Graduate level Final and Journal
student2006
ICS_Form204-Fillable1.docxASSIGNMENT LIST (ICS 204)
ICS 204
Assignment List
Purpose. The Assignment List(s) (ICS 204) informs Division and Group supervisors of incident assignments. Once the Command and General Staffs agree to the assignments, the assignment information is given to the appropriate Divisions and Groups.
Preparation. The ICS 204 is normally prepared by the Resources Unit, using guidance from the Incident Objectives (ICS 202), Operational Planning Worksheet (ICS 215), and the Operations Section Chief. It must be approved by the Incident Commander, but may be reviewed and initialed by the Planning Section Chief and Operations Section Chief as well.
Distribution. The ICS 204 is duplicated and attached to the ICS 202 and given to all recipients as part of the Incident Action Plan (IAP). In some cases, assignments may be communicated via radio/telephone/fax. All completed original forms must be given to the Documentation Unit.
Notes:
The ICS 204 details assignments at Division and Group levels and is part of the IAP.
Multiple pages/copies can be used if needed.
If additional pages are needed, use a blank ICS 204 and repaginate as needed.
|
Block Number |
Block Title |
Instructions |
|
1 |
Incident Name |
Enter the name assigned to the incident. |
|
2 |
Operational Period Date and Time From Date and Time To |
Enter the start date (month/day/year) and time (using the 24-hour clock) and end date and time for the operational period to which the form applies. |
|
3 |
Branch Division Group Staging Area |
This block is for use in a large IAP for reference only. Write the alphanumeric abbreviation for the Branch, Division, Group, and Staging Area (e.g., “Branch 1,” “Division D,” “Group 1A”) in large letters for easy referencing. |
|
4 |
Operations Personnel Name, Contact Number(s) · Operations Section Chief · Branch Director · Division/Group Supervisor |
Enter the name and contact numbers of the Operations Section Chief, applicable Branch Director(s), and Division/Group Supervisor(s). |
|
5 |
Resources Assigned |
Enter the following information about the resources assigned to the Division or Group for this period: |
|
|
Resource Identifier |
The identifier is a unique way to identify a resource (e.g., ENG-13, IA-SCC-413). If the resource has been ordered but no identification has been received, use TBD (to be determined). |
|
|
Leader |
Enter resource leader’s name. |
|
|
# of Persons |
Enter total number of persons for the resource assigned, including the leader. |
|
|
Contact (e.g., phone, pager, radio frequency, etc.) |
Enter primary means of contacting the leader or contact person (e.g., radio, phone, pager, etc.). Be sure to include the area code when listing a phone number. |
|
5 (continued) |
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information |
Provide special notes or directions specific to this resource. If required, add notes to indicate: (1) specific location/time where the resource should report or be dropped off/picked up; (2) special equipment and supplies that will be used or needed; (3) whether or not the resource received briefings; (4) transportation needs; or (5) other information. |
|
6 |
Work Assignments |
Provide a statement of the tactical objectives to be achieved within the operational period by personnel assigned to this Division or Group. |
|
7 |
Special Instructions |
Enter a statement noting any safety problems, specific precautions to be exercised, dropoff or pickup points, or other important information. |
|
8 |
Communications (radio and/or phone contact numbers needed for this assignment) Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel) |
Enter specific communications information (including emergency numbers) for this Branch/Division/Group. If radios are being used, enter function (command, tactical, support, etc.), frequency, system, and channel from the Incident Radio Communications Plan (ICS 205). Phone and pager numbers should include the area code and any satellite phone specifics. In light of potential IAP distribution, use sensitivity when including cell phone number. Add a secondary contact (phone number or radio) if needed. |
|
9 |
Prepared by Name Position/Title Signature Date/Time |
Enter the name, ICS position, and signature of the person preparing the form. Enter date (month/day/year) and time prepared (24-hour clock). |
ASSIGNMENT LIST
(
ICS 204
)
1. Incident Name:
Severe Acute Respiratory
Syndrome (SARS)
2. Operational Period:
Date From:
7/26/2018
Date To:
7/28/2018
3
.
Time From:
0700
Time To:
1900
B
ranch:
F
ire
and
emergency
services
4. Operations
Personnel:
Name
Contact Number(s)
Division:
E
mergency
services
Operations Section Chief:
J
ohn
deb
o
r
n
XXX
-
XXX
-
XXXX
Group:
medics
Branch Director:
M
eke
kruger
XXX
-
XXX
-
XXXX
Staging
Area:
E
mergency
llocation
Division/Group
Supervisor:
A
nn
grey
XXX
-
XXX
-
XXXX
5
. Resources Assigned:
# of
Persons
Contact (e.
g.
, phone, pager,
radio frequency, etc.)
Reporting
Location, Special
Equipment and Supplies,
Remarks,
Notes, Information
Resource Identifier
Leader
1199.n
james
50
233
-
125
E
mergency
location
2013.m
john
500
215
-
658
E
mergency
location
6
. Work Assignments:
T
reat
the infected individuals accordingly
P
rovide
first aid services to new arrivals.
R
ecord
and report the data on patients worked on.
C
ommunicate
any
resource
needed for effective services provision
7
. Special Instructions:
E
nsure
that you are well protected when in contact with the infected.
8
. Communications
(radio and/or phone contact numbers needed for this assignment)
:
Name
/
Functio
n
n
Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
james
/
medi
cs
233
-
125
john
/
medicine
215
-
168
/
/
9
. Prepared by:
Name:
john deborn
P
osition/Title:
o.p.c
Signature:
ASSIGNMENT LIST (ICS 204)
1. Incident Name:
Severe Acute Respiratory
Syndrome (SARS)
2. Operational Period:
Date From: 7/26/2018 Date To: 7/28/2018
3.
Time From: 0700 Time To: 1900
Branch: Fire and emergency
services
4. Operations
Personnel:
Name
Contact Number(s)
Division:
Emergency services
Operations Section Chief: John deborn XXX-XXX-XXXX
Group:
medics
Branch Director: Meke kruger XXX-XXX-XXXX
Staging
Area:
Emergency llocation
Division/Group
Supervisor:
Ann grey XXX-XXX-XXXX
5. Resources Assigned:
# of
Persons
Contact (e.g., phone, pager,
radio frequency, etc.)
Reporting Location, Special
Equipment and Supplies, Remarks,
Notes, Information Resource Identifier Leader
1199.n james 50 233-125 Emergency location
2013.m john 500 215-658 Emergency location
6. Work Assignments:
Treat the infected individuals accordingly
Provide first aid services to new arrivals.
Record and report the data on patients worked on.
Communicate any resource needed for effective services provision
7. Special Instructions:
Ensure that you are well protected when in contact with the infected.
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name /Function
n
Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
james /medics 233-125
john /medicine 215-168
/
/
9. Prepared by: Name: john deborn Position/Title: o.p.c
Signature:
