Department of Forestry and Fire Protection Office of State Fire Marshal, State Fire Training 1-3: Inspect SCBA Candidate Information Candidate Name and SFT ID Number: Circle One: Day 1 First Attempt / Day 1 Second Attempt / Day 2 First Attempt / Day 2 Second Attempt General Information Standard: Office of the State Fire Marshal / CTS Guide: 1-3 / Course Plan: Fire Fighter 1A, Topic 2-5 Performance Outcome: Inspect SCBA, noting any wear and or damage, ensure cylinder pressure is within department standards or replaced, check low air alarm for activation, open bypass value to ensure operation, check pass device for operations, and place the unit back into service. Candidate Directions: You will inspect and prepare the SCBA for reuse and demonstrate and verbalize all checks. The test will begin when I say, “start.” The test will end when you say, “done.” Do you understand the directions? Performance Measures (check appropriate box) Pass Fail The candidate must complete all steps (100%) to receive a passing score. 1. Wears and uses appropriate PPE/SCBA/equipment at all times during evaluation 2. Prepares SCBA for inspection 3. Checks air cylinder pressure and replaces cylinder if less than 90% of rated capacity 4. Identifies all SCBA components are present: harness assembly, cylinder, face piece, and PASS device 5. Inspects all SCBA components for damage; if any damage is found, reports to evaluator 6. Opens cylinder valve slowly; verifies operation of low air pressure alarm; if low air alarm does not activate, repeats steps or places unit out of service 7. Compares cylinder gauge to regulator gauge to ensure they are within 100 psi of each other or per manufactures recommendations or AHJ 8. Checks all hose connections, rapid intervention crew/company universal air connections (RIC UAC), and verifies they are tight and free from leaks 9. Checks bypass operation 10. Checks condition of face piece for cracks and missing/broken straps, and ensures cleanliness 11. Dons face piece and checks for proper seal 12. Inspects regulator for DRAFTdamage and checks regulator operation by connecting to face piece and breathing 13. Checks all gauges and/or indicators (i.e. heads-up display) are providing similar pressure readings 14. Checks operation of PASS device (If PASS device is an integrated part of SCBA unit, check is performed in accordance with manufacturers’ instructions.) Month Year Fire Fighter 1 Page 1 of 2 Department of Forestry and Fire Protection Office of State Fire Marshal, State Fire Training 15. Closes cylinder valve and drains all air from system (manufacturers’ instructions) (Low air alarm activates when regulator gauge reads 25% or 33%.) 16. Prepares SCBA for reuse Evaluation Results Overall Evaluation: Pass / Fail (circle one) Student Signature / Date: Evaluator Signature / Date: Comments: DRAFT Month Year Fire Fighter 1 Page 2 of 2 Department of Forestry and Fire Protection Office of State Fire Marshal, State Fire Training 1-4: Don Structural PPE Candidate Information Candidate Name and SFT ID Number: Circle One: Day 1 First Attempt / Day 1 Second Attempt / Day 2 First Attempt / Day 2 Second Attempt General Information Standard: Office of the State Fire Marshal / CTS Guide: 1-4 / Course Plan: Fire Fighter 1A, Topic 2-4 Performance Outcome: Don personal protective clothing in 60 seconds ensuring all elements of the ensemble are worn according to manufacturer guidelines. Candidate Directions: You will don personal protective clothing within 60 seconds. The test will begin when I say, “start.” The test will end when you say, “done.” Do you understand the directions? Performance Measures (check appropriate box) Pass Fail The candidate must complete all steps (100%) to receive a passing score. 1. Dons pants and boots with all fasteners secured and suspenders in place 2. Dons hood, covering ears, head, and neck 3. Dons coat with storm flap closed and collar up and secured 4. Dons helmet and secures with chinstrap 5. Dons gloves with no skin exposed 6. Completes within 60 seconds • 1st time: ______________ • 2nd time: ______________ Evaluation Results Overall Evaluation: Pass / Fail (circle one) Student Signature / Date: Evaluator Signature / Date: Comments: DRAFT Month Year Fire Fighter 1 Page 1 of 1 Department of Forestry and Fire Protection Office of State Fire Marshal, State Fire Training 1-5: Don SCBA Candidate Information Candidate Name and SFT ID Number: Circle One: Day 1 First Attempt / Day 1 Second Attempt / Day 2 First Attempt / Day 2 Second Attempt General Information Standard: Office of the State Fire Marshal / CTS Guide: 1-5 / Course Plan: Fire Fighter 1A, Topic 2-5 Performance Outcome: Don SCBA verifying activation and operation of the unit within 60 seconds. Candidate Directions: You will demonstrate donning an SCBA within 60 seconds. The test will begin when I say, “start.” The test will end when you say, “done.” Do you understand the directions? Performance Measures (check appropriate box) Pass Fail The candidate must complete all steps (100%) to receive a passing score. 1. Verifies that SCBA is ready for services and confirms amount of air in cylinder is above minimum acceptable level 2. Opens SCBA cylinder valve fully, checking gauge for operation, and verbally verifies air cylinder 3. Dons SCBA backpack assembly using over-the-head or coat method 4. Verifies activation and operation of PASS device 5. Dons face piece 6. Checks face piece seal and operation of exhalation valve 7. Connects face piece to air supply/regulator and checks function by taking several normal breaths 8. Has all personal protective clothing correctly in place 9. Completes all elements within 60 seconds • 1st time: ________________________ • 2nd time: ________________________ Evaluation Results Overall Evaluation: Pass / Fail (circle one) Student Signature / Date: Evaluator Signature / Date:DRAFT Comments: Month Year Fire Fighter 1 Page 1 of 1 Department of Forestry and Fire Protection Office of State Fire Marshal, State Fire Training 1-6: Doff SCBA Candidate Information Candidate Name and SFT ID Number: Circle One: Day 1 First Attempt / Day 1 Second Attempt / Day 2 First Attempt / Day 2 Second Attempt General Information Standard: Office of the State Fire Marshal / CTS Guide: 1-6 / Course Plan: Fire Fighter 1A, Topic 2-5 Performance Outcome: Doff the SCBA and prepare it for reuse. Candidate Directions: You will doff your SCBA and prepare it for reuse. The test will begin when I say, “start.” The test will end when you say, “done.” Do you understand the directions? Performance Measures (check appropriate box) Pass Fail The candidate must complete all steps (100%) to receive a passing score. 1. Removes SCBA 2. Closes cylinder valve completely 3. Bleeds air from high and low pressure hosts 4. Shuts off PASS device 5. Checks air cylinder pressure and replaces cylinder if lass than 90% of rated capacity 6. Returns all straps, valves, and components, preparing SCBA for reuse Evaluation Results Overall Evaluation: Pass / Fail (circle one) Student Signature / Date: Evaluator Signature / Date: Comments: DRAFT Month Year Fire Fighter 1 Page 1 of 1 Department of Forestry and Fire Protection Office of State Fire Marshal, State Fire Training 1-7: Doff, Inspect, and Prepare Structural PPE for Reuse Candidate Information Candidate Name and SFT ID Number: Circle One: Day 1 First Attempt / Day 1 Second Attempt / Day 2 First Attempt / Day 2 Second Attempt General Information Standard: Office of the State Fire Marshal / CTS Guide: 1-2 and 1-7 / Course Plan: Fire Fighter 1A, Topic 2-4 Performance Outcome: Doff and inspect PPE, preparing all parts for reuse. Candidate Directions: You will doff your PPE, and inspect and prepare all parts for reuse, verbalizing all elements of the inspection process. The test will begin when I say, “start.” The test will end when you say, “done.” Do you understand the directions? Performance Measures (check appropriate box) Pass Fail The candidate must complete all steps (100%) to receive a passing score. 1. Removes protective clothing 2. Inspects all elements of PPE for damage and cleaning needs • Helmet • Turnout coat and pants • Hood • Boots • Gloves 3. Describes AHJ cleaning and decontamination policies and procedures 4. Cleans equipment as needed 5. Removes damaged equipment from service and reports to Officer (if applicable) 6. Places clothing in a ready state Evaluation Results Overall Evaluation: Pass / Fail (circle one) Student Signature / Date: Evaluator Signature / Date: Comments: DRAFT Month Year Fire Fighter 1 Page 1 of 1 Department of Forestry and Fire Protection Office of State Fire Marshal, State Fire Training 1-8: Doff SCBA and PPE for Gross Decontamination Candidate Information Candidate Name and SFT ID#: Circle One: Day 1 First Attempt / Day 1 Second Attempt / Day 2 First Attempt / Day 2 Second Attempt General Information Standard: Office of the State Fire Marshal / CTS Guide: 1.8 / Course Plan: Fire Fighter 1A, Topic 2-7 Performance Outcome: Doff SCBA and structural PPE in a manner that reduces contaminant exposure. Candidate Directions: Doff SCBA with contaminated PPE. The test will begin when I say, “start.” The test will end when you say, “done.” Do you understand these instructions? Performance Measures (check appropriate box) Pass Fail The candidate must complete all steps (100%) to receive a passing score. 1. Applies water to flush surface contaminants from PPE 2. Sets aside all tools and equipment in bucket or carry-all for contaminated tools and equipment 3. Removes SCBA pack from back while