Daily Shelter Manager Report for County EOC (based upon last 24 hours)              Report Number: :report_number:

Name of person completing report: :completer:


Sender's Call: :sender_call:

Facility: :facility:

Opening Date of Shelter

:open_shelter_date:

Current Date

:current_date:

Expected Closure Date

:closing_date:

Client Population Count (Noon)

:population_count:

DAMAGES

Did the Shelter Facility sustain damage?

:shelter_damaged:

Date and Cause of Damages:

:shelter_damaged_date:

Brief Description of Damages and Cause:

:shelter_damage_description:

SUPPLIES

Is there an urgent need for any supplies at the Shelter?

:urgent_supplies_needed:

What facility supplies have you used today in the shelter?

:supplies_consumed:

STAFFING

Shelter Manager:

:shelter_manager:

RN:

:registered_nurse:

Shelter Supervisor (1):

:shelter_supervisor_1:

Licensed Mental Health professional:

:mental_health_professional:

Shelter Supervisor (2):

:shelter_supervisor_2:

RN Support by phone?

:rn_phone_support:

Mental Health support by phone?

:mental_health_phone_support:

Shelter Supervisor (3):

:shelter_supervisor_3:

# DOH Employees supporting:

:number_doh_employees:

# spontaneous volunteers supporting:

:number_volunteers:

# County Employees supporting:

:number_county_employees:

# DOE Employees supporting:

:number_doe_employees:

Total # of staff at shelter:

:total_number_staff:

FEEDING

# Snacks provided:

:number_snacks:

# Meals provided:

:number_meals:

# with Special Diets:

:number_special_diets:

Source of Food

:food_source:

BEHAVIORAL HEALTH

# of people with behavioral health needs:

:number_people_behavioral:

# of people with psychiatric medication needs:

:number_people_psych_meds:

# of mental health contacts:

:number_mental_health_contacts:

EPIDEMIOLOGY

# of people with gastrointestinal illness

:number_gi_illness:

# of people with respiratory illness

:number_resporitory_illness:

# of people with wounds or skin rashes

:number_wounds_rashes:

PUBLIC HEALTH

# of acutely ill and injured

:number_acutely_ill:

# needing dialysis

:number_need_dialysis:

# needing dialysis in 24 hrs.

:number_need_dialysis_24:

# of people with oxygen needs

:number_people_oxygen:

# of people needing translators

:number_people_require_tranlators:

Languages

:number_of_langauges:

# people who need DME

:number_people_dme:

# of people with medical needs that require power or refrigeration

:number_people_require_power:

# of people who need a caregiver

:number_people_require_caregiver:

ENVIRONMENTAL ASSESSMENT

# of service animals

:number_service_animals:

# of pets in pet shelter

:number_pets:

Is water available?

:water_available:

Are there pests at the facility?

:pests_present:

# of working toilets

:number_working_toilets:

Are there sewage issues?

:sewage_issues:

Is there ventilation in each of the rooms?

:room_ventilation:

Is the garbage being disposed of?

:garbgage_disposed:

SECURITY

Is security present at shelter?

:security_present:

Is there a need for more security?

:need_more_security:

# of unaccompanied minors?

:number_unaccompanied_minors:

# of security incidents?

:number_security_incidents:

Notes