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Facility Name ... · Web viewFacility “Go Box” that includes items needed for immediate...
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Arizona Health Care Association DISASTER PLANNING AND EMERGENCY MANAGEMENT GUIDE DISASTER PREPAREDNESS INVENTORY LIST SYSTEMS, EQUIPMENT AND SUPPLIES PREPARED BY: FACILITY NAME: ADDRESS: CITY, ZIP, STATE: PHONE: FAX: E- MAIL: DISASTER PREPAREDNESS INVENTORY LIST SYSTEMS, EQUIPMENT AND SUPPLIES YES NO QUANTIT Y (if COMMENTS Primary communication system for emergency management (portable radios, cell phones with two- way radio capabilities, etc.) Secondary communication system (back-up) Facility-wide public address or similar system Extra cell phones, batteries and chargers Designated facility cell phone with different area code Analog telephone directly connected to phone line System to forward telephone calls to temporary shelters or alternate facility during evacuation Page 1 of 10
Transcript of Facility Name ... · Web viewFacility “Go Box” that includes items needed for immediate...
Facility Name:______________________________________________________________________Date:______________________________
CALIFORNIA ASSOCIATION OF HEALTH FACILITIESDISASTER PLANNING GUIDE
DISASTER PREPAREDNESS INVENTORY LIST SYSTEMS, EQUIPMENT AND SUPPLIES
Arizona Health Care AssociationDISASTER PLANNING AND EMERGENCY MANAGEMENT GUIDE
DISASTER PREPAREDNESS INVENTORY LISTSYSTEMS, EQUIPMENT AND SUPPLIES
PREPARED BY:
FACILITY NAME:
ADDRESS:
CITY, ZIP, STATE:
PHONE:
FAX:
E-MAIL:
DISASTER PREPAREDNESS INVENTORY LIST
SYSTEMS, EQUIPMENT AND SUPPLIES
YES
NO
QUANTITY
(if applicable)
COMMENTS
Primary communication system for emergency management (portable radios, cell phones with two-way radio capabilities, etc.)
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Secondary communication system (back-up)
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Facility-wide public address or similar system
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Extra cell phones, batteries and chargers
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Designated facility cell phone with different area code
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Analog telephone directly connected to phone line
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System to forward telephone calls to temporary shelters or alternate facility during evacuation
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System to forward mail delivery to alternate facility during evacuation
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Resident identification system and tracking system (wristband system or similar system, including tracking logs)
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Vehicles operated by facility have fuel tanks maintained near full levels at all times (no less than half tank at any time)
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Emergency water supply (minimum three-day supply)
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Emergency water supply exceeds minimum three-day supply (cite amount available), five- to seven-day supply preferred
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Emergency water supply stored in suitable and accessible location
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Emergency water supply consistent with applicable regulatory requirements
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Logistics, equipment and containers available to transport water supplies during evacuation
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Equipment needed to boil large volumes of water (adequate supply of large pots, commercial cooking kettles, etc.)
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Empty containers to store and transport boiled water (buckets, jugs, etc.)
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Water purification tablets (halazone)
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On-site water and sewage treatment
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Emergency food supply (minimum three-day supply)
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Emergency food supply exceeds the minimum three-day supply (cite amount available). Five- to seven-day supply preferred
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Emergency food supply stored in a suitable/accessible location
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Emergency food supply consistent with regulatory requirements
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Logistics, equipment and containers available to transport food supplies during evacuation
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Ready-to-eat foods available
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System in place to rotate food and water to ensure all are used within expiration dates
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Specific disaster menu on file
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Disposable food service supplies (plates, utensils, serving containers, plastic bags, etc.)
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Plastic ice chests
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Portable chairs and tables for evacuation relocation/staging
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Non-electric can openers
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Wind-up style alarm clocks
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Extra oxygen concentrators
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Extra oxygen tanks (portable)
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Portable IV poles for transport
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Suction machines (manual and electric)
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Portable commodes
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Containers (like five-gallon buckets/heavy duty garbage bags) for sanitation
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Extra supply of toilet paper
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Extra supply of incontinence products
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Extra supply of disposable diapers
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Extra sanitation supplies (soap, wipes, bleach, etc.)
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Extra supply of red bags for bio-waste disposal
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Extra supply of disposable masks and gloves of various sizes
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Eye washing station/equipment
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De-contamination equipment/showers
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Medical/first-aid supplies to sustain operations for at least five days.
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Cold packs
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Ice packs
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Insect repellant
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Supply of body bags
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Writing supplies (pens, pencils, permanent markers, note pads, notebooks for logs, etc.)
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Flashlights and battery-operated lanterns
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Self-illuminating light sticks
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Supply of spare (fresh) batteries
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Whistles for alerting purposes
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Bull horn or portable public address communication device
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Battery-operated AM/FM radios
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Portable/battery-operated television
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Weather alert radios
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Heavy-duty plastic sheeting to block windows, doors, air ducts, etc. during hazardous conditions outside facility
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Rope caulking to seal doors/windows
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Tarps
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Utility knives; box cutters
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Heavy-duty scissors
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Tape, various types—duct, masking, transparent, packing, etc.
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Yellow “Caution” tape
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Standard tool boxes (wrenches, screwdrivers, hammers, pliers, etc.) in various locations throughout the facility
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Various power tools (drill, saws, awl, etc.)
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Electrical wiring kit (various connectors, caps, terminals, electrical snips, etc.)
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Various types of rope and twine
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Wire for binding
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Specialized digging tools (picks, shovels, axe, etc.)
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Wet/dry vacuums
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Commercial / heavy duty fans
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Commercial/heavy duty blowers
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Commercial/heavy duty portable de-humidifiers
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Manual siphon pumps
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Empty gasoline safety containers for use with siphon pump
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Portable electric sump pumps
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Extra garden hoses for portable sump pumps
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Heavy duty gasoline powered portable pumps
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Appropriately sized hoses for portable pumps
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Squeegees and large brooms
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Ladders
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Hard hats
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Dust/filter-type masks
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Eye protection (goggles, safety glasses, etc.)
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Plywood sheeting for board-up
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Wooden shoring material (2 x 4, 4 x 4, etc.)
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Nails, screws and fasteners
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Supply of elastic cords (bungee cords, etc.)
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Sandbags
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Gas-powered chain saw for tree removal
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Box of heavy-duty chains
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Wheelbarrows
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Approved heavy-duty extension cords
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Battery-chargers
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Power converters (AC/DC)
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Approved portable generators (in addition to facility generator)
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Extra supply gasoline in approved safety containers
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Extra fire extinguishers
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Extra sleeping provisions (blankets, pillows, etc.)
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Portable mattresses and air pumping equipment
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Portable cots
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Matches or butane lighters in water-proof container
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Sewing kit and fabric mending supplies (scissors, tape, twine, etc.)
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Severe Weather/Take Cover Shelters or safe areas are clearly identified with sign/placard (self-illuminating pictograph, etc.)
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Facility “Go Box” that includes items needed for immediate evacuation (cell phone, charger, cash, credit cards, additional keys to facility, list of contacts, list of employees and other items that would be helpful during evacuation)
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Ramps, lifts or similar system to board ambulatory residents on buses
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