/ A SPECIAL EDUCATION
GUIDELINE FOR DEVELOPING EVACUATION PLANS / N
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TO:Principals, School Psychologists, Counselors, Nurses, and Special Education Staff

FROM:Jamie Nord, Sarah Brown, and Troy Ferguson

RE:Developing Evacuation Plans

DATE:October 2011

This is a new special education guideline.

Please file in the Guideline Manual

Any student with an Individualized Education Program (IEP) or 504 Accommodation Plan who is unable to independently follow directions and move to designated areas in drill or emergency situations needs to have an Individual Evacuation Plan. The “Checklist for Determining if a Student Needs an Evaluation Plan” included in this guideline can assist teams in making this determination.

If the IEP team decides an Individual Evacuation Plan is needed, the team will need to determine and document the equipment needed, the staff who will be providing assistance and the procedures to be followed in order to ensure the student’s safety. Included in this guideline is an “Individual Evacuation Plan” template for teams to use to document the student’s plan.

The IEP Manager is responsible for the development of this plan, through consultation with any of the following, as appropriate:

  • School Nurse
  • Physical Therapist (Sue Witthuhn or Wendy Pickar) – student with mobility issues
  • Occupational Therapist (Carol Houfer or Sheila Hughes)
  • Social Behavior Collaborative Planner (Christine Matthews or Robyn Smith)
  • Physical Health Disabilities Consulting Teacher (Jeanne Johnson)
  • Parents, as part of the IEP team

Evacuation Plans are to be updated at least annually, or whenever there is a change is the student’s schedule/classroom assignments, mobility, health/medical status or behavioral compliance.

Checklist for Determining if a Student Needs an Evacuation Plan

Each student with an IEP or 504 Plan should be considered for Individual Evacuation Plan development on a yes-no basis. Any student who cannot be expected to safely exit using the standard school evacuation procedures needs an Individual Evacuation Plan. If the IEP Team answers Yes to one or more of the following items, development of an Individual Evacuation Plan should be considered.

Student’s Name ______

Date ______

Age-Related Factors to Consider… / Yes (√) / No (√)
Is the student too young to independently apply “follow the group” procedures?
Behavioral Factors to Consider… / Yes (√) / No (√)
Does the student lack the cooperation skills needed to follow adult directives in the case of an emergency, to the degree that it could interfere with his/her capacity to follow standard procedures?
Does the student display oppositional behavior when given adult directives, to the degree that it could interfere with his/her capacity to follow standard procedures?
Does the student lack the self-management skills to handle stressful situations, to the degree that it could interfere with his/her capacity to follow standard procedures?
Will the student panic/ become overly anxious during an emergency, to the degree that it could interfere with his/her capacity to follow standard procedures?
Does the student lack adequate self-responsibility skills, to the degree that it could interfere with his/her capacity to follow standard procedures?
Does the student require special instructions and/or accommodations in addition to the routine procedures required in the case of an emergency situation?
Does the student display impulsive behaviors, to the degree that it could interfere with his/her capacity to follow standard procedures?
Cognitive/Sensory/Physical/Health Factors to Consider… / Yes (√) / No (√)
Does the student have cognitive (e.g., difficulty following directions) and/or neurological deficits that could interfere with his/her capacity to follow standard procedures?
Does the student have sensory deficits (Hearing, Vision) that could interfere with his/her capacity to follow standard procedures?
Does the student have physical mobility issues (e.g., endurance, balance, ability to navigate obstacles) that could interfere with his/her capacity to follow standard procedures?
Does the student have health/medical concerns that could interfere with his/her capacity to follow standard procedures?

Individual Evacuation Plan

Including Fire, Tornado and Lockdown

Student ______Building ______

School Year/Term ______IEP Manager ______

Parent Name ______Parent Phone # ______

A. What specialized equipment is needed? List (from each physical location during the school day):

______

______

______

B. What specialized equipment must remain with the student? List:

______

______

______

C. Describe the identified behaviors, if any, that occur to the degree that it could interfere with the student’s capacity to follow standard procedures:

______

______

______

D. General Considerations

  • The elevator will not be used during a drill or emergency.
  • The student will calmly be informed of what is happening throughout the process.
  • Staff will remain with the student throughout any drill or emergency procedure.
  • This plan will be reviewed and revised as needed, based on changes in the student’s class schedule, classroom assignments, mobility, health status and behavioral needs.
  • If student’s “go-to” point is the same for students with disabilities as for those without disabilities – specify. If a different “go-to” point is required – specify.

E. This student requires (check all that apply):

_____A staff person(s) to evacuate the building

Name of first-assigned staff ______

Name of back-up staff ______

_____Staff to carry the student and the

____ wheelchair ____ stander ____ scooter _____other equipment

Name of first-assigned staff ______

Name of back-up staff ______

_____Describe behavioral supports recommended – “staff model calm behavior”

______

F. Describe student-specific plans for the three situations listed:

1)When exiting the building is required (e.g., Fire) and exit can be accomplished,

identify “go-to” point:

_____Same as for other students in the class

Describe Location: ______

______

Plan Details: ______

______

______

2)When exiting the building is required and when exit cannot be accomplished, identify “go-to” point:

On ______floor ______

On ______floor ______

On ______floor ______

Plan Details: ______

______

______

3)When students are to remain in the building (e.g. – Tornado), identify the “go-to” point:

_____Same as for other students in the class

On ______floor ______

On ______floor ______

On ______floor ______

Plan Details: ______

______

______

4)When students are to remain in the building (e.g. – “Lockdown”)

  • This is a stay-put situation
  • Students/staff will remain in the classroom until the “all-clear” is given.

Plan Details: ______

______

______

G. Training Procedures for Staff (Describe)

  • List assigned staff.
  • Describe specific training procedures (Example: Tuk-n-Kari Procedure).

______

Trainer ______Training Date (s) _________

Trainer’s Position ______

Individuals Trained (include parents, staff, etc.):

______

______

______

______

H. Adoption/Revision Dates

Date ______ (Initial Plan Adoption)

Date ______(Revision)

Date ______(Revision)

Date ______(Revision)

  • Attach copy of student’s current class schedule
  • Attach copy of Individual Evacuation Plan to student’s IEP
  • Place a copy of Individual Evacuation Plan in teacher’s substitute file – require review by substitute teacher prior to student’s class.
  • Provide a copy of Individual Evacuation Plan to all staff who may be involved, including paraprofessionals and para sub files
  • Copy to parents

Case Manager Signature: ______

Name: ______

Date Approved: ______

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