Safe School Plan - William S. Hart Union High School District
Safe School Plan - William S. Hart Union High School District
Safe School Plan - William S. Hart Union High School District
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
ACCOUNTABILITY REPORT FORM<br />
Complete this form and send it to the Incident Command Post (ICP) via student runner ASAP<br />
ROOM#<br />
VALENCIA HIGH SCHOOL<br />
Teacher/Staff Member Time of Report Site/<strong>School</strong><br />
1) IMMEDIATE ASSISTANCE REQUIRED DESCRIBE DETAILS:<br />
MEDICAL<br />
FIRE<br />
SEARCH & RESCUE<br />
SUPPORT PERSONNEL<br />
NONE<br />
SPECIFIC LOCATION:<br />
2)<br />
3)<br />
Condition of STUDENTS: ALL Accounted for NUMBER MISSING<br />
TYPE OF INJURY/INJURIES<br />
NO Injuries NUMBER INJURED (LEFT IN ROOM) # SERIOUS<br />
NO immediate help required NUMBER INJURED (SENT TO 1ST AID) # MODERATE<br />
# MINOR<br />
# UNKNOWN<br />
Condition of STAFF: ALL Accounted for NUMBER MISSING<br />
TYPE OF INJURY/INJURIES<br />
NO Injuries NUMBER INJURED (LEFT IN ROOM) # SERIOUS<br />
NO immediate help required NUMBER INJURED (SENT TO 1ST AID) # MODERATE<br />
# MINOR<br />
# UNKNOWN<br />
STAFF MEMBER NEEDS RELIEF TO MEET WITH TEAM!<br />
Continued on back<br />
Tallied at ICP by _________________________<br />
--------------------------------------------------------------------------------------------------------------------------------------<br />
ACCOUNTABILITY REPORT FORM<br />
Complete this form and send it to the Incident Command Post (ICP) via student runner ASAP<br />
VALENCIA HIGH SCHOOL<br />
Teacher/Staff Member Time of Report Site/<strong>School</strong><br />
ROOM#<br />
1) IMMEDIATE ASSISTANCE REQUIRED DESCRIBE DETAILS:<br />
MEDICAL<br />
FIRE<br />
SEARCH & RESCUE<br />
SUPPORT PERSONNEL<br />
NONE<br />
SPECIFIC LOCATION:<br />
2)<br />
3)<br />
Condition of STUDENTS: ALL Accounted for NUMBER MISSING<br />
TYPE OF INJURY/INJURIES<br />
NO Injuries NUMBER INJURED (LEFT IN ROOM) # SERIOUS<br />
NO immediate help required NUMBER INJURED (SENT TO 1ST AID) # MODERATE<br />
# MINOR<br />
# UNKNOWN<br />
Condition of STAFF: ALL Accounted for NUMBER MISSING<br />
TYPE OF INJURY/INJURIES<br />
NO Injuries NUMBER INJURED (LEFT IN ROOM) # SERIOUS<br />
NO immediate help required NUMBER INJURED (SENT TO 1ST AID) # MODERATE<br />
# MINOR<br />
# UNKNOWN<br />
10/06<br />
STAFF MEMBER NEEDS RELIEF TO MEET WITH TEAM!<br />
Continued on back<br />
Tallied at ICP by _________________________<br />
102
Change language