Station Inspection Form
In conjunction with the Station Chore Chart
DateTime
Supervisor
Adam
Cariota
Kirkdorffer
Pagel
Parks
Puerto
Roberts
Tuttoilmondo
Wogan
Cameron
Shift
A
B
C
D
Other/Event
Station
91
92
93
94
95
96
97
980
Other/Event
Day of the week
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
In-Charge
Attendant
Attendant
Third
BLS / Debit
BLS / Debit
Daily Chores (If complete check box. If incomplete or not done leave box unchecked and leave comment.)
Comments
Day specific chores (Select the chores that correspond with the wall chart.)
Comments
Compliance (visible PHI/ immediate safety issues)
Comments
Overall Score (0-7)
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Note to Crew
In-Charge #1 Email
example@example.com
Attendant #1 Email
example@example.com
Third Crew Member #1 Email
example@example.com
In-Charge #2 Email
example@example.com
Attendant #2 Email
example@example.com
Third Crew Member #2 Email
example@example.com
BLS / Debit #1
example@example.com
BLS / Debit #2
example@example.com
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Should be Empty: