STATE FIRE COMMISSION WV FIRE OFFICER 1 EQUIVALENT CERTIFICATION SUBMISSION FORM



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STATE FIRE COMMISSION WV FIRE OFFICER 1 EQUIVALENT CERTIFICATION SUBMISSION FORM NAME: RANK: ADDRESS: CITY: ZIP: PHONE NUMBERS: DEPARTMENT AFFILIATION: ADDRESS: CITY: COUNTY ZIP: CHIEF: PHONE: YEARS OF FIRE SERVICE EXPERIENCE: YEARS OF FIRE OFFICER EXPERIENCE (list all ranks obtained and time held): ATTACH COPIES OF THE FOLLOWING PRE-REQUISITE CERTIFICATES: FIREFIGHTER 2: FIRE SCIENCES DEGREE? YES NO (If yes attach copy, stop here. If no, continue application.)

FIRE OFFICER 1 JOB PERFORMANCE REQUIREMENTS: HUMAN RESOURCE MANAGEMENT JPR-4.2.1 Assign tasks or responsibilities to unit members, given an assignment at an emergency operation, so that the instructions are complete, clear, and concise; safety considerations are addressed; and the desired outcomes are conveyed. Attach copy of MCTO-P or equivalent certificate, or detailed description of your experience and ability to deliver instructions for frequently assigned unit tasks based on training and standard operating procedures or guidelines. JPR-4.2.2 Assign tasks or responsibilities to unit members, given an assignment under non-emergency conditions at a station or other work location, so that the instructions are complete, clear, and concise; safety considerations are addressed; and the desired outcomes are conveyed. Attach copy of Leadership 3 or equivalent certificate, or a detailed description of your experience and ability to issue frequently assigned nonemergency unit tasks based on departmental policies and guidelines. JPR-4.2.3 Direct unit members during a training evolution, given a company training activity and training policies and procedures, so that the evolution is performed in accordance with safety plans, efficiently and as directed. Attach copy of MCTO-P or equivalent certificate, or a detailed description of your experience and ability to distribute issue-guided directions to unit members during training evolutions. JPR-4.2.4 Recommend action for member related problems, given a member with a situation requiring assistance and the member assistance policies and procedures, so that the situation is identified and the actions taken are within the established policies and procedures. Attach copy of MCTO-D or equivalent certificate, or a detailed description of your experience and ability to recommend a course of action for a member in need of assistance. JPR-4.2.5 Apply human resource policies and procedures, given an administrative situation requiring action, so that departmental policies and guidelines are followed. Attach copy of MCTO-D or equivalent certificate, or a detailed description of your experience and ability to communicate orally and in writing, and to relate interpersonally.

JPR-4.2.6 Coordinate the completion of assigned tasks and projects by members, given a list of projects, tasks, and job requirements of subordinates, so that the assignments are prioritized, a plan for the completion of each assignment is developed, and members are assigned to specific tasks and are supervised during the completion of the assignments. Attach copy of MCTO-D or equivalent certificate, or a detailed description of your experience and ability to plan and set priorities while supervising basic human resource management. COMMUNITY AND GOVERNMENT RELATIONS JPR-4.3.1 Initiate action on a community need, given policies and procedures, so that the need is addressed. Attach copy of INTRO TO FIRE OFFICER 1 or equivalent certificate, or a detailed description of your experience and ability to perform public relations duties and communicate verbally while conducting community projects. JPR-4.3.2 Initiate action to a citizen s concern, given policies and procedures, so that the concern is answered or referred to the correct individual for action, and all policies and procedures are complied with. Attach copy of INTRO TO FIRE OFFICER 1 or equivalent certificate, or a detailed description of your experience and ability to perform public relations duties and communicate verbally while addressing a citizen s concern. JPR-4.3.3 Respond to a public inquiry, given policies and procedures, so that the inquiry is answered accurately, courteously, and in accordance with applicable policies and procedures. Attach copy of INTRO TO FIRE OFFICER 1 or equivalent certificate, or a detailed description of your experience and ability to relate interpersonally while responding to public inquiries. JPR-4.3.4 Deliver a public education program, given the target audience and topic, so that the intended message is conveyed clearly. Attach copy of INTRO TO FIRE OFICER 1 or equivalent certificate, or a detailed description of your experience and ability to communicate with the target audience.

ADMINISTRATION JPR-4.4.1 Recommend changes to existing departmental policies and/or implement a new departmental policy at the unit level, given a new departmental policy, so that the policy is communicated to and understood by unit members. Attach copy of LEADERSHIP 3 or equivalent certificate, or a detailed description of your experience and ability to relate interpersonally with unit members. JPR-4.4.2 Execute routine unit level administrative functions, given forms and record-management systems, so that the reports and logs are complete and files are maintained in accordance with policies and procedures. Attach copy of LEADERSHIP 3 or equivalent certificate, or a detailed description of your experience and ability to communicate orally and in writing while conducting routine administrative functions. JPR-4.4.3 Prepare a budget request, given a need and budget forms, so that the request is in the proper format and is supported with data. Attach copy of LEADERSHIP 3 or equivalent certificate, or a detailed description of your experience and ability to communicate in writing while preparing budget requests. INSPECTION AND INVESTIGATION JPR-4.5.1 Evaluate available information, given a fire incident, observations, and interviews of first arriving members and other individuals involved in the incident, so that a preliminary cause of the fire is determined, reports are completed, and if required, the scene is secured and all pertinent information is turned over to an investigator. Attach copy of Arson 1 or equivalent certificate, or a detailed description of your experience and ability to determine basic fire cause, conduct interviews, and write reports. JPR-4.5.2 Secure an incident scene, given rope or barrier tape, so that unauthorized persons can recognize the perimeters of the scene and are kept from restricted areas, and all evidence or potential evidence is protected from damage or destruction.

Attach copy of Arson 1 or equivalent certificate, or a detailed description of your experience and ability to establish perimeters and secure a fire scene. EMERGENCY SERVICE DELIVERY JPR-4.6.1 Develop a pre-incident plan, given an assigned facility and preplanning policies, procedures, and forms, so that all required elements are identified and the approved forms are completed and processed in accordance with policies and procedures. experience and ability to write reports, communicate orally, and evaluate skills while preparing a pre-incident plan. JPR-4.6.2 Develop an initial action plan, given size-up information for an incident and assigned emergency response resources, so that resources are deployed to control the emergency. experience and ability to analyze emergency scene conditions; to activate the local emergency plan, including local evacuation procedures; to allocate resources; and to communicate orally. JPR-4.6.3 Implement an action plan at an emergency operation, given assigned resources, type of incident, and a preliminary plan, so that resources are deployed to mitigate the situation. experience and ability to implement an incident management system, to communicate orally, to manage scene safety, and to supervise and account for assigned personnel under emergency conditions. JPR-4.6.4 Develop and conduct a post-incident analysis, given a single unit incident and post-incident analysis policies, procedures, and forms, so that all required critical elements are identified and communicated, and the approved forms are completed and processed in accordance with policies and procedures. experience and ability to write reports, to communicate orally, and to evaluate skills while conducting a post-incident analysis.

HEALTH AND SAFETY JPR-4.7.1 Apply safety regulations at the unit level, given safety policies and procedures, so that required reports are completed, in-service training is conducted, and member responsibilities are conveyed. Attach copy of Incident Safety Officer or equivalent certificate, or a detailed description of your experience and ability to identify safety hazards and to communicate safety issues orally and in writing. JPR-4.7.2 Conduct an initial accident investigation, given an incident and investigation forms, so that the incident is documented and reports are processed in accordance with policies and procedures. Attach copy of Incident Safety Officer or equivalent certificate, or a detailed description and ability to communicate orally and in writing while conducting interviews and accident investigations. VERIFICATION OF SUBMITTED INFORMATION All statements and attachments submitted within this document are accurate and true. Signature of Applicant: Date:

INDEPENDENT REVIEW All applications for equivalent certification must have a completed verification of an independent review. The Chief of Department must verify the application of all subordinate officers. If applicant is Chief of Department, the Board President or Mayor must sign verification. I have reviewed the above statements and attachments and confirm that all information submitted is true and accurate to the best of my knowledge. Chief of Department: or Board President or Mayor: Date: RETURN COMPLETED APPLICATION TO: STATE FIRE COMMISSION STANDARDS EVALUATION COMMITTEE 1207 QUARRIER STREET, 2 ND FLOOR CHARLESTON, WV 25301 FIRE COMMISSION APPROVAL COMMITTEE RECCOMENDATION: YES NO CHAIRMAN: DATE: