Workspace
Alternate/Temporary Location
Determine if it is possible to set up an alternate or temporary location if your primary site is
unavailable. Would this site become your new primary site? Do you serve the community from
multiple locations? Does your nonprofit have options for relocation in the same area? How
much work can be done virtually? Would a work-from-home strategy work for your
organization? What pre-agreements would you need for these options?
These templates have been compiled from industry best practices. Please modify to fit your
needs.
ALTERNATE LOCATION
SECOND ALTERNATE LOCATION
STREET ADDRESS
STREET ADDRESS
CITY, STATE, ZIP CODE
CITY, STATE, ZIP CODE
TELEPHONE NUMBER
TELEPHONE NUMBER
IS THERE A PRE-AGREEMENT IN PLACE?
IS THERE A PRE-AGREEMENT IN PLACE?
POINT OF CONTACT
POINT OF CONTACT
CONTACT NAME
CONTACT NAME
TELEPHONE NUMBER
ALTERNATE NUMBER
TELEPHONE NUMBER
ALTERNATE NUMBER
E-MAIL ADDRESS
E-MAIL ADDRESS
SITE ASSESSMENT
SITE ASSESSMENT
NUMBER AND TYPE OF STAFF TO WORK HERE
NUMBER AND TYPE OF STAFF TO WORK HERE
SUPPLIES ALREADY IN PLACE
SUPPLIES ALREADY IN PLACE
SUPPLIES THAT WOULD BE NEEDED
SUPPLIES THAT WOULD BE NEEDED
TIME TO SET UP OPERATIONS
TIME TO SET UP OPERATIONS
LENGTH OF TIME YOU CAN STAY AT THIS SITE
LENGTH OF TIME YOU CAN STAY AT THIS SITE
POSSIBLE HAZARDS IN THE AREA
POSSIBLE HAZARDS IN THE AREA
NOTES:
NOTES:
Insurance Coverage Discussion Form
Use this form to discuss your insurance coverage with your agent. Having adequate coverage
now will help you recover more rapidly from a catastrophe.
INSURANCE AGENT:
STREET ADDRESS
CONTACT NAME
CITY, STATE, ZIP CODE
CONTACT TELEPHONE NUMBER
TELEPHONE NUMBER
FAX NUMBER
CONTACT EMERGENCY TELEPHONE
EMERGENCY
TELEPHONE
WEBSITE
CONTACT EMAIL
INSURANCE POLICY INFORMATION
TYPE OF
INSURANCE
POLICY NUMBER
DEDUCTIBLES
POLICY LIMITS
COVERAGE
(GENERAL
DESCRIPTION)
DISASTER RELATED INSURANCE QUESTIONS
Do you need Flood Insurance? □ Yes □ No
What perils or causes of loss does my policy
cover?
Do you need Earthquake Insurance? □ Yes □
No
How will my property be valued?
Do you need Business Income and Extra
Expense Insurance? □ Yes □ No
Does my policy cover the cost of required
upgrades to code? □ Yes □ No
How much insurance am I required to carry to
avoid becoming a co-insurer?
What does my policy require me to do in the
event of a loss?
What types of records and documentation will
my insurance company want to see?
Am I covered for lost income in the event of
service interruption because of a loss? Do I
have enough coverage? For how long is
coverage provided? How long is my coverage
for lost income if my facility is closed by order
of a civil authority?
How will my emergency management
program affect my rates?
To what extent am I covered for loss due to
interruption of power? Is coverage provided
for both on- and off-premises power
interruption?
To what extent am I covered for reduced
income due to clients/constituents not all
immediately coming back once the facility
reopens?
Do I have vital document coverage?
NOTES
Agency Emergency Plan
Note the location of your agency emergency plan and other response plans (including fire drill)
that your organization has already developed.

Where is the plan(s) located? ______________________________________________

How frequently are they updated? _________________________________________

Have your staff and clients been trained on the plans? ___________________________
FACILITY PREPARATION
INDICATE THE LOCATION OF THE FOLLOWING ITEMS:
Wrenches and other tools
Clearly mark your gas and water shut-off valves. Post legible step-by-step
directions (in multiple languages if necessary)
Keep a conveniently located set of tools to facilitate prompt gas shut off. Tools
should include pipe and crescent wrenches
Fire extinguisher
Emergency first aid supplies
Portable radio (AM/FM or Weather radio) and extra batteries
Flashlight and extra batteries
Garbage bags and duct tape
In the case where you would need to shelter-in-place, you will need food and
water.
What else will be needed depending on your clients?
Item:
Location:
PREPARING STAFF FOR EMERGENCIES
In an emergency, the first concern of staff will be the safety and welfare of their family members.
Check if completed.
Have all staff and key volunteers trained in basic emergency preparedness for the
organization. Your agency will want to ensure that all staff members have an
opportunity to check on their homes and family members as soon as possible
following a disaster.
Encourage staff and key volunteers to have a family or home emergency plan.
This increases the likelihood that staff and their families can cope with the
disaster without outside help.
MEETING THE NEEDS OF THE PEOPLE YOU SERVE
How many clients would likely be at your site in a disaster (day, evening,
weekend?)
How would you find out about the condition of people you serve off-site?
In an emergency, who else needs information about the status of people that you
serve? (off-site staff, families of clients, etc.)
List critical contacts:
BUILDING EVACUATION (FIRE, etc.)
Alarm sounded, 9-1-1 notified
Are there program participants who will need assistance evacuating your facility?
Remember to assign staff and volunteers to help these participants and have
assistive aids/devises available to help with their evacuation.
If your facility must be evacuated, assign a staff person the responsibility of
taking a head count to ensure all staff, volunteers and program participants have
exited.
Name:
Create an "agency go-kit". Include copies of your emergency plan, action
checklists, phone rosters, copies of vital documents, credit cards, etc.
Practice your evacuation plan.
The following suggestions anticipate that you must evacuate your building and that you are
responsible for the care and shelter of the people you serve.
Locate and secure a temporary shelter to be used (consider churches, nearby
community centers, schools, other residential facilities). You may want to
develop mutual aid agreements with these sites.
Temporary shelter name:
Address:
Contact name:
Phone:
Create a phone list and a system for letting the authorities, family and friends
know where you are sheltering your program participants.
Designate and identify alternative transportation for moving your program
participants to your temporary shelter, or to clients’ homes, if necessary.
Alternative transportation:
Contact name:
Phone:
Assign responsibility for the care of your clients at the alternate site(s). Identify
this person or persons.
If evacuated, what will your clients need that may not be available in the
temporary shelter?
CONSIDERATIONS FOR PROTECTIVE ACTION (SHELTER-IN-PLACE)
Evacuation may not be the best decision. Sudden occurrences (explosions, tornadoes, violent storms/weather
conditions, hazardous materials events, etc.) may make sheltering-in-place the best choice.
Information gathered from County/Local EMA & Emergency Services about the
emergency.
Considerations:
Is there time to evacuate?
Is it safe outside?
Is there time to send the staff and clients home?
Are the staff and clients’ homes in a danger area?
Can the staff and clients be safe inside the building?
How long will this event last?
Ensure that designated shelter areas are ready to receive and shelter staff and
clients.
Take attendance to establish accountability for all staff and clients.
Remain in place and await further instructions from designated staff person.
Depending on the type of hazard:
Close windows, blinds, drapes & doors to impede debris from becoming missiles.
Close air intakes for HVAC.
Reduce all other sources of external air.
Other parties notified.
Provide meals to sheltered staff and clients if the duration of the emergency
warrants.
"All-Safe" signal sounded. Who has the authority to give?
(What will the signal be? ______________________________________)
Other parties notified that the situation is back to normal.
BUILDING INTRUDER/SUSPICIOUS ACTIVITY
Time is essential here. Everyone must immediately take action. Any staff member who is aware of a
potentially dangerous intruder should sound the alarm.
9-1-1 notified.
Intruder Alarm given to all concerned parties (via loudspeaker or other method.)
All interior and exterior doors locked and windows closed.
Staff and clients moved to shelter in the facility.
List the room where they will be sheltered:
Other parties notified.
Building searched by police to find intruder.
Other parties notified that the situation is back to normal.