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<br />. <br /> <br />. . <br /> <br />JP;'... <br /> <br />.....<1 <br />- <br /> <br />~F-- <br />..,....~.'~~~ <br />~...../''ir <br /> <br />EXHIBIT "D" <br />SCHOOL CROSSING GUARD CERTIFICATION 2002-2003 <br /> <br />oyee Name <br /> <br />Dept <br /> <br />---- <br /> <br />Intersection <br /> <br />~ ONLY ONE SCORE FOR EACH SECTION OF THE EV ALVA nON <br /> <br />:TION I - Uniform <br />-ve the Crossing Guard in uniform at the site: <br /> <br />3uard is using regulation stop sign, is wearing Company issued vest and hat, has <br />.ppropriate shoes, is neat, clean and has an overall professional appearance, score------------------------ 20 <br /> <br />3uard is using all Company issued items, is wearing appropriate shoes, <br />,ut does NOT have a neat, clean, professional appearance,. score _______._________n______________________ 10 <br /> <br />3uard is NOT using one or more Company issued items oris not wearing appropriate shoes, score -------. 5 <br /> <br />:TlON II - Securing the Intersection <br />-ve the Crossing Guard in the act of crossing pedestrians: <br /> <br />3uard gives clear instructions to pedestrians to wait on curb until called, <br />J look both ways before stepping from curb, AND successfully holds all pedestrians <br />) curb until intersection is secured, score ________n______________________________n-u---------------. 40 <br /> <br />~ITHER Guard gives clear instructions but pedestrians do not wait OR pedestrians wait without guard <br />jving clear instructions, score___ _________n_________ ____________ _n___n__ _n____________________.___. 20 <br /> <br />,}uard fails to give instruction and does not hold pedestrians to curb until intersection is secured, score - - - 0 <br /> <br />" <br /> <br />~TlON III - Safety Agility Assessment <br />I is required to walk at a rate of four (4) feet per second. (Supervisor to use computation card) <br /> <br />:num allowed Safety Agility Score for this intersection _ Score obtained by Guard - <br /> <br />If Guard's score is lower than maximum allowed, score ___________~_________________________________ 40 <br /> <br />If Guard's score is higher than maximum allowed, score ____________n______________________________. 0 <br /> <br />Passing Score is 65 points TOTAL SCORE EARNED 0 <br /> <br />, <br />'reviewed the above information with my Supervisor and understand .that if I have not earned a passing score <br />will be re-evaluated and must earn a passing score at that time or be subject to termination. <br /> <br />Date <br /> <br />nployee Signature <br /> <br />Date <br /> <br />ISSUEDo 3.(l3 <br /> <br />.ea Supervisor Signature <br />