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(Probability x Risk) x Preparedness = Total Score |
| District
Name
Building Name |
County
Building Number |
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| High | Med | Low | None | Life Threat | Health Safety | High Disrupt | Mod Disrupt | Low Disrupt | Poor | Fair | Good | ||
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| Building Access – vehicle (proximity of parking, pickup, drop-off, delivery) | |||||||||||||
| Building Access – pedestrian (tracking visitor, parent, vendor, accessibility, door/window access) | |||||||||||||
| Mail delivery (building access, opening procedures, package identification) | |||||||||||||
| Food Supply (access to food supply, delivery, preparation process, worker background) | |||||||||||||
| Water Supply (incoming lines protected, wells, water delivery) | |||||||||||||
| HVAC (outside access, operability) | |||||||||||||
| Boiler/Steam (accessibility, maintenance) | |||||||||||||
| Chemical Storage (chemistry, pool/cleaning supplies; accessibility, proximity to students, containers) | |||||||||||||
| Special Events (security, accessibility, monitoring, maximum attendance) | |||||||||||||
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(Probability x Risk) x Preparedness = Total Score |
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| High | Med | Low | None | Life Threat | Health Safety | High Disrupt | Mod Disrupt | Low Disrupt | Poor | Fair | Good | ||
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| Communications
(Accessibility of incoming lines, hard lines to each room, backup system, cell, 2-way, walkie-talkies, stand-alone radio system, building to building capabilities, contact with buses, first responders, etc) |
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| Transportation (reliability, bus to bus/bus to school communication, bus to 9-1-1, driver on-call availability, ability to move student population, back up system, etc) | |||||||||||||
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| Assess building/campus vulnerability based on distance from the following: | ||||||||
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| Railway | ||||||||
| Expressway | ||||||||
| Pipeline (oil/gas) | ||||||||
| Navigable Waterway | ||||||||
| Nuclear Power Plant | ||||||||
| Chemical Production/Storage | ||||||||
| Fuel Depot/Storage | ||||||||
| Propane Dispensing/Storage | ||||||||
| Major Airport | ||||||||
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Total
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| Vulnerability Assessment Sign-Off | ||||||||
| Name of School Official (printed) | Title of School Official | |||||||
| Signature of School Official | Date | |||||||
| Name of Contractor (if applicable) (printed) | ||||||||
| Signature of Contractor | Date | |||||||