NORTHERN SUBURBAN SPECIAL EDUCATION DISTRICT
760 Red Oak Lane  .  Highland Park IL 60035
(847) 831-5100  .  (847) 831-5108
www.nssed.org

TRANSPORTATION CONCERN

Please complete this form and return to Judy Sutton in the NSSED Business Office with any concern you have regarding a student’s transportation. This form should be submitted within 24 hours of noting the concern.
Date of Incident: Time:
Name of Student: School:
Your Name: Student's Therapist

 

Please indicate transporation provider: Septran 303 Cab All Ways American
  Western Lakeside Other:

 

Please check specific concern:

Wheelchair Issues

Passenger three-point restraint not used or not positioned properly
Wheelchair/stroller tie down not attached properly to vehicle
Wheelchair/stroller tie down not attached properly to wheelchair/stroller
Tray on wheelchair during transportation
Wheelchair transported in tilted position
Improper use of bus lift
Power wheelchair not disengaged on lift
Wheelchair brakes not locked
Wheelchair not facing outward on the lift
Wheelchair driven onto the lift in up position from the bus
Face forward seating available but not used
Face forward seating not available on the bus
Loose items not securely fastened
Strapping/fasteners problems
Improper installation of safety vest

Car Seats

Car seat improperly installed (indicate to or from school)
Define:

Driver Issues

Ethical/professional behavior of bus driver
Define:

Arrival/departure Time
Define:

Student dropped off without supervision/teacher assistant was not present to receive the student
Student dropped off at an unscheduled location
Not reporting behavioral issues
Doors to the cab were not locked

Scheduling issues
Define:

Careless driving noted
Define:

Student Issues

Not wearing seat belt
Student_Issue_ modified transportation with driver
Additional students in vehicle when not approved
Improper use of cell phone

Other

Additional information/comments: