HICS 214 - ACTIVITY LOG

The HICS 214 - Activity Log records details of notable activities for any Hospital Incident Management Team (HIMT) position. These logs provide basic documentation of incident activity, and a reference for any After Action Report (AAR). Personnel should document how relevant incident activities are occurring and progressing, or any notable activities, actions taken and decisions made.
Initiated and maintained by personnel in HIMT positions as it is needed or appropriate.
A completed HICS 214 must be submitted to the Documentation Unit Leader. Individuals may retain a copy for their own records.

Multiple pages can be used if needed. If additional pages are needed, use another HICS 214 and repaginate as needed.

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 (mm-dd-yyyy) 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
• 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.
• Notable Activities
• Activities described may include notable occurrences or events such as task assignments, task completions, injuries, difficulties encountered, etc.

8. Prepared by
• Name
• Position/Title • Signature
• Date/Time

Enter the name plus ICS position/title of the person preparing the form. Since this is a radio delivery form, a typed name is same as a signature. Click field to enter date/time, (mm-dd-yyyy) and time prepared (24-hour clock).

More Information



You can save your completed HTML to a text file. This will allow you to reload the HICS214 with ALL entered form data. You do this prior to submitting the form. Then you can open a new 214 and load the saved HTML form data. NOTE: Date and Times will be the previous, so change if needed. It will save the info as a text file with the Date and Time as the text file name. Now you can use any browser, save your form, (as many versions as you like), and then re-populate.

Printing this form is dependent upon your selected printer and its settings. Various Web Browsers and and their viewing sizes are not all the same. Printing from a browsers print function may be different from the operating systems default print mode. Select what works for you, for both printing and viewing. You may print direct to the printer as a HTML or save as a PDF then print the PDF. In some instances Landscape mode may print better than Portrait.

There is a feature to allow you to clear the acivity log. This is so you do not have to enter the data above it again.

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Copy and Paste Data From Spreadsheet

Copy the data from the spreadsheet and paste in box below, then click "Parse Data"
TAB delineation only. Ensure fields match and data does not exceed field lengths, or HTML will miss some data.


        

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                   HICS214 - ACTIVITY LOG
                 HICS - Hospital Incident Command System
   1. Incident Name

     

                     
   2. Operational Period     (#):  

         Date From      To  

         Time From         To  

   3. Name    4. HIMT Position  

  
5.  Activity Log      Page #                       Paste Data from a Spreadsheet               
Date / Time Notable Activities


   6. Prepared by 
  Date/Time   Facility 

     Attach CSV data file to message? Yes    No  
                                        

                             HICS 214 v 9.6