NFPA 1006 Skills Evaluation Check Sheet - REACT

1 YesNo YesNo1234516 PassPassFailFailNFPA 1006 Skills Evaluation Check SheetSkill Sheet Identify Support Resources Student #:JPR Site Operations RandomSelects rehab areasDate:Student Name:Directions: Identify the needed support resources, given a specific type of rescue incident, so that a resource cache is managed, scene lighting is provided for the tasks to be undertaken, environmental concerns are managed, personnel rehabilitation is facilitated, and the support operation facilitates rescue operational NumberManage personnel rotationsTaskRetestIdentifies lighting resourcesIdentifies structures for shelter and thermal control optionsTracks equipment inventorsInitial TestWere all tasks completed in a SAFE manner?

2 ( NO indicates automatic failure)Pass/Fail Criteria: Any "No" constitutes a failure of the Signature (retest):Evaluator Signature (initial):Evaluator Comments:Version nfpa 1006 2008 editionVersion nfpa 1006 2008 editionYesNo YesNo123416 PassPassFailFailPass/Fail Criteria: Any "No" constitutes a failure of the Signature (retest):Evaluator Signature (initial):Evaluator Comments:Were all tasks completed in a SAFE manner? ( NO indicates automatic failure)TaskRetestGathers informationRelays informationIs able to read reference materialsInitial TestUses information gathering resourcesDirections.

3 Size up a rescue incident, given background information and applicable reference materials, so that the type of rescue is determined, the number of victims is identified, the last reported location of all victims is established, witnesses and reporting parties are identified and interviewed, resource needs are assessed, search parameters are identified, and information required to develop an incident action plan is NumberNFPA 1006 Skills Evaluation Check SheetSkill Sheet Size Up an Incident Student #:JPR Site Operations RandomDate:Student Name:Version nfpa 1006 2008 editionVersion nfpa 1006 2008 editionYesNo YesNo12345616 PassPassFailFailDirections.

4 Manage incident hazards, given scene control barriers, personal protective equipment, requisite equipment, and available specialized resources, so that all hazards are identified, resource application fits the operational requirements, hazard isolation is considered, risks to rescuers and victims are minimized, and rescue time constraints are taken into NumberNFPA 1006 Skills Evaluation Check SheetSkill Sheet Manage Incident Hazards Student #:JPR Site Operations RandomDate:Student Name:Places scene control barriersOperates control and mitigation equipmentTaskRetestIdentifies incident hazardsAssesses victim viability (risk benefit)Identifies resource capabilities and limitationsInitial TestUtilizes technical referencesWere all tasks completed in a SAFE manner?

5 ( NO indicates automatic failure)Pass/Fail Criteria: Any "No" constitutes a failure of the Signature (retest):Evaluator Signature (initial):Evaluator Comments:Version nfpa 1006 2008 editionYesNo YesNo1234567816 PassPassFailFailDirections: Manage resources in a rescue incident, given incident informatin, a means of communication, resources, tactical worksheets, personnel accountability protocol, applicable references, and standard operationg procedures, so that references are utilized, personnel are acounted for, deployed resources achieve desired objectives, incident actions are documented, rescue efforts are coordinated, the command structure is established, task assignments ar communicated and monitored.

6 And actions are consistent with appplicable NumberNFPA 1006 Skills Evaluation Check SheetSkill Sheet Manage Resources Student #:JPR Site Operations RandomDate:Student Name:Matches resources to operational needsOperates communications equipmentTaskCommunicates in a manner so that incident objectives are metRetestCompletes tactical worksheetsUses reference materialsImplements the Incident Management SystemInitial TestEvaluate incident informationManages incident communicationsWere all tasks completed in a SAFE manner?

7 ( NO indicates automatic failure)Pass/Fail Criteria: Any "No" constitutes a failure of the Signature (retest):Evaluator Signature (initial):Evaluator Comments:Version nfpa 1006 2008 editionYesNo YesNo123456789 PassPassFailFailEffective communications are maintained between team membersAll rescuers safely exit the search areaPass/Fail Criteria: Any "No" constitutes a failure of the Signature (retest):Evaluator Signature (initial):Evaluator Comments:Persons within the search area are questioned and the info is relayed to commandStudent Name:Task NumberTaskInitial TestRetestHazards are managed effectivelyA personnel accountability system is utilized for both rescuers Search parameters are establishedSearch is systematic and thoroughDirections: Given hazard specific PPE, equipment pertinent to the search assignment, an incident location, victim(s) profile and working as a member of a search team, the candidates will conduct a thorough and systematic all tasks completed in a SAFE manner?

8 ( NO indicates automatic failure)Victim profile is established and communicatedNFPA 1006 Skills Evaluation Check SheetSKILL Sheet CONDUCT A SEARCHS tudent #:JPR Site Operations RandomSearch is expedient given the conditionsDate:Version nfpa 1006 2008 editionYesNo YesNo1234 PassPassFailFailDirections: Perform ground support operations for helicopter activities, given a rescue scenario/incident, helicopter, operational plans, PPE, requisite equipment, and available specialized resources, so that rescue personnel are aware of the operational characteristics of the aircraft and demonstrate operational proficiency in establishing and securing landing zones and communicating with aircraft personnel until the assignment is all tasks completed in a SAFE manner?

9 ( NO indicates automatic failure)Uses appropriate PPENFPA 1006 Skills Evaluation Check SheetSKILL Sheet HELICOPTER GROUND SUPPORTS tudent #:JPR Site Operations RandomCommunicates with aircrewsDate:Student Name:Task NumberTaskInitial TestRetestLanding zone is identified, established and controlledReviews standard operating procedures for helicopter operationsPass/Fail Criteria: Any "No" constitutes a failure of the Signature (retest):Evaluator Signature (initial):Evaluator Comments:Version nfpa 1006 2008 editionYesNo YesNo123456 PassPassFailFailAsset and personnel tracking systems are used to assure personnel and equipment are returned to a state of readinessWere all tasks completed in a SAFE manner?

10 ( NO indicates automatic failure)Post event analysis is conductedPass/Fail Criteria: Any "No" constitutes a failure of the Signature (retest):Evaluator Signature (initial):Evaluator Comments:Task NumberTaskInitial TestRetestUses sound risk analysis, rescuer risk is managedScene security & control is established/continued until custody of the scene is transferred to a responsible partyNFPA 1006 Skills Evaluation Check SheetSKILL Sheet TERMINATE AN INCIDENTS tudent #:JPR Site Operations RandomData is collected and used to complete record keeping and documentationDate:Student Name:Hazards are recognized and managedDirections.