Head Start/Early Head Start Emergency Preparedness Survey

Head Start/Early Head Start Emergency Preparedness

Head Start Early Head Start Emergency Preparedness Survey - Revised

Head Start/Early Head Start Emergency Preparedness Survey

OMB: 0970-0368

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Head Start/Early Head Start Emergency Preparedness Survey



Directions:

Please complete the following questions to the best of your ability. The Office of Head Start is interested in learning about your program’s emergency preparedness policies and plans for large-scale emergencies. If you come across a question that you can not answer, please consult with others in your program to obtain the answer. The information you provide is very helpful for the Office of Head Start and we thank you for your attention and participation.


For the purposes of this study a large-scale emergency refers to circumstances of hurricanes Katrina, Rita, and Wilma; the terrorist attacks of September 11, 2001; or other incidents where assistance may be warranted under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.).















Section A: Presence of a large-scale emergency plan and emergencies included


1. Has your program developed emergency preparedness and response policies and procedures for large-scale emergencies?

Yes (please go to question 1A)

No (please go to question 2)


1A.Which of the large-scale emergencies below are currently included within your program’s emergency preparedness and response plan’s policies and procedures? Check all that apply.

 Wildfire

 Flood

 Chemical/industrial accident (beyond the facility)

 Severe weather event (for example, tornado, hurricane, ice storm, extreme heat)

 Earthquake

 Tsunami (tidal wave)

 Civil disorder/rioting

 Terrorist attack (such as nuclear/biological/chemical)

 Pandemic influenza or other outbreak of infectious disease

 Widespread loss of electrical power

 Breakdown of electronic communications (such as widespread failure of phone

networks)

 None of the above

 Other_____________________________________

 Other_____________________________________


1B. How often is your large-scale emergency preparedness and response plan updated?

 Monthly

 Four times a year

 Twice a year

 Once a year

 Other_______________________________________

 We have not updated our large-scale emergency preparedness and response

plan

2. Which of the large-scale emergencies below has your program been affected by from January 1, 2000 to the present? Check all that apply.



None

One

Two

Three

Four

Five

Six or more

Wildfire

Flood

Chemical/industrial accident (beyond the facility)

Tornado

Hurricane

Ice storm

Extreme heat

Earthquake

Tsunami (tidal wave)

Civil disorder/rioting

Terrorist attack (for example, a nuclear, biological, or chemical attack, or the attacks of September 11, 2001

Outbreak of infectious disease in the community

Widespread loss of electrical power

Breakdown of electronic communications (such as widespread failure of phone networks)

Other 1

Other 2

If you have indicated “Other” – please describe

Other 1: ____________________________________________


Other 2: ____________________________________________


3. Which of the large-scale emergencies below are required by your State or local statutes, regulations or policies to be in your written emergency preparedness and response plans? Check all that apply.

 Wildfire

 Flood

 Chemical/industrial accident (beyond the facility)

 Severe weather event (for example, tornado, hurricane, ice storm, extreme heat)

 Earthquake

 Tsunami (tidal wave)

 Civil disorder/rioting

 Terrorist attack (such as nuclear/biological/chemical)

 Pandemic influenza or other outbreak of infectious disease

 Widespread loss of electrical power

 Breakdown of electronic communications (such as widespread failure of phone

networks)

 Other_____________________________________

If you responded to any of the emergencies above, please go to question 4

 No written plan is required by our State statutes, regulations or policies (please

go to question 3A)

 No written plan is required by our local statutes, regulations or policies (please

go to question 3A)

 Don’t Know (please go to question 4)


3A. If your State or local statutes, regulations or policies do not require your program to have a written emergency preparedness and response plan for large-scale emergencies (for example, hurricanes, tornadoes, wildfires, floods, industrial accidents, terrorist attacks, etc.), what are the reasons for which you developed your own policies and procedures? Check all that apply.

 Our program experienced a large-scale emergency

 Our community experienced a large-scale emergency

 Our community is making an effort to plan for a large-scale emergency

 Other programs experienced a large-scale emergency

 Our program wanted to be prepared

 There is a grant opportunity that we pursued for emergency preparedness

 Develop or maintain a collaborative relationship with other programs/agencies

 Other_____________________________________

 Other_____________________________________

 Other_____________________________________

 Other_____________________________________

 We have not developed a plan.


Section B: Drills of your emergency preparedness plan, policies and procedures


4. Do your program policies and procedures designate the position of the person (example: Director, lead teacher, program supervisor, etc.) who is responsible for each part of the emergency preparedness and response plan?

 Yes

 No

 Does not apply, currently no emergency preparedness policies/procedures for

large-scale emergencies


5. Do your program’s emergency preparedness and response policies and procedures

require that you conduct drills?

 Yes (if yes, please go to question 5A)

 No (if no, please go to question 6)

 No emergency preparedness and response policies and procedures exist (please

go to question 6)


5A. What do your large-scale emergency preparedness drills focus on? Check all that apply.

 Drills for a specific large-scale emergency

 Evacuation

 “Shelter-in-place”

 Damage assessment

 Risk assessment

 Communication with emergency personnel

 Other_______________________________________

6. Which of the following methods does your program use to test procedures to be used in the event of a large-scale emergency? Check all that apply.

 “Tabletop” exercises (staff discussion of specific assigned roles,

responsibilities and actions in the event of an emergency)

 Simulated events (fire drills, evacuation drills, shelter-in-place)

 “After-action review” (review of the effectiveness of communication

procedures that were used during an actual event)


 Other:________________________________________

 No method for testing of these procedures is conducted


7. Do your emergency preparedness and response drills include simulated or actual communication and coordination with the following? Check all that apply.


Simulated

Actual Communication

Actual Coordination

Federal emergency management agencies

State emergency management agencies

Local emergency management agencies

Non-governmental emergency management organization

Other______________________________

No emergency preparedness and response drills conducted (please go to question 9)


8. Do your emergency preparedness and response drills include simulated or actual communication and coordination with relief agencies and other response and recovery resources (after the immediate impact of the emergency has passed? Check all that apply.


Simulated

Actual Communication

Actual Coordination

Medical organizations or agencies

Mental health providers/organizations/agencies, crisis counselors

Red Cross

Insurance consultants

Other______________________________

Other______________________________

None of the above


Section C: Communication of your emergency preparedness plan, policies and procedures for staff, parents, and others


9. Who receives copies of your emergency preparedness and response plan? Check all that apply.

 Staff

 Volunteers

 Parents

 Community Partners

 Other_______________________________________

 No plans are provided (please go to question 10)


9A. How often is your emergency preparedness and response plan provided to

others?


Monthly

Twice a year

At initial involvement with program

At the beginning of the program year

During orientation/ training

Not applicable

Staff

Volunteers

Parents

Community Partners

Other

(from 9)


10. What accommodations for communicating emergency procedures have you made? Check all that apply.

 Posted emergency information in English and in other languages

representative of the languages spoken by staff, parents, and volunteers

 Pictograms (such as pictures or diagrams of evacuation routes, locations of

essential equipment or supplies)

 Audible pre-recorded instructions (for vision-impaired staff or volunteers)

 Tactile guides for evacuation routes for the visually impaired

 Other_______________________________________

 No accommodations for communicating emergency procedures have been

made


11. What are your programs policies and procedures for how to communicate with parents and staff in the event of large-scale emergency? Check all that apply.


Parents

Staff

Telephone (including cell phone text messaging)

TTY (text telephone devices for the hearing impaired)

Email

Emergency contacts in lieu of parents (pre-designated and authorized to receive information regarding the individual child)

Pre-designated local radio and television stations

Specific procedures for communicating with parents of limited English proficiency


Specific procedures for communicating with homeless families



Other:________________________________________________


Other:________________________________________________

No policies and procedures for communication exist


12. How do you keep contact information for parents, staff, and volunteers? Check all that apply.


Hard copy in office

Hard copy kept off site

Electronic

Electronic backup off site

Information not kept

Parents

Staff

Volunteers


13. How often do you update your contact information for:


Monthly

Twice a year

When entering the program

At the beginning of the year

During training

No updates are made

Parents

Staff

Volunteers


14. What information are parents and staff informed of in advance?


Parents

Staff

The types of emergencies that they will be contacted about?

How they will be contacted in the event of a large-scale emergency?

Changes to the programs large-scale emergency policies and procedures when they are made?


Other: _______________________________________________


Other: _______________________________________________

None of the above


Section D: Financial support of your emergency preparedness plan


15. Does your program budget include Federal and/or non-Federal-share resources dedicated to emergency preparedness? Check all that apply.


Costs of training

Supplies

Equipment

Facilities

No resources are provided

Federal

Non-Federal

Other


16. Are costs/expenses associated with your program’s emergency preparedness planning represented as a line item(s) in your program’s budget?

 Yes

 No


17. Are any emergency preparedness services, equipment, supplies, facilities, or financial resources donated or contributed to your program? Check all that apply.

 Services (ex. training of Head Start staff and volunteers, broadcast of

emergency messages)

 Materials (ex. emergency supplies such as bottled water, long shelf-life foods,

equipment such as walkie-talkies, weather radios)

 Facilities (evacuation space, off-site storage of supplies, back-up records)

 Financial resources (ex. grants)

 Other_______________________________________

 No donations or contributions have been made


18. How many days of pre-positioned emergency supplies do you have to provide for staff and children, if necessary? Check one response for each row.


None

1 Day

2 Days

3 Days

4 Days

5 Days

More than 5 days

Water

Food

Medications

Batteries for flashlights and radios

Personal care/toiletry items

Other:_______________________

If you have responded “None” to any of the above in #18, please complete question 18A.


18A. If you have indicated “None” for water, food, medications, batteries for flashlights and radios, and/or personal care/toiletry items, how was this decision made? Check all that apply.


Water

Food

Medications

Batteries for flashlights and radios

Personal care/toiletry items

Not enough money to provide supplies

Not enough space to store supplies

Not enough staff time to manage the inventory and track expiration dates

Not identified as likely that the facility would be isolated for more than a

day

Not a priority

Other


19. Where are these pre-positioned emergency supplies stored? Check all that apply.


On-site

Off-site

Other 1

Other 2

No supplies

Water

Food

Medications

Batteries for flashlights and radios

Personal care/toiletry items

Other:_______________________

If you have indicated “other” (ex. an arrangement for access to emergency supplies with a community partner) – please describe

Other 1: ____________________________________________


Other 2: ____________________________________________


Section E: Connecting your program with State and local (jurisdictions) evacuation and emergency protocols


20. Which of the following methods does your program use to keep up to date on State and local (jurisdictions) evacuation and emergency protocols? Check all that apply.

 Mailings

 E-mail

 Listserv (through local/State authorities)

 Direct communication from representatives of local and State emergency

preparedness and response agencies or workgroups

 Program staff participation on local or State emergency preparedness

and response agencies or workgroups

 Other_______________________________________

 No methods used

21. Does the program have policies and procedures for staff training on State and local (jurisdictions) evacuation and emergency protocols?


State protocols

Local (jurisdictions) protocols

Yes

No


22. How often does your program provide staff training on State and local (jurisdictions) evacuation and emergency protocols (check all that apply):

Once a year

Twice a year

Four times a year

When changes are made to evacuation and emergency protocols

No training provided

Staff training – State protocols

Staff training – Local (jurisdictions) protocols

If no training provided for both state and local (jurisdictions) protocols please go to question 23.


22A. Who conducts staff training on State and local (jurisdictions) evacuation and emergency protocols? Check all that apply.


State protocols

Local (jurisdictions) protocols

Program Staff

Outside consultants (paid by Program funds)

Outside consultants (unpaid local, State or Federal partners)

Other: ___________________________________

Not applicable


22B. Which staff participates in the training on State and local (jurisdictions) evacuation and emergency protocols? Check all that apply.


Teachers

Teacher aids

Support staff

Transportation personnel

Volunteers

Other

Not applicable

Staff training – State protocols

Staff training – Local (jurisdictions) protocols

If you have indicated “other”– please describe

Other State: ____________________________________________

Other Local (jurisdictions): ____________________________________________


23. Which of the following methods are used to test the procedures for carrying out State and local (jurisdictions) evacuation and emergency protocols? Check all that apply.


State

Local (jurisdictions

“Tabletop” exercises (staff discussion of specific assigned roles, responsibilities and actions in the event of an emergency)

Simulated events (fire drills, evacuation drills, shelter in place)

“After-action review” (review of the effectiveness of communication procedures that were used during actual event)


Other: _______________________________________________


Other: _______________________________________________

There are no State or local (jurisdictions) evacuation and emergency protocols

No methods are used to test procedures for carrying out these protocols


Section F: Coordination with emergency management agencies and organizations


24. Which emergency management agencies/organizations does your program have policies and procedures for communicating and coordinating with in the event of a large-scale emergency? Check all that apply.



Communicating

Coordinating

Federal emergency management agencies

State emergency management agencies

Local emergency management agencies

Non-governmental emergency management organizations

Other: ___________________________________

We have no such policies or procedures


25. Were your program’s policies and procedures for communicating and coordinating with emergency management agencies developed for your program or a larger system? Check all that apply.

 For your Head Start program specifically

 For a larger system of which the program is a part (ex. school system)

 Other______________________________________

 We have no such policies or procedures (please go to question 26)


25A. Which of the agencies/organizations below were directly involved in developing your policies and procedures for communicating and coordinating between your program and the emergency management agencies? Check all that apply.

 Federal emergency management agencies

 State emergency management agencies

 Local emergency management agencies

 Non-governmental emergency management organizations

 Other______________________________________

 No such agencies or organizations were involved

 Don’t know


25B. Did you or your program inform any of the following agencies/organizations about your policies and procedures for communicating and coordinating with them? Check all that apply.

 Federal emergency management agencies

 State emergency management agencies

 Local emergency management agencies

 Non-governmental emergency management organizations

 Other______________________________________

 Don’t know

 No such agencies/organizations were informed

Section G: Preparing for response and recovery from large-scale emergencies


26. Does your program have policies and procedures for designating and maintaining access to critical records (for example, medication logs, consent forms, etc.) in the event of an emergency requiring evacuation or shelter-in-place?


Evacuation

Shelter-in-place

Yes

No


27. Does your program have policies and procedures for communicating with parents and staff during the response and recovery stages of a large-scale emergency (after the immediate impact of the emergency has passed)?


Parents

Staff

Yes

No


28. In the case of a large-scale emergency, does your program have partnerships or agreements with individuals/practices in the medical community to provide resources for your (check all that apply):


Yes

No

Children

Parents

Staff


29. In your program communication procedures and policies for the response and recovery stages of a large-scale emergency what contact information for identified individuals (by name or by title) representing relief agencies and other resources are included? Check all that apply.

 Individuals in federal emergency management agencies

 Individuals in state emergency management agencies

 Individuals in local emergency management agencies

 Individuals from non-governmental emergency management organizations

 Other______________________________________

 We have no such procedures or policies


30. Which of the following are included in your program emergency preparedness and response policies and procedures for Continuity of Operations planning (planning for the continuing delivery of program services once the immediate impact of the large-scale emergency has passed)?


 Back-up systems for computer files – on-site

 Back-up systems for computer files – off-site

 Provisions for temporary relocation of program classrooms and other center-

based services

 Identification of key equipment for the safe operation of the facility

 A list of vendors who can provide critical repair or replacement when needed

 Transportation

 Other

 We have no policies or procedures for Continuity of Operations


31. Do program emergency preparedness and response policies and procedures include preparation through identification of resources and training in (check all that apply):



Identification of resources

Training

How to conduct a facility damage assessment

Documentation of facility damage assessment

Identification of resource needs to resume program operation

Prioritization of resource needs to resume program operation

Notification of financial entities (insurance carriers, funding agencies, FEMA)

Other

We have no such polices or procedures


32. Do program emergency preparedness and response policies and procedures include training of staff in the:


Children

Families

Staff

Effects of traumatic events such as large-scale emergencies upon:

Provision of mental health support during response and recovery for:


Section H: Emergency preparedness and response planning for localized emergencies


The next five (5) questions are based on your policies and plans for localized emergency preparedness and response. A localized emergency is one that happens either within the center or on a smaller scale than a large-scale emergency.


33. Which of the localized emergencies below are currently included within your program’s emergency preparedness and response plan’s policies and procedures? Check all that apply.

 Hostage situation in the center

 Abduction/attempted abduction

 Violence in the center

 On-site fire

 Infrastructure failure (e.g., roof collapse, major plumbing/flood)

 Other_________________________

 Other_________________________

 No localized plan exists (please go to question 34)


33A. How often is your localized emergency preparedness and response plan updated?

 Monthly

 Four times a year

 Twice a year

 Once a year

 Other_______________________________________

 We have not updated our localized emergency preparedness and response

plan


34. Which of the localized emergencies below has your program experienced from January 1, 2000 to the present? If experienced more than once, please indicate by entering number of times this has occurred. Check all that apply.

 Hostage situation in the center___

 Abduction/attempted abduction___

 Violence in the center___

 On-site fire___

 Infrastructure failure (e.g., roof collapse, major plumbing/flood)

 Other_______________________ ____

 Other_______________________ ____

 No localized emergencies have occurred


35. Do your program’s emergency preparedness and response policies and procedures

require that you conduct drills?

 Yes (if yes, please go to question 35A)

 No (if no, please go to question 36)

 Not applicable (please go to question 36)


35A. What do your localized emergency preparedness drills focus on? Check all that apply.

 Drills for a specific large-scale emergency

 Evacuation

 “Shelter-in-place”

 Damage assessment

 Risk assessment

 Communication with emergency personnel

 Other_______________________________________


36. Which of the following methods does your program use to test procedures to be used in the event of an emergency? Check all that apply.

 “Tabletop” exercises (staff discussion of specific assigned roles,

responsibilities and actions in the event of an emergency)

 Simulated events (fire drills, evacuation drills, shelter-in-place)

 “After-action review” (review of the effectiveness of communication

procedures that were used during an actual event)


 Other:________________________________________

 No methods are used to test the procedures.


37. What are your programs policies and procedures for how to communicate with parents and staff in the event of localized emergency? Check all that apply.


Parents

Staff

Telephone (including cell phone text messaging)

TTY (text telephone devices for the hearing impaired)

Email

Emergency contacts in lieu of parents (pre-designated and authorized to receive information regarding the individual child)

Pre-designated local radio and television stations

Specific procedures for communicating with parents of limited English proficiency


Specific procedures for communicating with homeless families



Other:________________________________________________


Other:________________________________________________

We have no policy and procedures for communication



38. Have you conducted an assessment of potential risks to your facility associated with an emergency, such as:

 Structural integrity of your building

 Susceptibility of your facility to loss of electrical power

 Susceptibility of your facility to loss of water or sanitation

 Susceptibility of your facility to loss of ability to communicate to the outside

 Susceptibility of your facility to loss of access to and from the outside

 Nearby facilities or installations that pose a potential risk (such as dams

nuclear power plants, chemical plants, etc.)

 Proximity to tree line in the event of wildfire

 Location on a slope in the event of mud-slide or avalanche

 Security of center assessment

 Other _________________________________

 No assessment of potential risks conduced


39 Does your program have individuals on staff or in a consulting capacity that are trained to deal with the emotional response to trauma for: (Check all that apply)


Yes

No

Children

Families

Staff
























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File TitleAppendix B
AuthorDHHS
Last Modified BySeth F. Chamberlain
File Modified2009-07-14
File Created2009-07-14

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