| HCS # |
Agency |
HUD POC |
Agency Contact |
Date(s) of attempted contact |
Date of Successsful Contact |
Agency Operational Y/N |
Operational on-site Y/N |
Operational Remotely Y/N |
Facility Damaged but open Y/N |
Facility Damaged and closed Y/N |
Staff impacted Y/N |
% of staff able to provide services |
Are you able to provide all of your approved housing counseling sevices? |
If not what services can you provide? |
Is your facility accessible for persons with disabilities?Y/N |
If not, do you have alternate methods to deliver services to persons with disabilities during the disaster period? Y/N |
Does your organization have the capacity to ensure effective communication with persons with disabilities, such as through the use of interpreters, captioning, and alternate format materials? Y/N |
Does your organization have the capacity to ensure meaningful access to persons with Limited English Proficiency? Y/N |
Would you like your delivery methods to be expanded to include phone, email, etc.? Y/N |
Are there any outreach activities to clients? Y/N |
Any contact with FEMA, State or local agencies for assistance? Y/N |
Any contact with FEMA, state or local agencies to offer assistance? Y/N |
Interested in participating in future loss mit or other programs related to Recovery? Y/N |
Have you been in touch with your parent agency for assistance or guidaance? Y/N |
If not impacted , are you able/willing to assist clients from impacted areas/agencies?Y/N |
If so, what services can you assist with? |
Notes |