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Have A Question? Contact Us At 702-799-CCSD
department avatarSafety and Insurance Services Section

Commonly Used Forms

Completed forms can be faxed to 702-799-2995 or emailed to Safety@nv.ccsd.net

Monthly Playground Safety Inspection Form

Checklist for playground safety site inspections.

Safety Concern Form CCF-305

Report a safety concern that you would like us to investigate.

Supervisor's Accident/Incident Investigation Report CCF-99

Complete after every accident involving an employee.  This will assist our office in developing procedures and training to reduce the number of injuries and help our employees work safer.

Hazard Assessment Form

Job Hazard Analysis (JHA)

You may have some hazards that may or may not require the use of (PPE) Personal Protective Equipment. In any case review the hazards found with your immediate supervisor and determine what can be done about the hazard(s).

For assistance with completing any of these forms or for general questions, please contact the Safety Office at 799-6496 or safety@nv.ccsd.net