Forms

FORMS

INCIDENT ACTION PLAN SAFETY ANALYSIS (IMS 215-A)

INCIDENT ACTION PLAN SAFETY ANALYSIS (IMS 215-A)

IMS 215-A

Incident Action Plan Safety Analysis

Purpose: The purpose of the Incident Action Plan Safety Analysis (IMS 215A) is to aid the Safety Officer in completing an operational risk assessment to prioritize hazards, safety, and health issues, and to develop appropriate controls. This form communicates to the Operations and Planning Section Chiefs safety and health issues identified by the Safety Officer.

Preparation: The IMS 215-A is typically prepared by the Safety Officer during the incident action planning cycle. When the Operations Section Chief is preparing for the tactics meeting, the Safety Officer collaborates with the Operations Section Chief to complete the Incident Action Plan Safety Analysis. This worksheet is closely linked to the Operational Planning Worksheet (IMS 215-G). Incident areas or regions are listed along with associated hazards and risks. For those assignments involving risks and hazards, mitigations or controls should be developed to safeguard responders, and appropriate incident personnel should be briefed on the hazards, mitigations, and related measures. Use additional sheets as needed.

Distribution: This form is attached to the Incident Safety Plan and is distributed according to the instructions for Safety Plans. It may also be attached to the IAP, or influence General Safety Messages recorded in IMS 202 and IMS 1001. This form may be used as a display, or distributed during the planning meeting.

Note: This worksheet can be made into a wall mount, and can be part of the IAP. If additional pages are needed, use a blank IMS 215-A and repaginate as needed. Other, hazard-specific versions of this form may also be used, depending on nature of the incident.

Instructions: IMS 215