SEIU 73 Health & Safety Tracking Form

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This form does not replace grievances, or seek to provide immediate assistance. Contact your steward or union rep for immediate issues. Immediately report issues to your building level safety committee. We will use this data to inform our bargaining with CPS. You can fill this form out more than once about different incidents.

First Name *

Last Name *

Personal Cell

Personal Email *

School *

Job Title *

Security Officer

Custodian

SECA

Bus Aide

Bus Monitor/Parent Worker

Other:

Health & Safety PPE: Please Check All that Apply

We are not receiving safety kits for SECAS

We do not have sneeze guards for security officers greeting visitors

We do not have N95 masks, gowns, gloves

We do not have adequate hand sanitizer and disinfecting wipes

We did not receive safety trainings

Other:

Health & Safety Cleaning: Please Check All that Apply

We don't have enough cleaning supplies

Replenishing cleaning supplies takes longer than 24-48 hrs

Protocols for cleaning and disinfecting are unclear

Buses are not being cleaned regularly

Classrooms are not being cleaned regularly

I am not a custodian and being asked to deep clean

Other:

If you answered cleaning supplies please specify what supplies are needed

Health & Safety Contact Tracing: Please Check All that Apply

I was exposed and contacted more than 3 days after exposure

I was exposed and not contacted at all

Our school is not sending out notice of covid case to school community

Other:

Accommodations & Leave: Please Check All that Apply

I was denied paid time off to quarantine for CPS mandated quarantine

I was told to use my own benefit time to quarantine for CPS mandated quarantine

Other:

Care Room: Please Check All that Apply

I was directed to staff the care room but I have not volunteered

I was not given N95, gown, gloves to volunteer in the careroom

I am volunteering in the care room and not receiving my $250 additional stipend

Other:

Testing: Please Check All that Apply

We don't have frequent access to testing

The times available for tests are unclear

I was tested at CPS and did not receive my results within 72 hours

Other:

Quarantine: Check All that Apply

I was directed by CPS to quarantine due to exposure

I was exposed but not directed by CPS to quarantine

Other:

Have you tried to resolve any of the above issues? *

Yes

Have you tried to resolve any of the above issues through the building level safety committee? *

Yes

If you have tried to resolve the issues, what did you do? What was the response? Was it resolved? *

Report any other concerns you have with reopening not covered by the above questions

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