LAC 28:CXXXIII.2501. Worksheet Instructions

A. Use this worksheet as a guide to conduct a survey of the instructional facility. Answer each of the listed questions by circling the answer that applies to the condition at the facility. "Y" indicates "Yes," "N" indicates "No," and "N/A" indicates "Not Applicable." If any of the questions are answered "N" for "No," it is the sign of a condition that may indicate a possible hazard. For every "N" marked, write a brief description of the deficient condition observed in the space provided at the end of the worksheet.