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Sample Role Evaluation Checklist (cont’d)

Role Evaluation Checklist
Job Action Sheet (JAS) Criteria: Clinic Manager (Flu Scenario)

Part II. Job Action Evaluation

Mission:Oversee all POD functions. Met Not Not N/A Comments/
Met Observed Recommendations
1. Read entire JAS. X

2. Obtained briefing from mass care X
unit leader.

3. Obtained list of assigned staff X Noted and recorded
and site location.

4. Ensured that all assigned staff X All staff were in atten-
were present at work site. dance.

5. Briefed all POD staff on the cur- X
rent situation; communicated the
Incident Action Plan (IAP).

6. Assigned JAS and tasks to the X
POD staff.

7. Ensured that all necessary paper- X
work and supplies were in place at
work site in advance.

8. Received and forwarded all X
requests for additional personnel,
equipment, supplies, and trans-
portation.
9. Continually reassessed work flow X
and patient flow.

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