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Fill and Sign the Tsgli Claim Form

Fill and Sign the Tsgli Claim Form

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Safety Officer Position Checklist The following checklist should be considered as the minimum requirements for this position. Note that some of the tasks are one-time actions; others are ongoing or repetitive for the duration of the incident. Task 1. Obtain briefing from Incident Commander and/or from initial on-scene Safety Officer. 2. Identify hazardous situations associated with the incident. Ensure adequate levels of protective equipment are available, and being used. 3. Staff and organize function, as appropriate: In multi-discipline incidents, consider the use of an Assistant Safety Officer from each discipline. Multiple high-risk operations may require an Assistant Safety Officer at each site. Request additional staff through incident chain of command. 4. Identify potentially unsafe acts. 5. Identify corrective actions and ensure implementation. Coordinate corrective action with Command and Operations. 6. Ensure adequate sanitation and safety in food preparation. 7. Debrief Assistant Safety Officers prior to Planning Meetings. 8. Prepare Incident Action Plan Safety and Risk Analysis (USDA ICS Form 215A). 9. Participate in Planning and Tactics Meetings: Listen to tactical options being considered. If potentially unsafe, assist in identifying options, protective actions, or alternate tactics. Discuss accidents/injuries to date. Make recommendations on preventative or corrective actions. 10. Attend Planning meetings: 11/29/04 1 Safety Officer Position Checklist Sample Planning Meeting Agenda Agenda Item Briefing on situation/resource status. Discuss safety issues. Set/confirm incident objectives. Plot control lines & Division boundaries. Specify tactics for each Division/Group. Specify resources needed for each Division/Group. Specify facilities and reporting locations. 1 2 3 4 5 6 7 8 9 10 11 12 13 Responsible Party Planning/Operations Section Chiefs Safety Officer Incident Commander Operations Section Chief Operations Section Chief Operations/Planning Section Chiefs Develop resource order. Consider communications/medical/ transportation plans. Provide financial update. Discuss interagency liaison issues. Discuss information issues. Finalize/approve/implement plan. Operations/Planning/Logistics Section Chiefs Logistics Section Chief Logistics/Planning Section Chiefs Finance/Administration Section Chief Liaison Officer Public Information Officer Incident Commander/All 11. Participate in the development of Incident Action Plan (IAP): Review and approve Medical Plan (ICS Form 206). Provide Safety Message (ICS Form 202) and/or approved document. Assist in the development of the “Special Instructions” block of ICS Form 204, as requested by the Planning Section. 12. Investigate accidents that have occurred within incident areas: Ensure accident scene is preserved for investigation. Ensure accident is properly documented. Coordinate with incident Compensation and Claims Unit Leader, agency Risk Manager, and Occupational Safety and Health Administration (OSHA). Prepare accident report as per agency policy, procedures, and direction. Recommend corrective actions to Incident Commander and agency. 13. Coordinate critical incident stress, hazardous materials, and other debriefings, as necessary. 14. Document all activity on Unit Log (ICS Form 214). 11/29/04 2

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