Please read this entire page before beginning.

What is the purpose of the Level 2 Self Assessment?

The Level 2 Self Assessment will help students take a look at factors that affect the INDOOR air quality at their school. This assessment will likely identify areas where changes can be made to improve indoor air quality. These factors will later be used and addressed in the Level 2 class projects.

(Please note that the next step in Level 2, the Student Activity, will address the OUTDOOR air quality of your school.)

How do students complete the Level 2 Self Assessment?

1)PLEASE PRINT THIS DOCUMENT and have students write on the printed version. Once completed, save it for your records. This document should not be submitted to GGHS. It should be kept for your records and used for later reference.

2)We encourage students to do as much of the assessment as possible. Teacher guidance should and can be provided. Students can work together and complete this document as a class or small groups.

Disclaimers:

1)Some of the questions in this self-assessment may not be applicable, or may not be achievable.

2)Some of the areas that will be addressed in the following assessment may require assistance from school administrators, building facility managers, principals, or other applicable school staff. PLEASE ENSURE THAT YOU AND YOUR STUDENTS HAVE GIVEN PROPER NOTIFICATION AND HAVE RECEIVED PERMISSION TO ACCESS RESTRICTED AREAS that may be addressed in this assessment. If you are unsure, please discuss any questions with your principal.

The following checklists were adapted from EPA’s Indoor Air Quality Tools for Schools.

Date:
School Name:
Grade Level(s):
Number of Students in School:
Number of Students Participating:

Indoor Inspection 1

Please make a copy of this checklist for each of the following areas, and complete as many as possible.

Note: We suggest that teachers divide students into pairs or small groups to assess each of these areas.

Classrooms*Hallways* Offices* Auditorium Gymnasium

* Please note that students do not have to survey EVERY classroom, hallway or office; but should choose a number that provides adequate representation.

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Room Number/Name: ______Date:______Names: ______

Yes / No / Observation
The temperature is within acceptable ranges for the season. (68°-78°).
The air exchange is adequate (doesn’t seem stuffy).
The area is generally free of odors.
The area does not have evidence of ongoing water damage.
The area has no signs of mold/mildew.
The area is clean and relatively dust free.
The area is free of pests or any signs of them.
Food and food waste are properly disposed of in the area (not left lying around).
Trash cans are emptied daily.
Science chemicals, cleaning chemicals and art supplies are stored and handled properly.
If there are animals in classroom:
- The cages are cleaned regularly and waste is disposed regularly.
- Animal food is stored in tightly sealed containers.
- Students are taught proper care and handling of animals.
The paint is in good condition with no peeling or flaking. [1]
Three specific diseases – asbestosis, lung cancer, and mesothelioma (a cancer) – have been linked to asbestos exposure. Asbestos products, with few exceptions, are not currently banned in the US and are still legally “managed-in-place” in thousands of schools nationwide.
Asbestos tests been conducted in our school.[2]
If asbestos has been identified in your school, has it been properly removed or is it being properly managed?
Radon is a cancer-causing natural radioactive gas that you can’t see, smell or taste. Its presence in your school can pose a danger to everyone’s health.
Our school has been tested for radon.[3]
If a radon problem existed, appropriate corrective measures have been taken.
Do you have any other observations?

Out of the questions above, which factors (if any) might affect the indoor air quality of your school?

______

Indoor Inspection 2

Please make a copy of this checklist for each of the following areas, and complete as many as possible.
Note: we suggest that teachers divide students into pairs or small groups to assess each of these areas.

Bathrooms* (complete Part 1 only)

Locker Rooms (complete Part 1 only)

Plumbing/Utility Room (complete Part 1 and 2)

Janitorial Supply Closets (complete Part 1 and 2)

Furnace Room (complete Part 1 and 2)

Kitchen (complete Part 1 and 2)

* Please note that students do not have to survey EVERY bathroom, but should choose a number that provides adequate representation.

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Room Number/Name: ______Date: ______Names: ______

Part 1 / Yes / No / Observations
The room has operating exhaust fans.
If yes, are the fans clean?
The drains do not have standing water.
The water faucets or pipes are not leaking.
The room is free of mold and mildew.
Odorous or “hazardous” house cleaning chemicals are used with adequate ventilation and/or only when school is unoccupied.
The paint is in good condition (no flaking or peeling).
Part 1 / Yes / No / Observations
The room does not have combustion gas/fuel odors.
Appliances (gas furnaces, boilers, water heaters, etc.) have working ventilation components or exhaust hoods.
All ventilation components are free from leaks, disconnections, and deterioration (rust).
The ventilation components are clean and clear of obstruction.
The exhaust fans are used when appliances are in operation.

Out of the questions above, which factors (if any) might affect the indoor air quality of your school?

______

______

______

Outdoor Inspection Checklist

Remember – OUTDOOR factors can also affect the INDOOR air quality of your school! The following checklist may require assistance from a building facility manager or custodian. Please ensure you have permission to access these areas of the building. Some of these areas may have restricted access to students; therefore associated questions should be inspected and answered by appropriate school personnel.

Date: ______Names: ______

Yes / No /

Observation

The school ventilation units are on.
If yes, is air flowing into the outdoor air intake?
The outdoor air intakes are not blocked or obstructed.
The air intakes are free of animal materials (droppings, nests, fur, etc.)?
The roof top air intakes located far away from sources of vehicle exhaust accumulation (parking, loading docks, bus loading, etc.).
Building maintenance (roofing, painting, etc.) on areas near air intakes is scheduled ONLY when school is unoccupied.
Plumbing stacks are at least 10 feet away from rooftop air intakes.
There are no exhaust vents located within 10 feet of outdoor rooftop air intakes.
Vehicles adjacent to the building are prohibited from idling.
There are no garbage dumpsters located near air intakes or windows and doors that are frequently open.
There are no other potential sources of air contamination (chimneys, stacks, industry) located near the building.
Roof gutters and down spouts direct water away from the building.
The perimeter of the school building has good drainage (i.e. no pooling near foundation).
Sprinklers spray away from the building and air intakes.
All entrances have clean “walk-off” mats to collect shoe dust and dirt.
The paint outside is in good condition (i.e. no peeling or flaking).
Do you have any other observations?

Out of the questions above, which factors (if any) might affect the indoor air quality of your school?

Congratulations! Your class has successfully completed the Level 2 Self Assessment for the Georgia Green and Healthy Schools program!

To continue working towards completion of Level 2, your class should complete the Level 2 Student Activity.

If you have any questions, please contact the Green and Healthy Schools Program team.

404-362-4513 - Cindy Wolfe

GGHS – air 1Jan ‘09

[1]Schools built before 1978 may have paint that contains lead.

[2]For more information:

[3]For more information: