Please read the guidance notes before attempting to complete this form. Section 1 - Overview

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Route 1 Application Section 1 Information you provide on this form will be held and used in accordance with the Data Protection Act 1998.By supplying your contact details you are consenting to receive news and marketing information from. Please read the guidance notes before attempting to complete this form. Section 1 - Overview Pre-experience indicators Describe how your organisation meets the requirements of the pre-experience quality indicators, including any relevant policies and procedures. You might want to include some or all of the following examples: how learning outcomes are negotiated, and how they can be tailored to meet the needs of specific users; how your policies recommend pre-visit meetings with teachers to negotiate the programme; how you work in partnership with users to design and improve the programme. During the experience indicators Describe how your organisation meets the requirements of the during the experience quality indicators, including any relevant policies and procedures. You might want to include some or all of the following examples: reference to your recruitment policy; reference to your staff/volunteer training policy/plan; what procedures you have in place to ensure continuing suitability of equipment and facilities; how your provision can be tailored to meet user needs, for example different learning styles. Post-experience indicators Describe how your organisation meets the requirements of the post-experience quality indicators, including any relevant policies and procedures. You might want to include some or all of the following examples: how you evaluate your provision, and how this feeds into your programmes to ensure continual improvement to meet the needs of users; what policies you have in place to evaluate the performance of teaching staff and/or volunteers. Organisational Indicators Describe how your organisation meets the requirements of the organisational quality indicators, including any relevant policies and procedures You might want to include some or all of the following examples: reference to the process you have in place to review key policies; your Child Protection/Safeguarding policy; Health and Safety policies and risk management procedures in place; the policies covering communication with users. October 2012 Page 1 of 11

Section 2 Indicators Pre Experience Indicators Indicator The provider has a process in place to assist users to plan the learning experience effectively. 1 NB: Planning must involve communication in some form between the provider and the user. 1a My organisation offers guidance or information on the roles and responsibilities of both the user and the provider i.e. who does what. AND / My organisation agrees roles and responsibilities of both the user and the provider i.e. who does what 1b 1c 1d 1e 1f My organisation captures learning objectives AND / My organisation agrees learning objectives Mr organisation offers a menu of activities, with a purpose for each activity, linked to learning objectives AND / My organisations plans a tailored programme of work, with a purpose for each activity, linked to learning objectives My organisation takes into account any equality, diversity and inclusion issues and needs My organisation offers guidance or information to the user for assessing learner progress during the overall experience and how the experience will be evaluated AND / My organisation agrees a process with the user for assessing learner progress during the overall experience and how the experience will be evaluated My organisation offers guidance and/or resources for preparation and follow-up to the visit AND / My organisation discusses with the user preparation and follow-up to the visit October 2012 Page 2 of 11

Indicator 2 2a 2b The provider provides accurate information about its offer. My organisation ensures that any promotional and/or written materials provide an accurate description of amenities, facilities and services provided and contact details My organisation has charging policies that state honestly the charges of the experience During the experience indicators. Indicator The provider provides activities, experiences or resources which meet learner needs. 3 3a My organisation offers a variety of activities delivered through a range of teaching and learning styles 3b 3c 3d 3e 3f Equipment and materials are suitable for tasks and activities, the age and ability of the learners, are current and in good working order My organisation makes good use of its location The amenities, facilities and services are as described in promotional and/or written materials Educational or instructional staff members and volunteers at my organisation are competent My organisation has a process in place for monitoring and evaluating the quality of the teaching/instruction of our education or instructional staff members and volunteers October 2012 Page 3 of 11

Post experience indicators Indicator The provider reviews the experience and acts upon feedback 4 4a My organisation evaluates its services 4b 4c My organisation gathers feedback from users (teachers and learners), including: Whether what was agreed at the planning stage was delivered; Whether learning objectives have been met; and Whether value for money has been achieved My organisation has a process in place to change practices as a result of review, evaluation and feedback. Organisational Indicators Indicator The provider meets the needs of users 5 5a My organisation communicates effectively with users 5b 5c 5d Essential written policies and procedures are reviewed, maintained and updated. This is undertaken in a regular basis and covers all venues and all activities My organisation has an understanding of sustainability issues and the impact of activities and shares this with users My organisation has a process in place to monitor the overall quality of provision across its site (or sites) and makes changes where necessary. October 2012 Page 4 of 11

Indicator 6 6a 6b 6c 6d 6e 6f 6g The provider has safety management processes in place to manage risk effectively My organisation has safety management procedures in place so that risks are identified and appropriately managed. These are shared with users. My organisation complies with all external regulation relating to it, e.g. Health & Safety at Work Act, Equalities Act etc My organisation has appropriate public liability insurance My organisation has relevant safeguarding procedures in place and robust child protection policies and procedures which are communicated to all staff All staff who work in a regulated activity or a specified place are subject to the appropriate CRB check Where animals are kept on site or used as part of the education service the appropriate welfare standards are maintained There are no animals on site or used as part of the education service Where there is contact with animals, appropriate hygiene and handwashing procedures are in place There is no contact with animals October 2012 Page 5 of 11

Extra information 1 The LOtC Quality Badge must cover the total extent of services that you provide to schools or other educational establishments. Where an activity falls outside the area of expertise of the Route 1assessors, further assessment could be required before the award can be made. Please indicate on the list below any activities available at your site. NB the declaration applies to facilities and activities which you provide directly or indirectly via a third party as a part of your promoted education provision. Abseiling Hill walking Sail boarding Activities happening outside the UK Horse riding Sailing Archery Ice climbing Sand yachting Artificial wall climbing Improvised rafting Sea level traversing Bell boating Kayaking Shooting Bushcraft activities Kite flying Sledging Canoeing Low ropes courses Snorkel and/or aqua lung activities Coasteering Mine exploration Snow sports Coastal work Mountain biking Surfing Cycling Mountain boarding Swimming open water Dog sledging Mountaineering Swimming pool Dragon boating Pony trekking Towed water sports/water skiing D of E expeditions Potholing Wave skiing Farm visits or farming activities Powered boats White water rafting Field studies in remote or upland places Practical conservation work Wild camping Ghyll scrambling Quad biking Windsurfing Gorge walking Rock climbing Work in rivers/streams where entering the water or at the base of fragile cliffs (i.e. hard hat areas) High ropes courses Rowing Zip wires October 2012 Page 6 of 11

Extra Info 2 a b Extra Info 3 a b Circus Skills provision My organisation does not provide any of the activities outlined as Circus Skills requiring extra assessment My organisation does provide activities as defined in the Route 1 description as Circus Skills requiring extra assessment. I understand that my application for the LOtC Quality Badge will incur a Health & Safety inspection charge over and above the cost of registration and agree to this charge. Occasional Residential provision / sleepovers My organisation never provides overnight accommodation for users or learners My organisation provides overnight accommodation for users or learners. I understand that this provision may be subject to a health and safety inspection, the cost of which will be met by my organisation. I understand that if residential travel forms a part of my educational offer I will be required to apply for the LOtC Quality Badge via Route 2 Important note: if accommodation is offered with other services such as travel the provision may be considered a Package as defined in the Package Holiday Regulations 1992. By submitting this application the provider is stating that they have sought legal advice and have complied with all necessary regulations. Any significant element of travel will necessitate a Route 2 application under the appropriate Awarding Body. October 2012 Page 7 of 11

Route 1 Residential provision checklist WELFARE R1 WCs are available for users close to sleeping areas at a ratio of no less than one WC for every 10 users R2 Washbasins with hot and cold water are available for users close to sleeping areas at a ratio of no less than one washbasin for every 10 users R3 Where a residential stay is to last longer than one night, a shower or bath with hot and cold water is available for every 15 users Residential visits at my site never last longer than one night R4 Opaque blinds or curtains are provided in bathroom and sleeping areas, where appropriate R5 When more than one group is using the facilities, procedures are in place to ensure suitability and security My facilities are only ever used by one group at a time R6 Separate bathroom facilities and sleeping areas are available for male and female users R7 Separate sleeping and bathroom facilities are available for male and female staff R8 Security arrangements are in place to ensure that unauthorised visitors cannot access the sleeping areas during the residential visit R9 All non-user visitors, and contractors, are signed in and badged October 2012 Page 8 of 11

R10 There is an evening / night duty system in place R11 Secure storage for valuables if provided where necessary Users are informed well in advance of the visit that secure storage is not available FIRE SAFETY R12 Fire risk assessments have been carried out R13 A fire drill or walk-through is carried out prior to the users first overnight stay R14 Fire exits are clear, accessible and visibly signed. All users are made aware of their location and that of the fire assembly point before the first overnight stay R15 The fire alarm is regularly tested and is audible throughout the accommodation R16 Smoke detectors are in place and are tested at regular intervals R17 Fire extinguishers and blankets are in place and are checked regularly (and have at least an annual check by external provider e.g. Chubb) FOOD HYGIENE R18 All food preparation carried out on my premises is compliant with the relevant food safety legislation No food preparation is carried out on my premises October 2012 Page 9 of 11

R19 All staff involved in food preparation hold appropriate health and hygiene qualifications No food preparation is carried out on my premises R20 The kitchen standard is assessed by at least an Environmental Health Officer s visit 4 star or above: recommendations of EHO carried out or planned over an acceptable period No food preparation is carried out on my premises R21 HACCP assessments; fridge and freezer temperature records; and food probe records are kept daily No food preparation is carried out on my premises R22 There is a daily, weekly and monthly kitchen cleaning routine in place No food preparation is carried out on my premises GENERAL HEALTH & SAFETY R23 Appropriate and safe heating & ventilation is provided in sleeping areas R24 Adequate lighting is provided in sleeping areas R25 My facility complies with ACOP L8 Control of Legionella R26 A risk assessment has been carried out for accidents or medical emergencies; users are fully aware of procedures in place R27 Trained first aiders are available to users at all times and a fully stocked first aid box provided October 2012 Page 10 of 11

R28 Upstairs windows are fitted with locks, stays or barriers to prevent falls There are no upstairs windows at my site R29 All electrics are in good working order and all sockets and switches are fitted correctly R30 All plate glass windows or patio doors have anti-collision stickers There are no plate glass windows or patio doors at my site R31 All carpets on stairways are in good condition and securely fixed There are no stairways on my site / all stairways are uncarpeted R32 All balconies are at least 1m high with no horizontal bars There are no balconies at my site R33 Any individual water heaters in rooms are powered by electricity rather than gas There are no individual water heaters at my site October 2012 Page 11 of 11