division of emergency medical services · 17-1 4.3.15 water supply – hydrant – forward lay...
TRANSCRIPT
Division of Emergency Medical Services
Volunteer Firefighter Practical Skills Examination Packet
EFFECTIVE APRIL 1, 2019
INDEX OF PRACTICAL SKILL SHEETS – VOLUNTEER FIREFIGHTER
SKILL # OBJECTIVE SKILL TEST
METHOD
STATE MAXIMUM ALLOTTED
1-2 4.1.2 Personal Protective Equipment - Donning PPE M 1 Minute
1-3 4.3.1 Personal Protective Equipment - Donning SCBA M 1 Minute
1-4 4.3.1 4.2.4
Personal Protective Equipment - SCBA Emergency Procedures
M 5 Minutes
7-3 4.3.6 One Firefighter Extension Ladder Carry and Raise M 10 Minutes
12-1 4.3.10 Advancing a Charged Line Outdoors M 10 Minutes
2-1 4.3.20 Knots and Hoisting R 10 Minutes
3-1 4.2.3 Communications – Radio Transmission R 1 Minute
4-1 4.3.2 Responding on Apparatus R 5 Minutes
6-1 4.3.4 Forcible Entry R 5 Minutes
7-1 4.3.6 Two Firefighter Ladder Carry and Raise R 10 Minutes
7-7 4.3.10 Operating A Hose Line from a Ladder R 2 Minutes
10-7 4.2.4 Declaring a Mayday R 3 Minutes
14-1 4.3.11 Horizontal Ventilation R 15 Minutes
16-1 4.3.14 Two Firefighter Salvage Cover Fold and Deployment R 10 Minutes
16-2 4.3.14 One Firefighter Salvage Cover Roll and Spread R 10 Minutes
17-1 4.3.15 Water Supply – Hydrant – Forward Lay Connections R 10 Minutes
17-2 4.3.15 Water Supply – Hydrant – Reverse Lay Connections R 10 Minutes
18-1 4.3.16 Operating Portable Fire Extinguishers R 3 Minutes
19-1 4.3.18 Securing Building Utilities R 3 Minutes
EMS 0206 4/19 [760-1092] Page 3 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
PERSONAL PROTECTIVE EQUIPMENT (PPE) DONNING PPE
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Personal Protective Equipment - Donning PPE Skill No. 1-2
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.1.2
Candidate Instruction
The candidate, given a complete ensemble of personal protective clothing, shall don personal protective clothing according to manufacturer’s recommendations within 1 minute. Candidate shall clap hands or verbalize at completion of skill; this will allow the evaluator to stop time when clap of hands or verbal indication is heard.
Timing starts when the candidate first touches any article of turnout gear after telling the evaluator he or she is ready to start. Timing will end when all protective clothing is donned and the candidate has clapped hands or verbalized completion of the skill.
State Maximum Allotted 1 minute
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
Safely performs the following steps: P F P F P F
Dons boots, pants, protective hood, coat, helmet, and gloves. — CRITICAL POINT
All personal protective clothing donned properly (no exposed skin except for facial area), helmet strap is tightened, coat collar is up, and all fasteners are secured). — CRITICAL POINT
Skill shall be completed within 1 minute. — CRITICAL POINT
Firefighter must have at least 70% pass mark for each skill and perform all critical points (3/3 required).
Score: / 3
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 3 / 3 / 3
TIME EVALUATOR COMMENTS
EMS 0206 4/19 [760-1092] Page 4 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 0206 4/19 [760-1092] Page 5 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
PERSONAL PROTECTIVE EQUIPMENT (PPE) DONNING SCBA
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Personal Protective Equipment - Donning SCBA Skill No. 1-3
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.1
Candidate Instruction
The candidate, wearing complete ensemble of personal protective clothing, shall properly don a self-contained breathing apparatus according to manufacturer’s recommendations within 1 minute. The candidate shall have the hood on and pulled back. The helmet and gloves are not worn to start the practical skill but must be worn to complete the skill. The candidate may use any of the following: Over-the-head method, Coat method, Seat mount method, or Compartment method. Candidate shall clap hands or verbalize at completion of skill; this will allow the evaluator to stop time when clap of hands or verbal indication is heard.
Timing starts when the candidate first touches any part of the SCBA after telling the evaluator he or she is ready to start. Timing will end when all protective clothing and SCBA are donned, the PASS device is armed, and the candidate has clapped hands or verbalized completion of the skill.
State Maximum Allotted 1 minute
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
Safely performs the following steps: P F P F P F
Wearing complete ensemble of personal protective clothing. — CRITICAL POINT
Dons SCBA using one of the listed methods and ensures unit is secured and adjusted properly. — CRITICAL POINT
Open cylinder valve completely. — CRITICAL POINT
Dons face piece, attaches regulator (if using waist mount regulator, attaches breathing tube to regulator), inhales activating regulator, listens for proper seal ensuring there are no leaks. — CRITICAL POINT
Ensures exhalation valve is working properly and PASS device is armed. — CRITICAL POINT
Dons hood, helmet, and gloves and ensures there is no exposed skin. — CRITICAL POINT
Skill shall be completed within 1 minute. — CRITICAL POINT
Firefighter must have at least 70% pass mark for each skill and perform all critical points (7/7 required).
Score: / 7
EMS 0206 4/19 [760-1092] Page 6 of 40
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 7 / 7 / 7
TIME EVALUATOR COMMENTS
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 0206 4/19 [760-1092] Page 7 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
PERSONAL PROTECTIVE EQUIPMENT (PPE) SCBA EMERGENCY PROCEDURES
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Personal Protective Equipment - SCBA Emergency Procedures Skill No. 1-4
Reference Source NFPA 1001 Standard, 2019 Edition JPR(s) 4.3.1, 4.2.4
Candidate Instructions
The candidate, wearing complete ensemble of personal protective equipment (PPE), shall demonstrate controlled breathing techniques and be able to demonstrate the ability to perform an emergency procedure check on the SCBA.
Warning: No emergency breathing procedure is endorsed by manufacturers, IFSTA, ANSI, or any other regulating agency. These procedures should be used only as a last resort in life threatening situations.
State Maximum Allotted
5 minutes
PERFORMANCE STEPS
TEST 1 RETEST 2 RETEST 3
P F P F P F
Wearing complete ensemble of PPE.
Declares MAYDAY, activates PASS device. — CRITICAL POINT
Notifies partner of SCBA problem. — CRITICAL POINT
Does not remove face piece. — CRITICAL POINT
Hand goes to the face piece and regulator, checking by-pass valve.
Uses bypass or cylinder valve to control air flow (depending on free flow or no flow).
Corrects problem if possible.
Moves to exit as quickly as possible.
Firefighter must have at least 70% pass mark for each skill and perform all critical points (6/8 required).
Score: / 8
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 8 / 8 / 8
TIME
EVALUATOR COMMENTS
EMS 0206 4/19 [760-1092] Page 8 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 0206 4/19 [760-1092] Page 9 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
ONE FIREFIGHTER EXTENSION LADDER CARRY AND RAISE
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task One Firefighter Extension Ladder Carry and Raise Skill No. 7-3
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.6
Candidate Instruction
The candidate, wearing complete ensemble of personal protective equipment (PPE), shall remove the 24’ extension ladder from the fire department pumper and carry it to a point of service (as indicated by the evaluator). The candidate shall properly raise (for the purpose of rescue) the 24’ extension ladder to the second floor window. The candidate shall properly spot and secure the 24’ extension ladder for climbing. Note: The student is not permitted to run at any time.
State Maximum Allotted
10 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
Safely performs the following steps: P F P F P F
Wearing complete ensemble of PPE.
Avoids any unsafe act or operation while carrying, raising, or operating on the ladder. — CRITICAL POINT
Proper ladder carry (low or high shoulder, butt-end forward).
Checks and verbalizes for overhead and ground obstruction before raising. — CRITICAL POINT
Proper spotting of ladder (1/4 of used length from building).
Proper raise using beam or flat raise (uses building to butt, fly section in, flush to building).
Proper placement (just below sill, rolls ladder to fly out, 75 degree climbing angle), halyard is secured with a clove hitch, and overhand safety and locks are visually checked, verbalized, and corrected if needed.
Skill shall be completed within 10 minutes.
Firefighter must have at least 70% pass mark for each skill and perform all critical points (6/8 required).
Score: / 8
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 8 / 8 / 8
TIME EVALUATOR COMMENTS
EMS 0206 4/19 [760-1092] Page 10 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 0206 4/19 [760-1092] Page 11 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
ADVANCING A CHARGED LINE OUTDOORS
CANDIDATE NAME (PLEASE PRINT)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Advancing Fire Hose Skill No. 12-1
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.10
Candidate Instruction
The candidate, wearing complete ensemble of personal protective equipment (PPE), and given the necessary equipment and assistance, shall advance a 1-½” or 1-¾” or larger hoseline.
State Maximum Allotted
10 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
ADVANCING A CHARGED LINE OUTDOORS P F P F P F
Wearing complete ensemble of personal protective equipment.
Advances hoseline with partner; both firefighters are on the same side of hose.
Sets nozzle pattern.
Bleeds air out of hoseline before spraying outdoor property. — CRITICAL POINT
Firefighter must have at least 70% pass mark for each skill and perform all critical points (3/4 required).
Score: / 4
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 4 / 4 / 4
TIME EVALUATOR COMMENTS
EMS 0206 4/19 [760-1092] Page 12 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 0206 4/19 [760-1092] Page 13 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
KNOTS AND HOISTING
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Knots and Hoisting Skill No. 2-1
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.20
Candidate Instruction
The candidate, wearing personal protective clothing and given a fire service rope(s), shall tie an appropriate knot and hoist listed equipment. The candidate shall demonstrate each of the following: bowline, clove hitch with appropriate overhand safety.
State Maximum Allotted
10 Minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
Safely performs the following steps: P F P F P F
Wearing personal protective clothing.
Correctly ties the following knots: bowline, clove hitch. Both knots must be completed with the appropriate overhand safety. — CRITICAL POINT
Ties a secure and appropriate knot for one of the following pieces of equipment: pick head axe, exhaust fan, uncharged section of 1 ½” or 1 ¾”, charged section of 1 ½” or 1 ¾”, roof ladder, and pike pole. — CRITICAL POINT
Hoists tools and equipment without complications. — CRITICAL POINT
Firefighter must have at least 70% pass mark for each skill and perform all critical points (3/4 required).
Score: / 4
NUMBER OF ATTEMPTS TEST1 RETEST 2 RETEST 3
SCORE / 4 / 4 / 4
TIME
EVALUATOR COMMENTS
EMS 0206 4/19 [760-1092] Page 14 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 0206 4/19 [760-1092] Page 15 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
COMMUNICATIONS - RADIO TRANSMISSION
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Communications - Radio Transmission Skill No. 3-1
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.2.3
Candidate Instruction
The candidate shall demonstrate transmitting and receiving radio messages using a two-way portable radio.
State Maximum Allotted
1 minute
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
USING A TWO-WAY RADIO P F P F P F
Checks equipment and ensures that radio is on correct frequency, battery is fully charged, and radio is ready to be used. — CRITICAL POINT
Waits for open channel prior to transmitting ensuring that they are not interrupting other transmissions.
Begins with call sign of station being called.
Uses radio phonetics correctly.
Transmits message clearly, concisely, and using clear speech (no codes). — CRITICAL POINT
Firefighter must have at least 70% pass mark for each skill and perform all critical points (4/5 required).
Score: / 5
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 5 / 5 / 5
TIME EVALUATOR COMMENTS
EMS 0206 4/19 [760-1092] Page 16 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 0206 4/19 [760-1092] Page 17 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
RESPONDING ON APPARATUS
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Incident Response - Responding on Apparatus Skill No. 4-1
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.2
Candidate Instruction
The candidate, wearing personal protective clothing, shall properly use all safety devices and equipment while responding on an apparatus to an emergency. The candidate shall properly mount and dismount apparatus, recognizing potential hazards.
State Maximum Allotted
5 minutes
PERFORMANCE STEPS TEST 1 RETEST 1 RETEST 3
Safely performs the following steps: P F P F P F
Starting properly dressed in all personal protective clothing & equipment. — CRITICAL POINT
Mounts apparatus using proper foot and hand holds.
Sits in a proper location and fastens seatbelt and other safety devices. — CRITICAL POINT
Indicates to driver that they are seated and secured.
Completes in cab functions which do not require removal of safety devices.
Remains seated until driver indicates that dismount is safe. — CRITICAL POINT
Dismount using appropriate hand rails and steps while observing the surroundings.
Firefighter must have at least 70% pass mark for each skill and perform all critical points (5/7 required).
Score: / 7
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 7 / 7 / 7
TIME EVALUATOR COMMENTS
EMS 0206 4/19 [760-1092] Page 18 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 0206 4/19 [760-1092] Page 19 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
FORCIBLE ENTRY
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Forcible Entry Skill No. 6-1
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.4
Candidate Instruction
The candidate, wearing complete ensemble of personal protective clothing and given a selection of forcible entry tools, shall demonstrate procedures for forcing their way into one, or a combination of the following: doors, windows, or through walls. The charter training program may demonstrate and/or perform this skill using props.
State Maximum Allotted
5 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
Safely performs the following steps: P F P F P F
Wearing complete ensemble of personal protective clothing. — CRITICAL POINT
Selects proper forcible entry tool for task and identifies locking mechanism or obstruction.
Identifies potential hazards. — CRITICAL POINT
Opens door, window, or wall using approved methods. — CRITICAL POINT
Props open door or window to prevent closure OR ensures it is safe to force their way through a wall.
Firefighter must have at least 70% pass mark for each skill and perform all critical points (4/5 required).
Score: / 5
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 5 / 5 / 5
TIME EVALUATOR COMMENTS
EMS 0206 4/19 [760-1092] Page 20 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 0206 4/19 [760-1092] Page 21 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
TWO FIREFIGHTER LADDER CARRY AND RAISE
CANDIDATES NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Ladders - Two Firefighter Ladder Carry and Raise Skill No. 7-1
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.6
Candidate Instruction
The candidate, wearing complete ensemble of personal protective equipment (PPE), provided with one assistant, and given a fire service extension ladder (24 to 28 foot extension ladder), shall correctly carry the ladder using an approved carry technique. The candidate shall raise ladder, set proper climbing angle, climb the ladder to a designated point, descend the ladder, and safely lower ladder to ground. The candidate shall be giving all placement and movement commands.
State Maximum Allotted
10 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
Safely performs the following steps: P F P F P F
Wearing complete ensemble of PPE.
Carries ladder to the building using approved carrying technique (suitcase, shoulder, flat).
Checks for overhead and ground obstructions before raising and places butt of ladder on ground at a point determined for proper climbing angle. — CRITICAL POINT
Raises ladder to vertical position using a flat or beam raise.
Fly section is extended to necessary height depending on task.
Ladder is stable and under control at all times. — CRITICAL POINT
Ensures proper climbing angle to designate task, halyard is secured with clove hitch, and overhand safety and locks are visually checked. — CRITICAL POINT
Ensures ladder is heeled at all times while on ladder.
Safely climbs to assigned point maintaining three points of contact on ladder.
Safely descends ladder and lowers ladder to ground.
Firefighter must have at least 70% pass mark for each skill and perform all critical points (7/10 required).
Score: / 10
Note: Candidate must be able to demonstrate pivoting ladder, if required.
EMS 0206 4/19 [760-1092] Page 22 of 40
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 10 / 10 / 10
TIME EVALUATOR COMMENTS
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 0206 4/19 [760-1092] Page 23 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
OPERATING A HOSE LINE FROM A LADDER
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER I
PRACTICAL SKILL EVALUATION
Primary Task Ladders – Operating A Hose Line Skill No. 7-7
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.10
Candidate Instruction
The candidate, wearing complete ensemble of personal protective equipment with SCBA, will operate a charged hose line (1½” diameter or larger) while secured to a ground ladder.
State Maximum Allotted
2 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
LADDERS – OPERATING A HOSE LINE P F P F P F
Verifies that ladder is securely tied off and properly heeled.
Climbs ladder, maintaining 3 points of attachment, carrying a hose rope tool or webbing to secure hose to the ladder.
Climbs to proper position and performs a leg lock or secures to ladder with ladder belt. — CRITICAL POINT
Brings up charged hose line using the hand - over - hand method.
Places nozzle over the rung approx. 12” and secures hose to the ladder using hose rope tool or webbing.
Directs hose line to be secured to the ladder every 20’.
Operates then closes nozzle slowly to prevent water hammer.
Firefighter must have at least 70% pass mark for each skill and perform all critical points (5/7 required). The charter training program may demonstrate and/or simulate this skill.
Score: / 7
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 7 / 7 / 7
TIME
EVALUATOR COMMENTS
EMS 0206 4/19 [760-1092] Page 24 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 0206 4/19 [760-1092] Page 25 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
DECLARING A MAYDAY
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Declaring A Mayday Skill No. 10-7
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.2.4
Candidate Instruction
The candidate, wearing personal protective equipment including SCBA, shall demonstrate procedures for declaring a mayday.
State Maximum Allotted
3 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
DECLARING A MAYDAY P F P F P F
Wearing complete personal protective clothing including SCBA.
Transmits on radio that MAYDAY is declared (repeat three times) and reports his / her assignment. — CRITICAL POINT
Listen for acknowledgement of MAYDAY, if no response, repeat.
Reports nature of MAYDAY and current location (last known location).
Manually activates PASS device. — CRITICAL POINT
Firefighter must have at least 70% pass mark for each skill and perform all critical points (4/5 required). The charter training program may demonstrate and/or simulate this skill.
Score: / 5
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 5 / 5 / 5
TIME
EVALUATOR COMMENTS
EMS 0206 4/19 [760-1092] Page 26 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 0206 4/19 [760-1092] Page 27 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
HORIZONTAL VENTILATION
CANDIDATE NAME (PLEASE PRINT)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Horizontal Ventilation Skill No. 14-1
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.11
Candidate Instruction
The candidate, wearing complete ensemble of personal protective equipment (PPE), and given an assistant and the necessary tools and equipment, shall demonstrate ventilating a structure using the following methods.
State Maximum Allotted
15 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
MECHANICAL VENTILATION P F P F P F
Wearing complete ensemble of PPE.
Organizes and collects necessary equipment.
Uses or simulates safe procedures for clearing window/door glass and removing obstructions with respect to wind conditions. — CRITICAL POINT
Ensures exit opening is proportioned to entry opening and establishes a draft path.
Positions and starts fan.
Ensures smoke is cleared before shutting down fan. — CRITICAL POINT
Firefighter must have at least 70% pass mark for each skill and perform all critical points (5/6 required).
Score: / 6
MECHANICAL VENTILATION
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 6 / 6 / 6
TIME EVALUATOR COMMENTS
EMS 0206 4/19 [760-1092] Page 28 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 1258 1/18 [760-1092] Page 29 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
TWO FIREFIGHTER SALVAGE FOLD AND DEPLOYMENT
CANDIDATE NAME (PLEASE PRINT)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Salvage - Two Firefighter Salvage Fold and
Deployment Skill No. 16-1
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.14
Candidate Instruction
The candidate, wearing personal protective clothing, and given a salvage cover and an assistant, shall demonstrate the following salvage cover fold. The candidate shall also demonstrate deploying the folded salvage cover after arranging furnishings.
State Maximum Allotted
10 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
SALVAGE COVER FOLD P F P F P F
Wearing personal protective clothing.
Folds cover in half lengthwise.
Takes open corners and folds cover lengthwise again.
Takes open corners from one end to the other end placing them on top (all 4 corners should be together at this point).
Folds cover end over end until desired size.
Properly arranges furnishings.
Opens and correctly deploys folded salvage cover (edges tucked under furniture).
Firefighter must have at least 70% pass mark for each skill and perform all critical points (5/7 required).
Score: / 7
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 7 / 7 / 7
TIME
EVALUATOR COMMENTS
EMS 1258 1/18 [760-1092] Page 30 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 1258 1/18 [760-1092] Page 31 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
ONE FIREFIGHTER SALVAGE – COVER ROLL AND SPREAD
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task One Firefighter Salvage Cover Roll and Spread Skill No. 16-2
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.14
Candidate Instruction
The candidate, wearing protective clothing, and with the assistance of the evaluator or an assistant, shall roll a salvage cover for the one - firefighter spread. The candidate shall arrange and cover the assortment of furniture using the one - firefighter spread with a rolled cover. The candidate must use the cover that he/she prepared.
State Maximum Allotted
10 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
SALVAGE COVER ROLL AND SPREAD P F P F P F
Wearing complete personal protective clothing.
Cover prepared correctly (creates inside/outside folds, folds ends approximately 12” in, rolls to one end).
Properly arranges furnishings.
Cover deployed correctly (unrolled from one end, edges tucked under furniture).
Skill shall be completed within 10 minutes.
Firefighter must have at least 70% pass mark for each skill and perform all critical points (4/5 required).
Score: / 5
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 5 / 5 / 5
TIME
EVALUATOR COMMENTS
EMS 1258 1/18 [760-1092] Page 32 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 1258 1/18 [760-1092] Page 33 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
WATER SUPPLY - HYDRANT - FORWARD LAY CONNECTIONS
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Water Supply - Hydrant - Forward Lay Connections Skill No. 17-1
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.15
Candidate Instruction
The candidate, wearing complete ensemble of personal protective equipment (PPE), and given supply or intake hose, hose tools, and a fire hydrant, shall connect a fire department pumper to a water supply with a forward lay and ensure connections are tight and water flow is not obstructed.
State Maximum Allotted
10 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
HYDRANT (FORWARD LAY CONNECTION) P F P F P F
Wearing complete ensemble of PPE.
Grasps needed equipment and sufficient hose (spanner and hydrant wrench, necessary appliance and adapter).
Secures hydrant, ensuring they are not between hose and hydrant, and signals pump operator to start lay. — CRITICAL POINT
Removes cap from appropriate outlet(s) and ensures other outlet caps are tightened (uses appropriate outlet nearest fire).
Places hydrant wrench on the valve stem operating nut and operates hydrant to flush debris from hydrant.
Closes hydrant, removes hose loop from hydrant, and connects hose to hydrant outlet closest to fire.
Installs hydrant gate(s) on extra outlet(s) as required by department guidelines.
Ensures supply line is attached to pumper OR hose clamp is used and placed properly by verbal or visual command.
Opens hydrant slowly and ensures water flow is not restricted.
Firefighter must have at least 70% pass mark for each skill and perform all critical points (7/9 required).
Score: / 9
EMS 1258 1/18 [760-1092] Page 34 of 40
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 9 / 9 / 9
TIME EVALUATOR COMMENTS
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 1258 1/18 [760-1092] Page 35 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
WATER SUPPLY - HYDRANT - REVERSE LAY CONNECTIONS
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Water Supply – Hydrant - Reverse Lay Connections Skill No. 17-2
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.15
Candidate Instruction
The candidate, wearing complete ensemble of personal protective clothing, and given supply or intake hose, hose tools, and a fire hydrant, shall connect a fire department pumper to a water supply with a reverse lay and ensure connections are tight and water flow is not obstructed.
State Maximum Allotted
10 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
REVERSE LAY CONNECTION P F P F P F
Wearing complete ensemble of personal protective clothing.
Grasps needed equipment and sufficient hose (spanner and hydrant wrench, necessary appliance and adapter) to reach attack pumper intake.
Anchors hose to stationary object and signals driver to start reverse lay.
Supply line is attached to attack pumper OR hose clamp is used and placed properly.
Intake hose is connected from supply pumper or hydrant and opens hydrant properly and ensures water flow is not restricted.
Prepares supply hose for connection and connects to discharge outlet of supply pumper and charges line once attack pumper is ready (releases hose clamp if used).
Ensures all connections are tight.
Firefighter must have at least 70% pass mark for each skill and perform all critical points (5/7 required).
Score: / 7
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 7 / 7 / 7
TIME
EVALUATOR COMMENTS
EMS 1258 1/18 [760-1092] Page 36 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 1219 1/17 [760-1092] Page 37 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
OPERATING PORTABLE FIRE EXTINGUISHERS
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Operating Portable Fire Extinguishers Skill No. 18-1
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.16
Candidate Instruction
The candidate, wearing complete ensemble of personal protective clothing, and given a selection of portable fire extinguishers, shall extinguish an incipient Class A, B, or C fire so that the correct extinguisher is chosen, the fire is completely extinguished, and proper extinguisher handling techniques are followed.
State Maximum Allotted
3 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
OPERATING PORTABLE FIRE EXTINGUISHERS P F P F P F
Wearing complete ensemble of personal protective clothing.
Identifies class of fire (A, B, C).
Correct fire extinguisher/agent is selected.
Verbalizes disrupting electrical current prior to extinguishing (class C only).
Assures operation prior to using (fully charged and test fire extinguisher).
Uses Pull, Aim, Squeeze, and Sweep method of application.
Extinguishes fire completely and backs away when retreating. — CRITICAL POINT
Firefighter must have at least 70% pass mark for each skill and perform all critical points (5/7 required).
Score: / 7
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 7 / 7 / 7
TIME EVALUATOR COMMENTS
EMS 1219 1/17 [760-1092] Page 38 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
EMS 1219 1/17 [760-1092] Page 39 of 40
OHIO DEPARTMENT OF PUBLIC SAFETY
SECURING BUILDING UTILITIES
CANDIDATE NAME (Please Print)
DATE
CHARTER
CHARTER #
VOLUNTEER FIREFIGHTER
PRACTICAL SKILL EVALUATION
Primary Task Securing Building Utilities Skill No. 19-1
Reference Source NFPA 1001 Standard, 2019 Edition JPR 4.3.18
Candidate Instruction
The candidate, wearing complete PPE, employing all safety precautions, and given tools, shall demonstrate the ability to secure building utilities.
State Maximum Allotted
3 minutes
PERFORMANCE STEPS TEST 1 RETEST 2 RETEST 3
SECURING BUILDING UTILITIES P F P F P F
Wearing complete PPE.
Identifies utility control device and selects proper tool to shut off supply.
Identifies any hazards present and controls or avoids identified hazards.
Uses proper methods to safely secure utilities.
Ensures utility company has been called.
Firefighter must have at least 70% pass mark for each skill and perform all critical points (4/5 required). The charter training program may demonstrate and/or simulate this skill.
Score: / 5
NUMBER OF ATTEMPTS TEST 1 RETEST 2 RETEST 3
SCORE / 5 / 5 / 5
TIME EVALUATOR COMMENTS
EMS 1219 1/17 [760-1092] Page 40 of 40
PRINT NAME FIRST EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE FIRST EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME SECOND EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE SECOND EVALUATOR
X
Overall Skill Sheet Score
Pass Fail
PRINT NAME THIRD EVALUATOR
CERT #
SKILL TEST DATE
/ /
SIGNATURE THIRD EVALUATOR
X
Overall Skill Sheet Score
Pass Fail