DISASTER PREPAREDNESS PLAN

Template for use in

LONG TERM CARE FACILITIES

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Introduction
A volcano is a mountain that serves as a vent through which molten rock and
other gases escape. When pressure from the gas and molten rock becomes too
great, an eruption occurs.

Volcanic eruptions may be subtle or explosive and can produce dangerous

lava flows, poisonous gases, and flying rocks and ash. Many volcanic
eruptions are also accompanied by other natural hazards, such as
earthquakes, landslides, debris flows, flash floods, fires and tsunamis. If you
live near a volcano, active or dormant, be prepared to act on short notice.

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I. PURPOSE
To provide guidance to (facility name) on emergency
policies and procedures to protect the lives and property of residents, staff and visitors.

II. SITUATION AND ASSUMPTIONS

B. Situation
1.The Fako Division is vulnerable to eruption of the Fako Mountain at any moment
in time.

2.Residents of this area require special emergency considerations in planning for

such an emergency and in ensuring safety.

C. Assumptions
1.The possibility exists that an eruption may occur at any time.

2.In the event an emergency exceeds the area’s capability, external services and
resources may be required.

3.Local, state and regional departments and agencies may provide assistance
necessary to protect lives and property.

4.Depending on the scope of the event and the type of assistance needed, local,
state and regional departments and agencies may be unable to respond
immediately. It is the responsibility of the care facility to be prepared to care for
the residents, staff and visitors for seven to ten days.

5.The care facility will comply with all state and local requirements for review and
inspection of safety plans and procedures.

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III. CONCEPT OF OPERATIONS
The care facility should have an emergency action plan in place capable of providing for
the safety and protection of residents and visitors. Procedures should be developed to
insure that residents who are cognitively impaired, physically impaired, hearing impaired,
speech impaired, or have English as a second language are properly informed and
alerted as necessary.

This plan can be effective for either internal or external emergencies.

A. Pre-Emergency
1.Evaluate the town’s potential vulnerabilities. (See Attachment A.)

2.Review, exercise and re-evaluate existing plans, policies and procedures.

3.Develop Mutual Aid Agreements with similar types of areas, both in and outside
the immediate area. Review and update the Agreements regularly.
4.Review and update inventory/resource lists.

5.Determine communication systems. (E.g., cellular phones and fax machines

may offer the best means in the event of a power loss. A supply of quarters
and accessibility to a pay phone may serve as a reasonable alternative.)

6.Ensure the availability and functioning of facility emergency warning system /

public announcement system.

7.Test reliability of emergency telephone roster for contacting personnel and

activating emergency procedures.
8.Install and maintain emergency generators.

a. Identify power needs based on which equipment and appliances are

necessary for the safety and security of residents, staff and visitors.

b. Have a licensed electrician install the generator.

c. Develop procedures for testing generators and equipment supported by

emergency generators.

d. Maintain a 7 to 10 day supply of emergency fuel. Establish a delivery

agreement with a supplier.

e. Activate and test the generator under load according to National Fire
Protection Association (NFPA) requirements and state and local
regulations.

f. Document all testing procedures.

9.Ensure a 7 to 10 day supply of food and water for residents and staff. (Have at
least one gallon of water, per person, per day on hand.)

a. Arrange for a private contact to supply back-up resources.

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 b. Rotate supplies and check expiration dates regularly.

10. Schedule employee orientation training and in-service training programs on the
operations of the emergency plan.

11. Enhance emergency education.

a. Distribute preparedness checklists provided in Attachment B.

b. In accordance with state and local codes and requirements: Post display
of evacuation routes; alarm and fire extinguisher locations; and emergency
contact telephone numbers.

c. Provide demonstrations on warning systems and proper use of emergency

equipment for the staff, residents, and residents’ families.

d. Encourage personal preparedness for all staff.

12. Conduct fire drills at a minimum of once per quarter per shift. (Check fire
regulations in your community for local, federal and state compliance
requirements.)

a. One drill is required per quarter for each shift at varied times.

b. Document each drill, instruction or event to include date, content and

participants involved.

i. Identify and document any problems associated with the drill.

ii. Develop and implement an improvement plan for problems associated

with the drill.

13. It is recommended that at least one drill be conducted on an annual basis to

exercise all aspects of the emergency action plan. Document drills with
critiques and evaluations.

14. Develop and maintain Standard Operating Procedures (as Attachment C to this
document) to include:

a. Task assignments (by title, not individual names)

b. Security procedures

c. Personnel call down lists

d. Emergency supplies; storage, maintenance and use

15. (location) is the designated Command Post

(CP) and will serve as the focal point for coordinating operations. If evacuation
is necessary, the alternate location will be
(location).

16. Ensure all staff are trained on the disaster plan to execute the activities of the
Command Post. All staff should know the location of the Disaster
Preparedness Plan.

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17. Plan for evacuation and relocation of residents.

a. Identify the individual responsible for implementing facility evacuation

procedures.

b. Determine the number of ambulatory and non-ambulatory residents.

Identify residents who may need more than minimal assistance to safety
evacuate (including Hospice) and ensure staff are familiar with individual
evacuation plans for those residents.

c. Identify and describe transportation arrangements made through Mutual

Aid Agreements of Memoranda of Understanding that will be used to
evacuate residents. (Attach copies of documents to this plan as Annexes.)

d. Describe transportation arrangements for logistical support to include

moving and protecting records, medications, food, water and other
necessities.

e. Identify facilities and include in the plan a copy of the Mutual Aid
Agreement or Memorandum of Understanding that has been entered into
with a facility to receive residents. (Attach copies of documents to this plan
as Annexes.)

f. Identify evacuation routes that will be used as well as secondary routes

should the primary routes be impassable.

g. Determine and specify the amount of time it will take to successfully

evacuate all patients to the receiving facility.

h. Specify the procedures that ensure facility staff will accompany evacuating
residents and procedures for staff to care for residents after evacuation.

i. Identify procedures to keep track of residents once they have been

evacuated. Include a log system.

j. Determine what items and how much each resident should take.

k. Plan for evacuation and shelter of pets and service animals.

l. Establish procedures for responding to family inquiries about residents who

have been evacuated.

m. Establish procedures to ensure all residents and staff are out of the facility
and accounted.

n. Determine when to begin pre-positioning of necessary medical supplies

and provisions.

o. Specify at what point Mutual Aid Agreements for transportation and the
notification of alterative facilities will begin.

18. Identify contact information for community resources available to provide

emergency services during a disaster. These may include: volunteers,
churches, clubs and organizations, emergency medical services, law
enforcement, fire departments, businesses, hospitals, and local government
departments and agencies.

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 19. Establish a plan for donations management. Delineate what is needed; where
items will be received and stored; and who will manage donation management
operations.

B. Preparedness
Upon receipt of an internal or external warning of an emergency, the facility
Administrator or appropriate designee(s) should:

1. Notify staff in charge of emergency operations to initiate the disaster plan. Use
Notification Check List or Emergency Call Down Roster. Advise personnel of
efforts designed to guarantee resident and staff safety.

2. If potential disaster is weather related, closely monitor weather conditions and

update department directors as necessary.

3. Inform key agencies of any developing situation and protective actions

contemplated.

4. Review Disaster Preparedness Plan, including evacuation routes, with staff

and residents.

5. Prepare the (location) for Command Post

operations and alert staff of impending operations.

6. Contact residents’ families. Coordinate dissemination of messages.

7. Control facility access.

8. Confirm emergency staff availability. Facilitate care of their families.

9. Pre-arrange emergency transportation of non-ambulatory residents (dialysis

residents, etc.) and their records.

10. Check food and water supplies.

11. Monitor radio.

12. Have a plan in place for pharmaceuticals with

(pharmacy name) and an alternate source to determine emergency
operations in the event of halted deliveries or the need for backup.

13. Warn staff and residents of the situation and expedient protective measures.
Schedule extended shifts for essential staff. Alert alternate personnel to be on
stand-by.

C. Response
In response to an actual emergency situation, the facility Administrator will
coordinate the following actions:

1. Complete the actions of Pre-emergency and Preparedness outlined above.

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 2. Activate the Disaster Preparedness Plan and conduct Command Post
operations, including communications, message control and routing of
essential information.

3. Ensure communications with residents’ families and physicians.

4. Determine requirements for additional resources and continue to update

appropriate authorities and/or services.

5. Coordinate actions and requests for assistance with local jurisdiction

emergency services and the community.

6. Ensure prompt transfer and protection of resident records (in case of

evacuation).

D. Recovery
Immediately following the emergency situation, the facility Administrator should
take the provisions necessary to complete the following actions:

1. Assess the event’s impact upon the facility, residents and staff members.

2. Coordinate recovery operations with the local Emergency Management Agency

and other local agencies to restore normal operations, to perform search and
rescue, and to re-establish essential services.

3. Provide crisis counseling for residents and families as needed.

4. Provide local authorities a master list of displaced, missing, injured or dead;

and notify the next of kin.

5. Provide information on sanitary precautions for contaminated water and food to

staff, volunteers, residents and appropriate personnel.

6. If necessary, arrange for alternate housing or facilities.

IV. ORGANIZATION AND RESPONSIBILITIES

The facility Administrator is responsible for the overall direction and control of facility
emergency operations, receiving requested assistance from the heads of each internal
department, the local Emergency Management Agency, local Fire Department, local
Police Department, private and volunteer organizations and various local and state
departments and agencies.

Duties and activities that should be directed or assigned by the Administrator are:

1. Coordinate the development of disaster preparedness plans and

procedures.

2. Coordinate the activation, and oversee the implementation, of disaster

preparedness plans and procedures.

3. Direct Command Post operations.

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4. Assign a coordinator for the delivery of residents’ medical needs.

5. Assign a coordinator accountable for residents, their records, and needed

supplies.

6. Assign responsibility for maintaining facility safety, including securing

necessary equipment and alternative power sources.

7. Regularly review inventory of vehicles and report to administrative

services.

8. Coordinate the emergency food services program.

9. Ensure availability of special resident menu requirements and assess

needs for additional food stocks.

10. Assign a coordinator to ensure the cleanliness of all residents and

provision of residents’ supplies for 7 to 10 days.

11. Coordinate the inspection of essential equipment (wet/dry vacuums) and

protection of facility (lower blinds, close windows, secure loose equipment, etc.).

12. Provide security of facility/grounds. Limit access to facility as necessary.

13. Coordinate provision of assistance to Maintenance and Housekeeping

Departments.

14. Supervise notification of families on emergency operations.

15. Facilitate telecommunications and oversee release of information.

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EXAMPLE: Possible organizational chart for disaster response activities.

ADMINISTRATOR
NOTE: All functions remain with the
Administrator unless otherwise assigned

Operations Logistics

Track and account for Residents Maintain emergency food and water supplies
Care for residents medical needs Obtain and track medical supplies
Conduct Evacuation processes as necessary Make alternate shelter arrangements
Maintain cleanliness of residents and facility Arrange transportation
Maintain vehicle inventory

Planning Finance
Develop Memos of Understanding Budget for disaster preparation
Track expenses associated with disaster

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Attachment A: Hazard Assessment
Evaluate your facility and the area surrounding it for vulnerability to each of the identified natural
hazards.

Directions: Using the rating system identified below, enter the appropriate number for your
estimate of Potential Damage, Frequency of Event, and Secondary Problems. Then, multiply
each figure by the following figure to get the Total Score. (Scores may range from 1 to 125
points.)

Potential Damage: Range 1 - 5

1 = Little or no likelihood of this event occurring in or affecting your area.
2 = Some likelihood of this event occurring in or affecting your area.
3 = Moderate likelihood of this event occurring in or affecting your area.
4 = High likelihood of this event occurring in or affecting your area.
5 = Very high likelihood of this event occurring in or affecting your area.

Frequency: Range 1 - 5
1 = Has not occurred in last 100 years.
2 = Happens at least once every fifty years.
3 = Happens at least once every ten years.
4 = Happens at least once every five years.
5 = Annual event, or more often.

Secondary Problems: Range 1 – 5

Remember, secondary effects include loss of services such as power and phone services. It may affect roadways and
access to other areas of the city. Secondary effects may interfere with food and medical supplies being delivered to the
area.
1 = No secondary effects or problems likely.
2 = At least one secondary effect, short-term in nature.
3 = Multiple secondary effects; may 2 or 3 days. (Begins to be a problem.)
4 = Significant secondary effect(s). May last a week. (Is a problem.)
5 = Significant secondary effects last more than a week. (Long-term and/or big problem.)

Example:
POTENTIAL SECONDARY
HAZARD DAMAGE FREQUENCY PROBLEMS? TOTAL SCORE
Flood 3 4 2 24
(Probably will affect (Happens about (Would probably cause
this area) every 5 years) problems, but short-term)
Out of a possible 125 points, this would be considered a pretty low risk.

Score your hazards now:

POTENTIAL SECONDARY TOTAL
HAZARD DAMAGE FREQUENCY PROBLEMS? SCORE
Earthquake
Fire (e.g., wildfires)
Flood
Landslide
Severe Weather
Volcanic Eruption

Once you have completed the scoring, look at the Total Scores. The highest number indicates
what you think may be your highest risk(s).

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Attachment B: Emergency Checklists
The following pages provide emergency response checklists for natural hazards
that may occur in the Pacific Northwest.

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B-5: Volcanic Eruption
Most of the local hazards associated with volcanic eruption are “secondary” in
nature such as ashfall and mud flows.

Steps to be completed ahead of time (in addition to All-Hazards Preparation):

1. Evaluate the facility for volcanic hazard(s). (Is your
facility near a volcano or in the path of potential mud
flows?)
2. Obtain dust masks for all residents and staff.
3. Evaluate individuals for additional breathing protection
needs.

During and after the event:

1. Monitor local radio and TV for current information.
2. Follow safety directions from emergency responders.
3. Stay indoors with windows and doors shut. Turn off
HVAC systems. Close any chimney dampers or other
vents.
4. Use a dust mask or damp cloth over the face to help
breathing.
5. Wear long-sleeved shirts and long pants if outside.
6. Clear roofs of ashfall. Ashfall is very heavy and can
cause buildings to collapse. Exercise great caution when
working on a roof.
7. Avoid driving in heavy ashfall. Driving will stir up more
ash that can clog engines and stall vehicles. (If you
must drive, keep speeds below 35 mph.)

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