Attached are examples of real life ICS 214 forms from disaster incidents as well as planned events such as memorial services. Please remember that while these are not secret documents they are "responder Sensitive" which means we do not share them with the general public. Please complete empty journal
Here find a video showing how to fill out an ICS 214 form for class.
ACTIVITY LOG (ICS 214) 1. Incident Name:
2. Operational Period: Date From: Date To: Time From: Time To:
3. Name:
4. ICS Position:
5. Home Agency (and Unit):
6. Resources Assigned: Name ICS Position Home Agency (and Unit)
7. Activity Log: Date/Time Notable Activities
8. Prepared by: Name: Position/Title: Signature:
ICS 214, Page 1 Date/Time:
ACTIVITY LOG (ICS 214) 1. Incident Name: 2. Operational Period: Date From: Date To:
Time From: Time To:
7. Activity Log (continuation): Date/Time Notable Activities
8. Prepared by: Name: Position/Title: Signature:
ICS 214, Page 2 Date/Time:
ICS 214 Activity Log Purpose. The Activity Log (ICS 214) records details of notable activities at any ICS level, including single resources, equipment, Task Forces, etc. These logs provide basic incident activity documentation, and a reference for any after- action report. Preparation. An ICS 214 can be initiated and maintained by personnel in various ICS positions as it is needed or appropriate. Personnel should document how relevant incident activities are occurring and progressing, or any notable events or communications. Distribution. Completed ICS 214s are submitted to supervisors, who forward them to the Documentation Unit. All completed original forms must be given to the Documentation Unit, which maintains a file of all ICS 214s. It is recommended that individuals retain a copy for their own records. Notes: • The ICS 214 can be printed as a two-sided form. • Use additional copies as continuation sheets as needed, and indicate pagination as used.
Block Number Block Title Instructions
1 Incident Name Enter the name assigned to the incident. 2 Operational Period
• Date and Time From • Date and Time To
Enter the start date (month/day/year) and time (using the 24-hour clock) and end date and time for the operational period to which the form applies.
3 Name Enter the title of the organizational unit or resource designator (e.g., Facilities Unit, Safety Officer, Strike Team).
4 ICS Position Enter the name and ICS position of the individual in charge of the Unit. 5 Home Agency (and Unit) Enter the home agency of the individual completing the ICS 214. Enter
a unit designator if utilized by the jurisdiction or discipline. 6 Resources Assigned Enter the following information for resources assigned:
• Name Use this section to enter the resource’s name. For all individuals, use at least the first initial and last name. Cell phone number for the individual can be added as an option.
• ICS Position Use this section to enter the resource’s ICS position (e.g., Finance Section Chief).
• Home Agency (and Unit) Use this section to enter the resource’s home agency and/or unit (e.g., Des Moines Public Works Department, Water Management Unit).
7 Activity Log • Date/Time • Notable Activities
• Enter the time (24-hour clock) and briefly describe individual notable activities. Note the date as well if the operational period covers more than one day.
• Activities described may include notable occurrences or events such as task assignments, task completions, injuries, difficulties encountered, etc.
• This block can also be used to track personal work habits by adding columns such as “Action Required,” “Delegated To,” “Status,” etc.
8 Prepared by • Name • Position/Title • Signature • Date/Time
Enter the name, ICS position/title, and signature of the person preparing the form. Enter date (month/day/year) and time prepared (24-hour clock).
- 1 Incident Name_19:
- 3 Name:
- 4 ICS Position:
- 5 Home Agency and Unit:
- NameRow1_3:
- ICS PositionRow1:
- Home Agency and UnitRow1:
- NameRow2_3:
- ICS PositionRow2:
- Home Agency and UnitRow2:
- NameRow3_3:
- ICS PositionRow3:
- Home Agency and UnitRow3:
- NameRow4_3:
- ICS PositionRow4:
- Home Agency and UnitRow4:
- NameRow5_3:
- ICS PositionRow5:
- Home Agency and UnitRow5:
- NameRow6_3:
- ICS PositionRow6:
- Home Agency and UnitRow6:
- NameRow7:
- ICS PositionRow7:
- Home Agency and UnitRow7:
- NameRow8:
- ICS PositionRow8:
- Home Agency and UnitRow8:
- DateTimeRow1:
- Notable ActivitiesRow1:
- DateTimeRow2:
- Notable ActivitiesRow2:
- DateTimeRow3:
- Notable ActivitiesRow3:
- DateTimeRow4:
- Notable ActivitiesRow4:
- DateTimeRow5:
- Notable ActivitiesRow5:
- DateTimeRow6:
- Notable ActivitiesRow6:
- DateTimeRow7:
- Notable ActivitiesRow7:
- DateTimeRow8:
- Notable ActivitiesRow8:
- DateTimeRow9:
- Notable ActivitiesRow9:
- DateTimeRow10:
- Notable ActivitiesRow10:
- DateTimeRow11:
- Notable ActivitiesRow11:
- DateTimeRow12:
- Notable ActivitiesRow12:
- DateTimeRow13:
- Notable ActivitiesRow13:
- DateTimeRow14:
- Notable ActivitiesRow14:
- DateTimeRow15:
- Notable ActivitiesRow15:
- DateTimeRow16:
- Notable ActivitiesRow16:
- DateTimeRow17:
- Notable ActivitiesRow17:
- DateTimeRow18:
- Notable ActivitiesRow18:
- DateTimeRow19:
- Notable ActivitiesRow19:
- DateTimeRow20:
- Notable ActivitiesRow20:
- DateTimeRow21:
- Notable ActivitiesRow21:
- DateTimeRow22:
- Notable ActivitiesRow22:
- DateTimeRow23:
- Notable ActivitiesRow23:
- DateTimeRow24:
- Notable ActivitiesRow24:
- 8 Prepared by Name:
- PositionTitle_15:
- DateTime_15:
- 1 Incident Name_20:
- Date From:
- Date To:
- Time From:
- Time To:
- DateTimeRow1_2:
- Notable ActivitiesRow1_2:
- DateTimeRow2_2:
- Notable ActivitiesRow2_2:
- DateTimeRow3_2:
- Notable ActivitiesRow3_2:
- DateTimeRow4_2:
- Notable ActivitiesRow4_2:
- DateTimeRow5_2:
- Notable ActivitiesRow5_2:
- DateTimeRow6_2:
- Notable ActivitiesRow6_2:
- DateTimeRow7_2:
- Notable ActivitiesRow7_2:
- DateTimeRow8_2:
- Notable ActivitiesRow8_2:
- DateTimeRow9_2:
- Notable ActivitiesRow9_2:
- DateTimeRow10_2:
- Notable ActivitiesRow10_2:
- DateTimeRow11_2:
- Notable ActivitiesRow11_2:
- DateTimeRow12_2:
- Notable ActivitiesRow12_2:
- DateTimeRow13_2:
- Notable ActivitiesRow13_2:
- DateTimeRow14_2:
- Notable ActivitiesRow14_2:
- DateTimeRow15_2:
- Notable ActivitiesRow15_2:
- DateTimeRow16_2:
- Notable ActivitiesRow16_2:
- DateTimeRow17_2:
- Notable ActivitiesRow17_2:
- DateTimeRow18_2:
- Notable ActivitiesRow18_2:
- DateTimeRow19_2:
- Notable ActivitiesRow19_2:
- DateTimeRow20_2:
- Notable ActivitiesRow20_2:
- DateTimeRow21_2:
- Notable ActivitiesRow21_2:
- DateTimeRow22_2:
- Notable ActivitiesRow22_2:
- DateTimeRow23_2:
- Notable ActivitiesRow23_2:
- DateTimeRow24_2:
- Notable ActivitiesRow24_2:
- DateTimeRow25:
- Notable ActivitiesRow25:
- DateTimeRow26:
- Notable ActivitiesRow26:
- DateTimeRow27:
- Notable ActivitiesRow27:
- DateTimeRow28:
- Notable ActivitiesRow28:
- DateTimeRow29:
- Notable ActivitiesRow29:
- DateTimeRow30:
- Notable ActivitiesRow30:
- DateTimeRow31:
- Notable ActivitiesRow31:
- DateTimeRow32:
- Notable ActivitiesRow32:
- DateTimeRow33:
- Notable ActivitiesRow33:
- DateTimeRow34:
- Notable ActivitiesRow34:
- DateTimeRow35:
- Notable ActivitiesRow35:
- DateTimeRow36:
- Notable ActivitiesRow36:
- 8 Prepared by Name_2:
- PositionTitle_16:
- DateTime_16:
,
Emergency and Disaster Preparedness
Group 1 Alpha Group 2 Gamma Janiece Austin-Lindsey Caszhmere Chaison Katrina Aydlett-White Reagan Charlton Elizabeth Beadle Harley Chivers Victoria Blount Steven Clark Caroll Boykins Jr. William Conaway Charli Brooks Keegan Massey
Group 3 Delta Group 4 Sigma Evan Cox Cyna Hudson Marame Dai Anita Hurrdle Jazmine Dunham Rodney Jones Rose Frederick Dennis Lassiter IV Marcia Gallop Caleb Dolan Tyra Gutierrez Destini Mitchell
Group 5 Beta Group 6 Sigma Jade Mitchell McKenzye Smalls Sydney Moore Etavian Stokes Joseph Morris Jalen Thompson Johnny Neal Nigel Trafton Nyla Phillips Addison Travis Danielle Silver Jakari Washington
Group 7 Omega Juanita Wiggins David Wilkerson Adrionna Williams Kyl Williams General Xo D'angelo Mosby