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Worksite Learning
Foster High School Worksite Learning
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Business Street Address
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City, ZIP Code
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Overview of Worksite Learning: The Tukwila School District Worksite Learning program provides an opportunity for students to take the skills and knowledge they have gained in the classroom and apply them as an employee at a worksite.
Understood
Review WSL Training Agreement: The Worksite Learning program is a partnership between employers, schools, students and parents/guardians.
Understood
Review of WSL Learning Plan/Evaluation: The Employer, WSL Coordinator and the student all participate in the Learning Plan/Evaluation process.
Understood
Review documentation requirements for student hours: Student work hours will be documented with a WSL Student Work Hours form (requires employer signature).
Understood
New Employee Orientation requirements
Orientation must address: •
L&I employment standards for minors (
www.lni.wa.gov
) •
On-the-job orientation specific to student’s initial job duties/tasks •
Employer’s worksite safety and health program •
How/when to report on-the-job injuries, including location of first-aid materials •
How to report unsafe conditions and practices •
Emergency procedures •
Identification of hazardous materials – procedures to follow •
Sexual harassment and discrimination training, including reporting procedures•
Use and care of personal protective equipment (PPE)
Understood
Occupational Health and Safety
Required Personal Safety Equipment
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Yes
No
N/A
Accident Prevention Program
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Yes
No
N/A
Worksite Insurance
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Yes
No
N/A
Safety Data Sheets (SDS) as required WAC 296-901-14014
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Yes
No
N/A
Health and Safety Checks(i.e. worksite, WISHA, OSHA, Dept. of Health, Fire Dept., etc.)
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Yes
No
N/A
Variance ApplicationsWAC 296-125-030 (Equipment related)
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Yes
No
N/A
This worksite complies with all health and safety requirements listed above. (These can be found in WAC 296-125, WAC 296-131, and WAC 180-50-315).
Confirmed
Master Business License: A minor work permit is required if students under 18 are employed.
Confirmed
Must adhere to Fair Labor Standards Act
Confirmed
Comments
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Employer's Name
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Employer's Title
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By typing your name here, you reaffirm that the contents of this form are true and complete to the best of your knowledge and ability.
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Tukwila School District Career & Technical Education ♦ 4242 S 144th Street ♦ 206 901 7907 ♦
www.tukwilaschools.org
WSL-0 ♦ Rev 9/2015
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