6530 6000 2B
User Manual: 6530
Open the PDF directly: View PDF 
.
Page Count: 18
DEPARTMENT OF THE NAVY
COMMANDER, NAVAL SURFACE FORCE
UNITED STATES PACIFIC FLEET
2841 RENDOVA ROAD
SAN DIEGO, CALIFORNIA 92155-5490
COMMANDER
NAVAL SURFACE FORCE ATLANTIC
1430 MITSCHER AVE
NORFOLK, VA 23551-2494 IN REPLY REFER TO
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
N01M/N02M
8 Oct 10
COMNAVSURFPAC/COMNAVSURFLANT INSTRUCTION 6000.2B
From: Commander, Naval Surface Force U.S. Pacific Fleet
Commander, Naval Surface Force Atlantic
Subj: MEDICAL READINESS INSPECTION PROGRAM
Ref: (a) OPNAVINST 6530.4B
(b) NAVMED P-117 (MANMED)
(c) COMNAVSURFORINST 6000.1
(d) COMFLTFORCOMINST 6600.1
(e) HA POLICY 06-001, Policy on Oral Health and Readiness
Encl: (1) Medical Readiness Inspection Checklist
1. Purpose. To establish a Medical Readiness Inspection (MRI)
program for afloat Medical Departments per references (a)
through (c). Dental readiness standards for ships without an
assigned Dental Officer is contained in references (d) and (e).
2. Background. The mission of the ship’s Medical Department is
two-fold: to maintain the health and readiness of the ship’s
crew and to maintain the readiness of the Medical Department.
To ensure a continuous state of readiness, the Medical
Department must provide for and promote the health and wellness
of their crew, prevent and treat illness or injury and maintain
complete documentation in medical and administrative records on
individuals and medical programs.
3. Cancellation. COMNAVSURFORINST 6000.2A
4. Intent. To provide the Commanding Officer (CO) of a ship,
the Immediate Superior in Command (ISIC) and the Type Commander
(TYCOM), a timely pre-deployment assessment on the readiness of
the ship’s Medical Department and its ability to accomplish its
mission, functions and tasks. The MRI is used by the TYCOM to
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
2
certify the ship as medically ready for deployment. This
certification is valid for a period of 18 months. No medical
readiness certification shall exceed the 18 month periodicity
without a TYCOM waiver. Platforms exceeding 18 months without a
waiver will lose certification.
5. Action
a. The Regional Medical Representative (RMR) will conduct a
formal MRI no greater than D-120 and less than D-90 days prior
to the departure date for any deployment which will be greater
than 90 days. The RMR will conduct the MRI using the checklists
contained in enclosure (1) of this instruction. The RMR will
ensure that all chapters and sections of the inspection
checklist are completed. Due to the wide variety of ship
classes within the Surface Fleet, not all sections of the
checklist will be applicable to all ships. Those sections not
applicable to the ships being inspected will be marked “NA” for
not applicable. Requests to modify the checklist to conform to
class specific requirements must receive formal approval from
the TYCOM prior to use of a modified checklist. Each section
and sub-section will receive a grade of SAT, UNSAT or NA. A
comment is required for all UNSAT grades. When an UNSAT grade
is noted for an sub-section that is marked “Critical”, the
entire section is deemed UNSAT. The RMR will review and verify
the percentages and dates to be provided in the MRI.
b. Chapter grading is based on the percentage of
satisfactory sections within a chapter. Divide the number of
satisfactory sections by the number of applicable sections then
multiply the resulting product number by 100 to determine the
percentage. The Overall Summary Grade is determined by
averaging the percentages of Chapters 1 thru 6:
(1) C-1 Fully Ready >= 90%
(2) C-2 Substantially Ready>= 80%
(3) C-3 Marginally Ready >= 70%
(4) C-4 Not Ready <= 69%
c. The Regional Medical Representative will provide a
verbal out brief with unit leadership at the conclusion of the
inspection and will forward a copy of the full MRI report, to
the unit, the operational ISIC and the TYCOM. C-1/C-2
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
3
Inspection results will be reported in writing within 10 days of
the inspection. Scores of C-3 or lower will be reported to the
unit, operational ISIC and TYCOM via fastest available means not
to exceed 48 hours. The senior inspector will submit the final
written report along with a Plan of Action and Milestones
(POA&M) within 14 days after the date of the inspection.
d. The RMR can conduct a Technical Assist Visit (TAV) at
any time when requested by the unit leadership, when
questionable circumstances exist within the ship’s Medical
Department, prior to the SMDR turnover and/or prior to a formal
MRI. The TAV is considered an informal review of the Medical
Department and the results of the visit are for use by the
inspected command and the ISIC to provide guidance to the SMDR
and their chain of command.
6. Review Responsibility. COMNAVSURFPAC and COMNAVSURFLANT
Medical Officers are responsible for the annual review of this
instruction.
R. A. ROGERS J. P. GELINNE
Chief of Staff Chief of Staff
Distribution:
Electronic only, via COMNAVSURFOR Directives Web site,
https://www.surfor.navy.mil/directives0/pages/default.aspx
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
Enclosure (1)
NAVAL SURFACE FORCE
MEDICAL READINESS INSPECTION
UNIT:
MRI/TAV DATE:
Commanding Officer:
DEPLOYMENT DATE:
Executive Officer:
SMDR:
Senior Inspector:
CHAPTER Percentage C-STATUS HEALTH MAINTENANCE PERCENT
1. Administration and Training 0% 0 Tetanus 0%
2. Supplies and Equipment 0% 0 Influenza, Seasonal 0%
3. Emergency Medical Preparedness 0% 0 Hepatitis A 0%
4. Ancillary Services 0% 0 Hepatitis B 0%
5. Environmental Health Programs 0% 0 MMR/Titer 0%
6. Occupational Health Programs 0% 0 OPV/IPV 0%
AMAL Status (%): 0.00%
Tuberculosis Surveillance 0%
Current IMR % 0.00%
HIV 0%
Blood Bank Certification Date: 0-Jan-00
Periodic Health Assessments 0%
Ship's Sanitation Control Certification Expiration Date: 0-Jan-00 Women's Health Examinations 0%
OVERALL SUMMARY GRADE 0.0% DNA 0%
Comments: Audiograms 0%
Dental Readiness (IDC Ships) 0%
GRADING CRITERIA:
Chapter C-Status:
Chapter grading is based on the percentage of satisfactory sections.
Any UNSAT in a critical sub-section will make the entire
section UNSAT
Divide the number of satisfactory sections by the number of applicable sections.
Multiply this amount by 100 to determine percentage.
(Number of Satisfactory Sections / Number of Applicable Sections X 100) = %
Overall Summary Grade:
Overall Summary Grade is determined by averaging the percentages of chapters 1 through 6.
C-1 FULLY READY C-1 >= 90%
C-2
SUBSTANTIALLY
READY C-2 >= 80%
C-3 MARGINALLY READY C-3 >= 70%
C-4 NOT READY C-4 <= 69%
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
2
Enclosure (1)
NAVAL SURFACE FORCE
MEDICAL READINESS INSPECTION
EXECUTIVE SUMMARY
CHAPTER 1 - ADMINISTRATION AND TRAINING
1. EXTERNAL REPORTS SAT UNSAT Comments
a. DNBI (report submitted weekly) Date Last Submitted:
b. IMR % (90% or above) 0.00% Date Last Upload:
c. DEERS (report submitted weekly) Date Last Submitted:
SAT UNSAT
2. MEDICAL DEPARTMENT DAILY STATUS REPORTS SAT UNSAT Comments
a. Report of Sick and Injured (Submitted Daily)
b. Medical 8 o'clock Report (Submitted Daily)
c. Reviewed and signed by ship's CO/XO. Submitted in
a way as to ensure patient privacy.
SAT UNSAT
3. SICK CALL LOG MAINTAINED IN SAMS/TMIP SAT UNSAT Comments
a. All sickcall visits entered.
SAT UNSAT
4. PROFESSIONAL BOOKS AND MATERIALS SAT UNSAT Comments
a. Current STATREF version onboard
b. Required Books, Publications and Instructions per
BUMEDINST 6820 and CFFC/PACFLT 6820.
SAT UNSAT
5. OTHER ADMINISTRATION SAT UNSAT Comments
a. Current TMIP/SAMS version onboard: Critical
(1) Daily back-ups being accomplished on separate
media?
(2) Password on file with CMS/Security Manager?
(3) All Medical Department personnel proficient
with TMIP/SAMS?
(4) TMIP/SAMS has network connectivity? Critical
(5) Providers have access to CHCS/AHLTA?
b. Health records management
(1) Record security maintained?
(2) TMIP/SAMS data matches health record data?
(Compare 1% of random crew records)
c. Medical admin files maintained per SECNAVINST
5210.2 series?
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
3
Enclosure (1)
d. Injury reports completed and routed through the
COC?
e. Emergency relief procedures for HMs standing non-
medical watches on file in OOD Binder/log?
SAT UNSAT
6. CURRENT, FUNCTIONAL TICKLER SAT UNSAT Comments
a. Follow-up appointments tracked
b. Consultation Log
SAT UNSAT
7. TRAINING SAT UNSAT Comments
a. Inservice Training for Medical Personnel
conducted?
(1) PQS/JQR used for Jr. HMs
(a) Completed w/in six months of reporting
(2) BCLS Certification
(a) All Medical Department personnel
(3) ACLS Certification (As applicable)
(4) Medical inservice training conducted and
documented semi-weekly at a minimum
b. Medical Training for Stretcher-Bearers conducted
and documented bi-weekly
c. Medical Training Team (MTT) identified
d. Medical conducts training with "I" Division
e. Crew training per Long Range Training Plan and
documented in Med ADP and ships training database
SAT UNSAT
8. DENTAL (SHIPS WITHOUT DENTAL DEPARTMENTS) SAT UNSAT Comments
a. Shipboard dental procedures manual onboard
b. Dental kit instruments packed/sterilized
c. Dental readiness <95% CAT I & II=UNSAT
I 00% II 00% III 00% IV 00% Overall: 00% 0.00%
SAT UNSAT
TOTAL SECTIONS: 8
SAT SECTIONS: 0
APPLICABLE SECTIONS: 8
PERCENT SAT: 0% (# SAT DIVIDED BY # APPLICABLE X 100) = %
CHAPTER C-STATUS
C-1 C-2 C-3 C-4
>= 90% >= 80% >= 70% <= 69%
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
4
Enclosure (1)
Chapter 2: SUPPLIES AND EQUIPMENT
NAVAL SURFACE FORCE
MEDICAL READINESS INSPECTION
1. AMAL DOCUMENTS APPLICABILITY SAT UNSAT Comments
a. Sams used for supply tracking
b. Current AMAL update being used Critical Date:
c. Supply/Medical Department has Prime Vendor
Account
SAT UNSAT
2. AMAL STATUS <90%=UNSAT SAT UNSAT Comments
a. Total Combined AMAL percentage: 0.00%
(1) General Medicine Percentage 0.00%
(2) Minor Surgery AMAL Percentage 0.00%
(3) Preventive Medicine AMAL Percentage 0.00%
(4) Pharmacy AMAL Percentage 0.00%
b. Current bulkhead-to-bulkhead inventory (Annual)
DATE:
SAT UNSAT
3. EQUIPMENT, MAINTENANCE & REPAIR <90%=UNSAT SAT UNSAT COMMENTS
a. Equipment AMAL Percentage: 0.00%
b. Biomedical repair checks accomplished per PMS:
DATE:
c. All equipment included in 3M system (OHMS-
NG/SNAP) Critical
d. NAVMED 6700/3 current and maintained for each
piece of medical equipment
e. Reefer temp maintained at 36 - 46 degrees
Fahrenheit? Reefer log maintained per 6000.1: Critical
f. Reefer alarm functional and audible (audible outside
of Medical if not manned 24/7): Critical
g. SERP list for ship current and aligned with AMAL:
h. CASREP submitted for non-functioning Medical
equipment:
i. ACLS equipment available and functional: Critical
j. Medical oxygen cylinder hydrostatic testing up-to-
date? (Review min 10% onboard)
k. Sterilizer(s) functional test:
l. Medical WBGT functional test:
SAT UNSAT
TOTAL SECTIONS: 3
SAT SECTIONS: 0
APPLICABLE SECTIONS: 3
PERCENT SAT: 0% (# SAT DIVIDED BY # APPLICABLE X 100) = %
C-1 C-2 C-3 C-4
CHAPTER C-STATUS
>= 90% >= 80% >= 70% <= 69%
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
5
Enclosure (1)
NAVAL SURFACE FORCE
MEDICAL READINESS INSPECTION
Chapter 3: EMERGENCY MEDICAL
PREPAREDNESS
Stocked Per AMAL = 100%
ONBOARD
1. EMERGENCY RESPONSE KIT
SAT UNSAT COMMENTS
a. Emergency Response Kit (MORK/IDC)
(1) Stocked per 53/56 AMAL Critical __________%
(2) Inventoried semi-annually and documented.
Last Inventory:
b. Jr. HM Emergency Response Kit (1 kit per 2 Jr HMs
on MO ship/1 per Jr HM on IDC ship)
(1) Stocked per 55 AMAL Critical __________%
(2) Inventoried semi-annually and documented.
Last Inventory:
SAT UNSAT
2. CRASH CART
SAT UNSAT COMMENTS
a. Stocked per 54 AMAL Critical __________%
b. Anti-pilferage device used
c. Inventoried monthly and documented Critical Last Inventory:
d. ACLS algorithm current and posted
SAT UNSAT
3. MINOR SURGICAL PACKS (open one and verify)
SAT UNSAT COMMENTS
a. Appropriate number of packs for ship class (Per
CNSL/CNSP 6000.1)
b. Instruments properly cleaned, packed & sealed
c. Packs labeled with applicable expiration dates
d. Sutures / knife blades attached to outside of pack
SAT UNSAT
4. OXYGEN
SAT UNSAT COMMENTS
a. PMS accomplished on all Oxygen cylinders:
b. "Grade B shock mounting" installed & in use Critical
c. Valve covers on "stowed" cylinders
d. Non-sparking wrenches available
e. At least 1 "in-service" cylinder ready for use.
(minimum 75% full):
f. Oxygen handling and stowage precautions posted
(Appendix of CNSP 6000.1)
SAT UNSAT
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
6
Enclosure (1)
5. FIRST-AID BOX (FAB)
SAT UNSAT COMMENTS
a. Stocked per 50 AMAL Critical __________%
b. Required locations adequate
c. Properly marked
d. Contents divided in thirds; stored in plastic
e. Anti-pilferage device used
f. Inventoried semi-annually and documented Critical Last Inventory:
SAT UNSAT
6. FIRST-AID KIT, GUN CREW (GUN BAG)
SAT UNSAT COMMENTS
a. Stocked per 57 AMAL Critical __________%
b. One per two First Responders (Stretcher Bearers)
c. Anti-pilferage device used
d. Stored in plastic bags inside Gun Bag
e. Stored in BDS
f. Inventoried semi-annually and documented Critical Last Inventory:
SAT UNSAT
7. BATTLE DRESSING STATIONS (BDS)
SAT UNSAT COMMENTS
a. Stocked per 52 AMAL Critical __________%
b. Routes to BDS marked (interior/exterior)
c. Access signs on BDS doors
d. Surgical light & emergency lighting operable
e. Potable water tank with diagram and valve
labeling
f. Surgical sink operable
g. Operating table functionable with straps and pads
h. Inventoried semi-annually and documented Critical Last Inventory:
SAT UNSAT
8. MASS CASUALTY BOX (MCB)
SAT UNSAT COMMENTS
a. Stocked per 51 AMAL Critical __________%
b. Required number onboard
c. Located & mounted properly
d. Contents contained in plastic bags
e. Anti-pilferage device used
f. Inventoried semi-annually and documented Critical Last inventory:
SAT UNSAT
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
7
Enclosure (1)
9. FIRST-AID KIT, GENERAL PURPOSE (BOAT BOX)
SAT UNSAT COMMENTS
a. Stocked per 58 AMAL Critical __________%
b. One per each Rhib, MWB, and Gig,
c. Contents sealed in plastic bag
d. Anti-pilferage device used
e. Inventoried semi-annually and documented Critical Last inventory:
SAT UNSAT
10. FORCE HEALTH PROTECTION
SAT UNSAT COMMENTS
a. Stocked per 05 AMAL
(1) CBR Medication (<100% = UNSAT) Critical __________%
(2) Pandemic Medication (<90% = UNSAT)
__________%
b. Quarterly SLEP update completed:
c. Inventoried annually and documented: Critical Last inventory:
d. Contents stored in locked or secure area:
SAT UNSAT
11. STRETCHER/LITTERS # Reqd # On Board CONDITION Properly
located
Patient
straps Comments
SAT/ UNSAT
a. Stokes Stretchers 2
Authorized to
carry extra. No pt
straps on flt deck
or hanger bay
b. Sea-Air Rescue (SAR) Litters 1
(1) Wire Rope Assembly 1
(2) Sling Rescue, Helicopter with valid weight test available Critical 2 Date:
c. Decon Litters and Stands (LHA/LHD ONLY) 100
d. Reeves Sleeve Critical 1 per BDS
(1) Handling Lines for litters with Locking Gate
2
SAT UNSAT
TOTAL SECTIONS: 11
SAT SECTIONS: 0
APPLICABLE SECTIONS: 11
PERCENT SAT: 0% # SAT DIVIDED BY # APPLICABLE X 100 = %
CHAPTER C-STATUS
C-1 C-2 C-3 C-4
>= 90% >= 80% >= 70% <=69%
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
8
Enclosure (1)
NAVAL SURFACE FORCE
MEDICAL READINESS INSPECTION
Chapter 4: ANCILLARY SERVICES
1. LABORATORY APPLICABILITY SAT UNSAT COMMENTS
a. Stocked per 32 AMAL <90%=UNSAT __________%
b. Laboratory Procedures Manual current and available
c. Laboratory Log maintained
d. Equipment function test Critical
SAT UNSAT
2. BLOOD BANK (CRTS ONLY) SAT UNSAT COMMENTS
a. Stocked per 33 AMAL <90%=UNSAT __________%
b. Blood Bank Procedures Manual current and available
c. Blood Bank Assessment Current DATE:
d. Required Blood Products Onboard (PRBC)
e. Blood Bank Training Current (annual) (HM-8506)
f. Blood Bank Pack-up Kit (PUK) complete and within
periodicity: (On applicable CRTS. Maintained by Supply Dept)
g. Emergency Backup system for blood bank available
and functional: (CO2 bottles 100% filled):
SAT UNSAT
3. X-RAY SAT UNSAT COMMENTS
a. Stocked per 31 AMAL <90% = UNSAT __________%
b. X-Ray Procedures Manual current and available
c. X-Ray Log maintained
d. Films Forwarded For Radiologist's Reading
e. Performance Test current Critical DATE:
f. Dosimetry Program current
g. External Audit current DATE:
h. Equipment function test Critical
SAT UNSAT
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
9
Enclosure (1)
4. PHARMACY
SAT
UNSAT
COMMENTS
a. Stocked per 34 AMAL
<90=UNSAT
b. Prescriptions per MANMED Chap 21
c. Designated pharmacy space can be locked
d. Controllled Substances
(1) AMAL quantity onboard and maintained in Bulk
Stock
(2) Custodians and inventory board members assigned
in writing
(3) Proper administrative procedures followed
(4) Controlled Substances Inventory conducted as
required
Critical
SAT UNSAT
5. ICU/WARD
(As applicable) SAT
UNSAT
COMMENTS
a. Stocked per 23 AMAL
<90=UNSAT
b. ICU and Ward SOP current and available
c. Nursing procedures current and available
d. Linen
provisions adequate
e. Dietary provisions adequate
f. Infection Control
(1) Universal Precautions posted
(2) Isolation Plan current and available
(3) Mattresses meet Blood-Borne Pathogen
Standards
g. Required number of patient beds onboard and
functional
h. Oxygen, suction unit, patient vital signs monitor and
intravenous pump available at each ICU bed and
functional: (100%
function check)
Critical
i. Mechanical ventilators available, calibrated and
functional
Critical (LHA/LHD - 10; LPD-17 - 6)
j. Electrocardiogram machine available and functional
Critical
SAT UNSAT
6.
PATIENT ADMINISTRATION (As applicable) SAT
UNSAT
Comments
a. Admission criteria current and available
b. Mechanism for Patient Identification In Use
c. Patient Tracking Plan/Status Board
d. MO orders written for each
patient
e. Proper forms utilized for documenting care
f. Restraint policy current and available
g. Thrombolytic Therapy Protocol and Supplies
h. Inpatient Records Maintained & Retired properly
SAT UNSAT
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
10
Enclosure (1)
7. OPERATING ROOM (CRTS ONLY)
SAT UNSAT COMMENTS
a. Stocked per 21 AMAL (<90% = UNSAT)
b. Stocked per 20 AMAL (<90% = UNSAT)
(1) AMAL requirement of Dantrolene onboard.
c. Sterility of Supplies
(1) Utilizing Event Related Sterilization
(2) Cold Disinfectant Documented
(3) Weekly biological testing conducted and
documented. (For all non
-table top sterillizers)
d. Patient Administration/Identification
(1) Proper Form for Documentation of Care (and
maintained for two years)
(2) Pathological Specimen Procedures current and
available
(3) Pathology Specimen Log maintained
(4) IV Conscious Sedation Protocol current and available
e. Structure and Equipment Functionality
(1) Anesthesia Machines/RGM's certified, functional and
calibrated
Critical DATE:
(2) Required surgical scopes onboard (EGD, Colon,
Bronch) and functional
(3) Electrosurgical apparatus w/ necessary accessories
functional
(4) Operatin beds and transport gurneys with safety
restraints
(5) Suction and oxygen available in each OR room and
functional
(6) Hypo/Hyperthermia and Fluid Warming Equipment
available and functional:
f. Required Number / Type of Surgical Sets Onboard
g. Wrong Surgical Site
Protocol current and available
SAT UNSAT
TOTAL SECTIONS: 7
SAT SECTIONS: 0
APPLICABLE SECTIONS: 7
PERCENT SAT: 0% (# SAT DIVIDED BY # APPLICABLE X 100) = %
CHAPTER C-STATUS
C-1 C-2 C-3 C-4
>= 90% >= 80% >=70% <=69%
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
11
Enclosure (1)
NAVAL SURFACE FORCE
MEDICAL READINESS INSPECTION
Chapter 5: ENVIRONMENTAL HEALTH
PROGRAMS
1. SANITATION
SAT UNSAT Comments
a. Food Safety Program
(1) Formal Inspections in periodicity
(a) Inspections forwarded to Supply Officer &
Commanding Officer
(b) Discrepancies corrected in a timely manner &
verified on inspection form
(2) Food Service Physical Examinations conducted as
required & documented
b. Quarterly Habitability Report: (Areas as applicable)
(1) Berthing & Head Facilities (Officer and Enlisted)
(2) Barber Shop(s)
(3) Potable Water System and supplies
(4) CHT/MSD Systems
(a) Inspections Completed
(b) NKO Course complete and current
(5) Ship's Store and Vending areas
(6) Laundry
(7) Fitness/Exercise Facilities
(8) Brig
SAT UNSAT
2. MEDICAL WASTE
SAT UNSAT Comments
a. Current Instruction
available OPNAV P-45-113-3-99
b. Proper disposal procedures followed
c. Waste properly stored onboard
d. Medical waste log maintained
SAT UNSAT
3. PEST CONTROL SURVEYS / TREATMENTS
SAT UNSAT Comments
a. HM Pest Control Certifications Current
b. Personal Protective Equipment available
c. Pest Control Program documented using SAMS
d. Ship's Sanitation Control Certification
Expiration Date:
SAT UNSAT
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
12
Enclosure (1)
4. POTABLE WATER SANIT
ATION SAT UNSAT Comments
a. Halogen Residual Testing conducted and
documented when necessary
b. Bacteriological Testing conducted and documented
weekly
c. Potable water log maintained using SAMS
SAT UNSAT
5. TUBERCULOSIS CONTROL PROGRAM
SAT UNSAT Comments
a. Ensure annual evaluations are conducted for
converters <100% UNSAT
Critical
b. New reactors evaluated by an MO
Critical
c. INH therapy complete and documented
Critical
SAT UNSAT
6. HEALTH MAINTENANCE <90%=UNSAT
SAT UNSAT PERCENT Comments
a. Tetanus
0%
b. Influenza
0%
c. Hepatitis A
0%
d. Hepatitis B (for required personnel)
<100%=UNSAT 0%
e. MMR
0%
f. OPV/IPV
0%
g. Tuberculosis Surveillance/Screening (Annual)
<100%=UNSAT
Critical 0%
h. Periodic Health Assessment (Annual)
0%
i. Pap Smears (if applicable) results recorded in Health
Record
0%
j. HIV (Projected through deployment)
0%
k. DNA Verification
<100%=UNSAT 0%
l. Blood
Type 0%
m. G6PD
0%
n. Sickle Cell
0%
o. Baseline audiogram (DD 2215)
0%
p. HCP Audiogram (DD 2216) (Annual)
0%
SAT UNSAT
TOTAL SECTIONS: 6
SAT SECTIONS: 0
APPLICABLE SECTIONS: 6
PERCENT SAT: 0% (# SAT DIVIDED BY # APPLICABLE X 100) = %
CHAPTER C-STATUS
C-1 C-2 C-3 C-4
>= 90% >= 80% >= 70% <= 69%
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
13
Enclosure (1)
NAVAL SURFACE FORCE
MEDICAL READINESS INSPECTION
Chapter 6: OCCUPATIONAL HEALTH PROGRAMS
1. INDUSTRIAL HYGIENE SURVEY
SAT UNSAT Comments
a. Baseline Industrial Hygiene Survey on file
Critical Date:
b. Follow up completed within 2 years
Date:
SAT UNSAT
2. ASBESTOS MANAGEMENT
SAT UNSAT Comments
a. Command Asbestos Management Plan current and
available
b. Personnel assigned to AMSP have current
screenings per OPNAVINST 5100.19
c. Roster of personnel assigned to AMSP current and
available
d. If Emergency
Asbestos Rip-out Team (EART)
established medical surveillance current?
SAT UNSAT
3. HEAT STRESS
SAT UNSAT Comments
a. Heat stress training conducted at "I" Division
documented.
b. Heat Stress Program
Binder current and complete
per CNSFINST 6000.1
c. Heat Stress Surveys signed by the CO
SAT UNSAT
4. HAZARDOUS MATERIAL CONTROL AND
MANAGEMENT (HMC & M)
SAT UNSAT Comments
a. Medical
Department assists Supply Department
with Hazardous Material training.
b. Medical Department maintains a complete copy of
the MSDS File
Critical
SAT UNSAT
5. HEARING CONSERVATION PROGRAM
SAT UNSAT COMMENTS
a. Audiogram % for personnel assigned to HCP
<90% = Unsat __________%
b. Hearing Conservation Program Binder current and
complete per CNSFINST 6000.1
c. Roster of personnel assigned to HCP current and
available.
d.
PPE provided for personnel assigned to HCP
e. Hearing Conservation training conducted at "I"
Division documented.
f. Annual refresher training conducted for personnel in
the HCP documented.
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
14
Enclosure (1)
g. Work
-related STS incidents are entered in WESS
SAT UNSAT
6. SIGHT CONSERVATION PROGRAM
SAT UNSAT COMMENTS
a. Eye examination % for personnel assigned to SCP
(HT, MR)
<90% = Unsat __________%
b. Sight Conservation Program Binder current
and
complete per CNSFINST 6000.1
c. Roster of personnel assigned to SCP current and
available.
d. Sight Conservation Signs posted as required by IH
Survey
e. PPE provided for personnel assigned to SCP
f. Safety
Officer maintains a current list of eye-wash
stations onboard
SAT UNSAT
7. RESPIRATORY PROTECTION PROGRAM
SAT UNSAT COMMENTS
a. Medical screening conducted for personnel to wear
respirators
SAT UNSAT
8. LEAD CONTROL PROGRAM (LCP)
SAT UNSAT Comments
a. Personnel exposed to lead informed of OSHA Lead
Standard, 29 CFR 1910.1025 Appxs A & B
b. Personnel assigned to LCP received initial / follow
up exam with
Occ. Health
SAT UNSAT
TOTAL SECTIONS: 8
SAT SECTIONS: 0
APPLICABLE SECTIONS: 8
PERCENT SAT: 0% (# SAT DIVIDED BY # APPLICABLE X 100) = %
CHAPTER C-STATUS
C-1 C-2 C-3 C-4
>=
90%
>=
80%
>=
70% <= 69%
COMNAVSURFPACINST 6000.2B/
COMNAVSURFLANTINST 6000.2B
8 Oct 10
15
Enclosure (1)
SURFACE FORCE MEDICAL READINESS INSPECTION HEALTH RECORD REVIEW
Unit: Date: Inspector:
Requirement
Records Reviewed
1
2
3
4
5
6
7
8
9
10
%
Last 4 SSN
Record jacket in good or better
condition
0
0%
Record jacket information complete
(inside/outside)
0 0%
Current Adult Prev & CC Flowsheet
(DD Form 2766)
0 0%
Hepatitis A (Completed series of 3)
0 0%
Hepatitis B (Completed series of 2)
0
0%
MMR (Completed series of 2)
0
0%
OPV/IPV (Single dose)
0
0%
Tetanus (Q 10 yrs)
0
0%
Influenza (Annual)
0
0%
Tuberculosis (TB)
Surveillance/Screening (Annual)
0
0%
DNA (Drawn and verified as being on
file at AFIP Repository)
0
0%
Blood Type (ABO/RH)
0
0%
G6PD
0 0%
Sickle Cell
0
0%
HIV (Drawn Q 2 yrs)
0
0%
Baseline Audiogram (DD 2215)
0
0%
Annual Audiogram (DD 2216) As
required for Hearing Conservation Pgm
0
0%
Medical Surveillance Questionnaire
(OPNAV 5100/15)
0
0%
PHA (SF-600) - (Annual)
0
0%
Required Specialty Exams complete
(CS, HT, MA, HM, etc.)
0
0%
Well Woman Exam (Results in Record)
- (Annual)
0
0%
Total
0
0%
1. Pull HR's randomly and include CHT, CS, TB reactor, SH (barber, laundry), HCP, and Women's Health.
2. Place in each box (an "X" if complete, a "0" if missing, and "N/A" if not applicable).
3. Overall Score = Number of items required - Number of items missing / Number of items required x 100
Comments:
