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Environment and Workplace Health

Indoor Air Quality - Tools for Schools Action Kit for Canadian Schools

Chapter 4: How to Get Started (Continued)

Coordinator Forms

IAQ Management Plan Checklist

______________________________________________

IAQ Coordinator

School

Date Completed


Use the checklist below to record and monitor the steps you have taken to activate the IAQ Management Plan

Steps Taken Date Comments/Notes

1. Selected IAQ Coordinator

Name:

 

 

2. Read Guidance

 

 

3. Obtained Administrative Support

 

 

4. IAQ Checklist Interval Established

Number of times each year:

Date:

 

 

5. Prepared Emergency Response

  • Contacted local health agency

 

 

  • Identified and contacted IAQ professional

 

 

  • Prepared or identified equipment and supplies for wet carpets or contacted local professional cleaning firm

 

 

  • Completed local IAQ Service Providers form

 

 

6. Informed Committees and Groups

  • Contacted health and safety committee(s)

 

 

  • Contacted building committee(s)

 

 

  • Informed/notified PTA

 

 

  • Others:

 

 

7. Prepared and Distributed IAQ Policies

  • Smoking

 

 

  • Pest control

 

 

  • Ventilation system operation

 

 

  • Painting

 

 

  • Others:

 

 

IAQ Coordinator's Checklist

________________________________________________

IAQ Coordinator

School

Date Completed


Use the checklist below to record and monitor the steps you have taken to activate the IAQ Management Plan

Steps Taken Date Comments/Notes
1. Start Checklists Log

 

 

2. Distribute Action Packets
  • All appropriate people have received an Action
    Packet

 

 

  • Each Action Packet type has been distributed

 

 

3. Receive and Summarized IAQ Checklists
  • Receive all IAQ Checklists

 

 

  • Review IAQ Checklists

 

 

  • Transfer data to Checklist Log

 

 

  • List things to review during walk-through inspection

 

 

4. Perform Walkthrough with Walkthrough
Checklist

 

 

5. Identified Recent Changes
  • Flooding/water damage

 

 

  • Night or weekend classes

 

 

  • New Staff

 

 

  • Other

 

 

6. Set Repair and Upgrade Priorities
  • Made to-do list

 

 

7. Gain Consensus and Approval for Repairs and Upgrades

 

 

8. Distribute Status Report

 

 

9. Perform Repairs and Upgrades

 

 

10. Conduct Follow-up Inspections

 

 

11. Develop Schedule of IAQ Events
  • Set next date for applying IAQ Checklist

 

 

  • Note upcoming renovation and repairs

 

 

  • Note future addition of staff

 

 

12. Assess Problem Solving Performance

 

 

13. Establish and Update IAQ Policies

 

 

14. Distribute Summary Report to:
  • Students and staff

 

 

  • Parents

 

 

  • School administration

 

 

15. Check Contacts List

 

 

16. File paperwork, Checklists, Reports, and Notes

 

 

Checklists Log

Local IAQ Service Providers List

Hazardous
Materials
Hotline

Firm

Contact

Phone

Address

Title

Emergency

Local
Health
Department

Firm

Contact

Phone

Address

Title

Emergency

Provincial/
Territorial
Health Canada
Department

Firm

Contact

Phone

Address

Title

Emergency

Carpet
Cleaner

Firm

Contact

Phone

Address

Title

Emergency

IAQ
Consultant

Firm

Contact

Phone

Address

Title

Emergency

Mechanical
Systems
Operator

Firm

Contact

Phone

Address

Title

Emergency

 

Firm

Contact

Phone

Address

Title

Emergency

 

Firm

Contact

Phone

Address

Title

Emergency

 

Firm

Contact

Phone

Address

Title

Emergency

Last Updated: 2005-08-03 Top