Marin Business Emergency Readiness (MʹBER) Emergency Plan

Business: ______Version: v0.1 Effective Date: __/__/____

Helplinks connect to online Help Screens providing more details and reference materials. You can also go directly to the Help page.

A. INTRODUCTION & COMMITMENT

A1. Business Covered help
Name of Business:
Location(s):
A2. Normal Mission Statement (Goods and services you provide your customers) help
A3. Essential Functions for Disaster Survival & Recovery
(Business functions that must continue at all times)help
A4. Potential Effects of a Major Disaster (How might your mission change after a disaster?) help
A5. Emergency Planning Responsibilitieshelp
Emergency Coordinators / Name / Phone(s) / Alternate Phone / Email
Primary
Alternate
Senior Executive
A6. MBER Reference Sheet Posted help
Location(s):
A7. Current Emergency Plan Most Recently Distributed help
Distributed to:
Date: / Version:
A8. Emergency Plan Submitted for Verification help
Responsible Jurisdiction:
Date: / Version:
Status:

B. HAZARD ASSESSMENT AND MITIGATION

B1. Hazard Vulnerability Assessment (HVA) What Hazards are you at risk for in your location? help
Event / Probability
(0-3) / Likely Impact
(1-4) / Risk/Exposure to Loss (Multiply prior 2 columns)
Fire
Earthquake
Flood
Landslide
Thunderstorm/Lightning
Tsunami
Wind storm
Pandemic
Hazardous Material Incident
Terrorism
Plane Crash
Utilities-Power Outage
Utilities-Water
Utilities-Gas
Telecommunication Failure
HVAC Failure
Network System Failure
Virus/Hacker
Labor Strike
Theft/Vandalism
Workplace Violence
Other:
B2. Insurance agents consulted help
Type of Insurance / Agency / Agent Name / Contact/Phone / Most recent Contact (MM/DD/YYYY)
B3. Recommended Hazard Mitigation Steps to Reduce Risks(steps to take to minimize the effects of a disaster) help
Facility Preparation / Responsible Staff Member / Date Last Done/Checked
  1. Emergency supplies & equipment checked & labeled

  1. Emergency roles assigned to staff

  1. Fire protection equipment, if present, visible & operational (excluding optional smoke & carbon monoxide detectors).

  1. Label & clear path of fire exits. Indicate evacuation collection site in emergency plan.

  1. Mark gas, electricity, water shut-offs. Post simple instructions in appropriate languages. Keep shut-off tools at shut-off valves.

  1. Remove fire & chemical hazards.

  1. Maintain routine Fire Marshal inspections.

  1. Physical structure has been checked for safety.

  1. Knox Box accessible with current contact information.help

  1. Other:

C. PREPAREDNESS

C1. Equipment & Supplies
Items / Locations / Responsible Employee(s) / Last Inspection Date
a.Copy of Emergency Plan
b. Copy of floor plan with exit routes posted.
c. Fire Extinguishers
d. First Aid Supplies help
e. Battery Operated AM/FM radiowith extra batteries
f. Landline Phone (not dependent on electricity for power)
g. Shelter-in-Place Supplieshelp
h. Grab & Go Bag for evacuation help
i. Automated External Defibrillator (AED) optional
j. Blood Borne Pathogens Kits optional
k. Flood gates visible & operational help optional
C2. Staff Training help
Procedures / Employees Trained / Date Provided
a. Disaster Roles Assigned
b. Evacuation Procedures
c. Shelter-in-Place Procedures
d.Medical Emergency Procedures
e. First Aid Training
f. CPR/AED Training
g.Current list of first aid/CPR trained staff posted
C3.Staff Drills and Exercises help
Activity / Most recent MM/DD/YYYY / After-Action Report Prepared
a. “Table-top” Exercise
b. Evacuation Drill
c. Shelter-in-place Drill
d. Medical Emergency Drill
e. Others:
C4. Employee Preparedness: help
Subject Matter / Date of annual check
  1. Emergency contact information is kept current.

  1. Staff knows alternative routes between home & work.

  1. Staff members each maintain family emergency /communication plans,
including familiarity with their own community’s emergency plan (schools, care facilities if appropriate)
  1. Individual emergency preparedness trainingis offered annually
(Get Ready, CERT:
  1. Staff members each maintain emergency preparedness kits (personal Grab & Go Bags) in car/work space.

  1. Other:

D. EMERGENCY RESPONSEhelp

D1. Emergency Response Leadership Structure help
Name/Position / Emergency Role / Reports to
D2. Communication Procedures help
Groups to contact
(e.g., employees, owners, landlords, customers, vendors) / Responsibility / Communication Method
D3. Emergency Contact Information (office, home, cell) help
Stored on-site at: / Stored off-site at:
Group / Name / Email addresses (o/h) / Phone numbers (o/h/c)

Add one row per person

D4.Evacuation Planhelp
Assembly Site(s):
Alternate Site(s):
Assembly Manager: / Alternate Manager:
Responsibilities:
Flood Wardens:
Responsibilities:
Person Responsible for Giving the “All Clear”:
Evacuation Grab & Go Bag Contents: help
Bag Storage Location:
D5. Shelter-In-Place Planhelp
Shelter Location:
Alternate Location:
Shelter Manager: / Alternate Manager:
Responsibilities:
Person Responsible for Giving the “All Clear”:
D6. Internal Medical Emergency Procedurehelp
Procedure:
Posted Locations:
D7. Procedures for other Area-Specific Hazardshelp
Hazard/ Procedure:
Hazard/ Procedure:
D8. Special Assistance Needshelp
Individual / Disability/Medical Condition / Assistance Needed

E. BUSINESS CONTINUITY / RECOVERY PLAN
(How to keep your doors open after a disaster) help

E1.Back-up Arrangements/Procedures in Place with Vendors/Suppliers/Other Organizations help
Materials/services provided:
Company: / Contact: / Acct #:
Address:
Phone: / Email: / Fax:
Nature of Agreement:
Materials/services provided:
Company: / Contact: / Acct #:
Address:
Phone: / Email: / Fax:
Nature of Agreement:
Materials/services provided:
Company: / Contact: / Acct #:
Address:
Phone: / Email: / Fax:
Nature of Agreement:
Materials/services provided:
Company: / Contact: / Acct #:
Address:
Phone: / Email: / Fax:
Nature of Agreement:

(Copy and paste the table above for each additional existing agreement)

E2. Financial and Administrative Procedureshelp(Briefly describe your accounting, payroll and any other mission-essential procedures/systems.)
Accounting:
Payroll:
Others:
How do you protect yourcomputer hardware/software from cyber threats:
E3. Back-up Location and Systemshelp
Person Responsible for Back-up Plans:
Back-up Location: / Address:
Contact Person: / Phone: / Email:
Back-up Accounting System:
Back-up Payroll System:
Back-up Other Mission-Essential Systems:
E4. Back-up Copies of Financial Records help
Financial Support Documentation / On-site / Off-site
Insurance Policies
Deed or Lease on Facilities
Bank Information
Tax Records (including Tax EIN)
Cash Position and Credit Agreements
Others:
Stored on-site at:
Stored off-site at:

F. HELPING OTHERS

F1. Helping Othershelp
Volunteer Activity / Recent Contributions
Lead educational campaign on emergency preparedness
Contribute supplies/services to emergency response efforts in your community
Adopt a school preparedness program
Redirect advertising to emergency messaging
Other:

AUG 2016MBER Emergency Plan Template v3.01