Hazard And Vulnerability Analysis Template printable pdf download

Hazard and Vulnerability Analysis

Issues to consider for preparedness include, but are not limited to:

This document is a sample Hazard Vulnerability Analysis tool. It is not a

substitute for a comprehensive emergency preparedness program. Individuals or

1 Status of current plans

organizations using this tool are solely responsible for any hazard assessment and

2 Frequency of drills

compliance with applicable laws and regulations.

3 Training status

4 Insurance

INSTRUCTIONS:

5 Availability of alternate sources for critical supplies/services

Evaluate potential for event and response among the following categories using

Issues to consider for internal resources include, but are not limited to:

the hazard specific scale. Assume each event incident occurs at the worst

possible time (e.g. during peak patient loads).

1 Types of supplies on hand/will they meet need?

2 Volume of supplies on hand/will they meet need?

Please note specific score criteria on each work sheet to ensure accurate recording.

3 Staff availability & training

4 Coordination with MOB's

Issues to consider for probability include, but are not limited to:

5 Availability of back-up systems

1 Known risk

6 Internal resources ability to withstand disasters/survivability

2 Historical data

Issues to consider for external resources include, but are not limited to:

3 Manufacturer/vendor statistics

4 Subjective evaluation/best estimate

1 Types of agreements with community agencies/drills?

5 Local Emergency Planning Committee input

2 Coordination with local and state agencies

3 Coordination with proximal health care facilities

Issues to consider for response include, but are not limited to:

4 Coordination with treatment specific facilities

1 Time to marshal an on-scene response

5 City/County EMS services capabilities

2 Scope of response capability/staff training

6 Community volunteers/training

3 On site support resources/supplies

7 Vendor Pre-incident response plans/contracts

4 Estimated severity & duration of the incident

8 Other community resources

5 Historical evaluation of response success

6 Local Emergency Planning Committee input

Issues to consider for human impact include, but are not limited to:

Complete all worksheets including Natural, Technological, Human and Hazmat.

1 Potential for staff death or injury

The summary section will automatically provide your specific and overall relative threat.

2 Potential for patient/visitor death or injury

3 Emotional/psychological impact

4 Local cultural norms

Issues to consider for property impact include, but are not limited to:

Notes:

1 Cost to replace

a. Plan not yet developed

2 Cost to set up temporary replacement

b. Plan approved

3 Cost to repair

c. Training program developed

4 Time to recover

d. Support materials not on hand

e. Support materials on hand

Issues to consider for business impact include, but are not limited to:

f. Staff trained

1 Business interruption

g. Drill/Exercise conducted

2 Employees unable to report to work

h. Goals Not Met

3 Customers unable to reach facility

i. Goals Met

4 Company in violation of contractual agreements

/P = Partial

5 Company in violation of regulatory standards

6 Imposition of fines and penalties or legal costs

Note:

7 Interruption of critical supplies

Coordinated with City of Santa Clarita, Emergency Preparedness Coordinator - 2/05/2004

8 Interruption of product distribution

Coordinated with LA County Sheriff, Emergency Preparedness Coordinator

9 Reputation and public image

Coordinated with LA Fire Department, HazMat Emergency Preparedness Coordinator

10 Financial impact/burden

HVAlDetailedHM.xls

Hazard And Vulnerability Analysis Template

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