Evaluator 1: Evaluator 2: Evaluator Information: Ratings Definitions Rating Definition The targets and critical tasks associated with the core capability were completed in a manner that achieved without objective(s) and did not negatively impact the performance of other activities. Performance of this activity (P) contribute to additional health and/or safety risks for the public or for emergency workers, and was accordance with applicable plans, policies, procedures, regulations, and laws. The targets and critical tasks associated with the core capability were completed in a manner that achieved objective(s) and did not negatively impact the performance of other activities. Performance of this activity with Some contribute to additional health and/or safety risks for the public or for emergency workers, and was (S) accordance with applicable plans, policies, procedures, regulations, and laws. However, opportunities to effectiveness and/or efficiency were identified. The targets and critical tasks associated with the core capability were completed in a manner that achieved with Major objective(s), but some or all of the following were observed: demonstrated performance had a negative (M) performance of other activities; contributed to additional health and/or safety risks for the public or for workers; and/or was not conducted in accordance with applicable plans, policies, procedures, regulations, be Performed The targets and critical tasks associated with the core capability were not performed in a manner that objective(s). Name: Evaluator E-mail: Information: Determine the [amount of time] it takes for [insert facility location name] to identify a patient with [insert special pathogen name] universal travel screening and triage Determine the [amount of time] it takes for [insert facility location name] to isolate the patient with [insert special pathogen name] Task Completed Evaluator Observation Notes and Associated Critical Tasks Explanation of Rating YES NO Not Observed Ability to identify a highly infectious disease patient: Exposure criteria: [insert special Signs/symptoms compatible with pathogen name and clinical signs/symptoms] Travel History
Evaluator Information: Evaluator 1: Evaluator 2: Ratings Definitions Rating Definition without (P) The targets and critical tasks associated with the core capability were completed in a manner that achieved objective(s) and did not negatively impact the performance of other activities. Performance of this activity contribute to additional health and/or safety risks for the public or for emergency workers, and was accordance with applicable plans, policies, procedures, regulations, and laws. with Some (S) The targets and critical tasks associated with the core capability were completed in a manner that achieved objective(s) and did not negatively impact the performance of other activities. Performance of this activity contribute to additional health and/or safety risks for the public or for emergency workers, and was accordance with applicable plans, policies, procedures, regulations, and laws. However, opportunities to effectiveness and/or efficiency were identified. with Major (M) The targets and critical tasks associated with the core capability were completed in a manner that achieved objective(s), but some or all of the following were observed: demonstrated performance had a negative performance of other activities; contributed to additional health and/or safety risks for the public or for workers; and/or was not conducted in accordance with applicable plans, policies, procedures, regulations, be Performed The targets and critical tasks associated with the core capability were not performed in a manner that objective(s). Evaluator Information: Name: E-mail: Determine the [amount of time] it takes for [insert facility location name] to identify a patient with [insert special pathogen name] universal travel screening and triage Determine the [amount of time] it takes for [insert facility location name] to isolate the patient with [insert special pathogen name] Task Completed YES NO Not Observed Associated Critical Tasks Evaluator Observation Notes and Explanation of Rating Ability to identify a highly infectious disease patient: Exposure criteria: Signs/symptoms compatible with [insert special pathogen name and clinical signs/symptoms] Travel History