Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Reviewed By:

Approved By:

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Table of contents
Introduction 4
Objective 4
l. purpose 4
ll. situation and assumption 4
a .situation 4
assumptions 4
lll .concept of operations 5
a. pre- emergence 5
b. preparedness 7
c. response 8
d. recovery 8
lv. Organization and responsibilities 8
v. Authorities and references 9
a. authorities 9
b .references 9
Notification procedures 9
tab a 10
tab b 11
emergency call-down roster 11
emergency checklist 11
Evacuation procedure 11
Tab c 12
Emergency checklists 12
Specific disasters\incidents fire safety 12
Tab d 13
Emergency checklist 14
Natural disasters 14
Emergency checklist 14
Water \electrical outage 14
Tab e 16
Emergency checklist 16
Department responsibilities 16
Administrative services 16
Emergency checklist 16
Maintenance service 17
Emergency checklist 18

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Nursing\medical services 18
Emergency checklist 18
Security services 19
Tab f 19
Inventory checklist 19
Tab g 19
Emergency points of contact directory 20

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

INTRODUCTION
The need for an emergency action plan for AlAin Initial Services Center is to include plans for relocation of
residents. This need is further established in federal and state regulation.
This plan refers to assisted living, residential care, and continuum of care, nursing homes and intermediate
care facilities.
OBJECTIVE
This plan is designed as a resource tool to assist in the development and implementation of an emergency
action plan within your organization. Specific compliance requirements addressed in this plan have been
researched to the best of our ability. Once in place, it is recommended that the plans be reviewed and
updated on a routine basis to ensure their accuracy.
l. purpose
to provide guidance to all employees of AlAin Initial Services Center on an emergency situation to protect
the lives and property of residents, staff and patients.
ll. situation and assumption
A .situation
1. AlAin Initial Services Center is open to natural and technological disasters.

2. Resident of this facility require special emergence consideration in planning for disasters or
emergencies and in ensuring safety.

B. assumptions
1. The possibility exists that an emergency may occur at any time.
2. In the event an emergency exceeds the facility’s capability, external services and resources may be
required.
3. Local, state and federal departments and agencies may provide assistance necessary to protect lives and
property.
4. It is the responsibility of the health authority and \or the office of the state fire marshal to inspect the
facility for compliance with published safety guidelines.
5. The local emergency management agency is available to assist in writing and reviewing the facility’s
emergency action plan.
6. The health authority is responsible for the annual inspection of the facility for compliance with all state
and federal statutes and regulations .this emergency action plan will be reviewed at these inspections.
7. Based on authority, the state fire marshal or the local fire department may be responsible for The annual
review and inspection of fire safety plans and procedures
lll .concept of operations
because the state is subject to the adverse effects of natural or technological disasters, the facility
administrator should developed and revise, in coordination with the health authority, the office of the state
fire marshal and the local emergency management director, an emergency action plan capable of providing
for the safety and properly informed and alerted as necessary .this plan can be effective for either internal or
external emergencies.
a. pre –emergence

The primary focus of this phase is on the development, revision, testing and training of the emergency action
plan.
1. Review, exercise and re-evaluate existing plans, policies and procedures.
2. Coordinate plans with the local emergency management agency and provide input in to the county
emergency plans .a memorandum of understanding or mutual aid agreement should be in place.
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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

3. Review and update resource lists. (see tab f)

a. Ensure the availability of manpower needed to execute emergency procedures.

b. Work with the local emergency management director, in locating needed resources.
c. Identify staff needing transportation and arrange for provision of this service.
4. Determine communication system .for example, cellular phones and fax machines may offer the best
means of telecommunication in the event of a power loss .however, a supply of quarters and
accessibility to a pay phone may serve as a reasonable alternative.
5. Ensure the availability and functioning of facility emergency warning system.
6. Test reliability of emergency telephone roster for contacting emergency personnel and activating
emergency procedures.
7. Develop procedure for testing generators and equipment supported by emergency generators.

A .ensure a 48hour supply of emergency fuel and establish an agreement for delivery with a supplier.
b. activate the generators for a minimum of eight hours every thirty days.
c. document all testing procedures.
9. Schedule employee orientation training and in-service training programs on the operations of the
emergency plan.
10. Enhance emergency education.
a. Distribute personal preparedness checklists on fire safety, protection from natural disasters, etc.(see
TAB D)
b. Post display of evacuation routes, alarm and fire extinguisher locations and telephone numbers of
emergency contacts.
c. Provide demonstration on warning systems and proper use of emergency equipment for the staff, and
resident families at home.

11. Conduct, at a minimum, twelve unannounced fire drills per year. Check fire regulations for local
compliance requirements.
a. One drill is required per quarter for each shift.
b. Document each drill, instruction or event to include dates, content and the participants
involved.

12. It is recommended that, at minimum, annual unannounced drill exercising all aspects of the emergency
action plan be conducted. Document drills with critiques and evaluations.

13. Develop and maintain Standard operating procedures including procedures and tasking assignments,
resources, security procedures, personnel call down lists and inventories of emergency supplies. Include
section designating staff.

15. Designate staff trained in the content of the disaster plan to execute the activities of the command post.

16. Plan for evacuation and relocation

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Describe the policies, role responsibilities and procedures for the evacuation of residents from the facility
(See

The supplement to the emergency action plan for is open to natural and technological disasters. Facilities)

a. Identify the individual responsible for implementing facility evacuation procedures.

b. Determine the number of ambulatory and non-ambulatory patients.
c. Describe transportation arrangement for logistical support to include moving records medications
and other necessities.
d. Identify facilities and include in the plan a copy of the mutual aid agreement that has been entered
into with a facility to receive residents/patients.
e. Identify evacuation routes that will be used and secondary routes should the primary route be
impassable.
f. Specify the amount of time it will take to successfully evacuate patients/residents to the receiving
facility.
g. Specify the procedures that ensure facility staff will accompany evacuating patients.
h. Identify procedures that will be used to keep track of residents once they have been including alog
system.
i. Determine what and how much each resident take should.
j. Establish procedures for ensuring all resident are accounted for and are out of the facility.
k. Determine at what point to begin the pre-positioning of necessary medical supplies and provisions.
l. Specify what point the mutual aid agreements for transportation and the notification of alternative
facilities will begin.

Mutual Aide Agreements mutual-aid agreement content will vary but items to consider addressing
include the following elements or provisions:

 Definitions of key terms used in the agreement;

 Roles and responsibilities of individual;
 Procedures for requesting and providing assistance;
 Notification procedures;
 Protocols for interoperable communications;
 Relationships with other agreements among jurisdictions;
 Workers compensation;
 Treatment of liability and immunity;
 Recognition of qualifications and certification; and
 Sharing agreement, as required.

B. Preparedness
Upon receipt of an internal or external or external warning of an emergency, the facility administrator
or appropriate designee(s), in coordination with the local fir department, should:

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

1. Notify staff in charge of emergency operations to initiate the disaster plan; advise personnel of
efforts designed to guarantee resident safely. (see TAB A for notification checklist and TAB B for
emergency call-down roster)
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 the emergency plan including evacuation routes with staff and residents.
5. Prepare the………….(designated area) for command post operations and alert staff of impending
operations.
6. Coordinate dissemination of messages.
7. Control facility access.
8. Confirm emergency staff availability and facilitate care.
9. Pre-arrange emergency transportation of non-ambulatory residents (dialysis residents, etc.) and their
record.
10. Coordinate with local authorities/agencies and private contacts to confirm availability of resources,
including medical services, response personnel, etc
11. Have a plan in place with (pharmacy name) and an alternate source to determine emergency
operations in the event of halted deliveries or need for backup.
12. Warn the staff and residents of the situation and expedient protective measures.
13. Remain calm, reassure residents to minimize fear and panic.
14. Schedule extended shifts for essential staff and alert alternate personnel to remain 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.

2. Activate the emergency action plan and conduct command post operations involving emergency
communications, message control and routing of essential information.
3. Coordinate actions and requests for assistance with local jurisdiction emergency service and the
community.
4. Determine requirement for additional resources and continue to update appropriate authorities and
/or services.
5. Ensure communication with residents ‘families and physicians.
6. Ensure prompt transfer of resident record.

D. Recovery

Immediately following the emergency situation, the facility administrator should take the provisions
necessary to complete the following action.

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

1. 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
2. Provide local authorities a master list of displaced, missing, injured or dead and notify the next-
of-kin.

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, private and volunteer organizations and various local and state
department and agencies.(see TAB department checklists)

Duties and actives that should be directed or assigned by the administrator:

Coordinate the activation oversee the implementation of the emergency plans.

Direct operation of the command post.
Assign a coordinator accountable for patient at home and their record; and needed supplies.
Assign responsibility for maintaining safety of the facility grounds-securing necessary equipment and
alternative power sources.
Review regularly the inventory of vehicles and report to administrative services.
Coordinate the inspection of essential equipment (wet/dry vacuums) and protection of facility (lower
blinds, close windows, secure loose equipment, etc.)
Provide security of facility/grounds and limit access to facility as necessary.
Coordinate provision of assistance to maintenance.
Facilitate telecommunication and releases of information.

V. authorities and references

A. Authorities
Ambulance: 999

Air ambulance: 999, the police will dispatch a helicopter to

Transport the injured, if the accident is deemed
Fire emergency: 997

General directorate of Abu Dhabi police: 999

Marine emergencies, accidents or suspicious

Activity (critical national infrastructure 996
Authority):

Water and electricity emergencies: 8002332

Emergencies concerning municipality of Abu
Dhabi city: 993
Weather condition and earthquakes

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Emergencies: +97126667776
Directory enquiry services

Etisalat: 181

Du 800 155(from any use phone)

155(direct from your du mobile)

B. References
1. United states department of homeland security: natural disasters website:
Htt://www.ready.gov/natural disasters.html
2. Are you ready? An In-depth guide to citizen preparedness, United States department of
homeland security: http//www.fema.gov/pdf/areyouready/areyouready_full.pdf
3. http:// www.abudhabi.ae / egovPoolPortal _ war/ appmanager /ADeGP/citizen?_nfpb =true& _
page la bel = p6600&lang=en

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

NOTIFICATION PROCEDURES
TAB A
I. Warning systems

External receipt of warning

Local government authorities should issue warning of a disaster by mass media (radio and television)

Internal

An internal warning of an emergency should come from the facility’s administrative services and
should be disseminated to staff, patient and visitors by……………………………………..
(Intercom, alarm system)

In the event of a power failure, the alternate alert/warring system shall be

…………………………………………………………………….

II. Communications procedures

All calls shall be routed though the command post.

Completed Initial

……….. ……….. 1 . Alert staff, patient and visitors of emergency.

………. ………... 2. Call off-duty staff from emergency call-down roster
………. …………. 3. Notify appropriate authorities. These authorities include:
……. a. Local fire department
#......................
.……. b. local emergency mgmt agency
#....................
ATTACH LIST OF PHYSICIAN AND FAMILY NAMES AND NUMBERS.

………… ………. 4. Keep authorities updated on emergency operations.

.......... …………
Signature Date

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

TAB B
EMERGENCY CALL-DOWN ROSTER
EMERGENCY SERVICES

Fire: # 997

Police: # 999

Ambulance: # 999

Water & Electricity:#800 2332

FACILITY
ADMINISTRATOR
NO

Administration
Service director
NO.

Nurse/medical
Service director
NO

Maintenance
service
Director
NO

Security service
Director
NO

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Emergency checklists
Evacuation procedures
Tab c

Note: it is recommended that two types of evacuation procedures be developed. 5these include internal
evacuation procedures and external evacuation procedures.
Completed initials
------------ ---------1-Identify and designate plainly marked exits, evacuation routes, and alternatives on
master floor plan for both internal and external evacuation

 Plan safe routes – avoid wooden stairs, open stairwells ,boiler rooms ,windows, etc .
 Assign handicapped or non-ambulatory resident to ground floor rooms , close to exits.
 Designate facility compartments for internal evacuation and for planning the safest
external evacuation routes

--------- ----------2- inform staff and residents on exit locations and evacuation procedures
---------- ---------3-keep residents calm
---------- ----------4-evacuate residents in orderly fashion, according to physical condition. Ambulatory
wheelchair bedfast
---------- ----------5-search bathrooms, laundry room, storage closets and vacant rooms for stranded
residents, visitors or staff and assist in their evacuation .
--------- ----------6-clear corridors of any obstructions such as carts, wheelchairs , etc.
--------- ----------7-turn off electrical appliances
--------- ----------8- recount residents to assure no missing residents
--------- ----------9- remove residents records

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Emergency checklists
Specific disasters/incidents fire safety
Tab D
If prepared ,insert completed fire plan in this tab
Completed initials :

-------- ---------1-post location of fire alarms

-------- ---------2-post location of fire extinguishers
-------- ----------3-train employees on use of alarm system and extinguishers
--------- ---------4-post direction on how to utilize emergency equipment.
-------- ---------5-follow race procedures
-----------------R:Rescue-Rescue residents in immediate danger
-----------------A:Alarm-sound nearest alarm if not already activated
-----------------C:Confine –close doors behind you to confine fire . crawl low if exit route is blocked by
smoke
-----------------E:Extinguish –utilize fire extinguisher as situation permits or ; Evacuate-follow evacuation
procedures

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Emergency checklist
Natural disasters
Complete initials
1-Severe electrical storms

-------------------a- relocate to inner areas of building as possible

-------------------b-keep away from glass windows , doors ,skylights and appliances
-------------------c-refrain from using phones ,talking showers
------------------d-stay away from computers

2-winter/sand storm
-------------------a-secure facility against frozen pipes
-------------------b-check emergency and alternate utility sources
-------------------c-check emergency generator : does it start ? is there fuel?
-------------------d-conserve utilities- maintain low temperatures , consistent with health needs
-------------------e-equip vehicles with chains and snow tires
--------------------f-keep sidewalks clear
3-flooding(external source).
----------------------a- shut off water main to prevent contamination
-----------------------b-pack refrigerators/food lockers with dry ice
-----------------------c-prepare to evacuate.
4-flooding (internal source)
--------------------------a-turn off building electricity
--------------------------b-move residents as required

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Emergency checklist
Water/electrical outage
Completed initials
Preparedness:
--------------------1- ensure a four day supply of food and water for residents and staff and 48 hours supply of
emergency fuel
--------------------2-arrange for a private contact to serve as an added back-up resource
--------------------3-work with the local emergency management agency in establishing a back – up resource
-------------------4- keep an accurate blueprint of all utility lines and pipes associated with the facility and
grounds
-------------------5- develop procedures for emergency utility shutdown
-------------------6-list all day and evening phone numbers of emergency reporting and repair services utility
companies
-------------------7-list names and numbers of maintenance personal for day and evening notification
Response- electric power failure
------------------1- call # 800 2332 (power company)
------------------2- notify the maintenance staff
------------------3-evacuate the building if danger of fire
------------------4- keep refrigerated food and medicine storage units closed to retard spoilage
------------------5- turn off power at main control point if short is suspected
------------------6-follow repair procedure
Response – water main break
------------------1- call # --------------------- ( facility maintenance)
-----------------2- shut off valve at primary control point.
------------------3-relocate articles which may be damage by water
------------------4-call --------------- (pre- designated assistance groups) if flooding occurs
Response- gas line break
------------------1-evacuate the building immediately . follow evacuation procedures .
------------------2- notify maintenance staff ,Administrator, local public utility department , gas company and
police and fire departments. List all numbers here
-------------------3- shut off the main valve
--------------------4-open windows
---------------------5- re-enter building only at the discretion of utility officials

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Tab E
Emergency checklists
Department responsibilities
Administrative services
Completed initials

---------- ----------1-Alert staff of emergency

--------- -----------2-Determine extent /type of emergency
---------- ----------3-Activate emergency plans
---------- ----------4-Activate emergency staffing
----------- ---------5-provide transportation of emergency personnel , as needed
------------ --------6- notify local jurisdiction support
----------- -----------7-contact pharmacy to determine :
------------a: cancellation of delivers?
-------------b:availability of backup pharmacy?
-------------c: availability of 3-days of medical supplies?
-------- ---------8-authorize operation of crisis command post
-----------------a:provide checklist to staff
------------------b:ensure communications equipment is operational
-------- ----------9-monitor the emergency communication station
-------- - ---------10-receive briefings from department heads on pending operations
-------- ----------11-closely monitor weather reports for significant weather changes or warnings
-------- ----------12- arrange for emergency transportation of ambulatory patients

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Emergency checklist
Maintenance service
Completed initials

-------------- -------- 1-review staffing /extend shifts

-------------- --------2-check safety of surroundings ground ( secure loose outdoor equipment and
furniture)
----------- --------3-secuer doors
----------- --------4-check /fuel emergency generator and switch to alternative power as necessary .
--------------a-alert department heads of equipments supported by emergency generator
---------------b-if pump or switch on emergency generator is controlled electrically , install
manual pump or switch
--------- ---------5- check hazardous materials
---------- ---------6-conduct inventory of vehicles, tools and equipment and report to administrative
service
--------- ---------7-fuel vehicles
-------- ----------8-identify shut off valves and switches for gas , oil , water and electricity and post chart
s to inform personnel
-------- ----------9-identify hazardous and protective areas of facility and post locations.
-------- ----------10-close down / secure facility in event of evacuation

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Emergency checklist
Nursing / medical services

Completed initials

------------- -------- 1- ensure residents medical needs

------------- ---------2-assess special medical situation
------------- --------3-coordinate oxygen use
------------ ---------4-relocate endangered residents
----------- ---------5-ensure availability of medical supplies
----------- ---------6-ensure safety of patients or resident records
---------- ---------7-maintain resident accountability and control
---------- -------8-supervise residents and their release to ralatives , when approved
----------- -------9-ensure proper control of arriving residents and their records
---------- ---------10-screen ambulatory residents to identify those eligible fo0r release
--------- ----------11- maintain master list of all residents, including their dispositions . forward this
list to the local authorities

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Policy and Procedure Title:

EMERGENCY ACTION PLAN

Code: Effective Date: Ownership:
AlAin Initial Services Center

Emergency checklist
Security services
Completed initials
-------- --------1-assess building security
-------- ---------2-secure building as needed
-------- ---------3-control entry and exit
--------- ---------4-provide protection for residents and staff
TAB F
INVENTORY CHECKLIST
Vehicle resources available
location and # of car

points of
contact--------------------------------------------------------------------------------------------------------------------
TAB G
EMERGENCY POINTS OF CONTACT DIRECTORY
LOCAL FIRE DEPARTMENT

NAME :--------------------------------------
ADDRESS :-------------------------------------
PHONE EMER# :-------------------------------------
BUS# :-------------------------------------
LOCAL POLICE DEPARTMENT
NAME :-------------------------------------
ADDRESS :-------------------------------------
PHONE EMER# :--------------------------------------
BUS# :----------------------------------------
LOCAL EMERGENCY MEDICAL SERVICES
NAME :----------------------------------------
ADDRESS :-----------------------------------------
PHONE EMER# :------------------------------------------
BUS# :-------------------------------------------
LOCAL EMERGENCY MANAGEMENT AGENCY
NAME :-----------------------------------------
ADDRESS :------------------------------------------
PHONE EMER# :------------------------------------------
BUS# :-------------------------------------------
COUNTRY HEALTH DEPARTMENT
NAME :-------------------------------------------
ADDRESS :------------------------------------------
PHONE EMER# :--------------------------------------------
BUS# :--------------------------------------------

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