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Safe School Plan - William S. Hart Union High School District

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SITE STATUS REPORT - COMMAND CENTER (CC) MESSAGE FORMs<br />

TO: Administrative Center CP<br />

FROM: (name)_______________________<br />

@Site/<strong>School</strong>: _________________ DATE: _____________________ TIME: ________<br />

Incident Commander: ___________________________<br />

Message via: ___ 2-way Radio, ____ Radio, ____Telephone, ____ Messenger,<br />

______________<br />

(Other--specify)<br />

EMPLOYEE/STUDENT STATUS<br />

Students<br />

Site Staff<br />

Others<br />

# sent to Unaccounted for # released # being<br />

Absent Injured hosp./med. Dead Missing (away from site) to parents supervised<br />

STRUCTURAL DAMAGE [check damage/problem and indicate location(s)]<br />

No. Damage/Problem(s)<br />

Location(s)<br />

gas leak(s)<br />

water leak(s)<br />

fire(s)<br />

electrical<br />

communication(s)<br />

heating/cooling<br />

other(s):<br />

MESSAGE: (Include kind of immediate assurance required. Can you hold out without assistance/how long? What is the<br />

overall condition of campus, neighborhood, and streets? Which outside agencies are on campus and what actions they are<br />

taking? ASAP: accountability of personnel, e.g., names of injured, dead, or missing.)<br />

105

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