Ics Form 209 - Incident Status Summary Page 16

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Block
Block Title
Instructions
Number
*34
Life, Safety, and Health
Note any details in Life, Safety, and Health Status/Threat Remarks (Block
Threat Management
33), and provide additional explanation or information as relevant in Blocks
28, 36, 38, 40, 41, or in Remarks (Block 47). Additional pages may be
necessary for notes.
A. Check if Active
Check any applicable blocks in 34C–P based on currently available
information regarding incident activity and potential.
B. Notes
Note any specific details, or include in Block 33.
C. No Likely Threat
Check if there is no likely threat to life, health, and safety.
D. Potential Future Threat
Check if there is a potential future threat to life, health, and safety.
• Check if there are any mass notifications in progress regarding
E. Mass Notifications In
Progress
emergency situations, evacuations, shelter in place, or other public safety
advisories related to this incident.
• These may include use of threat and alert systems such as the
Emergency Alert System or a “reverse 911” system.
• Please indicate the areas where mass notifications have been completed
(e.g., “mass notifications to ZIP codes 50201, 50014, 50010, 50011,” or
“notified all residents within a 5-mile radius of Gatlinburg”).
F. Mass Notifications
Check if actions referred to in Block 34E above have been completed.
Completed
G. No Evacuation(s)
Check if evacuations are not anticipated in the near future based on current
Imminent
information.
H. Planning for
Check if evacuation planning is underway in relation to this incident.
Evacuation
I. Planning for Shelter-in-
Check if planning is underway for shelter-in-place activities related to this
Place
incident.
J. Evacuation(s) in
Check if there are active evacuations in progress in relation to this incident.
Progress
K. Shelter-In-Place in
Check if there are active shelter-in-place actions in progress in relation to
Progress
this incident.
L. Repopulation in
Check if there is an active repopulation in progress related to this incident.
Progress
M. Mass Immunization in
Check if there is an active mass immunization in progress related to this
Progress
incident.
N. Mass Immunization
Check if a mass immunization effort has been completed in relation to this
Complete
incident.
O. Quarantine in Progress
Check if there is an active quarantine in progress related to this incident.
P. Area Restriction in
Check if there are any restrictions in effect, such as road or area closures,
Effect
especially those noted in Block 28.

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