Devices and Special Needs SURVEY OF STAFF EMERGENCY SKILLS
DEVICES and SPECIAL NEEDS Name: Room #: Date: During an emergency or disaster it is important to be able to draw from all available resources
to include those of the staff. Please check any of the following skills
training
capabilities or devices that you have that you would be willing to use during a school emergency or disaster. Also
please indicate if you would require special assistance during an evacuation
lockdown or shelter-in-place situation so others can assist you
in times of need. When finished
please return this survey to the office administrator. Cell phone (number) Bi/multi-lingual (specify below) Pager (number) Sign language First aid (current card? yes/no) Ham radio operator CPR (current card? yes/no) CB radio EMT (current card? yes/no) Bus/truck driver Triage Mechanical ability Fire safety/firefighting/HAZMAT Construction (electrical
plumbing
carpentry
etc.) Search & Rescue Structural engineering license yes/no Critical incident stress debriefing Survival training & techniques Law enforcement (specify below) Food preparation Emergency planning/management Special assistance needed (inform school nurse) Shelter management Other (specify below) Other
specify below: What would make you feel more prepared should a disaster strike while you were at school? Signed:
Menu
