CEHS Program Assessment

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Center for Environmental Health and Safety Program Assessment

This assessment is intended for those who have regular health and safety correspondence with the Center for Environmental Health and Safety (CEHS) and would like to participate in a detailed program assessment. If you have comments about a particular experience with CEHS, please use our customer service feedback form. Please check each CEHS program area you have contacted in the past year. For those areas you have contacted, rate your level of satisfaction with their services (using the following key):

1 - Very Dissatisfied

2 - dissatisfied

3 - Satisfied

4 - Very Satisfied

Did you contact?	CEHS Program Area	Satisfaction Level
	Accident Investigation	1	2	3	4
	Asbestos/Lead Consultation	1	2	3	4
	Biosafety	1	2	3	4
	Chemical Exposure Monitoring	1	2	3	4
	Environmental Programs (air, soil, water pollution control)	1	2	3	4
	Ergonomics	1	2	3	4
	Hearing Conservation	1	2	3	4
	Hazardous Materials (including Chemical Inventory)	1	2	3	4
	Hazardous Waste (chemical, radioactive, etc.)	1	2	3	4
	Indoor Air Quality	1	2	3	4
	Radiation Safety	1	2	3	4
	Respiratory Protection	1	2	3	4
	Lab Safety Consultation	1	2	3	4
	Office Safety Consultation	1	2	3	4
	Shop Safety Consultation	1	2	3	4
	Training Specify:	1	2	3	4
	Other Specify:	1	2	3	4

Please rate your agreement with the following statements (using the following key):

1 - Strongly Disagree 2 - Disagree 3 - Agree 4 - Strongly Agree

CEHS is: Agreement Level

Understanding of my departmental needs and requirements 1 2 3 4

Accessible to me via phone 1 2 3 4

Accessible to me via voice mail 1 2 3 4

Accessible to me via e-mail 1 2 3 4

Responsive within an acceptable time 1 2 3 4

Effective in providing advice/guidance 1 2 3 4

Effective in providing support 1 2 3 4

Effective in providing problem faciliation and resolution 1 2 3 4

Effective in providing accurate, up-to-date information 1 2 3 4

Professional 1 2 3 4

Knowledgeable 1 2 3 4

Courteous 1 2 3 4

Helpful 1 2 3 4

Overall Satisfaction 1 2 3 4

Suggestions for Improvement:

General Campus Awareness:

To be filled out by all survey respondants: Yes No

I understand my rights, roles and responsibilities regarding health and safety requirements.

Campus requirements are simple and easy to understand.

Quality training is readily available for campus requirements.

I am familiar with my department's IIPP (Injury Illness Prevention Program)

I have been made aware of workplace hazards

I know what a Material Safety Data Sheet (MSDS) is

I know how to access an MSDS

I know what to do when a regulatory agency inspector arrives on-site

I know what to do before, during and after a serious injury

I know what to do before, during and after an earthquake

I know what to do before, during and after a fire

I know where the closest fire extinguisher is

I know how to use the fire extinguisher

To be filled out by Hazardous Material Users only:

I know how to access other hazardous materials information

I know how to properly manage hazardous waste

I know how to dispose of hazardous waste properly

I know what to do in the case of a spill of hazardous material

I know what to do if I am contaminated with a hazardous material

I am familiar with my site specific laboratory CHP (Chemical Hygiene Plan)

I know how to safely work with the hazardous materials

Tell us about yourself

What is your Vice-Chancellor Area:
Administration
Academic Affairs
Student Affairs
Institutional Advancement
N/A (i.e. President's Office)

What best describes your title:
Department Safety Coordinator
Lab Manager
Manager
Principal Investigator
Other

How often do you contact CEHS:

What do you feel is the primary function of CEHS:
Service
Regulation of the campus
Record Keeping
Technical Consultation
Other