Thompson Lab – Wildlife, Fish & Conservation Biology Department, UC Davis
Individual Training Record - Animal Care and Use, Chemical, Lab, and Field Safety
Name:
Title:
Work Location:
Starting Date:
PI:
Department:
A. I have read and understand the following Animal Care and Use Protocols
and have received training for the specific tasks I will be performing under
these protocols:
Protocol Number:
Protocol Title:
B. I have completed the online Animal Care and Use Occupational Health
Program risk assessment and will update this if a change occurs to my risk,
according to IACUC policy: http://safetyservices.ucdavis.edu/ps/a/IACUC/po
1. Submitted my Online Application to access the Health Surveillance
Questionnaire, through the Animal Care and Use Occupational Health
Program: http://safetyservices.ucdavis.edu/ps/occh/acuohp Your supervisor
must first complete the Risk Assessment form:
https://animalrisk.ucdavis.edu/RA.aspx
C. I have attended the following courses or received instruction in:
1. Animal Care and Use 101
http://safetyapps.ucdavis.edu/EHS/Training/index.cfm#acu101
2. Animal Care and Use 101-R (on-line exam)
3. Aseptic Surgical Technique:
http://safetyapps.ucdavis.edu/EHS/Training/index.cfm#rodent
4. Laboratory Animals Skills:
http://safetyapps.ucdavis.edu/EHS/Training/index.cfm#labanimalskills
5.
D. I have received training/information on the following:
1. Reporting Animal Care and Use concerns
2. Animal handling and husbandry
3. Identifying pain and discomfort in the animal(s) I am working with
4. Euthanasia
5. Animal carcass disposal and handling
6. Anesthesia monitoring
7. Animal records with regard to pre, peri, and post-op monitoring
8. Safe Handling of anesthetic gases including scavenging procedures
9. Animal Bite Instructions (Must be reported to supervisor)
10. Potential zoonotic diseases, with which I may be in contact in my work area,
including: Cryptosporidiosis, Mycobacterium, Aeromonas spp.
11. Personal hygiene in the workplace
12. Notification of my responsibility to contact my supervisor for
training/information before I perform any task for which I am not trained
13. The content and purpose of the Injury and Illness Prevention Plan (IIPP)
14. The emergency action plan for my work area (in IIPP)
15. Location of emergency shower and eye wash stations
16. Chemicals in the lab; location, content and use of the MSDS (Safety Net
#45)
17. The use of the UC Davis Safety Services' online Hazard Analysis Tool
http://safetyservices.ucdavis.edu/ps/occh/acuohp/pem/hazardAnalysisTool
Revised 28 June 2013
Initial
Initial
Initial
Trainer
Trainer
Trainer
Date
Date
Date
Thompson Lab – Wildlife, Fish & Conservation Biology Department, UC Davis
E. I have reviewed the following SafetyNets that are relevant to the procedures
Initial
Trainer
I am doing in the lab:
 Guidelines for Disposal of Sharps, Biological and Medical Waste (#3)
 Partial List of Incompatible Chemicals (#4)
 Eye and Face Safety Protection for Laboratory Workers (#5)
 Can This Go Down the Drain? (#6)
 Hazardous Material Inventory Requirements (#7)
 Guidelines for Disposal of Chemical Waste (#8)
 Why Didn’t the Custodian Pick Up My Trash? (#12)
 Guidelines for Chemical Spill Control (#13)
 Guidelines for Mercury Spill Control (#16)
 Personal Computer Workstation Checklist (#17)
 General Safety Guidelines for Chemical Laboratories (#19)
 Controlling Laboratory Ergonomic Risk Factors (#27)
 OSHA Bloodborne Pathogen Standard Worker Information (#36)
 Health and Safety Hazards: A Student’s Right to Know (#40)
 What You Should Know to Protect Your Wrists and Hands from Repetitive Motion Injury (#41)
 General Guidelines for Management of Laboratory Chemicals (#42)
 Glossary of MSDS (Material Safety Data Sheet) Terms (#45)
 Lifting (#46)
 Emergency Medical Care (#52)
 Compressed Gas Safety (#60)
 Needle and Syringe Safety (#62)
 Emergency Eyewash and Shower Testing and Use (#66)
 Non-structural Seismic Safety (#83)
 Respiratory Protection Program (#88)
 Keyboard and Mouse Use (#96)
 Indoor Air Quality (#99)
 Power Outages (#109)
 Guidelines for Completing the Chemical Waste Label (#110)
 Heat Illness Prevention (#123)
 Empty Container Management (#124)
 Biological and Biohazardous Spill Response (#127)
F. Safety for Field Work. I have received training/information on the following:
 Cryptosporidiosis
 Giardiasis
 Valley Fever
 Lyme disease and ticks
 West Nile Virus
 Hantavirus pulmonary syndrome
 Snake bites
 Mountain lions
 Black bears
 Poison oak
 Heat illness prevention
 Hypothermia prevention
 Thunderstorm and lightning hazards
 Boating safety (UCD Boating Safety Training Course)
 Wilderness First Aid
 Swiftwater Rescue
 Safe electrofishing practices
G. Additional Sources for Training (optional)
 AALAS Learning Library online courses: http://www.aalaslearninglibrary.org/
Revised 28 June 2013
Date