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2018 POWER OUTAGE EXERICSEINSERT AGENCY/FACILITY NAME FULL SCALE EXERCISE
2018POWER OUTAGE EXERCISE AGENCY/FACILITY NAME
Last Revised: 11/4/2018
EXERCISE PLAN
FULL SCALE EXERCISE
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2018 POWER OUTAGE EXERICSEINSERT AGENCY/FACILITY NAME FULL SCALE EXERCISE
TABLE OF CONTENTSEXERCISE OVERVIEW..........................................................................................3GENERAL INFORMATION.....................................................................................5
EXERCISE OBJECTIVES & CAPABILITIES..........................................................................................5SCENARIO............................................................................................................................................. 7EXERCISE FORMS................................................................................................................................ 7PLANS AND POLICIES ADDRESED......................................................................................................7EXERCISE ASSUMPTIONS & ARTIFICIALITIES...................................................................................8
EXERCISE SCHEDULE..........................................................................................9EXERCISE LOGISTICS........................................................................................10
SAFETY................................................................................................................................................ 10SITE ACCESS- DELETE IF NOT APPLICABLE...................................................................................10REGISTRATION/CHECK-IN.................................................................................................................11PHOTO DOCUMENTATION................................................................................................................. 11
POST-EXERCISE & EVALUATION ACTIVITIES.......................................................12EVALUATION........................................................................................................................................ 12AFTER-ACTION REPORT/ IMPROVEMENT PLAN.............................................................................12
APPENDIX A: SAMPLE OBJECTIVES & TASKS.......................................................13APPENDIX B: SCHEDULE OF EVENTS & EVALUATION GUIDE.................................16APPENDIX C: PARTICIPANT ROLES.....................................................................17APPENDIX D: PARTICIPANT INFORMATION & GUIDANCE......................................19
EXERCISE RULES............................................................................................................................... 19PLAYER INSTRUCTIONS.................................................................................................................... 19
APPENDIX E: SAFETY CHECKLIST.......................................................................21SITE CONTROL/SCENE SAFETY........................................................................................................21PARTICIPANT SAFETY........................................................................................................................ 21
APPENDIX F: EXERCISE PARTICIPANTS..............................................................22APPENDIX G: COMMUNICATIONS PLAN..............................................................23
PUBLIC AFFAIRS................................................................................................................................. 23COMMUNICATIONS CHECK...............................................................................................................23INTERNAL (SITE) COMMUNICATIONS...............................................................................................23EXTERNAL COMMUNICATIONS.........................................................................................................23EXERCISE COMMUNICATIONS DIRECTORY....................................................................................23
APPENDIX J: FORMS.........................................................................................25
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EXERCISE OVERVIEW
Exercise Name 2018 Power Outage Exercise
Exercise Date November 13th -15th
Threat or Hazard
Extended power outage
Scope
This full-scale exercise (FSE), planned for the Santa Barbara County Disaster Healthcare Partners Coalition, will take place on November 13-15, 2018.This FSE is being conducted to evaluate existing plans, policies, and procedures of Santa Barbara County Disaster Healthcare Partners’ in a no-fault environment. The pre-written Schedule of Events and Evaluation Form will provide a timeline with exercise injects for the facility or agency exercise manager. Players will respond to defined injects within established time frames. Exercise play will include “boots on the ground” components specific to each facility or agency, as well as exercise of status reporting and other communication to the public health department. This exercise was designed by Public Health Emergency Preparedness Program and Disaster Healthcare Coalition partners. An after action meeting will be conducted on December 13, 2018.
Capabilities
HPP Capability 2. Health Care and Medical Response Coordination HPP Capability 3. Continuity of Health Care Services Delivery HPP Capability 4. Medical Surge PHEP Capability 3. Emergency Operations Coordination PHEP Capability 6. Information Sharing
Overall Objectives
Hospitals and Skilled Nursing Facilities will complete an immediate bed availability survey within 30 minutes of receiving the request via ReddiNet.
Hospitals and Skilled Nursing Facilities will complete status report assessment within 1 hour of receving the resquest via ReddiNet
Participants will confirm receipt of the CAHAN alert within 30 minutes. Participants will submit status report to the PHD DOC within 1 hour of receiving
request. 75% of participants will participate in a situation status conference call with the
Public Health Department Operations Center.
Facility/Agency Specific Objectives
For sample objectives, please refer to the Objectives list in Appendix: A Facility/Agency specific objectives can be found in Table 2 below.
Participating Organizations
A list of participating organizations is kept by the PHD.
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EXERCISE OBJECTIVES & CAPABILITIES
Table 1 : Exercise objectives for the community based-response Table 2: Your facility/agency specific objectives.
Table 1: Healthcare Coalition Objectives
Exercise Objective CapabilityHospitals and Skilled Nursing Facilities will complete an immediate bed availability survey within 30 minutes of receiving the request via ReddiNet.
Capability 2. Health Care and Medical Response Coordination (HPP)
Hospitals and Skilled Nursing Facilities will complete status report assessment within 1 hour of receving the resquest via ReddiNet.
Capability 2. Health Care and Medical Response Coordination (HPP)
Participants will confirm receipt of the CAHAN alert within 30 minutes.
Capability 3. Emergency Operations Coordination (PHEP)
Participants will submit status report to the PHD DOC within 1 hour of receiving request.
Capability 2. Health Care and Medical Response Coordination (HPP)
75% of participants will participate in Joint Information conference call with PHD PIO.
Capability 6: Information Sharing (PHEP)
Home Health & Hospice providers will provide a list of impacted patients to the PHD within 2 hours of receiving the request.
Capability 2. Health Care and Medical Response Coordination (HPP)
Dialysis Centers will provide a list of impacted patients and their needs to PHD within 2 hours of receiving the request.
Capability 2. Health Care and Medical Response Coordination (HPP)
Dialysis Centers will provide information on generator capabilities and requirements to the PHD.
Capability 2. Health Care and Medical Response Coordination (HPP)
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Table 2: Place your facility/agency specific objectives and tasks/activities in this table. The associated Accrediation Standards and Core Elements for the Centers of Medicare and Medicaid (CMS) Emergency Preparendess Rule can be included here.
Table 2: Facility/Agency Specific Objectives
Exercise Objective Task/ActivitesAccreditation
Standards(TJC, DNV, CHAP,
AAAHC, etc. )
CMS EP Rule Core Element
(Emergency Plan, Communicatoin plan,
Training and Testing or Policies & Procedures)
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SCENARIOCountywide Impacts:
Early morning on November 13th a winter storm causes widespread power outages and road closures in Southern and Northern Santa Barbara County.
The power outages are anticipated to last for several days.
Road Closures: NB/SB 101 closed at Cravens Lane in Carpinteria due to flooding Hwy 1 between Lompoc and 101 closed due to rock slide Hwy 154 closed below Painted Cave closed in both directions due to rock and mudslides
(insert road closure map)
Healthcare Impacts: 1 SNF/Assisted Living in Montecito has reported a need to evacuate due to loss of generator.
3 dialysis centers without power – Fresenius Kidney Care in Santa Barbara, Santa Barbara Artificial Kidney Center, and DaVita in Santa Maria.
Loss of power at many outpatient provider sites reported.
Hospitals receiving multiple calls for oxygen or location to plug in oxygen concentrators Lompoc Valley Medical Center sustained roof damage and heavy water damage in operating rooms and emergency department.Santa Ynez Cottage hospital fuel tank for generator damaged and unable to use back up power.
Facility Specific Scenario: (Include your facility specific scenario below)
Impacts to Facility:
Power is currently out in the facility. Backup generator is (running/not working/do not have). Fuel supplies are estimated to last for (hours/days). (if have generator).
Communication systems available: (select what you would have available during power outage- phone, email, cell, fax, radio etc.)
Impacts to Staff:
(# of staff) staff are unable or late arriving to work due to multiple road closures.
Impacts to Patients:
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EXERCISE FORMSList the forms that you used to plan for or participate in your exercise
The forms below were designed by the Public Health Emergency Preparedness Program to assist agencies and facilities to plan and document their full scale exercise.
These forms are available on: https://countyofsb.org/phd/statewideexercise/2018-forms/
• Partner Instructions
• Schedule of Events & Evaluation Guide
• Participant Evaluation Forms Template
• After Action Report (AAR) Template
• Status Report Forms
• Resource Request Forms
• List here any facility/agency specific forms that players should use in the exercise.
FACILITY/AGENCY PLANS AND POLICIES ADDRESSED• List the policies or procedures here that you will be using/testing in this exercise.
Examples:• Emergency Operations Plan (EOP)
• Communication plan
• Power outage procedures
• Downtime procedures
• Continuity of Operations Plan (COOP)
EXERCISE ASSUMPTIONS & ARTIFICIALITIESIn any exercise, assumptions and artificialities may be necessary to complete play in the time allotted and/or account for logistical limitations.
Exercise participants should be reminded that although the scenario or timeline may not be realistic they should continue to play in the exercise as they would in a real event.
The following assumptions and/or artificialities apply to this exercise:
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The exercise is conducted in a no-fault learning environment wherein capabilities, plans, systems, and processes will be evaluated.
Assume that the scenario is plausible, and events occur as they are presented. Time lapses may be inserted to achieve the exercise objectives.
Exercise simulation contains sufficient detail to allow players to react to information and situations as they are presented as if the simulated incident were real.
Real-world emergencies take priority Participating agencies may need to balance exercise play with real-world emergencies.
Decisions made in the exercise are not precedent setting, and may not reflect you’re your organization would do in a real event..
Impacts are seen across the spectrum of the response community. Participants should use existing plans, policies, and procedures. If during the course of
the exercise there is disagreement with existing plans, policies, and procedures, this should be noted, and relevant stakeholders should assess the need to change documents after the exercise.
There are no “hidden agendas” or trick questions. All players receive information at the same time. Include any additional assumptions / artificialities to be used in the exercise.
EXERCISE SCHEDULE
TIME PERSONNEL ACTIVITY LOCATIONPre-Exercise Activities
October 9th
October 16thHealthcare Partners
• Pre-Exercise Training for Healthcare Partners
Santa Barbara/Santa Maria
October 26th
November 2nd
November 9th
1000-1100
Healthcare Partners
• Pre-Exericse Confrence Calls
Conference Call
November 6th
9-10
Healthcare Partners/ PHD DOC Staff
• Pre-Exercise Tabletop and Final Meeting
Santa Barbara
• Insert staff training, and any tabletops you plan to do
At own facility/agency
November 13th -15th
November 13th
0900-1200
Home Health ProvidersPHD DOC Staff
• Exercise Day #1- Home Health
At own facility/agency
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TIME PERSONNEL ACTIVITY LOCATIONNovember 14th
0900-1200
Dialysis CentersPHD DOC Staff • Exercise Day #2- Dialysis
At own facility/agency
November 15th
0900-1200
Hospitals, SNF/ICFs, Assisted Living, Clinics, Ambulatory Surgery Centers, Other AgenciesPHD DOC Staff
• Exercise Day #3 – Hospitals, Clinics, ASC, SNF/ICF, Assisted Living and other agencies
At own facility/agency
Immediately Following the exercise
All • Hot Wash/Debrief at facility/agency
At own facility/agency
Date of Post-Exercise ActivitiesDecember 13th 20181000-1200
Healthcare Partners
• Healthcare Coalition After Action Meeting
Santa Barbara
December 31st
Healthcare Partners
• Submit After Action Report and Improvement Plan to PHD
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COMMUNICATIONS PLANFacilities/agencies should use any pre-existing communications plans. For entities and organizations without an established communications plan, the plan below may be utilized instead.
All spoken and written communications will start and end with the statement “THIS IS AN EXERCISE.”
PUBLIC AFFAIRSThe sponsor organization and participating sites are responsible for coordinating and disseminating public information before the FSE. Each venue should follow internal procedures.
If on site Media/Observers are permitted a written plan should include: Eescorting media/observers to designated areas. Accompanied by a designated staff member or exercise controller at all times.
COMMUNICATIONS CHECKBefore the FSE, the Controllers will conduct a communications check with all interfacing communications nodes (i.e. SitRep URL, CalREDIE system, etc.) to ensure redundancy and uninterrupted flow of control information.
INTERNAL (SITE) COMMUNICATIONSExercise communications do not interfere with real-world emergency communications. Sites should use any pre-existing communications modes such as: telephone, email, text, radio, etc.
EXTERNAL COMMUNICATIONSDuring exercise play, each site will communicate with external partners via the following modes: CAHAN, ReddiNet, Email, Phone and ARES
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EXERCISE COMMUNICATIONS DIRECTORY
DOC Operations [email protected] (ICF, SNF, Assisted Living, & Hospitals)
[email protected] – (Clinics & Ambulatory Surgery Centers, Dialysis, Home Health)
DOC Fax805-681-5192
805- 681-5142 Alternate
Healthcare Partners conference call at 11:00am
Call (855)748-3535
Use Passcode: 536574
Exercise Controller- (Any questions during the exercise)
Jan Koegler 805-331-8360
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EXERCISE LOGISTICSEach facility/agency should fill in logistics information specific to their exercise.
SAFETY SEE EXAMPLE-MODIFY AS NEEDED) SAFETY CHECKLIST APPENDIX D
SITE ACCESS- DELETE IF NOT APPLICABLE
SecurityFollow your facility/organization security policies, procedures, and protocols. Players should advise their site’s Safety Office and Controller of any unauthorized persons.
Media/Observer Coordination Sites with media personnel and/or observers attending the event should coordinate with the Public Information Officer (PIO). Media/Observers are escorted to designated areas and accompanied by the PIO at all times. FSE participants should be advised of media and/or observer presence.
Exercise Identification Exercise staff may be identified by badges, hats, and/or vests that clearly display exercise roles; additionally, uniform clothing may be worn to show facility/agency affiliation.
REGISTRATION/CHECK-IN All participants should check in prior to the exercise and receive instructions on facility characteristics. A sample sign-in sheet may be found in Appendix ??
PHOTO DOCUMENTATIONParticipants will be photographed during the exercise for documentation purposes. Facility/Agency may have participants sign a waiver to be photographed.
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POST-EXERCISE & EVALUATION ACTIVITIES
EVALUATION
Hot Wash/DebriefingsPost-exercise debriefings are used to collect data to support effective evaluation and improvement planning. At the conclusion of exercise play, controllers facilitate a Hot Wash/Debrief and ask players to discuss strengths and areas for improvement. Evaluators can ask players for clarification regarding player actions and decision-making processes. All participants may attend; however, observers are not encouraged to attend the meeting.
Participant Feedback Forms- Delete if you are not using feedback forms.Participant Feedback Forms provide players with the opportunity to comment candidly on exercise activities and design, as well as strengths and areas for improvement. These forms should be collected at the conclusion of the Hot Wash/Debrief. Sample Participant Feedback Form can be found in Appendix J.
AFTER-ACTION REPORT/ IMPROVEMENT PLAN
Facility/Agency will submit an AAR/IP to the Santa Barbara County Public Health Department upon completion.
The after action report and improvement plan (AAR/IP) provides a written report that analyzes the achievement of the exercise objectives. The AAR primarily focuses on the ability to complete identified tasks and activities related to the exercise objectives. Strengths and areas for improvement should be listed.
The improvement plan is a section in the AAR that identifies corrective actions, assigns them to the responsible parties, and establishes target dates for their completion.
A template for an AAR/IP is available by clicking the link in Appendix J.
The Santa Barbara County Diaster Healthcare Partners Coalition After Action Meeting will be held on December 13, 2018 from 10am-12pm.
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APPENDIX A: SAMPLE OBJECTIVES & TASKS The following are sample objectives and activities for a facility or agency to include as exercise objectives in Table 2 of this exercise plan.
Once you have chosen and inserted your objectives and activities into Table 2 you may delete Appendix A.
Activation
Activate the Incident Command System (ICS) and the Center’s Command Center (if applicable) within [insert timeframe] of incident notification, to provide a structured and successful emergency response.
Evaluate the facility’s ability to activate the Emergency Operations Plan and other supporting plans.
Identify staffing needs and activate staff members as needed within [insert timeframe] of notification of an incident/event and begin call-down procedures
Develop an Incident Action Plan (IAP), including operational periods, and conduct associated IAP meetings every [insert timeframe]
Communication
Evaluate the facilities ability to alert and notify personnel of activation of the facility’s Emergency Operations Plan.
Identify immediate resource needs and communicate them to the MHOAC and/or other response partners within [insert timeframe]
Communicate with staff, patients, and visitors to notify them of Command Center activation and incident response strategies, as appropriate, within [XX] minutes of activation
Utilize and test redundant communication systems [insert specific systems to test, such as radio, email, mass notification software, etc.] to notify the MHOAC and/or other response partners of the center’s status and resource needs, within [insert timeframe]
Evaluate facility’s ability to share information with the Public Health Department/Medical Health Operational Area Coordinator via ReddiNet or by submitting a status report.
Evaluate the ability to provide situation status report to all response and partner agencies. Utilize 5 communication methods to test redundancies and efficiencies, ensuring ability of
health care providers to provide and receive status information The [Long Term Care Facility (LTCF) Incident Commander/Administrator] submits a facility
status report to [insert relevant local emergency management authorities] within [XX] hours of the start of the emergency
The facility, if appropriate, notifies local emergency authorities of available bed capacity within [insert timeframe] of request
Establish a secure radio channel and review proper radio etiquette within [insert timeframe] of HCC activation with all those assigned a radio
Evacuation
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2018 POWER OUTAGE EXERICSEINSERT AGENCY/FACILITY NAME FULL SCALE EXERCISE Evaluate ability of facility to evacuate staff, and clients/patients in [set time period]. From the
building. Test ability of facility to receive evacuated residents from other long term care facilities. Implement the facility’s evacuation and/or relocation plans within [insert timeframe] of
notification that the facility can no longer provide a safe working environment Develop objectives, strategies, and tactics for the transportation of all staff, patients, and
visitors within [insert timeframe], and ensure they are documented Collect and organize appropriate medical records to accompany relocated residents while
maintaining Health Insurance Portability and Accountability Act (HIPAA) compliance Identify resources (e.g., medication, supplies, staff, etc.) that will be needed to accompany
evacuated residents Conduct a coordinated evacuation effort with local emergency management officials and
state survey agencies to ensure the safe evacuation and transfer of residents
Resources
Facility/agency will demonstrate ability to communicate resource requests to obtain scarce resources, such as diesel or gasoline for generators.
Test ability to use established procedures to request resources from vendors, the Public Health Department and City agencies.
Determine impact and response measures & resources needed for loss of utilities:o Watero Medical Gaso Power & Dieselo Generator o HVACo Steam
Medical Surge
Activate the (hospital/clinic/SNF) medical surge plan. Activate the (e.g., Medical Surge Plan, Pandemic Plan, Mass Casualty Plan, etc.) within
[insert timeframe] after notification of a surge of patients. Activate the medical surge staging area with all equipment and supplies by XX time from
notification. Facility will demonstrate capacity to triage XXX number of patients within XXX time. Facility will demonstrate capacity to triage and treat XX number of patients within XX
time. Track patients from entry into the healthcare system through discharge throughout the
exercise Provide information on the bed status/bed capacity consistently, every [insert timeframe],
to the [local operational area/DOC/EOC]
Continuity of Operations
Facility/agency will demonstrate the ability to activate staffing to implement their Continuity of Operations Plans (COOP) and include COOP status updates within staff briefings and operational objectives.
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Facility/agency will demonstrate ability to prioritize patients for medical services within XX hours of a power loss.
Facility/agency will demonstrate ability to determine alternate method to provide for prioritized patient care/services within XX hours of a power loss.
Facility/agency will demonstrate ability to determine and communicate to staff priority operations and the service locations within XX hours of a power loss.
Facility/agency will demonstrate ability to identify available relocation sites in accordance with the facility’s EOP and Continuity of Operations Plans (COOP), and in coordination with local authorities.
Facility/agency will demonstrate ability to determine the facility/agency priorities for ensuring key functions are maintained throughout the emergency, including the provision of care to existing and new patients within [insert timeframe].
Put in place succession planning to maintain operations if primary positions become vacant due to the implications of the event
Ensure that business operations are sustainable for a potentially long-term event, and identify strategies for sustainability in a long-term recovery plan and/or objectives
Ensure the provision of continued staff and resources for Administrative and Finance functions throughout response
Consider the need for sheltering-in-place, facility lockdown, closue or evacuation, and notify all internal staff within [insert timeframe] of the decision to initiate any such actions
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APPENDIX B: SCHEDULE OF EVENTS & EVALUATION GUIDEBackground Exercise Scenario In- Templatefor 2018 exercise found on exercise webpage. [Insert exercise scenario]
Inject #/Dat
eTime Objective/
Task From To Message/Task Expected Outcomes/Action
Observed Outcome/ Comments & Evaluation
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APPENDIX C: PARTICIPANT INFORMATION & GUIDANCE EXERCISE RULES
The following general rules govern exercise play:
• Real-world emergency actions take priority over exercise actions.• Exercise players will comply with real-world emergency procedures, unless otherwise
directed by control staff.• All communications (including written, radio, telephone, and e-mail) during the exercise
will begin and end with the statement “This is an exercise.”• Insert your organization/facility’s specific rules here.
PLAYER INSTRUCTIONS
Players should follow certain guidelines before, during, and after to ensure a safe and effective exercise.
Before the Exercise• Review appropriate organizational plans, procedures, and exercise support documents.
• Be at the appropriate site at least 30 minutes before the exercise starts. Wear the appropriate uniform and/or identification item(s).
• Sign in when you arrive.• [Insert your jurisdiction/organization/facility’s specific tasks here.]
During the Exercise Respond to exercise events and information as if the emergency were real, unless
otherwise directed by an exercise controller. Controllers will only give you information they are specifically directed to disseminate.
You are expected to obtain other necessary information through existing emergency information channels.
Do not engage in personal conversations with controllers, evaluators, observers, or media personnel. If asked an exercise-related question, give a concise answer. If you are busy and cannot immediately respond, indicate that, but report back with an answer as soon as possible.
If you do not understand the scope of the exercise or are uncertain about an organization’s participation in an exercise, ask a controller.
Parts of the scenario may seem implausible. Recognize that the exercise has objectives to satisfy and may require incorporation of unrealistic aspects. Every effort has been
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made to balance realism with safety, and to create an effective learning and evaluation environment.
All exercise communications will begin and end with the statement “This is an exercise.” This precaution is taken so that anyone who overhears the conversation will not mistake exercise play for a real-world emergency.
Maintain a log of your activities. Many times, this log may include documentation of activities that were missed by a controller or evaluator.
• Insert your jurisdiction/organization/facility’s specific tasks here.
After the Exercise Participate in the Hot Wash with controllers and evaluators. Complete the Participant Feedback Form, which allows you to comment candidly on
emergency response activities and exercise effectiveness. Provide the completed form to a controller or evaluator.
Provide any notes/materials generated from the exercise to your controller or evaluator for review and inclusion in the AAR.
• Insert your jurisdiction/organization/facility’s specific tasks here.
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APPENDIX D: SAFETY CHECKLIST Each facility/agency should fill in safety checklist information specific to their exercise.Exercise participant safety takes priority over exercise events. The following general requirements apply to the exercise:
• A safety briefing will occur prior to the start of the exercise. • A Safety Controller is responsible for participant safety; any safety concerns must be
immediately reported to the Safety Controller. The Safety Controller and Exercise Controller will determine if a real-world emergency warrants a pause in exercise play and when exercise play can be resumed.
• For an emergency that requires immediate assistance, use the phrase “THIS IS NOT A DRILL.” The following procedures should be used in case of a real emergency during the exercise:– Anyone who observes a participant who is seriously ill or injured will immediately
notify emergency services and the closest controller, and, within reason and training, render aid.
– A controller aware of a real emergency will initiate the “THIS IS NOT A DRILL” broadcast and provide the Exercise Controller and Safety Controller with the location of the emergency and resources needed, if any. The Exercise Controller will notify the rest of the participants as soon as possible.
Fire Safety -delete section if not applicableStandard fire and safety regulations relevant to the [participant site] will be followed during the FSE. [Insert any site-specific guidelines/protocols]
SITE CONTROL/SCENE SAFETY
Access to exercise sites is limited to exercise participants. All participants check in before the exercise. Media/Observers are escorted to designated areas and accompanied by an exercise
controller at all times. Exercise staff is wearing the pre-determined badges, hats, and/or vests to clearly display
their exercise roles. A perimeter fence or other types of barrier controls are in place. Site access points to the site or building have been identified and will be monitored during
the duration of the exercise. Vehicle traffic is separated from pedestrian traffic on the site. Vehicle barriers at the perimeter and building maintain access for emergency responders,
including large fire apparatus. Signs provide control of vehicles and people.
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2018 POWER OUTAGE EXERICSEINSERT AGENCY/FACILITY NAME FULL SCALE EXERCISE All existing fire hydrants on the site are accessible. Floor plans posted show exits, entrances, location of security equipment, etc.
PARTICIPANT SAFETY
All participants are aware that there is a Safety Controller on scene. All participants know to use the phrase “THIS IS NOT A DRILL” if an emergency arises that
requires assistance. All participants are aware that they should notify emergency services and the closest
controller if they observe another participant who is seriously ill or injured. All participants know to advise their venue’s controller or evaluator of any unauthorized
persons. All participants are aware of exercise identification items, and will be able to identify exercise
staff. All participants are aware of the exits, entrances, location of security equipment, etc. All participants are aware of and have agreed to the relevant weapons policy.
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APPENDIX E: EXERCISE SAMPLE SIGN-IN SHEETNAME POSITION EMPLOYEE ID SIGNATURE
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APPENDIX J: FORMS The following forms can be found on the 2018 Exericse webpage: https://countyofsb.org/phd/statewideexercise/2018-forms/
Partner Instructions
Schedule of Events & Evaluation Guide
Status Report
Resource Request
Participant Feedback Form
After Action Report/Improvement Plan
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