Documentation

Question 1

Puncture Exposure Forms

Answer 1

• Royce Log (ER)
• SBCo Dept. of Public Health Exposure Documentation Report
• EPCR
• Report of Employee Injury(Intranet)
• DWC-1 Workers comp
• Sharps injury Log
• Logbook Entry

Question 2

Body Fluid Exposure Forms

Answer 2

• Royce Log (ER)
• SBCo Dept. of Public Health Exposure Documentation Report
• Report of Employee Injury(Intranet)
• DWC-1 Workers comp
• Logbook Entry

Question 3

Airborne Exposure Forms

Answer 3

• Royce Log (ER)
• SBCo Dept. of Public Health Exposure Documentation Report
• Report of Employee Injury(Intranet)
• Logbook Entry

Question 4

Unknown Exposure Forms

Answer 4

• SBCo Dept. of Public Health Exposure Documentation Report

* Logbook Entry

Question 5

DICO (Designated Infection Control Officer)

Answer 5

EMS Director Pam Martinez

Question 6

IPAD- EMS Mandatory Reporting Forms

Answer 6

APS- Adult protective services
Cal OSHA- Notification Data Form
CPS- Child Protective Services
DNR- DNR report form
SIRF- Submersion Incident Report Form

Question 7

IPAD- Wildland Forms

Answer 7

ICS 214
ICS 225
IRPG 2018

Question 8

IPAD- Major Disaster

Answer 8

Target Hazard survey Map

Target Hazard Damage Categories

Question 9

Work Improvement Plan (aka Performance improvement plan)

Answer 9

*Usually initiated when an employee is struggling to meet standards.
*Can be for Performance or behavior
*Interim step prior to discipline or part of discipline process
*Must define problem and expected solution
SMART objectives

Question 10

When is a Probationary Firefighter evaluation required?

Answer 10

Required at end of mini-academy, 5-month and 9-month landmarks.
May be done more often as needed.
Will be utilized monthly for any employee on a Work Improvement Plan.

Question 11

PACE

Answer 11

Performance And Coaching Excellence

Question 12

SMART Objectives

Answer 12

Specific
Measurable
Attainable
Relevant
Time based

Question 13

When are probationary employee PACE evaluations done?

Answer 13

6 Month-due prior to 6 month test(Without and employee input form)
11 month employee input form
12 month PACE with 11 month employee input form

Question 14

What other documents can be done for a probationary firefighter?

Answer 14

Probationary Employee evaluation form
Employee development plan
Employee development plan update

Question 15

Captains daily notes

Answer 15

Help recall past accomplishments, struggles and patterns of behavior.
Can be formatted different ways
Should be updated daily for probationary employee and as needed for others
Capture formal and informal interaction

Question 16

When must a telephone report be made for child abuse?

Answer 16

36 hours

Question 17

When must a telephone report be made for elder abuse?

Answer 17

48 hours

Question 18

When should a written report be made for child or elder abuse?

Answer 18

ASAP. Reference should be made to the report in the incident narrative.

Question 19

When should a written report be made for child or elder abuse?

Answer 19

ASAP. Reference should be made to the report in the incident narrative.