Emergency Plan Manual

AFTER DISASTER EVALUATION FORM Last Disaster identification (Hurricane name, etc): ___________________________________________________ Evaluation date: __________ Evaluated by: _______________________________Title: __________________ Plan implemented as approved All key staff participate in evaluation, CEMP compliance Collected/updated prioritized patient list Communication plan was activated, email, text revised Chain of command roles compliance Activation procedures on time by the administrator Shelter patients were registered ________________________________________________________________ Education of staff, patient, family, community before and after plan completed Notification, warnings, about the disaster was in compliance (clients and staff) Local county involved department monitored (DOH, Emergency Management, etc) On Call procedures implemented Backup Agency contacted, to be sure patient’s care continue after disaster All active patients notified of cease operation due to disaster Evacuation orders verified, county route discussed Data backup completed as scheduled Protection of records (patient, staff, financial, administrative) guaranteed Business property protected, as applicable Staff protection plan implemented, family communication plan AFTER DISASTER Service/care to patient reinstated ASAP after conditions are safe for the staff Damage to Agency notified to local authorities (DOH, EM, etc) if any __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Schedule of visits revised, reinstated, staff and patient contacted Any communication problems: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Business Recovery plan implemented Determined needs to reinstated services Enough Supplies, vendor contacted Computer system reinstated, vendor contacted, backup verified Communication plan tested, working as expected, alternate ways in place, verified cellular carrier that are working Building, facility problem detected : ________________________________________________________ ______________________________________________________________________________________ Utilities failure _________________________________________________________________________ Tenant/landlord contacted if applicable All active patient, staff contacted Community assessed for road opens, communication, etc Signature/Title: _________________________________________ Date: ___________________ Other:________________________________ _____________________________________ _____________________________________