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Emergency Services > 04 Fire and Disaster Plans (47 docs)

04 Fire and Disaster Plans (47 docs)

Free Forms, caregiving, nursing forms, policies, Licensing, Training, Case Management, Home Care, Assisted Living, DD, MI, HCBS

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Documents in 04 Fire and Disaster Plans (47 docs) (47)

This is a free document from Centers for Disease Control Prevention on what to do after an earthquake.

Be prepared for additional earth movements called After an Earthquake
This is a form designed to document the details of a drill. Special questions are included relating to quality, performance, and improvements. After Drill Review
This is a free document from Centers for Disease Control Prevention on being prepared for an earthquake.

While California has been the state most prone to serious earthquakes in recent years, there are many other fault zones in other areas of the United States. For example, geologists and seismologists have predicted a 97 percent chance of a major earthquake in the New Madrid seismic zone of the central United States (including Arkansas, Missouri, Tennessee, and Kentucky) between now and the year 2035. Being Prepared for an Earthquake
This form is designed to be part of the assisted living facility or residential care home's Emergency Fire and Disaster Plan.  It covers essential emergency contact information, and other important business information that should be used during an emergency. Business Emergency Plan Information
CMS Issues Emergency Preparedness - For long term care homes, nursing homes, SNF, assisted living, centers for the developmentally disabled. CMS Issues Emergency Preparedness
This is a free document from Centers for Disease Control Prevention on what to do during an earthquake.

Indoor Safety
There are actions you can take, even while an earthquake is happening, that will reduce your chances of being hurt. Lights may be out, and hallways, stairs, and room exits may be blocked by fallen furniture, ceiling tiles, and other debris. Planning for these situations will help you to take action quickly. During an Earthquake
This is a free document from Centers for Disease Control Prevention on assisting persons with special needs during an earthquake.

Before an earthquake:

~Write down any specific needs, limitations, and capabilities that you have, and any medications you take. Make a copy of the list and put it in your purse or wallet.
~Find someone (a spouse, roommate, friend, neighbor, relative, or co-worker) to help you in case of an emergency. Give them the list. You may wish to provide a spare key to your home, or let them know where they can find one in an emergency. Earthquake - People with Special Needs
Care homes have special needs during an earthquake or when a disaster strikes.  The primary concern is the vulnerable residents who may have physical and mental disabilities, contagious illnesses, plus, the resident's medications, medical equipment and service pets.  Of course you also have the safety of the staff and visitors and the issue of major water & supplies to care for everyone if need be.

The way to handle it all is to be prepared.  You must have good working emergency plans & supplies and a well-trained staff who will automatically assume their emergency duties.  This means drills, constant training, working the plans until you have a plan that works on automatic pilot.  This also means spending the money to have water and food stocked, reliable evacuation plans, which includes contracts with, appropriate transportation sources and temporary housing.   This also means having money set aside to pay for necessary expenses during an emergency. Earthquake Disaster Drills For Care Homes
These Earthquake Drill Cards are used to help conduct an emergency earthquake drill with staff, residents and visitors. Earthquake Drill Cards
EARTHQUAKE DRILL FORM - for evaluating earthquake drills in community care facilities, homes for the developmentally disabled and mentally ill. EARTHQUAKE DRILL FORM - for evaluating earthquake drills
Community Based Care Facilities should have an earthquake plan, if there is any chance of an earthquake in their area.  

To find out if there is a danger, you can call your local county emergency service office to see if your location is at risk. 

Care homes located on the coast should find out the risks of a tsunami, and those near nuclear facilities and scientific specialty labs should be aware and integrate their local nuclear crisis plans. 

The residents and staff of assisted living, nursing homes, and residential care facilities need to know what to do should an earthquake happen.  The care home?s earthquake and evacuation plans ( as well as all their emergency plans ) need to be available for reference and review by employees, and copies shall be furnished to any county, state or federal officials for review upon request. Earthquake Emergency Plans for Residential Care Homes, Nursing Homes, Assisted Living Facilities
Whenever the situation arises where a serious concern is discovered, the Administrator or Facility Manager shall gather the staff for briefing and gather the following information:


Current Situation
Pending Danger
Resident status ? resident special needs
Structural concerns
and more.... Emergency Briefing Checklist
This document is a basic sample plan for a small residential care and assisted living homes for developmentally disabled, elderly and mentally ill.  These are basic policies, procedures, and reporting requirements in cases of emergency care, fire and/or disaster. Basic sample emergency disaster plan.

In order for all staff to immediately know which residents require physical assistance to get out of the building, the facilities Resident Roster is conveniently located in the Medication Area, the Administrator's office, and in the Kitchen.  Residents who may need physical assistance are Emergency Care, Fire and Disaster Plans
Very simple basic Emergency Disaster Plan Form, that may be used in some states as an Emergency Disaster plan.  Full emergency plans encompass more than what can be written on this simple form.  Please see the Table of Contents for the Emergency Service Manual for additional emergency and disaster documents. Emergency Disaster Plan Form
This great fire drill evaluation form covers the essential questions and is good for assisted living businesses, small 6 bed residential care homes for the elderly, developmentally disabled and mentally ill facilities.  All types of support housing communities need to have drills to ensure everyone know what to do in an emergency and have trained.  This drill evaluation is good for fire drills, disaster drills, evacuation drills and more.  It also includes a section for staff performance. Emergency Drill Evaluation Form
This Emergency Drill Yearly Record is great for documenting down each month's emergency drills.  This form works well for assisted living businesses, small 6 bed residential care homes for the elderly, developmentally disabled and mentally ill facilities. All types of support housing communities need to have drills to ensure everyone know what to do in an emergency and have trained. This Emergency Drill Yearly Record is good for fire drills, disaster drills, evacuation drills and more. It also includes a section for recommendations. Emergency Drill Yearly Record
This Emergency Fire Equipment Quick Check List gives a good overview of an assisted living or residential care home's essential fire equipment and what should be checked or reviewed.  This form has built in reminders which enable staff to better carry out their duties. Emergency Fire Equipment Quick Check List
This form is used to list the various types of fire equipment such as fire extinguishers, Fire Alarm Companies, Emergency Lighting and so on. This form is for use by residential care homes for the elderly, developmentally disabled, group homes for kids, secured perimeter facilities for Alzheimer's and Dementia residents, nursing homes and assisted living facilities. Emergency Fire Safety Equipment & Location
Emergency Roster Supplement - this form is used in conjunction with the Resident Roster Form and the Emergency Staffing Roster Form Emergency Roster Supplement
Designation of authority and responsibility to follow the emergency service plan.

The Emergency Service Plan of this facility has been created to help respond to, manage and recover from emergencies and incidents that could harm the residents, staff, visitors, or negatively impact this business.  Safety of everyone is the first priority.

The Administrator has the power and authority to activate our Emergency Service Plan at any time he/she feels it is necessary.   In his or her absence the Facility Manager has the power and authority to activate the plan. Emergency Services Authority and Responsibility
Changes made to the emergency service plan need to be documented. Emergency Services Record of Changes
This document provides you with the information that should be included in any Fire & Evacuation Floor Plan.

Emergency Site and/or Floor Plan should contain the following information:

~Building layout, include room numbers and use
~Exits and building evacuation routes
~Fire Alarm Control Station  - Fire Alarm Suppression Systems
~Portable Fire Extinguishers ... Emergency Site Plan Information
Explosions - What to Do In Case of An Explosion - part of Emergency Plans. Explosions - What to Do In Case of An Explosion
Extreme Heat Policies and Procedures to help ensure safety of the residents, staff and visitors. Extreme Heat Policies and Procedures
Procedures of what to do in case of extreme winter conditions. Extreme Winter Conditions
Sample of fire and disaster evacuation floor plan to post in various areas of a care facility. Fire & Disaster Evacuation Floor Plan - Sample
Cover for Section 4 of the Emergency Service Manual which covers fire and disaster plans. Fire and Disaster Plans Cover
This fire drill evaluation form is used by the care home staff to evaluate how they performed during a fire drill. Good for assisted living facilities, group homes and residential care homes.

Was the local fire district notified that you are going to be conducting a drill?
Was your alarm monitoring company notified of the fire drill?
Emergency Phone Number called? (fake one)
Portable telephone or cell phone taken to re-grouping area?
Was fake fire found, and residents removed from danger, first aid administered? ...... Fire Drill Evaluation
A form used by care facilities to audit and review Fire Equipment and Safety. Fire Equipment and Safety Review
This document explains the use of various fire fighting equipment and techniques to use in case of fire.

Federal regulations require that employers who provide portable fire extinguishers in the workplace also provide training for all employees in proper use of the extinguishers. All Employees receive training at the time of hire, see Safety Training Check off List and review training every six-month there after. Fire Fighting Equipment and Techniques
free info - Fire Investigation Report on North York High Rise Fire Investigation Report on North York
Flooding - Facts and What to Do Flooding - Facts and What to Do
General 6-Bed Fire Safety Standards link. General 6-Bed Fire Safety Standards
Lightning Storms - Procedures on What To Do Lightning Storms - Procedures on What To Do
Nuclear Preparedness Check off list
We all hope nuclear attack never happens, but it could and it can?t hurt to be prepared if it does.  Many people will survive.  For example if a nuclear attack occurred in Washington DC many people would die at ground zero, and it will effect the areas around Washington DC as well.  One scenario estimated that 300 thousand would die, 650 thousand would be injured, and over 700 thousand would be required to evacuate.  The world as we know it will change.   

Based on various predictions and scenarios if we are aware what could happen, then we can prepare for it.  Below is a list of things to know, things that are likely to happen and questions to answer: Nuclear Attack Check Off List
Adapted from http://www.fema.gov/

A nuclear blast is an explosion with intense light and heat, a damaging pressure wave and widespread radioactive material that can contaminate the air, water and ground surfaces for miles around. During a nuclear incident, it is important to avoid radioactive material, if possible. While experts may predict at this time that a nuclear attack is less likely than other types, terrorism by its nature is unpredictable.

If there is advanced warning of an attack
Take cover immediately, as far below ground as possible, though any shield or shelter will help protect you from the immediate effects of the blast and the pressure wave. Nuclear Threat
Free Emergency Action Plan developed by the State of Oklahoma for use in long term care facilities. Oklahoma LTC Emergency Plan
1.Have a written viable plans for sheltering in place during emergencies. 
2. Make sure the plans for sheltering in place take into account all known limitations of the facility to withstand flooding and wind. (This includes any indeterminable limits as well)
3. Take into account all requirements (if any) by the local Office of Homeland Security and Emergency Preparedness.
4. Have written viable plans for adequate staffing when sheltering in place. Plans for Sheltering in Place
In light of the Hurricane Katrina evacuation disaster this article deals with being prepared for evacuation in case of a similar emergency.

There is something care facilities subject to flooding, hurricanes, earthquakes, fires or other natural disaster can do to help protect their residents and staff, it's called an evacuation plan.  It's the Administrator's responsibility to make sure the residents and staff are safe.   In a May 2006, Federal Health Care Director Cynthia Bascetta, testified before the senate Commission on Aging stating: ... Preparing for Evacuating
Adapted from http://www.fema.gov/
A radiation threat, commonly referred to as a Radiation Threat
Adapted from http://www.sfgov.org/
If instructed to, if you hear Alerting and Warning Sirens, or if you become aware of a hazardous material release, you can shelter in place to stay as safe as possible. Follow these ten steps:

1.	SHELTER ? Go inside the nearest building. You are looking for enclosed protection from the outside.
2.	SHUT ? Close all doors and windows. The tighter and more complete the seal the better. Close as many windows and doors between the outside and your shelter-in-place room as possible. Close curtains and then stay away from the windows. Shelter-In-Place
The Three Types of Evacuation - evacuation orders. The Three Types of Evacuation
Emergency Tornado Procedures to follow for staff and residents in case of tornado danger. Tornados
This form is used during an emergency for listing utility location and shut off points, at a care facility or for a care giver providing home care.

GAS/PROPANE Shut off - Shut off the gas/propane if you smell a related odor, or if you suspect a leak. Most gas shutoffs work by turning the lever 1/4 turn, if the valve won't work call 911 and the gas company. (Follow manufacture's instructions)  Cease all operations, and have everyone exit the area immediately. Once turned off, the gas/propane company must turn it back on. Utility Shut Offs In Emergencies for Care Facilities and Home Care
What to Do During an Earthquake - FEMA information good for everyone. What to Do During an Earthquake
This is a free document from Centers for Disease Control Prevention on what to do if the power goes out after some form of disaster.  Helpful advise for all types of care facilities.

Safe Drinking Water
When power goes out, water purification systems may not be functioning fully. Safe water for drinking, cooking, and personal hygiene includes bottled, boiled, or treated water. Your state or local health department can make specific recommendations for boiling or treating water in your area. Here are some general rules concerning water for drinking, cooking, and personal hygiene. Remember: ... When the Power Goes Out
This is a form used to inspect residential care homes for fire safety. Wisconsin Fire Inspection
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