1. Training Name Training Title Here

1. Training Name
Training Title Here / 2. Operational Period to be covered by IAP (Date/Time)
From: __/__/__ To: __/__/__ / TAP IAP COVER SHEET
3. Approved by Incident Commander(s):
ORG NAME
FD ______
FD ______
______
______
TRAINING ACTION PLAN
The items checked below are included in this Incident Action Plan:
ICS 201- Organization Chart, Safety Message, Priorities, Key Decisions/Directions)
______
ICS 204- (Crew Assignment Lists)
ICS 205- (Communications Plan)
ICS 206- (Medical Plan)
ICS 208- (Safety Message)
ICS 214- Training Log(s)
ICS 215 – Facility Needs Worksheet
ICS 215a – Hazard Assessment / Safety Plan
Map/Chart
Weather forecast /
Other Attachments
Master Contact List
Master list of tasks & notes
4. Prepared by: ______FD Training Bureau Incident Commander Date/Time __/__/__
1. Training Name
Training Title Here / 2. Operational Period to be covered by IAP (Date/Time)
From: __/__/__ To: __/__/__ / INCIDENT OBJECTIVES
ICS 202-TAP
Command Structure:
4. Operational Period Command Emphasis (Safety Message, Priorities, Key Decisions/Directions)
Approved Site Safety Plan Located at:
5. Prepared by: ______Date/Time __/__/__
1. Training Name
Training Title Here / 2. Operational Period to be covered by IAP (Date/Time)
From: __/__/__ To: __/__/__ / Assignment List
ICS 204-TAP
3. Type
Type ___ – ______Training / 4. Division/Group/Staging
______
5. Operations Personnel Name Affiliation Contact # (s)
Training Lead:
Adjunct Instructors :
6. Resources Assigned: Class Descriptions “X” indicates 204a attachment with additional instructions
Date / Lead / Adjuncts / # of Persons / Reporting Info/Notes/Remarks
o
o
o
o
o
o
o
o
7. Work Assignments
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment)
Name/Function Radio: Freq./System/Channel Phone Cell/Pager ______
Lead instructor will request Ops and FG from Metcom each day
Emergency Communications
Medical Evacuation Other
10. Prepared by Date/Time
/ 11. Reviewed by Lead Date/Time / 12. Reviewed by Chief West Date/Time
MEDICAL PLAN / 1.  Incident Name / 2.  Date Prepared / 3.  Time Prepared / 4.  Operational Period
5. Incident Medical Aid Station
Medical Aid Stations / Location / Paramedics
Yes No
6. Transportation
A. Ambulance Services
Name / Address / Phone / Paramedics
Yes No
B. Incident Ambulances
Name / Location / Paramedics
Yes No
South Metro Fire Rescue
7. Hospitals
Name / Address / Travel Time
Air Ground / Phone / Helipad
Yes No / Burn Center
Yes No
8. Medical Emergency Procedures
Prepared by (Medical Unit Leader) / 10. Reviewed by (Safety Officer)
SAFETY MESSAGE
Incident: / Volunteer Conference / Date: / Time:
9/8/2010 / 14:05
Operational Period: / 10/1 - 3/10 / 0800-1700
Major Hazard and Risks:
Narrative:
Prepared By:
SAFETY OFFICER
1. Training Name
Training Title Here / 2. Operational Period to be covered by IAP (Date/Time)
From: __/__/__ To: __/__/__ / Supplies Needed
ICS 215-TAP
3. Type
Type ___ – ___ Training / 4. Division/Group/Staging
Facility and Supply Needs
5. Operations Personnel Name Affiliation Contact # (s)
Conference Incident Commander:
6. Facility and Supply Needs “X” indicates 204a attachment with additional instructions
Items Needed / In Stock / Date Ordered / Responsibility / Location Needed
o
o
o
o
o
o
o
o
o
o
o
Special Notes:
10. Prepared by Date/Time / 11. Reviewed by Lead Date/Time / 12. Reviewed by Date/Time

FD Training Bureau lesson plan ICS Format (Rev 01/2010)

INCIDENT ACTION PLAN SAFETY ANALYSIS / 1. Incident Name
TIC/live fire / 2. Date
October 1-3 (Volunteer Conference) / 3. Time
07:00-17:00
Division or Group / Potential Hazards / Mitigations (e.g. PPE, buddy system, escape routes)
Type of Hazard:
Thermal Injuries
/ Type of Hazard:
Slip and Falls
/ Type of Hazard:
Heat exposure
/ Type of Hazard:
Dehydration
/ Type of Hazard: / Type of Hazard: / Type of Hazard: / Type of Hazard
Prepared by (Name and Position)

FD Training Bureau lesson plan ICS Format (Rev 01/2010)

TRAINING LOG / 1. Incident Name / 2. Date Prepared / 3. Time Prepared
4. Unit Name/Designators / 5. Unit Leader (Name and Position) / 6. Operational Period
7. Personnel Roster Assigned
Name / Position / Home Base
8. Activity Log
Time / Major Events
Daily Notes
Injuries:
Unusual Circumstances:
Needs for next session:
Comments:
9. Prepared by (Name and Position) / Turn in Completed Training Logs Each Day

Master Contact List

Name / Agency / Position / Phone / e-mail

FD Training Bureau lesson plan ICS Format (Rev 01/2010)