Attention Pilot Teacher / Team Member: Please write questions, comments, and other feedback about specific self-assessment items next to these items on this form.

Georgia Green & Healthy Schools

INTEGRATED PEST MANAGEMENT

DRAFT Requirements Chart

Please Note: In the chart below, schools are only required to complete the Short Form Self-Assessment and Extended Form Self-Assessment for the purposes of this pilot program. Please attach additional page(s) to answer the four questions below.

Step 1:
Discovery and Inventory / Step 2:
Action and Implementation / Step 3: (Optional)
Reaching Higher
*Pledge to become a Georgia Green & Healthy School.
*Complete the Short Form Assessment. / *Complete the Extended Form Assessment.
*Pesticides are applied by certified applicators.
*Pesticide application notices are posted.
*Incorporate IPM education into the classroom and community. / *Apply for the IPM Star certification offered by IPM Institute of North America, Inc. www.ipminstitute.org/IPM_Star/ipmstar_organizations.htm
* Develop an IPM policy and get it approved or improve an existing policy.
* Document and publicize your achievements with GA DOE and your local newspaper.

1. How feasible would it be for your school to complete all the requirements listed in “Step 1: Discovery & Inventory” in the chart above?

2. How feasible would it be for your school to complete all the requirements listed in “Step 2: Action &Implementation” in the chart above?

3. How feasible would it be for your school to complete all the requirements listed in “Step 3: Reaching Higher” in the chart above?

4. What changes would you recommend to improve this requirements chart?

INTEGRATED PEST MANAGEMENT

Green & Healthy Schools Self- Assessment

Part 1: Basic Knowledge (DRAFT Short Form)

Integrated Pest Management, or IPM, is an approach to pest control that relies on a combination of common sense practices for preventing and controlling pests and unnecessary exposure of children to pesticides. In an IPM approach, considerable effort is put toward preventing pest problems by controlling conditions and practices of facility users that may attract and support pests. Depending on the type of pest(s), condition of school facilities, resources, and commitment of the administration and staff, IPM plans take many forms – each unique to the setting, community and school’s needs and desires.

School Pest Management: (To be completed by school’s administrative and operations staff.)

1. Does your school or school district have a written pest management policy for

indoor pest management?

School ___ Yes School District ___ Yes

___ No ___ No

outdoor pest management?

School ___ Yes School District ___ Yes

___ No ___ No

staff, students and parents are notified of pesticide use prior to its application?

School ___ Yes School District ___ Yes

___ No ___ No

2. Does your school use any pesticides in the school building?

___ Yes

___ No

on the school grounds?

___ Yes

___ No

Please attach a list of pesticides used including fungicides, insecticides, herbicides and rodenticides.

You may have to obtain this list from a central office at your school district.

3. If yes, who applies pesticides in your school or on the school grounds?

___ Teachers ___ Custodian Staff ___Contractors ___ Others (list) ______

___ Trained and licensed professional applicators on school staff

4. What pest problems does your school have? Place an “I” for Indoor and/or an “O” for Outdoor.

___ Cockroaches ___ Spiders ___ Stinging Insects ___ Ants ___ Flies

___ Moths ___ Rodents ___ Mold/Fungus ___ Head Lice ___Aphids

___ Weeds ___ Plant diseases ___ Ladybugs

___ Wood-destroying Insects (e.g. carpenter ants, termites) ___ Other ______

This assessment is based on and uses components of the “Green Flag Program,” a project of the national Child Proofing Our Communities Campaign, coordinated by the Center for Health, Environment and Justice. It is also designed to complement US EPA’s new “Healthy School Environment Assessment Tools” for school district facilities managers.

INTEGRATED PEST MANAGEMENT

Green & Healthy Schools Self- Assessment

Part 2: Digging Deeper (DRAFT Extended Form)

Integrated Pest Management, or IPM, is an approach to pest control that relies on a combination of common sense practices for preventing and controlling pests and unnecessary exposure of children to pesticides. In an IPM approach, considerable effort is put toward preventing pest problems by controlling conditions and practices of facility users that may attract and support pests. Depending on the type of pest(s), condition of school facilities, resources, and commitment of the administration and staff, IPM plans take many forms – each unique to the setting, community and school’s needs and desires.

School Pest Management: (To be completed by school’s administrative and operations staff.)

1. If your school or school district has a written policy on indoor or outdoor pest management or the

notification of staff, students and parents of pesticide use prior to its application, please document it by

attaching copies of the policies to this assessment. Refer to the IPM Short Form Assessment,

Question #1.

2. If your school uses pesticides either in the school building or on the school grounds, please list the

product, check the appropriate column as to whether it is used indoors or outdoors, and designate the

pests that it is used specifically to control. The product information should be readily accessible from

the completed IPM Short Form Assessment, Question #2.

Beyond Pesticides provides information about the 48 Commonly Used Toxic Pesticides in Schools at http://www.beyondpesticides.org/schools/publications/index.htm Please note by the placement of an asterisk (*) next to the product name whether it is on this list.

Product* Indoor Outdoor Pest(s)

3. Where are the Material Safety Data Sheets (MSDS) for the pesticides that are used at your school kept

on file?

___ School Principal office ___ Facility Manager office ___ School District office

___ School Business office ___ Other ______

OSHA requires that schools must have MSDS for all chemicals used on file and available for public inspection. MSDS information on pesticides can be readily accessed at the Northwest Coalition for Alternatives to Pesticides website http://www.pesticide.org/MSDS.html and the Pesticide Action Network of North America’s pesticide database http://www.pesticideinfo.org/Index.html

A guide to reading MSDS is available at http://fp.arizona.edu/riskmgmt/guide_to_reading_a_material_safe.htm

4. Where are the records kept of pesticide applications?

___ School Principal office ___ Facility Manager office ___ School District office

___ School Business office ___ Other ______

5. How are these records kept?

___ Log book ___ Invoice ___ Other

6. How long are these records kept? (Enter the number in front of the appropriate unit.)

___ Days ___ Weeks ___ Months ___ Years ___ Other

7. Designate the contractor(s) or school employee(s) that are responsible for pest management at your

school. Refer to IPM Short Form Assessment, Question # 3.

Include a copy of the contractor service agreement with your completed assessment.

Private Firm School Employee Other (specify)

Indoor pest control
Outdoor pest control
Weed control

8. If your school notifies people of the application of pesticides, whom do they tell?

___ Staff and faculty ___ Students ___ Parents ___ Community

___ Other ______

9. How are people notified?

___ Bulletin board posting ___ Letter home to parents ___ Letter to staff/faculty

___ Signs are posted indoors ___ Students are told ___ Teachers are told

___ Signs are posted outdoors ___ Other ______

10. What information is provided in the notification of pesticide use?

___ Site of application ___ Date of application ___ Products to be applied

___ Health effects of products ___ Information on how to avoid exposure

___Contact information ___ Information on how to appeal proposed application

___ Other ______

11. Is notice given before or after the pesticide application?

___ Before ___ After

If notice is given before application, how long before is notice given? Specify the number in front of

the appropriate unit.

___ Hours ___ Days

If notices are posted, how long after the pesticide application do they remain posted? Specify the

number in front of the appropriate unit.

___ Hours ___ Days ___Weeks

12. Is the school nurse or other staff member(s) trained to recognize pesticide poisoning? Please

designate who is trained.

___ Yes Trained person ______

___ No

13. Does your school’s emergency management plan address possible pesticide accidents or exposures?

___ Yes

___ No

14. Does your school have a designated IPM Coordinator?

___ Yes

___ No

15. Does your school practice any IPM or non-chemical methods to reduce pest problems? Examples of

these methods include measures to keep food away so as not to attract pests and physical deterrents

to keep pests out.

___ Yes

___ No

For a complete list of practices, see the IPM Standards for Schools on the website for The IPM Institute of North America, Inc. http://www.ipminstitute.org/school.htm

For additional information and resources, refer to the following websites:

Beyond Pesticides http://www.beyondpesticides.org/ offers the fact sheets and publications, such as “Safer Schools: Achieving A Healthy Learning Environment Through Integrated Pest Management” and even a resource page for Georgia policies.

The US Environmental Protection Agency’s IPM in Schools http://www.epa.gov/pesticides/ipm/#bkmrk3 offers additional links and informational material.

16. Does your school teach IPM concepts in the classroom/laboratory or on field trips?

___ Yes

___ No

The Institute of Food and Agricultural Science at the University of Florida offers links and references to teaching curricula http://schoolipm.ifas.ufl.edu/teach.htm and educational presentations including videos, posters, fact sheets and activity guides http://schoolipm.ifas.ufl.edu/pres.htm

The IPM Institute of North America, Inc. has lesson plans for Grades 1-7 in their “IPM Super Sleuth” section, as well as, links to additional educational resources at http://www.ipminstitute.org/supersleuth.htm

This assessment is based on and uses components of the “Green Flag Program,” a project of the national Child Proofing Our Communities Campaign, coordinated by the Center for Health, Environment and Justice. It is also designed to complement US EPA’s new “Healthy School Environment Assessment Tools” for school district facilities managers.

Georgia Green & Healthy Schools

Integrated Pest Management Self-Assessment

Overall Feedback

Thank you for your honest feedback about the overall quality of this environmental self-assessment form. Your comments will be used to revise and improve the form before the launch of the “Georgia Green & Healthy Schools” program next school year. Please attach additional pages to answer the following questions.

1. This self-assessment was piloted with students from the following grade level(s):

K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th

2. Please provide details on how you used this form with students. Overall, did you and your students find this self-assessment form to be user-friendly? Why or why not?

3. Were you able to use this self-assessment form to help students master school curriculum objectives and/or state education standards? How or why not?

4. Did this assessment reveal useful information about current conditions or practices at the school?

5. What changes do you suggest to improve this self-assessment?

6. Do you plan to participate in the revised “Georgia Green & Healthy Schools” program and/or recommend the program to other teachers when it is launched in the 2005 – 2006 school year? Why or why not?

7. Please provide any additional comments you think would be helpful to the “Georgia Green & Healthy Schools” planning team.

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Attention Pilot Teacher / Team Member: Please write questions, comments, and other feedback about specific self-assessment items next to these items on this form.