<?xml version="1.0" encoding="UTF-8"?>
<item xmlns="http://omeka.org/schemas/omeka-xml/v5" itemId="1075" public="1" featured="0" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://omeka.org/schemas/omeka-xml/v5 http://omeka.org/schemas/omeka-xml/v5/omeka-xml-5-0.xsd" uri="https://sleepyhollow.localarchives.org/items/show/1075?output=omeka-xml" accessDate="2026-09-19T10:19:03+00:00">
  <fileContainer>
    <file fileId="1075">
      <src>https://sleepyhollow.localarchives.org/files/original/681c7b5aed8aae661889fad53b913fae.pdf</src>
      <authentication>5c1a20d01399180f0514efce7609ced7</authentication>
      <elementSetContainer>
        <elementSet elementSetId="4">
          <name>PDF Text</name>
          <description/>
          <elementContainer>
            <element elementId="52">
              <name>Text</name>
              <description/>
              <elementTextContainer>
                <elementText elementTextId="19563">
                  <text>su?
Minutes of the Board of Trustees
Village of Sleepy Hollow
A work session of the Board of Trustees of the Village of Sleepy Hollow was held on
Tuesday, November 6th, 2007 starting at 7:00 P.M. in the boardroom at Village Hall, 28
Beekman Avenue, Sleepy Hollow, New York.
Present:

I

Mayor Philip E. Zegarelli
Deputy Mayor Mario DiFelice
Sandra Morales
Andy Murray
Ken Wray
Kay Gi ala

Trustees

Also Present: Dwight H. Douglas, Village Administrator
Diane Jacobson, Village Treasurer
Sean McCarthy, Building Inspector
Mayor Zegarelli called the meeting to order at 7:00 p.m.
At 7:25 p.m. the Mayor called the Board into special session.
On a motion of Trustee Murray seconded by Trustee Grala and subject to the review, and
approval of the Mayor, the subject department heads, the trustee subcommittee chairs and
the Village Treasurer the warrant of November 6th, 2007 and any vouchers as
consolidated in said warrant were unanimously approved. Two items in the subject
warrant - payments to the MTA and Women's Training - were held over for additional
review.

I

The attached resolutions were acted upon as shown.
At 7:50 p.m. on a motion of Trustee DiFelice, seconded by Trustee Murray and carried
unanimously the special meeting was adjourned.
Respectfully submitted,
DwightrHL Douglas,
Village Administrator

I

O^

�\CA

Meeting Date:
Resolution #:

11/06/07
11/205/07

Resolution of the Mayor and Board of Trustees of the Village of Sleepy Hollow
Establishes Special Session to Review Draft Special Permit Conditions
for the Lighthouse Landing Project
BE IT RESOLVED that the Mayor and Board of Trustees herein establishes a Special Session
on Tuesday, November 13, 2007, at 7:00 p.m. to continue the review of the Draft Special
Permit Conditions for the Lighthouse Landing project. No formal action on the Special Permit is
anticipated for this meeting.

Moved: Trustee DiFelice

Seconded: Trustee Murray

Vote: Unanimous

�S^D
Meeting Date:
Resolution #:

11/06/07
11/206/07

Resolution of the Mayor and Board of Trustees of the Village of Sleepy Hollow
Confirming the December Meeting Schedule

I

NOW, THEREFORE, BE IT RESOLVED that the Mayor and Board of Trustees herein establish
the following schedule of meetings for December:
December 4

Work Session at 7 p.m.

December 11 Regular Board Meeting at 8 p.m. preceded by Work Session
a t 7 p.m.
December 18 Day of Remembrance commencing at 7 p.m. with a potential Special
Session of the Board to follow if necessary and subject to due notice.
There will be no meeting on December 25, 2007 or on January 1, 2008.
Moved: Trustee Murray

I

I

Seconded: Trustee Grala

Vote: Unanimous

�Meeting Date:
Resolution #:

11/06/07
11/207/07

Resolution of the Board of Trustees of the Village of Sleepy Hollow
Adopting Public Speaking Guidelines
WHEREAS, the Mayor and Board of Trustees are desirous to permit, obtain and foster the
fullest possible public comment on matters of concern in the Village; and
WHEREAS, in order to enable people to speak freely in a timely fashion within the time period
set aside for public discussion and comment, it is deemed prudent by the Mayor and Board of
Trustees to establish certain policies and procedures; and
WHEREAS, on occasion the public may have gone beyond what is commonly considered
appropriate and prudent comment designed to inform the Mayor and Board of Trustees to
govern effectively; and
WHEREAS, it is the Board's policy to ensure reasonable conduct and behavior is demonstrated
at the Village's Board Meetings; and
WHEREAS, the Mayor and Board of Trustees have reviewed and prepared the draft Public
Speaking Guidelines policy attached hereto and wish to adopt same and that these guidelines
shall be incorporated into the Village's by-laws to be reviewed and re-adopted as necessary at
the annual re-organizational meeting.
NOW, THEREFORE, BE I T RESOLVED that the attached Public Speaking Guidelines policy is
herein adopted; and
BE IT FURTHER RESOLVED that as noted in said policy, the Mayor and Board of Trustees
reserve the right to make necessary amendments to this policy to ensure the public at large
with the fullest opportunity to voice their opinions.

Moved: Trustee Grala

Seconded: Trustee Morales

Vote: Unanimous

�It is the official policy of the Sleepy Hollow Village Mayor and Board of Trustees to seek out and
encourage opportunities for public comment and commentary during the ordinary course of
governmental business. In balancing this desire in soliciting public comment and discussion,
there is also a need for good order in providing for the administration of good government at
official Village Board Meetings. The Mayor and Board of Trustees have adopted Robert's Rules
of Order for the conduct of business for our Board meetings. Additionally, we have
incorporated into our by-laws the following guidelines for when people wish to address the
Mayor and Board of Trustees at Official Board sessions:
1. The public is first directed to the posted agenda section indicating the first public
comment period. This comment period is provided for in the initial part of the session
and is to be limited for public comment on agenda items only. Depending on the
question and the nature of the comment, the speakers will be limited to a five (5) minute
period of time. The Mayor and Board, at their discretion, reserve the right to permit
items of special concern to the public at large to be addressed in this section on a caseby-case basis.
2. All comments or inquires will be made or addressed to the Mayor as Chair of the meeting
and be recognized by the Mayor as such.
3. Individuals wishing to address the Board will be requested to state their name, address
and the nature of the comment or inquiry. No speaker may be heard a second time until
everyone who wishes to speak has spoken a first time.
4. Upon completion of the comments or inquiries and response (if any) by the Mayor or a
Trustee, the statement shall be deemed as complete. Any additional statement can be
made after all who wish to speak have been heard. These additional statements shall be
limited to three (3)minutes.

�5. Sleepy Hollow residents and taxpayers take precedence over others in being heard at
Board meetings.
6. No speaker may yield time to any other speaker.
7. Public comment is also provided at the end of the official meeting prior to adjournment
and interested persons should refer to the published agenda. This period of time is
allocated for non-agenda items or other items of concern that the public may desire to
share with the Mayor and Board of Trustees. The same limitations noted above will be in
effect.
8. The use of profanity or abusive language and/or personal attacks or threats on Sleepy
Hollow public officials or employees is strictly prohibited. All speakers will be warned to
cease and desist. Failure to adhere to this provision will subject the speaker to forfeiture
of speaking privileges. The speaker will be asked to exit the meeting and Mayor shall
have the option of referring the matter to the police department for action.
9. Unless otherwise indicated, the provision for public comment is not provided for village
work sessions and/or special sessions of the Mayor and Board of Trustees. Public
hearings, normally a part of official meetings of the Mayor and Board of Trustees, are
separate, special purpose meetings to address the advertised purpose of the hearing.
Public comments outside of the purpose of the hearing will not be addressed or
accepted.

�Meeting Date:
Resolution #:

11/06/07
11/208/07

Resolution of the Board of Trustees of the Village of Sleepy Hollow
In Opposition to the FAA's Plan to Reroute &amp; Expand Planes Operating
In Westchester County
WHEREAS, the Federal Aviation Administration is continuing with its plan to reroute
and intensify its new Flight Plan regarding aircraft over not only the Village of Sleepy
Hollow, but also over the Counties of Westchester and Rockland; and
WHEREAS, its latest proposal to reroute planes operating at the Westchester County
Airport is still unacceptable and must be changed; and
WHEREAS, the proposed reassignment of air traffic could undo decades of hard work,
public understanding and good will and is unacceptable not only to the Village of Sleepy
Hollow, but to the Counties of Westchester and Rockland; and
WHEREAS, in the County of Westchester, and especially in the Village of Sleepy
Hollow, hundreds of thousands of people will be affected by the additional noise and
pollution if the routes are not only changed, but the attempt to expand is curtailed.
NOW, THEREFORE, BE IT RESOLVED, that the Village of Sleepy Hollow is in
complete opposition to the FAA's plan to reroute and expand planes operating in and to
the Westchester County Airport, and said attempt to reroute and expand is
unacceptable and must be changed; and it is further
RESOLVED, that efforts be directed to reduce rather than increase the level of noise
and pollution presently emanating from the traffic in and to the Westchester County
Airport; and it is further
RESOLVED, that the Federal Aviation Authority do further research in the New
York/New Jersey/Philadelphia Airspace Redesign Draft Environmental Impact Statement
issued in December, 2005, regarding the adequacy of the Noise Mitigation Report
issued by the FAA on April 6, 2007, since these documents together fail to meet the
primary purpose of the DEIS concerning the potential noise impacts and pollution on
the hundreds of thousands of interested and affected people in Westchester and the
DEIS fails to meet the requirements since its failure is not cured by the Noise Mitigation
Report, and the attempted reassignment and increase of air traffic without the legally
required level of review could undo decades of work, public understanding and good
will, and that deficiencies in the Noise Mitigation Report be addressed regarding our
community; and it is further

�_r&gt;«^-:^.S
RESOLVED, that the Mayor be authorized to contact our representatives, namely
Senators Clinton and Schumer and Congresspersons Lowey, Engel and Hall, for the
purpose of them taking action to further investigate the devastating plan and the
drastic consequences that will ensue should the FAA be permitted to proceed with its
plan that will be injurious to not only the hundreds of thousands of persons in this area,
but the noise and pollution that will be caused by their plan that will have drastic impact
for hundreds of thousands of residents and the environment in general; and it is further
RESOLVED, that copies of this Resolution be furnished to the Mayors and Supervisors
of the approximately 40 communities in this area that will be affected by the plan so
that they may take similar action being taken by the Village of Sleepy Hollow; and it is
further

I

RESOLVED, that copies of this Resolution be sent to the Federal Aviation Authority and
County Executives of the Counties of Westchester and Rockland.

Moved: Trustee Murray

Seconded: Trustee DiFelice

Vote: Unanimous

I

I

�STO. Vp
Meeting Date:
Resolution #:

11/06/07
11/209/07

Resolution of the Board of Trustees of the Village of Sleepy Hollow
Adopting the Workplace Violence Prevention' Policy
WHEREAS, Public Sector HR Consultants LLC has developed a Workplace Violence Prevention
Program which complies with the New York State Workplace Violence Prevention Act; and
WHEREAS, Public Sector HR Consultants LLC has met with the Village Administrator and
Treasurer to assist in the development of this policy; and
WHEREAS, Public Sector HR Consultants LLC has completed interviews with employees and
training sessions with Department Heads; and
WHEREAS, the developed program and policy has been reviewed and suggested amendments
made by labor counsel; and
WHEREAS, said changes have been incorporated into the attached draft.
NOW, THEREFORE, BE IT RESOLVED that the Mayor and Board of Trustees herein adopt
the annexed Workplace Violence Prevention Policy and Program.

Moved: Trustee Grala

Seconded: Trustee Morales

Vote: Unanimous

�F i n a l Copy
(10/17/07)

Village of
Sleepy Hollow

1

WORKPLACE VIOLENCE
PREVENTION PROGRAM

I
PublicSectorHR
—^CONSULTANTS LLC
Human Resource Solutions Made Simple

Prepared by:
Public Sector HR Consultants
LLC
14 Knollwood
Drive
Glen\nlle, New York 12302
Telephone:
518.399.4512
Fax: 518.384.1963

�SD.
F I N A L COPY
(10/17/07)

1

Village of
Sleepy Hollow
WORKPLACE VIOLENCE
PREVENTION PROGRAM

I
Copyright © 2007 Public

Sector

HR Consultants

LLC, Glenville,

NY

This program manual is copyrighted material and is intended only for the internal use of the
Village of Sleepy Hollow. The Village of Sleepy Hollow may copy this manual for distribution to
its employees. The contents of this manual may not be copied or reproduced in any form or by
any means for any other individual or organization without the prior written permission of Public
Sector HR Consultants LLC.

I

�"\

TABLE OF CONTENTS
SECTION 1 - INTRODUCTION

1

POLICY STATEMENT

1

OVERVIEW OF THE NEW YORK STATE WORKPLACE VIOLENCE PREVENTION ACT

2

WHAT IS WORKPLACE VIOLENCE?

2

WHAT IS A WORKPLACE VIOLENCE INCIDENT?

3

SAVINGS CLAUSE

3

SECTION 2 - EMPLOYEE AND SUPERVISORY ROLES AND RESPONSIBILTIES _4
EMPLOYEE RESPONSIBILITY

4

DEPARTMENT HEAD / SUPERVISOR RESPONSIBILITY

5

HAZARD REDUCTION TEAM

5

SECTION 4 - RESPONSE PROCEDURES

7

DURING AN INCIDENT

7

POST INCIDENT

7

DEALING WITH CONFLICT

8

DO'S AND DON'T'S FOR DEALING WITH POTENTIALLY VIOLENT INDIVIDUALS

8

SECTION 6-TRAINING AND EDUCATION
TRAINING AND EDUCATION

10
10

SECTION 7 - INCIDENT RECORDKEEPING AND REPORTING, INVESTIGATION^ 1
RECORDKEEPING

11

INCIDENT REPORTING

11

INCIDENT INVESTIGATION

12

SECTION 8-WORKPLACE RISK EVALUATION

13

EVALUATION PROCESS

13

EVALUATION OUTCOMES

14

SECTION 9 - F O R M S

39

�S~3G

SECTION 1 - INTRODUCTION
POLICY STATEMENT
The Village of Sleepy Hollow is committed to providing its employees a work
environment that is healthy, safe, secure, and free of harassment, threats, intimidation
and violence. "Violence" includes physically or emotionally harming another, fighting,
shoving, pushing, stalking, harassing, intimidating, coercing, brandishing weapons,
and threatening or talking of engaging in those activities. The Village also considers
the safety of its residents, vendors, contractors, and the general public ("visitors") to
be of paramount importance and strives to provide them the same type of protections
while on Village property.
The Village will not tolerate any acts of violence and will take all reasonable measures
to prevent violence and threats of violence and to protect employees and visitors from
acts or threats of violence. This includes but is not limited to threatening or violent
actions by:
1.
2.
3.
4.

Employees directed against other employees or Village property.
Employees directed against visitors.
Visitors directed against Village employees or Village property or facilities.
Individuals who are conducting Village business in an off-property location.

Employees are prohibited from possessing weapons of any kind while on Village
premises; in Village vehicles while conducting business for the Village; or at work
sites, at Village sponsored functions or any other location during working hours or
while representing the Village, regardless of whether the person is licensed to carry
the weapon. Weapons include but is not limited to guns, knives, explosives, and other
items with the potential to inflict harm. The only exceptions are law enforcement
personnel and security personnel. If any employee has knowledge of another
employee's possession of a weapon in the workplace, that knowledge should be
reported immediately to a supervisor or Department Head.
Any and all incidents of workplace violence must be promptly reported in accordance
with the reporting procedure outlined in Section 2 (Employee Responsibility) of this
manual.
Enforcement of this policy will be accomplished through the implementation of a
Workplace Violence Prevention Program, and by complying with the requirements of
the NYS Workplace Violence Prevention Act, as set forth in NYS Labor Law Section
27-b. A copy of the Village's Program can be obtained from the Village Manager's
office. A general review of this program will be conducted every year, upon a
workplace violent incident reported or change in operations or physical structure of
any building evaluated.
Violations of this policy will result in appropriate remedial, disciplinary, and/or legal
action, up to and including termination of employment according to the circumstances.
Village of Sleepy Hollow Final Program - 10/17/07

I

Page 1

�OVERVIEW OF THE NEW YORK STATE WORKPLACE VIOLENCE
PREVENTION ACT
Based on an increasing awareness of and in response to workplace violence in
public sector workplaces, the New York State Workplace Violence Prevention Act
was passed in 2006. The Act amended NYS Labor Law by adding a new Section
27-b requiring that all state and local government employers take steps to ensure
their employees are provided adequate protection from potential incidents of
violence in the workplace.
Among other stipulations, Section 27-b requires every public sector employer to:
1. conduct a risk assessment of their worksites to identify and address any existing
risk factors that may increase the possibility of workplace violence;
2. provide training for all employees (upon initial assignment and annually
thereafter) which informs them of the risk factors that may be present in their
workplace(s), measures they can take to protect themselves from such risks, and
the steps the employer has implemented to protect employees, such as
appropriate work practices, emergency procedures, and use of security alarms
and other devices; and
3. develop and implement a written workplace violence prevention program that
lists the risk factors and the methods the employer is using to prevent violence
and minimize or eliminate identified hazards. (Required if the employer has 20 or
more full-time employees).

WHAT IS WORKPLACE VIOLENCE?
Workplace violence includes but is not limited to any act of physical violence, threats
of physical violence, harassment, intimidation, or other threatening, disruptive
behavior that occurs in the workplace. Workplace violence can affect or involve
employees, visitors, contractors, and others.
Workplace violence incidents are generally categorized as:
•
•
•

Level I - Disruptive behavior such as verbal abuse
Level II - Aggressive or threatening behavior
Level III - Physical Assault

For purposes of this policy, the workplace is defined as any location, either
permanent or temporary, where an employee performs any work-related duty. This
includes, but is not limited to, Village-owned buildings and facilities, parking lots, and
traveling to and from work assignments.

Village of Sleepy Hollow Final Program - 10/17/07

Page 2

�3"3^

Workplace Violence may occur for a number of reasons. It may be the result of nonwork-related situations, such as domestic violence or "road rage." Workplace
violence can be inflicted by an abusive employee, a supervisor, member of the
public, family member, or even a stranger. Whatever the cause or whoever the
perpetrator, workplace violence will not be accepted or tolerated.
Workplace violence presents unique challenges for employers who are committed to
maintaining a safe and healthy workplace. During the last decade homicide was the
third leading cause of death for all workers and the leading cause of occupational
death for female workers. The majority of violent type incidents affecting workplaces
are cases of assaults, threats, domestic violence, forms of harassment and physical
and/or emotional abuse.

WHAT IS A WORKPLACE

VIOLENCE

INCIDENT?

A workplace violence incident is defined as one or more of the following according to
the NYS Department of Labor:
a. An attempt or threat, whether verbal or physical, to inflict injury upon another
person.
b. Any intentional display of force which would give a person reason to fear or
expect bodily harm.
c. Intentional and wrongful physical contact with a person without his or her
consent that entails some injury or offensive touching.
d. Harassment of a nature that would give a person reason to fear escalation or
make it difficult to pursue a normal work life or private life when the
harassment arises out of or in the course of employment.
e. Stalking a person with the intent of causing fear when such stalking has
arisen through or in the course of employment.
An incident may occur without one person actually touching or striking or doing
bodily harm to another person. Sexual Harassment by coworkers as defined in
Executive Order #19 and the New York State Human Rights Law is specifically
excluded from this definition.

SAVINGS

CLAUSE

The Village of Sleepy Hollow has made every effort to ensure that this Workplace
Violence Prevention Program complies with NYS Department of Labor regulations.
In the event any of the provisions, portions or applications of this program are found
to be contrary to or inconsistent with any superseding legal requirements by any
forum of competent jurisdiction, then the provisions, portions or applications
specified in such decision shall be of no force and effect, but the remainder of this
program shall continue to be in full force and effect.

Village of Sleepy Hollow Final Program - 10/17/07

I

'

Page 3

�SECTION 2 - EMPLOYEE AND SUPERVISORY
ROLES AND RESPONSIBILITIES

EMPLOYEE RESPONSIBILITY
It is the responsibility of every Village employee to assist and cooperate in making
our workplace as safe as possible. In order to accomplish this task, all employees
need to fully understand and adhere to the provisions of this Workplace Violence
Prevention Program.
Any employee who witnesses or is the victim of any form of workplace violence as
specified in this policy or who notices or perceives any physical condition,
procedure, or any other factor which may contribute to the potential risk of workplace
violence, should immediately report such to the employee's Department Head. If the
Department Head is a party to the violation, the report should be made to the Village
Administrator or the Treasurer. Such reports should be documented using the
Workplace Violence Incident Report Form (Form-1) or the Employee Security
Survey Form (Form-2), as appropriate. A copy of these forms are contained in this
Manual. The Department Head is required to submit all reports to the Village
Administrator.
If an employee properly refers a matter of concern as set forth above, and the
Village is given reasonable opportunity to address the matter but fails to resolve the
situation, or if the employee believes that an imminent danger exists, the employee
has the right to contact the Department of Labor, in writing, to request inspection by
the Department of the situation.
Individuals who apply for or obtain a protective or restraining order which lists
specific workplace locations as being protected areas, must provide their
Department Head and the Hazard Reduction Team a copy of the petition and
declaration used to seek the order, and a copy of any temporary or permanent
protective or restraining order that was granted..
The Village will follow
confidentiality procedures that recognize and respect the privacy of the reporting
employee.
An "Authorized Employee Representative(s)" will be given the opportunity to
contribute information, assist with analyzing statistics and conducting the workplace
risk evaluation and determination and participate in incident reviews.
No employee shall be subjected to or otherwise raising concerns, retaliation
or disciplinary action for making a good faith report of acts pursuant to this
program.

Village of Sleepy Hollow Final Program - 10/17/07

Page 4

�DEPARTMENT HEAD / SUPERVISOR RESPONSIBILITY
Department Heads and supervisors have responsibility for ensuring that these
policies and procedures are clearly communicated and understood by all employees,
as well as enforcing them in a fair and consistent manner. Department Heads and
supervisors are accountable for ensuring all aspects of this program under their area
of responsibility are properly met.
Department Heads and supervisors must carefully review and assess information
provided by employees or other sources. If a problem situation or location is
identified, appropriate precautions should be taken based on the specific situation.
Information about the problem should be communicated to the Hazard Reduction
Team for possible notification of other employees who may work in a similar/identical
situation and updates to the Workplace Violence Prevention Program.

HAZARD REDUCTION TEAM
The Hazard Reduction Team's primary responsibility is to conduct the risk
assessment. They will have the ongoing task of completing employee surveys and
building audits. Once the level of risk is determined, the team will develop risk
reduction strategies, which will then be implemented during employee training.
A Hazard Reduction Team will be established and part of their duties will be to
assess the vulnerability to workplace violence and make determinations on
preventive actions to be taken. The team will be responsible for maintaining and
monitoring the Village's overall Workplace Violence Prevention Program.
The Hazard Reduction Team will consist of:
Name
Diane Jacobson
Dwight Douglas

Title
Village Treasurer
Village Administrator

Phone Number
(914)366-5104
(914)366-5100

The team will oversee employee training programs in violence prevention and plan
for responding to acts of violence. They will communicate this plan internally to all
employees. The Hazard Reduction Team will begin its work by reviewing previous
incidents of violence at the workplace. They will analyze and review existing records
identifying patterns that may indicate causes and severity of the incidents and
identify changes necessary to correct any hazards. These records include but are
not limited to, SH-900 logs, past incident reports, medical records, insurance
records, Workers' Compensation records, police reports, accident investigations,
training records, grievances, minutes of meetings, etc.
Village of Sleepy Hollow Final Program - 10/17/07

Page 5

�Additionally, they will inspect the workplace and evaluate the work tasks of all
employees to determine the presence of hazards, conditions, operations and other
situations which might place workers at risk of occupational assault incidents.
Employees will be surveyed to identify the potential for violent incidents and to
identify or confirm the need for improved security measures. These surveys shall be
reviewed, updated and distributed as needed.

Village of Sleepy Hollow Final Program - 10/17/07

Page 6

�SECTION 4- RESPONSE PROCEDURES
DURING AN INCIDENT
If a threatening situation arises:
•
•
•
•
•

Try to remain calm.
Remove yourself from the threat as soon as possible.
Immediately call ot alert others to call appropriate help (e.g., police, supervisor,
and ambulance) to obtain immediate on-site assistance.
Refer to the Village's emergency evacuation plan for appropriate emergency
contact number.
Notify co-workers as soon as practical to enable them to also reach safety if
danger is imminent and applicable to them.

POST INCIDENT
Steps will be taken to review risks and determine whether additional security
measures are needed to mitigate a threat or violent incident. An investigation will
take place to determine what actions are appropriate to prevent a similar
occurrence. The Village will respect privacy and confidentiality rights of employees,
as feasible, during investigations.
•
•
•

•

If warranted, increased worksite protection will be provided when threats of
violence have been made, such as additional police or security patrols.
Anyone who might be affected if the threat-maker carries out his or her threat will
be given proper notification.
Increased protection will be provided to threatened employees, such as new
phone numbers, relocation, loan of a cellular phone, or a quick-response distress
button.
Counseling will be provided to potential victims about options available to them,
such as obtaining a restraining order, services through EAR.

After the occurrence of a threat or an incident of workplace violence, the Village will
maintain open lines of communication to alleviate anxiety and reduce
misinformation.
Employees will be assisted with the possible psychological consequences that may
result from a workplace violence incident. Counseling services and follow-up
treatment, as needed, will be offered to employees and their families.

Village of Sleepy Hollow Final Program - 10/17/07

Page 7

�DEALING WITH CONFLICT
There is no sure way to tell whether someone will become violent; however, there
are often warning signs before violence occurs. These warning signs do not mean
that the individual will actually become violent, but in combination, they shouid be a
cause for concern. Warning signs of potentially violent individuals:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•

Written, oral, or implied threats or intimidation
Fascination with weaponry or acts of violence
Theft or sabotage of projects or equipment
Alcohol or drug abuse in the workplace
Expressions of hopelessness or heightened anxiety
Intention to hurt self or others
Lack of concern for the safety of others
Externalization of blame
Irrational beliefs and ideas
Romantic obsession
Displays of excessive or unwarranted anger
Feelings of victimization
Inability to take criticism
New or increased sources of stress at home or work
Productivity and/or attendance problems

DO'S AND DON'T'S FOR DEALING WITH POTENTIALLY VIOLENT
INDIVIDUALS
Do's
1.
2.
3.
4.
5.
6.

Do project calmness. Move and speak slowly, quietly, and confidently.
Do listen attentively and encourage the person to talk.
Do let the speaker know that you are interested in what he or she is saying.
Do maintain a relaxed yet attentive posture.
Do acknowledge the person's feelings and indicate that you can see he is upset.
Do ask for small, specific favors such as asking the person to move to a quieter
area.
7. Do establish ground rules. State the consequences of violent or threatening
behavior.
8. Do employ delaying tactics that give the person time to calm down. For example,
offer a cup of water.
9. Do be reassuring and point out choices.
10. Do help the person break down big problems into smaller, more manageable
problems.

Village of Sleepy Hollow Final Program - 10/17/07

Page 8

�'3^
11.Do accept criticism. When a complaint might be true, use statements such as,
"You're probably right" or "It was my fault." If the criticism seems unwarranted,
ask clarifying questions.
12. Do arrange yourself so that your exit is not blocked.
1 3. Do make sure there are three to six feet between you and the other person.
Don'ts

I

1.
2.
3.
4.

Don't make sudden movements that may seem threatening.
Don't speak rapidly, raise your volume, or use an accusatory tone.
Don't reject all demands.
Don't make physical contact, jab your finger at the other person, or use long
periods of eye contact.
5. Don't pose in challenging stances: directly opposite someone, hands on hips, or
with arms crossed.
6. Don't challenge, threaten, or dare the individual. Never belittle the other person.
7. Don't criticize or act impatient.
8. Don't attempt to bargain with a threatening individual.
9. Don't try to make the situation seem less serious than it is.
10. Don't make false statements or promises you cannot keep.
11. Don't try to impart a lot of technical or complicated information when emotions
are high.
12. Don't take sides or agree with distortions.
1 3. Don't invade the individual's personal space.

I

Village of Sleepy Hollow Final Program - 10/17/07

I
1

Page 9

�SFXTION 6 - TRAINING AND EDUCATION

TRAINING AND EDUCATION
No matter what level of risk an employee is faced with, all employees are trained in
techniques for recognizing the potential for violence, cash-handling procedures,
travel safety, proper use of security hardware, and appropriate response to incidents
cf violence or emergency situations. Specific training content will be based upon the
results of the risk-evaluation process. Procedure, policies and work environment
accommodations, which were developed to control the risk to workers, as well as
procedures for reporting, investigating and documenting incidents of violence, are
included in the training. How to obtain medical assistance and follow-up are
included as well. This training will be given during regular working, hours. Time will
be set aside for questions and answers. Additional training may be warranted
before an employee starts a new job assignment, annually, or when laws or
procedures change. Specialized training is provided for department heads and
supervisors and those at higher risk.
Training for all employees, including managers and supervisors, will be repeated
every year. Workplace Violence Prevention training will be given to new employees
as part of their new employee orientation.
Training will address the following:
1. An overview of any risk factors identified during the Workplace Risk Evaluation.
2. A review and definition of the three levels of workplace violence.
3. A full explanation and full description of this program (all employees will be given
a copy of this program at the time of training or orientation).
4. Instructions on how to report all incidents, including threats and verbal abuse.
5. Methods of recognizing and responding to the three levels of violence.
6. Review of measures that have been instituted in this organization to prevent
workplace violence.
7. Use of security equipment and procedures.
8. How to attempt to diffuse hostile or threatening situations.
9. How to summon assistance in case of an emergency or hostage situation.
10. Post-incident procedures, including medical follow-up and the availability of
counseling and referral.
At the end of each training session, employees are asked to evaluate the session
and make suggestions on how to improve the training. Employees will be required
to sign a training acknowledgement form, which will be placed in the employee's
personnel folder.

Village of Sleepy Hollow Final Program - 10/17/07

Page 10

�SECTION 7 - INCIDENT RECORDKEEPING AND
REPORTING, INVESTIGATION

RECORDKEEPING
Accurate records will be maintained regarding any workplace violence incidents.
The Village will adhere to all of the requirements of 12 NYCRR Part 801, known as
the Public Employer Recordkeeping Rule, which is implemented pursuant to Section
27-a of the Labor Law, for recording of employee injuries or illnesses due to
workplace violence incidents. All incident report forms will be kept according to the
applicable retention and disposition schedules.
If an injury requires more than first aid or is a lost-time injury, it requires a record to
be made to the SH-900 log. If an injury requires modified duty or there was loss of
consciousness, a record needs to be made to the SH-900 log. Doctors' and
supervisors' reports will be kept on each recorded incident, if applicable.
Incidents of verbal attack, aggressive behavior, and abuse that is threatening to the
employee but does not result in injury, must also be recorded using the Workplace
Violence Incident Form. These records will be reviewed by the hazard reduction
team on a regular basis.

INCIDENT REPORTING
The Village will follow all federal, state and local laws and procedures in the
reporting of workplace violence incidents. Any workplace violence incident that may
be of a criminal or domestic violence nature will be immediately reported to the
appropriate police authorities or be handled in accordance with accepted operating
procedures.
Village Incident Reporting Procedures - All incidents of Level I violence must be
reported within 48 hours of occurrence. All Level II and Level II! incidents must be
reported immediately. The reporting structure is outlined in Section II (Employee
Responsibility) of this Manual. An "Incident Report Form" will be completed for all
incidents. One copy will be forwarded to the Hazard Reduction Team for their
review and a copy will be filed with the Village Administrator.
The report will include at a minimum the following information: (a) Workplace
Location, (b) Date of Incident, (c) Time of Day, (d) Incident Description, (e) Names of
involved employees, (f) Extent of Injuries, (g) Names of witnesses, and (h)
Information on preventative actions that the Village has taken or is considering as a
result of the incident to mitigate against further like occurrences. Such reports shall
Village of Sleepy Hollow Final Program - 10/17/07

Page 11

�be maintained for use when the program is reviewed and updated. The Incident
Report Form contained in this manual or the DOSH (Division of Safety and Health)
SH-900.2 form or C-2 form with the required information added may be utilized.
The Village is also required to report any workplace violence related fatalities and
multiple hospitalizations to the DOSH District Office within 8 hours of the incident.
The nearest DOSH District Office, which is located at:
White Plains District Office
120 Bloomingdale Road, Room 250, White Plains, NY 10605
Tel. (914)997-9514
Workplace violence complaints received by the Department of Labor will be
evaluated by the Division of Safety and Health using the same criteria as that utilized
by the PESH (Public Employee Safety and Health) Program. Valid complaints may
result in a worksite inspection to determine if the Village has implemented the
requirements of the Workplace Violence Prevention Act.
In the event of an
employee fatality or multiple employee hospitalizations resulting from a workplace
violence incident, the Department will conduct a worksite inspection using the same
criteria as that of the PESH Program.

INCIDENT INVESTIGA TION
Each incident will be investigated by the Hazard Reduction Team. The investigation
may take various forms, depending upon the type of incident (e.g. Threat
Assessment, Administrative, Criminal).
The team will discuss the causes of the incident and will make recommendations on
how to revise the Workplace Violence Prevention Program, if necessary, to prevent
similar incidents from occurring. All revisions of the Program will be put into writing
and made available to all employees.
After the occurrence of a workplace violence incident, the Village will consider global
(all worksites) prevention enhancements which may be necessary to properly protect
employees.

Village of Sleepy Hollow Final Program - 10/17/07

Page 12

�SECTION 8 - WORKPLACE RISK EVALUATION

EVALUATION PROCESS
As required by Section 27-b of NYS Labor Law, in February 2007 the Village
performed an evaluation of the workplace in general, and each worksite specifically,
to identify existing or potential hazards that might place employees at risk of
workplace violence. The risk evaluation process included:
•

A review of occupational injury and illness records (e.g. SH-900 and SH-900.2,
C-2 forms) and any available insurance, police, or other incident reports to
identify injuries that may have resulted from workplace violence incidents

•

An examination of the history of past incidents to identify patterns or trends which
occurred in the workplace

•

A survey of employees regarding details associated with the potential for or the
occurrence of workplace violence incidents

•

An examination of the workplace to determine existing or potential hazards that
may place employees at risk for incidents of workplace violence

In accordance with Department of Labor guidelines, the Village will perform a risk
evaluation and determination at least annually and immediately after the occurrence
of a workplace violence incident.
Participation of an Authorized Employee
Representative will be encouraged.

Village of Sleepy Hollow Final Program - 10/17/07

Page 13

�EVALUATION OUTCOMES
RECORDS REVIEW - This part of the evaluation included a review of current
policies and procedures, completed employee surveys, and interviews with select
Department Heads and employees. There were no recorded incidents of workplace
violence contained on occupational injury and illness records for 2006 (C-2 forms).
Village Hall (Includes Police, Fire, Ambulance Departments)
1. No pre-employment background checks conducted except for police.
2. Members of the public using intimidating language, aggressive and threatening
behavior towards elected officials at Village meetings and while conducting
business in departments.
3. No procedures on how to handle violent situations that occur in the workplace.
4. Employees feel that better security is needed during court sessions as case
loads are increasing.
5. No procedures or supervisory training on how to handle difficult employee
terminations that may have a potential for violence.
6. Employees, department heads, elected officials sometimes use intimidating and
aggressive behavior towards each other.
7. Threats of assault, obscene calls and stalking have occurred to elected officials.
8. Pushing and grabbing has occurred towards elected officials by residents.
9. Employees, department heads, and elected officials feel unsafe at times while
working alone.
10.Intimidating and aggressive behavior has occurred towards employees and
department heads while working off-site.
11. Recreation staff note feeling unsafe at times while working alone.
DPW (Includes parks, water/sewer, highway, sanitation)
1. No pre-employment background checks conducted.
2. Employees sometimes use inappropriate and intimidating language and
aggressive behavior towards each other, on the road and in the facility.
3. Water Department employees note feeling unsafe at times while working alone.
4. General Foreman cannot see who enters the building from his office. He is often
alone in the office. Non-employees entering the building cannot be identified .
Fire Houses (2)
No risk factors identified or communicated.
Parks
No risk factors identified or communicated.
Pump Station
No risk factors identified or communicated.

Village of Sleepy Hollow Final Program - 10/17/07

Page 14

�•srVV
INSPECTION - This part of the evaluation included an inspection of the workplace
to determine the presence of hazards, conditions, operations and situations which
might place workers at risk of occupational assault incidents.
Some of the factors considered in this inspection include the following:

I

•
•
•
•

Exchange of money with the public
Working alone or in small numbers
Working late at night or early in the morning
Working in community settings

From this inspection the following issues have been identified:
Village Hall (Includes Police, Fire, Ambulance Departments)
1. No countertop or barrier in Registrar, Building and Recreation Departments
between employees and the public.
2. No clear evacuation procedures and/or plans posted.
3. No assessment or exit interviews given at the time of an employee's separation
to determine their potential for future workplace violence.
4. Door to Clerk's office can be locked but is kept unlocked as there is high traffic in
and out of office. Unauthorized individuals have walked in making personnel feel
unsafe.
5. Panic button in Boardroom but not known if operational.
6. No metal detectors; either walk through or wand for the court.
7. No secondary exit for personnel on the top floor in the event they cannot leave
through the front door.
DPW (Includes parks, water/sewer, highway, sanitation)

I

1. Two video cameras viewing areas outside the building are not in operation.
Fire Houses (2)
No risk factors identified.
Parks
1. Signage at every park lists rules and regulations but no wording for zero
tolerance to violence.
Pump Station
No risk factors identified.

Village of Sleepy Hollow Final Program - 10/17/07

I

Page 15

�SL\
RECOMMENDATIONS - In order to reduce the risk of workplace violence., the
following measures are recommended. It must be recognized, however, that there
are no certain means by which workplace violence can be completely prevented,
that no process can wholly identify any and all conditions and risk factors that may
exist in the Village of Sleepy Hollow's workplace, and that the Village's ability to
mitigate those conditions and risk factors may be limited by fiscal and administrative
constraints.
A. Engineering Controls, Building and Work Area Design:
Village Hall (Includes Police, Fire, Ambulance Departments)
1.
2.
3.
4.
5.
6.
7.
8.

Post the Workplace Violence Prevention Policy Statement in each Department
where it is easily visible to employees and members of the public.
Install a push button lock that requires a code that can be changed regularly in
the Clerk's office.
A panic button will allow any personnel the ability to alert police that a situation
needs immediate attention. In the office of the Village Clerk, such a button
would be recommended.
Test all panic buttons once a year.
Post signs indicating nearest exits and alarms in each room.
Use a metal detector wand on individuals entering the court.
Post signs stating that "Minimal or No Cash on Premises" in Village Hall
reception area and on the front entrance door.
Provide an escape for personnel on the top floor in the event they cannot exit
through the front door.

I

DPW (Includes parks, water/sewer, highway, sanitation)
1.
2.

Install mirror so that the General Foreman can identify anyone entering the
building from his office.
Repair video cameras outside the building that are not operating.

Fire Houses (2)

I

No recommendations.
Parks
1.

Add wording to signage that the Village has a, "Zero Tolerance to Workplace
Violence".

Pump Station
No recommendations.

Village of Sleepy Hollow Final Program - 10/17/07

Page 16

I

�sMio
B. Administrative Policies and Procedures:
It is recommended that the Village develop and implement the following
administrative policies and procedures that would be applicable to ajj departments.
Conduct training on the Village's Workplace Violence Prevention Program.
This training should include:

I

•
•
•
•
•
•
•
•
•
•

Information about the Workplace Violence Prevention Act
What is Workplace Violence
The Village's commitment to Zero Tolerance of Workplace Violence
Techniques on how to recognize and avoid Workplace Violence situations
Roles and responsibilities of supervisors and employees
How to report a Workplace Violence incident and complete an incident
report
The importance of reporting all incidents
How and when incidents will be investigated by the employer
Where employees can go for assistance
Review of the Village's Workplace Violence Prevention Policy

Implement a Corrective Discipline Program, including supervisory training, so
that employees are held accountable for violations of the Workplace Violence
Prevention Program. This Corrective Discipline Program should include how to
conduct workplace investigations, when to use counseling versus formal
discipline, how to develop a counseling memo, and how to apply formal
disciplinary procedures in accordance with Civil Service Law Section 75 and
collective bargaining agreements.

I

Ensure that a comprehensive policy prohibiting all forms of workplace
harassment is in place and enforced. Provide training so that supervisors are
informed as to how to recognize and deal with workplace harassment and
employees are aware of their role in creating a harassment-free workplace.
Develop a Workplace Harassment Complaint Form and train supervisors on
how to receive and document complaints.
Train all personnel on basic conflict resolution techniques, including methods
for dealing with violent co-workers and residents, and when to call for
assistance.
Develop a pre-employment drug testing procedure and background and
reference checking program so that all candidates are thoroughly screened
prior to employment with the Village. Implement proper procedures to ensure
that such background and reference checks comply with employment
regulations. Develop necessary forms to administer this process, such as Hold
Harmless Agreements and Reference Checking Questionnaires.

Village of Sleepy Hollow Final Program - 10/17/07

1

Page 17

�7.

Develop proper procedures and provide supervisory training on terminating
employees. When dismissing an employee, make sure a third person is in the
room and perform it at the end of the day if possible.

8.

The Village should implement a policy regarding Exit Interviews upon
separation. This policy should be uniformly applied so that employees return all
keys, uniforms, ID badges, etc. This also provides the opportunity to gauge the
individual's demeanor and assess potential risks.

9.

Develop an internal procedure that employees who work alone (including
external locations) must notify their Department Head when shifts are
completed.

10.

Develop evacuation procedures and conduct periodic exercises.

11.

Post on the Village's website the Policy Statement so that employees,
residents, vendors, and visitors are made aware of the Village's position on
workplace violence.

RESULTS OF INDIVIDUAL WORKSITE EVALUATIONS - Physical inspections
were performed of each location where a Village employee performs any duties
pertaining to the employee's assigned job functions.
The results of these inspections are detailed in the following pages.

Village of Sleepy Hollow Final Program - 10/17/07

Page 18

�^&gt;

WORKPLACE RISK EVALUATION
SECURITY CHECKLIST
Facility:
Evaluation Done By:
Date of Evaluation:

Village Hall
Public Sector HR Consultants
April 17, 2007
YES

I

A. Work Area Evaluation
Are all areas being
evaluated?
B. Control measures

NO

COMMENT

X

Three floors. Includes Police, Fire and
Ambulance Departments.
'

•

:

* ' ' '

' " ' ' "

1. Engineering
.-'

/•.•'•.'

.

' • ' .

:

-

•

-

, ' • ' ; : • " . '

'

• "

•'

.•'•'

••

.-'';

•

';

'.'

X

Key entry system.

B. Panic buttons

X

The Boardroom has a panic button but it
is not known if it is operational. A panic
button in the Clerk's office is
recommended as they deal heavily with
the public.

D. Closed circuit

X
Cameras are located throughout the
facility and are viewed in the Police
Department.

X

E. Stationary metal
detector
F. Sound detection

X

G. Intrusion panel

X

H. Monitors

X

I. Video tape recorder

X

X

J. Switcher

X

K. Hand-held metal
detector

X

L. Motion detectors

X

Village of Sleepy Hollow Final Program - 70/7 7/07

1

•'

' " '

A. Door Control(s)

C. Door detectors

I

. . • . '

" ' •

There are no automatic controls set up
to turn lights on.
The Court Officer should have a wand
to detect people entering court with a
weapon.

Page 19

^/£&gt;

�Engineering
Controls
(cont.)
M. Parking lot well lit

YES

N. Interoffice phone
system used
O. Have structural
modifications been
implemented, such
as:
1. Plexiglass

X

2. Partitions

COMMENT

NO

X

:

.

•

'

•

'

'

'

.

'

'

•

'

'

'

:

'^V:'&lt;

'''-:-''::

'..-.••(

^.'y'':^^.--'-

Police Department entrance door and
front window.

X

I

X

3. Other
2. Work practice
Controls
A. Desks clear of
objects

B. Are exits kept clear
C. SH-900, 900.1,
900.2 forms
complete
D. Money kept on
premises

E. Reception area
available
F. Visitor sign in/out

Most are clear. By day's end, all files,
papers, etc., should be returned to
proper areas. Letter openers and
scissors should be kept within the desk
when not in use.

X

X
X

X

The SH-900.1 needs to be posted
between February 1 and April 30. SH900 log needs to be maintained.
No more than $500 cash should be kept
on the premises at any time. Regular
deposits are made each day. Signs
posting that minimal or no cash is kept
on premises is recommended.

X
X

G. Visitor escorted

X

H. Countertops to
separate visitors
from work areas

X

I. One entrance used

X

Village of Sleepy Hollow Final Program - 10/17/07

Due to the size of this facility, not
recommended.
Due to the size of this facility, not
recommended.
Separations help to avert complete
access to Village Personnel. The
Registrar, Recreation and Building
Departments should have a barrier such
as a countertop.
Three are used. Police, Fire and
Administrative offices
Page 20

I

�3"SO
Work Practice Controls
(cont.)
J. Separate interview
area
K. Exit interviews
performed

YES

NO

COMMENT

X

L. ID badges used

X

Should be performed to gauge
demeanor of employee and to make
sure all keys, ID badges, uniforms, etc.
are returned.
By Police Officers.

M. Emergency phone
numbers posted
N. Internal procedures
for conflict situations

X

911 system in effect.

X

0. Security Guard
usage:
1. Employed

;

2. Contracted from
agency
3. At entrances
4. Local Law
enforcement
considered
C. Floor/Evacuation Plan

Clear guidelines for different levels of
violence are recommended to deescalate aggressive behaviors.

X

, . . :

..

, • ; •

. . • . ' ; .

'

'

,

.

.

'

•

'

' ; " • ' ' • ; ,

X

Not recommended at this time.

X

Not recommended at this time.

X

Not recommended at this time.

X

,

•

:

One Office is assigned to the Court on
Mondays.

'

A. Are evacuation plans
current

X

B. Are floor plans posted
showing entrance /
exits, area of security
equipment

X

D. Training
Has training been
conducted

.

•

. " '

•

•

•

•

Village of Sleepy Hollow Final Program - 10/17/07

.

: • • '

•

•

'

" '

'

'

'

.

•

' •

'

"

.

:

'

:

'

•

'

•

•

•

Plans should be developed,
implemented and communicated to all
personnel. Once a year, a practice drill
should be performed.
A posting of the floor plan and where
the nearest exits are not only aids
Village personnel but visitors as well.
Each office, hallway, and the elevator
should be equipped with this
information.
"

X

"

',

•

•

'•

•

'

.

'

.

"

'

.

'

"

!•

All employees, supervisors, department
heads and elected officials should be
trained in risks identified at the Village
Hall, ways to report it and ways to avoid
it.

Page 21

�Training (cont.)

YES

NO

A. Prior to initial
assignment

X

B. Annually thereafter

X

COMMENT
A review of the program should be
mandatory upon the start of their
assignment.
Per the Workplace Violence Prevention
Law, annual training is required.
• , . . , . , ,

Does training include:

i

...

-, j

. , _,.

^

.... ^ ,.-

,;, j .

A. Components of
Workplace Violence
Prevention Program
B. Engineering controls

X

Each area of the program manual
should be reviewed.

X

C. Work practice controls

X

D. Techniques to use in
potentially volatile
situations
E. How to read/anticipate
behavior
F. Procedures to follow
after an incident

X

Personnel should be advised of where
and how to use safety devices.
Personnel should be trained in
procedures that lessen risk of violence.
Personnel should be given techniques
to de-escalate situations.

G. Periodic refresher for
on-site procedures

X

H. What constitutes
workplace violence

X

J. Are training records
kept

X

X
X

Village of Sleepy Hollow Final Program - 10/17/07

Training on what is violence is essential
in determining inappropriate behavior.
A clear line of communication and forms
to complete after an incident should be
included in training so no time is
wasted, evidence is preserved, and
working toward the incident not
occurring again is achieved.
The Workplace Violence Prevention Act
requires annual review, but it is
recommended that any change in
workplace, job, or upon an incident of
violence, a review of the program and
procedures takes place.
Not all forms of violence are recognized;
a thorough training of what constitutes
workplace violence is a requirement of
the WVP Act.
When training is performed, each
person involved is recorded and when it
occurred. A log is kept of this
information, as well as the outcome of
such training. This will be necessary
if/when PESH performs an audit.

Page 22

�WORKPLACE RISK EVALUATION
SECURITY CHECKLIST
Facility:
Evaluation Done By:
Date of Evaluation:

DPW
Public Sector HR Consultants
May 10, 2007
YES

A. Work Area Evaluation
Are all areas being
evaluated?

NO

COMMENT
.
The office, main garage and salt shed
are included. Parks, water/sewer,
highway and sanitation are part of the
DPW.

X

B. Control measures
1. Engineering
A. Door Control(s)

Standard key entry locks.

X

B. Panic buttons

X

C. Door detectors

X

D. Closed circuit

X

There are two camera positioned to
view the outside of the building but they
are not operational.

E. Stationary metal
detector
F. Sound detection

X

G. Intrusion panel

X

H. Monitors

X

I. Video tape recorder

X

J. Switcher

X

K. Hand-held metal
detector
L. Motion detectors

X

M. Parking lot well lit

X

The video cameras are not operational
and therefore are not recording.

X
X

Village of Sleepy Hollow Final Program - 10/17/07

No complaints of poor lighting.

~

Page 23

�Engineering Controls
(cont.)
N. Interoffice phone
system used
0 . Have structural
modifications been
implemented, such
as:
1. Plexiglass

YES

NO

COMMENT

X

'."•: '

'': '., •
:

•••

. •'"••• ^

{

'\^

: &gt;

^:'l^&amp;cy.

X
X

2. Partitions
3. Other
2. Work practice
Controls
A. Desks clear of
objects

B. Are exits kept clear

X

Most are clear. By day's end, all files,
papers, etc., should be returned to
proper areas. Letter openers and
scissors should not be kept on the desk
when not in use.
Three exits in the main office.

X

C. SH-900, 900.1,
900.2 forms
complete

X

D. Money kept on
premises
E. Reception area
available
F. Visitor sign in/out

X
X

G. Visitor escorted

X

H. Countertops to
separate visitors
from work areas
I. One entrance used
J. Separate interview
area
K. Exit interviews
performed

Village Hall should have the log of the
occupational injury and illnesses that
have occurred at this facility. It is not
available in Village Hall however.

X

Few visitors to this facility

X

Separations help to avert complete
access to Village Personnel. This
facility has few visitors so not
recommended.

X
X
X

Village of Sleepy Hollow Final Program - 10/17/07

Page 24

�s.s&lt;y
Work Practice Controls
(cont.)
L. ID badges used

I

M. Emergency phone
numbers posted
N. Internal procedures
for conflict situations
0. Security Guard
usage:
1. Employed
2. Contracted from
agency
3. At entrances

I

YES

NO

Employee's name is on their shirt along
with colors identifying them to show
which department they work in.
911 system in effect.

X

X
X

'

'

'

•

.

'

'

•

•

•

'

:

*

'

'

'

'

•

M

'

'

;

"

•

X

Not recommended at this time.

X

Not recommended at this time.

X

Not recommended at this time.

X

A. Are evacuation plans
current
B. Are floor plans posted
showing entrance /
exits, area of security
equipment
D. Training

X

Has training been
conducted

X

A. Prior to initial
assignment

X

B. Annually thereafter

X

'

'

••

" • • ' : ' •

The office is small with three exits
available.

X

Does training include:
X

Village of Sleepy Hollow Final Program - 10/17/07

I

Clear guidelines for different levels of
violence are recommended to deescalate aggressive behaviors.
'

4. Local Law
enforcement
considered
C. Floor/Evacuation Plan

A. Components of
Workplace Violence
Prevention Program

COMMENT

All employees, supervisors, department
heads and elected officials should be
trained in risks identified, ways to report
it and ways to avoid it.
A review of the program should be
mandatory upon the start of their
assignment.
Per the Workplace Violence Prevention
Law, annual training is required.
•' '
•':''.
Each area of the program manual
should be reviewed.

Page 25

�Training (cont.)

YES

NO

B. Engineering controls

X

C. Work practice controls

X

D. Techniques to use in
potentially volatile
situations
E. How to read/anticipate
behavior
F. Procedures to follow
after an incident

X

G. Periodic refresher for
on-site procedures

X

H. What constitutes
workplace violence

X

J. Are training records
kept

X

X
X

Village of Sleepy Hollow Final Program - 10/17/07

COMMENT
Personnel should be advised of where
and how to use safety devices.
Personnel should be trained in
procedures that lessen risk of violence.
Personnel should be given techniques
to de-escalate situations.
Training on what is violence is essential
in determining inappropriate behavior.
A clear line of communication and forms
to complete after an incident should be
included in training so no time is
wasted, evidence is preserved, and
working toward the incident not
occurring again is achieved.
The Workplace Violence Prevention Act
requires annual review, but it is
recommended that any change in
workplace, job, or upon an incident of
violence, a review of the program and
procedures takes place.
Not all forms of violence are recognized;
a thorough training of what constitutes
workplace violence is a requirement of
the WVP Act.
When training is performed, each
person involved is recorded and when it
occurred. A log is kept of this
information, as well as the outcome of
such training. This will be necessary
if/when PESH performs an audit.

Page 26

�3~iSG

WORKPLACE RISK EVALUATION
SECURITY CHECKLIST
Facility:
Evaluation Done By:
Date of Evaluation:

I

Fire Houses (2)
Public Sector HR Consultants
May 10, 2007
YES

A. Work Area Evaluation
Are all areas being
evaluated?

NO
X

COMMENT
There are two fire houses separate from
the main department iocated in the
Village Hall. One facility was partially
inspected closest to the Village Hall. A
full inspection was not possible however
as certain areas inside the facility
required push button lock codes and
they were not provided. An inspection
was performed of the outside and the
main area where the fire truck is kept.

B. Control measures
1. Engineering
A. Door Control(s)

i

X

D. Closed circuit

X

.

•

.

,

Two in main area inside the facility

E. Stationary metal
detector
F. Sound detection

X

G. Intrusion panel

X

H. Monitors

X

X

X

Village of Sleepy Hollow Final Program - 10/17/07

I

.

X

C. Door detectors

I. Video tape recorder

".••

Standard key entry lock to enter
building. Push button locks to the
upstairs sleeping quarters and the
basement.

X

B. Panic buttons

I

'

Page 27

�Engineering
(cont.)
J. Switcher

Controls

YES

COMMENT

NO
X
X

K. Hand-held metal
detector
L. Motion detectors

X

M. Parking lot well lit

X

N. Interoffice phone
system used
0 . Have structural
modifications been
implemented, such
as:
1. Plexiglass

X

Personnel equipped with two-way
radios as well.
•

'

.

;

, ,

,('

•

• 1

'

'

,

'

,

•

"

'

' , ' • ' •

.

'

'

.

*

'

'

,'"'•

'

•"

•

'

,' '

'•

(C

'

X

2. Partitions

X

3. Other
2. Work practice
Controls
A. Desks clear of
objects
B. Are exits kept clear
C. SH-900, 9 0 0 . 1 ,
900.2 forms
complete
D. Money kept on
premises
E. Reception area
available
F. Visitor sign in/out

.''''.' .• ..
*

X

,

'

v

.

-

•

;

'

(

'

'

/

'

'

.

'

"

,

•

'

'

&lt;

\

• ; »

I

'

,,',

Most are clear. By day's end, all files,
papers, etc., should be returned to
proper areas.

X
X

X

Occupational injury and illness records
for this facility should be available at the
Village Hall but were not provided.
No more than $500 cash should be kept
on the premises at any time.

X
X

G. Visitor escorted

X

H. Countertops to
separate visitors
from work areas
I. One entrance used

X

X

Village of Sleepy Hollow Final Program - 10/17/07

~

Page 28

I

�NO

COMMENT

Work Practice Controls
(cont.)
J. Separate interview
area
K. Exit interviews
performed

YES

L. ID badges used

X

M. Emergency phone
numbers posted
N. Internal procedures
for conflict situations

X

911 system is in effect.

X

Board of Fire Wardens handle
complaints. The Chief brings the
complaints to the Board.

X
X

0 . Security Guard
usage:
1. Employed

•' ' '

'' • '',.,

.,.'•'/

'

'

•

- ' • ' . '

i •

'

'.'&gt;..'

X

2. Contracted from
agency
3. At entrances

X
X

4. Local Law
enforcement
considered
C. Floor/Evacuation Plan
A. Are evacuation plans
current
B. Are floor plans posted
showing entrance /
exits, area of security
equipment
D. Training

Exit interviews provide the opportunity
to gauge employees demeanor and to
have ID badges, uniforms, etc. returned.

X

X
X

Has training been
conducted

X

A. Prior to initial
assignment

X

B. Annually thereafter

X

Village of Sleepy Hollow Final Program - 10/17/07

All employees, supervisors, department
heads and elected officials should be
trained in risks identified, ways to report
it and ways to avoid it.
A review of the program should be
mandatory upon the start of their
assignment.
Per the Workplace Violence Prevention
Law, training is required each and every
year.

Page 29

�T r a i n i n g (cont.)

YES

NO

Does training include:

C O M M E N T -VJV, '. - /£&gt;••..:«&gt;$:,-.; W~•'$$$..
. ;: /•••'^ ' i^

\\;'f-l'r

'•''••''} ' ' " I v ' v v ' K . ' ^ ' ' ' '

A. Components of
Workplace Violence
Prevention Program
B. Engineering controls

X

Each area of the program manual
should be reviewed.

X

C. Work practice controls

X

D. Techniques to use in
potentially volatile
situations
E. How to read/anticipate
behavior
F. Procedures to follow
after an incident

X

Personnel should be advised of where
and how to use safety devices.
Personnel should be trained in
procedures that lessen risk of violence.
Personnel should be given techniques
to de-escalate situations.

G. Periodic refresher for
on-site procedures

X

H. What constitutes
workplace violence

X

J. Are training records
kept

X

X
X

Village of Sleepy Hollow Final Program - 10/17/07

Training on what is violence is essential
in determining inappropriate behavior.
A clear line of communication and forms
to complete after an incident should be
included in training so no time is
wasted, evidence is preserved, and
working toward the incident not
occurring again is achieved.
The Workplace Violence Prevention Act
requires annual review, but it is
recommended that any change in
workplace, job, or upon an incident of
violence, a review of the program a n d
procedures takes place.
Not all forms of violence are recognized;
a thorough training of what constitutes
workplace violence is a requirement of
the WVP Act.
When training is performed, each
person involved is recorded and w h e n it
occurred. A log is kept of this
information, as well as the outcome of
such training. This will be necessary
if/when PESH performs an audit.

Page 30

�WORKPLACE RISK EVALUATION
SECURITY CHECKLIST
Facility:
Evaluation Done By:
Date of Evaluation:

Parks
Public Sector HR Consultants
May 1 0, 2007
YES

A. W o r k Area Evaluation
Are all areas being
evaluated?
B. Control measures
1.

Barnhardt, Devries, Douglas, Kingsland
and Sykes.

X

.
!

Engineering

M

A. Door Control(s)

X

B. Panic buttons

X

C. Door detectors

X

D. Closed circuit

X

E. Stationary metal
detector
F. Sound detection

X

G. Intrusion panel

X

H.

X

Monitors

•

'

•

•

'

'

.

Open facilities.

X

I. Video tape recorder

X

J.

X

Switcher

COMMENT

NO

K. Hand-held metal
detector
L. Motion detectors

X

M. Parking lot well lit

X

N. Interoffice phone
system used

X

X

Village of Sleepy Hollow hinal Piogiam - 10/17/07

Street lighting u s e d . No park has flood
lighting. Parks are closed at dusk.

Page 31

�Engineering Controls
(cont.)
O. Have structural
modifications been
implemented, such
as:
1. Plexiglass

YES

NO

|

COMMENT

•

'•'

•' &gt; •••'•'• ': '"'

'^'•i^'/'liM^':^^.

X
X

2. Partitions
3. Other
2. Work practice
Controls
A. Desks clear of
objects
B. Are exits kept clear

.

• ..';•

.•'

•

,

•

-..'

.-"

••'*•"...&gt;

^ ' : v / ; \ ' % &gt; V

X
X

D. Money kept on
premises
E. Reception area
available
F. Visitor sign in/out

X

X

G. Visitor escorted

X

H. Countertops to
separate visitors
from work areas
I. One entrance used

X

M. Emergency phone
numbers posted
N. Internal procedures
for conflict situations

••'

Not applicable.

C. SH-900, 900.1,
900.2 forms
complete

J. Separate interview
area
K. Exit interviews
performed
L . ID badges used

'•••'•'•.':•'•

Village Hall should have the log of the
occupational injury and illnesses that
have occurred at these facilities. It is
not available in Village Hall however.

Not applicable.

There are many ways to enter the park.

X

Not applicable
X
X

Names are on shirts provided by the
Village.
X
X

Clear guidelines for different levels of
violence are recommended to deescalate aggressive behaviors.

Village of Sleepy Hollow Final Program - 10/17/07

Page 31

�Work Practice Controls
(cont.)
O. Security Guard
usage:
1. Employed

YES
;

•'.'

A. Are evacuation plans
current
B. Are floor plans posted
showing entrance /
exits, area of security
equipment
D. Training

• ; • ' ' : • • : •

COMMENT

. • • •

••

•'•

' • ' • '

' . •

. ' . ' "

•

•

•

•

•

'

•

•

•

' •

;

.

.

(

-

X

2. Contracted from
agency
3. At entrances
4. Local Law
enforcement
considered
C. Floor/Evacuation Plan

NO

X
X
Local police perform periodic drive by
inspections.

X

X

Open areas.

X

Open areas.

,. •

' .

Has training been
conducted

X

A. Prior to initial
assignment

X

B. Annually thereafter

X

'

':'.

'

,

"

'

'

'

"

"

'

'

-

.

•

'

•

'

.

" "

All employees, supervisors, department
heads and elected officials should be
trained in risks identified, ways to report
it and ways to avoid it.
A review of the program should be
mandatory upon the start of their
assignment.
Per the Workplace Violence Prevention
Law, annual training is required.

Does training include:
A. Components of
Workplace Violence
Prevention Program
B. Engineering controls

X

C. Work practice controls

X

D. Techniques to use in
potentially volatile
situations

X

Each area of the program manual
should be reviewed.

X

Village of Sleepy Hollow Final Program - 10/17/07

•

Personnel should be trained in
procedures that lessen the risk of
violence.
Personnel should be given techniques
to de-escalate situations.

Page 33

'

�(p^&gt;

Training (cont.)

YES

NO

E. How to read/anticipate
behavior
F. Procedures to follow
after an incident

X

G. Periodic refresher for
on-site procedures

X

H. What constitutes
workplace violence

X

J. Are training records
kept

X

X

COMMENT
Training on what is violence is essential
in determining inappropriate behavior.
A clear line of communication and forms
to complete after an incident should be
included in training so no time is
wasted, evidence is preserved, and
working toward the incident not
occurring again is achieved.
The Workplace Violence Prevention Act
requires annual review, but it is
recommended that any change in
workplace, job, or upon an incident of
violence, a review of the program and
procedures takes place.
Not all forms of violence are recognized,
so a thorough training of what violence
is, is a requirement of the WVP Act.
When training is performed, each
person involved is recorded and when it
occurred. A log is kept of this
information, as well as the outcome of
such training. This will be necessary
if/when PESH performs an audit.

I

I

Village of Sleepy Hollow Final Program - 10/17/07

Page 34

I

�^S (ot-\

WORKPLACE RISK EVALUATION
SECURITY CHECKLIST
Facility:
Evaluation Done By:
Date of Evaluation:

Pump Station
Public Sector HR Consultants
May 1 1 , 2007
YES

A. Work Area Evaluation
Are all areas being
evaluated?
B. Control measures

NO

COMMENT
One floor for office and equipment.

X

1. Engineering
A.

DoorControl(s)

'..•••
X

B. Panic buttons

Standard key entry with security code
required.
X

C. Door detectors

X

Alarmed for security.

D. Closed circuit

X

Three cameras utilized at facility.

E. Stationary metal
detector
F. Sound detection

X

G. Intrusion panel

X

X

H. Monitors

X

I. Video tape recorder

X

Sensophone for PH levels.

J. Switcher

X

K. Hand-held metal
detector
L. Motion detectors

X
X

M. Parking lot well lit

X

N. Interoffice phone
system used

X

Village of Sleepy Hollow Final Program - 10/17/07

Hours are 7:00 am to 2:30 p m . Only in
an emergency is someone there at
night.

Lights outside the building come on with
darkness.

911 system is in effect.

Page 35

�Engineering Controls
(cont.)
0 . Have structural
modifications been
implemented, such
as:
1. Plexiglass

YES

2. Partitions

X

COMMENT

NO

'

•

'

,

•

,

;

.

•

v f &gt; ' v ' ' i r ; ; - : _ . ? ' • " • '."•'.•••.'''•'•':''_

' ••/

?Y;:'&gt;^:.'.'.V'

Front entrance door.

X

I

3. Other
2. Work practice
Controls
A. Desks clear of
objects
B. Are exits kept clear

•',

.

'.

X

X
X

C. SH-900, 9 0 0 . 1 ,
900.2 forms
complete
D. Money kept on
premises
E. Reception area
available
F. Visitor sign in/out
G. Visitor escorted
H. Countertops to
separate visitors
from work areas
I. One entrance used
J. Separate interview
area
K. Exit interviews
performed
L . ID badges used
M. Emergency phone
numbers posted
N. Internal procedures
for conflict situations

'•;:

. - • ' " , '

'

•'

,

'I.1'

''•','

."•

,V ''\'.

•

Most are clear. By day's end, all files,
papers, etc., should be returned to
proper areas.
There are t w o additional exits besides
the front door.
Village Hall should have the log of the
occupational injury and illnesses that
have occurred at these facilities.

X
X
X

Very few visitors to this facility.

X

I

X

X
X
X
X
X

911 system is in effect.
X

Village of Sleepy Hollow Final Program - 10/17/07

Clear guidelines for different levels of
violence are recommended to deescalate aggressive behaviors.

Page 36

�S&lt;PCO

Work Practice Controls
(cont.)
O. Security Guard
usage:
1. Employed

I

2. Contracted from
agency
3. At entrances
4. Local Law
enforcement
considered
C. Floor/Evacuation Plan

YES
:.

'.

.'

COMMENT

NO
' •

" ' . ' . '
1

- '

• • ' '

' ' •

;

,

' " " ' " »

' • '

• ' • ' ' • ' ' . '

, ' . ' : ' ' . '

Not recommended at this time.

X

Not recommended at this time.

X

Not recommended at this time.

;

' ' • ' '

'.'•

x

A. Are evacuation plans
current

X

B. Are floor plans posted
showing entrance /
exits, area of security
equipment
D. Training

X

Has training been
conducted

X

A. Prior to initial
assignment

X

B. Annually thereafter

X

Small facility but a plan should be
developed, implemented and
communicated.
A posting of the floor plan and where
the nearest exits are not only aides
Village personnel.

,••'.•'""•','

.•'

.''••.'

.\:"

.

• , •.

.'

All employees, supervisors, department
heads and elected officials should be
trained in risks identified, ways to report
it and ways to avoid it.
A review of the program should be
mandatory upon the start of their
assignment.
Per the Workplace Violence Prevention
Law, annual training is required.

Does training include:
A. Components of
Workplace Violence
Prevention Program
B. Engineering controls

X

Each area of the program manual
should be reviewed.

X

C. Work practice controls

X

D. Techniques to use in
potentially volatile
situations

X

Personnel should be advised of where
and how to use safety devices.
Personnel should be trained in
procedures that lessen risk of violence.
Personnel should be given techniques
to de-escalate situations.

Village of Sleepy Hollow Final Program - 10/17/07

I

•

X

...V

i

'

\

Page 37

'

�Training (cont.)

YES

NO

E. How to read/anticipate
behavior
F. Procedures to follow
after an incident

X

G. Periodic refresher for
on-site procedures

X

H. What constitutes
workplace violence

X

J. Are training records
kept

X

X

COMMENT
Training on what is violence is essential
in determining inappropriate behavior.
A clear line of communication and forms
to complete after an incident should be
included in training so no time is
wasted, evidence is preserved, and
working toward the incident not
occurring again is achieved.
The Workplace Violence Prevention Act
requires annual review, but it is
recommended that any change in
workplace, job, or upon an incident of
violence, a review of the program and
procedures takes place.
Not all forms of violence are recognized;
a thorough training of what constitutes
workplace violence is a requirement of
the WVP Act.
When training is performed, each
person involved is recorded and when it
occurred. A log is kept of this
information, as well as the outcome of
such training. This will be necessary
if/when PESH performs an audit.

I

I

Village of Sleepy Hollow Final Program - 10/17/07

Page 38

�SECTION 9 - FORMS
The following forms are to be used in administering the Workplace Violence Prevention
Program.
FORM-A - Workplace Violence Incident Report Form
FORM-2 - Employee Security Survey Form
FORM-3 - Policy Acknowledgment Form
FORM-4 - Training Acknowledgment Form

Village of Sleepy Hollow Final Program - 10/17/07

Page 39

�c

\

Workplace Violence Incident.
Report Form

Viti.A6#6F6LEEPY HOLLOW

This form is to be used to document any reportable workplace violence incident. This form is to be completed
and forwarded to the Village Administrator's Office for determination of investigation.
Vic f im Name
Job Title
Department / Location
Date and Time of Incident
Name / Title of Individual Completing this Report
Date Incident Report Completed
Date Incident Report Received by Village Administrator
Village Administrator's Name / Signature
Date Report Submitted to the Local Office of the
D e p t . o f L a b o r . (If required - reter to Reporting Requirements
in Section 7 of the Workplace Violence Prevention Manual)

List any individuals who may have witnessed this incident:
Witness Name

Witness Job Title

Witness Work Phone Number

Check the Type of Violence the victim experienced (Levels I, II, or III):

Level I Violence
•
O

Intimidation
Shouting

•
L)

Bullying
Swearing

•
O

Verbal abuse
1 Z] Minimal harassment
Obscene gestures | I ] False statements

O

Suicide threat

•

Threats of assault

[ ] Advanced harassment

•

Swore at directly

•

Obscene calls

[~1 Being followed or stalked

Level III Violence
•
Shooting

•

Stabbing

•

1 1 Sexual assault

| I Pushing

•

Grabbing

•

Striking with an
object
Throwing objects

Level II Violence
•
Psychological
Trauma
LJ Shouted at directly

r-ORM-1

•

Homicide

Page 1 of 2

�Please provide a detailed description of the incident.

I

Assailant / Perpetrator
Member of the Public
Employee's Spouse
Employee's Significant Other
Employee's Supervisor
Co-worker
Former employee
Other (specify)

V

Name

City

Address

State

n
3
3
3
3
3
3

Did police respond to the incident?

•

Yes

Q No

If yes, please specify the name of the Police Department
Was a police report filed?
Were you injured?

•

•

Yes

Yes

•
•

No

Police Report Number

No

If yes, please specify your injuries and the name / location of any treatment that you received.

I

Did you lose any work days?

•

Yes

•

Have you received counseling since this incident?

No

If yes, how many days_
•

Yes

Did you have any reason to believe that this incident might occur?

•

No
•

Yes

D No

Has the employer taken measures to avert this incident from occurring in the future that you are aware of?
•

Yes

•

No

Please describe:

Has the Union Representative been notified?

FORM-1

I

•

Yes (Date)_

CJNo

Page 2 of 2

�?VtLp6f :dl=:'3LEBPY: HOIJbOW.

Employee Security Survey Form

As part of the Village's effort to minimize the potential for workplace violence, we are requesting your feedback by
completing the following survey. Although providing your name is optional, if further clarification is needed, it allows
the surveyor to contact you directly. Please complete this survey and return it to the Village Treasurer in a sealed
envelope.

I

Name / Job Title: (optional)
Department:
Work Location:
The following are examples of Level I types of workplace violence. Please check if during the last twelve months
of your employment, you have been the victim of or have witnessed an incident of this nature.
•

None

•

Verbal threat

•

Harassment of any kind

•

Shouting

•

Intimidation/bullying

•

Obscene language/gestures

Please describe any incident in greater detail:

The following are examples of Level II types of workplace violence. Please check if during the last twelve
months of your employment, you have been the victim of or have witnessed an incident of this nature.
•

None

•

Threats of assault

•

Obscene calls

•

Being followed or stalked

Please describe any incident in greater detail:.

FORM-2

Page 1 of 2

I

�sn^
The following are examples of Level 111 types of workplace violence. Please check if during the last twelve
months of your employment, you have been the victim of or have witnessed an incident of this nature.
•

None

•

Sexual assault

•

Striking with hands or feet

•

Pushing or grabbing

•

Shooting

•

Striking with an
object

•

Assault with biological or
chemical material

•

Stabbing

•

Poor security in
and around building
and parking lots

Poor lighting in or around
building and parking lots

Please describe any incident in greater detail:

I
Have you experienced any of the following:
•

Working alone
in off hours
where you felt
unsafe

•

Working in isolated
areas or where your
whereabouts are
unknown to coworkers

•

What training do you feel would help create a more productive and safer work environment?

I

•

•

Conflict
Resolution

•

Other (please specify)

What to do if
Subjected to
Workplace Violence

•

How to Prevent
Harassment in the
Workplace

•

How to Implement
Effective Counseling and
Corrective Discipline

Do you have any other concerns with respect to workplace violence that you would like to address:.

Thank you for completing this survey.

FORM-2

Page 2 of 2

�VILLAGE OF SLEEPY tipLLOW

Policy Acknowledgment
Form

I hereby acknowledge that I have received a copy of the Village of Sleepy Hollow's
Workplace Violence Prevention Program manual outlining the Village's policy,
objectives, procedures, and regulations regarding violence in the workplace. I further
acknowledge that I have read or will read the contents of the program manual and will
contact rny Department Head or supervisor with any questions.
I understand that the objectives, procedures and regulations in this manual will remain
in effect unless changes become necessary.
I understand that the Village of Sleepy Hollow reserves the right to interpret, add to, or
revise any part of this manual, consistent with statutory requirements in its sole and
exclusive or discretion. Moreover, this manual may be subject to alteration by changes
in federal or state legislation, rules, and/or regulations.
I agree to abide by the Village of Sleepy Hollow's Workplace Violence policies and
procedural requirements.

EMPLOYEE NAME (PLEASE PRINT)

EMPLOYEE SIGNATURE

DATE OF SIGNATURE

A copy of this form is to be placed in the employee's personnel file.
FORM-3

Page 1 of 1

�i\rt|ipss: -OF:'si^)ij^'l«3^tijw;:

I

Training A c k n o w l e d g m e n t
Form

I hereby acknowledge that I have received training on the dangers of workplace violence,
identified risk factors and available prevention methods, my responsibilities and rights with
respect to addressing potentials for workplace violence. I have been informed of the
Village's policy regarding workplace violence and the program and procedures in place to
minimize risks.

DATE OF TRAINING

EMPLOYEE NAME (PLEASE PRINT)

SIGNATURE OF EMPLOYEE

DATE OF SIGNATURE

I

A copy of this form is to be placed in the employee's personnel file.

FORM-4

Page 1 of 1

�Meeting Date:
Resolution #:

11/06/07
11/210/07

Resolution of the Board of Trustees of the Village of Sleepy Hollow
Authorizing the Payment of an Emergency Claim
WHEREAS, the Village of Sleepy Hollow is required by municipal law to follow purchasing
policies which includes guidelines for emergency services and purchases; and
WHEREAS, an emergency situation occurred at Rescue Hose on Lawrence Avenue where
damage to the roof caused flooding in the meeting room of Rescue Hose on Lawrence Avenue
after the last torrential downpour.
NOW, THEREFORE, BE IT RESOLVED that the Board of Trustees declares this an emergency
and authorizes the payment of the claim to George's Seamless Gutters for $4980.00.

Moved: Trustee Morales

Seconded: Trustee Murray

Vote: Unanimous

�</text>
                </elementText>
              </elementTextContainer>
            </element>
          </elementContainer>
        </elementSet>
      </elementSetContainer>
    </file>
  </fileContainer>
  <collection collectionId="86">
    <elementSetContainer>
      <elementSet elementSetId="1">
        <name>Dublin Core</name>
        <description>The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.</description>
        <elementContainer>
          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="12287">
                <text>Board of Trustees Meeting Minutes &amp; Resolutions-2007</text>
              </elementText>
            </elementTextContainer>
          </element>
        </elementContainer>
      </elementSet>
    </elementSetContainer>
  </collection>
  <itemType itemTypeId="1">
    <name>Text</name>
    <description>A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.</description>
  </itemType>
  <elementSetContainer>
    <elementSet elementSetId="1">
      <name>Dublin Core</name>
      <description>The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.</description>
      <elementContainer>
        <element elementId="50">
          <name>Title</name>
          <description>A name given to the resource</description>
          <elementTextContainer>
            <elementText elementTextId="6811">
              <text>MINS_TRUST_2007-11-06</text>
            </elementText>
          </elementTextContainer>
        </element>
        <element elementId="49">
          <name>Subject</name>
          <description>The topic of the resource</description>
          <elementTextContainer>
            <elementText elementTextId="6812">
              <text>Board of Trustees Minutes-2007</text>
            </elementText>
          </elementTextContainer>
        </element>
        <element elementId="40">
          <name>Date</name>
          <description>A point or period of time associated with an event in the lifecycle of the resource</description>
          <elementTextContainer>
            <elementText elementTextId="6813">
              <text>2007</text>
            </elementText>
          </elementTextContainer>
        </element>
        <element elementId="47">
          <name>Rights</name>
          <description>Information about rights held in and over the resource</description>
          <elementTextContainer>
            <elementText elementTextId="6814">
              <text>Village of Sleepy Hollow All Rights Reserved.</text>
            </elementText>
          </elementTextContainer>
        </element>
        <element elementId="51">
          <name>Type</name>
          <description>The nature or genre of the resource</description>
          <elementTextContainer>
            <elementText elementTextId="6815">
              <text>Text</text>
            </elementText>
          </elementTextContainer>
        </element>
      </elementContainer>
    </elementSet>
  </elementSetContainer>
</item>
