Appendix Sample Facility Planning and Policy Documents for Emergency Preparedness DIETARY EMERGENCY SUPPLY WORKSHEET

Insert residents/staff/family, number of days, and number of servings or ounces per can to determine number of cans needed.

Facility Has

Fruits/Vegetables Residents + staff + families × # of days × 4 servings = number of servings needed Divide by number of servings in can = # of cans needed

Starches

Residents + staff + families × # of days × 4 servings = number of servings needed Divide by number of servings in can = # of cans needed

Protein

Residents + staff + families × # of days × 4 servings = number of servings needed Divide by number of servings in can = # of cans needed

Milk

Residents + staff + families × # of days × 16 ozs = number of servings needed Divide by number of servings in cans/bags = # of cans/bags needed

Water

1 gallon of water/resident is to be provided. 1 gallon × Facility has

Individual Serving Containers

Quantity for 50-Bed Facility (95 Residents/Staff/Family)

Item 9" paper plates

Paper cereal/soup bowls Small paper dessert bowls Styrofoam coffee cups Plastic forks Plastic spoons Plastic knives Paper napkins

3-Day

1,000 350 750

2,000 1,000 1,000 1,000 1,000

7-Day

2,000 750

1,500 4,000 2,000 2,000 2,000 2,000

Adjusted Quantity for Your Facility

3-Day 7-Day Quantity on Hand residents/staff/families × gallons of water on hand. days = Number of gallons needed

Cans or Bags

Cans Cans Cans

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