YCS ENVIRONMENT OF CARE RECORD REQUIREMENTS
Directions for Documentation Requirements:
When the form is completed:Abbreviations: O = Other; M = Monthly;BA= Bi- Annually (every 6 months); AN = Annually
NAME OF DOCUMENT / O / M / BA / AN / DIRECTIONS FOR USE:Table of Contents / Informational
Annual Monitor Form / X / X / This form is completed monthly (the form lists all 12 months and should be sent to the Research Department when completed for the year). New monitors are chosen by the Corporate Environment of Care each year. This should be filed in the EOC Binder.
Hazard Vulnerability Analysis (HVA) Form / X / On this checklist, each program must rate the likelihood of particular emergencies happening in their area. If an emergency is determined likely, a plan of action needs to address the emergency’s particulars. This should be filed in the Fire/ Disaster Drill Log Book.
Disaster Plan Template Attachment A / X / This form is completed once, but updated for current and accurate information on an as needed basis. This should be filed in the Fire/ Disaster Drill Log Book.
Disaster Questions to Think About form / X / This form is to be completed when completing the “tabletop” disaster drill. This should be filed in the Fire/ Disaster Drill Log Book.
Disaster Drill Evaluation Form / X / This form is to be completed for every disaster drill. This should be filed in the Fire/ Disaster Drill Log Book.
Fire Drill Form / X / This form is to be completed monthly. Each time a fire drill occurs file it in the Fire/ Disaster Drill Log Book.
EOC Monthly Inspection Report / X / This 8-page checklist of items is divided into sections (i.e. offices, basement). This checklist is to be completed monthly by the Site Administrator/ Safety Rep./or designee. This form is then emailed to the Research Department. This form should be filed in the EOC Binder.
Monthly Site Meetings / X / Site Meetings are to occur monthly. Safety issues and other EOC concerns should be discussed. Information should be documented on the site staff meeting minutes.
Annual Egress Form / X / This form is to be completed annually. This form should be filed in the Fire/ Disaster Drill Log Book.
Exit Report Priority Follow- up Form / X / This form is to be completed one week after the EOC exit report is sent to the program. This form shall be emailed to the EOC Coordinator, Research Department.
Interim Life Safety Measures (ILSMs) paperwork / X / These documents are to be completed on an as needed basis. Refer to the Policy and Procedure for ILSMs. These forms, when completed should be filed in the Fire/ Disaster Drill Log Book.
Annual EOC Inspection Report / X / This 4-page checklist of items is divided into sections (i.e. general areas, offices, etc.) This form is to be completed annually by the YCS programs considered as “business occupancies” only. This form should be filed in the EOC Binder.
Attachment A: EOC Record Requirements: Revised 1/081