Get Psap/recc Annual Certification Of Compliance Form This Form ... - Mass

The PSAP/RECC Annual Certification of Compliance Form is essential for Public Safety Answering Points and Regional Emergency Communication Centers in Massachusetts to ensure compliance with state regulations. This guide provides clear and structured steps to assist users in accurately completing the form online.

Follow the steps to fill out the PSAP/RECC Annual Certification of Compliance Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the name of the PSAP/RECC, along with the address, city/town, zip code, telephone number, fax number, and website.
3. Provide the name and title of the authorized signatory. If this address differs from the main address, include that too, along with their telephone number, fax number, and email address.
4. In the declaration statement, provide your name in the designated space and certify your authority to complete this certification.
5. Complete the section confirming that every enhanced 911 telecommunicator is certified according to the regulations.
6. List all enhanced 911 telecommunicators by providing their details, including a record of their training and certification.
7. For primary PSAPs, Regional PSAPs, and RECCs, indicate if EMD is provided through certified emergency medical dispatchers or another certified resource.
8. If EMD is provided, specify the expiration dates of certifications for each telecommunicator listed.
9. Indicate the EMD protocol being utilized by checking one of the provided options.
10. Identify who performs the quality assurance for the Certifying Entity.
11. Document the number of medical calls received and the percentage reviewed for quality assurance.
12. Describe the method of documentation used for quality assurance and attach additional pages if necessary.
13. Acknowledge notification to the local emergency medical services provider and understand the public record implications of the submitted records.
14. Print your name, sign the document, and include the date.
15. Finally, once completed, save any changes, download, print, or share the form as needed, then submit it to the State 911 Department.

Complete your PSAP/RECC Annual Certification of Compliance Form online to ensure your compliance today.