financial hardship (i.e. hiring additional staff). • Direct threat to the health and safety of other children or staff members. • Would change the fundamental nature of the (group care) program.

Enrollment Requirements Evaluate each child individually to determine if we can meet the child’s needs. We have specific procedures in place for this:

1. Special Needs Inquiry: Maintain a positive attitude. Encourage cooperation and exchange of information. Get the parent to tour the center with the child.

2. Call Regional Director for advice on how to move forward. 3. Gather information about the child’s needs – DOCUMENT.

a. Ask the parent about the child’s care & school experience. b. Request IEP (Individualized Education Plan). c. Ask the parent about the child’s needs – get specifics. d. Ask permission to speak to prior care providers, health care providers, current

teachers about the child’s needs. 4. Work with the Regional Director to assess the center’s ability to meet the child’s needs.

a. Think flexibly. b. Try not to speculate – make decisions based on facts and the child’s experience. c. Maintain communication with the parent. d. Help the teachers to feel comfortable with the situation.

5. Conditional enrollment/trial basis a. If uncertain whether/how we can meet the child’s needs, try enrolling the child for

a trial period (i.e. 2 weeks). b. Document child’s behavior and progress.

6. Remember: it is always easier to address these issues prior to enrolling a child than after the child is already enrolled!

Behavioral Issues and Disenrollment

1. Document child’s progress. 2. If there are behavioral problems or if the child is requiring significant one-on-one

attention, call your Regional Director. a. Document any issues. Have teachers keep a log indicating how much one-on-

one time they spend with the child. b. Discuss the issues with the parent.

3. DO NOT DISENROLL WITHOUT TALKING TO YOUR REGIONAL DIRECTOR!

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Student Liability Insurance Phoenix Children’s Academy’s Student Liability Insurance is through Chartis Insurance. In this section you will find all the forms you need as well as instructions and a letter to the parents explaining the process. If you do have a child injury at your school, contact your Director and/or Assistant Director immediately. They will contact the parents to notify them of the injured child. If the injury is severe call for an ambulance, do not take risks with children’s injuries. It costs the Company more to take risks than it does to be safe and/or over-protective of the child that has been injured. Console the child until the parents arrive. Use your first aid kit and any items that can be used to help ease the pain the child may be experiencing. Do not have the child go back into the classroom until you are certain they are injury free and the parents have been called and have decided to not seek medical treatment. If the parents do decide to seek medical treatment please give them the Chartis Claim Form to take with them to the Doctor / Emergency Room. Follow the Instructions that follow and contact Human Resources any time you have a question. Claims cannot be filed with Chartis UNTIL we have a completed claim form. The longer the form takes to complete the longer payments are delayed to the parents. Again whenever you have a question contact Human Resources for help. Our goal is to not have any accidents with our children but if one does happen, make sure you are prepared and you handle it quickly, professionally and as if it was your own child.

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Student Accident Helpful Hints 1. If a student accident occurs with a severe injury call 911 and get an ambulance to the

scene. Call parents AS SOON as you have completed call to 911. 2. Follow up with the parents to check on child’s condition. Also remind them to return the

Chartis claim form (see Chartis Claim Form Instructions on next page).

3. Send a card from Children and Staff.

4. Listen to what parents are saying: • Lost time from work • Haven’t slept, distraught • Child is in terrible pain

5. Express your concern and offer your help.

• What can I do to help? • What can I do to make the situation easier for you? • What can I do to keep you and your child happy?

6. Treat the situation as if this was your own child – make sure you show real concern and

empathy. • Our goal is to make this situation as easy on the parents as possible. • Contact Human Resources with any questions on bills received by the parents. • Always let the parents know we are there for them and their child.

7. When child returns to school make sure the parents feel secure in leaving them on the

premises.

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Chartis Claim Form Instructions

1. Call/Email Human Resources and report the claim. 2. Email Human Resources the name and address of Child’s parents.

CLAIM FORM: Section A to be filled out by the Director of the School

1. School Name, Number & Address 2. Full Name of Student

a. Social Security Number - Mandatory b. Date of Birth c. Name of Director

3. Description of Injury 4. Date & Time of Accident / Where and When the Accident Happened 5. Name Activity (i.e. play time) 6. Check B, C, D; Yes or No 7. Claims will be signed once they have been filed with Corporate.

Note: Please include Incident/OUCH/OH OH Report and/or any witness statements with the completed claim form. If your state requires a separate filing form, please also include that in with the completed claim form. Section B to be filled out by the Parent

1. Name of Guardian and Relationship to Student 2. Address of Guardian / Parent 3. Parent’s Insurance Information (MUST include) 4. Guardian / Parents Signature and Date 5. MUST complete Social Security Number Information in Section 2 of the form (under

Director’s portion). Please make sure the form is legible so that all payments are sent to the correct address and person. Once the form is complete please fax or email to Human Resources. You do not submit the form to Chartis – simply complete and send to Corporate (attention HR). In an effort to ensure timely payments all Hospital/Doctor statements must come to the Corporate Office (attention HR). The parents can give to you or mail them directly.

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PROOF OF LOSS

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Chartis Insurance A&H Claims Department P.O. Box 25987 Shawnee Mission, KS 66225-5987 800-551-0824

NAME OF GROUP: POLICY NUMBER:

Phoenix Childrens Academy SRG9103420

SPECIAL RISK ACCIDENT AND SICKNESS CLAIM FORM INSTRUCTIONS: 1.) You must have SECTION A fully completed by a designated official of the Policyholder. 2.) SECTION B is to be completed, signed and dated by the claimant or parent/guardian of claimant, if claimant is a minor. 3.) Attach itemized bills for all medical expenses being claimed including the claimant's name, condition being treated (diagnosis), description of services, date of service(s) and the charge made for each service. PLEASE MAIL COMPLETED FORM AND BILLS TO ABOVE ADDRESS. PRIMARY PLAN - benefits are payable for covered medical expenses from the first dollar without regard to payments made by other insurance up to the policy maximum.

EXCESS PLAN - Eligible covered expenses will be determined after benefits have been paid by other valid and collectible insurance. You must submit your claim to your other insurance company first. When you receive their Benefit Statement (EOB) send it to us along with the itemized bills. Benefits for eligible expenses will be paid per policy terms.

The furnishing of this form, or its acceptance by the Company, must not be construed as an admission of any liability on the Company, nor a waiver of any of the conditions of the insurance contract. SECTION A - MUST BE COMPLETED AND SIGNED BY A DESIGNATED REPRESENTATIVE OF THE POLICYHOLDER NAME/ AND/OR LOCATION OF GROUP/CLUB/SPORT/SCHOOL, ETC. CLAIMANT'S FULL NAME (PLEASE PRINT CLEARLY OR TYPE)

SOCIAL SECURITY NO. MANDATORY

DATE OF BIRTH NAME OF SUPERVISOR

DATE COVERAGE BEGAN N/A

DATE COVERAGE WILL END/HAS ENDED N/A

NATURE OF INJURY OR ILLNESS. (DESCRIBE FULLY, INCLUDING WHICH PART OF BODY WAS INJURED.) DESCRIBE HOW, WHEN AND WHERE ACCIDENT OCCURRED (DATE AND TIME).

NAME OF ACTIVITY DID ACCIDENT OCCUR: A. WHILE CLAIMANT WAS SUPERVISED

YES

NO

B. DURING SPONSORED ACTIVITY

YES

NO

INDICATE THE SPORT (IF APPLICABLE) C. DURING PROGRAMMED HOURS

YES

NO

N/A D. WHILE TRAVELING TO OR FROM REGULARLY SCHEDULED ACTIVITY IN A SUPERVISED GROUP

YES

NO

DATE LAST WORKED N/A

DATE RETURNED TO WORK N/A

WEEKLY EARNINGS N/A

POLICYHOLDER REPRESENTATIVE (PLEASE PRINT OR TYPE) HUMAN RESOURCE MANAGER

TITLE DAYTIME TELEPHONE NUMBER ( )

SIGNATURE OF POLICYHOLDER REPRESENTATIVE DATE SECTION B - MUST BE COMPLETED LIST NAME, ADDRESS, AND PHONE # OF OTHER INSURANCE COMPANIES UNDER WHICH CLAIMANT IS INSURED:

POLICY #/ACCOUNT #

IF CLAIMANT IS A MINOR, NAME OF CLAIMANT’S GUARDIAN/RELATIONSHIP TO CLAIMANT ADDRESS OF CLAIMANT (IF CLAIMANT IS A MINOR, NAME AND ADDRESS OF CLAIMANT’S GUARDIAN)

GUARDIAN’S SOCIAL SECURITY NUMBER

NAME/ADDRESS/TELEPHONE # OF EMPLOYER (IF CLAIMANT IS A MINOR, GUARDIAN’S EMPLOYER)

EMPLOYER’S DAYTIME TELEPHONE # ( )

I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. AUTHORIZATION and ASSIGNMENT OF BENEFITS

I, the undersigned authorize any hospital or other medical-care institution, physician or other medical professional, pharmacy, insurance support organization, governmental agency, group policyholder, insurance company, association, employer or benefit plan administrator to furnish to the Insurance Company named above or its representatives, any and all information with respect to any injury or sickness suffered by, the medical history of, or any consultation, prescription or treatment provided to, the person whose death, injury, sickness or loss is the basis of claim and copies of all of that person's hospital or medical records, including information relating to mental illness and use of drugs and alcohol, to determine eligibility for benefit payments under the Policy Number identified above. I authorize the group policyholder, employer or benefit plan administrator to provide the Insurance Company named above with financial and employment-related information. I understand that this authorization is valid for the term of coverage of the Policy identified above and that a copy of this authorization shall be considered as valid as the original. I understand that I or my authorized representative may request a copy of this authorization. I authorize payment of medical benefits to the physician or supplier for service performed. YES NO

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CLAIMANT OR AUTHORIZED PERSON'S SIGNATURE DATE

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Dear Parents, We are very sorry that your child has experienced an injury at our location. In an effort to explain and expedite the reporting process, please follow the instructions below. If you have questions at any time during this process, please do not hesitate to call HR at PCA 866-607-7552 ext. 13180. In order to process your claim the following is needed: Completed and signed CHARTIS Claim Form. Section A will be filled out by the Director. There is a new Federal Mandate that requires your Child’s Social Security Number to be included on

the claim form. Your claim will not be processed without it. Please make sure the Director of the school has this information.

Section B is to be filled out and signed by you. We DO need your insurance information. ALL copies of original bills and primary insurance explanation of benefits should be sent to

Phoenix Children’s Academy 8767 E. Via de Ventura Suite 200, Scottsdale AZ 85258; Attention: Human Resources. PLEASE DO NOT SEND STATEMENTS.

All bills must include: diagnosis codes, procedure codes and provider's tax ID number. If any information is missing your claim could be delayed.

Please be aware that due to New HIPAA regulations, CHARTIS cannot obtain bills or missing information from the providers. Only parents are able to obtain the necessary information to process the claim. Any missing information will delay your claim. Once all of the information required has been received, your claim will be processed. However, please note it may take 45-60 business days to receive any payments. There is a $50.00 deductible per accident. Deductible checks will be sent to you from Phoenix Children’s Academy as soon as we receive notice from the hospital or Doctor’s of the deductible due. Please note that you may owe this money to the provider up front. CHARTIS Insurance will pay $250.00 per tooth for a dental claim, the deductible also applies. We do not pay out of pocket expenses. All claims must go through CHARTIS Insurance. We do need to have your Primary Insurance Carrier information on the Chartis Claim Form. You will also need to send a signed copy of the claim form to PCA Corporate, attention HR in order to process (if you have already given a copy to the school, they will forward to me). If you have any questions, please do not hesitate to call. Regards, Human Resources Phoenix Children's Academy 8767 E Via de Ventura, Suite 200 Scottsdale, AZ 85258

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LAUNDRY ROOMS

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Laundry Room Safety Fire Protection Purpose To eliminate the possibility of fire in the laundry room. Facts:

• There are 15,000 laundry room fires per year.

• These fires cause an average of 15 deaths and 400 injuries per year.

• 70% of all dryer fires are the result of operations deficiencies – “failure to clean.”

Dryer Procedure

1. Dryer lint traps are to be cleaned after each load, and replaced if damaged. 2. The maintenance person or Safety Coordinator will be responsible for inspecting all

laundry room equipment on a monthly basis to ensure that it is in good working order and free of hazards.

3. The dryer vents shall be cleaned out monthly. 4. Materials containing plasticized linings (i.e. Bibs) must be removed immediately after

drying. 5. Any material that has been subject to grease or other such substances must be washed

and pre-soaked before being put in the dryers. 6. Never put foam, rubber, or plastic materials in dryer. 7. Never put towels used to clean up flammable liquids in the dryer, even if they have been

washed. 8. Exhaust vent should be as short as possible with limited bends to provide adequate

airflow. 9. Do not let dryer run if you are not in the school.

Warning Signs:

• One obvious warning sign of a clogged vent is when heavy clothes, such as towels are taking a lot longer to dry.

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Washer Check the Washer Washing machines pull in and push out large volumes of water during each cycle. If something goes wrong, all the water can end up flooding the school. The water for your washing machine comes from two hoses, one hot and one cold. These water valves are always turned on full force, released only when the washer is turned on. When the washer is not operating, water pressure builds up in the hoses. If your hoses are made of rubber, they can leak or even rupture, flooding the school with running water at a rate of up to 600 gallons an hour. Consider replacing them with braided steel hoses or shutting off the water in between washer loads. The water that leaves your washing machine during the spin cycle is ejected forcefully. Find the rubber hose that takes the dirty water down the drain and make sure the hose is securely connected at the drain, so the force of the water doesn’t push the hose out, spraying your laundry room with dirty water. If your hose flows into a utility sink instead, be sure you never leave anything in the sink that could float around and ultimately block the sink drain, causing water to flood your laundry room. Laundry Products

1. All laundry products should be stored in a locked or childproofed cabinet.

2. Bleach, stain removers, even detergent can be toxic if consumed.

3. Always sweep or wipe any products that spill onto the machines or the floor.

4. Liquid capsules or soft packets of detergent are particularly dangerous. If they are punctured, the product often squirts into the eyes of children and can cause corneal burns.

5. Some chemical like chlorine bleach and ammonia – when combined form toxic fumes even if the child does not consume the products. Never leave any chemical within reach of a child.

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FOOD PREPARATION

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Food Preparation Personal Hygiene:

• All personnel are required by licensing and health agencies to have a routine health screening and a copy of the examination report is to be kept on file at the center.

• Persons with a contagious disease will be forbidden in the kitchen or food storage areas.

• No smoking is permitted in center.

• Food service personnel are required to wash their hands in the separate hand-wash sink

PRIOR to preparing food and AFTER any interruption in the food preparation process (phone calls, etc.).

• Soap and paper towels are always available at the hand-wash sink.

• Persons who act in the food preparer/cook capacity may not care for children during their scheduled work day unless they meet the requirements set forth by state licensing.

• Long hair must be pulled back or secured during food preparation and serving. Food service personnel with long hair should take special precautions to keep hair away from food. Hair nets or hats must be used where required by licensing.

• Food preparers are urged to wear a smock/apron to protect their clothing.

• Food preparers may choose to wear gloves to protect their hands from detergent and hot water.

• Food service personnel must meet any additional regulations established by licensing, health and fire departments in order to be in compliance per assigned area.

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Safety in the Kitchen Receiving and storing items:

1. Remove nails, rather than bending them, when opening boxes. This requires a claw hammer.

2. Store heavy materials on bottom shelves, medium weight boxes next above, light weight

on top.

3. Keep food containers covered except when in actual use.

4. Remove all dirt, grease and garbage promptly to reduce fire hazards.

5. Use ladders, not boxes or chairs, to obtain items from high shelves. Avoid losing your balance by over reaching.

6. Avoid lifting or carrying heavy objects. Lift with your legs and keep your back straight when lifting. Avoid carrying objects so large that you cannot see over or around them.

Food Preparation:

1. Keep stove top and hood free from grease to avoid dangerous fires.

2. Use pot-holders to handle hot cooking utensils.

3. When checking cookware, lift the edge of the lid away from you first so that steam will escape in the opposite direction from your face. Stand far enough back when removing lids so steam cannot reach you. Refrain from peeking into open steam jacketed kettles.

4. Keep pan handles away from stove and out of the aisle so that utensils cannot be brushed off the stove. Make certain that the handle is away from an open flame or extreme heat source.

5. Keep oven doors closed when not in use.

6. Wait until oven has cooled before cleaning it.

7. Avoid over-filling containers with hot liquids or foods.

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Drawers and Doors:

1. Be careful when closing drawers, they can pinch fingers.

2. Keep drawers closed when not in use. Open using handles or knobs. Handling Knives:

1. Knives should be stored out of children’s reach. 2. Cut away from your body and away from fellow workers.

3. When drying a knife, keep the sharp edge away from you.

4. Refrain from leaving knives in the sink or in water or where they cannot be easily seen.

5. A sharp knife is safer than a dull one. It cuts more easily, requires less pressure and

has less danger of slippage.

6. If a knife falls, get out of the way!! DON’T grab it!

Food Preparation Machines:

1. Familiarize yourself with printed instructions posted on or near machine.

2. Be sure all safety devices are in place before using machines.

3. Pull electrical plug or switch machine to “off” position before cleaning or adjusting the machine. Make certain all electrical switches are in the “off” position prior to plugging the unit into the outlet.

4. Keep fingers, hands, spoons, etc. away from moving parts. Wait until machine stops before moving food.

Floors:

1. Keep floors clean and dry. Wipe up spills immediately. Use WET FLOOR sign.

2. When cleaning, wet mop first, then rinse and dry mop, doing one small area of the floor at a time.

3. Tile floors may become slippery during humid muggy weather conditions. Extra caution is required at these times to avoid falls.

4. Never leave utensils on the floor for someone to trip and fall over.

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Garbage Disposal:

1. Place food leftovers in covered containers.

2. Take care not to overfill containers.

3. Report broken or defective garbage containers to management.

Fire Safety:

1. Practice kitchen fire drills regularly. 2. Immediately report any fire, no matter how small, so that the fire department may be

called.

3. Know where the fire extinguishers are located and how each should be used. If you find an extinguisher partially used that needs recharging, or one with its seal broken, report it to your supervisor immediately.

4. Know the location of fire exits and the procedure to be followed in case of a fire.

5. Keep fire doors, fire exits and fire stairs clear of material and equipment. Use only in the event of an emergency or fire drill.

6. Keep grill canopies and filters grease-free as grease accumulation is a major source of kitchen fires.

7. Hood systems should be checked annually.

General Maintenance Procedures: Other items and areas in the kitchen require careful attention and respect to cleaning.

1. The can opener must be washed daily following the same procedures use in washing dishes.

2. Cupboards should be wiped frequently and cupboard drawers should be organized and

crumb free.

3. The silverware tray should be kept clean and covered, whether it remains in a drawer or on the counter top.

4. Counter tops should be cleaned frequently during the day.

5. Floors should be swept and wet-mopped daily. Walls, ceilings and vents should be maintained in a sanitary condition.

6. Stove drip pans should be lined with foil and changed as required.

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7. Refrigerator, stove, hood and oven should be maintained in a sanitary condition at all times. Cleaning behind the stove and refrigerator should be done monthly or more frequently. The hood filter should be washed in hot, sudsy water weekly.

8. The garbage can should be emptied daily into an outdoor container, replaced with a new liner and routinely washed.

Food Storage:

1. Food will be stored in kitchen cupboards and approved storage areas.

2. Food must be stored off the floor surface and should be stored as soon as it is delivered or brought into the kitchen.

3. Staple items, such as flour, sugar, rice and pastas, must be stored in clean, air-tight containers.

4. Food and beverage items stored in the refrigerator must be covered.

Leftovers:

1. Be aware of local regulations regarding leftovers.

2. Many leftover items may be frozen for later use.

3. Leftovers should be used as soon as possible.

Food Protection: Bacteria are ever present in food; however, they are not a problem unless conditions are favorable for them to multiply. The best weapon against bacteria is temperature.

1. Foods should not be allowed to remain long at room temperature.

2. Apart from preparing and serving, food items should always be placed in a covered container or wrapped in cellophane or foil.

3. Many food items containing starch thickening, such as salad dressing and cream fillings, are especially prone to becoming contaminated and causing gastrointestinal disturbances. Food poisoning is prevented by properly protecting and immediately refrigerating these items.

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Pest Control: Rats, mice, roaches and flies all carry germs and disease. All food and equipment should be safeguarded from these sources of contamination.

1. Keep areas clean, neat and free from garbage and places where rodents can hide.

2. Block their entrances by closing openings with metal or cement.

3. Use garbage containers with tight fitting lids to prevent rodents from getting to food waste.

4. Store food and supplies off the floor – 12 inches or more.

5. Keep everything in the kitchen clean and keep all foods covered.

6. Keep garbage cans tightly closed.

7. Dispose of garbage daily and discard cardboard packing boxes.

Medication:

1. Medication requiring refrigeration is stored in a separate, locked enclosed area clearly labeled.

2. Non-refrigerated medication and cleaning agents are stored separately from food and out of children’s reach in a locked cupboard.

3. Carefully follow licensing regulations regarding medication.

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Food Preparation Guides to Safe Food Service:

• Purchase federally inspected meat and poultry.

• Rinse fresh poultry before preparing.

• Avoid buying or accepting bulging cans.

• Work with as small a quantity of food as possible.

• Avoid alternate refrigeration and heating.

• Treat all leftovers with great care.

• Use leftovers within 24 hours or discard (NO exceptions!).

• Do NOT refreeze defrosted food items.

• Keep food hot or keep it cold.

• Always keep food covered.

• When in doubt, throw it out!

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Hand Washing The best way to STOP disease is to wash your hands well. Use this method to make sure your hands are free from germs. HOW

• Use soap and running water. • Rub your hand vigorously as you wash them. • Wash ALL surfaces, including:

o Backs of hands o Wrists o Between fingers o Under fingernails

• Rinse your hands well. Leave water running. • Dry your hands with a single-use towel. • Turn off the water using a Paper Towel instead of bare hands.

WHEN

• When you come into the center each morning. • Before preparing or serving food (hand sanitizer does NOT replace washing). • After diapering a child, wiping a nose or cleaning up messes. • After you have been to the bathroom, either with a child or by yourself.

KEEP THE CHILDREN’S HANDS WASHED TOO

• When they arrive at the center. • Before they eat or drink. • After they use the toilet or have their diapers changed. • After they have touched a child who may be sick.

If they are too young to do it themselves, YOU wash their hands. Older children should get into the habit of hand washing to STOP disease from spreading. REMEMBER: Children learn by watching you. Children copy what they see adults doing, especially when they love those who care for them. NOTE: You must wear sanitary gloves when changing diapers, serving food, or caring for an accident. This does NOT eliminate the need to wash your hands afterwards!!

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Forms

*Also located on the Company’s Intranet

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Forms Emergency Preparedness Team NOTE: Each position should have two (2) different people appointed in cases where one individual might be absent/away from the center during a crisis. The two (2) individuals should plan and act as one.

1. Operations Management a. Team Leader/Alternate b. Members

i. Determine appropriate actions for students, i.e. evacuate school buildings, lock down, etc. Collect, analyze information; provide overall direction for all activities that occur during an emergency.

1. Name: ______________________________________________

2. Name:_______________________________________________

2. Communications a. Team Leader/Alternate b. Members

i. Maintain communications with local authorities, local news and communicate with all parents.

1. Name: ______________________________________________

2. Name: ______________________________________________

3. First Aid a. Team Leader/Alternate b. Members

i. Determine need for, request assistance, provide overall direction for emergency functions as appropriate. Collect all information concerning injuries, facility damage, assessment, etc. report to the Director.

1. Name: _______________________________________________

2. Name: _______________________________________________

4. Food, Water and Supply Management a. Team Leader/Alternate b. Members

i. Assess food preparation, adequacy of available water, food, blankets, other supplies.

ii. Control conservation of water. iii. Establish list and determine needs. Report to Director.

1. Name: ______________________________________________

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2. Name: ______________________________________________

5. Building Control a. Team Leader/Alternate b. Members

i. Check building, determine safety of exit/entrance, and report to the Director.

ii. Be prepared to direct emergency vehicles to proper entrance for access.

1. Name: _______________________________________________

2. Name: _______________________________________________

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Attachment A EMERGENCY PHONE NUMBERS

Name/Company Contact/Town Telephone Number Director Ambulance Fire Poison Control Police Human Resources 866-607-7552 ext. 13180 Local Health Department Building Inspector Sponsor Liaison Sponsor of Security Dept. of Social Services Health Consultant State Licensor Air Conditioning Appliance Repair Cleaning/Maintenance Copy Machine Electric Company Electrician Glass Company Heating Company Locksmith Plumber Snow Removal Taxi Trash Removal Water Department

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Attachment F Bomb Threat Report Directions: If you receive a bomb threat. Remain calm, listen carefully and do not interrupt the caller. By discreet prearranged signal, alert a second person. Complete as much of the information below as possible to keep the caller on the phone and prolong the call. Date: Time: Time Call Ended: Questions: Answer: When is the bomb going to explode?

What kind of bomb is it?

Where is the bomb right now?

What does the bomb look like?

Why did you place the bomb?

Where are you calling from?

Caller’s Identity Circle the ones that apply: Age: Male Female Adult Juvenile Language: Good Poor Foul Slang Accent: Local Not Local Foreign Tone of Voice: Raspy Pleasant Loud Soft

High Intoxicated Deep Pitched High Speech Pattern: Distinct Fast Slow Nasal

Lisp Slurred Stutter Manner: Coherent Incoherent Calm Angry

Rational Irrational Laughing Deliberate Emotional Other:

Background Noise: Voices Bedlam (trains, Factory Machines, Animals) Traffic Airplanes Quiet

Was the voice similar? Yes No If yes whose?

Exact words of the caller:

Did the caller use familiar terms? Yes No If yes, describe:

Person Receiving Call: Name: Receiving Telephone Number: Number Called:

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Immediately after call notify your Director and Security. Talk to no one else, unless instructed to do so. Attachment G Organizational Roles and Responsibilities List all staff names, address, and phone numbers (regular and emergency) as well as position in the program. For each person, list whom that person reports to, in order of responsibility. Be able to show at a glance who is in charge if someone above them is unable to respond. STAFF Name: Address Phone Numbers Reports to: Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Director / Asst Director Answer the questions:

• Who will provide first aid? _________________________________________________ • Who will take medication? _________________________________________________ • Who will take the first aid kit? ______________________________________________ • Who will take emergency information on each child? ____________________________ • Who will call for help? ____________________________________________________ • Who will carry the cellular phone? ___________________________________________ • Who will carry the emergency kits? __________________________________________ • Which groups of children go with which staff? __________________________________ • Who makes sure everyone is out of the building? _______________________________

Share the list with the staff and discuss it so there is no surprise during an emergency. Everyone should know their primary and back up responsibilities. Maintain an attendance list at all times; do not put children, staff, visitors, or emergency personnel at risk by not knowing these three things:

4. Who is in the building? 5. When did they arrive? 6. When did they leave?

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Have emergency information with attendance list. Make sure you know health information and have permission for emergency medical treatment and know of any special requirements or medications for children and staff. EMERGENCY DRILL LOG Center Number: ___________________________ Year: ________________________ Director Name: ____________________________

Date Time # of

Children Present

# of Adults Present

“Type” of Emergency Practiced

Length of time to complete

Management Signature

1st Quarter

2nd Quarter

3rd Quarter

4th Quarter

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Safety Coordinator’s Fire Drill Log Date: How Long Did the Drill

Take: Concerns to be addressed before next drill:

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FIRE DRILL LOG Center Number: ___________________________ Year: ________________________ Director Name: ____________________________

Date Time # of

Children Present

# of Adults Present

Length of Time to Evacuate

Management Signature

Fire Extinguisher Inspection Date

January

February

March

April

May

June

July

August

September

October

November

December

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EMPLOYEE SAFETY MEETING

Date: ______________________________ Time:_____________________ a.m./p.m.

Conducted by: _______________________________________________________________ Title: ________________________________________________________________________ Subject Discussed: ____________________________________________________________ Employees in Attendance (please write legibly) _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________ _________________________ _______________________ _______________________

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Teacher’s Classroom Safety/Sanitation Checklist

CLASSROOM: DATE: INSPECTED BY: CLASSROOM ISSUES YES NO COMMENT

1 Floor clean and in good repair? 2 Walls clean and in good repair? 3 Windows clean and in good repair? 4 Carpet clean and in good repair? 5 Trash containers with lids, emptied

appropriately?

SANITATION ISSUES

1 Good hygiene practices? 2 Proper Diaper Changing/Toilet

Procedures

3 Adult hand washing practices correct? 4 Children’s hand washing practices

correct?

5 Gloves in use? 6 Toys sanitized properly and frequently? 7 Changing tables sanitized properly? SAFETY ISSUES

1 Adult items out of reach? 2 Approved classroom chemicals only? 3 Chemicals labeled (bleach, water, etc.)

properly?

4 Chemicals out of reach? 5 Outlets covered? 6 Electrical cords out of reach? 7 Toys appropriate and safe? 8 Fire Safety 9 Doors not blocked?

10 Evacuation notice properly displayed? 11 Evacuation cribs identified? 12 Safety belts in baby chairs? 13 Room free of hazards? 14 Classroom equipment in good repair? 15 Chairs not stacked on tables while room

is occupied?

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ACCIDENTS WITHIN THE PAST MONTH DATE TIME

TYPE

1

2

3

4

5

6

7

8

9

10

Additional Notes for Next Safety Meeting: ______________________________________________ ______________________________________________________________________________ _______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _________________________________________________________________________________ ______________________________________________________________________________

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SAFETY SANITATION INSPECTION Center: _____________________________ Director: ____________________________ KEY INSPECTION ITEMS DEFICIENCY COMMENTS 11. Health Practices Regarding

Children

Hygienic Practices Diaper Changing Disposable Wipes Diaper Proper Handling 12. Site Free of Hazards Outdoor Play Areas Protected Water Hazards Fencing intact, good shape Insect, Vermin/Animal Control

13. Facility Lighting – all lights operational

Clean Surfaces Floors Walls

Electrical Openings Protected Safety Glass/Decals Storage of Harmful Items Gates Handrails, Barriers Clean, Safe Interior Clean Safe Exterior Ceilings

14. Safety of Equipment Physical Building Furnishings, Toys

Cribs, Playpens, Feeding Chairs Safety Barriers Microwave Ovens

Non-toxic Materials Stored Room Temperature First Aid Supplies Playground Equipment

15. Bathrooms Toilets/Lavatories Step Stools Training Equipment

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Ventilation Clean Good Repair

KEY INSPECTION ITEMS DEFICIENCY COMMENTS Water Temperature Soap Individual Towels Easily Cleanable Walls

Easily Cleanable Receptacles 16. Water Supply

Source, Supply, Pressure Drinking Fountain

17. Waste Disposal Water Tight Containers Garbage, Solid Waste Liquid Waste / Sewerage Soiled Diapers

Proper Cleaning Procedures 18. Preparation, Serving,

Storage of Food / Protection of Supplies

Hand washing facilities Protected/Stored Properly Handled Properly

Single Serve Articles Stored, Used Properly

Common Drinking Cups Personal Health Personal Hygiene of Staff Hazardous Foods Properly Prepared

Adequate Temperatures Special Foods Labeled Source, Sound Condition No Spoilage Stored Food Properly Labeled

19. Cleaning, Storage, Handling of Utensils, Equipment

Washing, Rinsing, Sanitizing

Food Contact Surfaces Sanitizing Test Kits Storage of Utensils Handling of Utensils Kitchen Hood Clean Refrigeration/Freezer

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compartments clean Floor Condition

KEY INSPECTION ITEMS DEFICIENCY COMMENTS 20. Teacher Training

CPR 1st Aid Safety Issues

Comments: Signed: _______________________________________________ Date: __________________________________________

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Safety Inspection School: __________________________ Director: _____________________________ Date: _________________ Discussed with Safety Coordinator on date: ______________________________________________________ YES NO INJURY, ILLNESS AND PREVENTION PLAN Floors are smooth and have non-skid surfaces. Rugs are skid proof. Doors that children can access are easily opened by children and adults. Doors in children’s areas have see-through panes for easy visibility for anyone opening

the door. Doors have slow closing devices and/or rubber gaskets on the edges to prevent finger

pinching. Windows cannot be opened more than 6 inches from the bottom. All windows have closed permanent screens. Bottom windows are lockable. Walls and ceilings have no peeling paint or cracked plaster. The Childcare setting is free of toxic or lead paint and or crumbly asbestos. Safety covers are on all electrical outlets. Electrical cords are out of children’s reach. Covers of guards for fans have openings small enough to keep fingers out. Freestanding space haters are NOT used. Nobody smokes or has lighted cigarettes, matches or lighters around children. Tap water temperature is 120 degrees to 130 degrees Fahrenheit or lower. All trash containers are covered at all times. All furniture has cushioned edges. Emergency lighting equipment works. Children are always visible in all areas. Poisonous plants are not present indoors or outdoors in the child care area. All adult handbags are kept out of children’s reach. All cleansers, cleaners, medicine and paint are kept out of children’s reach and kept in

locked cabinets. Pesticides are not used during normal operation of the childcare setting. A certified pest control operator applies pesticides. Children are never left alone in infant seats on tables or other high places. Teaching aids such as the TV and VCR’s are put away when not in use. YES NO TOYS AND EQUIPMENT Toys have no sharp edges or points, small parts or pinch points. All toys are painted with lead-free paint. Toys are put away when not in use. Toys that are mouthed are washed after every use. Children are not allowed to play with any type of plastic bag or balloon. Toys are too large to fit into child’s mouth. Infants and Toddlers are not permitted to eat foods that they can easily choke on (i.e.

hot dogs, grapes, hard candy, popcorn, etc.). Toy chests have air holes and a lid support or have no lid. Shooting and Projectile toys are not present.

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YES NO TOYS AND EQUIPMENT All commercial art materials are stored out of children’s reach. Rugs, curtains, pillows, blankets and cloth toys are flame resistant. Cribs, playpens and highchairs are away from electrical cords and wires. Toys are not hung across cribs of infants who can sit up. Rattles, pacifiers or other objects are never hung around an infant’s neck. YES NO PLAYGROUND The playground offers a wide range of parallel and interactive activities. All surfaces underneath play equipment are covered with 10 to 12 inches of impact-

absorbing materials such as sand, wood chips, or pea gravel. YES NO VEHICLES All vehicles work well. Staff helps to buckle and unbuckle children at drop-off and pickup. All vehicles are locked when not in use. The caregiver has current emergency contact information when driving children. Trip plans include how to manage emergencies. Children wear identification when transported. Pickup and drop-off points are away from traffic. Driver knows where children are before putting vehicle in reverse. All children that do not meet the age or weight requirements for your State must be in a

car seat (Check you State specific current law). Bicycles and other riding toys are stable, well-balanced and of the appropriate size. YES NO HALLWAYS AND STAIRS Handrails are securely mounted at Child’s height. Doorways to unsafe or unsupervised areas are locked unless used as an emergency exit. Emergency Exit Doors have easy open latches. Safety glass is used in all areas of potential impact. Caregivers can easily monitor all entrances and exits to keep out strangers. Stairways and hallways are clear of objects that can cause a fall. YES NO KITCHEN AND FOOR PREPARATION AND STORAGE AREAS Caregivers always wash their hands before handling food. Caregivers always wash children’s hands before mealtimes. Trash is always stored away from food preparation and storage areas. All perishable foods are stored in covered containers at 40 degrees Fahrenheit or

lower. Pest strips are not used. Cleansers and other poisonous products are stored in their original containers, away

from food and out of reach of children. Non-perishable food is stored in labeled, insect-resistant metal or plastic containers

with tight lids. Refrigerated medicines are kept in closed containers to prevent spills that would

contaminate food. Food preparation surfaces are clean and are free of cracks and chips. Appliances and sharp hazardous cooking utensils are stored out of children’s reach. A fire extinguisher is securely mounted on the wall near the stove. All Caregivers are trained in proper handling of fire extinguishers. Trash is stored away from the furnace, stove and hot water heater.

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YES NO KITCHEN AND FOOR PREPARATION AND STORAGE AREAS Kitchen area is not accessible to children without constant adult supervision. Caregivers do not cook while holding a child. Hot food and liquids are kept out of children’s reach. Stable step stools are used to reach high places, not chairs. YES NO BATHROOMS Stable step stools are available where needed. Electrical outlets have safety covers or are modified to prevent shock. Cleaning products and disinfectants are locked in a cabinet out of children’s reach. Toilet paper is located where children can reach it without having to get up from the

toilet. If potty-chairs are used, they must be easily cleaned with a bleach solution. There are enough toilets so children do not have to stand in line. Caregivers and children always wash hands after toileting and diaper changing. The changing of diapers or soiled underwear is done in a special, separate area away

from food and play. The diapering or changing table has rails to keep the child from rolling off. Trash cans for diapers, tissues and other materials that come in contact with body

fluids can be opened with a step pedal and are lined with a plastic bag, emptied daily and kept clean.

Paper towels and liquid soap are readily available at the sink. Children are never left alone on a changing table, bed or any other elevated survace. Children are never left unsupervised in or near water. YES NO EMERGENCY PREPAREDNESS All Caregivers share roles and responsibilities in case of fires, injuries, or other

disasters. One or more Caregivers who is certified in first aid and infant CPR is always present. All first aid kits have the required supplies, and are stored where Caregivers can easily

reach them in an emergency. Gloves are used when necessary to clean up injuries. Each room and hallway has a fire escape clearly posted. Emergency Procedures and telephone numbers are posted near a phone and can easily

be taken along in case of an emergency. Emergency procedures include the following:

8. How to phone emergency medical services (EMS). 9. Transportation to an emergency facility. 10. Notification of parents. 11. Where to meet if the child care setting evacuated. 12. All emergency exits are posted. 13. Plans for an adult to care for the childe while a Caregiver stays with the inured

children. 14. How to escort children to Emergency Medical Care.

All exits are clearly marked and free of clutter. Doors and gates open for easy exit. Children are taught to tell if they or anyone is hurt. Monthly Fire Drill is conducted and logged on fire drill sheet in the handbook, including

time spent exiting and the date.

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EMPLOYEES SAFETY SUGGESTIONS

Name: ___________________________________ Date: ______________________ Supervisor’s Name: ________________________ School # ___________________ Practice or Condition Now: Suggestions: Benefits Expected from Change: Action Taken: Date Acted On: Date of Final Action Notice to Suggestion: Implementation Date:

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SAFETY COORDINATOR – AGENDAS

MONTH THEME SAFETY TALKS POWER POINT

PRESENTATION HANDOUTS POSTERS

January Proper Lifting Techniques

February Emergency Procedures

March First Aid

April Nap room Safety, Walkways, clutter,

stepping over Children

May On the job injury procedures

June Playground Safety Spread out, Sun Safe

Spare the Air Days

July Keep hands and arms clear of doors

August Spills, Entry/Hall Walkways (high traffic

areas)

September Strains, Sprains, proper lifting

October Food Preparation, Spills/Slips lunch area

November Cleanliness and Hygiene

December Classroom Safety Checklist

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Basic Fall Incident Analysis Spreadsheet

Accident Number

Date/Time

Name of Person

Weather Condition

Slip or Trip

Slip or Trip on What

Type of Floor Surface

Conditions and Comments

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QUARTERLY MAINTENANCE CHECKLIST School: _______________________ Date: ______________________________ Checklist Completed by: _______________________________________________ Director’s Signature: __________________________________________________ Date Reviewed

Item

Status

Repairs/Corrections

Date Completed

Downspouts/Gutters Clean

Roof-damage/missing shingles

Exterior sprinkler system-timing/damage

Exterior light-timing/bulbs

Playground-fencing-posts brackets

HVAC Units air-flow clear

Dryer exhaust clear

Vent lines – gaskets

Stove-hood vents

Interior flooring-cracks, tears, damages

Interior cover base / base boards damage

Interior Sprinkler System-test

Other Items to Address:

Cold Weather Preparations: Ice melt-containers outside

Sand-containers outside

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Maintenance Log For the Month of: ________________________________

DATE CENTER # HOURS WORKED

WORK PERFORMED DIRECTOR’S INITIALS

TOTAL HOURS WORKED: ____________________ COST: ____________________

223 Updated 6/14

GENERAL MAINTENANCE REPORTING DATE ROOM GENERAL MAINTENANCE PERFORMED DATE

COMPLETED COMMENTS

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DAILY VAN MAINTENANCE CHECKLIST Name: _____________________________ Vehicle # & Plates: ________________ Mileage: Monday _______ Friday _______ Location: ________________________ Items must be CHECKED DAILY for proper operation Functioning Properly M T W T F Comments Brakes Lights (front) Lights (back) Brake Lights Windshield Wipers Seat Belts Horn Turn Signals Interior Lights Heater / Air Conditioner All Doors / Windows All Emergency Exits Engine / Exterior Check Wiper Fluid Filled Radiator Filled Oil Filled Engine Belts Inspected NO Leak drips Clean exterior Exterior body integrity Tires PROPERLY inflated Interior Check Windshield clean, no cracks Seats secure to floor Interior CLEAN First Aid Kit and Flashlight Emergency cards for riders Car seats secure Fire extinguisher on board Interior Check Vehicle drives appropriately Any issues reported to Supervisor Driver / Inspector Signature: ________________________________ Date: ____________________ Director / Supervisor Signature ______________________________ Date: ____________________

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DAILY BUS MAINTENANCE CHECKLIST Name: _________________________ Bus #: __________ PMI Mileage: __________ Today’s Date: ___________________ Today’s Mileage: _______________________ Remaining Days: ________________ Mileage Remaining: _____________________ Note: Within 5 days or 300 miles call for PMI Inspection if required. The daily Inspection list must have an “OK” or if defective place an “X”. DO NOT DRIVE IF THERE IS A DEFECT OR SAFETY ISSUE! ITEM OK NOTES Approaching Bus Fluid pooling under bus Flat ties New body damage Engine Compartment Fluids: oil, water, steering, transmission Battery terminals Fan belts, hoses, leaks on engine Exterior All lights Tires, lugs, side walls, wheel cover, stems, mud flap Fuel cap, secure and present Windshield wipers, present, not cracked or tearing All glass / mirrors secure Lettering / CA# , clear and present Tail pipe, license plate Emergency door / buzzer Capacity / CHP 292 Card Back up buzzer Interior Driver’s seat, belt, mirror, horn, setting All lights, dome, step, dash, monitor Gauges, oil, battery, fuel, water, transmission Heater, defroster Passenger seat belts Windows, latches Walls, padding, ceiling rivets, floor, runners Seats, cushions, modesty panel, hand rail, seat backs Emergency exit, unlock, doors open, buzzer, light Emergency Equipment/Extra Equipment First aid kit Fire Extinguisher Road side reflectors Hand held stop sign

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ITEM OK NOTES Communicable Disease kit Hydraulic Brakes Inspection Hydraulic Test Parking Brake 2 Stops Driver’s Signature: _____________________________________________________________ Maintenance required & Date Complete: ___________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Follow-Up Items: ______________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Director’s Signature: ___________________________________________________________

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REGIONAL PLAYGROUND SAFETY CHECK REPORT Date: _____________________ Regional Director: ____________________________ School # Playground Safety Synopsis Plan of Correction

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PLAYGROUND SAFETY CHECKLIST Date Time Location Age

Group Number of Students

Number of Teachers

Student/ Teacher Ration

Ratio Met

Safety Checklist Yes No Fall Zone Material meets licensing regulations. Yes No Ground cover is in good repair. Yes No Gate latches are in good repair. Yes No Gates are locked. Yes No Landscaping bushes do not have sharp or small objects (i.e. berries) that can be

swallowed. Yes No Wooden dividers, borders of sandboxes, etc. do not contain rough edges or have splinters

exposed Yes No Tricycles are in good repair. Check for missing peddles, handlebar grips, loose parts. Yes No Bike/Trike riding areas is separate from other equipment. Yes No Sandboxes are located in the shade, have smooth frames, and are covered when not in

use. Yes No Sandbox sand is raked and checked weekly. Yes No Fencing is in good repair. (Walk the entire length of the fencing; note any unsafe

condition. Yes No Ground cover is free of any inappropriate materials. Yes No Grass is healthy and no potholes are present (walk the entire grass areas). Yes No Swings are in good repair (check each swing for any unsafe issues). Yes No Ride toys and push toys are in good repair. Yes No First aid supplies are available outside. Yes No Sidewalks are cleanly swept. Yes No Daily sweeping schedule and system is in place. Yes No Drinking fountains are clean and sanitized. Yes No Drinking fountains are in good repair and functioning. Yes No No puddles of water are present in any area of the playground. Yes No All playground equipment meets current licensing regulations. Yes No Exposed concrete or hard anchoring material is covered. Yes No There are no sharp edges, loose connections, exposed nails or bolts present. Yes No Play equipment present is appropriate to the size and development of the children. Yes No All equipment is checked for inappropriate heat before used by children. Yes No Garden hose is contained in an appropriate holder and not left out causing an unsafe

situation for children, parents and staff. Yes No Play equipment is used appropriately by the children & staff (i.e. jump ropes, etc.).

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TEACHER / CHILD INTERACTION Is there a teacher stationed by all large equipment observing and reminding the children of the rules?

Are teachers located in different areas of the playground supervising all areas of the playground?

Are there any blind spots on the playground? Do you observe any Teachers standing together in conversation?

Do you observe any organized Teacher directed activity available to the children?

Did the teacher(s) conduce a safety pre-check before the children were set free to play?

Are there playground rules posted and present on the playground?

Is role call taken as children arrive on the playground and as they exit the playground?

Are children entering the building without adult supervision?

Are children wearing appropriate footwear for outside play?

Are the teachers monitoring the amount of time that children are outside and how the heat is affecting the children?

What method of water play is used? Wet/Dry tables, buckets, sponges, water balls, hoses or sprinklers?

Can a child fit inside of a bucket you are using for water play?

Are the water toys stored properly when not in use? Where are they stored?

Swimming pools – what is the ratio used? Explain the process for usage?

Explain security system for the gate when not in use?

Any unsafe issues present?

Additional Comments: ______________________________________________________________ _______________________________________________________________________________ Director’s Signature: ____________________________________ Date: ___________________ Regional Director’s Signature: _____________________________ Date: ____________________

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SEASONAL INSPECTION LIST FOR CHILDCARE OUTDOOR SETTINGS Location: ______________________ Date of Inspection: ______________________ Director: _______________________ Signature: _____________________________ Name of Person Checking: _______________________________________________ Winter (to be completed in November

OK NO Comments Action Needed

Action Taken / Date/ Signature

Gates are free of all obstructions such as ice build up to allow for easy access.

Gates are closed properly.

All Summer play equipment is stored properly.

All Winter Play equipment is checked and added to playground.

Spring (to be completed in March) Gates are checked for frost damage which could lift the gates posts preventing them from closing properly.

Fence posts are checked for frost damage.

Pathways are checked for frost damage causing cracks, pot holes, etc.

All winter play equipment is properly stored.

All summer play equipment is checked and added to the playground.

Summer (to be completed mid June)

Activities planned to accommodate summer weather.

Adequate shade is available. All foliage has been checked in and around playground.

Site is in generally acceptable location.

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Fall (to be completed by Mid-September)

Leaves are raked up as necessary and are swept off pathways, climbers, etc.

All items which received a NO should be attended to without delay.

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PLAYGROUND MAINTENANCE REPORTING

Date Area Maintenance Required Date Completed

Comment / Additional Follow up

233 Updated 6/14

DAILY PLAYGROUND LOG Your signature on this log indicates that you have performed the indicated task in accordance with the procedures outlined in the Phoenix Children’s Academy Policy and Procedures Manual. Date: _____________________ Playground Supervisor: _______________________ Safety Pre-check – must take place BEFORE children enter playground Class Time Signature

Class Time Signature

234 Updated 6/14

235 Updated 6/14

236 Updated 6/14

Accident Investigation Report Form

Date:________________

Part 1 - (To be completed by the injured employee)

Employee Name: _______________________________________________

Employee Number: ______________________________________________

Address (Street): _______________________________ Home

Phone:__________________________________

City: _________________________________________ Zip Code:_______________________

Position: _____________________________________ Hourly Wage: ____________________

Department or School Site: ______________________________________________________

Date Hired For This Position: ___________________ Hours: From __________ to __________

Site Administrator/Supervisor’s Name: _____________________________________________

Date of Injury: ______________________________ Time of Injury: ___________ a.m. or p.m.

Name of Person Injury Reported To: _____________________________________________

Department or Name of School Where Injury Occurred:

___________________________________________________________________________

Were You Doing Your Regular Job? _____ Yes _____ No

State Fully What You Were Doing At The Time Of The Injury And How The Injury Occurred:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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Nature and Location of Injury (Describe fully exact location of injury, i.e., right or left arm, shoulder, etc.)

___________________________________________________________________________

___________________________________________________________________________

Was Any Other Part of The Body Injured? _____ Yes _____ No

Describe: ___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Was First-Aid Give? _____ Yes _____ No (Describe and list name(s) of person(s) who administered first-aid)

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Was Anyone Else Injured In This Accident? _____ Yes _____ No

Name(s): ___________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Were There Any Witnesses To This Accident? _____ Yes _____ No

Name(s): ___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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Part 2 - (To be completed by site administrator or supervisor)

Name: __________________________________Position: ___________________________

Department or School Site: _____________________________________________________

Date You Were Notified Of Accident: __________________ Time: __________ a.m. or p.m.

Did the Employee Require Medical Treatment: _____ Yes _____ No

If Yes, Where Was Medical Treatment Administered? ________________________________

___________________________________________________________________________

Date Employee Returned To Work: ___________________ Time: ___________ a.m. or p.m.

Was The Employee Performing His Regular Job? _____ Yes _____ No

Was The Employee Properly Instructed On Safe Job Performance? _____ Yes _____ No

Describe: ___________________________________________________________________________

___________________________________________________________________________

Cause of Injury Protective Equipment Type Required In Use? _______Inattention to duties being performed Hard Hat

_______Insufficient instructions Safety Glasses

_______Improper instructions Dust Goggles

_______Inadequate job planning Full Face Shield

_______Lack of knowledge or skill Respirator

_______Improper use of equipment Welding Hood

_______Inadequate or wrong equipment Hearing Protection

_______Fatigue Cutting Goggles

_______Physical disability Other

_______Uncooperative

_______Other

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What Was Defective, In Unsafe Condition, or Wrong With Method Used?

___________________________________________________________________________

___________________________________________________________________________

What Did Employee Do Unsafely?

___________________________________________________________________________

___________________________________________________________________________

What Could Or Should Have Been Done To Prevent Injury?

___________________________________________________________________________

___________________________________________________________________________

What Steps Have Been Or Will Be Taken To Prevent Similar Injuries?

___________________________________________________________________________

___________________________________________________________________________

Was The Employee Instructed To Use Any Special Protective Equipment Or Safety Procedures?

_____ Yes _____ No Explain:

___________________________________________________________________________

___________________________________________________________________________

Did The Employee Follow These Instructions? _____ Yes ______ No Describe:

___________________________________________________________________________

___________________________________________________________________________

Was The Injury The Result Of Failure Of The Employee To Follow Instructions Or Established Safety Rules?

_____ Yes _____ No Explain:

__________________________________________________________________________

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What Action Has Been Or Will Be Taken Because Of This Failure?

___________________________________________________________________________

___________________________________________________________________________

Comments: ___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________ ____________________________________________________________________________ Copy emailed/faxed to Regional Director on Date: ___________________________________ Copy emailed/faxed to Human Resources on Date: __________________________________

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Incident Accident Report

Email or Fax to Human Resources in the Corporate Office

School Name and Number School Address Type of Incident / Accident Date and Time Reported By Description of Incident Description of Damage Description of Injury Vehicle Information (year, make, model, vin number) Name & Address Involved Party

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MOTOR VEHICLE RECORD POLICY It is the policy of the Phoenix Children's Academy to obtain and review Motor Vehicle Records (MVR) on each prospective employee when driving is part of their job description. Motor Vehicle Records are checked each year with our insurance renewal and when a license is renewed. It is the employee's responsibility to give a copy of their valid driver's license and sign new MVR forms at the time they renew their license. Management of Phoenix Children's Academy will review the Motor Vehicle Record to be sure the employee holds a valid driver's license and their driving record is within the parameters set by company policy. If the employee's driving record does not meet the criteria set by management, remedial training or other disciplinary action may be taken, up to and including removal as a qualified driver. I give Phoenix Children's Academy permission to obtain my Motor Vehicle Records. I understand that my Driving Record will be considered as one of the criteria for employment and continued employment. Print Name Drivers License Number Signature License State Date Date of Birth School #

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DRIVING POLICY AGREEMENT

Vehicles owned or leased by this Company are to be used solely for Company business. Unless approved by Regional Director, there shall be no personal use of Company vehicles (including commuting to and from work). Individuals driving Company vehicles may have occasions where an incidental stop is necessary between business stops. Such use shall not be considered to be in violation of this policy. The Company requires that vehicles not in use shall be parked in designated areas on the Company premises. No personal items are to be stored in Company vehicles. Company materials and supplies are to be secured in the trunk, lock boxes or within the Company offices. Keys are to be returned to your Supervisor, or designee, upon the close of business each day. If you are assigned or are using a Company vehicle, we require that it be operated in accordance with the Company’s Vehicle Use Policies as well as prevailing laws and regulations. Only employees who have completed Company Drivers Approval forms are authorized to operate Company vehicles. If you are authorized to operate a motor vehicle for the Company, you acknowledge that under no circumstances will you operate the motor vehicle without being in possession of a valid driver’s license. You must maintain an acceptable driving record and you acknowledge that if your driver’s license should expire, be revoked or suspended, or if you fail to maintain an acceptable driving record you will immediately notify your supervisor and will no longer operate the Company’s vehicle. The Company may, on occasion, conduct a Motor Vehicle record (MVR) verification to ensure compliance with the Driving Policy. Employees driving for the company will required to sign an authorization for an MVR check. If the employee refuses to sign this authorization, all privileges will be revoked. If the position requires driving to perform the essential functions of the position, refusal to sign the authorization of the MVR check may lead to disciplinary action, up to and including termination. Being an acceptable driver/ an acceptable driving record is defined as:

• Possessing a valid driver’s license issued in the state where you are working. • Being at least 21 years of age. • One non chargeable accident within the past three years (no points). • One speeding ticket/moving violation within the past three years. • No DUI.

The Company requires that: • Drivers must be 21 years or older and have a valid driver’s license in the state

they are driving and as required by law to transport children. • Drivers must be CPR and First Aid Certified prior to operating a vehicle. • Under NO circumstances should any person, other than a child enrolled in the

center, or an adult chaperone be transported in a company vehicle.

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• Personal use of the vehicle where permitted, is limited to driving to and from work only.

• Radios are not to be used in vehicle at any time. • Use of cell phones and/or texting is prohibited. You must stop the vehicle in a

safe location to use the cell phone. Unless a bona fide emergency, you can only use the Company cell phone to make calls. However, the Company reserves the right to investigate a claim of a bona fide emergency.

Vehicle Drivers are responsible for the following: • Conduct an overall check of the vehicle; check to be sure you have a current Auto

ID insurance. • Review Vehicle Rules with the children on a regular basis. • Safely transporting all children. • Ensure that each child is wearing a seatbelt. • Ensure that all children remain seated with seatbelt until the vehicle comes to a

complete stop. • Wear a seatbelt at all times. • Make sure that all children board and leave the vehicle safely. • Be sure that all people and obstacles are at safe distance before operating the

vehicle. • Maintain an accurate “Vehicle Attendance Log” to account for all children (The

vehicle driver must take attendance each time a child enters or exits the vehicle). • Notify the Director immediately if a scheduled child does not get on the vehicle.

(The vehicle driver must not leave school grounds until receiving confirmation that the child is not being picked up).

• Notify your Director if you are not able to operate a vehicle due to illness or it you are taking medication that could impair your judgment or performance.

• Stop the vehicle in a safe location to deal with disciplinary problems. • Do not leave a child UNATTENDED in a vehicle at any time. • Be sure your vehicle is well maintained at all times, and serviced regularly as

required and in coordination with your School Director. • Ensure that the vehicle is operated in accordance with any restrictions on your

license. • NO SMOKING, EATING or DRINKING is permitted on the vehicle.

If using a personal auto for company business, the Company does not provide any physical damage reimbursement for your personal auto. If you are in an accident, you must notify your liability insurance company immediately. The above has been discussed with me by my Director. I understand the contents and acknowledge and understand the corrective action required. I also understand the potential consequences of non-compliance. Name Date

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CHARTIS CLAIM FORM INSTRUCTIONS

3. Call/Email Human Resources and report the claim. 4. Email Human Resources the name and address of Child’s parents.

CLAIM FORM: Section A to be filled out by the Director of the School

8. School Name, Number & Address 9. Full Name of Student

a. Social Security Number - Mandatory b. Date of Birth c. Name of Director

10. Description of Injury 11. Date & Time of Accident / Where and When the Accident Happened 12. Name Activity (i.e. play time) 13. Check B, C, D; Yes or No 14. Claims will be signed once they have been filed with Corporate.

Note: Please include Incident/OUCH/OH OH Report and/or any witness statements with the completed claim form. If your state requires a separate filing form, please also include that in with the completed claim form. Section B to be filled out by the Parent

6. Name of Guardian and Relationship to Student 7. Address of Guardian / Parent 8. Parent’s Insurance Information (MUST include) 9. Guardian / Parents Signature and Date 10. MUST complete Social Security Number Information in Section 2 of the form

(under Director’s portion). Please make sure the form is legible so that all payments are sent to the correct address and person. Once the form is complete please fax or email to Human Resources. You do not submit the form to Chartis – simply complete and send to Corporate (attention HR). In an effort to ensure timely payments all Hospital/Doctor statements must come to the Corporate Office (attention HR). They can give to you or mail them directly.

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Chartis Insurance A&H Claims Department P.O. Box 25987 Shawnee Mission, KS 66225-5987 800-551-0824

PROOF OF LOSS NAME OF GROUP: POLICY NUMBER:

Phoenix Childrens Academy SRG9103420

SPECIAL RISK ACCIDENT AND SICKNESS CLAIM FORM INSTRUCTIONS: 1.) You must have SECTION A fully completed by a designated official of the Policyholder. 2.) SECTION B is to be completed, signed and dated by the claimant or parent/guardian of claimant, if claimant is a minor. 3.) Attach itemized bills for all medical expenses being claimed including the claimant's name, condition being treated (diagnosis), description of services, date of service(s) and the charge made for each service. PLEASE MAIL COMPLETED FORM AND BILLS TO ABOVE ADDRESS. PRIMARY PLAN - benefits are payable for covered medical expenses from the first dollar without regard to payments made by other insurance up to the policy maximum.

EXCESS PLAN - Eligible covered expenses will be determined after benefits have been paid by other valid and collectible insurance. You must submit your claim to your other insurance company first. When you receive their Benefit Statement (EOB) send it to us along with the itemized bills. Benefits for eligible expenses will be paid per policy terms.

The furnishing of this form, or its acceptance by the Company, must not be construed as an admission of any liability on the Company, nor a waiver of any of the conditions of the insurance contract. SECTION A - MUST BE COMPLETED AND SIGNED BY A DESIGNATED REPRESENTATIVE OF THE POLICYHOLDER NAME/ AND/OR LOCATION OF GROUP/CLUB/SPORT/SCHOOL, ETC. CLAIMANT'S FULL NAME (PLEASE PRINT CLEARLY OR TYPE)

SOCIAL SECURITY NO. MANDATORY

DATE OF BIRTH NAME OF SUPERVISOR

DATE COVERAGE BEGAN N/A

DATE COVERAGE WILL END/HAS ENDED N/A

NATURE OF INJURY OR ILLNESS. (DESCRIBE FULLY, INCLUDING WHICH PART OF BODY WAS INJURED.) DESCRIBE HOW, WHEN AND WHERE ACCIDENT OCCURRED (DATE AND TIME)

NAME OF ACTIVITY DID ACCIDENT OCCUR: A. WHILE CLAIMANT WAS SUPERVISED

YES

NO

B. DURING SPONSORED ACTIVITY

YES

NO

INDICATE THE SPORT (IF APPLICABLE) C. DURING PROGRAMMED HOURS

YES

NO

N/A D. WHILE TRAVELING TO OR FROM REGULARLY SCHEDULED ACTIVITY IN A SUPERVISED GROUP

YES

NO

DATE LAST WORKED N/A

DATE RETURNED TO WORK N/A

WEEKLY EARNINGS N/A

POLICYHOLDER REPRESENTATIVE (PLEASE PRINT OR TYPE) HUMAN RESOURCES

TITLE DAYTIME TELEPHONE NUMBER ( )

SIGNATURE OF POLICYHOLDER REPRESENTATIVE DATE SECTION B - MUST BE COMPLETED LIST NAME, ADDRESS, AND PHONE # OF OTHER INSURANCE COMPANIES UNDER WHICH CLAIMANT IS INSURED:

POLICY #/ACCOUNT #

IF CLAIMANT IS A MINOR, NAME OF CLAIMANT’S GUARDIAN/RELATIONSHIP TO CLAIMANT ADDRESS OF CLAIMANT (IF CLAIMANT IS A MINOR, NAME AND ADDRESS OF CLAIMANT’S GUARDIAN)

GUARDIAN’S SOCIAL SECURITY NUMBER

NAME/ADDRESS/TELEPHONE # OF EMPLOYER (IF CLAIMANT IS A MINOR, GUARDIAN’S EMPLOYER)

EMPLOYER’S DAYTIME TELEPHONE # ( )

I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. AUTHORIZATION and ASSIGNMENT OF BENEFITS

I, the undersigned authorize any hospital or other medical-care institution, physician or other medical professional, pharmacy, insurance support organization, governmental agency, group policyholder, insurance company, association, employer or benefit plan administrator to furnish to the Insurance Company named above or its representatives, any and all information with respect to any injury or sickness suffered by, the medical history of, or any consultation, prescription or treatment provided to, the person whose death, injury, sickness or loss is the basis of claim and copies of all of that person's hospital or medical records, including information relating to mental illness and use of drugs and alcohol, to determine eligibility for benefit payments under the Policy Number identified above. I authorize the group policyholder, employer or benefit plan administrator to provide the Insurance Company named above with financial and employment-related information. I understand that this authorization is valid for the term of coverage of the Policy identified above and that a copy of this authorization shall be considered as valid as the original. I understand that I or my authorized representative may request a copy of this authorization. I authorize payment of medical benefits to the physician or supplier for service performed. YES NO CLAIMANT OR AUTHORIZED PERSON'S SIGNATURE DATE

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Dear Parents, We are very sorry that your child has experienced an injury at our location. In an effort to explain and expedite the reporting process, please follow the instructions below. If you have questions at any time during this process, please do not hesitate to call HR at 866-607-7552 ext. 13180. In order to process your claim the following is needed: Completed and signed CHARTIS Claim Form. Section A will be filled out by the Director. There is a Federal Mandate that requires the Child’s Social Security Number to be included on the

claim form. Your claim will not be processed without it. Please make sure the Director of the school has this information.

Section B is to be filled out and signed by you. We DO need your insurance information. ALL copies of original bills and primary insurance Explanation of Benefits should be sent to

Phoenix Children’s Academy 8767 E. Via de Ventura, Suite 200, Scottsdale, AZ, 85258, Attention: HR. PLEASE DO NOT SEND STATEMENTS.

All bills must include: diagnosis codes, procedure codes and provider's tax ID number. If any information is missing your claim could be delayed.

Please be aware that due to New HIPAA regulations, CHARTIS cannot obtain bills or missing information from the providers. As parents, you and only you must obtain the necessary information to process the claim due to privacy regulations. Once all of the information required has been received, your claim will be processed. However, please note it may take 45-60 business days to receive any payments. There is a $100.00 deductible per accident of which will be refunded to you. Deductible checks will be sent to you by our Corporate Office. Please note that you may owe this money to the provider up front. CHARTIS Insurance will pay $250.00 per tooth for a dental claim, the deductible also applies. We do need to have your Primary Insurance Carrier information on the Chartis Claim Form. You will also need to send a signed copy of the claim form to PCA Corporate, attention HR in order to process (if you have already given a copy to the school, they will forward to HR). If you have any questions, please do not hesitate to call me. Regards, Human Resources Phoenix Children's Academy 8767 E Via de Ventura, Suite 200 Scottsdale, AZ 85258

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