Shift Report Entry – Centreville Volunteer Fire Department

Your Email Address *

Used to send confirmation of shift report.

Shift Start Time *

Date

Time

Shift End Time *

Date

Time

Vehicle Used *

Unit Identifier for Shift *

Driver *

Officer in Charge (OIC) *

Other (3rd)

Other (4th)

Number of Calls Run *

Overview of Calls Run

Please say a few words about each call. Do NOT include any PII.
Example: “Call 1: MVA on Rt 28, transported one BLS patient. Call 2: Added on to MEDICAL, Medic transported, back in service.”

General Shift Notes *

Please provide general commentary about how the shift went. Good model: What went well? What didn’t go well? What would you do differently next time?

Training Accomplishments

Please say a few words about any training completed during the shift, to include AIT/DIT training or progress in a BLS Internship Task Book.

Was an Electronic Vehicle Inspection form completed? *

Yes
No

Use paper FRD-167 if Intranet is down.

Were any vehicle deficiencies noted? *

Yes
No

Were the vehicle deficiencies logged in M5? *

Yes
No

If no, explain below.

Please describe the vehicle deficiencies and actions taken. *

Was a First Day Inspection completed using PSTrax? *

Yes
No

First Day Inspections are required on the first shift of the month or during the first 10 days of the month, whichever comes first.

This requires opening up all bags that have a seal, inspecting contents for expiration dates and quantities, placing a new seal, and recording all information in PSTrax.

Have all seals been checked and confirmed in PSTrax? *

Yes
No

Was an FRD-036 (SCBA Field Inspection) completed for each SCBA onboard? *

Yes
No

Was an FRD-212 (ALS Med Inventory) completed? *

Yes
No

Was the station logbook stamped (blue ink) and filled out completely? *

Yes
No

Was all EMS equipment, including BLS and ALS medications, properly secured at the end of the shift? *

Yes
No

Was all CVFD property, including vests, radio straps, passports, helmet shields, etc. properly secured at the end of the shift? *

Yes
No

Is vehicle ready for service? *

Yes
No

“Ready for service” includes vehicle cleaned inside and out, trash bins emptied, and fuel above 3/4 tank.

Please explain why the vehicle is not ready for service. *