FORMS Flashcards
Memorandum
Addresses city employees, notifies them of internal changes, specific problems/solutions, or events. Memo template found on workvivo, if numbered memo…filed indefinitely
Community Engagement Request
Used to coordinate station tours, community events, school visits etc. Found on city website, fire page, resources tab, if no access to internet we may fill out for them, FD staff will follow up, BC will notify other BCs, tracked through BC teams page
PACE
Performance and coaching excellence, done during probationary period and 1 time annually past probation, supervisors notified through workday, forms found on workvivo, employee does input form, supervisor does development plan, saved on workday profile
Reimbursement Request
Must have verbal approval from supervisor prior to purchase, <$50 = petty cash, fill out form and submit to office specialist
> $50 = reimbursed via check, send email to office specialist with info, amounts, purpose of purchase, and scanned receipt
> $500 require Finance Executive Director approval prior
Petty cash slip found at stations and in admin
What form do we fill out following a community event?
Community Engagement Survey, done by Captain
Which sections of exposure documentation report do we do?
A and B
Who is contacted regarding exposures?
BC and DICO
Narcotic Discrepancy Memo
Completed when discrepancy is found (late check, missing, miscount)
Notify BC and EMS captain
Form found on policy, fill out, forward to EMS captain and BC, file in PSTrax, then perform narc check
Adult Abuse
APS report on iPad, done ASAP but within 48 hours, notify EMS captain or EMS nurse, seamless doc on iPad uploaded, follow up with a phone call, do not attach to epcr
Child Abuse
CPS report done on iPad, fill out ASAP but within 36 hours, notify CPS/EMS bureau/EMS captain or nurse/PD if danger, follow up phone call, do not attach to EMS report
Sharps Log Injury
Anytime sharps injury occurs, notify BC and DICO, utilize infection control kit, forward form to DICO ASAP, only complete exposure paperwork if necessary (blood borne pathogens)
Submersion Incident Report
Any water related incident involving children (even no transport), notify EMS bureau, seamless doc on iPad, forwarded to Safe Kids Inland Empire
CAL OSHA
Used for serious injury, illness, or death of employee in place of employment or in connection with employment. Seamless doc on iPad, notify EMS captain, follow up phone call to OSHA within 24 hours of the incident
Property Damage Report
Complete any time damage has been done to private or city property, captain notifies BC, NC notifies DC ops, DC support services, and Risk, form found on workvivo, complete within same shift
Report of Employee Injury
Completed anytime an employee is injured regardless of disposition, found on work vivo, employee completes employee section, captain completes supervisor section, filed in admin and Risk indefinitely