Confined Space Rescue Level I

Skill Sheet Evaluation

Dates
Location
Lead Instructor
Lead Instructor
Signature
Student Name
Student Signature
Student Address
(email)
Student Agency
Course Title / Confined SpaceRescue Level I

***All KSA’s are developed in accordance with NFPA 1006. All KSA’s which are signed (initials) by the instructor and student will indicate either a PASS or FAIL result for the course. Students receiving a PASS successfully demonstrated appropriate mastery of the KSA under the direct supervision/evaluation of the course instructors.

Confined Space Rescue Level I

Objectives / Pass / Fail
The student shall identify procedures for recognizing and identifying the hazards associated with confined space emergencies. (Hazardous atmospheres, Hazardous chemicals, Temperature extremes)
The student shall identify and utilize procedures for initiating contact and establishing communications with the victim(s).
The student shall identify and utilize procedure for identifying and recognizing confined spaces.
The student shall identify and utilize procedures for implementing site control and scene management.
The student shall identify and utilize procedures for sizing up existing and potential conditions.
The student shall identify and utilize procedures for protecting personnel from hazards within the confined space.
The student shall identify and perform the duties of rescue entrant, attendant, backup entrant, and team leader.
The student shall identify and utilize procedures for monitoring and ventilating the confined space atmosphere.
The student shall identify and utilize procedures for victim packaging. (SKED, Backboard, Hasty 2:1, Harness)
The student shall identify and utilize procedures for communications in a confined space. (Verbal and Non verbal)
The student shall identify and utilize procedures for planning and implementing a confined space rescue operation plan.
The student shall construct and utilize a rope hauling and lowering system in a confined space environment.
The student shall construct and utilize tripods as part of a retrieval system to manipulate a victim/rescuer load.
The student shall operate within a confined space environment.
The student shall identify and utilize procedures for supplied air breathing apparatus operations.
The student shall identify and utilize procedures for record keeping and documentation during entry operations.
The student shall direct confined space rescue operations utilizing a confined space checklist.

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