Fillable 6-8-16 TWU Family-Emergency-Plan Final

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6-8-16 TWU Family-Emergency-Plan Final

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My
Post these numbers next to all phones.
*
Review with all family members.
*
Carry this information in purse, briefcase, glove box,
*
etc.
Family name:
__________________________________
_____________________________________
Cross street:
__________________________________
_
Home phone(s): 1.______________ 2._____________
Work phone(s): 1. ______________ 2._____________
Doctor #1:
___________________________________
Doctor #1 Phone:
_____________________________
Neighbor #1:
_________________________________
Neighbor #2:
_________________________________
Our children:
Name:
_________
Age:
___
School:
_______________
Name:
_________
Age:
___
School:
_______________
Name:
_________
Age:
___
School:
_______________
It is important to work through the plan with your family, friends and neighbors. Once completed,
make the plan available by putting a copy at home, work, and in your vehicles.
Make certain your child’s school or child care
*
provider’s emergency contact card is accurate and
up-to-date.
Notify
*
the adults you authorize, of any special
medical or dietary requirements your child has.
Let
*
your child know who will pick them up at
school or child care if you are unable to do so.
Keep
*
emergency supplies in your car, including
comfortable shoes, water and warm jackets.
Des
*
ignate an out-of-state contact to relay family
emergency information.
Brin
*
g photo ID with you to pick-up your child.
Youth Plan
Local Emergency Contact
Name:
___________________________________
Home phone:
__________________________________
Cell phone: __________________________________
Local Radio Stations:
KRLD 1080 AM WBAP 820 AM
Local Television Stations:
Emergency Alert System
Emergency Contacts
Out of Area Contact Person
Call 9-1-1 in case of life-threatening
emergency or fire.
1
If you or your loved ones are separated during a disaster, each
person should call the designated contact person to report his/her
location and condition. This contact should be out-of-state
because it is easier to call long distance during a disaster.
Name:
_____________________________________
Home phone:
________________________________
Cell phone:
__________________________________
E-mail: _____________________________________
Family Emergency Plan
KDFW Fox 4
WFAA Channel 8
For emergency information:
Texas Woman's University:
Pioneer Alert
Doctor #2:
___________________________________
Doctor #2 Phone:
_____________________________
Instructions: Please use pencil to fill out the Family Emergency Plan to allow for future edits.
Neighbor #1 Phone
_:____________________________
Neighbor #2 Phone
_:____________________________
Home Evacuation and Shelter-In-Place Map
Use this page to draw a floor plan of your house. Make a floor plan for each story of your home.
Indicate p
*
rimary exits from each room (doors, windows) and include location of escape ladders,
ropes, etc.
Identify location of emergency supplies and equipment (Ex: Fire Extinguishers).
*
Mark location of utility valves, circuit breakers or fuses.
*
Be sure all family members know where utilities are and how to turn them off.
*
Be sure all family members know how to use a fire extinguisher.
*
Share your plan with visitors.
*
Designated area for evacuation is located: ________________________________
*
______________________________________________________________________________
*
2
Mark the
*
Shelter-In-Place locations for severe weather.
Post the Evacuation and Shelter-In-Place map on each floor of the home in a visible spot.
Evacuation and Shelter-In-Place Map
If we get separated, our rallying point is located: ________________________________
*
Emergency Action Plan
If you were told to evacuate, what do you take?
Personalize the following list, if you had to leave in:
5 minutes:
Item
Location
Radio
Address books
Vital medication
Supplements
Emergency Supply Kit/food
Important documents
Business/computer records
Damp towel for the smoke
Pets
Pillow
Special needs supplies
__________________________________________
__________________________________________
__________________________________________
60 minutes (1 hour):
Item
Location
Photo albums, negatives
Vital documents
Business records
Financial records
Stocks and bonds
Fire extinguisher
Computer and/or hard drive
Camera
__________________________________________
__________________________________________
__________________________________________
If you have a car or truck:
Item
Location
Family heirlooms
Clothing
Computers
Original art
Additional Pet supplies
__________________________________________
__________________________________________
_______________________________________
Evacuation Plan
For all emergencies, remember to:
Stay calm & evaluate your surroundings.
*
Seek additional information from local sources.
-
*
Take appropriate action without hesitation.
*
Locate and grab emergency supplies.
*
Check for and treat injuries (Call 911 if condition is
life threatening.
*
Earthquakes and Aftershocks
Move away from windows, bookshelves, cabinets,
1.
and exterior walls.
If indoors “ride it out” until the shaking stops.
3.
Pay attention to damaged utilities. Shut off those
4.
utilities that are damaged.
Check for structural damage.
5.
Check on neighbors.
6.
Prepare for aftershocks.
7.
Keep streets clear for emergency traffic.
8.
Evacuation/Fire
Communicate the fire to others.
1.
Grab emergency supplies (If possible).
3.
Calmly walk toward emergency exits.
4.
Call 911 to report fire and injuries once in the
designated area.
6.
7.
Once outside, go to your designated area.
5.
Give first aid as necessary to stabilize the person.
Use fire extinguisher (If fire less than 3 ft. tall.
2.
Shelter-in-Place (Severe Weather)
1.
Communicate to others (Friends and family).
2.
Go indoors and take shelter in the shelter-in-
place location.
4.
Take account of all family and friends.
6.
Provide first aid as necessary to stabilize.
7.
Use weather radio or cell phone to look up
weather information to determine if storms
have passed.
8.
Receive alert of Severe Thunderstorm Warning
or Tornado Warning.
Grab emergency supplies (If possible).
-
3.
5.
Go indoors and take shelter in the shelter-in-
place location.
Duck under something sturdy (Ex: Desk), cover the
back of your neck, and if safer location is nearby
crawl to it and hold on.
2.
3
Emergency Supplies Checklist
Protecting lives from fire
We have at
least one A-B-C fire extinguisher in our
home and know how to use it.
We have changed the batteries in our smoke
detectors.
We use surge protectors as to not overload our
electrical outlets.
We store flammable liquids in air-tight containers
away from ignition sources such as pilot lights
(Example location: outdoor shed).
Maintenance Plan
We have non-perishable food for family
members and pets for 72 hours.
Battery-powered radio or NOAA Weather Radio
Flashlights for each family member
First aid kit
Cash
Manual can opener for canned foods
Extra batteries
Extra medication for each family member
Extra protective clothing (Ex: Long-sleeves and
pants
____________________________________
Check and replace as needed:
Batteries for flashlights, smoke
detectors, radio, etc.
___________
Perform a fire drill.
___________
Rotate water supply.
___________
Every year:
Rotate canned goods.
___________
Update school release forms.
___________
Replace emergency medications.
___________
Every two years:
Review and photograph personal
property inventory.
___________
Update insurance policies.
___________
Every six months:
Date last checked
Landscaping against fire
We have cl
eared our property of excess and
dead
vegetation and highly flammable plants.
We have trimmed branches that hang over our
home.
We trim grass and vegetation at least 100 feet
around our home.
We have garden hoses connected to outside
faucets.
We store firewood away from our house.
Home maintenance
Our house n
umbers are large and easily read from
the street.
We have spark arresters on our chimneys.
Our roof is fire-retardant.
We keep leaves and debris out of our
rain gutters.
(Location 1)
Fire Hazard Mitigation Plan
4
We have a minimum of 1 gallon of water per
person per day for at least 72 hours. The more
water you can store, the better off you will be.
Calculate how much water your family needs:
___p
eople/pets in
household x 1 gals = _____ gals.
Toiletries and sanitary materials (Ex: Toilet paper)
Copies of important documents (Ex: Insurance)
Books, games, and activities for children
Everyone has a copy of this plan
Locations of Emergency Supplies
(Location 2)
____________________________________
Review and update family plan.
___________
Perform a severe weather drill.
___________
Questions and Help?
For questions and help completing your plan,
contact the following:
Blake Abbe, Executive Director of Risk Management
Department of Risk Management
Texas Woman's University
Email: gabbe@twu.edu
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6-8-16 TWU Family-Emergency-Plan Final

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Completed 17 November 2019

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