3.18 3.18
LABOR AND POLICY\Workplace Violence Prevention Program Policy—Adopt Amended Version Again—4-16-18
RESOLUTION AUTHORIZING ADOPTION OF AMENDED TOWN OF
QUEENSBURY WORKPLACE VIOLENCE PREVENTION PROGRAM
RESOLUTION NO.: ,2018
INTRODUCED BY:
WHO MOVED ITS ADOPTION
SECONDED BY:
WHEREAS, the Queensbury Town Board has long recognized the value of its employees
by seeking to provide a safe working environment for each and every Town employee and
minimize the risk of workplace violence, and
WHEREAS, on April 2, 2018, by Resolution No.: , the Town Board authorized
adoption of an amended Workplace Violence Prevention Program("Program"), and
WHEREAS, the New York State Department of Labor has recommended further changes
to the Town's Program, and
WHEREAS, the results of those suggested changes have been incorporated into a further
amended proposed Program, and the Town Board wishes to accordingly authorize such proposed
amended Program as presented at this meeting,
NOW, THEREFORE, BE IT
RESOLVED, that the Queensbury Town Board hereby authorizes the adoption of the
amended Town of Queensbury Workplace Violence Prevention Program including the suggestions
from the New York State Department of Labor substantially in the form presented at this meeting
and authorizes and directs the Town Supervisor to make arrangements for the distribution of copies
to all Town employees, including members of the Town's Unit of the Civil Service Employees
Association, and
BE IT FURTHER,
RESOLVED, that the Town Board further authorizes and directs the Town Supervisor to
forward a certified copy of this Resolution along with the amended Workplace Violence
Prevention Program to the appropriate representatives of the New York State Department of Labor,
and the Town Supervisor, Town Safety Officer, Town Counsel and/or Town Budget Officer to
take any action necessary to effectuate the terms of this Resolution.
Duly adopted this 16th day of April, 2018, by the following vote:
AYES
NOES :
ABSENT .
APPENDIX"C"
Explain Risk Factors and Protection Measures from Workplace
Assessment
Highway/Water and Waste Water De t. Recreation Maintenance gec clin
A. Working in remote work assignments-
Employees will work hours assigned by their supervisor and will notify
supervisor of any needed change in work schedule. Employees should be aware
of closest phone or radio for 911 calls
B. Dealing with irritated people outside of fellow staff
• Employees are to keep calm and not escalate the situation and walk away from
irate individuals and call 911 if necessary
C. Employee internal disputes
• Employees will be instructed that screaming,yelling, cursing, make derogatory
remarks about each other is unacceptable behavior in the work place.
• Internal arguing and yelling will not be tolerated. Employees need to walk away
and exit the area immediately then report incident to their Supervisor. If you
cannot exit you need to take appropriate action to get away. If there has been
a threat of workplace violence, fill out an incident report.
D. Employee External disputes
• Employees will be instructed that this is unacceptable behavior in the work
place.
• Arguing and yelling with residents or individuals from the outside will not be
tolerated. Employees need to walk away and exit the area immediately then
report incident to their Supervisor. If there has been a threat of workplace
violence,fill out an incident report.
Field Service Personnel
Fire Marshal Code Enforcemep1jAppraiser
A. Dealing with irate people in the field
• See Above
B. Dealing with irate people in the office/counter
• See Above
• Activate panic buttons if available
• Notify direct or appropriate supervisor
• Notify others in the building if warranted
• Limit public access to public areas only
C. Conflict via phone
• Do not escalate situation and speak calmly
• Take notes
• Notify direct or appropriate supervisor.
7
Clerical
A. Dealing with irritated people at windows or open counters, including handling
of cash. Residents access open offices
• Employees will be instructed on when to call 911 and to make others in the
building aware of an emergency.
• The public will be kept out of offices whenever practical
• Alternate persons will make cash bank deposits at different times of day.
• Employees will be trained on keeping calm if an irate person confronts them.
Employees will not get into vocal confrontations with the public. Such
behavior is unacceptable. Employees should notify and involve their
supervisor and let them handle it if warranted.
B. Irate people attending court, board meetings and public hearings
• Instructions will be given on use of the panic button in the meeting room,the
building intercom as well where there is a phone available to dial 911 will be
given during training.
• Officials and the public will be advised of emergency exits at the beginning of
all public meetings.
C. Working alone in the building
• Employees will work hours that have been assigned by their supervisor and
will notify their supervisor of any needed change in work schedule.
Employees should be aware of closest phone for 911 calls
D. Employee internal disputes
• Employees will be instructed that this is unacceptable behavior in the work
place.
Internal arguing and yelling will not be tolerated. Employees need to walk
away and exit the area immediately then report incident to their Supervisor.
If there has been a threat of workplace violence, fill out an incident report
8
Public Officials
Irate people attending court, board meetings and public hearings
• Officials and the public will be advised of emergency exits at the beginning of
all public meetings.
• Instructions will be given on use of the panic button in the meeting room,
where there is a phone available to dial 911 will be given during training.
• Elected and appointed officials will be trained on the proper conduct for
officials at public meetings. Officials will not get into vocal confrontations
with the public or each other
• Court bailiffs will be present for court nights and metal detectors used to
screen all attending court. The rear door of court room (by restrooms) will
be locked so court attendees cannot enter once exiting that door
Employee internal disputes
• Employees will be instructed that yelling and fighting is unacceptable
behavior in the work place. Internal arguing and yelling will not be tolerated.
Employees need to walk away and exit the area immediately then report
incident to their Supervisor. If there has been a threat of workplace violence,
fill out an incident report_
EMPLOYEE TRAINING
Employees will be trained about the physical risks at their respective places of
employment with regard to workplace violence by their Department Head and/or
supervisor. See Appendix D for physical hazards.
9
APPENDIX "D"
This is the name of each building evaluated, followed by the names of the
persons performing the evaluation, a physical description of each building
evaluated and the specific hazards identified during this evaluation.
Senior Center: Chuck Rice'and Susan Sheehan
This is a two-story building with the downstairs (basement) containing
storage and a wood shop used by the employees of buildings and grounds.
The building is very busy daily with programs for seniors. There are no
areas of previous security concerns with these activities. The biggest
concern is the employee from buildings and grounds who is alone in this
building in the evenings for cleaning.- This will be a recurring theme for shift
workers and a "panic" button to be worn on their person seems a
reasonable solution.
Town Board meeting every other Monday may at some time present a
security conoem if there are any contentious issues. There are no safety
officers staffed for these potential occurrences.
TOWN OFFICE CAMPUS BUILDING: Two story building housing multiple
departments. Seven entrances to building and many windows.
Security/safety breakdowns are below for each department.
Supervisor's Office: Chuck Rice and Susan Sheehan
This area contains the receptionist area for the administrative assistant and
the supervisor's office. The main safety/security concern in this area is a
visit from a disgruntled member of the public. There are panic-buttons and
paths of egress for the Supervisor, but not for the administrative assistant.
Accounting Department: Chuck Rice and Susan Sheehan
This department has stellar security in place. No concerns here.
10
Department of Parks and Recreation: Chuck Rice and Susan Sheehan
Though there is an adequate barrier to the public in the reception atrium,
the Clerk from Parks and Recreation has been tasked with greeting all
persons who enter the atrium to visit the office building. They should be
equipped with a panic button for emergency calls for help.
Assessor's Office: Chuck Rice and Susan Sheehan
This office should NOT have, open counter space. If there is a need to
interview a taxpayer (for an assessment review, for example) they should
take them into the Supervisor's conference room or be provided with a
separate interview area. There is no protection from disgruntled persons
and the employee present during this assessment says they are not
uncommon. A barrier should be provided that protects the employee from
any type of potential assault.
Town Clerk's Office: Chuck Rice and Susan Sheehan
The only time that persons other than employees need to be behind the
counter is for FOIL requests. The glass barrier separating the employees
of this office from the public is not bulletproof. It is essentially useless.
Zoning and Buildings and Codes: Chuck Rice and Susan Sheehan
This department is extremely secure. No potential problems identified.
Buildings and Grounds: Chuck Rice and Susan Sheehan
Though the offices for this department are downstairs in the Town Office
Building, there are many satellite locations where the employees of this
department also go to perform their assigned tasks, including: Town Court,
State Police Barracks, Banner at Quaker and Bay, Aviation Rd. Welcome
sign, roundabout Aviation and Dixon, Queensbury EDC Dix Avenue, Bus
11
stop Media Drive, Sunnyside Historical and maintain kiosk at Main Street.
This work is largely outside and there is minimal interaction with the public.
Highway Department and Historian: Mike Palmer and Susan Sheehan
This assessment is for the administrative section of the Highway
Department and the Historian's office. The camera that covers the lobby
needs to have an angle change or there needs to be another camera
installed. If the visitor rings the bell and proceeds to the door they are
obscured from the camera angle by the hallway. This was the only
concern.
Highway Department Garage: Mike Palmer and Susan Sheehan
The Highway Department is slated to be refurbished and/or replaced. The
areas of concern will most likely be addressed by having this done. It
would be wise to note them here though. The Parts Shop is a cave. There
is one path of egress and anyone can enter. This is dangerous for multiple
reasons. In an active shooter situation, any employee (s) in this location
would have to run towards the gunfire to escape. There should be another
path of egress for this area. The next issue is the tight quarters for so large
a number of employees that work LONG hours. The past incidence of
workplace violence that the union has been made aware of in this
department were worker on worker incidence. They need a LARGER more
modern break area with more space to spread out and get away from
others if they choose. Training on diffusing difficult situations is also called
for and sexual harassment is imperative given the outstanding investigation
into charges that all witnesses and the accused stated: "That's the
environment here." UNACCEPTABLE
Solid Waste (Ridge Rd. & Luzerne Rd.): Mike Palmer and Susan
Sheehan
The only risk to employees here (as disposing of one's trash doesn't in and
of itself cause too much stress) are not in any imminent danger from the
public. This can be re-evaluated annually.
12
Town Court: Mike Palmer and Susan Sheehan
The courts (like the accounting department) is very secure and there are
two security guards during court on Monday evenings. They are trained
and armed. The employees had no issues with security. I would
recommend perhaps one more panic button at a desk. There is one in the
courtroom and one at the front window.
Cemetery: Michelle Hatin and Susan Sheehan
The cemetery is a fairly secure environment. Warren County Sheriffs patrol
intermittently and the only area of some concern is that the receptionist and
Cemetery Superintendent have only one path of egress and would be
trapped in any time of concern.
Crematorium: Michelle Hatin and Susan Sheehan
The crematorium is secure.
Water Department Administrative Building: Mike Palmer and Susan
Sheehan
The doors have locks and bars but are not always secured after hours
providing entry to anyone. The reception desk downstairs has no barrier to
the public and no panic button. Further, if confronted with a disgruntled
individual, there is no way for the person to get out. They are trapped and
there is no panic button. Each office downstairs should be armed with
panic buttons.
Water Treatment Plant: Mike Palmer and Susan Sheehan
This is a non-secure facility in which there are often employees working
alone throughout the night. There needs to be a different entry system for
this facility and better protocol for outside contractors working after hours.
Many times, the operator on duty is not even informed that there may be
others in the facility after hours. Beside better security for the doors, the
13
employee on duty alone after hours should be armed with a panic device to
summon assistance for emergencies.
Water Distribution: Mike Palmer and Susan Sheehan
Multiple exits. The prior report of violence here was employee on
employee(s). As with the highway department, training in diffusing
situations with difficult people would be warranted.
Wastewater Department: Mike Palmer and Susan Sheehan
No areas of concern here.
Gurney Lane: Steve Lovering and Susan Sheehan
Gurney Lane has not suffered any areas of safety concerns since doing
away with the evening free swim. There is a supervisory employee there or
available at all times to handle any issues that may arise with the public.
Jenkensville Park: Steve Lovering and Susan Sheehan
No areas of previous concern here. Plenty of exits from all buildings.
Security (tag) system for entering the building should be applied to Water
Treatment Plant.
14
DEPARTMENT: Senior Center Supervisor's Office Accounting Dept.of Parks&Rec.
Security Features YES NO N/A YES NO N/A YES NO N/A YES NO N/A
Reception Area X X X X
Barriers separating client from work area X X X
Separate Interview areaX
X X X X
Emergency Numbers posted by phones X X X X
Multiple Exits X X X X
Unobstructed Office Exits X x X x
Door Control(s)lock,buzzer,panic bar some doors/not all X X X
Door Detector alarm(s) X X X X
Adequate lighting in and around X X X X
Parking lot well lighted X X X X
Panic Button(s) X X X
Video Monitor(s) X X X X
Landscaping to provide unobstructed view X X X X
of workplace
Limiting signs on windows X X
X X
Employee Risk Factors
Working with the public X X X X
Work late night or early morning X X X X
Exchange money with the public X X X X
Work alone or in small numbers X X X X
Work in a location with uncontrolled X X X X
public access
Areas of previous security concerns X X X X
Any other factors that might place
employees at risk
Town Counsel Assessor's Office Town Clerk's Office Codes and Zoning
YES NO N/A YES NO N/A YES NO N/A YES NO N/A
X X X X
X X X X
X X X except FOILS X
X X X X
X X(shared door) X X
X X X X
X X X X
X X X X
X X X X
X X X X
? X X X
X X X X
X X X X
X X X X
X X X X
X X X X
X X X X
X X X X
X X X X
X
? X X X
DEPARTMENT: Buildings and Grounds Highway Admin/Hist. Highway Garage Luz Rd.Solid Waste
Security Features Yes No N/A Yes No N/A Yes No N/A Yes No N/A
Reception Area X X X X
Barriers separating clients for work area X X X X
Separate Interview area X X X X
Emergency Numbers posted by phones X X X X
Multiple Exits X X X X
Unobstructed Office Exits X X X X
Door Control(s) lock, buzzer,panic bar X X X X
Door Detector alarm(s) X X X X
Adequate lighting in and around X X X X
Parking lot well lighted X X X X
Panic Button(s) X X X X
Video Monitor(s) X X X X
Landscaping to provide unobstructed view X X X X
of workplace
Limitinng signs on windows X X X X
Employee Risk Factors
Working with the public X X X X
Work late night or early morning X X X X
Exchange money with the public X X X X
Work alone or in small numbers X X X X
Work in a location with uncontrolled X X X X
public access
Areas of previous security concerns X emp./emp. X X X
Any other factors that might place
employees at risk
Ridge Rd.Solid Waste Courts Cemetery Crematorium
Yes No N/A Yes No N/A Yes No N/A Yes No N/A
X X X X
x x x x
x X x x
x x x x
x x x x
x x X x
x x x x
X x X x
X x x X
X x x x
x X x X
x X x X
x x x x
x X x x 00
wo
x x x x
x x x x
x x x x
x x x x
x x x x
x x x x
DEPARTMENT: Wtr/W.Water Admin Water Plant Water Distribution Wastewater Dept.
security Features Yes No N/A Yes No N/A Yes No N/A Yes No N/A
Reception Area X X X X
Barriers separating client from work area X X X X
Separate Interview area Xup Xdown X X X
Emergency Numbers posted by phones X X X X
Multiple Exits X X X X
Unobstructed Office Exits Xup Xdown X X X
DoorControl(s)lock,buzzer,panic bar X X X X
Door Detector alarm(s) X X X X
Adequate lighting in and around X X X X
Parking lot well lighted X X X X
Panic Button(s) X X X X
Video Monitor(s) X X X X
Landscaping to provide unobstructed X X X X
view of workplace
Limited signs on windows X X X X
Employee Risk Factors
Working with the public X X X X
Work late night or early morning X X X sometimes X sometimes
Exchange money with the public Xdown Xup X X X
Work alone or in small numbers X X X X
Work in a location with uncontrolled X X X X
public access
Areas of previous security concerns X X X X
Any other factors that might place
employees at risk
Gurney Lane Rec. Jenkinsville Rec.
Yes No N/A Yes No N/A
X x
X x
X x
X x
X x
X x
X x
X x
X x
X x
X x
X x
X x
x x N
x x
x x
x x
x x
x x
x x
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Senior Center
1. Security Features Yes No N A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s) ✓
Emergency Numbers Posted by Phones /
Multiple Exits
Unobstructed Office Exits V/
{ Door Control(s)lock, buzzer, panic bar SOW d0csr5
Door Detector(s)alarm Y
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitors) (rte Qa
Landscaping to provide 1,00 O,PAi$S
unobstructed view of workplace /
Limiting signs on windows ✓
Other
2. Em Io ee Risk Factors Yes No N/A
Working with the public
Work late night or early morning
i/
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled J
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
21
3. NO Security guards in this department
4. Description of the Building:#entrances and exits, number of employees,
access to building, security features, areas of concern related to security
t6wy- +
a(�K - I q- 12-10 5QAA)rl UJcb-A
�� o
S. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
�D PWOX-
Evaluation Performed by:
22
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Supervisor's Office
1. Security Features Yes No
. 7—
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits
Unobstructed Office Exits ✓
Door Control(s) lock,buzzer,panic bar ✓
Door Detector(s) alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Employee Risk Factors Yes No
Working with the public
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns ,
Any other factors that might place employees
at risk
23
3. NO Security guards in this department
4. Description of the Bulidin :#entrances and exits, number of employees,
access to building,security features, areas of concern related to security
C'�a s
S. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by: ...
Lb
24
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Accounting
1. SecurltV Features Yes No NLA
Reception Area
Barriers separating clients from work area >/
Separate Interview Area(s) )�
Emergency Numbers Posted by Phones ✓
Multiple Exits
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar
Door Detector(s) alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
kLandscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Em to ee Risk Factors Yes No N/A
Working with the public V
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled ✓
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
25
3. NO Security guards in this department
4. Description of the Buildin ._#entrances and exits, number of employees,
access to building,security features, areas of concern related to security
S. Soecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
26
Town of Queensbury March 12,, 2018
Evaluation of the Physical Environment:
Department of Parks and Recreation 4ou" ceqw-
1. Security Features Yes No WA
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones VX
Multiple Exits
Unobstructed Office Exits
Door Control(s)lock,buzzer, panic bar
Door Detector(s)alarm
Adequate lighting in and around
Parking Lot well lighted V/
Panic Button(s)
Video Monitor(s) Cp-f\k� C&NAD-4
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
other
2. Em to ee Risk Factors Yes No N/A
Working with the public
Work late night or early morning V
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
27
3. NO Security guards in this department
4. Descri tion of the BuildinK..#entrances and exits, number of employees,
access to building, security features, areas of concern related to security
'tit
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section S.
'.pjm� cet'2rj
Evaluation Performed by: �
P
28
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Assessors Office
1. Securitv Features Yes No MA
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits C.� JAY,40
Unobstructed Office Exits
Door Control(s)lock, buzzer, panic bar
Door Detector(s)alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace arnA J&eL
Limiting signs on windows
Other
2. Employee Risk Factors Yes No -----PLA
Working with the public V/
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
29
3. NO Security guards in this department
4. Description of the Buiidin : #entrances and exits, number of employees,
access to building, security features, areas of concern related to security
t
S. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
112-22-
30
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Town Clerks Office
1. Security Features Yes No _____NLA
Reception Area /
Barriers separating clients from work area V ;
3
Separate Interview Area
Emergency Numbers Posted by Phones
-k< Multiple Exits ✓
Unobstructed office Exits
Door Control(s)lock buzzer, panic bar
Door Detector(s)alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s) V/
Video Monitor(s) "
Landscaping to provide /
unobstructed view of workplace V
Limiting signs on windows
Other v -�
2. Employee Risk Factors Yes No N A
Working with the public
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns �[3Cy0
Any other factors that might place employees "''
at risk
31
3. NO Security guards in this department
4. Description of the Building: #entrances and exits, number of employees,
access to building, security features, areas of concern related to security
So, ade
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
32
3
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Zoning „,_&"�-3 +C
1. Securitv Features Yes No N/A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones /
Multiple Exits >�
Unobstructed Office Exits
Door Control(s) lock, buzzer,panic bar �J /
Door Detector(s)alarm %X/
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide /
unobstructed view of workplace /
Limiting signs on windows ✓✓✓
Other
2. Employee Risk Factors Yes No N A
Working with the public
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns law Uw
Any other factors that might place employees
at risk
33
3. NO Security guards in this department
4. Description of the Building:#entrances and exits, number of employees,
access to building,security features, areas of concern related to security
C'-t, c9vk-,s
S. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
2jy�W6
Evaluation Performed by:
34
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Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Buildings and Grounds
1. Security Features Yes No N/A
Reception Area ✓
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits V/ J
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar
Door Detector(s) alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s) CrIWOUYN
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Em to ee Risk Factors Yes No N 'A
Working with the public
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
36
I NO Security guards in this department
4. Description of the BuIldInC.#entrances and exits, number of employees,
access to building, security features, areas of concern related to security.
'.
ecurity.'w
'S I
v, j44V ��
WON), 4�� wk
bxt r
cwx�
S. S �Mthe specific
pecific Hazards: Using the information from Sections I-
hazards related to this evaluation in Section 5.
Evaluation Performed by:
37
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment;
�p Highway Department 4- no"
1. Securitv Features Yes No N A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s) /
Emergency NumbF
erssPosted by Phones
Multiple Exits Unobstructed
Office Exits �Door Control(s) lock, buzzer, panic bar V (rmt 'J"q
Door Detector(s) alarm �
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Employee Risk Factors Yes No N, A
Working with the public
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled /
public access ✓/
Areas of previous security concerns
Any other factors that might place employees
at risk
38
3. NO Security guards in this department
4. Descri tion of the Buildin #entrances and exits, number of employees,
access to building,security features, areas of concern related to security
S. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5,
Evaluation Performed by:
39
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
�p�
Highway Department GaA 6
1. Security Features Yes No N A
Reception Area J
Barriers separating clients from work area
Separate Interview Area(s) V/
Emergency Numbers Posted by Phones ✓
.Multiple Exits-}'
Unobstructed Office EXL'
Door Control(s) lock, buzzer, panic bar
Door Detector(s)alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s) ✓
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Employee Risk Factors Yes No N/A
Working with the public
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled ✓ � � �,p
public access
Areas of previous security concerns '"
Any other factors that might place employees
at risk
40
3. Na Security guards in this department
4. Description of the Buildin »#entrances and exits, number of employees,
access to building, security features, areas of concern related to security
S. S stifle Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section S.
CA
Evaluation Performed by:
41
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
Solid Waste—Luzerne Rd.
1. Security Features Yes No
Reception Area
Barriers separating clients from work area
Separate Interview Area(s) V/
Emergency Numbers Posted by Phones
Multiple Exits
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar
Door Detector(s) alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Em loyee Risk Factors Yes No
Working with the public
Work late night or early morning /
-V
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
42
3. NO Security guards in this department
4. Descri tion of the Buildin . #entrances and exits, number of employees,
access to building, security features,areas of concern related to security
5. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation performed by:
43
Town of Queensbury March 14, 20118
Evaluation of the Physical Environment:
Solid Waste--Ridge Rd.
1. Securitv Features Yes No N
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits /
Unobstructed Office Exits ✓
Door Control(s)lock, buzzer, panic bar f
Door Detector(s) alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s) V
Video Monitor(s)
Landscaping to provide f
unobstructed view of workplace ✓
Limiting signs on windows
Other
2. Employee Risk Factors Yes No N A
Working with the public
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
44
3. NO Security guards in this department
4. Description of the Buiidin :#entrances and exits, number of employees,
access to building,security features, areas of concern related to security
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
45
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
-4S
1. Security Features Yes No NLA
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits q L
Unobstructed Office Exits J
Door Control(s) lock, buzzer, panic bar ✓
Door Detector(s) alarm /
Adequate lighting in and around ✓
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide /
unobstructed view of workplace ✓�
Limiting signs on windows
Other
2. Employee Risk Factors Yes No N/A
Working with the public V/
Work late night or early morning V
Exchange money with public V/
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns {,V
Any other factors that might place employees
at risk
46
3. NO Security guards in this department ,
A ?A� C&�
4. Description of the Buildin :#entrances and exits, number of employees,
access to building, security features,areas of concern related to security
S. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
47
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Cemetery
1. Security Features Yes No N/A
Reception Area
Barriers separating clients from work area / 1�
Separate Interview Area(s) ✓
Emergency Numbers Posted by Phones
Multiple Exits
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar ✓
Door Detector(s) alarm V
Adequate lighting in and around ✓
Parking Lot well lighted V/
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Employee Risk Factors Yes No N A
Working with the public
Work late night or early morning rf
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access /
Areas of previous security concerns
Any other factors that might place employees
at risk
48
3. NO Security guards in this department W PJ(W
, .�
� y
4. Description of the Building: #entrances and exits, number of employees,
access to building, security features, areas of concern related to security
r a Pat
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed b 'T1
Y
49
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Crematorium
1. Security Features Yes No N A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones /
V
Multiple Exits J
Unobstructed Office Exits V
Door Control(s) lock, buzzer, panic bar V
Door Detector(s) alarm
Adequate lighting in and around V "
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace ✓
Limiting signs on windows
Other
2. Employee Risk Factors Yes No N A
Working with the public J
Work late night or early morning V/
Exchange money-with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
50
3. NO Security guards in this department
4. Description of the Building: #entrances and exits, number of employees,
access to building, security features,areas of concern related to security
Shy, CMkZt, :�rO-U-)
3
64t kq (-3
S. 5 eclfic Hazards: Using the information from actions 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by: AuA a,�,
r
51
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Work in public settings-e.g.Health Care,Police.
Officers,Firefighters,Social Workers _ Iz5
Work late night or earl morning hours _
Exchanste M2ne
I with the Public _
Work alone or in small numbers
Work in a location with uncontrolled public access
Areas of previous security concerns
Any other factors that might place employees at risk---
r
isk _
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Are guards posted at entrance(s)
Do thElpatrol the building __ eq
Are they provided with communication?If yes, /
kn
indicate whatjvpe in notes.
Any other relevant inforulation -
,
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1t3
TOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY. 12804-5902
Workplace Violence Risk Evaluation walk through with Sue Sheehan, President of Town of
Queensbury CSEA—the union employees group.
I, .- 6. Tl (Print name)
have walked through and reviewed the Town of Queensbury worksite:
with Sue Sheehan,president•of the Town of Queensbury's employee's union.
We have made any comments,notes,and suggestions for training employees who work in this
job site on how to handle any foreseeable workplace violence possible scenarios,on the attached
risk evaluation.
Date and tim _ _. .� 0 At(—.._...__----
Signed by:
Department Manager or Safety Officer:
w
Date:
Sue Sheehan:
Date: 3 Z
" Home of Natural Beauty ... A Good Place to Live "
i
i
54
Town of Queensbury March 14, 2418
Evaluation of the Physical Environment:
Water Admin. Bldg (SIJ +6OW
1. Security Features Yes No N/A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s) ✓�1' (riN"
Emergency Numbers Posted by Phones J
Multiple Exits UP 3 �✓
Unobstructed Office Exits W ?'' ✓ ,�(},�
Door Control(s)lock, buzzer, panic bar
Door Detector(s) alarm
Adequate lighting in and around �App V
Parking Lot well lighted ✓✓
Panic Button(s)
Video Monitor(s) ✓j�
Landscaping to provide J
unobstructed view of workplace ✓� J
Limiting signs on windows
Other
2. Em to ee Risk Factors YR s No N A
Working with the public
Work late night or early morning ✓✓
Exchange money with public Vie) VLAf
Work alone or in small numbers
Work in a location with uncontrolled r / ,7
public access 1/ V/)
Areas of previous security concerns
Any other factors that might place employees
at risk
55
I NO Security guards in this department
4. Description of the Building: #entrances and exits, number of employees,
access to building, security features, areas of concern related to security
r+' ��3 *W sA
"6
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section S.
Evaluation Performed by: 4(�I
56
Town of Queensbury March 14, 2015
Evaluation of the Physical Environment:
Water Plant
1. Security Features Yes No N A
Reception Area
Barriers separating clients from work area ✓
Separate Interview Area(s) V/
Emergency Numbers Posted by Phones
Multiple Exits W1 11T I
Unobstructed Office Exits
Door Control(s)lock,buzzer, panic bar
Door Detector(s) alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s) f
Video Monitor(s)
Landscaping to provide /
unobstructed view of workplace V/
Limiting signs on windows
Other
2. Em to ee Risk Factors Yes No N A
Working with the public V
Work late night or early morning V
Exchange money with public l
Work alone or in small numbers
Work in a location with uncontrolled
public access g
Areas of previous security concerns PUID C
Any other factors that might place employees LAI([U)_J
at risk
57
3. NO Security guards in this department
4. Description of the Buildin :#entrances and exits, number of employees,
access to building, security features, areas of concern related to security
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section S.
Evaluation Performed by:
i
58
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
Water Distribution
1. SecuritvFeatures Yes N N A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s) /
Emergency Numbers Posted by Phones
Multiple Exits to
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar
Door Detector(s) alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitors)
Landscaping to provide V
unobstructed view of workplace
Limiting signs on windows
Other
2. Em to ee Risk Factors Yes No ALA-
Working
AWorking with the public
Work late night or early morningQ
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access l
Areas of previous security concerns
Any other factors that might place employees
at risk
59
3. NO Security guards in this department
4. Descri flan of the Buildin #entrances and exits, number of employees,
access to building,security features,areas of concern related to security
S. S ecific Hazards; Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
60
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
Wastewater Department
1. Security Features Yes No NIA
Reception Area
Barriers separating clients from work area J
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar
Door Detector(s) alarm /
Adequate lighting in and around
Parking Lot well lighted /
Panic Button(s)
Video Monitor(s) ✓
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Em to ee Risk Factors Yes No NIA
Working with the public
Work late night or early morning
Exchange money with public V
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
61
3. NO Security guards in this department
4. Description of the Build.inK. #entrances and exits, number of employees,
access to building, security features, areas of concern related to security
S. Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
62
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Gurney Lane
1. Security Features Ye No N A
Reception Area
Barriers separating clients from work area V
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar
Door Detector(s)alarm /
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s) V/
Video Monitor(s)
Landscaping to provide /
unobstructed view of workplace
Limiting signs on windows
Other C u^ c a "VA4
2. Employee Risk Factors Ye No —
WA-Working with the public
Work late night or early morning
Exchange money with public
Work alone or in small numbers f
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
63
3. NO Security guards in this department
4. Description of the Building: #entrances and exits, number of employees,
access to building, security features, areas of concern related to security
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
G"
Swum tlu SSS pA MY J j S
'IV
stag ?ktAe
3 Pat)/
Evaluation Performed by:
`1 G 1 12
64
1 `
(INSERT EMPLOYER`AME]
APPENDIX 2-B [I\SER?DATE)
Sam a Evaluation o_f the Physical Environment
Location: "r - - e-Cr -
Person(s)conducting the evaluation:
Date of assessment:
This section requires the participation of the authorized employee representative(s).
Instntctions:All sections below refer to present conditions.Cheri;"NA"for any items you do not consider applicable to the
%vorksitelfacilite being evaluated.Using the information from Sections 1-3 and<<otu workiug lato«ledge of the building describe in
Section 4 the building i.e.number of stories.number of entrances and exits.nuiuber of employees.access to the building,security
features.areas of concern related to security.Using tine infomnation from Sections 14 list the specific hazards related to this
evalttatiouu hiec ionn
- - - -
xrVM
1.Securi Features - __ 'Notes/Comments
Reception Area Available - -
Barriers to Se anile Clients from Work:area - -
Separate Lttemiew Area(s) - - N
Enrersenev Numbers Posted b_ v Phones
�o
;Multiple Exits -
Unobsuvcted Office Exits -
Door Controls)i.e.locks.remote buzzer.panic
bars
Door Detector(s)door alarm -
Ades unite lighline in and around the work _irate
Parkina lot well li_ah_ted
Panic Button(s)
Video A•ionitor(s)
Landscaping to provide unobstnncted view of the _
workplace
Lituitin,the 72stina of sieurs on windows - -
Other: -
s
[I`SERT EMPLOYER 1 1IEj
x.Factors That Mght Place Employees at Risk -
Work in public settings-e.g.Health Care.Police
Otficels.Firefighters.Social'Workers
NYork late night or early monuins hours
Exchange money with the Public -- - --
'l'lsork alone or in snxall numbers
Work in a location with uncontrolled public access -
Arens of previous security concerns
Any other factors that inight place employees at risk-
3.
isk3.Security Guards
Are security au"Irds present at the location _ -
Axe guards posted at entrance(s)
Do they Introl the buildiue
Are they provided with couununicatioiP If tits.
indicate Mint m-1v in notes.
Any other relevant information
4.Description of the Bulldiug:Using the infibu-p-ti s Irk"'—:S+ertioris:1= aivl Bilge of.tIie biuilding descn'lae in.
Sectiou 4 the building(nutuber of entrances and exits,number ofemployees,access to the building,security features:areas of concern
related to secure
0 . 'Rete
IMSERT EMPLOYER NAME]
e
S.Specific Hoards:Usitaa the informalion from Scitions 1-4 list the specift hazards reloted to this evaltmtion in Section S.
� v
67
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Jenkinsville
1. Security Features Yes No. N LA
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits ✓
Unobstructed Office Exits i/
Door Control(s) lock, buzzer, panic bar
Door Detector(s) alarm ✓
T Adequate lighting in and around
Parking Lot well lighted
Panic Button(s) ✓
Video Monitor(s) ✓
Landscaping to provide /
unobstructed view of workplace
Limiting signs on windows
Other
2. Employee Risk Factors Yes No N A
Working with the public CmO 11 ( +%A-
Work late night or early morning
Exchange money with public / f
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
68
3. NO Security guards in this department
4. Description of the Buildin :#entrances and exits, number of employees,
4
access to buildin , security features, areas of concern related to security
S. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section S.
Evaluation Performed by:
69
(INSERT L•N•IPLOYER N NME]
APPEIDII?-B m _ 11-INSERT DATE]
- Sale Evaluatio of the Physical Environment
Location:_ - ' -
Person(s)conducting the evaluation:
Date of assessment: (2
This section requires the participation of the authorized employee representative(s).
Instructions:all sections below refer to present conditions.Check for arty items you do not consider applicable to the
%vorksite/facility being evaluated.Using the information from Sections I and your worldttg 15ron'ledste of the building describe in
Section 4 lite building i.e.uttntber of stories.munber of entrances and exits.number of employees.access to the building.security.
features.areas of concern related to sectwity.Using the inforuiatiou from Sections 1-4 list the specific hazards related to this
evaltL111011 iir Section 5-
1.Securi ;Features _ Notes/Comments
Reception Area Available - -
Banters to Se tnrnte Clients from Work Area -
- O
Separrte hrten-iew area(s) r-
Emergency Numbers Posted by Phones -
Multiple Exits
Unobstructed Office Exits
Door Coutrol(s)i.e.locks.remote buzzer.panic
bars
Door Delector(s)door alarm
Adequate li_tditin,in and around the worklace
Parking lot well lighted -
Panic Btuton(s) `
Video\Ionilor(s) -
Landscaping to provide unobstructed view of the_ -
n'orkplace
Limitine the postin_of signs on windows -
Other: - - - - -
bGr-e
&A*d - �.
(INSERT EMPLOYER
2:Fitctors That Might Place Employees at Risk - -
Work in public settings-e.g.Health Care.Police
Officers.Firi figtets.Social'Workers
Work late night or early morning hours
-50
Exchange money with the Public
Work alone or in small munbeis
wort,in a location with uncontrolled public access -
Aieas of previous security concerns
any other factors that iuight place employees at risk
3.Secur1t).•Guards - - -
.Axe security guards present at the location
.Aj•e guards posted at entrance(s) -
Do they Patrol the building
Are they provided with eomumu nicatiom'?If yes.
t`
indicate what tti a in notes.
Any other relevant information Q
fv
.1 t
4.Description of the Building:Using the utformation frons Sections 1-3 and your workingknoxWedge of the building describe in
Section 4 the building(number of entrances and exits,number of employees,access to the building,security features,areas of concern
related to secu rit .
- 1
(INSERT EINIPLOITR ti.1 MEj
S.S cclflc Hazards:Using The infoMMlion from Seclioas 141ist.ihe s ific hazards related to tlds evaluation in Section S.
72
Town of Queensbury
Workplace Violence Prevention Program
Adopted April 2, 2018
Table of Contents
Page No.
Introduction 1
Purpose 1
Statement of Program 2
Scope of Program 2
Application of Program 2
Training 2
Reporting of Violence 3
Workplace Risk Evaluation 4
Introduction 4
Risk Evaluation and Methods to Prevent Incidents 4
Hierarchy of Controls 4
Program Review Plan 4
Appendix "A" 5
Workplace Violence Prevention Policy Statement 5
Appendix `B" 6
Workplace Violence Incident Report 6
Appendix "C" 7
Explain Risk Factors and Protection Measures from
Workplace Assessment 7
Clerical g
Public Officials 9
Appendix "D"
Site Specific Assessment and Hazards 10-72
i
Overview
Workplace Violence Prevention Program
Introduction
Workplace violence presents a serious occupational safety hazard for workers. On June
7, 2006,New York State enacted legislation that requires the Town of Queensbury to
perform a risk evaluation of its workplaces and develop and implement programs to
prevent and minimize workplace assaults and homicides. The Town of Queensbury
along with the authorized union representatives, were given the opportunity and assisted
in the development of this program, the evaluation of the physical and environmental
threats which they face, and the annual review of the workplace violence program. The
Town of Queensbury has adopted a Workplace Violence Prevention Policy Statement
which is attached hereto as Appendix"A."
Purpose
The purpose of the Workplace Violence Prevention Program is to provide information to
managers, supervisors, and employees about preventing and responding to incidents of
workplace violence or threats of violence and the "New York State Public Employer
Workplace Violence Prevention Law"contained in Section 27-b of the New York State
Labor Law.
The goals of the program are:
1. To reduce the probability of threats or acts of violence in the workplace, and
2. To ensure that any incident, complaint, or report of violence is taken seriously
and dealt with in a timely manner.
The Town of Queensbury will not tolerate violence in the workplace. All incidents,
complaints, and or reports of violence and threats of violence, will be taken seriously
because the Town of Queensbury is committed to providing its employees with a
reasonably safe and secure work environment. The Town of Queensbury's Workplace
Violence Prevention Policy Statement will be conspicuously posted in each location as
well as on the Intranet to advise all employees where they may report violations.
1
The purpose of this program is to address the issue of potential workplace violence,
prevent workplace violence from occurring to the fullest extent possible, and set forth
procedures to be followed when such violence has occurred.
Statement of Program
Violence and threats of violence in the workplace will not be tolerated by the Town of
Queensbury. Examples of workplace violence can include oral or written statements,
gestures, or expressions that communicate a direct or indirect physical threat of harm.
Such behavior will be taken seriously and will be dealt with appropriately.
Scope of Program
All the Town of Queensbury employees are required to comply with this program. In
addition, since visitors of the Town of Queensbury owned property and facilities are
required to conduct themselves in a non-violent manner in conformity with existing law,
employees who observe or experience visitors of the Town of Queensbury property
engaging in violent behavior should follow the procedures in our policy for the reporting
such behavior.
Application of Program
Violence and other physical disruptive behavior by or against an employee of the Town
of Queensbury are unacceptable. Individuals who commit such acts may be removed
from the premises and may be subject to appropriate disciplinary action, including, where
legally appropriate,termination of employment and or criminal penalties.
Training
All employees will be informed of the requirements of the law,the risk factors in their
workplace, and the location of the written workplace violence prevention program.
Training is also required for employees on the measures they can take to protect
themselves from the risks identified in the assessment and the details of the written
workplace violence prevention program. Employee workplace violence training is to be
provided annually.
2
Reporting of Violence
An effective reporting system: (1) protects the Town of Queensbury's employees from
harm in the workplace; (2) assists management in its effort to maintain a safe and
productive work environment; and(3) ensures management the opportunity to investigate
and determine the cause(s) and make recommendations to minimize recurrence. All
workplace violence incident reports must be in writing.
Any employee who witnesses or encounters any act of violence should:
• Complete and submit the"Workplace Violence Incident Report'attached
hereto as Appendix`B" and is available on the intranet or with their
Department Manager. The Town of Queensbury will take necessary
action. Any employee who believes that an imminent danger exists should
bring the matter to the Town of Queensbury's immediate attention.
• Immediately notify his/her supervisor and/or HR, as appropriate
• As appropriate, notify building security
• As appropriate, call 911
Supervisors/managers should approach such situations with caution, balancing the need
to maintain an orderly workplace with personal safety. Following notification, if the
Town of Queensbury's management has been given reasonable time to take corrective
action and no such action has been taken,the employee or his or her representative may
inform the Commissioner of Labor of the danger and request that an inspection be
conducted. Such request must be in writing and include with a reasonable level of
specificity the grounds of the notice.
The Town of Queensbury is prohibited by law from taking any retaliatory action against
any employee who: (1)has made the Town of Queensbury management aware of what the
employee deems to be an imminent danger; (2) has requested that the Commissioner of
Labor conduct an inspection; or (3) accompanies the Commissioner during an inspection
of the Agencies,pursuant to §27-b.6 of Article 2 of the State Labor Law.
12 NYCRR Part 800.6(g)(2)(viii) Note: Nothing in this part shall require the disclosure
of information otherwise kept confidential for security reasons. Such information may
include information which, if disclosed:
• Would interfere with law enforcement investigations or judicial proceedings;
• Would deprive a person of a right to a fair trial or impartial adjudication;
• Would identify a confidential source or disclose confidential information relating
to a criminal investigation;
• Would reveal criminal investigative techniques or procedures, except routine
techniques and procedures; or
• Would endanger the life or safety of any person.
3
Workplace Risk Evaluation
Introduction
Certain factors or situations may place employees at a greater risk of workplace violence.
This workplace evaluation is based upon surveys of all of the Town of Queensbury's
facilities conducted by Town of Queensbury representatives and authorized employee
representatives.
Risk Evaluation and Methods to Prevent Incidents
Workplace violence can occur in any workplace setting. However, some settings or
factors may pose a greater degree of workplace violence risk. Employment situations or
factors that may pose higher risks for the Town of Queensbury employees include, but
not limited to:
• Working public settings
• Working alone in small numbers
• Having a mobile workplace assignment, and
• Worker on worker workplace violence
Records Examination and Risk Evaluations were also conducted and the methods and
means by which the hazards are being addressed are listed in the document"Explain Risk
Factors and Protective Measure from Workplace Assessment attached hereto as
Appendix"C"."All Town of Queensbury sites were surveyed along with authorized
employee representatives and hazards are identified in`Explain Risk Factors and
Protective Measure from Workplace Assessment."
Hierarchy of Controls
A hierarchy of controls to which the program shall adhere as follows: engineering
controls, work practice controls, and finally personal protective equipment.
Program Review Plan
The Town of Queensbury has a plan for program review and update on at least an annual
basis. Such review and update shall set forth any mitigating steps taken in response to any
incident of workplace violence. The review will also include the participation of the
authorized employee representative(s).
4
APPENDIX"A"
Workplace Violence Prevention Policy Statement
The Town of Queensbury is committed to the safety and security of our employees.
Workplace violence presents a serious occupational safety hazard to our agency, staff,
and clients. Threats,threatening behavior, or acts of violence against the Town of
Queensbury's employees where any work related duty is performed will be thoroughly
investigated and appropriate action will be taken, including summoning criminal justice
authorities when warranted. All employees are responsible for helping to create an
environment of mutual respect for each other as well as clients, following all policies,
procedures and program requirements, and for assisting in maintaining a safe and secure
work environment.
This policy is designed to meet the requirements of NYS Labor Law 27b and highlights
some of the elements that are found within our Workplace Violence Prevention Program.
The process involved in complying with this law included a workplace evaluation that
was designed to identify the workplace violence hazards our employees could be exposed
to. Authorized Employee Representative(s)will, at a minimum, be involved in:
• The evaluation of the physical environment;
• The development of the Workplace Violence Prevention Program and;
• The review of workplace violence incident reports at least annually to identify
trends in the types of incidents in the workplace and review of the effectiveness of
the mitigating actions taken.
All employees will participate in the annual Workplace Violence Prevention Training
Program.
The goal of this policy is to promote the safety and well-being of all people in our
workplace. All incidents of violence or threatening behavior will be responded to
immediately upon notification.
All Town of Queensbury personnel are responsible for notifying the contact person
designated below of any violent incidents, threatening behavior, including threats they
have witnessed, received, or have been told that another person has witnessed or
received.
First Contact Person:
Direct Department Supervisor
Second Contact Person:
Town Supervisor's office®Executive Assistant or Town Supervisor
5
APPENDIX"B"
Workplace Violence Incident Report
1. Date of Incident
2. Time of day/shift when the incident occurred ............
3. Workplace Location where incident occurred
4. Provide a detailed description of the incident including:
Events leading up to the incident and how the incident ended;
Names and job title of involved employee(s);
Name or other identifier of other individuals involved;
Nature and extent of injuries arising from the incident and;
Name of witnesses
Name of Employee Reporting the Incident(Optional)
Note: Refer to 12 NYCRR Part 800.6 Section(i)(3)(ii)for special instruction on privacy
concern cases.
Print additional sheets if necessary.
Date
6
APPENDIX"C"
Explain Risk Factors and Protection Measures from Workplace
Assessment
Maintenance/Recycling
A. Working in remote work assignments-
Employees will work hours assigned by their supervisor and will notify
supervisor of any needed change in work schedule. Employees should be are
of closest phone or radio for 911 calls
B. Dealing with irritated people outside of fellow staff
Employees are to keep calm and not escalate the situation and walk away from
irate individuals and call 911 if necessary
C. Employee internal disputes
• Employees will be instructed that screaming, yelling, cursing, make derogatory
remarks about each other is unacceptable behavior in the work place®
• Internal arguing and yelling will not be tolerated. Employees need to walk away
and exit the area immediately then report incident to their Supervisor, If you
cannot exit you need to take appropriate action to get away. If there has been
a threat of workplace violence, fill out an incident report.
D. Employee External disputes
• Employees will be instructed that this is unacceptable behavior in the work
place.
• Arguing and yelling with residents or individuals from the outside will not be
tolerated. Employees need to walk away and exit the area immediately then
report incident to their Supervisor. If there has been a threat of workplace
violence, fill out an incident report.
Field Service Personnel
it Marshal, Code Enforcement, Appraiser)
A. Dealing with irate people inthe field
0 See Above
B. Dealing with irate people int office/counter
• See Above
• Activate panic buttons if available
• Notify direct or appropriate supervisor
• Notify others in the building if warranted
• Limit public access to public areas only
C. Conflict via phone
• Do not escalate situation and speak calmly
• Take notes
• Notify direct or appropriate supervisor.
7
Clerical
A. Dealing with irritated people at windows or open counters, including handling
of cash. Residents access open offices
• Employees will be instructed on when to call 911 and to make others in the
building aware of an emergency.
• The public will be kept out of offices whenever practical
• Alternate persons will make cash bank deposits at different times of day.
• Employees will be trained on keeping calm if an irate person confronts them.
Employees will not get into vocal confrontations with the public. Such
behavior is unacceptable. Employees should notify and involve their
supervisor and let them handle it if warranted.
B. Irate people attending court, board meetings and public hearings
• Instructions will be given on use of the panic button in the meeting room,the
building intercom as well where there is a phone available to dial 911 will be
given during training.
• Officials and the public will be advised of emergency exits at the beginning of
all public meetings.
C. Working alone in the building
• Employees will work hours that have been assigned by their supervisor and
will notify their supervisor of any needed change in work schedule.
Employees should be aware of closest phone for 911 calls
D. Employee internal disputes
• Employees will be instructed that this is unacceptable behavior in the work
place.
Internal arguing and yelling will not be tolerated. Employees need to walk
away and exit the area immediately then report incident to their Supervisor.
If there has been a threat of workplace violence,fill out an incident report
8
Public Officials
Irate people attending court, board meetings and public hearings
• Officials and the public will be advised of emergency exits at the beginning of
all public meetings.
• Instructions will be given on use of the panic button in the meeting room,
where there is a phone available to dial 911 will be given during training.
• Elected and appointed officials will be trained on the proper conduct for
officials at public meetings. Officials will not get into vocal confrontations
with the public or each other
• Court bailiffs will be present for court nights and metal detectors used to
screen all attending court. The rear door of court room (by restrooms) will
be locked so court attendees cannot enter once exiting that door
Employee internal disputes
• Employees will be instructed that yelling and fighting is unacceptable
behavior in the work place. Internal arguing and yelling will not be tolerated.
Employees need to walk away and exit the area immediately then report
incident to their Supervisor. If there has been a threat of workplace violence,
fill out an incident report.
EMPLOYEE TRAINING
Employees will be trained about the physical risks at their respective places of
employment with regard to workplace violence by their Department Head and/or
supervisor. See Appendix D for physical hazards.
9
APPENDIX "D"
This is the name of each building evaluated, followed by the names of the
persons performing the evaluation, a physical description of each building
evaluated and the specific hazards identified during this evaluation.
Senior Center: Chuck Rice and Susan Sheehan
This is a two-story building with the downstairs (basement) containing
storage and a wood shop used by the employees of buildings and grounds.
The building is very busy daily with programs for seniors. There are no
areas of previous security concerns with these activities. The biggest
concem is the employee from buildings and grounds who is alone in this
building in the evenings for cleaning., This will be a recurring theme for shift
workers and a "panic" button to be worn on their person seems a
reasonable solution.
Town Board meeting every other Monday may at some time present a
security concem if there are any contentious issues. There are no safety
officers staffed for these potential occurrences.
TOWN OFFICE CAMPUS BUILDING: Two story building housing multiple
departments. Seven entrances to building and many windows.
Security/safety breakdowns are below for each department.
Supervisor's Office: Chuck Rice and Susan Sheehan
This area contains the receptionist area for the administrative assistant and
the supervisor's office. The main safety/security concern in this area is a
visit from a disgruntled member of the public. There are panic-buttons and
paths of egress for the Supervisor, but not for the administrative assistant.
Accounting Department: Chuck Rice and Susan Sheehan
This department has stellar security in place. No concerns here.
10
Department of Parks and Recreation: Chuck Rice and Susan Sheehan
Though there is an adequate barrier to the public in the reception atrium,
the Clerk from Parks and Recreation has been tasked with greeting all
persons who enter the atrium to visit the office building. They should be
equipped with a panic button for emergency calls for help.
Assessor's Office: Chuck Rice and Susan Sheehan
This office should NOT have open counter space. If there is a need to
interview a taxpayer (for an assessment review, for example) they should
take them into the Supervisor's conference room or be provided with a
separate interview area. There is no protection from disgruntled persons
and the employee present during this assessment says they are not
uncommon. A barrier should be provided that protects the employee from
any type of potential assault.
Town Clerk's Office: Chuck Rice and Susan Sheehan
The only time that persons other than employees need to be behind the
counter is for FOIL requests. The glass barrier separating the employees
of this office from the public is not bulletproof. It is essentially useless.
Zoning and Buildings and Codes: Chuck Rice and Susan Sheehan
This department is extremely secure. No potential problems identified.
Buildings and Grounds: Chuck Rice and Susan Sheehan
Though the offices for this department are downstairs in the Town Office
Building, there are many satellite locations where the employees of this
department also go to perform their assigned tasks, including: Town Court,
State Police Barracks, Banner at Quaker and Bay, Aviation Rd. Welcome
sign, roundabout Aviation and Dixon, Queensbury EDC Dix Avenue, Bus
11
stop Media Drive, Sunnyside Historical and maintain kiosk at Main Street.
This work is largely outside and there is minimal interaction with the public.
Highway Department and Historian: Mike Palmer and Susan Sheehan
This assessment is for the administrative section of the Highway
Department and the Historian's office. The camera that covers the lobby
needs to have an angle change or there needs to be another camera
installed. If the visitor rings the bell and proceeds to the door they are
obscured from the camera angle by the hallway. This was the only
concern.
Highway Department Garage: Mike Palmer and Susan Sheehan
The Highway Department is slated to be refurbished and/or replaced. The
areas of concern will most likely be addressed by having this done. It
would be wise to note them here though. The Parts Shop is a cave. There
is one path of egress and anyone can enter. This is dangerous for multiple
reasons. In an active shooter situation, any employee (s) in this location
would have to run towards the gunfire to escape. There should be another
path of egress for this area. The next issue is the tight quarters for so large
a number of employees that work LONG hours. The past incidence of
workplace violence that the union has been made aware of in this
department were worker on worker incidence. They need a LARGER more
modern break area with more space to spread out and get away from
others if they choose. Training on diffusing difficult situations is also called
for and sexual harassment is imperative given the outstanding investigation
into charges that all witnesses and the accused stated: "That's the
environment here." UNACCEPTABLE
Solid Waste (Ridge Rd. & Luzerne Rd.): Mike Palmer and Susan
Sheehan
The only risk to employees here (as disposing of one's trash doesn't in and
of itself cause too much stress) are not in any imminent danger from the
public. This can be re-evaluated annually.
12
Town Court: Mike Palmer and Susan Sheehan
The courts (like the accounting department) is very secure and there are
two security guards during court on Monday evenings. They are trained
and armed. The employees had no issues with security. I would
recommend perhaps one more panic button at a desk-. There is one in the
courtroom and one at the front window.
Cemetery: Michelle Hatin and Susan Sheehan
The cemetery is a fairly secure environment. Warren County Sheriffs patrol
intermittently and the only area of some concern is that the receptionist and
Cemetery Superintendent have only one path of egress and would be
trapped in any time of concern.
Crematorium: Michelle Hatin and Susan Sheehan
The crematorium is secure.
Water Department Administrative Building: Mike Palmer and Susan
Sheehan
The doors have locks and bars but are not always secured after hours
providing entry to anyone. The reception desk downstairs has no barrier to
the public and no panic button. Further, if confronted with a disgruntled
individual, there is no way for the person to get out. They are trapped and
there is no panic button. Each office downstairs should be armed with
panic buttons.
Water Treatment Plant: Mike Palmer and Susan Sheehan
This is a non-secure facility in which there are often employees working
alone throughout the night. There needs to be a different entry system for
this facility and better protocol for outside contractors working after hours.
Many times, the operator on duty is not even informed that there may be
others in the facility after hours. Beside better security for the doors, the
13
employee on duty alone after hours should be armed with a panic device to
summon assistance for emergencies.
Water Distribution: Mike Palmer and Susan Sheehan
Multiple exits. The prior report of violence here was employee on
employee(s), As with the highway department, training in diffusing
situations with difficult people would be warranted.
Wastewater Department: Mike Palmer and Susan Sheehan
No areas of concern here.
Gurney Lane: Steve Lovering and Susan Sheehan
Gurney Lane has not suffered any areas of safety concerns since doing
away with the evening free swim. There is a supervisory employee there or
available at all times to handle any issues that may arise with the public.
Jenkensville Park: Steve Lovering and Susan Sheehan
No areas of previous concern here. Plenty of exits from all buildings.
Security (tag) system for entering the building should be applied to Water
Treatment Plant.
14
Dept.Of parks&Rec.
Senior Center is is ofNOfice AccounS NO ting �
X
NO N/A YE k X X
DEPARTMENT'- YES
X X
Security tr X X X X x X
Receprlon Aresarea X XX X
rrt rs separating cit t fr r X X
Separate Interview are X X X
Emergency t4umbers posted by PhonesX X X
Multiple psi X X X
UnobstructedOfficeits s� doors/not X11 X X
anis r X X
buzzer, X X
Door Or�tls lick: X
Door Detector alarm(s) X X X
run X x
I
Adequate lighting X X in
parking lot wellli kited
Panic Button s x
Vides Monitor s3Brie X
�ri Unobstructed r
Landscaping rnX
X
of workplace
La s X
iting signs on X X
X X X
1 Wisk FactOrs X X X X
public X
Arkin With t �rric� X X X
Work latenightOr early X
r With thetic X X
Eche nr� X
X
Work alone or
in Ali X
raii�d
irk in location''With canc X
X
public access con rns
Areas OPrevioussecuritymight place
Any other factors that
employeesat risk
Town Counsel Assessor's Office Town Clerk's Office Codes and Zoning
YES NO N/A YES NO N/A YES NO N/A YES NO N/A
X X X X
X X X X
X X X except FOILS X
X X X X
X X(shared door) X X
X X X X
X X X X
X X X X
X X X X
X X X X
? X X X
X X X X
X X X X
X X X X
X X X X
X X X X
X X X X
X X X X
X X X X
X
? X X X
DEPARTMENT: Buildings and Grounds Highway Admin/Hist. Highway Garage Luz Rd.Solid Waste
Security Features Yes No N/A Yes No N/A Yes No N/A Yes No N/A
Reception Area X X X X
Barriers separating clients for work area X X X X
Separate Interview area X X X X
Emergency Numbers posted by phones X X X X
Multiple Exits X X X X
Unobstructed Office Exits X X X X
Door Control(s) lock, buzzer,panic bar X X X X
Door Detector alarm(s) X X X X
Adequate lighting in and around X X X X
Parking lot well lighted X X X X
Panic Button(s) X X X X
Video Monitor(s) X X X X
Landscaping to provide unobstructed view X X X X
of workplace
Limitinng signs on windows X X X X
Employee Risk Factors
Working with the public X X X X
Work late night or early morning X X X X
Exchange money with the public X X X X
Work alone or in small numbers X X X X
Work in a location with uncontrolled X X X X
public access
Areas of previous security concerns X emp./emp. X X X
Any other factors that might place
employees at risk
Ridge Rd.Solid Waste Courts Cemetery Crematorium
Yes No N/A Yes No N/A Yes No N/A Yes No N/A
X x x x
x x x x
X X x x
x x x x
x x x x
x x x X
x x x X
x x x x
x x x x
x x x x
x x x x
x x x x
x x x x
x x x x
x x x x
x x x x
x x x x
x x x x
x x x x
x x x x
DEPARTMENT: Wtr/W.water Admin water Plant Water Distribution Wastewater Dept.
Security Features Yes No N/A Yes No N/A Yes No N/A Yes No N/A
Reception Area X X X X
Barriers separating client from work area X X X X
Separate Interview area Xup Xdown X X X
Emergency Numbers posted by phones X X X X
Multiple Exits X X X X
Unobstructed Office Exits Xup Xdown X X X
Door Control(s)lock,buzzer,panic bar X X X X
Door Detector alarm(s) X X X X
Adequate lighting in and around X X X X
Parking lot well lighted X X X X
Panic Button(s) X X X X
Video Monitor(s) X X X X
Landscaping to provide unobstructed X X X X
view of workplace
Limited signs on windows X X X X
Employee Risk Factors
Working with the public X X X X
Work late night or early morning X X X sometimes X sometimes
Exchange money with the public Xdown Xup X X X
Work alone or in small numbers X X X X
Work in a location with uncontrolled X X X X
public access
Areas of previous security concerns X X X X
Any other factors that might place
employees at risk
Gurney Lane Rec. Jenkinsville Rec.
Yes No N/A Yes No N/A
x x
x x
x x
x x
x x
x x
x x
x x
x x
x x
x x
x x
x x
x x N
x x
x x
x x
x x
x x
x x
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Senior Center
1. Securltv Features Ye No N A
Reception Area I/
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits
Unobstructed Office Exits V/
. Door Control(s) lock, buzzer,panic bar So'r" d05
Door Detector(s)alarm ✓
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s) /
Video Monitor(s). P�1�2 Qa ✓
Landscaping to provide WO C,(l l 63
unobstructed view of workplace /
Limiting signs on windows ✓
Other
2. Emplov,ee Risk Factors Yes No N A
Working with the public
Work late night or early morning /
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
21
I NO Security guards in this department
4. Description of the Building:#entrances and exits, number of employees,
access to building, security features, areas of concern related to security
+ loved.
- 3
5. S
eufic Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section S.
Evaluation Performed by:
22
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Supervisor's Office
1. Security Features Yes No N A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits v
Unobstructed Office Exits ✓
Door Control(s) back„ buzzer, panic bar
r�
Door Detector(s)alarm /
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Em to ee Risk Factors Yes No —ALA-
Working
AWorking with the public ✓
Work late night or early morning Vf
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns , 9)Lb�
Any other factors that might place employees
at risk
23
3. NO Security guards in this department
4. Description of the Building:#entrances and exits, number of employees,
access to building,security features, areas of concern related to security
cgL C"
S. Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
'et
a.4n
Evaluation Performed by:
677�
24
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Accounting
1. Securitv Features Yes No N A
Reception Area
Barriers separating clients from work area V
Separate Interview Area(s) 1/
Emergency Numbers Posted by Phones ✓
Multiple Exits
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar
Door Detectors alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s) rri
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Em to ee Risk Factors Yes No N A
Working with the public
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
25
3. NO Security guards in this department
4. Description of the Building: #entrances and exits, number of employees,
access to building,security features, areas of concern related to security
S. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
N"—/
Evaluation Performed by: �
jF
t
✓.+` f µ+ nM"
26
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Department of Parks and Recreation 40u." MtWL
1. Security Features Yes No N/A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones V/
Multiple Exits
Unobstructed Office Exits
Door Control(s)lock,buzzer, panic bar
Door Detector(s)alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Em to eeRisk Factors Yes No
Working with the public
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
27
3. NO Security guards In this department
4. Description of the Building:#entrances and exits, number of employees,
access to building,security features, areas of concern related to security
S. Specific Hazards.: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
:NA �Mw
Evaluation Performed by:
28
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Assessors Office
1. Security Features Yes No N
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits !66&NLd ✓'40 A&
Unobstructed Office Exits
Door Control(s)lock, buzzer,panic bar
Door Detector(s)alarm
Adequate fighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Empl!pyee Risk Factors Yes No
Working with the public
Work late night or early morning yj
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
29
3. NO Security guards in this department
4. Description of the Building.- #entrances and exits,number of employees,
access to building, security features,areas of concern related to security
S. SReclflc Hazards., Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by: J24-02
30
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Town Clerks Office
1. Security Features Yes No
Reception Area
Barriers separating clients from work area -3
Separate Interview Area
(S) 14,
Emergency Numbers Posted by Phones V/
-k< Multiple Exits
Unobstructed Office Exits
Door Control(s) lock, buzzer,panic bar
Door Detector(s) alarm
Adequate lighting In and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide V/
unobstructed view of workplace
Limiting signs on windows
Other 404-
2. Emplovee Risk Factors Yes No
Working with the public
Work late night or early morning
Exchange money with public V/
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
31
3. NO Security guards in this department
4. DescriDtion of the ggLiding.- #entrances and exits, number of employees,,
access to building, security features, areas of concern related to security
S. Specific Hazards: Using the information from Sections 1-4 list the specific
_
hazards related to this evaluation in Section S.
Evaluation Performed by:
32
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Zoning c�
1. Securltv Features Yes Na NLA
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits
Unobstructed office Exits
Door Control(s) lock, buzzer, panic bar
Door Detector(s)alarm X/
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows ✓
Other
2. Em loyee Risk Factors Yes No NLA
Working with the public
Work late night or early morning V/
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
33
3. NO Security guards in this department
4. Description of the Build
in . entrances and exits, number of employees,
access to building,,security features, areas of concern related to security
C'0
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
C,
Evaluation Performed by: 1,—CW —ae-w—A
34
[INSERT EMPLOYER NAME]
APPENDIX 24 [INSERT DATE]
Sam le Evaluation of the Physical Environment
Location.
^. - -
Person(s)conducting the evaluation:
Date of assessment:
This section requires the participation of the authorized employee representatWe(s).
Instructions:All sections below refer to present conditions.Check"DW for any items you do-not consider applicable to the
work-site/facility being evaluated.Using the information from Sections 1-3 and your working knowledge of the building describe in
Section 4 the building i.e.number of stories,number of entrances and exits,number of employees,access.to the building;security
features,areas of concern related to security.Using the information from Sections 1-4 list the specific hazards related to this
evaluation in Section S. r
Rece tion Area Available
Barriers to S -arate Clients from Work Area ,
Separate Interview Area(s)
Emerg.ency Numbers Posted b Phones
Multi le Exits _ 1 4- _
Unobstructed Office Exits
Door Controls)i.e.locks,remote buzzer,panic yv
bars -
Door Detect!?As)door alarm Z--e'
Adequate lighting in and around the worlace
Parking lot well lighted x
Panic Button s) -
Video Monitor(s)
Landscaping to provide unobstructed view of the
workplace•
Limiting the- sting of signs on windows : ;
Other: - - -
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Buildings and Grounds
1. Securltv Features Yes No N A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones l
Multiple Exits ►/
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar
Door Detector(s) alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s) ✓
Video Monitor(s) CbW4"T1 �11 �
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Em to ee Risk Factors Yes No N A
Working with the public l
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns /
Any other factors that might place employees 6
at risk
36
3. NO Security guards in this department
4. Description of the Buildin : #entrances and exits,number of employees,
access to building,security features, areas of concern related to security_
647o-m
S. Specific Hazards: Using the information from Sections 141Mhe specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
37
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:.
l ��p Highway Department 4-
1. Security Features Ye No N A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s) /
Emergency NumbF
erssPosted by Phones
Multiple Exits
Unobstructed Office Exits 7 PA L&
Door Control(s) lock, buzzer, panic bar 1/ (rfovt ( )
Door Detector(s) alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Employee Risk Factors Yes No ------NLA
Working with the public
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled /
public access ti/
Areas of previous security concerns
Any other factors that might place employees
at risk
38
3. NO Security guards in this department
4. Description of the Buildin #entrances and exits, number of employees,
access to building,security features,areas of concern related to security
S. Specific Hazards. Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section S.
Evaluation Performed by:
39
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
Highway Department Go�
1. Sec Features Yes No
��UfltY NLk-
Receptin Area
Barriers separating clients from work area
Separate Interview Area(s) V/
Emergency Numbers Posted by Phones V/
.Multiple Exits-q4�- q-ff- -
Unobstructed Office EXL+--") V/
Door Control(s) lock, buzzer® p nic bar V/
Door Detector(s)alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. EmploVee Risk Factors Yes No N/A
Working with the public
Work late night or early morning
Exchange one with public
Work alone or insmall numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns 6t vxv�'
Any other factors that might place employees
at risk
40
3. NO Security guards in this department
4. Description of the Building: #entrances and exits, number of employees,
access to building, security features, areas of concern related to security
S. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
41
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
Solid Waste—Luzerne Rd.
1. Securitv Features Yes No
Reception Area
Barriers separating clients from work area
Separate interview Area(sj
Emergency Numbers Posted by Phones
Multiple Exits
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar Cl
Door Detector(s) alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace ),V
Limiting signs on windows
Other
2. EM loyee Risk Factors Yes No N/A
Working with the public
Work late night or early morning -V/
Exchange money with public
Work alone or In small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
42
3. NO Security guards in this department
4. Description of the Buildin #entrances and exits, number of employees,
access to building, security features, areas of concern related to security
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
43
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
Solid Waste—Ridge Rd.
1. Security Features Yes No N
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar
Door Detector(s) alarm
Adequate lighting in and around
Parking Lot well lighted ✓
Panic Button(s) V
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace ✓j
Limiting signs on windows
Other
2. Employee Risk Factors Yes No N A
Working with the public
Work late night or early morning ,r
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
44
I NO Security guards in this department
4. Description of the auildine:#entrances and exits, number of employees,
access to building, security features, areas of concern related to security
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
45
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
'S
1. Securitv Features Yes No N A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits q G
Unobstructed Office lExits
_ J
Door Control(s) lock, buzzer, panic bar ✓
Door Detector(s) alarm /
Adequate lighting in and around ✓
Parking Lot well lighted
Panic Button(s) U � �
Video Monitor(s)
Landscaping to provide /
unobstructed view of workplace
Limiting signs on windows
Other
2. Em to ee Risk Factors Yes No N/A
Working with the public
Work late night or early morning V/ V/
Exchange money with public
Work alone or in small numbers /
Work in a location with uncontrolled v/
public access
Areas of previous security concerns LkCM '1r�QJ`1tY
Any other factors that might place employees W
at risk
a
46
3. NO Security guards in this department w
a �"4 06A4'-1 cel�
4. Description of the Building: #entrances and exits, number of employees,
access to building, security features,areas of concern related to security
S. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by: 14'.0i2 jk&h OA/�
47
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Cemetery
1. Security Features Yes No N/A
Reception Area
Barriers separating clients from work area V/
Separate Interview Area(s) ✓/
Emergency Numbers Posted by Phones
Multiple Exits ✓ °
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar
Door Detector(s)alarm V
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s)
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Em �lo ee Risk factors Yes No N/A
Working with the public
Work late night or early morning r✓
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access /
Areas of previous security concerns
Any other factors that might place employees
at risk
48
3. Na Security guards in this department 41AA* 0(w
4. Description of the Buildin : #entrances and exits, number of employees,
access to building, security features, areas of concern related to security
(W po
5. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
a, Pa� "v
Performed b : ----� --
Evaluation Y .----�
49
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Crematorium
1. Security Features Yes No N A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s) f/
Emergency Numbers Posted by Phones /
Multiple Exits
Unobstructed Office Exits V
Door Control(s) lock, buzzer, panic bar V
Door Detector(s) alarm
Adequate lighting in and around V, !
Parking Lot well lighted
Panic Button(s)
Video Monitor(s) V
Landscaping to provide
unobstructed view of workplace
Limiting signs on windows
Other
2. Em to ee Risk Factors Yes No N A
Working with the public
Work late night or early morning V
Exchange money-with public V
Work alone or in small numbers rf
Work in a location with uncontrolled
public access V
Areas of previous security concerns
Any other factors that might place employees
at risk
50
3. N8 Security guards in this department
4. Description of the Buildin : #entrances and exits, number of employees,
access to building, security features, areas of concern related to security
5. S ecific Hazards: Using the information from ections 1-4 list the specific
hazards related to this evaluation in Section S.
Evaluation Performed by:
51
9NSER•T EMPLOYER NAVE]
2'=!:Fajst st `ate° r e - MIN-R �.
. � :r.'^pr
SlG'i�:R,-v-, t£' {
s`
Work in public settings-e.g.Health Care,Police,
Officers,Firefighters.Social Workers ��--_ .. 3 _ _• _
Work late night or earl morning hours -
Exchange money with the Public
Work alone or in small numbers -
Work in a location with uncontrolled public access
Areas of previous security concerns
Any other factors that night place employees at risk
'Ly !•xr'�'- 9:q:.. .ryV�.�v�:' -ter r`yj, - - - _ - - - - - - €,_- ,�:.ri Tj"+f+.,.1"'{<:..
=3:;;��'cur;�.{`yxuGu�� c •= ' ' i�, i"':, x Fyt-s::".!a::��4•-:�i�,-.w
...,k .z.�a�=cP'p•a:,�ar;.v�x'_t:s:1.� �nc�'�,-=�r�:u:Gi���:^.";::�.ia•:}c�mr.,.�=< - - - - - - -- s�.:.,. •, t:'-�'' -
Are-security guards present at the location
.Are dards posted at entrance(s)
Do they€ trol the bWldinsz
Are they provided with communication?If yes,
indicate what t e in notes.
Any other relevant information
.��
,;.• f `�•�':�`. din `c�escn"lie�ii���:=�:,;.
�
4' 'D'-cY 'tiPi oi��q�itl�; iiildm�� {,•. w, ;_,„ ..
- � .��'� .+.(•".�. .u:.7�•.,�_ ark _ i'^
ec
h r�is
•'�:. o}s�,-.r��
°re
lated
A�CeoO �
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M
Vi
TOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY. 12804-5902
Workplace Violence Risk Evaluation walk through with Sue Sheehan, President of Town of
Queensbury CSEA—the union employees group.
1, i Y'(� ............._ --(Print name)
have walked through and reviewed the Town of Queensbury worksite:
with Sue Sheehan,president-of the Town of Queensbury's employee's union.
We have made any comments,notes,and suggestions for training employees who work in this
job site on how to handle any foreseeable workplace violence possible scenarios, on the attached
risk evaluation.
Date and tim
Signed by:
Department Manager or Safety Officer:
w
Date: A
Sue Sheehan:
�.. � Date:
i
"Horne of Natural Beauty ... A Good Place to Live "
r
54
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
Water Admin. Bldg I,t *DOt 1
1. Security Features Yes No N A
Reception Area /V//
Barriers separating clients from work area /.,n ✓I��
Separate Interview Area(s) ✓v 1' 0 "
Emergency Numbers Posted by Phones J
Multiple Exits tkP 3 ✓✓ /
Unobstructed Office Exits W tA Z ✓ ✓ f�,�
Door Control(s) lock, buzzer, panic bar ✓ Cvl W lS SV)j J
Door Detector(s) alarm ldxlc�
Adequate lighting in and around Jdp►' '
Parking Lot well lighted V/V/ 'a
Panic Button(s)
Video Monitor(s) ✓j�
Landscaping to provide J
unobstructed view of workplace l
Limiting signs on windows ✓✓
Other
2. Employee Risk Factors YR s No N A
Working with the public
Work late night or early morning V/
Exchange money with public � � \/Ltf
Work alone or in small numbers
Work in a location with uncontrolled /
public access V/ V/)
Areas of previous security concerns
Any other factors that might place employees
at risk
55
I NO Security guards in this department
4. Description of the Building: #entrances and exits, number of employees,
access to building, security features, areasofconcern related to security
� �r
3 -�D t�u.�` fit, C n CL R-�
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
..
Evaluation Performed by: �
56
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
Water Plant
1. Securitv Features Yes No N A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones V/
Multiple Exits Wt4f I
Unobstructed Office Exits
Door Control(s)lock, buzzer, panic bar
Door Detector(s) alarm
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s) f
Video Monitor(s)
Landscaping to provide f
unobstructed view of workplace V/
Limiting signs on windows
Other
2. Em lovee Risk Factors Yes No ----hVA
Working with the public
Work late night or early morning
Exchange money with public l
Work alone or In small numbers ✓
Work in a location with uncontrolled
public access
Areas of previous security concerns jOJ11u Q� '�`� p (lG 1
Any other factors that might place employees
at risk �a� .Q►�I '-'"`����"-"'
()A
57
3. NO Security guards in this department
4. Descri tion of the Buildin : #entrances and exits, number of employees,
access to building,security features, areas of concern related to security
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
58
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
Water Distribution
1. Security Features Yes N NLA
Reception Area
Barriers separating clients from work area
Separate Interview Area(s) /
Emergency Numbers Posted by Phones ✓
Multiple Exits to
Unobstructed Office Exits /
Door Control(s)lock, buzzer, panic bar V
Door Detector(s) alarm V
Adequate lighting in and around
Parking Lot well lighted
Panic Button(s)
Video Monitor(s) )
Landscaping to provide V
unobstructed view of workplace
Limiting signs on windows
Other
2. Em to ee Risk Factors Yes No N/A
Working with the public
Work late night or early morning �Q
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access l
Areas of previous security concerns �J
Any other factors that might place employees
at risk
59
3. NO Security guards in this department
4. Description of the Building:#entrances and exits, number of employees,
access to building, security features, areas of concern related to security
5. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section S.
Evaluation Performed by:
60
Town of Queensbury March 14, 2018
Evaluation of the Physical Environment:
Wastewater Department
1. Securltv Features Yes No N/A
Reception Area
Barriers separating clients from work area J
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits
Unobstructed Office Exits
Door Control(s)lock, buzzer, panic bar VJ/
Door Detector(s) alarm /
Adequate lighting in and around V
Parking Lot well lighted J
Panic Button(s) ✓
Video Monitor(s) ✓
Landscaping to provide ?r
unobstructed view of workplace
Limiting signs on windows
Other
2. Employee Risk Factors Yes No NIA
Working with the public
Work late night or early morning �we- ►^'�°
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
61
3. NO Security guards in this department
4. Description of theBuildin #entrances and exits, number of employees,
access to building, security features, areas of concern related to security
5. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by: G(1�
62
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Gurney Lane
1. Security Features Yes No N A
Reception Area
Barriers separating clients from work area
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits J
Unobstructed Office Exits
Door Control(s) lock, buzzer, panic bar
Door Detector(s)alarm
Adequate lighting in and around
Parking Lot well lighted ✓
Panic Button(s) V/
Video Monitor(s)
Landscaping to provide /
unobstructed view of workplace
Limiting signs on windows ✓
Other G�c;P u^ "w46
2. Employee Risk Factors Yes No NLA
Working with the public
Work late night or early morning
Exchange money with public
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns
Any other factors that might place employees
at risk
63
3. NO Security guards in this department
4. Description of the Building: #entrances and exits, number of employees,
access to building, security features, areas of concern related to security
I s4tyj
S. S ecific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
S(aunti (R-5 S res 12- Sc l v ur-► - ta. �~
�S
)' L S Yl
3 Poo I Ow
Evaluation Performed by: r)
64
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gyp' '' .srlvotiot►°S �C.�" the
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I�ocr1'tp° copdrrttin¢t� on oft dtuo"s- rp s'ectrous its.nut" list the sPe u�
perSop�S,�ss $, WX s the gA�rclgLet to prese1lt Colo iot fro sum Aird es Sectiosis I tiD
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hrs section Ya 11 sectio -luated•Uswio� 'pupba rlre it oru te nts
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IMSERT EMPLOYER.N%LAIE]
e
5.S ecillc Hazards:Usin the inforntation from Seetiotts 1-41iss the ecific hazards reiAted to this evaitation in Seclion S.
1 !
67
Town of Queensbury March 12, 2018
Evaluation of the Physical Environment:
Jenkinsville
1. Security Features Yes No N/A
Reception Area
Barriers separating clients from work area V
Separate Interview Area(s)
Emergency Numbers Posted by Phones
Multiple Exits ✓
Unobstructed Office Exits V
' Door Control(s) lock, buzzer, panic bar
�/ Door Detector(s) alarm
�., Adequate lighting in and around
p� Parking Lot well lighted
Panic Button(s) V/
Video Monitor(s) ✓
Landscaping to provide /
unobstructed view of workplace V/
Limiting signs on windows
Other
2. Employee Risk Factors Yes No N A
Working with the public (mrJ aI ran' '
Work late night or early morning
Exchange money with public /
Work alone or in small numbers
Work in a location with uncontrolled
public access
Areas of previous security concerns y
Any other factors that might place employees V/
at risk
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3. NO Security guards in this department
4. Description of the Buildin :#entrances and exits, number of employees,
4
access to building, security features, areas of concern related to security
"K1`"__ _ ' t 1
fl, .1- ��) 3 6uw -14
S. Specific Hazards: Using the information from Sections 1-4 list the specific
hazards related to this evaluation in Section 5.
Evaluation Performed by:
Y
69
e ,
(INSERT L•1IPLO1'ER\�,�IE)
APPS\DIS 2-B [INSERT DATE]
- Sample Evnluatio of the Phvsical Environment _
Location: r.
Person(s)conducting the evaluation: Ala
Date of assessment:
This section requires the participation of the authorized employee representative(s).
hrstnlctious:All sections below refer to present conditions_Check"2MV for any items you do not consider applicable to the
worksite/facility being evaluated.Using the information from Sections I and gout working knowledge of the building describe in
Section a the building i.e.number of stories.number of entrances and exits.number of employees.access to the building.security-
features.
ecuritfeatures.areas of concern related to security.Using the information from Sections 14 list the specific hazards related to this
ev.,tltr�lioll in Section 5
L Sec ri 'Features - Notes/Comments
Reception Aren Available
Miners to Separnte Clients from Work Area
- D
-separate hill iew Area(s) - r
Enrereencv Numbers Posted by Phones
Multiple Exits
Unobstructed Office Exits - -
Door Control(s)i.e.locks.remote buzzer.panic
bars
Door Dete_etor(s)door alarm
Adequate lining in and around the work lace
Parking lot well lighted
Panic Buttons)
'Video Monilor(s) -
Landscaping to provide unobstructed view of the
workplace _
Limiting theMosRiue of signs on windows '
Other: - - -
I OCK-eA
Cid pct .
1�`ees,at gtsk
hat
olit P�sce EwP
T � �,Itlt Ca re•Police �-
�,g�ictat"s �e.g.
ubuc settiu_ ` corkers
N1rott in P 1ers.Sock'►1 ltoius
of�cets.Fireftah warner
1�rork lute Ill- or earl the tblie
F aulle ntottez'With Pt
i alone or in swan ountbets ublic access
tivitli utIcoutrollea P =� t-
�vot'k!it a lacation�eLtr. coucerus
retiiotts
Qttt�h„ce esnPtoyees at ris1:
areas of N that tui_
affil other tactors
Guards cation
3_Security as Present at the to
sae security guar
et"Mas Posted at etitrance(s)
:ate` the buil&
patrol uuiicatioti'It yes. he;w
too titer %viih coutn ttildaag�scn ent
tlie}1�ro\=idea a of the1� of cone
sae t dotes. �otvledg feanres.areas
indicate tivltat t1 a is Cation and yattr�var8 . tng�sectrity
then rele�out in[orn gections 13 file btalcy
=5►►"° the
to er nttation of etz:Ptory* s,access to
uilditig�'Oslo?Q_ and eats'nu
d,Des fjou of the nttntbes of eutrauceS �
tiou 4 the buildwg
ielatecl to secttn f-oue-I VYN
. s
J11SER7 EMPLOYERNAME)
5_S pec1RcMmrds:Usjup the information from Sections 1-41ist.the specific hazards related to This evaluntion in Section 5.
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