PWS Attachment 1 HRTSE Checklist and Firefighting Checklist.pdf

NETC High-Risk Training Safety Evaluation Checklist

This checklist is used during High-Risk Training Safety Evaluations (HRTSE). It is not meant to be all-encompassing, but thorough review of high-risk training requirements. This checklist does not include all possible questions related to the physical condition of trainers, devices, and/or platforms.

***THIS CHECKLIST IS NOT ALL INCLUSIVE OF HRT AND SAFETY REGULATIONS, AND

DOES NOT INCLUDE QUESTIONS AND/OR SAFETY AND OCCUPATIONAL HEALTH

REQUIREMENTS CONTAINED IN 29 CFR 1910 OR OTHER STANDARDS***

UPDATED June 2021

Review Date:

4/13/2022

GENERAL HRTSE QUESTIONS YES NO N/A

Ref (a) NETCINST 1500.13C, Naval Education and Training High and Moderate-Risk Training Safety Program Ref (b) NETCINST 1500.5D, Instructor Qualification, Certification and Sustainment Program Ref (c) NAVEDTRA 135D, Navy School Management Manual Ref (d) OPNAVINST 1500.75D, Policy and Guidance for Conducting High-Risk Training Ref (e) OPNAV M-5100.23H, Navy Safety and Occupational Health Manual Ref (f) OPNAVINST 3500.39D, Operational Risk Management Ref (g) NETCINST 1540.2A, NETC Training Effectiveness Program

Curricula

1. Is the approved curriculum being used to conduct training? See Master Course File [Ref (a), page 18, para 6d(1)(d) / Ref (d), page 9, para 6e(4)]

a. CIN: ________________________ g. CIN: _____________________________

b. CIN: ________________________ h. CIN: _____________________________

c. CIN: ________________________ i. CIN: _____________________________

d. CIN: ________________________ j. CIN: _____________________________

e. CIN: ________________________ k. CIN: _____________________________

f. CIN: ________________________ l. CIN: _____________________________

2. Are safety policies, requirements, procedures, control measures, awareness training and lessons learned incorporated into the appropriate HRT curricula? [Ref (a), page 9, para 6c(1)(e) / page 12, para 6c(1)(n-o)]

3. Does the student indoctrination include discussion of safety requirements, precautions, and safeguards incorporated into the curricula, and the definitions of and procedures for reporting mishaps, near-misses, and unsafe/unhealthful working conditions? [Ref (a), page 27, para 6d(4)(a)]

4. Are TTO procedures included in all high-risk course curricula? [Ref (a), page 17, para 6c(5)(b)]

5. Are DOR procedures included in all voluntary high-risk course curricula? [Ref (a), page 17, para 6c(5)(a) / Ref (d), page 7, para 5d(12)]

YES NO N/A

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6. Are instructor lesson plans personalized? [Ref (a), page 24, para 6d(2)(f)13 / Ref (b), page 5, para 6c / Ref (c), page 3-17, para 4.11k]

7. Does the Learning Center / Learning Site ensure the course is not taught to students during the piloting phase until instructors are certified, and a risk assessment and EAP have been developed? [Ref (d), page 8, para 5d(20)]

8. Are physical, academic, medical screening and performance standards prerequisites reflected in the Catalog of Navy Training Courses (CANTRAC)? [Ref (a), page 9, para 6c(1)(f) / Ref (d), page 10, para 5g(1)]

9. Has Corporate Enterprise Training Activity Resource Systems (CeTARS) been validated and is the Special Course Indicator Code updated when high-risk courses are developed, modified, or when elements of risk are introduced into courses not previously considered high-risk courses? (D=High Risk DOR, H=High Risk, J=Moderate Risk) [Ref (a), page 9, para 6c(1)a]

10. Is an interim CUIT approved by the LC and completed by instructors before commencing any pilot course? [Ref (a), page 11, para 6c(1)(h)15 Note]

11. When a new or revised CUIT is received from the LC, is it compared with the current CUIT to identify additional qualifications required? [Ref (a), page 19, para 6d(1)(f)]

12. Is a safety review conducted subsequent to major curriculum changes, major course revisions, technical training equipment upgrades or upgrades? [Ref (a), page 36, para 6d(10)(a) / Ref (d), page 6, para 5d(8)]

Military Instructor Screening

13. Upon receipt of a prospective HRT instructor's orders, does the learning site coordinate with the detaching command to initiate instructor screening? [Ref (a), page 19, para 6d(2)(b) / Ref (d), page 10, para 5g(3)]

14. Was the service record review and personal interview at the learning site conducted by the CO/OIC or designated representative? Is the delegated representative designated in writing? [Ref (a), page 19, para 6d(2)(c)1]

15. Medical Record Review (MRR) Physical/Psychological screening completed by a competent medical authority? [Ref (a), page 20, para 6d(2)(c)2]

16. Is a NAVPERS 1070/613 (Page 13) in the training jacket documenting completion of service record review, personal interview, and medical/psychological screening completed and if the member was found suitable/unsuitable for high-risk instructor duty? [Ref (a), page 20, para 6d(2)(c)3 / Ref (d), page 7, para 5d(16)]

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Civil Service Instructor Screening

17. Medical Record Review (MRR) Physical / Psychological screening completed by a competent medical authority? [Ref (a), page 21, para 6d(2)]

18. Have civilian employees teaching high-risk courses received a medical screening every 3 years? (Unless required more frequent by other directives) [Ref (a), page 21, para 6d(2)Note]

19. Is a memorandum in the training jacket documenting that the personnel record review, interview, medical and psychological screening has been completed and member was found suitable/unsuitable for high-risk instructor duty? [Ref (a), page 21, para 6d(3) / Ref (d), page 7, para 5d(16)]

Contract Instructor Screening

20. Does the screening process include medical screening, drug screening and psychological screening? [Ref (a), page 22, para 6d(2)(e)1-3 / Ref (d), page 2, para 4c]

21. Was the medical screening conducted by a civilian medical doctor or credentialed PA or NP (family practice)? [Ref (a), page 22, para 6d(2)(e)1]

22. Are all required screening items on company letterhead, to include if the member was found suitable/unsuitable for high-risk instructor duty, and maintained in the instructor training? [Ref (a), page 22, para 6d(2)(e)4 / Ref (d), page 7, para 5d(16)]

23. Is the screening process for contractors serving as high-risk instructors renewed every 3 years and/or during contract re-compete or renewal? [Ref (a), page 22, para 6d(2)(e)]

24. Are clearly defined instructor qualifications and requirements, including completion of Personnel Qualification Standards, JQRs, certificates of course completion in desired subjects, (i.e., basic instructor, small arms instructor, crew served weapons instructor, emergency medical technician, CPR, basic first aid, explosives driver, swim, firefighter, rigid hull inflatable boat), and other assigned qualifications as applicable to the course of instruction and the CUIT in the PD, MOA, MOU or SOW? [Ref (a), page 13, para 6c(2)(a)1 / Ref (d), page 10, para 5f(8)]

25. A contract instructor shall have completed one of the following forms of training for instructor qualification:

a. Military service ITC.

b. Instructor training via an academic institution.

c. Academic credentialing (teacher/professor).

[Ref (b), page 3, para 4g(2)(a-b)]

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Instructor Qualifications / CUIT / Training Jacket

26. Certificate of completion for Instructor Training (IT), Navy Instructor Training Course (NITC) school (9502/805A) or equivalent? [Ref (a), page 24, para 6d(2)(f)11 / Ref (b), page 2, para 4a]

27. Instructors returning for a follow-on instructor duty tour who carry NEC 9502 or 805A in their NEC inventory shall complete the current version of NAVEDTRA 14300A if the interim time between instructor tours has been greater than five years. [Ref (b), page 3, para 4f]

28. Are there HIPAA violations from the medical and psychosocial screening in the instructor training jacket? [Ref (a), page 20, para 6d(2)(c)5 / page 21, para 6d(2)(d)5 / page 23, 6d(2)(e)4]

29. Have all prospective instructors attended, as a student, the course or all high-risk segments of the course(s) for which they are going to instruct. Maintain the certificate in their training jacket? [Ref (a), page 24, para 6d(2)(f)12 / Ref (d) page 6, para 5d(9)]

30. Do all instructors observe a certified instructor(s) present and facilitate course(s), lesson(s), and/or topic(s) in the classroom or laboratory prior to certification? [Ref (b), page 5, para 6b]

31. Do all instructor practice teach with a certified instructor in the course (s), module(s), section(s), lesson(s), and/or topic(s) for which certification is to be granted. [Ref (b), page 5, para 6d]

32. Have all certified instructors completed a CUIT prior to teaching students without another certified instructor present? [Ref (a), page 19, para 6d(2)Note / Ref (d), page 6, para 5d(9)]

33. Is the completed CUIT maintained in the ITJ? [Ref (a), page 19, para 6d(2)Note]

34. Does the CUIT contain the minimum required information:

a. Completion of command safety indoctrination. [Ref (a), page 23, para 6d(2)(f)2]

b. CPR training. [Ref (a), page 23, para 6d(2)(f)3 / Ref (d), page 7, para 5d(15)]

c. Bloodborne pathogen awareness training. [Ref (a), page 23, para 6d(2)(f)4 / Ref (d) page 6, para 5d(9)]

d. First aid training. [Ref (a), page 23, para 6d(2)(f)5 (First aid exempt, page 32, para

6d(7)(a) / Ref (d), page 7, para 5d(15)]

e. ORM training. [Ref (a), page 23, para 6d(2)(f)6 / Ref (d) page 5, para 5d(6)]

f. Familiarization with: [Ref (a), page 23-24, para 6d(2)(f)7 a-g]

1) All safety controls.

2) Emergency Action Plan.

3) Training equipment.

4) Personal Protective Equipment.

5) Daily Operations Readiness Test, as applicable.

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6) Site specific hazardous operations and training platforms.

7) Applicable safety policies, directives, precautions, technical manuals for training platforms, lessons learned from fleet mishaps.

g. Definitions of and procedures for reporting mishaps, near-misses, and unsafe/unhealthy working conditions. [Ref (a), page 24, para 6d(2)(f)8]

h. Guidance on TTO and DOR policies and procedures (as applicable). [Ref (a), page 24, para 6d(2)(f)9]

i. Emphasis on an instructor’s full understanding of the training platform operation, identified risks, and control measures necessary to identify and prevent HRT mishaps.

[Ref (a), page 24, para 6d(2)(f)10]

j. Completion of Instructor Training or a civilian equivalent school, prior to teaching students. [Ref (a), page 24, para 6d(2)(f)11]

k. Attending high-risk portions of course as a student. [Ref (a), page 24, para 6d(2)(f)12]

l. Personalize instructor guide. [Ref (a), page 24, para 6d(2)(f)13]

m. Requirement to receive, at a minimum, two evaluations assessing both technical knowledge of subject matter and instructional delivery skills (lab evaluations shall be in high-risk topics). [Ref (a), page 24, para 6d(2)(f)14 / Ref (b), page 6, para 6f]

n. Thorough understanding of the EAP. [Ref (a), page 24, para 6d(2)(f)15]

o. Have all instructors received initial and annual training in Sudden Cardiac Arrest (SCA), Exertional Collapse Associated with SCT (ECAST) and heat stroke signs, symptoms, prevention and response protocol, including Universal Training Precautions? (NAVADMIN 108-19)

35. Are the two initial (practice-teach) instructor evaluations maintained in the training jacket? [Ref (a), page 24, para 6d(2)(f)15Note]

36. Are all HRT instructors evaluated quarterly by means of an unscheduled evaluation (spot check)? [Ref (b), page 7, para 7b / ref (c), page 3-18, para 4.12b-c]

37. Has the instructor attended and completed scheduled in-service training (IST)? [Ref (b), page 6, para 6g]

Small Arms Training Instructors

38. Have Small Arms Marksmanship Instructors (SAMI) and Crew Served Weapons Instructor (CSWI) completed applicable instructor training course?

[Ref (h), page 11, para 11.b thru 11.i]

39. Have the instructors completed the applicable PQS for the weapons they instruct?

[Ref (h), page 10, para 11]

40. Are the instructors maintaining their qualifications for the course of fire and type of weapon they instruct? [Ref (h), page 12, para 12] [CSWI, encl (8), p 2]

41. Is the Range Safety Officer (RSO) appointed in writing by the Commanding Officer?

[Ref (h), page 12, para 14]

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42. Are SAMIs and CSWIs appointed in writing? [Ref (h), page 9, para 8g(4)]

43. Are line coaches designated in writing by the primary RSO? [Ref (h), page 10, para 10]

Students

44. Have all students completed the student medical screening form (NETC 1500/5) prior to conducting high-risk training? [Ref (a), page 27, para 6d(4)(b)]

45. Does the Training Site Authority sign each student medical screening form prior to attending training? [Ref (a), page 27, para 6d(4)(b)2]

46. Is the Training Site Authority appointed in writing by the CO/OIC? [Ref (a), page 27, para 6d(4)(b)2]

47. Are all student medical screening forms destroyed no later than 30 days after trainee graduated? [Ref (a), page 28, para 6d(4)(b)3]

48. Are there procedures in place to ensure instructors are informed of students who were previously “set back” due to medical conditions that might cause future problems? [Ref (a), page 27, para 6d(4)(c)]

49. Is a process in place to identify students with specific medical conditions or concerns?

[Ref (a), page 27, para 6d(4)(c)2]

Student Critiques

50. Are student surveys completed at the end of the course if it is one week (five working days) or longer in duration? [Ref (g), page 4, para 6e(4)]

51. Are student surveys completed for courses less than one week in duration? [Ref (g), page 4, para 6e(4)]

52. Are students dropped from training given the opportunity to complete a student survey?

[Ref (g), page 3, para 5d(2)]

53. Are all student critiques reviewed to identify potential safety issues? [Ref (a), page 37, para 6d(10)(b) / Ref (a), page 41, para 6e(13)]

54. Are student critiques summarized and recommended course of action to mitigate discrepancies provided? [Ref (c), page 5-14, para 4.3m(1)]

Risk Assessment

55. Is the risk assessment in the NETC established format? [Ref (a), page 30, para 6d(5)(a)]

56. Has the annual risk assessment review been documented and uploaded into ESAMS?

[Ref (a), page 30, para 6d(5)(d)]

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57. Has each step of the operation been thoroughly evaluated and identified on the risk assessment? [Ref (a), page 16, para 6c(4)(b)3 / page 30, para 6d(5)(a)3]

58. Were approved curricula job sheets, or other curricula related documents, utilized while developing, revising, or reviewing course risk assessments? [Ref (a), page 30, para 6d(5)(a)3 / page 40, para 6e(7)(c)]

59. Does the site ensure training that is conducted in an environment that subjects students and/or staff to extreme temperatures includes controls to mitigate the hazard? [Ref (a), page 36, para 6d(9)(a) / Ref (d) page 8, para 5d(18)]

Drop on Request (DOR) and Training Time Out (TTO)

60. Are students who are enrolled in voluntary high-risk courses briefed on DOR policy and procedures prior to commencement of the course? [Ref (a), page 31, para 6d(6)(a)]

61. If a student, in a voluntary high-risk course, desires to quit or DOR, is that student immediately and expeditiously removed from the training area? [Ref (d), Encl (1), page 1, para 4]

62. After a student is removed from voluntary training, do they submit a written request clearly detailing the reasons for DOR? [Resources/Instructions/NETC HRTS Instruction Addendum subdirectory in ESAMS, Drop on Request Procedures, page 1, para 2]

63. When a student elects to DOR, is a written summary of action documented on NAVPERS 1070/613 Administrative Remarks page 13 and entered in the student’s service record and a copy maintained in the command’s permanent records? [Ref (a), page 31, para 6d(6)(b) / Ref (d) page 7, 5d(12)]

64. Are procedures in place to ensure the student is not threatened or coerced to reconsider after they DOR? [Resources/Instructions/NETC HRTS Instruction Addendum subdirectory in ESAMS, Drop on Request Procedures, page 1, para 1]

65. Are personnel, assigned to conduct DOR interviews, familiar with suicide risk factors and prevention resources? [Ref (a), page 31, para 6d(6)(c)]

66. Is a procedure in place to ensure no one in the DOR chain refuses or delays a student’s request to DOR? [Resources/Instructions/NETC HRTS Instruction Addendum subdirectory in ESAMS, Drop on Request Procedures, page 1, para 1]

67. Do interviewers attempt to determine:

a. Motivation for DOR?

b. Any training factors that may lead other students to DOR?

c. If student desires to re-enter program?

d. If student retention were warranted, what actions would alleviate student’s perceived need to DOR?

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[Resources/Instructions/NETC HRTS Instruction Addendum subdirectory in ESAMS, Drop on Request Procedures, page 2, para 2a(1-4)]

68. Are students thoroughly briefed daily on TTO policy and procedures prior to the start of a training event? [Ref (a), page 32, para 6d(6)(d) / Ref (d) page 7, 5d(12)]

69. After a TTO is called, is training immediately ceased until the situation or condition is returned to a safe state? [Ref (d), Encl (1), page 8, para 41]

70. Do TTO signals conform, where feasible, to established fleet distress signals? [Ref (a), page 17, para 6c(5)(b) / page 32, para 6d(6)(d)]

Emergency Action Plan

71. Does the EAP include the following, at a minimum:

a. Primary and alternate communications.

b. Telephone numbers of emergency response activities and immediate COC, etc.

c. Applicable radio channels and call signs.

d. Locations of emergency response personnel.

e. Locations of emergency equipment.

f. Equipment emergency shutdown procedures.

g. Muster location(s).

h. Methods to maintain control of the scene and any non-affected personnel.

i. All immediate emergency procedures for each potential scenario.

[Ref (a), page 34, para 6d(8)(b)1-9]

72. Has an EAP been developed for response to mishaps for all high-risk training evolutions and locations? [Ref (a), page 34, para 6d(8)(b) / Ref (d), Encl (1), page 1, para 5a]

73. Does the EAP cover initial emergency actions for instructors and students to follow in the event of a mishap? [Ref (a), page 34, para 6d(8)(b)]

74. Has all required EAP data been entered into ESAMS? [Ref (a), page 34, para 6d(8)(a)]

75. Has the EAP been reviewed monthly and the quarterly walkthrough and annual exercise conducted? [Ref (a), page 35, para 6d(8)(c) / Ref (d), page 6, 5d(11)]

76. Is a safety brief conducted with all students prior to a high-risk event? [Ref (a), page 35, para 6d(8)(d)]

77. Is the EAP kept at the training site and available for use in the event of an emergency?

[Ref (a), page 35, para 6d(8)(e)]

78. Are all EAP exercises documented in writing and proceeded by thorough planning? [Ref (a), page 35, para 6d(8)(g)]

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79. Does the EAP Drill package contain the following:

a. Overall briefing of drill.

b. Listing of participants/evaluators.

c. Sequence of events.

d. Plan review and approval signatures.

e. Evaluator critiques.

[Ref (a), page 35, para 6d(8)(g)1-5]

High-Risk Training Safety Officer

80. Has the HRTSO completed a learning site specific JQR? [Ref (a), page 26, para 6d(3)(b)2 / Ref (d), page 7, para 5d(13)]

81. Does the HRTSO JQR consist of the following:

a. Familiarization with HRTS instructions.

b. HRTSO responsibilities.

c. All applicable curricula and associated CUIT plans.

d. Familiarization with all high-risk evolutions, associated training platforms, and devices to the extent necessary to properly evaluate assigned training.

e. Familiarization with ESAMS and other appropriate reporting and recording methods.

[Ref (a), page 26, para 6d(3)(b)3a-e / Ref (d), page 9, para 6f(1-3)]

82. Is the HRTSO appointed in writing? [Ref (a), page 25, para 6d(3)(b) / Ref (d), page 7, para 5d(13)]

83. Does the HRTSO designation letter contain:

a. All high-risk course identified by CIN under the HRTSO’s responsibility.

b. Observation periodicity for evolutions required by the CO/OIC (no less than once per year).

[Ref (a), page 25, para 6d(3)(b)]

84. Are HRTSO’s E5 or above, if military, or civilian equivalent? [Ref (a), page 26, para 6d(3)(b)(2)]

85. Does the HRTSO compile and maintain a binder that includes copies of fleet messages, training-related lessons learned, SOPs, copies of completed JQR and certificates of related training, high-risk instructions, or any other relevant data that would facilitate a smooth transition upon transfer of duties? [Ref (a), page 39, para 6e(5)]

86. Does the HRTSO ensure the required number of instructors and/or safety observers present whenever training is conducted? [Ref (a), page 40, para 6e(8)]

87. Does the HRTSO observe HRT evolutions, for each course assigned, and assess compliance with approved training procedures, safety precautions, risk mitigation, emergency procedures, and safety posture at a minimum of once every year? [Ref (a), page 37, para 6e(1)]

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88. Are all course observations, containing the following information documented in

ESAMS:

a. Verify that all recommended curriculum changes have been incorporated.

b. Verify that student-to-instructor ratios are accurate and reflected on the risk assessment as a mitigation factor.

c. Annually review all course risk assessments with supported LSs to ensure they are accurate.

d. Verify TTO (and DOR, as applicable) processes are in place and that students are thoroughly briefed on TTO (and DOR, as applicable) policies prior to commencement of training.

e. Verify condition of the training platform, training devices, equipment, and PPE, ensuring safe to use.

f. Verify compliance with approved training procedures, safety precautions, risk mitigation efforts, and EAP procedures.

g. Highlight observed safety issues noted during training.

h. Ascertain if SOPs are up to date and reflect any changes in processes.

[Ref (a), page 38, para 6e(1)a-h]

89. Does the HRTSO ensure all training-related mishaps, whether first aid, medical treatment, or lost time injuries are investigated, recorded in ESAMS, opened, reviewed, and closed within 30 days? [Ref (a), page 35, para 6d(8)(h) / Ref (a), page 38, para 6e(4)]

90. Does the HRTSO ensure the following items are entered into the ESAMS HRTS module:

a. HRTSO designation letter.

b. EAP quarterly walk-through and annual drill/exercise.

c. Risk assessment sheets for corresponding high-risk course(s).

d. The required frequency of the HRTSO observation for each high-risk course.

e. Documentation of HRTSO observations, including comments and any associated recommendations [Ref (a), page 39, para 6e(6)(a-e)]

91. Does the HRTSO ensure all instructor training records are maintained and contain required qualifications and certifications? [Ref (a), page 40, para 6e(11)]

92. Does the HRTSO ensure personnel have been properly trained to perform their duties in instances where non-instructors are required to fulfill a role in training (i.e., safety swimmers, observers, line handlers, etc.). Safety swimmers, observers, and other non-certified instructors shall not instruct or remediate students. [Ref (a), page 25, para 6d(2)(i)]

93. Has the HRTSO annual inspection of all HRT technical training equipment, devices, training areas, and/or platforms been completed and recorded in ESAMS as an internal annual inspection? (IDATS access is required) [Ref (a), page 38, para 6e(2)]

94. Has the annual safety review been conducted? [Ref (a), page 36, para 6d(10)(a) / Ref (c), page 5-17, para 8.1a-d / Ref (d), page 9, 6e(5) / Ref (d), Encl (1), page 7, para 30]

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95. Does the HRTSO review all HRT student critiques for identified safety issues and assist the LC/LS/HRTSA in developing a means for correction? [Ref (a), page 41, para 6e(13) / Ref (d), page 7, para 5d(14)]

96. Has an analysis been conducted to examine near misses and mishap data? [Ref (d), page 7, para 5d(14) / Ref (d), page 10, para 5f(5)]

97. Does the HRTSO participate in the biannual safety committee meetings with the supporting High-Risk Training Safety Administrator HR-TSA? [Ref (a), page 41, para 6e(14)]

Medical

98. Is an HM, EMT, or other qualified medical representative, and emergency oxygen available on scene during all aquatic and firefighter training? [Ref (a), page 33, para 6d(7)(d) / Ref (a), page 40, para 6e(10)]

99. Is an HM, EMT, or other qualified medical representative on site during any HRT conducted either on or off a military reservation if the training is located more than ten minutes away from emergency response services? [Ref (a), page 32, para 6d(7)(b) / page 40, para 6e(9)]

100. Do assigned medical personnel have a fully inventoried and appropriate medical response bag on-hand and ready for use during all HRT evolutions? [Ref (a), page 33, para 6d(7)(e)]

101. When an HM, EMT, or other medical support person is required, do they simultaneously serve in the role of an instructor during their assignment as an emergency responder. [Ref (a), page 33, para 6d(7)(c)]

102. Have personnel administering emergency oxygen received formal training? [Ref (a), page 33, para 6d(7)(d)]

Workplace Safety

103. Have all training areas received an annual workplace inspection? [Ref (d), Encl (1), page 3, para 13.b / Ref (e), Chapter 9, page 9-3, para 0903a]

104. Were workplace inspection results provided and was the abatement process initiated for identified hazards? [Ref (e), Chapter 9, page 9-4, para 0903i / Ref (e), Chapter 12, page 12-1, para 1202]

105. Has an industrial hygiene survey been conducted at all training sites, if applicable? [Ref (e), Chapter 8, page 8-1 through 8-5, para 0802a-g]

106. Have recommendations of the industrial hygiene survey been implemented? [Ref (e), Chapter 12, page 12-1, para 1202]

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107. Has the activity ensured that an assessment of all workplaces was conducted to determine if hazards are present that necessitate the use of PPE? [Ref (e), Chapter 20, page 20-1, para 2002]

108. Is documentation available to validate that a preventative maintenance system (PMS) is established and includes spot checks for all training equipment, devices and personal protective equipment (PPE)? [Ref (a), page 37, para 6d(10)(c) / Ref (d), page 7, para 5d(17) / Ref (d), page 9, para 5e(3)]

a. Firefighting

b. Diving

c. Small Boats

d. Small Arms Weapons ** See Preventive Maintenance Checklist

109. Are approved eyewash stations available for immediate use in training areas where corrosive materials are in use? [Ref (e), Chapter 19, page 19-1, para 1902]

110. Are plumbed eyewash units activated weekly for a period long enough to verify operation and flush the lines? [Ref (e), Chapter 19, page 19-1, para 1902]

111. Are the inspection and maintenance tags placed on self-contained eyewash units to document most current inspection/maintenance? [Ref (e), Chapter 19, page 19-1, para 1902]

112. Are pressurized and non-pressurized self-contained eyewash units’ service quarterly, as a minimum, or per manufacturer’s recommendations? [Ref (e), Chapter 19, page 19-1, para 1902]

113. Have all eye hazard training areas been properly posted? [Ref (e), Chapter 20, page 20- 2, para 2004]

114. Have all noise hazard training areas been properly posted? [Ref (e), Chapter 18, page 18-5, para 1805]

SPECIAL EMPHASIS – PHYSICAL READINESS TESTING

115. Is a Risk Assessment conducted at least 24 hours prior to the PRT? [ Ref: Navy PRT Guide 5, PRT Testing, page 6]

116. Is a safety plan in place? At a minimum, the plan must include telephone numbers and procedures for summoning aid, clear directions for emergency response personnel to avoid confusion and ensure prompt arrival. [ Navy PRT Guide 5, Testing page 6]

117. Was an emergency drill conducted with ACFLs, support personnel, and PRT monitors?

Did the drill assess skills and review emergency procedures? Did it include various scenarios and was it practiced until the desired results were obtained? [ Ref: Navy PRT Guide 5, PRT Testing, page 6.]

Firefighting Checklist

This checklist is used in conjunction with the NETC HRTSE Checklist for all NETC training sites which provide Aviation, Surface and Submarine firefighting training.

***THIS CHECKLIST IS NOT ALL INCLUSIVE OF HRT AND SAFETY REGULATIONS, AND

DOES NOT INCLUDE QUESTIONS AND/OR ALL SAFETY AND HEALTH REQUIREMENTS

CONTAINED IN 29 CFR 1910 OR OTHER STANDARDS***

UPDATED June 2021

Review Date:

4/13/2022

FIREFIGHTING HRTSE QUESTIONS YES NO N/A

Ref (a) NETCINST 1500.16A, Firefighting Training Safety Program Ref (b) NETCINST 1500.13C, NETC High and Moderate Risk Training Safety Ref (c) NAVMED P-117, Manual of the Medical Department U.S. Navy

Facilities

1. Was NETC advised of all changes or modifications to facilities or training platforms prior to conduct of work? [Ref (a), para 4.b(3)]

2. Do training structures have emergency portable fire extinguishers strategically placed around the fire field based on the local fire department evaluation? [Ref (a), Encl (1) - (3), para 3.b]

3. Is the communication system between the fire field instructors, facilitators and supervisors adequate to ensure emergencies can be signaled and understood? [Ref (a), Encl (1) - (3), para 3.a(1)(a),

4. Does the fire school/simulator have a backup communications system capable of notifying or directly communicating with base fire department (or other emergency responders) in case of primary communications failure and are such systems tested prior to start of the training day? [Ref (a), Encl (1) - (3), para 1.a(9)(a)&(b)]

5. Does the fire school/simulator have an operable means of broadcasting an emergency signal (e.g., bell, horn, whistle, or public address system) over the entire fire field and is this emergency signal/procedure part of the student indoctrination? [Ref (a), Encl (1) - (3), para 3.a(1)(b)]

6. Has a gage calibration program been established which identifies all critical system gages and calibration frequencies, and are gages appropriately calibrated? [Ref (a), Encl (1) - (3), para 4.d]

7. Do compressors utilized to fill SCBA’S meet grade “D” breathing air requirements, are they tested quarterly and is documentation of the air quality posted at the compressor site?

[Ref (a), Encl (1) - (3), para 5.b & 5.c]

8. Are SCBA cylinder refill operating instructions posted in the immediate vicinity of the refilling system? [Ref (a), Encl (1) - (3), para 5.a]

9. Is preventative maintenance conducted on all equipment? Including air compressors?

(Look at O&M Manual to see all required maintenance). Examples include: pre-op oil check, P a g e 2 | 5 check automatic condensate drain, valve checks, oil change, check pistons and rings, replace oil and water separator (if required), [Ref (a), Encl (1) – (3), para 4.] (See 3M Folder)

10. Is the air intake clear of any harmful items (smoking area, HAZMAT operations, etc.)

[Ref (a), Encl (1) – (3), para 5.f]

11. Does the air compressor have a CO alarm? If not, is there a high temperature alarm? If not, are frequent CO tests conducted? [Ref a, Encl (1) – (3), para 5.d & 5.e]

12. Is the Firefighter trainer inspected for damage prior to live fire training evolutions?

[Ref (a), Encl (1) - (3), para 2.a]

13. Are propane firefighter trainers run each day prior to exposing student to live flames?

[Ref (a), Encl (1) - (3), para 2.d]

14. Are all doors used for emergency exits marked and have panic hardware if applicable?

[Ref (a), Encl (1 - 3), para 2.e]

15. Does the ignition device meet the 2019 NFPA 1402 standard for training fireplace pilots (flame pilot system vice spark ignition devices)?

NFPA 1402 (2019) Chapter 8.4.4 – The pilot ignition source shall be applied at the design location with the designed intensity to ignite the flame pilot burner air-fuel mixture. 8.4.6 No substitute for flame pilot burners shall be utilized to ignite main burners. 8.4.7 All main burners shall be ignited directly from a confirmed and monitored pilot flame.

Mobile Aircraft Firefighting Training Device

16. Is there a minimum distance of 100 feet between the MAFTD and the nearest drain, unless the drain is engineered to capture and recycle run off? [Ref (a), Encl (3), para 2.f.]

17. Is the immediate area around the MAFTD free of combustible materials, safety hazards, and environmental concerns? [Ref (a), Encl (3), para 2.g.]

18. Is the MAFTD positioned a minimum 300 feet from overhead power lines? [Ref (a), Encl (3), para 2.f.]

19. Has the MAFTD been properly set-up and supported? [Ref (a), Encl (3), para 2.h.]

Personal Protective Equipment

20. Have all fire-fighting staff who are required to wear an SCBA been medically cleared to wear a respirator, received respirator training and been fit tested? [Ref (a), Encl (1) - (2), para 7.c, Encl (3), para 7.c.]

NFPA 1500 (2018) Chapter 7.13.3 – Fit testing of tight-fitting atmosphere-supplying respirators and tight-fitting powered air-purifying respirators shall be accomplished by

P a g e 3 | 5 performing “quantitative” fit testing in the negative-pressure mode, regardless of the mode of operation that is used for respiratory protection.

* IF COMS Contractors wear an SCBA during DORT, are they in Respirator Program?

21. Prior to fire-fighting exercises, do staff members inspect each student to ensure that protective equipment is properly donned and that all PPE is in suitable condition? [Ref (a), Encl (1) – (3), para 9.b.]

Instructor Additional Qualification Requirements

22. Does the instructor/facilitator qualification system provide for the following levels of qualification:

a. Instructor Operating Station Console Operator?

b. Instructor?

c. Structure Chief?

d. Field Safety Chief?

e. Control Tower Operator?

f. Dead Man Switch Operator [Ref (a), Encl (1), para 8.a(1)-(4), Encl (2), para 8.a(1)-(5), Encl (3), para 8.a(1)-(6)]

23. Have all fire field support personnel / laboratory instructors (such as smoke abatement system operator, fuel operator, etc.) met locally developed written qualifications (PQS)/training requirements? [Ref (a), Encl (1), para 8.b, Encl (2) & (3) para 8.c.]

24. Is a Hospital Corpsman (HM), Emergency Medical Technician (EMT), or medical support personnel, as well as emergency oxygen, available on scene during all firefighting training. [Ref (a), Encl (1) – (2), para 3.c, Ref (b), para 6.d.(7)(d)]

25. Is a Hospital Corpsman (HM), Emergency Medical Technician (EMT), or medical support personnel simultaneously assigned to instruct firefighting training evolutions?

[Ref (a), Encl (1) – (2), para 3.c, Ref (b), para 6.d(7)(c)]

Standard Operating Procedures (SOPs)

26. Are SOPs in place that identifies the initial equipment setup/startup and readiness processes for: DORT

a. Water supply alignment?

b. Emergency extinguishing system checks?

c. Placement and check of emergency equipment?

d. Electrical system check? *

e. Drainage alignment check?

f. Emergency alarm check? *

g. Ventilation system alignment? *

h. Fuel supply alignment? *

i. Communications checks? *

P a g e 4 | 5

[Ref (a), Encl (1) - (3), para 1.a(1) - (9)]

27. Are SOPS in place that identify the process for each fire scenario for:

a. Initial preparations?

b. PPE worn by instructors and students

c. Number of instructors, facilitators and safety observers; includes positions and duties?

d. Ventilation, if mechanical

e. Fueling system activation and securing? *

e. Ignition system activation and securing? *

f. Instructor/facilitator rotation procedures?

g. Securing procedures after final fire?

* Not required for 19F/21C12 trainers.

[Ref (a), Encl (1) - (3), para 1.b(1- 8)]

28. Are SOPs in place that identify the processes for facility/equipment shutdown and securing including:

a. Ignition system alignment and securing? *

b. Fuel system alignment and securing? *

c. Ventilation system alignment and securing? *

d. Electrical power? *

e. Water system alignment and securing?

f. Storage of extinguishers, hoses, burn pots, etc.?

g. Cooling of structures?

h. Wash-down and drainage?

i. Fuel systems

* "Instrument Power/24 Hour Mode" for 19F/21C12 trainers [Ref (a), Encl (1) - (3), para 1.c(1)(a)-(d) and 1.c(2)(a)-(e)]

29. Is an SOP in place which addresses the process for refueling procedures, including:

a. Safety precautions?

b. Operating Procedures (including approval authority)?

c. Emergency Procedures (including propane leaks)?

d. Notification of base Emergency Services?

[Ref (a), Encl (1) - (3), para 1.d(1 - 4)]

Equipment and Tactics

30. Is the curriculum consistent with the curriculum issued by the CCMM?

[Ref (a), para 4.c(2)(a)]

31. Are firefighting equipment and tactics consistent with Navy doctrine?

[Ref (a), para 4.b(2)]

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Medical Surveillance

32. Do all shore based firefighting instructors have a current 707 Firefighter (Comprehensive) medical surveillance/certification exam (within 5 years)? Is the 707 stressor logged in OMSS on ESAMS? [Ref (c), Article 15-110 (Firefighting Instructor Personnel Examinations and Standards)]

Physical Stressors, Audio/Noise (503, 512), Respirator (Certification Examinations, 716) is an annual, and is covered in the Medical Surveillance as well.

Also annual Bloodborne, which is accomplished in ESAMS, and Up to date CPR/AED, which is one of the reason for Bloodborne.