Sample Childcare Emergency Action Plan

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Sample ChildcareEmergency Action PlanNovember 2011For Training Purposes Only withMultihazard Planning for Childcare

This emergency action plan includes the following information for Mom’s Maple StreetChildcare Center:TitlePageBasic Information .1Emergency Contacts 1Shelter-in-Place Procedures .3Evacuation Procedures .Parent Reunification Procedures .Child/Parent Information Sheets .234This document presents a sample child care emergency action plan. It is recommended that youcoordinate with local law enforcement, fire, and emergency managers when developing your emergencyaction plan.This sample plan is for training purposes only and is based on a fictional child care facility and location. Itis important to tailor all emergency plans to the specific hazards and needs of your site and community.

Mom’s Maple Street Childcare Center: Emergency Action PlanBasic Information: Record information on your childcare site to ensure preparedness in case of anemergency.Facility Name:Facility Address:Facility Phone:Facility Main Contact:Emergency Kit Location(s):Number of Children:Mom’s Maple Street Childcare Center6789 Maple StreetGrand, Michigan 48000(313)123.1234Amelia MilneHall coat closet and basement3Emergency Contacts: Identify the contact information for emergencies and post in easily accessiblelocations.Fire/Rescue (911)Police (911)Fire (911)HospitalPoison ControlLocal Emergency ManagerElectric CompanyGas CompanyWater CompanyInsurance ProviderNovember 2011Contact NameGrand EMSSgt. JonesCapt. Mike ThomasGrand HospitalPoison CenterCarol GarciaGrand PowerGrand GasGrand WaterRon 0(313) 558.9999(313)888.1234(313)200.3333Email/Web www.grandh20.comR mccoy@ronins.comPage 1

Mom’s Maple Street Childcare Center: Emergency Action PlanEvacuation: In case of the need to evacuate our site, the following procedures will be followed:Evacuationroutes/exits: Children are cared for on the main level of the house only and are notpermitted on second level or in basement. Exits (all windows and doors are checked regularly to ensure opening):o Living room: Front door and windows.o Kitchen: Sliding doors and windowso Dining room/family room: Front door and windowsEvacuating Children will be evacuated together using a portable play yard with wheels.Infants/Toddlers:The site owns two portable play yards each of which remain placed neareach of the two exits (front and back doors). In case of the need to evacuate through the windows, children will be placedout windows first, using any items available to place them on the ground.Notification:Once all children are safely evacuated: 911 will be called Parents will be notified of the evacuationEmergency Emergency kits will be taken when possible.Kits/Information: Each portable play yard will have an envelope attached to it with each child’semergency contact information.Evacuation Sites: Neighborhood (e.g., for fire):Marcia Wilkinson6790 Maple StreetGrand, Michigan 48000(313)123.6789 Out-of-neighborhood (e.g., explosion, flooding):Main Street Elementary School1234 Main StreetGrand, Michigan(313)123.4422Contact: Tim Johnson Out-of-town (e.g., hurricane, widespread flooding)William and Sara Stevens (Brother and Sister-in-Law)5561 Highway 29Petit, Michigan(248)222-4455Transportation Children will be pushed in portable play yards or strollers to theto Evacuationneighborhood evacuation site and weather permitting to the elementaryLocations:school (.25 of a mile away). Children will be driven in a personal vehicle, with three car seats, to theelementary school or the Petit, Michigan location.November 2011Page 2

Mom’s Maple Street Childcare Center: Emergency Action PlanShelter-in-Place: In case of the need to stay put due to a tornado or notification from authorities, thefollowing procedures will be hildren will be taken to an interior room in the basement of the house. Emergency kits with food (including formula), toys, and water are stored inthe basement. A first aid it is stored in the basement. A battery-powered radio and NOAA radio is stored with the emergencysupplies. Cell phone will be brought to the basement. Emergency contact sheets are kept with the supplies. Supplies for sealing the room are stored in the basement. Parents/guardians will be notified once the immediate threat has passed.Parent Reunification: In case of the need to evacuate or when parents/guardians are unable to get tochildren, the following procedures will be followed to reunite children with parents/guardians (or othercontacts designated by parent/guardian) as soon as it is safe.Notification: Release:November 2011 Parents/guardians are provided:o Information on each evacuation site.o Contact information for Amelia Milne, cell phone and home phone.Parent/guardian contact numbers are:o Stored in Amelia Milne’s cell phone.o Attached to portable play yards.o Kept in emergency kits.Children will only be release to contacts listed on the child’s form withproper identification.Page 3

Mom’s Maple Street Childcare Center: Emergency Action PlanChild/Parent Information: For each child at your site identify contact and emergency information.Keep a copy of this information with your emergency kit(s).Child’s InformationChild’s Name: Matthew AdamsDate of Birth: 10/10/2010Address: 459 Buckingham RoadCity: GrandState: MIAllergies, Special Instructions, Comforting Items:Matthew is allergic to penicillin. Matthew uses a pacifier for comfort. He is not to haveblankets or other items when sleeping. Roxanne is Matthew’s sister.Parent Guardian Information (1)Parent/Guardian Name: Susan AdamsRelationship to Child: GrandmotherAddress: SameCity:State:(if different from child)Home #: (249)321.2233Cell #: (249)303.4499Work #: (249)730.6643Email (personal): s adams@yahgoo.netEmail (work): s adams@squashinvest.comPlace of Work:Squash InvestmentsAddress: 12 York St., Grand, MIParent Guardian Information (2)Parent/Guardian Name:Wayne AdamsRelationship to Child:GrandfatherAddress: SameCity:(if different from child)Home #: (249)321.2233Cell #: (249)303.4488Email (personal): w admas@yahgoo.netEmail (work):Place of Work:retiredAddress:State:Work #:Additional Emergency Contact (1)Name: Mary RhodesRelationship to Child: AuntAddress: 1262 Magnolia RdCity: GrandState: MIHome #: (249)440-8877Cell #: (249)303.7700Work #: Stay-at-home momEmail (personal): m rhodes@yahgoo.netEmail (work):Additional Emergency Contact (2)Name: Jason AdamsRelationship to Child: UncleAddress: 1047 Maryland Ave.City: SunshineState: WIHome #: (420)719.5566Cell #: (420)871.9870Work #: (420)448.2213Email (personal): j adams@yahgoo.netEmail (work): j adams@charlesuniv.eduMedical InformationPractice: West Grand PediatricsAddress: 45167 West Grand HighwayPhone #: (249)898.9000November 2011Doctor’s Name: Sheldon MurphyCity: GrandState: MIPage 4

Mom’s Maple Street Childcare Center: Emergency Action PlanChild’s InformationChild’s Name: Roxanne AdamsDate of Birth: 6/10/2008Address: 459 Buckingham RoadCity: GrandState: MIAllergies, Special Instructions, Comforting Items:Roxanne uses a pacifier to sleep and for comfort. She has a favorite blanket. Matthew isRoxanne’s brother.Parent Guardian Information (1)Parent/Guardian Name: Susan AdamsRelationship to Child: GrandmotherAddress: SameCity:State:(if different from child)Home #: (249)321.2233Cell #: (249)303.4499Work #: (249)730.6643Email (personal): s adams@yahgoo.netEmail (work): s adams@squashinvest.comPlace of Work:Squash InvestmentsAddress: 12 York St., Grand, MIParent Guardian Information (2)Parent/Guardian Name:Wayne AdamsRelationship to Child:GrandfatherAddress: SameCity:(if different from child)Home #: (249)321.2233Cell #: (249)303.4488Email (personal): w admas@yahgoo.netEmail (work):Place of Work:retiredAddress:State:Work #:Additional Emergency Contact (1)Name: Mary RhodesRelationship to Child: AuntAddress: 1262 Magnolia RdCity: GrandState: MIHome #: (249)440-8877Cell #: (249)303.7700Work #: Stay-at-home momEmail (personal): m rhodes@yahgoo.netEmail (work):Additional Emergency Contact (2)Name: Jason AdamsRelationship to Child: UncleAddress: 1047 Maryland Ave.City: SunshineState: WIHome #: (420)719.5566Cell #: (420)871.9870Work #: (420)448.2213Email (personal): j adams@yahgoo.netEmail (work): j adams@charlesuniv.eduMedical InformationPractice: West Grand PediatricsAddress: 45167 West Grand HighwayPhone #: (249)898.9000November 2011Doctor’s Name: Sheldon MurphyCity: GrandState: MIPage 5

Mom’s Maple Street Childcare Center: Emergency Action PlanChild’s InformationChild’s Name: Hope CarlisleDate of Birth: 4/04/2009Address: 3939 Parcell Rd.City: GrandState: MIAllergies, Special Instructions, Comforting Items:Hope does not have any allergies and loves chocolate. Hope’s stuffed bunny is her comfortingitem.Parent Guardian Information (1)Parent/Guardian Name:Lisa CarlisleRelationship to Child:MotherAddress: SameCity:State:(if different from child)Home #: (249) 766.0980Cell #: (249)560.3131Work #: (249)321.2498Email (personal): lisa 72@superemail.comEmail (work): carlisle lisa@yatestech.comPlace of Work:Yates TechnologyAddress: 49251 Douglas Highway, Grand, MIParent Guardian Information (2)Parent/Guardian Name:Benjamin CarlisleRelationship to Child:FatherAddress: SameCity:State:(if different from child)Home #: (249)766.0980Cell #: (249)746.9251Work #: (249)909.9900Email (personal): ben 70@superemail.comEmail (work): b car@franklinandcarlisle.comPlace of Work:Franklin and CarlisleAddress: 217 Main St., Grand, MIAdditional Emergency Contact (1)Name:Mary CarlisleRelationship to Child:GrandmotherAddress: 456 Gordon St.City: GrandHome #: (249)229.3442Cell #: (249)765.5673Work #: NAEmail (personal): mary@samdog.netEmail (work):State: MIAdditional Emergency Contact (2)Name:Brenda McCormickRelationship to Child:AuntAddress: 256 Brock Creek Rd.City: VictoryState: COHome #: (722) 505.7201Cell #: (722).671.2377Work #: (722)556.2091Email (personal): aunt b@yahgoo.comEmail (work): b Mc@overoutfitters.comMedical InformationPractice: East Boulevard Family PracticeAddress: 470 East Boulevard, Suite 200Phone #: (249)730.4400November 2011Doctor’s Name: Margaret SevillaCity: GrandState: MIPage 6

This sample plan is for training purposes only and is based on a fictional child care facility and location. It is important to tailor all emergency plans to the specific hazards and needs of your site and community. Mom’s Maple Street Childcare Center: Emergency Action Plan

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