Head Start/Early Head Start Emergency Preparedness Survey
Directions:
Please
complete the following questions to the best of your ability. The
Office of Head Start is interested in learning about your program’s
emergency preparedness policies and plans for large-scale
emergencies. If you come across a question that you can not answer,
please consult with others in your program to obtain the answer.
The information you provide is very helpful for the Office of Head
Start and we thank you for your attention and participation.
For
the purposes of this study a large-scale emergency refers to
circumstances of hurricanes Katrina, Rita, and Wilma; the terrorist
attacks of September 11, 2001; or other incidents where assistance
may be warranted under the Robert T. Stafford Disaster Relief and
Emergency Assistance Act (42 U.S.C. 5121 et seq.).
Section A: Presence of a large-scale emergency plan and emergencies included
1. Has your program developed emergency preparedness and response policies and procedures for large-scale emergencies?
Yes (please go to question 1A)
No (please go to question 2)
1A.Which of the large-scale emergencies below are currently included within your program’s emergency preparedness and response plan’s policies and procedures? Check all that apply.
Wildfire
Flood
Chemical/industrial accident (beyond the facility)
Severe weather event (for example, tornado, hurricane, ice storm, extreme heat)
Earthquake
Tsunami (tidal wave)
Civil disorder/rioting
Terrorist attack (such as nuclear/biological/chemical)
Pandemic influenza or other outbreak of infectious disease
Widespread loss of electrical power
Breakdown of electronic communications (such as widespread failure of phone
networks)
None of the above
Other_____________________________________
Other_____________________________________
1B. How often is your large-scale emergency preparedness and response plan updated?
Monthly
Four times a year
Twice a year
Once a year
Other_______________________________________
We have not updated our large-scale emergency preparedness and response
plan
2. Which of the large-scale emergencies below has your program been affected by from January 1, 2000 to the present? Check all that apply.
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None |
One |
Two |
Three |
Four |
Five |
Six or more |
Wildfire |
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Flood |
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Chemical/industrial accident (beyond the facility) |
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Tornado |
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Hurricane |
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Ice storm |
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Extreme heat |
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Earthquake |
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Tsunami (tidal wave) |
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Civil disorder/rioting |
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Terrorist attack (for example, a nuclear, biological, or chemical attack, or the attacks of September 11, 2001 |
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Outbreak of infectious disease in the community |
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Widespread loss of electrical power |
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Breakdown of electronic communications (such as widespread failure of phone networks) |
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Other 1 |
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Other 2 |
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If you have indicated “Other” – please describe
Other 1: ____________________________________________
Other 2: ____________________________________________
3. Which of the large-scale emergencies below are required by your State or local statutes, regulations or policies to be in your written emergency preparedness and response plans? Check all that apply.
Wildfire
Flood
Chemical/industrial accident (beyond the facility)
Severe weather event (for example, tornado, hurricane, ice storm, extreme heat)
Earthquake
Tsunami (tidal wave)
Civil disorder/rioting
Terrorist attack (such as nuclear/biological/chemical)
Pandemic influenza or other outbreak of infectious disease
Widespread loss of electrical power
Breakdown of electronic communications (such as widespread failure of phone
networks)
Other_____________________________________
If you responded to any of the emergencies above, please go to question 4
No written plan is required by our State statutes, regulations or policies (please
go to question 3A)
No written plan is required by our local statutes, regulations or policies (please
go to question 3A)
Don’t Know (please go to question 4)
3A. If your State or local statutes, regulations or policies do not require your program to have a written emergency preparedness and response plan for large-scale emergencies (for example, hurricanes, tornadoes, wildfires, floods, industrial accidents, terrorist attacks, etc.), what are the reasons for which you developed your own policies and procedures? Check all that apply.
Our program experienced a large-scale emergency
Our community experienced a large-scale emergency
Our community is making an effort to plan for a large-scale emergency
Other programs experienced a large-scale emergency
Our program wanted to be prepared
There is a grant opportunity that we pursued for emergency preparedness
Develop or maintain a collaborative relationship with other programs/agencies
Other_____________________________________
Other_____________________________________
Other_____________________________________
Other_____________________________________
We have not developed a plan.
Section B: Drills of your emergency preparedness plan, policies and procedures
4. Do your program policies and procedures designate the position of the person (example: Director, lead teacher, program supervisor, etc.) who is responsible for each part of the emergency preparedness and response plan?
Yes
No
Does not apply, currently no emergency preparedness policies/procedures for
large-scale emergencies
5. Do your program’s emergency preparedness and response policies and procedures
require that you conduct drills?
Yes (if yes, please go to question 5A)
No (if no, please go to question 6)
No emergency preparedness and response policies and procedures exist (please
go to question 6)
5A. What do your large-scale emergency preparedness drills focus on? Check all that apply.
Drills for a specific large-scale emergency
Evacuation
“Shelter-in-place”
Damage assessment
Risk assessment
Communication with emergency personnel
Other_______________________________________
6. Which of the following methods does your program use to test procedures to be used in the event of a large-scale emergency? Check all that apply.
“Tabletop” exercises (staff discussion of specific assigned roles,
responsibilities and actions in the event of an emergency)
Simulated events (fire drills, evacuation drills, shelter-in-place)
“After-action review” (review of the effectiveness of communication
procedures that were used during an actual event)
Other:________________________________________
No method for testing of these procedures is conducted
7. Do your emergency preparedness and response drills include simulated or actual communication and coordination with the following? Check all that apply.
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Simulated |
Actual Communication |
Actual Coordination |
Federal emergency management agencies |
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State emergency management agencies |
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Local emergency management agencies |
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Non-governmental emergency management organization |
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Other______________________________ |
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No emergency preparedness and response drills conducted (please go to question 9) |
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8. Do your emergency preparedness and response drills include simulated or actual communication and coordination with relief agencies and other response and recovery resources (after the immediate impact of the emergency has passed? Check all that apply.
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Simulated |
Actual Communication |
Actual Coordination |
Medical organizations or agencies |
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Mental health providers/organizations/agencies, crisis counselors |
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Red Cross |
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Insurance consultants |
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Other______________________________ |
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Other______________________________ |
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None of the above |
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Section C: Communication of your emergency preparedness plan, policies and procedures for staff, parents, and others
9. Who receives copies of your emergency preparedness and response plan? Check all that apply.
Staff
Volunteers
Parents
Community Partners
Other_______________________________________
No plans are provided (please go to question 10)
9A. How often is your emergency preparedness and response plan provided to
others?
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Monthly |
Twice a year |
At initial involvement with program |
At the beginning of the program year |
During orientation/ training |
Not applicable |
Staff |
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Volunteers |
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Parents |
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Community Partners |
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Other (from 9) |
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10. What accommodations for communicating emergency procedures have you made? Check all that apply.
Posted emergency information in English and in other languages
representative of the languages spoken by staff, parents, and volunteers
Pictograms (such as pictures or diagrams of evacuation routes, locations of
essential equipment or supplies)
Audible pre-recorded instructions (for vision-impaired staff or volunteers)
Tactile guides for evacuation routes for the visually impaired
Other_______________________________________
No accommodations for communicating emergency procedures have been
made
11. What are your programs policies and procedures for how to communicate with parents and staff in the event of large-scale emergency? Check all that apply.
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Parents |
Staff |
Telephone (including cell phone text messaging) |
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TTY (text telephone devices for the hearing impaired) |
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Emergency contacts in lieu of parents (pre-designated and authorized to receive information regarding the individual child) |
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Pre-designated local radio and television stations |
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Specific procedures for communicating with parents of limited English proficiency |
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Specific procedures for communicating with homeless families |
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Other:________________________________________________ |
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Other:________________________________________________ |
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No policies and procedures for communication exist |
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12. How do you keep contact information for parents, staff, and volunteers? Check all that apply.
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Hard copy in office |
Hard copy kept off site |
Electronic |
Electronic backup off site |
Information not kept |
Parents |
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Staff |
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Volunteers |
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13. How often do you update your contact information for:
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Monthly |
Twice a year |
When entering the program |
At the beginning of the year |
During training |
No updates are made |
Parents |
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Staff |
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Volunteers |
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14. What information are parents and staff informed of in advance?
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Parents |
Staff |
The types of emergencies that they will be contacted about? |
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How they will be contacted in the event of a large-scale emergency? |
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Changes to the programs large-scale emergency policies and procedures when they are made? |
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Other: _______________________________________________ |
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Other: _______________________________________________ |
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None of the above |
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Section D: Financial support of your emergency preparedness plan
15. Does your program budget include Federal and/or non-Federal-share resources dedicated to emergency preparedness? Check all that apply.
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Costs of training |
Supplies |
Equipment |
Facilities |
No resources are provided |
Federal |
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Non-Federal |
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Other |
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16. Are costs/expenses associated with your program’s emergency preparedness planning represented as a line item(s) in your program’s budget?
Yes
No
17. Are any emergency preparedness services, equipment, supplies, facilities, or financial resources donated or contributed to your program? Check all that apply.
Services (ex. training of Head Start staff and volunteers, broadcast of
emergency messages)
Materials (ex. emergency supplies such as bottled water, long shelf-life foods,
equipment such as walkie-talkies, weather radios)
Facilities (evacuation space, off-site storage of supplies, back-up records)
Financial resources (ex. grants)
Other_______________________________________
No donations or contributions have been made
18. How many days of pre-positioned emergency supplies do you have to provide for staff and children, if necessary? Check one response for each row.
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None |
1 Day |
2 Days |
3 Days |
4 Days |
5 Days |
More than 5 days |
Water |
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Food |
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Medications |
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Batteries for flashlights and radios |
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Personal care/toiletry items |
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Other:_______________________ |
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If you have responded “None” to any of the above in #18, please complete question 18A.
18A. If you have indicated “None” for water, food, medications, batteries for flashlights and radios, and/or personal care/toiletry items, how was this decision made? Check all that apply.
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Water |
Food |
Medications |
Batteries for flashlights and radios |
Personal care/toiletry items |
Not enough money to provide supplies |
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Not enough space to store supplies |
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Not enough staff time to manage the inventory and track expiration dates |
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Not identified as likely that the facility would be isolated for more than a day |
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Not a priority |
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Other |
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19. Where are these pre-positioned emergency supplies stored? Check all that apply.
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On-site |
Off-site |
Other 1 |
Other 2 |
No supplies |
Water |
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Food |
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Medications |
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Batteries for flashlights and radios |
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Personal care/toiletry items |
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Other:_______________________ |
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If you have indicated “other” (ex. an arrangement for access to emergency supplies with a community partner) – please describe
Other 1: ____________________________________________
Other 2: ____________________________________________
Section E: Connecting your program with State and local (jurisdictions) evacuation and emergency protocols
20. Which of the following methods does your program use to keep up to date on State and local (jurisdictions) evacuation and emergency protocols? Check all that apply.
Mailings
Listserv (through local/State authorities)
Direct communication from representatives of local and State emergency
preparedness and response agencies or workgroups
Program staff participation on local or State emergency preparedness
and response agencies or workgroups
Other_______________________________________
No methods used
21. Does the program have policies and procedures for staff training on State and local (jurisdictions) evacuation and emergency protocols?
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State protocols |
Local (jurisdictions) protocols |
Yes |
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No |
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22. How often does your program provide staff training on State and local (jurisdictions) evacuation and emergency protocols (check all that apply):
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Once a year |
Twice a year |
Four times a year |
When changes are made to evacuation and emergency protocols |
No training provided |
Staff training – State protocols |
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Staff training – Local (jurisdictions) protocols |
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If no training provided for both state and local (jurisdictions) protocols please go to question 23.
22A. Who conducts staff training on State and local (jurisdictions) evacuation and emergency protocols? Check all that apply.
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State protocols |
Local (jurisdictions) protocols |
Program Staff |
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Outside consultants (paid by Program funds) |
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Outside consultants (unpaid local, State or Federal partners) |
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Other: ___________________________________ |
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Not applicable |
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22B. Which staff participates in the training on State and local (jurisdictions) evacuation and emergency protocols? Check all that apply.
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Teachers |
Teacher aids |
Support staff |
Transportation personnel |
Volunteers |
Other |
Not applicable |
Staff training – State protocols |
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Staff training – Local (jurisdictions) protocols |
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If you have indicated “other”– please describe
Other State: ____________________________________________
Other Local (jurisdictions): ____________________________________________
23. Which of the following methods are used to test the procedures for carrying out State and local (jurisdictions) evacuation and emergency protocols? Check all that apply.
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State |
Local (jurisdictions |
“Tabletop” exercises (staff discussion of specific assigned roles, responsibilities and actions in the event of an emergency) |
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Simulated events (fire drills, evacuation drills, shelter in place) |
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“After-action review” (review of the effectiveness of communication procedures that were used during actual event) |
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Other: _______________________________________________ |
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Other: _______________________________________________ |
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There are no State or local (jurisdictions) evacuation and emergency protocols |
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No methods are used to test procedures for carrying out these protocols |
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Section F: Coordination with emergency management agencies and organizations
24. Which emergency management agencies/organizations does your program have policies and procedures for communicating and coordinating with in the event of a large-scale emergency? Check all that apply.
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Communicating |
Coordinating |
Federal emergency management agencies |
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State emergency management agencies |
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Local emergency management agencies |
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Non-governmental emergency management organizations |
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Other: ___________________________________ |
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We have no such policies or procedures |
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25. Were your program’s policies and procedures for communicating and coordinating with emergency management agencies developed for your program or a larger system? Check all that apply.
For your Head Start program specifically
For a larger system of which the program is a part (ex. school system)
Other______________________________________
We have no such policies or procedures (please go to question 26)
25A. Which of the agencies/organizations below were directly involved in developing your policies and procedures for communicating and coordinating between your program and the emergency management agencies? Check all that apply.
Federal emergency management agencies
State emergency management agencies
Local emergency management agencies
Non-governmental emergency management organizations
Other______________________________________
No such agencies or organizations were involved
Don’t know
25B. Did you or your program inform any of the following agencies/organizations about your policies and procedures for communicating and coordinating with them? Check all that apply.
Federal emergency management agencies
State emergency management agencies
Local emergency management agencies
Non-governmental emergency management organizations
Other______________________________________
Don’t know
No such agencies/organizations were informed
Section G: Preparing for response and recovery from large-scale emergencies
26. Does your program have policies and procedures for designating and maintaining access to critical records (for example, medication logs, consent forms, etc.) in the event of an emergency requiring evacuation or shelter-in-place?
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Evacuation |
Shelter-in-place |
Yes |
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No |
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27. Does your program have policies and procedures for communicating with parents and staff during the response and recovery stages of a large-scale emergency (after the immediate impact of the emergency has passed)?
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Parents |
Staff |
Yes |
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No |
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28. In the case of a large-scale emergency, does your program have partnerships or agreements with individuals/practices in the medical community to provide resources for your (check all that apply):
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Yes |
No |
Children |
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Parents |
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Staff |
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29. In your program communication procedures and policies for the response and recovery stages of a large-scale emergency what contact information for identified individuals (by name or by title) representing relief agencies and other resources are included? Check all that apply.
Individuals in federal emergency management agencies
Individuals in state emergency management agencies
Individuals in local emergency management agencies
Individuals from non-governmental emergency management organizations
Other______________________________________
We have no such procedures or policies
30. Which of the following are included in your program emergency preparedness and response policies and procedures for Continuity of Operations planning (planning for the continuing delivery of program services once the immediate impact of the large-scale emergency has passed)?
Back-up systems for computer files – on-site
Back-up systems for computer files – off-site
Provisions for temporary relocation of program classrooms and other center-
based services
Identification of key equipment for the safe operation of the facility
A list of vendors who can provide critical repair or replacement when needed
Transportation
Other
We have no policies or procedures for Continuity of Operations
31. Do program emergency preparedness and response policies and procedures include preparation through identification of resources and training in (check all that apply):
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Identification of resources |
Training |
How to conduct a facility damage assessment |
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Documentation of facility damage assessment |
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Identification of resource needs to resume program operation |
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Prioritization of resource needs to resume program operation |
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Notification of financial entities (insurance carriers, funding agencies, FEMA) |
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Other |
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We have no such polices or procedures |
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32. Do program emergency preparedness and response policies and procedures include training of staff in the:
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Children |
Families |
Staff |
Effects of traumatic events such as large-scale emergencies upon: |
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Provision of mental health support during response and recovery for: |
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Section H: Emergency preparedness and response planning for localized emergencies
The next five (5) questions are based on your policies and plans for localized emergency preparedness and response. A localized emergency is one that happens either within the center or on a smaller scale than a large-scale emergency.
33. Which of the localized emergencies below are currently included within your program’s emergency preparedness and response plan’s policies and procedures? Check all that apply.
Hostage situation in the center
Abduction/attempted abduction
Violence in the center
On-site fire
Infrastructure failure (e.g., roof collapse, major plumbing/flood)
Other_________________________
Other_________________________
No localized plan exists (please go to question 34)
33A. How often is your localized emergency preparedness and response plan updated?
Monthly
Four times a year
Twice a year
Once a year
Other_______________________________________
We have not updated our localized emergency preparedness and response
plan
34. Which of the localized emergencies below has your program experienced from January 1, 2000 to the present? If experienced more than once, please indicate by entering number of times this has occurred. Check all that apply.
Hostage situation in the center___
Abduction/attempted abduction___
Violence in the center___
On-site fire___
Infrastructure failure (e.g., roof collapse, major plumbing/flood)
Other_______________________ ____
Other_______________________ ____
No localized emergencies have occurred
35. Do your program’s emergency preparedness and response policies and procedures
require that you conduct drills?
Yes (if yes, please go to question 35A)
No (if no, please go to question 36)
Not applicable (please go to question 36)
35A. What do your localized emergency preparedness drills focus on? Check all that apply.
Drills for a specific large-scale emergency
Evacuation
“Shelter-in-place”
Damage assessment
Risk assessment
Communication with emergency personnel
Other_______________________________________
36. Which of the following methods does your program use to test procedures to be used in the event of an emergency? Check all that apply.
“Tabletop” exercises (staff discussion of specific assigned roles,
responsibilities and actions in the event of an emergency)
Simulated events (fire drills, evacuation drills, shelter-in-place)
“After-action review” (review of the effectiveness of communication
procedures that were used during an actual event)
Other:________________________________________
No methods are used to test the procedures.
37. What are your programs policies and procedures for how to communicate with parents and staff in the event of localized emergency? Check all that apply.
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Parents |
Staff |
Telephone (including cell phone text messaging) |
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TTY (text telephone devices for the hearing impaired) |
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Emergency contacts in lieu of parents (pre-designated and authorized to receive information regarding the individual child) |
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Pre-designated local radio and television stations |
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Specific procedures for communicating with parents of limited English proficiency |
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Specific procedures for communicating with homeless families |
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Other:________________________________________________ |
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Other:________________________________________________ |
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We have no policy and procedures for communication |
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38. Have you conducted an assessment of potential risks to your facility associated with an emergency, such as:
Structural integrity of your building
Susceptibility of your facility to loss of electrical power
Susceptibility of your facility to loss of water or sanitation
Susceptibility of your facility to loss of ability to communicate to the outside
Susceptibility of your facility to loss of access to and from the outside
Nearby facilities or installations that pose a potential risk (such as dams
nuclear power plants, chemical plants, etc.)
Proximity to tree line in the event of wildfire
Location on a slope in the event of mud-slide or avalanche
Security of center assessment
Other _________________________________
No assessment of potential risks conduced
39 Does your program have individuals on staff or in a consulting capacity that are trained to deal with the emotional response to trauma for: (Check all that apply)
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Yes |
No |
Children |
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Families |
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Staff |
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File Type | application/msword |
File Title | Appendix B |
Author | DHHS |
Last Modified By | Seth F. Chamberlain |
File Modified | 2009-07-14 |
File Created | 2009-07-14 |