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COVID 19 Hazard Report
Staff members may utilize this form to report potential COVID 19 hazards in the workplace. Entries will be sent automatically to the site principal, the Director of Operations, and the Executive Director of Human Resources and Facilities.
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Email
*
Your email
Name
Your answer
Site / Location
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District Office
Eagles Nest Preschool
Center Street Elementary School
Center Street TLC
Richmond Street Elementary School
Richmond Street TLC
El Segundo Middle School
El Segundo High School
Arena High School
Warehouse
Other
Please describe the specific area, activity, process, or equipment that potentially exposes employees to COVID-19 hazards.
Your answer
Please describe the exact place(s) and time(s) of the observed hazard(s).
Your answer
Please describe the existing related COVID-19 prevention controls in place (such as barriers, partitions, etc.).
Your answer
Please include any further comments or specific requests.
Your answer
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