| EMERGENCY OPERATIONS PLAN SURVEY |
|
| Total Points |
0 |
|
Name of person interviewed |
|
|
|
|
| Item # |
Question |
Response |
Point Value |
Notes |
| 1 |
Does the facility have a plan? |
Yes |
|
|
| 1.1 |
Who is responsible for the plan? |
|
|
|
| 1.1.1 |
Who has the authority to activate the plan? |
|
|
|
| 1.2 |
Does the plan address Access and Functional Needs (disabilities and integration) for children and staff? |
|
|
|
| Definition: “FEMA’s Office of Disability Integration and Coordination defines the term “others with Access and Functional Needs” (AFN) as individuals who may have additional needs before, during and after an incident in functional areas, including but not limited to maintaining independence, communication, transportation, supervision, and maintain health (C-MIST). Individuals needing additional response assistance may include those with disabilities; live in institutionalized settings, are seniors; are children; are from diverse cultures; have limited English proficiency or non-English speaking or are transportation disadvantaged.” Please see resource documents for Americans with Disabilities Act if you have any additional questions |
| 1.3 |
Is the plan available for staff review? |
|
|
|
| 1.3.1 |
Is the plan accessible to staff at all times? |
|
|
|
| 1.3.2 |
Are staff required to review it? |
|
|
|
| 1.3.3 |
Is it included during staff orientation? |
|
|
|
| 1.3.4 |
How will the facility contact federal authorities (ORR)? |
|
|
|
| 1.3.5 |
Do you have contact information for your ORR POC and at what point do you contact them to inform them you have activated your plan. |
|
|
|
| 1.4 |
Is the plan updated annually? |
|
|
|
| 1.4.1 |
Are updates to the plan made throughout the year if changes are needed? |
|
|
|
| 1.5 |
Does the staff drill (practice) pieces of the plan? |
|
|
|
| 1.5.1 |
If so, how often? |
|
|
|
| 1.5.2 |
Does the facility drill (practice) with the children? |
|
|
|
| 1.5.3 |
Is there documentation for each drill (practice)? |
|
|
|
| 1.5.4 |
How is it documented? |
|
|
|
| 1.6 |
Do you assign roles to staff by position during the activation of this plan? |
|
|
|
| 1.6.1 |
Are emergency responsibilities defined in job descriptions for each staff position responding to an emergency? |
|
|
|
| 2 |
Was the plan developed with local community-based hazard and risk assessment? |
|
|
|
| 2.1 |
Have nearby industrial hazards been identified (a chemical plant upwind, a nuclear power plant)? |
|
|
|
| 2.2 |
Is the facility located in any kind of evacuation zone? |
|
|
|
| 2.3 |
Has the completed plan been shared with local, county, and state response authorities? |
|
|
|
| 2.4 |
Is there a process in place to cooperate and collaborate with these authorities? |
|
|
|
| 2.5 |
Are each of the response partners listed in the plan with point of contact name and phone? |
|
|
|
| 2.6 |
If children are not on site are the emergency actions for these facilities known? |
|
|
|
| 2.7 |
When children are off site with staff, does the facility communicate with staff (chaperone) if EOP is activated? |
|
|
|
| 3 |
Does the facility have a Shelter in Place plan? |
|
|
|
| 3.1 |
Can the facility support up to 72 hours of lockdown |
|
|
|
| 3.2 |
Are the staff familiar with this plan? |
|
|
|
| 3.3 |
Are children familiar with this plan? |
|
|
|
| 3.4 |
Is the plan drilled (practiced) regularly? |
|
|
|
| 3.4.1 |
How often is it conducted? |
|
|
|
| 4 |
Does the facility have an offsite Evacuation Plan? |
|
|
|
| 4.1 |
Is the facility prepared to provide up to 72 hours of shelter offsite for children and staff in the event the facility is not safe or there is an evacuation order? |
|
|
|
| 4.1.1 |
Is there an ability for children to communicate with family, sponsors during the time they are sheltering offsite? |
|
|
|
| 4.2 |
Does the facility have a documented agreement with the offsite facility? |
|
|
|
| 4.2.1 |
Available for staff to access? |
|
|
|
| 4.2.2 |
Are there written transportation directions from the facility to the offsite location? |
|
|
|
| 4.2.3 |
Are sponsors/guardians aware of this plan and its location? |
|
|
|
| 5 |
Does the plan include instructions for specific hazards |
|
|
|
| 5.1 |
At a minimum- |
|
|
|
| 5.1.1 |
Fire |
|
|
|
| 5.1.2 |
Evacuation, specific to the region weather events |
|
|
|
| 5.1.3 |
Active shooter |
|
|
|
| 5.1.4 |
Protests, civil unrest/gang activity |
|
|
|
| 5.1.5 |
Medical/pandemic/local threat awareness |
|
|
|
| 5.1.6 |
Are there other situations not listed here? |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to gather information from care provider facilities on their existing emergency operations plans so that ORR may provide appropriate training and technical assistance. Public reporting burden for this collection of information is estimated to average 0.75 hours per respondent, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection of information (Homeland Security Act, 6 U.S.C. 279). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0558 and the expiration date is 11/30/2026. If you have any comments on this collection of information, please contact [email protected]. |