Appendix A
Program Evaluation Instrument
Please use the printable format when administering this instrument.
This evaluation will assist the office of Safety, Risk Management and Information Security in assessing the effectiveness of the training elements of the Respiratory Protection Program.
- Why is a respirator needed for your job or process?
- Why will improper fit, usage, or maintenance compromise the effectiveness of the respirator?
- What are the limitations and capabilities of your respirator?
- What should you do if there is an emergency situation regarding your respirator?
- What should you do if your respirator malfunctions?
- What are the critical steps necessary when putting your respirator on?
- What are the critical steps when removing your respirator?
- What are the critical elements involved in inspecting your respirator prior to use?
- What is the proper method for storing your respirator?
- Describe the maintenance routine for evaluating the effectiveness of your respirator?
- List some of the medical signs and symptoms that could prevent effective use of your respirator.
- Answer the following questions either True (T) or False (F).
- Wearing a beard will not affect the fit factor of a tight fitting respirator.
- Tight fitting negative air purifying respirators can be used in oxygen deficient atmospheres.
- I may bring any respirator I choose from home to use on the job.
- All respirators must be certified by OSHA.