Sample Page Emergency Preparedness Plan for Child Care Providers Emergency Preparedness Plan for Child Care Providers Radio Buttons Family Child Care Child Care Center Date of Plan Original Training Date Training Participant Name * Program Name * OCC License Number * Local Emergency Service Numbers Fire Department Ambulance Hospital Police Emergency Management Office Poison Control Center Local Office of Child Care Child Protective Services Health Department Electric Utility Gas Utility Water Utility Evacuation Site 1: Evacuation Site 2: Local Emergency Alert System (EAS) radio stations: AM FM For Family and Informal Child Care Neighbor: Phone #: Relative: Phone #: Substitute: Phone #: Persons Responsible for Emergency Response Person/Position Responsible Declare an Emergency: Declare an Emergency: Declare an Emergency: Declare an Emergency: Declare an Emergency: Declare an Emergency: Declare an Emergency: Declare an Emergency: Declare an Emergency: Declare an Emergency: Section Buttons frm_primary_label Alternate Declare an Emergency: Section Buttons Emergency Communication Person/Position Responsible for Communicating Emergency Information: Alternate Person/Position Responsible for Communicating Emergency Information: Items and Methods for Communicating in an Emergency: Cell Phones Walkie Talkies Location of Communication Items: Person/Position Responsible for Maintaining Communication Items: Location of Emergency Telephone Numbers: Method for Maintaining Communication Items: Evacuation Locations A minimum of two (2) evacuation locations are required. Name of Location Address Phone Number Contact Person Formal Written Agreement? Yes No Due Date Name of Location Address Phone Number Contact Person Formal Written Agreement? Yes No Due Date Name of Location Address Phone Number Contact Person Formal Written Agreement? Yes No Due Date Children and adults (including non-walking children and disabled adults) will be transported to evacuation sites by: Natural Emergency Situations Description of natural emergency situations that occur most often in the child care site’s region: Procedures for responding to natural emergency situations: Manmade Emergency Situations Description of manmade emergency situations that are likely to occur: Procedures for responding to manmade emergency situations: Difficult Situations with Adults Procedures in place to deal with a parent, guardian or authorized person or employee who is impaired or in a disgruntled state: If you are human, leave this field blank. Submit