Appendix Sample Facility Planning and Policy Documents for Emergency Preparedness

DISASTER PLAN CHECKLIST FOR DIETARY DEPARTMENT IN LONG-TERM CARE FACILITY

Every disaster can have different repercussions in a long-term care facility. Planning can help limit problems that might occur in the dietary department. The following list will help you develop and maintain a disaster plan. To ensure the plan is up to date, review it at least monthly and immediately prior to a potential expected threat, such as severe weather conditions.

Administrative Information ●

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Maintain a list of current dietary staff and their contact information (home and cell phone numbers). Have administrator’s contact information on file (home and cell phone numbers). ● Have dietary manager’s contact information on file (home and cell phone numbers). Include the on-call calendar for facility, with phone or beeper numbers for on-call staff. ● Maintain names and phone numbers for all food and supply vendors. Make sure that all staff know how to locate and implement the disaster plan. Other

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Plan to Ensure Uninterrupted Operation of Food-Service to Residents ●

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Maintain a written contract for a source of water in case of loss of water supply (need a minimum of ½ gallon/ resident/day for drinking), or maintain a 3-day supply of bottled water in-house.

Have a written contract with another facility to store perishable foods in the event of a sudden loss of freezer or cooler space, if possible.

● Keep a recent hard copy of your tray cards, or maintain a recent list of patients and their diets.

● Maintain backups for your other computer files (flash drive, CD, DVD, external hard drive, or system network). Store flashlights with working batteries in your kitchen and/or dietary offices, and know where they are located. ● Know your backup power source and how to implement the backup power plan.

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Understand which pieces of kitchen equipment you can operate when running under emergency power, without exceeding available power.

● Other

Supplies Needed to Ensure Uninterrupted Food-Service Operation to Residents ●

Maintain an emergency menu. ● ● ●

Ensure that a 3-day supply of nonperishable foods is available in-house. Keep a 3-day supply of paper/plastic/foam dishes and utensils in-house. Other

Signed: Date updated:

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