+-----------------------------------------------------------------------+
| Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date: |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                        |
|                                                                       |
| Location: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      |
+-----------------------------------------------------------------------+

+--------------------------------+-------------------------------------+
| Objective No.: 1               | # Warning                           |
+--------------------------------+-------------------------------------+

**Objective: Demonstrate the capability to initiate public warning
procedures at the EOC, to include activation of the Emergency Alert
System (EAS).**

## Performance Criterion 1

\[*Fill in the performance criterion/anticipated action as identified
for your exercise*\]

Points of Review:

+-----------------------------------------------------------------------+
| ### Please answer t                                                   |
| he following: Y = Yes, N = No, NA = Not Applicable, NO = Not Observed |
+-----------------------------------------------------------------------+

+--------------------------------------+-------+-------+-------+-------+
|                                      | # Y   | **N** | *     | *     |
|                                      |       |       | *NA** | *NO** |
+--------------------------------------+-------+-------+-------+-------+
| 1\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 2\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 3\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 4\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+

**Comments:**

+-----------------------------------------------------------------------+
| Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date: |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                        |
|                                                                       |
| Location: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      |
+-----------------------------------------------------------------------+

+--------------------------------+-------------------------------------+
| Objective No.: 2               | # Direction & Control               |
+--------------------------------+-------------------------------------+

**Objective: Demonstrate the capability of the local EOC to coordinate
comprehensive response activities.**

## Performance Criterion 1

\[*Fill in the performance criterion/anticipated action as identified
for your exercise*\]

**Points of Review:**

+-----------------------------------------------------------------------+
| ### Please answer t                                                   |
| he following: Y = Yes, N = No, NA = Not Applicable, NO = Not Observed |
+-----------------------------------------------------------------------+

+--------------------------------------+-------+-------+-------+-------+
|                                      | # Y   | **N** | *     | *     |
|                                      |       |       | *NA** | *NO** |
+--------------------------------------+-------+-------+-------+-------+
| 1\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 2\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 3\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 4\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+

**Comments:**

+-----------------------------------------------------------------------+
| Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date: |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                        |
|                                                                       |
| Location: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      |
+-----------------------------------------------------------------------+

+--------------------------------+-------------------------------------+
| Objective No.: 3               | # Evacuation                        |
+--------------------------------+-------------------------------------+

**Objective: Demonstrate the capability of management to conduct and
coordinate an evacuation.**

## Performance Criterion 1

\[*Fill in the performance criterion/anticipated action as identified
for your exercise*\]

**Points of Review:**

+-----------------------------------------------------------------------+
| ### Please answer t                                                   |
| he following: Y = Yes, N = No, NA = Not Applicable, NO = Not Observed |
+-----------------------------------------------------------------------+

+--------------------------------------+-------+-------+-------+-------+
|                                      | # Y   | **N** | *     | *     |
|                                      |       |       | *NA** | *NO** |
+--------------------------------------+-------+-------+-------+-------+
| 1\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 2\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 3\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 4\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+

**Comments:**

+-----------------------------------------------------------------------+
| Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date: |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                        |
|                                                                       |
| Location: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      |
+-----------------------------------------------------------------------+

+--------------------------------+-------------------------------------+
| Objective No.: 4               | # Shelter/Mass Care                 |
+--------------------------------+-------------------------------------+

**Objective: Demonstrate responsible organization capability to identify
shelters and mass care facilities for immediate use.**

## Performance Criterion 1

\[*Fill in the performance criterion/anticipated action as identified
for your exercise*\]

**Points of Review:**

+-----------------------------------------------------------------------+
| ### Please answer t                                                   |
| he following: Y = Yes, N = No, NA = Not Applicable, NO = Not Observed |
+-----------------------------------------------------------------------+

+--------------------------------------+-------+-------+-------+-------+
|                                      | # Y   | **N** | *     | *     |
|                                      |       |       | *NA** | *NO** |
+--------------------------------------+-------+-------+-------+-------+
| 1\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 2\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 3\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 4\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+

**Comments:**

+-----------------------------------------------------------------------+
| Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date: |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                        |
|                                                                       |
| Location: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      |
+-----------------------------------------------------------------------+

+--------------------------------+-------------------------------------+
| Objective No.: 5               | # Emergency Public Information      |
+--------------------------------+-------------------------------------+

**Objective: Demonstrate the collection and dissemination of information
to the public during emergency operations.**

## Performance Criterion 1

\[*Fill in the performance criterion/anticipated action as identified
for your exercise*\]

**Points of Review:**

+-----------------------------------------------------------------------+
| ### Please answer t                                                   |
| he following: Y = Yes, N = No, NA = Not Applicable, NO = Not Observed |
+-----------------------------------------------------------------------+

+--------------------------------------+-------+-------+-------+-------+
|                                      | # Y   | **N** | *     | *     |
|                                      |       |       | *NA** | *NO** |
+--------------------------------------+-------+-------+-------+-------+
| 1\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 2\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 3\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 4\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+

**Comments:**

+-----------------------------------------------------------------------+
| Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date: |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                        |
|                                                                       |
| Location: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      |
+-----------------------------------------------------------------------+

+--------------------------------+-------------------------------------+
| Objective No.: 6               | # Situational Assessment            |
+--------------------------------+-------------------------------------+

**Objective: Demonstrate the capability to conduct rapid situational
assessment.**

## Performance Criterion 1

\[*Fill in the performance criterion/anticipated action as identified
for your exercise*\]

**Points of Review:**

+-----------------------------------------------------------------------+
| ### Please answer t                                                   |
| he following: Y = Yes, N = No, NA = Not Applicable, NO = Not Observed |
+-----------------------------------------------------------------------+

+--------------------------------------+-------+-------+-------+-------+
|                                      | # Y   | **N** | *     | *     |
|                                      |       |       | *NA** | *NO** |
+--------------------------------------+-------+-------+-------+-------+
| 1\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 2\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 3\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 4\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+

**Comments:**

+-----------------------------------------------------------------------+
| Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date: |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                        |
|                                                                       |
| Location: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      |
+-----------------------------------------------------------------------+

+--------------------------------+-------------------------------------+
| Objective No.: 7               | # Health & Medical                  |
+--------------------------------+-------------------------------------+

**Objective: Demonstrate the ability to identify immediate supplemental
medical assistance to meet the health and medical needs of disaster
victims.**

## Performance Criterion 1

\[*Fill in the performance criterion/anticipated action as identified
for your exercise*\]

**Points of Review:**

+-----------------------------------------------------------------------+
| ### Please answer t                                                   |
| he following: Y = Yes, N = No, NA = Not Applicable, NO = Not Observed |
+-----------------------------------------------------------------------+

+--------------------------------------+-------+-------+-------+-------+
|                                      | # Y   | **N** | *     | *     |
|                                      |       |       | *NA** | *NO** |
+--------------------------------------+-------+-------+-------+-------+
| 1\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 2\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 3\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 4\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+

**Comments:**

+-----------------------------------------------------------------------+
| Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date: |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                        |
|                                                                       |
| Location: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      |
+-----------------------------------------------------------------------+

+--------------------------------+-------------------------------------+
| Objective No.: 8               | # Resource Management               |
+--------------------------------+-------------------------------------+

**Objective: Demonstrate procedures for tracking assets and resources
committed to response operations.**

## Performance Criterion 1

\[*Fill in the performance criterion/anticipated action as identified
for your exercise*\]

**Points of Review:**

+-----------------------------------------------------------------------+
| ### Please answer t                                                   |
| he following: Y = Yes, N = No, NA = Not Applicable, NO = Not Observed |
+-----------------------------------------------------------------------+

+--------------------------------------+-------+-------+-------+-------+
|                                      | # Y   | **N** | *     | *     |
|                                      |       |       | *NA** | *NO** |
+--------------------------------------+-------+-------+-------+-------+
| 1\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 2\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 3\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 4\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+

**Comments:**

+-----------------------------------------------------------------------+
| Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date: |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                        |
|                                                                       |
| Location: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      |
+-----------------------------------------------------------------------+

+--------------------------------+-------------------------------------+
| Objective No.: 9               | # Resource Management               |
+--------------------------------+-------------------------------------+

**Objective: Demonstrate the ability to prioritize and use
jurisdictional resources and assets for maximum effectiveness during
response operations.**

## Performance Criterion 1

\[*Fill in the performance criterion/anticipated action as identified
for your exercise*\]

**Points of Review:**

+-----------------------------------------------------------------------+
| ### Please answer t                                                   |
| he following: Y = Yes, N = No, NA = Not Applicable, NO = Not Observed |
+-----------------------------------------------------------------------+

+--------------------------------------+-------+-------+-------+-------+
|                                      | # Y   | **N** | *     | *     |
|                                      |       |       | *NA** | *NO** |
+--------------------------------------+-------+-------+-------+-------+
| 1\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 2\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 3\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 4\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+

**Comments:**

+-----------------------------------------------------------------------+
| Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date: |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                        |
|                                                                       |
| Location: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      |
+-----------------------------------------------------------------------+

+--------------------------------+-------------------------------------+
| Objective No.: 10              | # Requesting Assistance             |
+--------------------------------+-------------------------------------+

**Objective: Determine and identify the procedures required for
requesting assistance from higher levels of government.**

## Performance Criterion 1

\[*Fill in the performance criterion/anticipated action as identified
for your exercise*\]

**Points of Review:**

+-----------------------------------------------------------------------+
| ### Please answer t                                                   |
| he following: Y = Yes, N = No, NA = Not Applicable, NO = Not Observed |
+-----------------------------------------------------------------------+

+--------------------------------------+-------+-------+-------+-------+
|                                      | # Y   | **N** | *     | *     |
|                                      |       |       | *NA** | *NO** |
+--------------------------------------+-------+-------+-------+-------+
| 1\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 2\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 3\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+
| 4\.                                  |       |       |       |       |
+--------------------------------------+-------+-------+-------+-------+

**Comments:**