GaDOE BUS ACCIDENT REPORT The Bus Accident Report shall be submitted by the local school system to the Georgia Department of Education in accordance with State Board Rule 160-5-3-. 08. The report shall be submitted within 45 days of the accident. An accident is a sequence of events which produces unintended injury, death or property damage.
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Any school bus incident that: (1) generates a police accident or incident report; (2) involves any amount of property damage; (3) involves operation of the bus which causes personal injury or fatality to occupants in the bus, in other vehicles or pedestrians should be reported via the method prescribed by the Department. This report is used to monitor statewide trends so a more effective safety program can be presented in order to reduce preventable accidents. Accident Information * District Name-Click on box and select district name. * Date of Accident-Click on box and select date from calendar. Day of the Week Accident Occurred – Pick day from pull down box. * Time the Accident Occurred – Select from pull down box within 30 minutes. Then you can edit the minutes to the exact time. * Weather Conditions at Time of Accident – Pick from pull down box. * Accident Reported to What Law Enforcement Agency – Enter agency name. Examples: Georgia State Patrol, XYZ Sheriff’s Department, XYZ Police Department, NONE. Case Number Assigned by Agency Reported To – Enter number. * Accident Involved School Bus and – check all that apply. * Accident Occurred on – Pick from pull down box. * Roadway Surface Composition – Pick from pull down box. Road Accident Occurred On – Enter name of highway or street. Examples: Highway 441S, Green Street, Intersection of Highway 23 & Stephens Road, 3421 Ledan Road. City in Which Accident Occurred – Enter City if necessary. State in which accident occurred – Enter State if necessary from pull down box. * Accident Severity – Pick ONE of 4 Categories. Use drop down arrow or click within empty field to display choices. Bus Information * Bus Design Capacity – Pick from pull down box. * Number of Children on Bus – Enter number. * Bus Number – Enter number. *Year Model of Bus – Enter 4 digit year model of bus. Chassis Manufacturer – Pick from pull down box. * Body Company – Pick from pull down box. * Bus Driver’s First Name – Enter First Name. * Bus Driver’s Last Name – Enter Last Name. * Bus Driver’s Age – Enter age of driver. * Bus Driver’s Sex – Pick one. * Years of Bus Driving Experience – Enter number of years experience driving a school bus. Estimated Bus Pre-Crash Travel Speed – Enter speed of bus prior to accident. Estimated Impact Speed – Enter speed at time of impact. * Bus Towed from Accident Location – Pick one. Other Vehicle Information * Vehicle Type – Pick from pull down box.
Estimated Vehicle Pre-Crash Travel Speed – Enter estimated speed of vehicle prior to accident. * Other Vehicle Towed from Accident Location – Pick one. To Add Additional Vehicles (3, 4, etc. ) CLICK ON GREEN “ADD NEW BOX” to provide another line for data. You may add as many vehicles as required. If an unneeded blank row is displayed, please ignore. Injuries/Fatalities * Injured parties – Pick from pull down box – You will need to enter ALL injuries/fatalities that apply to the applicable category (None, Bus Driver, Bus Passengers, Other Vehicle Driver(s), Other Vehicle Passengers, Pedestrians). Total injuries – Enter Number per category or 0. * Treated by EMS & Released – Enter Number per category or 0. * Treated by doctor and released – Enter Number per category or 0. * Hospitalized – Enter Number per category or 0. * Fatalities – Enter Number per category or 0. After adding the First Category (example Bus Driver) CLICK ON GREEN “ADD NEW BOX” to provide another line if needed (example Bus Passengers, etc. ). You could possibly have 5 lines as an answer for this question. If an unneeded blank row is displayed, please ignore. Accident Causation Factors Cause of Accident – Pick ONE Cause of Accident. MISJUDGED CLEARANCE – TRACKING DIFFERENCE -struck hazard as result of rear wheels not following front wheels. MISJUDGED CLEARANCE – TAIL SWING -struck hazard as result of turning sharply & rear of bus swinging on path outside rear wheels. MISJUDGED CLEARANCE – OVERHEAD OBJECT -struck hazard with top part of bus. IMPROPER BACKING – RIGHT SIDE -backing, failed to avoid hazard w/right side. IMPROPER BACKING – LEFT SIDE -backing, failed to avoid hazard w/left side. IMPROPER BACKING – STRAIGHT BEHIND -backing, failed to avoid hazard w/rear.
FOLLOWING TOO CLOSE -struck vehicle in front as result of inadequate cushion space. FAILED TO YIELD -pulled in front of vehicle which had ROW. DISREGARD FOR STOP SIGN/SIGNAL -result of not stopping as required by law. IMPROPER LANE CHANGE/PASSING -result of pulling into a different lane. IMPROPER TURN -result of pulling into wrong lane during a turn. FAILED TO MAINTAIN LANE -result of drifting into another lane. MECHANICAL FAILURE -result of mechanical problem. TOO FAST FOR CONDITIONS -result of conditions warranting a slower speed. WEATHER CONDITIONS -result of weather conditions-not speed.
STRUCK PEDESTRIAN -struck someone outside bus. OTHER – any cause not specified above. * Who Was Charged? – Pick one. Statement Make a brief statement describing the accident and giving as best you can the location, causes and consequences. Type within the area provided. Avoid reference to “Veh. #1 & Veh. #2, but instead identify the school bus, other vehicle, etc. Additional Information * = Data Required Green Check = Save & Exit Red X = Delete Row “Summary” = Save & Exit Use Pull Down Boxes – Prevents Misspellings Save – Only saves data entered while continuing to be active in the report mode.
GaDOE software is designed to cycle off after 30 minutes. If you are idle in a report for over 30 minutes you could lose that report (may take you to the log in screen when you “Save and Exit. ” To ensure that you avoid this when working on a report you should perform the 2 step “Save & Exit” procedure below. This assigns a reference # and the report in progress can be accessed again using “To Access a Saved Report Not Submitted” below. Save & Exit – Selecting this will save any data that you’ve entered on the page and return you to the Summary Page. On the Summary Page you must also click “Save & Exit”.
A reference # will be assigned at this time (be sure you record this number on your records of each accident report to cross reference the accident). To Access a Saved Report Not Submitted – Go to My GaDOE Homepage. Under “Surveys” click on the “Saved” tab. Click on the accident report with the appropriate assigned reference number (be sure you record this number on your records of each accident report to cross reference the accident). To edit or add information click on “Edit”. # of Questions Answered – Will show different numbers in two different places. This is a GaDOE Software issue so please disregard the top number on the Summary Page.
To Print – Choose the landscape print option and set margins, etc. If document does not print while a report is in progress, “save and exit” and then print. CTRL “P” will also print the document if you run into problems. To Submit a Completed Report – “Save & Exit” from report in progress. Click on “Submit for Approval” button. Confirmation of Submittal – When a report has been successfully submitted, the page will display a confirmation message, “This application has been successfully submitted. ” No Superintendent approval is required. To Access Submitted Report – Go to My GaDOE Homepage. Under Surveys click on the “Submitted” tab.
Click on the accident report with the appropriate assigned reference number. To Delete a Saved Report – There is no way to delete an entire saved report. If you need to do away with a saved report you will pull it up and re-enter new data on an accident. Just click on the appropriate reference number and edit/enter data for the accident. To Delete a Submitted Report – Contact your Consultant by e-mail with the reference # to be deleted. “SAVE” often “Save & Exit” x 2 in order not to lose data after 30 minutes of inactivity “SAVE” often “Save & Exit” x 2 in order not to lose data after 30 minutes of inactivity