FACILITY NAME
STREET ADDRESS
CITY, CA ZIP
MEDICAL
POINT OF DISPENSING (POD)
INCIDENT ACTION PLAN
REVISED:
FACILITY INFORMATION CURRENT AS OF:
Due to the dynamic nature of a public health event, this Incident Action Plan is subject to change on short notice. Contact the City
Emergency Management Department for updated incident-specific plans.
v.6.30.11
BASIC PLANNING ASSUMPTIONS: MEDICAL POD ACTIVATION
IMPORTANT: This incident action plan includes strategies, tactics, and procedures for
non-emergency and emergency medical PODs.
ASSUMPTIONS AND DEFINITIONS FOR MEDICAL PODS:
1. To qualify as an NON-EMERGENCY public health event requiring POD activation, the circumstances must
meet one of the following two requirements:
 The Los Angeles County Department of Public Health notifies the City of Los Angeles Emergency
Management Department of the need to activate at least one (1) POD with a minimum of fourteen
(14) days notice.
-OR
The public health event does not present an imminent life threat.
2. To qualify as an EMERGENCY public health event requiring POD activation, the circumstances must meet
one of the following two requirements:
 The Los Angeles County Department of Public Health notifies the City of Los Angeles Emergency
Management Department of the need to activate at least one (1) POD with less than 48 hours
notice.
-OR
The public health event presents an imminent life threat.
3. Only the Los Angeles County Public Health Officer has the authority to declare a public health emergency.
4. The City of Los Angeles supports Los Angeles County Department of Public Health in implementing and
managing PODs by providing non-clinical resources including, but not limited to:
 facilities (when available) along with corresponding Incident Action Plans
 security and traffic control officers (as necessary)
 non-clinical staff
 barricades, tables, chairs, and other non-public health specific supplies
v.6.30.2011
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE DOCUMENT
ICS FORMS & ATTACHMENTS CHART
This plan includes strategies, tactics, and procedures for non-emergency and emergency
medical PODs. The chart below indicates the ICS forms and attachments applicable to all
medical PODs, and those that are specific to emergency or non-emergency PODs.
Unified Command should keep only those forms and attachments that are applicable to the
public health event and remove all others.
ICS FORMS
202 Event Objectives
203 Organization Assignment List
204 Assignment List: Form Distribution Group
204 Assignment List: Registration/Screening Group
204 Assignment List: Dispensing Group
204 Assignment List: Evaluation Group
204 Assignment List: Question & Answer Group
204 Assignment List: Flow Control Group
204a Assignment List Attachment: Diagram
204 Assignment List: Law Branch – Exterior Security Group
204a Assignment List Attachment: Diagram
204 Assignment List: Law Branch – Interior Security Group
204a Assignment List Attachment: Diagram
204 Assignment List: Law Branch – Security Group
v.6.30.2011
FOR USE AT ALL
MEDICAL PODS
FOR USE AT
EMERGENCY
MEDICAL PODS
FOR USE AT
NONEMERGENCY
MEDICAL PODS
X
X
X
X
X
X
X
X
X
X
X
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE
204 Assignment List: Law Branch – Traffic Control Group
205 Communications Plan (Radio)
205T Communication Plan (Telephone)
206 Medical Plan
213 General Message: Demobilization Planning
214 Activity Log
230 Daily Meeting Schedule
X
X
X
X
X
X
X
FOR USE AT ALL
MEDICAL PODS
ATTACHMENTS
Operational Worksheet
POD Layout and Client Flow
Diagram of POD Layout and Client Flow
General Briefing
Safety Briefing
POD Supply Delivery and Emergency Vehicle Access
POD Client Parking
POD Staff Transportation
POD Staff Parking
Transportation Details
Incident Commander Checklist
Facility Map & Transportation Diagram
ICS 202
EVENT OBJECTIVES
FOR USE AT
FOR USE AT NONEMERGENCY
EMERGENCY
MEDICAL PODS MEDICAL PODS
X
X
X
X
X
X
X
X
X
X
X
X
EVENT NAME/LOCATION
X
OPERATIONAL PERIOD
CONTROL OBJECTIVES
1. Provide a safe and accessible environment for people in an affected community to obtain prophylaxis within
reasonable driving/walking distance.
2. Los Angeles County Department of Public Health will dispense mass prophylaxis safely and efficiently, with support
from the City of Los Angeles, and within a time frame defined by the nature of the public health emergency and the
availability of the prophylaxis.
3. Deploy sufficient staff to meet the POD demands (based on nature, location, and size of the Public Health emergency),
and adjust the Organization Assignment List (ICS 203) as necessary.
WEATHER FORECAST FOR OPERATIONAL PERIOD
v.6.30.2011
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE
GENERAL / SAFETY MESSAGE
See General Briefing & Safety Briefing.
OTHER INFORMATION
PREPARED BY
DATE/TIME
ICS 203
ORGANIZATION ASSIGNMENT LIST
COMMAND STAFF
CITY INCIDENT COMMANDER
COUNTY INCIDENT COMMANDER
SAFETY OFFICER
PUBLIC INFORMATION OFFICER
PUBLIC INFORMATION OFFICER
EVENT NAME/LOCATION
OPERATIONAL PERIOD
LOGISTICS SECTION
City
County
County
County
City
AGENCY REPRESENTATIVES
SECTION CHIEF
County
SUPPLY UNIT
UNIT LEADER
STAFF
STAFF
STAFF
STAFF
RUNNER
RUNNER
County
County
County
County
County
County
County
PARKING LOT UNIT
PLANNING SECTION
SECTION CHIEF
County
DOCUMENTATION UNIT
UNIT LEADER
STAFF
UNIT LEADER
STAFF
STAFF
STAFF
STAFF
STAFF
County
County
County
County
County
County
PERSONNEL UNIT
UNIT LEADER
STAFF
STAFF
STAFF
County
County
County
OPERATIONS SECTION
SECTION CHIEF
DISPENSING GROUP
County
CLINICAL BRANCH
BRANCH DIRECTOR
County
FORM DISTRIBUTION GROUP
GROUP SUPERVISOR
STAFF
STAFF
STAFF
STAFF
STAFF
v.6.30.2011
County
County
County
County
County
County
GROUP SUPERVISOR
DISPENSING TEAM 1 LEADER
STAFF
STAFF
STAFF
STAFF
STAFF
RUNNER
DISPENSING TEAM 2 LEADER
STAFF
County
County
County
County
County
County
County
County
County
County
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE
STAFF
STAFF
County
County
REGISTRATION & SCREENING GROUP
GROUP SUPERVISOR
STAFF
STAFF
STAFF
STAFF
STAFF
STAFF
STAFF
RUNNER
County
County
County
County
County
County
County
County
FLOW CONTROL GROUP
County
County
County
County
County
County
County
County
EVALUATION GROUP
v.6.30.2011
County
County
County
County
County
QUESTION & ANSWER GROUP
GROUP SUPERVISOR
STAFF
County
County
LAW BRANCH
DIRECTOR
City
EXTERIOR SECURITY GROUP
GROUP SUPERVISOR
STAFF
STAFF
STAFF
STAFF
STAFF
STAFF
STAFF
GROUP SUPERVISOR
STAFF
STAFF
STAFF
STAFF
STAFF
STAFF
RUNNER
STAFF
STAFF
STAFF
STAFF
RUNNER
County
County
County
County
County
County
County
County
GROUP SUPERVSIOR
STAFF
STAFF
STAFF
STAFF
STAFF
City
City
City
City
City
City
INTERIOR SECURITY GROUP
GROUP SUPERVSIOR
STAFF
STAFF
STAFF
STAFF
STAFF
STAFF
City
City
City
City
City
City
City
TRAFFIC CONTROL GROUP
GROUP SUPERVISOR
STAFF
STAFF
STAFF
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE
City
City
City
City
ICS 207
ORGANIZATION CHART
EVENT NAME/LOCATION
OPERATIONAL PERIOD
Incident Commander
LACDPH
Public Information Officer
LACDPH
Incident Commander
LA CITY
Safety Officer
LACDPH
Assistant PIO
LA CITY
Operations Section Chief
LACDPH
Planning/Intelligence Section Chief
LACDPH
Clinical Branch Director
LACDPH
Form Distribution Group Supervisor
LACDPH
Form Distribution Staff
LACDPH
Interior Security Group Supervisor
LA CITY
Question & Answer Staff
LACDPH
Form Distribution Staff
LACDPH
Form Distribution Staff
LACDPH
Dispensing Team 1 Leader
LACDPH
Dispensing Team 2 Leader
LACDPH
Nurse
LACDPH
Nurse
LACDPH
Nurse
LACDPH
Nurse
LACDPH
Nurse
LACDPH
Nurse
LACDPH
Nurse
LACDPH
Nurse
LACDPH
Nurse
LACDPH
Nurse
LACDPH
Runner
LACDPH
Runner
LACDPH
v.6.30.2011
Nurse
LACDPH
Staff
LACDPH
Nurse
LACDPH
Staff
LACDPH
Nurse
LACDPH
Staff
LACDPH
Nurse
LACDPH
Staff
LACDPH
Nurse
LACDPH
Staff
LACDPH
Runner
LACDPH
Staff
LACDPH
Supply Unit Leader
LACDPH
Staff
LACDPH
Staff
LACDPH
Staff
LACDPH
Armed Law Enforcement
LA CITY
Traffic Control Officer
LA CITY
Armed Law Enforcement
LA CITY
Armed Law Enforcement
LA CITY
Traffic Control Officer
LA CITY
Unarmed Security
LA CITY
Armed Law Enforcement
LA CITY
Traffic Control Officer
LA CITY
Unarmed Security
LA CITY
Armed Law Enforcement
LA CITY
Unarmed Security
LA CITY
Unarmed Security
LA CITY
Unarmed Security
LA CITY
Unarmed Security
LA CITY
Flow Control Group Supervisor
LACDPH
Staff
LACDPH
Personnel Unit Leader
LACDPH
Armed Law Enforcement
LA CITY
Form Distribution Staff
LACDPH
Evaluation Group Supervisor
LACDPH
Traffic Control Group Supervisor
LA CITY
Exterior Security Group Supervisor
LA CITY
Form Distribution Staff
LACDPH
Dispensing Group Supervisor
LACDPH
Documentation Unit Leader
LACDPH
Law Branch Director
LA CITY
Question & Answer Group Supervisor
LACDPH
Logistics Section Chief
LACDPH
Staff
LACDPH
Staff
LACDPH
Staff
LACDPH
Staff
LACDPH
Runner
LACDPH
Runner
LACDPH
Staff
LACDPH
Staff
LACDPH
Parking Lot Unit Leader
LACDPH
Staff
LACDPH
Staff
LACDPH
Staff
LACDPH
Staff
LACDPH
Staff
LACDPH
Staff
LACDPH
Staff
LACDPH
This is a general organization chart; the specific number of positions in each group or unit
may change depending on the site-specific IAP.
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE DOCUMENT
ICS 204
ASSIGNMENT LIST
FORM DISTRIBUTION GROUP
EVENT NAME/LOCATION
PILL POD
OPERATIONAL PERIOD
VACCINE POD
OVERALL STRATEGIES
 Assist clients in completing screening form(s), answer client questions about the form(s) and the POD.
 Ensure all applicable sections of the form(s) are completed; clarify any confusing or miscellaneous marks on the form(s).
 Communicate with flow control group to facilitate client movement into the POD.
OPERATIONS PERSONNEL
OPERATIONS SECTION CHIEF
BRANCH DIRECTOR
GROUP SUPERVISOR
FORM DISTRIBUTION STAFF
PREPARED BY:
v.6.30.2011
DATE/TIME:
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE DOCUMENT
ICS 204
ASSIGNMENT LIST
REGISTRATION/SCREENING GROUP
EVENT NAME/LOCATION
PILL POD
OPERATIONAL PERIOD
VACCINE POD
OVERALL STRATEGIES
 Assist clients in completing screening form(s), answer client questions about the form and the POD.
 Ensure all applicable sections of the form(s) are completed; clarify any confusing or miscellaneous marks on the form.
 Mark the top right corner of the form(s) D or E, depending on whether the client should be directed to the Dispensing or
Evaluation (contraindication) stations. Specific directions regarding contraindications will be provided by supervisors.
OPERATIONS PERSONNEL
OPERATIONS SECTION CHIEF
BRANCH DIRECTOR
GROUP SUPERVISOR
REGISTRATION/SCREENING STAFF
PREPARED BY:
v.6.30.2011
DATE/TIME:
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE
ICS 204
ASSIGNMENT LIST
DISPENSING GROUP
EVENT NAME/LOCATION
PILL POD
OPERATIONAL PERIOD
VACCINE POD
OVERALL STRATEGIES
Review the client form and ensure their answers indicate they can receive the prophylaxis.
If client form indicates contraindications, direct client to a flow control monitor.
If clients cannot or will not receive standard medication, direct them to the Evaluation Station.
Give the standard medication to the client with the corresponding drug information sheet.
In the event of additional questions or side effects, instruct the client to call the LACPDH phone number on the
information sheet.
 Collect screening form.
 Direct client to exit or to Question & Answer Station if they have additional questions.





OPERATIONS PERSONNEL
OPERATIONS SECTION CHIEF
BRANCH DIRECTOR
GROUP SUPERVISOR
TEAM 1 LEADER
TEAM 2 LEADER
DISPENSING STAFF
TEAM 1
PREPARED BY:
v.6.30.2011
TEAM 2
DATE/TIME:
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE
ICS 204
ASSIGNMENT LIST
EVALUATION GROUP
EVENT NAME/LOCATION
PILL POD
OPERATIONAL PERIOD
VACCINE POD
OVERALL STRATEGIES
 Assess the client form and ensure the answers, and other assessment observations or questions, indicate the client
should be receiving alternate prophylaxis.
 Select the appropriate course of action: Give standard or alternative medication/dosage, OR do not give medication.
 If giving the medication: Give the standard or alternative medication to the client with the corresponding drug
information sheet.
 If informing client NOT to take the medication: Explain the risk factors associated with the medication and the
expectation of life-threatening complications with the preventative treatment.
 Collect screening form.
 Direct client to exit or Question & Answer station.
OPERATIONS PERSONNEL
OPERATIONS SECTION CHIEF
BRANCH DIRECTOR
GROUP SUPERVISOR
EVALUATION STAFF
PREPARED BY:
v.6.30.2011
DATE/TIME:
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE
ICS 204
ASSIGNMENT LIST
QUESTION & ANSWER GROUP
EVENT NAME/LOCATION
PILL POD
OPERATIONAL PERIOD
VACCINE POD
OVERALL STRATEGIES
 Answer client questions regarding the disease agent, symptoms, treatments, and purpose of preventative medications.
 Provide fact sheets regarding the applicable disease agent if available.
 Instruct clients to call LACPDH phone number on the drug information sheet in the event of additional questions or issues
related to the medication.
 Direct clients to exit.
OPERATIONS PERSONNEL
OPERATIONS SECTION CHIEF
BRANCH DIRECTOR
GROUP SUPERVISOR
QUESTION & ANSWER STAFF
PREPARED BY:
v.6.30.2011
DATE/TIME:
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE
ICS 204
ASSIGNMENT LIST
FLOW CONTROL GROUP
EVENT NAME/LOCATION
PILL POD




OPERATIONAL PERIOD
VACCINE POD
OVERALL STRATEGIES
Queue clients outside to prevent clients from entering the facility who may not be able to receive prophylaxis.
Only allow clients inside the facility as space and available prophylaxis allow.
Queue clients at designated locations to maintain an orderly flow.
Control the rate of client flow to prevent lines between or at stations.
NAME
FLOW CONTROL
POST LOCATION
SIGNATURE OF FLOW CONTROL GROUP SUPERVISOR
v.6.30.2011
DESCRIPTION OF FUNCTIONS AND DUTIES
SIGNATURE OF OPS CLINICAL BRANCH DIRECTOR
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE
ICS 204a
ASSIGNMENT LIST ATTACHMENT
DIAGRAM OF FLOW CONTROL GROUP
EVENT NAME/LOCATION
PILL POD
OPERATIONAL PERIOD
VACCINE POD
FC = Flow Control Monitor Post
See ICS 204 - Assignment List: Flow Control Group
PREPARED BY
v.6.30.2011
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE
v.6.30.2011
CITY OF LOS ANGELES MEDICAL POD PLAN – PUBLIC SAFETY SENSITIVE
ICS 204
ASSIGNMENT LIST
LAW BRANCH – EXTERIOR SECURITY
GROUP
EMERGENCY MEDICAL POD
EVENT NAME/LOCATION
PILL POD





OPERATIONAL PERIOD
VACCINE POD
SECURITY MEASURES AND STRATEGIES
Security staff should be positioned where they serve as a visible deterrent and should regularly patrol the facility.
All unused doors will remain locked with exit-only access via the panic bar.
Develop a plan to verify staff credentials to grant access to restricted areas.
Indoor restrooms should be restricted to POD and facility staff only.
Upon POD closing, security staff should remain at the facility until all supplies and biohazard waste are removed
and staff have checked out. Security staff will complete a final check of the facility to ensure the facility is locked
and cleared.
NAME
SECURITY POST
LOCATION
FUNCTION(S)
NUMBER
OF ARMED
OFFICERS
NUMBER OF
UNARMED
OFFICERS
TOTAL OFFICERS:
SIGNATURE OF EXTERIOR SECURITY GROUP SUPERVISOR
v.6.30.2011
SIGNATURE OF LAW BRANCH DIRECTOR
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ICS 204a
ASSIGNMENT LIST ATTACHMENT
DIAGRAM OF LAW BRANCH –
EXTERIOR SECURITY GROUP
EMERGENCY MEDICAL POD
EVENT NAME/LOCATION
PILL POD
Post
Location
Armed
Officers (A)
OPERATIONAL PERIOD
VACCINE POD
Unarmed
Officers (U)
See Emergency POD ICS 204 - Assignment List: Law Branch – Exterior
Security Group
PREPARED BY
v.6.30.2011
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ICS 204
ASSIGNMENT LIST ATTACHMENT
LAW BRANCH – INTERIOR SECURITY
GROUP
EMERGENCY MEDICAL POD
EVENT NAME/LOCATION
PILL POD





OPERATIONAL PERIOD
VACCINE POD
SECURITY MEASURES AND STRATEGIES
Security staff should be positioned where they serve as a visible deterrent and should regularly patrol the facility.
All unused doors will remain locked with exit-only access via the panic bar.
Develop a plan to verify staff credentials to grant access to restricted areas.
Indoor restrooms should be restricted to POD and facility staff only.
Upon POD closing, security staff should remain at the facility until all supplies and biohazard waste are removed
and staff have checked out. Security staff will complete a final check of the facility to ensure the facility is locked
and cleared.
NAME
SECURITY POST
LOCATION
FUNCTION(S)
NUMBER OF
ARMED
OFFICERS
NUMBER OF
UNARMED
OFFICERS
TOTAL OFFICERS:
v.6.30.2011
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
EMERGENCY MEDICAL POD
SIGNATURE OF INTERIOR SECURITY GROUP SUPERVISOR
EVENT NAME/LOCATION
ICS 204a
ASSIGNMENT LIST ATTACHMENT
DIAGRAM OF LAW BRANCH –
INTERIOR SECURITY GROUP
PILL POD
Post
Location
Armed
Officers (A)
SIGNATURE OF LAW BRANCH DIRECTOR
OPERATIONAL PERIOD
VACCINE POD
Unarmed
Officers (U)
See Emergency POD ICS 204 - Assignment List: Law Branch – Interior Security Group
PREPARED BY
v.6.30.2011
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
EMERGENCY MEDICAL POD
v.6.30.2011
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ICS 204
ASSIGNMENT LIST
LAW BRANCH – SECURITY GROUP
NON-EMERGENCY MEDICAL POD
EVENT NAME/LOCATION
PILL POD





OPERATIONAL PERIOD
VACCINE POD
SECURITY MEASURES AND STRATEGIES
Security staff should be positioned where they serve as a visible deterrent and should regularly patrol the facility.
All unused doors will remain locked with exit-only access via the panic bar.
Develop a plan to verify staff credentials to grant access to restricted areas.
Indoor restrooms should be restricted to POD and facility staff only.
Upon POD closing, security staff should remain at the facility until all supplies and biohazard waste are removed
and staff have checked out. Security staff will complete a final check of the facility to ensure the facility is locked
and cleared.
NAME
FUNCTION(S)
NUMBER
OF ARMED
OFFICERS
NUMBER OF
UNARMED
OFFICERS
TOTAL OFFICERS:
SIGNATURE OF SECURITY GROUP SUPERVISOR
v.6.30.2011
SIGNATURE OF LAW BRANCH
DIRECTOR
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
EVENT NAME/LOCATION
ICS 204
ASSIGNMENT LIST
LAW BRANCH – TRAFFIC CONTROL
GROUP
PILL POD
OPERATIONAL PERIOD
VACCINE POD
TRAFFIC CONTROL MEASURES AND STRATEGIES
NAME
LOCATION
FUNCTION(S)
NUMBER OF
OFFICERS
TOTAL TRAFFIC CONTROL OFFICERS:
SIGNATURE OF TRAFFIC CONTROL GROUP SUPERVISOR
v.6.30.2011
SIGNATURE OF LAW BRANCH DIRECTOR
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ICS 205
COMMUNICATIONS PLAN
(RADIO)
SYSTEM/CACHE
PREPARED BY
v.6.30.2011
EVENT NAME/LOCATION
CHANNEL
FUNCTION
OPERATIONAL PERIOD
FREQUENCY/TONE
ASSIGNMENT
REMARKS
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ICS 205T
COMMUNICATIONS PLAN
(TELEPHONE)
EVENT NAME/LOCATION
NAME
POSITION OR RESPONSIBILITY
CITY POD DESK
PREPARED BY
v.6.30.2011
OPERATIONAL PERIOD
PHONE #
NOTES
Provide City assistance and
support to Incident
Commanders and Volunteer
Coordinators.
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ICS 206
MEDICAL PLAN
EVENT NAME/LOCATION
PILL POD
OPERATIONAL PERIOD
VACCINE POD
AMBULANCE SERVICES
Ambulance service will be provided by the Los Angeles Fire Department through the 9-1-1 system.
HOSPITALS
NAME
ADDRESS
PHONE
HELIPAD
(Y/N)
BURN CENTER
(Y/N)
MEDICAL EMERGENCY PROCEDURES

A staff person who has a reaction to the medication being dispensed will be assessed and treated by the Public
Health Clinical Staff. The Clinical Branch Supervisor, or the Operations Section Chief if the Clinical Branch Supervisor
is not available, will make the determination if 9-1-1 is to be called. If there is a Public Health Physician present,
they shall direct all patient care until ambulance arrives.

If a staff person suffers a medical emergency outside of the POD facility, care shall be rendered and 9-1-1 shall be
called. The Public Health Clinical Staff may render care, but may not assume patient care responsibility.

After 9-1-1 is called and an ambulance is dispatched, send a runner to the street to direct the ambulance crew to the
patient.

Staff should follow their internal workers compensation guidelines for on-the-job related illness or injuries.

Notify City or County representatives of illness or injuries to their respective volunteers.

Transport of a staff person to a hospital will be according to Los Angeles County Emergency Medical Services
Protocol.

If staff person refuses medical care and/or transport to the hospital, the refusal shall be documented on the
Activity Log (ICS 214). The greatest source of liability for health care providers is a patient who refuses care with
being explained to possible adverse consequences of that refusal.

An ambulance may not be assigned to the POD. If one is assigned, the Operations Section Chief will brief Ambulance
on POD operations. If ambulance must leave, they will coordinate with the Operations Section Chief.
v.6.30.2011
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
SIGNATURE OF MEDICAL UNIT LEADER
v.6.30.2011
SIGNATURE OF SAFETY OFFICER
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ICS 213
GENERAL MESSAGE
DEMOBILIZATION PLANNING
EVENT NAME/LOCATION
TO:
POSITION:
FROM:
POSITION:
SUBJECT:
DEMOBILIZATION PLANNING
DATE:
OPERATIONAL PERIOD
TIME:
MESSAGE
Consider the following when planning for demobilization:
 The number of clients in line, the amount of prophylaxis left, and the through-put per hour.
 If the amount of available prophylaxis is projected to run out before the POD closing, a line monitor must be placed
at the end of the line to advise clients that only those in line are guaranteed prophylaxis.
 If there is sufficient prophylaxis to last until POD closing, bring the line inside the facility and close the door if there
is room for them. If the facility is not large enough to handle the line, place line monitors at the end of the line and
advise the public the facility is closed.
 If the line is going to be closed due to the prophylaxis running out before POD closing, place a line monitor with
information on other/future POD locations.
 Consider releasing volunteers first.
 Consider releasing entire units/groups at the same time.
SIGNATURE:
POSITION:
REPLY
DATE:
v.6.30.2011
TIME:
SIGNATURE/POSITION:
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ICS 214
ACTIVITY LOG
EVENT NAME/LOCATION
OPERATIONAL PERIOD
NAME
AGENCY
POSITION
TIME
SIGNIFICANT EVENTS
GENERAL COMMENTS
SIGNATURE
v.6.30.2011
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ICS 230
DAILY MEETING SCHEDULE
DATE/TIME
Start of shift
Start of shift
Start of shift
Start of shift
MEETING
v.6.30.2011
OPERATIONAL
PERIOD
PURPOSE
Incident Commander(s) gives general
General Briefing
POD operational information to
workers
Incident Commander(s) inform POD
Community Profile
workers about the community being
Briefing
served
Safety Officer informs POD workers
Safety Briefing
about safety risks and procedures
Section Chiefs and Group/Branch
Just-In-Time
Supervisors provide training to POD
Training
workers on their specific job
assignment
Evaluate inventory; determine
whether additional supplies
Situational
can/should be ordered; evaluate
Meeting
potential for early POD closure based
on supply and the number of people in
line
Closing Planning
Meeting
PREPARED BY
EVENT
NAME/LOCATION
Plan for the demobilization of the POD
ATTENDEES
LOCATION
All POD Staff
All POD Staff
All POD Staff
All POD Staff
Incident Commanders,
Planning Chief,
Operations Chief,
Documentation Unit
Leader, Supply Unit
Leader
Incident Commanders,
Section Chiefs
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ATTACHMENT: OPERATIONAL WORKSHEET
EVENT NAME/LOCATION
OPERATIONAL PERIOD
POSITION/UNIT/GROUP/TEAM
Incident Commander
Unified Command
Safety Officer
Public Information
Officer
Agency Representative
GENERAL DUTIES
Determine incident objectives and strategies. Overall management of the POD.
Ensure safety of staff and clients. Be vigilant for unsafe activities and correct if found.
Assure proper and accurate communications with media and public.
A liaison representing an agency that has a particular interest and/or role in the POD.
Planning Section Chief
Documentation Unit
Personnel Unit
Collect, evaluate, and manage incident and resource information. Forecast POD status.
Document POD throughput and types of prophylaxis dispensed.
Check in and out personnel. Issue job action sheets. Oversee the condition of personnel.
Logistics Section Chief
Obtain and manage resources.
Supply Unit
Order, receive, store, and maintain pharmaceutical inventory. Ensure adequate POD
supplies and resources. (Prepare vaccines if applicable.)
Parking Lot Unit
Direct clients to/through parking lot. Direct clients from parking lot to POD entrance.
Operations Section Chief
Clinical Branch Director
Oversee all activities in the Clinical Branch (form distribution, registration/screening,
dispensing, evaluation, flow control, and Question & Answer), and the Security Branch.
Manage and direct all activities in form distribution, registration/screening, dispensing,
evaluation, flow control, Question & Answer, and vaccine prep.
Form Distribution Group
Distribute forms at the queuing area.
Registration/Screening Group
Screen clients for special needs and review completed forms.
Question & Answer Group
Check registration/screening forms. Provide medication and medication instruction sheet
to clients. Collect forms.
Check registration/screening forms. Assess and dispense medication and medication
instruction sheet to clients with identified risk factors. Assess clients with adverse
reactions to the vaccines being dispensed, if it is a vaccination POD. Provide dispensing
services to families. Issue referrals for clients needing additional medical care. Collect
forms.
Direct clients throughout the POD to ensure efficient flow. See ICS 204 Assignment List:
Flow Control Group for specific assignments.
Distribute additional information. Answer questions.
Law Branch Director
Manage law-related activities including security and traffic control.
Dispensing Group
Evaluation Group
Flow Control Group
Exterior Security Group
Interior Security Group
Security Group (Nonemergency POD)
Traffic Control Group
Deter crime. Ensure clients do not enter restricted areas. Respond to incidents and call
for back-up as necessary.
Direct street traffic to ensure effective traffic flow in the immediate area around the site.
Specific duties will be provided on Job Action Sheets and at the Just-In-Time Training.
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CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ATTACHMENT: POD LAYOUT & CLIENT FLOW
EVENT NAME/LOCATION
OPERATIONAL PERIOD
PILL POD
VACCINE POD
POD FOOTPRINT DETAILS
Number of rooms designated for POD footprint
POD Stations(s)
Vaccine Prep Station (if applicable) – Must be adjacent
to an electrical outlet that is capable of providing 85w,
115v, and a voltage draw of 1.3amps during operation
and 6amps at kickoff, and located on the POD floor
Designated space
Estimated size in square feet
Number of entrances/exits to/from the outdoors
Number of entrances/exits to/from the POD Floor
Number of electrical outlets
INCIDENT COMMAND POST AND DESIGNATED STAFF-ONLY AREA
Space designated for the Incident Command Post
Space designated for POD staff briefings and breaks
Additional space available for a staff rest area
Designated staff entrance(s) and exit(s)
Supply delivery area
Accessibility Considerations
POD CLIENT FLOW
Description of POD Flow
Accessibility Considerations
PREPARED BY
v.6.30.2011
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ATTACHMENT: DIAGRAM OF POD LAYOUT AND CLIENT FLOW
EVENT NAME/LOCATION
OPERATIONAL PERIOD
PILL POD
PREPARED BY
v.6.30.2011
VACCINE POD
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
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CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ATTACHMENT: GENERAL BRIEFING – TALKING POINTS FOR THE INCIDENT COMMANDER
EVENT NAME/LOCATION
OPERATIONAL PERIOD

Thank you to everyone who will be helping today. Your time is very much appreciated.

If you have not checked in with the Personnel Unit, you must do so immediately after the briefing.

The purpose of the POD is to provide mass prophylaxis to the public in response to ____________. This is
not a medical care facility.

The POD is open to the public from ______ to ______. You will be notified if these times change.

This operational period is ______ to ______.

You are entitled to #____ of breaks for a time period of ____ minutes, and to #____ of lunch breaks.

Only your POD supervisor can dismiss you for breaks and at the end of your shift. Please do not leave the
facility without completing the check-out process with the POD Personnel Unit and notifying your
Supervisor. The POD Personnel Unit will be located ______.

Photography is not permitted in the facility. Report any incidents immediately to your POD supervisor.

Please do not speak with the media. If you see representatives from the media, notify your POD
supervisor or the Public Information Officer (PIO).

Please report any unsafe activities to your POD supervisor or the Safety Officer immediately.

If you have not already received the prophylaxis and would like to do so during your shift, please
coordinate with your supervisor before you leave your post to go through the POD.

Please be mindful of your personal items. The Command Post and Break Room will not be locked or
supervised. Neither the City nor the County are responsible for the loss of any personal items.

If LAPD, LAFD or General Services Office of Public Safety on-duty personnel visit the POD to receive the
medication/vaccine, please escort them to the front of the line.

A Community Profile Briefing will be given by _____________.
SIGNATURE
v.6.30.2011
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
EVENT NAME/LOCATION
OPERATIONAL PERIOD
ATTACHMENT: SAFETY BRIEFING – TALKING POINTS FOR THE SAFETY OFFICER

The Command Post is located _______________. The break room is located in the _______________.

The weather for today is forecasted as ________________. All staff will monitor clients for signs of
[heat/cold] exposure. Report any problems to the Safety Officer immediately.

Security will be provided by [LAPD, General Services Office of Public Safety, contract security officers]. If
criminal activity is observed, notify your supervisor or a security staff immediately. Keep the
person/people under observation but do not try to intervene.

In the event of civil unrest, remain in the building until police have secured the area. Security will provide
further instructions based on the nature of the incident.

Emergency exits are located _______________. If we need to evacuate the building, go directly to
____________ in a calm and orderly manner. Staff should direct clients to the appropriate emergency
exits. Supervisors will take roll outside to confirm that all of the members of their unit/group have
evacuated safely. Security will monitor the facility from a safe distance to make sure no one enters the
building until the all-clear is given.

If a fire alarm rings, evacuate the building immediately.

In the event of an earthquake, drop-cover-hold on until the shaking ends. If instructed, evacuate the
building.

If you witness an emergency situation during the operation of the POD, wave yours arms in the air to
alert your supervisor.

This POD will generate medical waste (show examples of waste disposal containers and bags). Nonclinical City volunteers will not handle these containers.

Vaccine POD only: If a needle stick occurs, report the incident to the Incident Commanders

Review ICS 206 - Medical Plan and Client Injury Guidelines.

If a client becomes ill or is injured:
 A client who has a reaction to the medication being dispensed will be assessed and treated by the
Public Health Clinical Staff. The Clinical Branch Supervisor, or the Operations Section Chief if the
Clinical Branch Supervisor is not available, will make the determination if 9-1-1 is to be called. If there
is a Public Health Physician present, they shall direct all client care until ambulance arrives.
 If a client suffers a medical emergency outside of the POD facility, care shall be rendered and 9-1-1
shall be called. The Public Health Clinical Staff may render care, but may not assume client care
responsibility. After 9-1-1 is called and an ambulance is dispatched, send a runner to the street to
direct the ambulance crew to the client.
 If a client refuses medical care and/or transport to the hospital, the refusal shall be documented on
the Activity Log (ICS 214). The greatest source of liability for health care providers is a client who
refuses care with being explained to possible adverse consequences of that refusal.
v.6.30.2011
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
SIGNATURE
v.6.30.2011
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
EMERGENCY MEDICAL POD
ATTACHMENT: POD SUPPLY DELIVERY AND EMERGENCY VEHICLE ACCESS
EVENT NAME/LOCATION
OPERATIONAL PERIOD
POD SUPPLY DELIVERY
Delivery Truck Access
Delivery Area
Accessibility Considerations
Resources Required
EMERGENCY VEHICLE ACCESS
Emergency Vehicle Access
Potential Staging Area
Accessibility Considerations
Resources Required
PREPARED BY
v.6.30.2011
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
EMERGENCY MEDICAL POD
ATTACHMENT: POD CLIENT PARKING
EVENT NAME/LOCATION
CLIENT
PARKING
AREA
OPERATIONAL PERIOD
TOTAL
# OF
# OF HANDICAP
SPOTS
SPOTS
Existing
INGRESS
(NOTE IF SIGNALIZED OR
CROSSWALKS)
EGRESS
(NOTE IF SIGNALIZED OR
CROSSWALKS)
ITEMS
IMPACTING
TRAFFIC FLOW
Additional
Needed
Existing
Additional
Needed
PREPARED BY
v.6.30.2011
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
RESOURCES REQUIRED
EMERGENCY MEDICAL POD
ATTACHMENT: POD STAFF TRANSPORTATION PLAN
EVENT NAME/LOCATION
OPERATIONAL PERIOD
POD STAFF BUS TRANSPORTATION
Bus Access
Bus Drop Off Location
Bus Pick Up Location
Accessibility Considerations
Resources Required
PARKING RESERVED FOR FACILITY STAFF
Facility Staff Reserved Parking
Area
Number of Spots
Number of Handicap Spots
(Existing/Needed)
Accessibility Considerations
Resources Required
PREPARED BY
v.6.30.2011
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
NON-EMERGENCY MEDICAL POD
ATTACHMENT: POD STAFF PARKING PLAN
EVENT NAME/LOCATION
STAFF PARKING AREA
OPERATIONAL PERIOD
TOTAL
NUMBER OF
SPOTS
NUMBER OF
HANDICAP SPOTS
ACCESSIBILITY CONSIDERATIONS
Existing
Additional Needed
Existing
Additional Needed
Existing
Additional Needed
PREPARED BY
v.6.30.2011
DATE/TIME
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ATTACHMENT: TRANSPORTATION DETAILS
EVENT NAME/LOCATION
OPERATIONAL PERIOD
FREEWAY, HIGHWAY, OR TOLL ROAD ACCESS
FREEWAY/HIGHWAY/TOLL ROAD
NEAREST ON-RAMP LOCATION
NEAREST EXIT
MAJOR CROSS STREETS
STREET NAME
DIRECTION STREET RUNS
STREETS BORDERING THE PREMISES
STREET
IS IT A ONE-WAY?
ARE THERE MEDIAN BARRIERS?
IF SO, NOTE LOCATION OF TURN
POCKETS.
North side
South side
East side
West side
PUBLIC TRANSIT ACCESSIBLE WITHIN ¼ MILE OF THE FACILITY
PROVIDER
LINE NUMBER
DIRECTION
STOP LOCATION
Bus
Light Rail
Subway
v.6.30.2011
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
ATTACHMENT: INCIDENT COMMANDER/POD MANAGER CHECKLIST
√
Check-in with the POD Personnel Unit and put on the appropriate vest.
Record your time of arrival: ________
Ensure all City and County Staff and Volunteers sign in on their respective sign in sheets.
Meet with the Incident Commanders – Unified Command.
Contact the City POD Desk at _______________ and report status and receive any last minute briefings.
Review POD Plan. If you have any questions contact the POD Desk at _______________.
Review with facility representative the locations of fire alarms, fire extinguishers and emergency exit routes.
Adjust non-clinical staff if positions are unfilled due to staff absences.
Act as the Public Information Officer (PIO) if that position is not filled.
Act as Safety Officer if that position is not filled.
Record all activities on the ICS 214 form. Ensure all City Staff and Volunteers complete an ICS 214.
Bring all POD workers together and provide General and Safety Briefing.
Record the time the briefings took place: ________
Ensure that adequate safety measures are in place.
Meet with security branch to review strategies.
Record the time set up was complete: ________
OPEN POD WHEN ALL STAFF ARE IN POSITION.
Record the time the POD opened for service: ________
Once the POD is open to the public, monitor activities.
Authorize release of information through the POD PIO.
Meet with Section Chiefs at __________ and conduct Situational Meeting, or sooner if needed.
Meet with Section Chiefs at __________ and develop a demobilization plan to include packing up equipment,
releasing workers, and returning facility to working order. Consider plans for the transfer of power if the POD is
to be open for more than one operational period.
At the conclusion of the POD, collect ICS 214 form from all City staff and volunteers and conduct a facility
inspection prior to the closing of the POD to assess damages or maintenance concerns caused by POD
activation.
If there are further operational periods, leave the tables and chairs.
If there are no more operational periods, put away tables and chairs.
Record the time the doors closed/operational period ended: _________
Record the time the facility closed: ________
Contact the POD Desk at __________ before you leave the facility.
Record the total number of clients served: _______
COLLECT THE FOLLOWING ITEMS, AND RETURN TO THE CITY OF LA EMD POD DESK:
 ICS 214 COMPLETED BY ALL POD STAFF
 COPY OF CITY STAFF AND VOLUNTEER SIGN-IN/SIGN-OUT SHEET
ALL FORMS CAN BE SENT TO THE CITY OF LA EMD: 200 N SPRING STREET, RM 1533 LA 90012 / MAILSTOP 988-1
NAME OF INCIDENT COMMANDER
v.6.30.2011
SIGNATURE
DATE/TIME:
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
EMERGENCY MEDICAL POD
ATTACHMENT: FACILITY MAP & TRANSPORTATION DIAGRAM
EVENT NAME/LOCATION
v.6.30.2011
OPERATIONAL PERIOD
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE
NON-EMERGENCY MEDICAL POD
ATTACHMENT: FACILITY MAP & TRANSPORTATION DIAGRAM
EVENT NAME/LOCATION
v.6.30.2011
OPERATIONAL PERIOD
CITY OF LOS ANGELES MEDICAL POD PLAN - PUBLIC SAFETY SENSITIVE