HCOE Workplace Violence Prevention Plan Survey
Please complete this form about workplace safety at HCOE.
What is your current classification?
*
Please Select
Certificated Teacher
Classified Paraprofessional
Classified Staff (non-paraprofessional)
Certificated Management
Classified Management
Confidential
What is your main worksite?
*
Please Select
HCOE Franklin Main Campus
Eureka Community School ERC
Garberville Community School
Eel River Community School
Von Humboldt Court School
Northcoast Children’s Services Preschool Arcata
Winzler Children’s Center
HCOE E Street
Harrison Site
SELPA Office
Glen Paul School
Arcata Elementary
Fortuna Junior Academy
Fortuna High School
Lafayette Elementary
Linnell K. Walker Elementary
Peninsula school
McKinleyville High School
McKinleyville Middle School
How long have you been in your current position
*
0-3 Years
4-9 Years
10-15 Years
16+ Years
What is Your Gender
*
Female
Male
Transgender
Nonbinary/Non-conforming
Prefer Not to State
What is Your Age Group?
18-25
26-35
36-45
46-55
56-65
66+
Who do you interact with on a daily basis?
Almost No Interaction
A Small Amount of Interaction
Some Interaction
Interaction All Day
Students
Staff
Parents
General Public
Do you believe there is adequate lighting in the parking/outside area of your worksite?
*
Yes
No
If you answered no to the above, please explain.
Have you experienced verbal abuse or the threat of physical violence while employed with us?
*
Yes
No
If so, how many times in the past two years?
Please Select
1
2
3
4
5
6
7
8+
Who was the aggressor in relationship to you?
Please Select
Parent
Colleague
Student
Community Member
Have you experienced physical violence while employed with us?
*
Yes
No
If so, how many times in the past two years?
Please Select
1
2
3
4
5
6
7
8+
Who was the aggressor in relationship to you?
Please Select
Parent
Colleague
Student
Community Member
Are you aware of any incidents of workplace violence involving others in your workplace or other sites?
*
Yes
No
If you answered yes to the above, please describe.
Do you feel your school site/work area and the surrounding community are safe from violence?
*
Very Safe
Safe
Unsafe
Very Unsafe
School Site/Work Area
Surrounding Community
If you marked unsafe about your school site or work area, please describe.
If you marked unsafe about the surrounding community, please describe.
Do you feel you are trained enough to handle a workplace emergency (lock down, fire, intruder, etc.)?
*
Yes
No
What training(s) do you feel are most beneficial for staff?
*
Keenan Online Trainings
Drills Throughout the Year
Annual Simulation Drills
Mandatory In-Person Trainings
Other
Do you feel comfortable reporting workplace violence incidents or concerns to your supervisor, administration, or HR?
*
Yes
No
Do you have any additional feedback or comments not already asked on this questionnaire?
Submit
Should be Empty: