Note: This template is designed to provide guidance for disaster planning where resident or business facilities are concerned particularly those serving the senior and/or special needs populations including high-rise structures.
Provide name, address and telephone number of the facility covered by this plan
Indicate the permanent location of the plan and distribution list
Provide the facility's policy concerning staff training in disaster preparedness, records on training and drills
Provide descriptive information on the facility including number of units, rooms, beds, levels of care offered to residents, services provided to community, type of building, number of buildings, location from major traffic arteries in town, etc. (All information describing your facility)
State the interval at which the plan will be reviewed for modification
State security procedures such as sign and sign out areas for visitors or procedures for staff to follow when dealing with public or visitors, if applicable
Detail the responsibilities of Administrator, Top Official, Manager, etc., during emergencies
Responsibilities of nurses, employees, assistance, etc., during emergencies
Responsibilities of maintenance, security, etc., during emergencies
Responsibilities of any other major department both in and out of the facility, residents, patients, etc.
The statement of responsibilities should include the establishment of an operations center for emergencies, what notifications are expected to whom, who will be in charge, what will be done to mitigate the effects of the emergency, procedures for completing the objective, the order of major actions, who will be responsible for specific major tasks, where activity will take place, where any equipment needed to complete tasks are located.
It is suggested that these details be formatted into checklists for each position, employee, etc., listing specific major tasks an assigned responsibilities they should perform.
This section should address the overall facility concerns and procedures to ensure the safety and well being of its employees, residents, patients, etc. An internal facility disaster is an unplanned event or episode in a facility, which may adversely affect the routine operation or delivery of services.
Procedures such as the loss of utilities, information on the loss of alarm systems and back-up plans to ensure safety.
Procedures in the event of a threat of structural damage to the facility including references to other sections of the plan.
Procedures for managing and reporting food-borne outbreaks or other infectious disease outbreaks
Procedures for supplementing staff in the event that scheduled staff do not report either as a result of a community disaster or strike
Procedures for relocation of residents due to violations or structure damage
If facility is a high rise, floor wardens should be utilized to alert residents on their designated floor on hazards or emergencies inside or outside of the building
Response teams can be coordinated if facility is either a high rise or not to be the facilities safety team. Teams should be trained in basic first aid, know how to alert facilities occupants on hazards and what steps should be taken, should be knowledgeable in evacuation routes and responsible for accountability of sections or areas of facility, know who to call, what to do and where to go during all hazards. (Training can be offered by the Red Cross or local emergency services)
A procedure statement should be implemented concerning the handling of a missing person and should at least have the following information: what the first person reporting a missing person should do, how to alert staff, residents, or community, how to conduct a search of the grounds or surrounding area, list of officials who should be notified such as 911, doctor, manager, etc., notification of next of kin, family or parents, and procedures for supplying description of missing person (i.e., photo, mental or physical status, etc.)
A sample of standardized fire drill evacuation form and directions should be used (contact local fire department for assistance)
Detailed fire safety directives and procedures for the facility
Procedures for detection of fire, notifications, fire containments, reporting requirements, etc.
A listing of locations of fire extinguishers and type at each location
Procedures for safe re-entry into building, including approval from fire official to do so when required
Name of insurance company, and notification of residents on coverage or information on renters insurance, fire policy, etc.
Fire evacuation floor plans need to highlight the location of fire extinguishers, alarm pull boxes, fire escapes and exits. Suggestions should be made out before hand with primary and secondary routes. Floor plans should be located on every floor and room.
Evacuation drills should occur at least once a year.
Priorities should be set up before hand for patient, employee or resident's with special needs evacuations
Setup a procedure for check and cross check of the evacuation of all persons in facility
Procedures for monitoring patients, employees and residents during the emergency
Procedures for the relocation of records, assignment of employees or response teams responsibilities, medication files on residents, employees or staff, etc.
Procedures for tracking residents, patients, etc.
Procedures for notification of families or responsible parties of relocated individuals, injured individuals, etc.
A list of outside designated areas for evacuations
A list of outside facilities which there are transfer agreements, including telephone numbers, address, location and directions from facility and transportation agreements
List of community facilities (i.e. shelters, etc.), and telephone numbers of contacts
Procedures for residents, employees etc., whom leave with family during or before a disaster
The policy should indicate to contact 911 immediately upon notification of a bomb threat
State procedures to search the building for any suspicious objects or packages
Provide safety instructions including recommendations from the local police department on bomb threats
Provide a bomb threat checklist to be used during call in threats at each telephone (available at state and local police stations and local emergency management agencies)
If a generator is located at the facility information on the generator should include: the percentage of normal power available by generator, type of fuel used, length of time it will operate without re-fueling, time delay for generator power after normal power is interrupted
List of vendors for emergency service and fuel for generator
Provisions for backup generator
Listings of areas or sections of facility connected to generator
List of delayed automatic and manual connections, description of electrical receptacles supplied by the generator (i.e., red plates)
Policy in the event of generator failure, location of flashlights and batteries
An external disaster plan is an unplanned event or episode outside of the immediate control of the facility, located in close proximity or in the neighboring community, which may affect routine operations. An external emergency may provide both the opportunity to offer assistance to the community or receive assistance.
Reference notification procedures
State monitoring, recording and reporting procedures
Identify the services which may be offered to the community, circumstances permitting
State the requirements for assessment of and approval for whatever assistance may be provided to the community
Learn about action steps to take in regards to "In-place Sheltering"
Know your local media stations (TV and radio stations) for alerts/warnings, and other emergency information
State the procedure to be followed for notification in the event of long term loss of utilities, including notification of police and fire departments by courier when indicated
Provide a policy for backup telecommunications
List alternative sites to be utilized (i.e., mutual aid organizations, etc.)
Have handy a list of local Utility organization emergency telephone numbers.
Know where shut off switches are located
List safety steps top take during specific outages or utility emergencies (reference your local utility organizations for information)
Create a policy for monitoring and preparedness prior to storm
Review emergency staffing policy and responsibilities of employees, residents, etc.
Create a policy for maintaining safety and security of the grounds
Vendors to be contacted to assist in snow and ice removal, if applicable
Alerts to residents or employees if vehicles need to be removed from designated "Snow Emergency Routes", and a plan to assist with relocation of such vehicles
List of TV and Radio stations locally for alerts and warnings and other emergency information
Two sources of information on safety during severe weather emergencies are your local Emergency Management and local American Red Cross Chapter
Your plan should included recommendations for monitoring and preparedness
Procedures for off duty personnel, and notification procedures for outside agencies, safety recommendations and a reminder of electrical appliances and equipment which should be disconnected
Facility responsibilities specific to departments including damage assessment and reporting
Procedures for safe re-entry into facility, including approval from local officials
List of local TV and Radio stations, and emergency service telephone numbers
Procedures for evacuation of facility
Make sure flood insurance is purchased or included in policy
Section should include monitoring and preparedness
Safety recommendations, policy and procedures for off duty personnel, department specific responsibilities and procedures and safe re-entry into facility from local officials.
Make sure to move employees, residents to basement or interior section of facility away from windows.
Information can be obtained by contacting your local Emergency Management or American Red Cross Chapter
List telephone numbers for emergency medical assistance, including police, fire, ambulance, poison control, pharmacy, hospital, oxygen services/supplies, laboratory services, x-ray services, local and state health departments, as appropriate.
List all resources available and the location of these resources for assessing and treating medical emergencies (manuals, medications, emergency medical equipment, trained staff/residents in first aid/CPR, etc.)
State notification procedure including families and physicians
This section should contain copies of all signed agreements with outside agencies for disaster assistance. This would include nursing homes, day cares, hospitals, host facilities, community facilities, transportation organizations, as well as companies who have agreed to meet other emergency needs such as water supply or port-o-let services any agreements with volunteer organizations active in disaster should be included
These agreements should be reviewed periodically to assure continued suitability in meeting of needs
Make sure this section includes the names of those residents, patients, or employees with known disabilities (i.e., bed ridden, health aided machine, hearing impaired, etc.) so emergency service personnel as well as your own staff knows their whereabouts for special consideration during evacuations or emergencies.
This list should be updated periodically and should be taken with top official during evacuations and given to emergency response personnel.
IN THE EVENT OF A DISASTER, WE CAN MITIGATE THE SUFFERING AND INCONVENIENCE TO OUR COMMUNITY. IT TAKES PLANNING, AND SHARING OF INFORMATION WITH ALL PERSONNEL AS WELL AS ON-GOING COMMUNICATION BETWEEN DISASTER RESPONDERS AND THE COMMUNITY IN, WHICH IT SERVES.
I HOPE THIS TEMPLATE IS USEFUL TO YOU. IF YOU WOULD LIKE MORE TECHINCAL ASSISTANCE WITH THE DEVELOPMENT OF YOUR FACILITIES DISASTER PREPAREDNESS PLAN, PLEASE CONTACT
