Form FEMA Form 142-1-1 FEMA Form 142-1-1 IPAWS Inventory & Evaluation Survey

DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY

O.M.B. Control No. 1660-0000
Expires

IPAWS INVENTORY & EVALUATION SURVEY

PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this form is estimated to average 5 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources,
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control number. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department
of Homeland Security, Federal Emergency Management Agency, 500 C Street SW, Washington, DC, 20472, Paperwork Reduction Project (1660-NEW 40). NOTE: Do not send
your completed form to this address.
DATA COLLECTOR
DATE

EMERGENCY FACILITY & ADDRESS

CONTACT NAME

PHONE, FAX, E-MAIL

DUTIES

IDENTIFY MISSION CRITICAL PUBLIC ALERT & WARNING SYSTEMS CURRENTLY IN OPERATION
System 1

System 2

System 3

System 4

System 5

Name of System (Brand/Version)
Purpose of System in Public Response
Station
How is Information Transmitted?
Was this system provided by FEMA?
What Functional Category does system
fall under (situational awareness, activates
warning, collaboration, emergency
notification?
Level of Satisfaction. 1-Unsatisfied through
5-Satisfied.
Reasoning for Level of Satisfaction:
Components
Funding Source
List other systems this system is similar to
What is the service life of the current System
(years)?
How frequently is system refreshed or updated
(in months)?

FEMA Form 142-1-1

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IDENTIFY MISSION CRITICAL PUBLIC ALERT & WARNING SYSTEMS CURRENTLY IN OPERATION - Continued
System 1

System 2

System 3

System 4

System 5

Does the system have a programmed or
anticipated termination date (Year)?
How long did the system take to deploy from
purchase to activation of system (in months)?
What are the annual maintenance costs of the
system?
What are the annual labor costs for the system?
What are the annual utility costs of the system?
How many personnel hours are dedicated to
operating and monitoring the system per week?
Record full time (40 Hours) as 1, part-time
(0-20 hours) as 1/2, and document vendors
separately.
What are the annual training costs for the
system?
How many hours annually are for training
on-site personnel?
How many hours annually are for training
remote-site personnel?
How often is system tested?
Is the system accredited/certified? (How often)
How often is system unavailable (in hours
annually)?

What causes the system to be unavailable?

Does the system have a backup?
Does the backup come on automatically
when primary system is offline?
Type of facility (AOC - Army Operations Center,
EOC, SEOC - State Emergency Operations
Center, or other, and if it is a primary or
secondary node)?

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IDENTIFY SECONDARY/SUPPORTING SYSTEMS CURRENTLY IN OPERATION
System 1

System 2

System 3

System 4

System 5

Name of System (Brand/Version)
Purpose of System in Public Response
Station
How is Information Transmitted?
Was this system provided by FEMA?
What Functional Category does system
fall under (situational awareness, activates
warning, collaboration, emergency
notification?
Level of Satisfaction. 1-Unsatisfied through
5-Satisfied.
Reasoning for Level of Satisfaction:
Components
Funding Source
List other systems this system is similar to
What is the service life of the current System
(years)?
How frequently is system refreshed or updated
(in months)?
Does the system have a programmed or
anticipated termination date (Year)?
How long did the system take to deploy from
purchase to activation of system (in months)?
What are the annual maintenance costs of the
system?
What are the annual labor costs for the system?
What are the annual utility costs of the system?
How many personnel hours are dedicated to
operating and monitoring the system per week?
Record full time (40 Hours) as 1, part-time
(0-20 hours) as 1/2, and document vendors
separately.

FEMA Form 142-1-1

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IDENTIFY SECONDARY/SUPPORTING SYSTEMS CURRENTLY IN OPERATION - Continued
System 1

System 2

System 3

System 4

System 5

What are the annual training costs for the
system?
How many hours annually are for training
on-site personnel?
How many hours annually are for training
remote-site personnel?
How often is system tested?
Is the system accredited/certified? (How often)
How often is system unavailable (in hours
annually)?

What causes the system to be unavailable?

Does the system have a backup?
Does the backup come on automatically
when primary system is offline?
Type of facility (AOC - Army Operations Center,
EOC, SEOC - State Emergency Operations
Center, or other, and if it is a primary or
secondary node)?

IDENTIFY SYSTEMS THAT ARE NOT CURRENTLY OPERATIONAL (OR ARE A DISTRACTOR) FOR WHATEVER REASON
Name of System
Brand/Vision

FEMA Form 142-1-1

Level of Satisfaction
1 Unsatisfactory - 5 Satisfactory
1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

Function, Purpose, and
Funding Source

List other systems this
system is similar to,
or shares capabilities with

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IDENTIFY SYSTEMS THAT ARE DESIRED OR ENVISIONED (PLEASE PROVIDE DETAILS)
Name of System
Brand/Vision

Level of Satisfaction
1 Unsatisfactory - 5 Satisfactory
1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

Function, Purpose, and
Funding Source

List other systems this
system is similar to,
or shares capabilities with

IDENTIFY SYSTEMS THAT ARE AVOIDED OR UNUSED (OR ARE A DISTRACTOR) FOR WHATEVER REASON
Name of System
Brand/Vision

Level of Satisfaction
1 Unsatisfactory - 5 Satisfactory
1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

Function, Purpose, and
Funding Source

List other systems this
system is similar to,
or shares capabilities with

FACILITY STANDING OPERATING PROCEDURES
For routine, non-emergency purposes, how does
EOC currently communicate with State, County,
and Federal authorities (ex., phone, UHF radios,
e-mail, etc.)?
For routine non-emergency purposes, how does
EOC currently communicate within the agency
and other local departments (ex., phone, UHF
radios, e-mail, etc.)?
What public alerts and notifications does the
EOC send, if any?
Who is authorized to send alerts on behalf of
the EOC jurisdiction?

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FACILITY STANDING OPERATING PROCEDURES - Continued
Is there an alternate or backup EOC? Can
alerts be sent from these locations? If so,
identify the locations.
Give description, with dimensions, and
photograph EOC location where alerts are sent
from. (Get approval from EOC prior to taking
any pictures.)
If unable to photograph, provide a scaled line
drawing, on grid paper, of alerting area and
attach to this document (archive same in
electronic form).
COMMENTS AND ADDITIONAL INFORMATION

FEMA Form 142-1-1

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