Graduate level Final and Journal

1. Incident Name:

Severe acute respiratory syndrome

2. Operational Period:

Date From: 7/26/2018

Date To: 7/28/2018

Time From: 0700

Time To: HHMM

3. Resource Number

4. New Status (Available, Assigned, O/S)

5. From (Assignment and Status):

6. To (Assignment and Status):

7. Time and Date of Change:

1199.n

available

Little Columbia county hospital

Emrgenyc location

0800

7/26/2018

2013.m

assigned

Little Columbia county hospital

Emergency location

1500

7/28/2018

8. Comments:

9. Prepared by:

Name: tj.m

Position/Title:

Signature:

ICS 210

Date/Time: Date

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

Resource Number

Enter the resource identification (ID) number (this may be a letter and number combination) assigned by either the sending unit or the incident.

4

New Status (Available, Assigned, Out of Service)

Indicate the current status of the resource:

· Available – Indicates resource is available for incident use immediately.

· Assigned – Indicates resource is checked in and assigned a work task on the incident.

· Out of Service – Indicates resource is assigned to the incident but unable to respond for mechanical, rest, or personnel reasons. If space permits, indicate the estimated time of return (ETR). It may be useful to indicate the reason a resource is out of service (e.g., “O/S – Mech” (for mechanical issues), “O/S – Rest” (for off shift), or “O/S – Pers” (for personnel issues).

5

From (Assignment and Status)

Indicate the current location of the resource (where it came from) and the status. When more than one Division, Staging Area, or Camp is used, identify the specific location (e.g., Division A, Staging Area, Incident Command Post, Western Camp).

6

To (Assignment and Status)

Indicate the assigned incident location of the resource and status. When more than one Division, Staging Area, or Camp is used, identify the specific location.

7

Time and Date of Change

Enter the time and location of the status change (24-hour clock). Enter the date as well if relevant (e.g., out of service).

8

Comments

Enter any special information provided by the resource or dispatch center. This may include details about why a resource is out of service, or individual identifying designators (IDs) of Strike Teams and Task Forces.

9

Prepared by

Name

Position/Title

Signature

Date/Time

Enter the name, ICS position/title, and signature of the person preparing the form. Enter date (month/day/year) and time prepared (24-hour clock).