School Crossing Was the full uniform being worn Yes No – Patrol Uniform full length coat fully fastened and peaked cap? How was the sign Inactive phase not ready to Green – displayed (‘x’ all cross that apply) Barrier - prevent pedestrians Green crossing Ready to cross drivers to stop Amber – Fail to stop or returning to Red pavement Return to pavement Red The school What is the condition of the Excellent sign. sign? Good ‘STOP’ ‘STOP’ (‘x’ all that apply) Poor Damaged School crossing Do you use hazard wigwags? (‘x’ Yes No patrol hazard which applies) wigwag lights Who turns them on/off? Were they working? (‘x’ which Yes No applies) Condition of lights? (‘x’ which Excellent applies) Good Poor Damaged Do you have How many of these signs? these signs displayed? What is their condition? (‘x’ which Excellent applies) Good Poor Damaged Are there any other signs or road markings that you think may be relevant (please describe) Road and Weather Rain weather Sunny conditions at time Cloudy of incident (‘x’ all Windy that apply) Fog
School Crossing Patrol Uniform Was the full uniform being worn – full length coat fully fastened and peaked cap? Yes No How was the sign displayed (‘x’ all that apply) Inactive phase – not ready to cross Green Barrier - prevent pedestrians crossing Green Ready to cross – drivers to stop Amber Fail to stop or returning to pavement Red Return to pavement Red The school ‘STOP’ sign. (‘x’ all that apply) What is the condition of the ‘STOP’ sign? Excellent Good Poor Damaged School crossing patrol hazard wigwag lights Do you use hazard wigwags? (‘x’ which applies) Yes No Who turns them on/off? Were they working? (‘x’ which applies) Yes No Condition of lights? (‘x’ which applies) Excellent Good Poor Damaged Do you have these signs displayed? How many of these signs? What is their condition? (‘x’ which applies) Excellent Good Poor Damaged Are there any other signs or road markings that you think may be relevant (please describe) Road and weather conditions at time of incident (‘x’ all that apply) Weather Rain Sunny Cloudy Windy Fog
School-Crossing-Patrol-Incident-Report.docx