Emergency Plan
Same month every year (annually)
Complete the Agreement with another Agency. (Fax to us the information to complete/submit the Plan)
Same month every year (annually)
Complete the Agreement with another Agency. (Fax to us the information to complete/submit the Plan)
Renew License Form: 60 days before to expiration date. CLIA application form
Every semester we offer 1 or 2 in-office training to your employees.
The following templates, must be used as Agenda for your meeting, the Administrator and DON must assure that the meeting was done with acceptable quorum, and active participation of each member of the committee.
Regular annual minute (May each year, plus Staff
Emergency annual In-service):
Members: Administrator, DON, Alt. Administrator, Alt. DON
Annual Meeting: Safety Meeting Minutes
Activation of Emergency Plan minute: Activation EP minute
All tasks must be completed (CoPs):
Table Top Exercise (Annual): Table Top Exercise
Disaster Drill (before Hurricane Season or other area hazard season each year)
Disaster/Fire Drill A full-scale community-based exercise with the county DOH, must be coordinated and noted (if community base is not available in your area of services, must complete a facility base drill (twice a year).
Community Base exercise documentation: Community Base Disaster Drill report Must be complete if community base
exercise was completed, involved the community, other healthcare facility, etc.
Miami Dade Community Response web Miami Dade Healthcare Preparedness Coalition
Business Continuation Plan (before Hurricane Season each year)
Business Communication Plan
Exercise Evaluation (Disaster/Fire Drill Evaluation) (Bi-Annual)
Exercise Evaluation After Disaster Evaluation: Emergency Plan Evaluation
(Complete only after any community disaster threat)
Office Safety Inspection Report (Annual)
Office Safety Inspection Report
Administrator/DON: Emergency Control Log (Monthly) (by category, can be Software generated)
Hazard Vulnerability Analyzes
Emergency In-Service Emergency In-Service OSHA Hazard Communication SDS Log (OSHA)
Safety Tracking LOG (All year long)
Safety Tracking Plan Specialty Shelter Refuse Registration: Shelter Refuse Registration
Staff Safety Incident Report (to report if needed)
Disclaimer: Every template is only your guide/AGENDA to type the Minutes of your meeting, your Agency Officials must assure that the meeting occur, the quorum is acceptable, and every member had active participation in the discussion
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