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Campsite (primary living area) 45

The purpose of this section is to enumerate major injury/

illness hazards that may be present. Inadequate drainage will be checked if it is obvious that there are large sections of the campsite that do not drain well after a hard

rain. It will also be checked if standing water is present. 46_

Close to swamp or dump. This section will be checked if

the swamp or dump is within approximately 14 mile

(1300 ft.) of the sleeping or dining areas. 47.

Loose trash or debris will be checked if the campground

has scattered trash, etc. in locations other than directly near the trash containers or the general area is covered

with trash. 48.---.

High weeds will be checked if the area around the camp

site has weeds in excess of 18 inches high. 49.

Sharp objects.
a. Structural will be checked if the sharp object is part

of a building or structure (ex: broken downspout,

broken porch floor on the end, etc.) b. Recreational equipment will be checked if the sharp

object is part of a jungle gym, tennis net assembly,

c. Maintenance equipment-self-explanatory.

d. Trash/debris (broken glass, metal, etc. 50.-

Improper trash containers. Check this section if the con

tainers are missing or uncovered or if trash is piled

around any containers present. 51.

Improperly constructed or located fire pits. Check if the

fire pit is so constructed to cause a burn injury to campers using it or a fire hazard to the area. Ex:

overhanging tree branches, high grass, etc. 52.

Unprotected wells or pits. Check if the well or pit is

covered with a wooden cover, if a concrete or metal cover is broken or cracked, or if no cover is present. Also, check this section if the pit is large and steep sided (with or without water in the bottom), unprotected farm type ponds, or if a cave entrance is present

and unprotected. 53.

Hazards, grounds or trails. Check if there are many

obvious chuck holes, above ground tree roots, etc. on or near well used trails or areas near the campsite. This

does not include adventure camp type trails. 54.

Power equipment improperly stored. This includes tractors

and motor vehicles as well as lawn mowers, etc. 55.

Hand tools improperly stored includes hand axes for use

by the campers as well as maintenance tools. 56_-

Self-explanatory. Must be in a locked area separate from

living area. 57

Self-explanatory. See question No. 56. Sport Areas 58.

Unsafe or hazardous condition. Describe any other haz

ardous condition not already mentioned.

Sleeping Facilities 59.

Structurally unsafe. Check if the sleeping area (cabins,

etc.) are obviously structurally unsafe. Ex: rotten floors, walls greatly out of plumb, broken porches, roofs with

holes, etc. 60_

Evidence of leaks. Check if the roof boards are stained

from obvious leakage, also walls and floors stained. If a cabin obviously has just been repaired and stains are

still present, then do not check. 61.-d

Space heaters. Check only if space heaters are present

and not vented, the vent pipes are broken, rusted, have holes, slope in a downward direction, have a non-AGA approved flexible connection, or no fuel shut-off valve at the heater. A rigid pipe connection is acceptable. If the heater is fueled by wood, coal, etc., check ash containers (covered metal containers) and combustible material under heater. All heaters should be at least 12 inches from combustible materials including beds.

All heaters should be solid or not easily overturned. 62

Single fire exit. Check if there is only one way out of the

cabin etc. in case of fire. Windows (openable) are acceptable if the distance from the sill to the ground is

5 feet or less. 63_

Electrical hazard. Check if bare electric wires, broken

fixtures, uncovered switches, outlets, junction boxes, etc.

are found. 64_

Other fire hazard. Check any other fire hazard not previ

ously checked. 65.

Self-explanatory. 66.

Self-explanatory. 67.

Evidence of insects or rodents. Check if insects or rodents

are seen or if signs their presence are noted. The main insects to be noted are mosquitoes, Black Widow and Brown Recluse Spiders and Scorpions (even though the last are not insects. Evidence of rats should be

checked. Ex : rub marks. 68_

Self-explanatory. 69_

Self-explanatory. Sanitary Facilities 70_72_

Self-explanatory. 73_.

Inadequate floors, curbing and drains should be checked

if there is excessive ponding of water on the floors, if the floors are cracked and/or broken and if shower

and/or other drains are non-existent or blocked. 74.-

Inadequate ventilation. Check if there is an excessive odor

in the facility or if no attempt was made to ventilate

the building. 75-

Inconvenient location. Check if facilities are more than

200 feet from sleeping areas. 76..

Cross connection. See question #29. If there is not an air

gap between the faucet and the overflow rim of the

fixture, check cross connection. 77.

Self-explanatory. Swimming Pool and Bathing Areas 78–79.

Self-explanatory. (N/A for Natural Bathing Areas.)
Inadequate filter design or maintenance. Check if gross

inadequacies are apparent or if major safety hazards are

seen. (N/A for Natural Bathing Areas.) 81.

Bottom of swimming pool or bathing area not visible. The

standard check on this question is, can a black circle 6 inches in diameter on a one foot square white background

be seen on the bottom of the bathing area. 82-84.



Kitchen Facility










See question No. 59.
In sanitary condition of kitchen area. Check if the kitchen

area is dirty in a general sort of way. This question is

designed both for equipment and structure. Self-explanatory. Unapproved food source. Check if food, including milk, does

not come from approved commercial sources. Ex: Un

Inspected meat, non-pasteurized milk. Inadequate facilities ... food temperatures. Check if the refrigerators (40°F), freezer (10°F), steam tables (140°F) do not meet temperature requirements or are

not present. Self-explanatory. Check if stored in cabinet used for other

purposes, inside food area, or in other hazardous manner. Persons with apparent communicable ... improper areas.

Check if persons in kitchen area have open sores, boils. etc. in food preparation areas and also if Food Handlers

Certificates (if State required) are not posted. Inadequate hygiene of food handler. Check if food handlers

are physically dirty or are wearing unclean clothing. This does not mean freshly soiled clothing from a task in progress or just completed, but an accumulation of

soil on the clothing from obviously past duties. Equipment improperly constructed or installed. Check if

equipment has open seams, cracks, or other imperfections which make them not easily cleanable; or if equipment

is not installed so as to be properly operated. Utensils improperly stored. Check if the cooking utensils

(pots, pans, etc.) are not stored upside down, hung from

racks, etc. Dishwashing facilities inadequate. Check if the dishwash

ing machine does not work or if the rinse water is not at least 180°F or if dishes are not washed in a three compartment sink. Pots and pans, etc, can be washed in a 2 compartment sink, but not dishes and tableware. Nonmachine dishwashing requirements for sanitation are

12 min. in 170°F water or 1 min. and 50 ppm cl. Tableware not sanitized. Check if knives, forks, spoons are

not rinsed in a sanitizing agent (ex: clorex) or in the dishwasher and/or not stored and air dried in con

tainers, handles up. Single service . . . etc. Check if single service items (one

time use cups, forks, plates, etc.) are not stored in a clean
area in their original or other approved (sanitary) con-

tainers or if they are used more than once.
Self-explanatory. See questions 16 and 76.
Accumulation of grease on stoves, filters, etc. Check if

grease is obvious on cooking surface and shows evidence

of less than regular attempts at removal. Self-explanatory. Garbage not stored in adequate . . . containers. Check if

garbage is not stored in containers not having tight fitting lids or if there is obviously not enough containers

available (ex: garbage on floor around containers). Garbage not removed from kitchen daily. Check if there is

obviously less than daily emptying of containers. Inadequate insect and rodent control. Check if rodent signs

are seen (rub marks, feces, etc.) and if an excessive

number of flies, mosquitoes, etc. are seen. Self-explanatory. Inadequate artificial light sources. Check if there are no



102-103_ 104. 105_

106_ 107




lights inside kitchen or if lights present leave many dark corners which could easily contain unseen soil or trash.


Kitchen Facility-Continued 112_

Floors not easily cleanable. Check if floors are excessively

warped, have many ridges, are worn or are covered with

broken tile, etc. 113_.

Walls and ceilings not easily cleanable. Check if the sur

faces are rough, contain many knooks, and cranies, etc.

and cannot be easily cleaned. 114_

Other improper facilities or operations. Check if items seen

do not match any other item in the form and explain

at end of section. Dining Facilities 115-118

Self-explanatory. 119.

See question No. 59. 120_

See question No. 90. 121

Utensils improperly stored. Check if silverware is stored

uncovered, with handles down, etc. Also check if any other eating utensils, condiments, etc. are stored in an

unsanitary manner. 122_

See question No. 109. 123

See question No. 110. 124.

See question No. 112. 125.

See question No. 113. 126_

See question No. 114.

Addenda to Instructions


Unsatisfactory location: The camp owned/operated water

supply is located in a hazardous location if the water source or intake is subject to flooding or drainage from sewage outfalls, privies, disposal fields or animal pens which may be uphill or upstream. The location of a water source less than 100 feet from any contamination is con

sidered unsatisfactory. 15

Unsatisfactory protection : Mark yes if there are openings

or conditions affording reasonable opportunity for con-
tamination to enter the system.
Wells : Absence of sanitary seal on casing, absence of

or broken concrete slab allowing entry of seepage.
Absence of a diversion trench to carry drainage

around if on a hillside. Springs: Absence of or faulty structural enclosure

allowing entrance of contamination. System : Pipes, tanks, reservoirs, pumps or other parts

of system which may allow entrance of contamination. Example

exposed pipe joints in pooled

water. 17

Mark yes where there are leaks in the system through which

contamination may enter. Solid Waste Disposal 39

Covered metal containers, leakproof with tight fitting

covers. 40

Landfill See Text. Incinerator—Look for incomplete burn

ing-accumulation of unburned garbage, foodwrappings or cartons.

Sleeping Facilities 66

Acid soda fire extinguishers may be considered out of date

if the inspection or recharge date is more than one year old. Other extinguisher types under pressure should

reflect pressures in effective use zones. 78

Chlorine residual and pH is adequate if the log shows

consistent readings of :
Free available chlorine residual of not less than 0.4 ppm
or more than 1.00 ppm and a pH of from 7.2 to 7.8.

Free available chlorine residual of from 1.0 ppm or higher

and a pH of from 8.0 to 8.9 ppm. These levels are less

likely to be encountered than in A above. Swimming Pool and Bathing Areas 83

Showers in conventional swimming pool installation should

be located nearest the pool to assure that all bathers can

shower before entering the pool. 84

Toilets in conventional swimming pool installations should

be located convenient but located so that bathers must

pass through shower areas before entering the pool. Kitchen Facility 87

Kitchen grease fires require foam type extinguishers. 91

Use the sense of sight and smell to judge spoiled food. 92

Unapproved food source. Home canned food is also an un

approved source. 93

In addition to temperatures check for overcrowding or poor

storage practices which would allow spillage to other foods or prevent food from reaching proper internal

temperatures quickly. Poisons, detergents and other toxic compounds should be

stored in separate cabinets or areas from food or food

ingredients. 96

In addition to physically dirty persons, hands and clothing

observe for insanitary habits or behavior. Examples: Return to work without washing hands after visiting bathroom or handling obviously contaminated materials. Picking or scratching sores, pimples, nose without wash

ing hands afterward. In addition check utensil storage (tableware and kitchen

ware) for locations or levels which subject them to spillage, splash or other contamination. Examples : Subject to splash from mopping floors or spillage from food preparation and other materials.




When to Complete a Report

An injury report is to be completed each time a camper reports for treatment to the person at a camp who is responsible for such treatment. This may be a physician or nurse in larger camps or it may be a senior counselor with first aid capability in smaller camps. In a serious accident, the injured camper may be taken directly to a hospital without seeing such a camp person. A form should still be completed. The rule regarding the fact that a camper see the camp medical person is designed to eliminate the need to search out all minor scratchs and bruises; it is not to be used to avoid reporting serious cases.

1. Today's date. Use numbers for month, day, year. Example: 6/15/73 for June 15, 1973.

2. Camp name. May be abbreviated.

3. Camp ID number. Each participating camp is assigned a number to be used on all forms from that camp.

4. Camper ID number. Number your cases serially within a camp session. Start with 001 and number consecutively. (This may be done by the Field Representative when the forms are collected.)

5. Age. Report in years. Example: A camper 8 years and 8 months old is reported as 8 years.

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