Faculty Chairperson or Designee ____________________________ Site Administrator or Designee _______________________________ Nurse or Support Staff ______________________________________ CafeteriaManager _________________________________________ Site Custodian ____________________________________________ Certificated Representative __________________________________ Classified Representative ____________________________________ Identify those areas of concern that the Committee believes need to be corrected. ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ _____________________ Polled faculty. Solicited advice from all interested parties. Report is available for site staff. Submit annual report to Risk Manager. Meet with Risk Manager to discuss recommendations. Receive report from Risk Manager indicating completion or progress of implantation of each section of the report. Must be received on or before the first day of the last month of school.

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