Alabama Fire College Rapid Intervention Crew Performance Evaluation Check-Off Sheet

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2 Alabama Fire College Rapid Intervention Crew Performance Evaluation Check-Off Sheet Name: Fire Department: Address: Training Location: Date Started: This Performance Evaluation Check-Off Sheet is to be used in conjunction with the Alabama Fire College Rapid Intervention Crew Skill Sheets. Students must pass all skills in order to be eligible for certification. These skills meet all the requirements of NFPA 1407 Training Fire Service Rapid Intervention Crews, 2010 edition. Skill Primary Task Pass/Fail Student Initial 01 Declaring a Mayday 02 Search and Rescue 03 Restricted Openings 04 Emergency Procedures 05 Victim Removal 06 Bringing Down a Ladder Evaluator Initial Date Based on NFPA 1407, 2010 Edition Revised 01/2012

3 Declaring a Mayday Meets JPR 7.5 of NFPA 1407 Training Fire Service Rapid Intervention Crews, 2010 edition Skill Sheet 1 The candidate, wearing personal protective equipment including SCBA, shall demonstrate procedures for declaring a mayday. Expected time to complete skill(s) is 10 minutes DECLARING A MAYDAY P F P F Transmits on radio that they are declaring a Mayday (repeats three times) CRITICAL POINT Gives LUNAR report (Location, Unit, Name, Assignment, Resources) CRITICAL POINT Manually activates PASS device after MAYDAY is acknowledged by command. CRITICAL POINT Candidate must successfully perform ALL steps including all critical criteria Score: /3 Evaluator Print Name & Signature: Date Overall Skill Sheet Score Re-Test Evaluator Print Name & Signature: Overall Skill Sheet Re-Test Score Candidate Print Name & Signature: Candidate: Print Name or Candidate # Alabama Fire College Revised- 01/12/2012

4 Search and Rescue Meets JPR 7.6 and 7.7 of NFPA 1407 Training Fire Service Rapid Intervention Crews, 2010 edition Skill Sheet 2 The candidate, wearing PPE including SCBA, shall demonstrate entering a simulated burning and smoke filled environment, conduct search operations and locate and remove incapacitated firefighter(s). Expected time to complete skill(s) is 10 minutes SEARCHING FOR INCAPACITATED FIREFIGHTER(S) P F P F Sizes up building for hazards, possible egress routes, and safe havens Collects all equipment required for searching (working radio, forcible entry tools, flashlight, rope, and thermal imaging camera as a minimum) CRITICAL POINT Checks door for heat before entering Uses proper search techniques and stays low during search CRITICAL POINT Maintains contact with rope/tag line during search Uses thermal imaging camera during search Searches under and around furniture, behind closed doors, and all closets Removes firefighter from entanglement if necessary Evaluates conditions and identifies possible safe havens throughout search Candidate must successfully perform 7/9 steps including all critical criteria Score: /9 Evaluator Print Name & Signature: Date Overall Skill Sheet Score Re-Test Evaluator Print Name & Signature: Overall Skill Sheet Re-Test Score Candidate Print Name & Signature: Candidate: Print Name or Candidate # Alabama Fire College Revised- 01/12/212

5 Restricted Openings Meets JPR 7.6, 7.7, and 7.13 of NFPA 1407 Training Fire Service Rapid Intervention Crews, 2010 edition Skill Sheet 3 The candidate, wearing full protective equipment including SCBA of his/her choice, shall safely exit an area with a restricted opening (vertical or horizontal opening that is too small to accommodate both the firefighter and the SCBA). Expected time to complete skill(s) is 20 minutes FIREFIGHTER SELF-RESCUE P F P F Recognizes situations under which rapid intervention is required for rescue and required techniques for calling for assistance CRITICAL POINT Is able to free themselves from entanglement Conducts rapid orientation of the room, including primary and secondary exit Breaches wall ceiling or floor if necessary Practices air management CRITICAL POINT Candidate must successfully perform 3/4 steps including all critical criteria RESTRICTED OPENINGS- SHIFTING THE SCBA Maintains contact with SCBA CRITICAL POINT Maintains physical, visual, or verbal contact with partner CRITICAL POINT Keeps all PPE intact CRITICAL POINT Checks conditions on other side of passage before entry CRITICAL POINT Loosen shoulder strap and then waist strap Shift SCBA to one side (depending on which side regulator is on) After obstruction is cleared, SCBA is repositioned and straps are tightened Candidate must successfully perform 5/7 steps including all critical criteria RESTRICTED OPENINGS- BACKWARDS SWIM TECHNIQUE Maintains contact with SCBA CRITICAL POINT Maintains physical, visual, or verbal contact with partner CRITICAL POINT Keeps all PPE intact CRITICAL POINT Checks conditions on other side of passage before entry CRITICAL POINT Sits with back against wall and centered between two obstacles Feet positioned in front of body as far as possible and buttocks raised off of ground to proceed through opening Pulls shoulders and elbows into center of body while pushing backwards through the space Once SCBA is clear the firefighter rotates the body, dipping the shoulder to bring the rest of the body through the obstacle Candidate must successfully perform 6/8 steps including all critical criteria Score: /4 Score: /7 Score: /8 Alabama Fire College Revised- 01/12/2012 Page 1 of 3

6 Restricted Openings edition Meets JPR 7.6, 7.7, and 7.13 of NFPA 1407 Training Fire Service Rapid Intervention Crews, 2010 Skill Sheet 3 The candidate, wearing full protective equipment including SCBA of his/her choice, shall safely exit an area with a restricted opening (vertical or horizontal opening that is too small to accommodate both the firefighter and the SCBA). Expected time to complete skill(s) is 20 minutes RESTRICTED OPENINGS-FORWARD DIVE TECHNIQUE P F P F Maintains contact with SCBA CRITICAL POINT Maintains physical, visual, or verbal contact with partner CRITICAL POINT Keeps all PPE intact CRITICAL POINT Checks conditions on other side of passage before entry CRITICAL POINT Centers body between two wall studs and places both arms in front through obstacle, attempting to get elbows past opening Exhales and arms are pulled inward to center of body, allowing firefighter to fall through opening Clears obstacle and uses arms to pull rest of body through opening Candidate must successfully perform 5/7 steps including all critical criteria Score: /7 RESTRICTED OPENINGS-FULL ESCAPE PROCEDURE Maintains contact with SCBA CRITICAL POINT Maintains physical, visual, or verbal contact with partner CRITICAL POINT Keeps all PPE intact CRITICAL POINT Checks conditions on other side of passage before entry CRITICAL POINT While lying to one side, loosens the shoulder straps and removes waist strap Rolls out of the backpack to the side of the regulator and does not lose contact with strap CRITICAL POINT SCBA is rotated with cylinder valve facing away from firefighter and straps are neat and organized to facilitate easy redonning Moves forward keeping SCBA in front and close to body CRITICAL POINT When clear of obstacle, redonn the SCBA by laying out straps and rolling into backpack assembly Candidate must successfully perform 7/9 steps including all critical criteria Score: /9 Alabama Fire College Page 2 of 3 Revised- 01/12/2012

7 Restricted Openings Meets JPR 7.6, 7.7, and 7.13 of NFPA 1407 Training Fire Service Rapid Intervention Crews, 2010 edition Skill Sheet 3 The candidate, wearing full protective equipment including SCBA of his/her choice, shall safely exit an area with a restricted opening (vertical or horizontal opening that is too small to accommodate both the firefighter and the SCBA). Expected time to complete skill(s) is 20 minutes Evaluator: Print Name & Signature: Date Overall Skill Sheet Score Re-Test Evaluator: Print Name & Signature: Overall Skill Sheet Re-Test Score Candidate: Print Name & Signature: Candidate: Print Name or Candidate # Alabama Fire College Page 3 of 3 Revised- 01/12/2012

8 Emergency Procedures Meets JPR 7.6 and 7.7 of NFPA 1407 Training Fire Service Rapid Intervention Crews, 2010 edition Skill Sheet 4 The candidate, wearing full personal protective equipment and SCBA shall demonstrate controlled breathing techniques, be able to demonstrate the ability to perform an emergency procedure check on their self contained breathing apparatus, be able to supply air to an incapacitated firefighter, and protect that firefighter in place. Warning: No emergency breathing procedure is endorsed by manufacturers, NFPA, ANSI, or any other regulating agency. These procedures should be used only as a last resort in life threatening situations. Expected time to complete skill(s) is 3 minutes CONSERVATION OF AIR (CONTROLLED BREATHING) P F P F Calls a Mayday - CRITICAL POINT Inhales normally through mouth and exhales normally through nose. Inhales and exhales slowly. Proceeds to exit as quickly as possible. Continues above steps until out of IDLH atmosphere - CRITICAL POINT Candidate must successfully perform 4/5 steps Score: /5 EMERGENCY PROCEDURE CHECK Calls a Mayday - CRITICAL POINT Does NOT remove face piece - CRITICAL POINT Left hand to face piece and regulator and checks bypass valve. Uses bypass or cylinder valve to control air flow (depending on free flow or no flow). Corrects problem if possible. Proceeds to exit as quickly as possible. Continues above steps until out of IDLH atmosphere or problem is corrected - CRITICAL POINT Candidate must successfully perform 4/5 steps Score: /5 Alabama Fire College Revised- 01/12/2012

9 Emergency Procedures Meets JPR 7.6 and 7.7 of NFPA 1407 Training Fire Service Rapid Intervention Crews, 2010 edition Skill Sheet 4 The candidate, wearing full personal protective equipment and SCBA shall demonstrate controlled breathing techniques, be able to demonstrate the ability to perform an emergency procedure check on their self contained breathing apparatus, be able to supply air to an incapacitated firefighter, and protect that firefighter in place. Warning: No emergency breathing procedure is endorsed by manufacturers, NFPA, ANSI, or any other regulating agency. These procedures should be used only as a last resort in life threatening situations. Expected time to complete skill(s) is 3 minutes SUPPLYING AIR TO AN INCAPACITATED FIREFIGHTER Repositions or replaces face piece on downed firefighter Replaces mask mounted regulator on downed firefighter Utilizes the RIC UAC, where available Alternates rescue air supply source Candidate must successfully perform 3/4 steps including all critical criteria Score: /4 PROTECTING AN INCAPACITATED FIREFIGHTER IN PLACE Provides and maintains a continuous air supply Provides protective hose lines Secures a dedicated radio channel for rescue ops Continuously monitor conditions that can affect the rescue ops Candidate must successfully perform 3/4 steps including all critical criteria Score: /4 Evaluator Print Name & Signature: Date Overall Skill Sheet Score Re-Test Evaluator Print Name & Signature: Overall Skill Sheet Re-Test Score Candidate Print Name & Signature: Candidate: Print Name or Candidate # Alabama Fire College 2 of 2 Revised- 01/12/2012

10 Victim Removal Meets JPR 7.10 and 7.12 of NFPA 1407 Training Fire Service Rapid Intervention Crews, 2010 edition Skill Sheet 5 The candidate, as a member of a team and wearing PPE, shall demonstrate proper victim removal techniques. Expected time to complete skill(s) is 10 minutes MOVING INCAPACITATED FIREFIGHTER(S) Demonstrates basic drags, lifts, and carries Demonstrates moving a downed firefighter up and down stairs Utilizes a rescue blanket or rescue board when appropriate Demonstrates moving a firefighter from below the area of operations (through floor) Demonstrates moving a downed firefighter in an attic space Demonstrates moving a downed firefighter through an elevated (restricted size) window in a room with limited space for crew movement (Denver Drill) Demonstrates the use of search ropes, slings, and harnesses where needed Demonstrates the use of mechanical advantage rope systems for rescue where needed Demonstrates appropriate rescue knots Candidate must successfully perform 7/9 steps Score: /9 Evaluator Print Name & Signature: Date Overall Skill Sheet Score Re-Test Evaluator Print Name & Signature: Overall Skill Sheet Re-Test Score Candidate Print Name & Signature: Candidate: Print Name or Candidate # Alabama Fire College Pg 1 of 2 Revised- 01/12/2012

11 Bringing Victims Down Ladder Meets JPR 7.5 of NFPA 1407 Training Fire Service Rapid Intervention Crews, 2010 edition Skill Sheet 6 The candidate, wearing PPE and provided with an appropriate ladder and a victim, shall bring a simulated unconscious person down the ladder from a safe height. Additional firefighters should be provided to assist victim out of the window and to secure the ladder. Expected time to complete skill(s) is 4 minutes CRADLE CARRY WHEN VICTIM PRESENTED HEAD FIRST P F P F Exterior rescuer on ladder at or below windowsill Victim s head is off to one side allowing victim s torso and legs to come across the ladder horizontally with back of victim facing rescuer Places one forearm and hand under victim s armpit and grasps ladder Other arm is placed one rung below under the top leg into groin area of victim Descends ladder while grasping the rails leaning inward to control victim Descends ladder safely with victim CRITICAL POINT Candidate must successfully perform 5/6 steps including all critical criteria Score: /6 CRADLE CARRY WHEN VICTIM PRESENTED FEET FIRST Exterior rescuer on ladder at or below windowsill Places victim s legs to the outside of ladder beams and hooks one arm into groin area of victim Both hands grasp ladder and the upper body of victim is placed on opposite arm one rung above Descends ladder while grasping the rails leaning inward to control victim Descends ladder safely with victim CRITICAL POINT Candidate must successfully perform 4/5 steps including all critical criteria Score: /5 Evaluator Print Name & Signature: Date Overall Skill Sheet Score Re-Test Evaluator Print Name & Signature: Overall Skill Sheet Re-Test Score Candidate Print Name & Signature: Candidate: Print Name or Candidate # Alabama Fire College Revised- 01/12/2012