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Being prepared protects your residents, your staff, and your peace of mind. This set of editable worksheets helps you gather, organize, practice, and maintain the information behind your facility's emergency and disaster plan, from contact rosters and staff roles to drills and supply checks. It's designed to work alongside the current official CDSS Emergency and Disaster Plan form for RCFEs (LIC 610E). Official CDSS forms are free from CDSS at cdss.ca.gov; this product gives you guidance, templates, and organization to help you complete them.
What's included:
Emergency Planning at a Glance (how each template supports the official plan)
Emergency Contact Roster and Staff Emergency Roles & Assignments
Evacuation Plan Worksheet; Shelter-in-Place & 72-Hour Readiness Worksheet
Utility Shut-Off Locations with floor-plan sketch area
Resident Emergency Information Sheet (confidential)
Emergency Supply Inventory and Evacuation Go-Kit checklists
Annual Drill Planner, Emergency Drill Log, and After-Action Review
Emergency Plan Training Record, Annual Plan Review Record, and Emergency Notification Log
File formats: PDF + editable Word (DOCX). Delivered as one ZIP download.
Educational templates for personal use at your own facility. Please review and adapt them to your facility and current regulations. Not legal advice. Using these templates does not guarantee license approval. Personal license: no resale or redistribution.
Being prepared protects your residents, your staff, and your peace of mind. This set of editable worksheets helps you gather, organize, practice, and maintain the information behind your facility's emergency and disaster plan, from contact rosters and staff roles to drills and supply checks. It's designed to work alongside the current official CDSS Emergency and Disaster Plan form for RCFEs (LIC 610E). Official CDSS forms are free from CDSS at cdss.ca.gov; this product gives you guidance, templates, and organization to help you complete them.
What's included:
Emergency Planning at a Glance (how each template supports the official plan)
Emergency Contact Roster and Staff Emergency Roles & Assignments
Evacuation Plan Worksheet; Shelter-in-Place & 72-Hour Readiness Worksheet
Utility Shut-Off Locations with floor-plan sketch area
Resident Emergency Information Sheet (confidential)
Emergency Supply Inventory and Evacuation Go-Kit checklists
Annual Drill Planner, Emergency Drill Log, and After-Action Review
Emergency Plan Training Record, Annual Plan Review Record, and Emergency Notification Log
File formats: PDF + editable Word (DOCX). Delivered as one ZIP download.
Educational templates for personal use at your own facility. Please review and adapt them to your facility and current regulations. Not legal advice. Using these templates does not guarantee license approval. Personal license: no resale or redistribution.