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<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> > <a href="/prep/" class="crumb_link">Public Health Preparedness Archive</a> > <a href="index.html" class="crumb_link">Disaster Alternate Care Facility Selection Tool</a> > <a href="dacfrep.htm" class="crumb_link">Disaster Alternate Care Facilities: Selection and Operation</a> > Appendix C (continued)</span></p>
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<td height="30px"><span class="title"><a name="h1" id="h1"></a>Disaster Alternate Care Facility Selection Tool </span></td>
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<tr>
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<td><div id="centerContent"><p><strong>Public Health Emergency Preparedness</strong></p> <div class="headnote">
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<p>This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.</p>
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<p>This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: <a href="https://info.ahrq.gov/">https://info.ahrq.gov</a>. Let us know the nature of the problem, the Web address of what you want, and your contact information. </p>
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<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
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<h2>Appendix C: Alternate Care Facility Questionnaire (continued)</h2>
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<p><strong>V. ACF Operations</strong></p>
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<p><strong>A. General</strong></p>
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<blockquote><p>1. In retrospect, would you have preferred your ACF to have been administered by a different agency?<br />
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___ Yes ___ No<br />
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1a. If yes, why?: _________________________________________________________________<br />
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______________________________________________________________________________<br />
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______________________________________________________________________________</p>
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<p>2. Was your ACF part of a shelter for otherwise healthy evacuees or was it purely a medical treatment facility?<br />
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____ Shelter care ____ Medical treatment facility</p>
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<p>3. Was your goal to serve as a place for hospitals to send their patients in order to "decompress" or were you a primary receiving facility?<br />
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____ Hospital decompression ____ Primary receiving facility</p>
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<p>4. How did you provide for the daycare needs of workers with young children? ____________________________<br />
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______________________________________________________________________________________<br />
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______________________________________________________________________________________<br />
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______________________________________________________________________________________</p>
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<p>5. Did you provide child care for children of patients when there were no family members available?<br />
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____ Yes ____ No</p>
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<p>6. Did you have any patients being cared for at the intensive care unit level?<br />
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____ Yes ____ No</p>
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<p>7. Do you think it is reasonable for an ACF to be expected to do so?<br />
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____ Yes ____ No</p>
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<p>8. If you provided inpatient care, did you have a formal rounds system?<br />
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____ Yes ____ No </p>
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<p>9. Did you place a limit on the number of visitors/family members?<br />
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____ Yes ____ No</p>
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<p>10. If you had an inpatient component, did you take for feed and shelter the family/visitors of patients?<br />
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____ Yes ____ No</p>
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<p>11. Did you integrate any outside State or Federal teams such as Disaster Medical Assistance Teams into your operations?<br />
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____ Yes ____ No</p>
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<p>12. Were there any lessons learned with regards to doing so?<br />
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___ Yes ___ No<br />
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12a. If yes, please elaborate: _______________________________________________________<br />
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______________________________________________________________________________</p>
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<p>13. Did you allow pets in your facility?<br />
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____ Yes ____ No</p>
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<p>14. Did you identify any issues with your facility that impaired operations (e.g. inability to control lighting, presence of noise, etc.)?<br />
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____ Yes ____ No<br />
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14a. If yes, please elaborate: __________________________________________________________<br />
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___________________________________________________________________________________<br />
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___________________________________________________________________________________<br />
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___________________________________________________________________________________</p>
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<p>15. Are there any other issues with regards to operations which you would like to share: __________________ <br />
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____________________________________________________________________________________<br />
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____________________________________________________________________________________<br />
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____________________________________________________________________________________</p>
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</blockquote>
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<p><strong>B. Patient Care </strong></p>
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<blockquote><p>1. Did patients self-present to your ACF?<br />
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____ Yes ____ No</p>
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<p>2. In your opinion, should ambulances bring patients directly to the ACF or should they go to the hospital (if available) first?<br />
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____ Directly to ACF ____ Hospital first</p>
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<p>3. Did you have mental health professionals at your facility?<br />
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____ Yes ____ No</p>
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<p>4. Did your definition of futility of care change during your operations?<br />
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___ Yes ___ No<br />
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4a. If so, what guidelines did you use? ________________________________________________________<br />
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______________________________________________________________________________________<br />
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______________________________________________________________________________________</p>
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<p>5. Which of the following did you have available to <u>provide care</u> for children?<br />
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____ Emergency nurses?<br />
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____ Emergency physicians?<br />
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____ Family physicians?<br />
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____ Pediatric emergency physicians?<br />
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____ Pediatric midlevel practitioners?<br />
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____ Pediatric nurses?<br />
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____ Pediatricians?<br />
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____ Other?<br />
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Please specify: ___________________________________________________________________</p>
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<p>6. Did you provide immunizations at your ACF?<br />
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____ Yes ____ No</p>
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<p>7. Did you conduct infectious disease surveillance at your ACF?<br />
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___ Yes ___ No<br />
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7a. If so, how? ___________________________________________________________________________<br />
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______________________________________________________________________________________<br />
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_______________________________________________________________________________________</p>
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<p>8. Did you have a system for transferring patients who were beyond the capabilities of your ACF to a hospital?<br />
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____ Yes ____ No</p>
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<p>9. Please indicate any of the following that were utilized in those hospitals to make room for patients transferred from the ACF:<br />
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____ Early discharge home<br />
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____ Transfer of hospital patients to the ACF<br />
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____ Transfer of ICU patients to the ward<br />
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____ Transfer of hospital patients to another hospital<br />
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9a. What criteria were used in selecting these patients, if known? _____________________________________<br />
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________________________________________________________________________________________<br />
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________________________________________________________________________________________</p>
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<p>10. Did your ACF specifically take care of populations with special medical needs?<br />
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___ Yes ___ No<br />
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10a. If yes, please indicate those populations:<br />
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____ Dialysis patients<br />
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____ Mental health patients<br />
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____ Ventilator patients<br />
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____ Other (please specify): ________________________________________________________________</p>
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<p>11. Are there any groups of patients who should have their own ACF set up in order to concentrate resources and/or expertise?<br />
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___ Yes ___ No<br />
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11a. If yes, please specify: ___________________________________________________________________<br />
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________________________________________________________________________________________<br />
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________________________________________________________________________________________</p>
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<p>12. Given your experience is it reasonable to expect an ACF to care for multiple ventilator-dependent patients?<br />
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____ Yes ____ No</p>
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<p>13. Are there any other issues with regards to special medical needs populations or patient care in general that you would like to share?
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__________________________________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________</p>
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</blockquote>
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<p><strong>C. Patient Tracking</strong></p>
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<blockquote><p> 1. How did you know which patients were currently at your facility? _______________________________________<br />
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________________________________________________________________________________________<br />
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_________________________________________________________________________________________</p>
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<p>2. How did you know where in the facility they were located? <u> </u>____________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________</p>
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<p>3. How did you track the disposition of patients (discharge or transfer)? ___________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________</p>
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<p>4. Had you developed a disaster patient tracking system prior to the event?<br />
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____ Yes ____ No</p>
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<p>5. How did you keep medical records? ____________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________</p>
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<p>6. Who became the custodian of those records after the event? <u> </u>__________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________</p>
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<p>7. Did you keep families together or were adult and pediatric patients separated? <br />
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____ Families kept together ____ Adult/peds separated</p>
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<p>8. Did you separate spouses in order to maintain separation of the sexes?<br />
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____ Yes ____ No</p>
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<p>9. In your opinion, is it better to keep families together throughout the care process?<br />
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___ Yes ___ No<br />
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9a. If yes, how do you maintain patient privacy? ____________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________</p>
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</blockquote>
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<p><strong>VI. ACF Finance</strong></p>
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<blockquote><p> 1. Did you have an active finance section?<br />
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____ Yes ____ No</p>
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<p>2. What percentage of the operating costs were born by each of the following? (total should equal 100%):<br />
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____<u>%</u> Volunteer<br />
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____<u>%</u> Charitable donations<br />
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____<u>%</u> Institution/Health care system<br />
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____<u>%</u> Private corporations<br />
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____<u>%</u> Local/Municipal/County<br />
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____<u>%</u> State<br />
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____<u>%</u> Federal<br />
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____<u>%</u> Other (please specify): ________________________________________________________________</p>
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<p>3. Did you submit an invoice to the Federal Government in order to be reimbursed for expenses which you accrued during the operation of your ACF?<br />
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___ Yes ___ No<br />
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3a. If so, have you received any reimbursement from them yet?<br />
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____ Yes ____ No</p>
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<p>4. Are there any "secrets" which you discovered to increase your chances of being reimbursed by the Federal Government: _________________________________________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________</p>
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<p>5. Did you have any issues of health care workers becoming ill or injured while working at the ACF?<br />
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____ Yes ____ No</p>
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<p>6. Were there any accompanying workmen's compensation issues that accompanied this?<br />
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___ Yes ___ No<br />
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6a. If so, what were they and how did you handle them? _______________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________</p>
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<p>7. Are there any other issues with regards to finance which you would like to share? __________________________ <br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________<br />
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_________________________________________________________________________________________</p>
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</blockquote>
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<blockquote>Any other comments that would benefit communities that would be setting up an Alternative Care Facility would be very much appreciated: _____________________________________________________________________________________<br />
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______________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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______________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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______________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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______________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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______________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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_____________________________________________________________________________________________<br />
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_____________________________________________________________________________________________</blockquote>
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<p class="size2"><a href="dacfrep.htm#contents">Return to Contents</a></p>
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<h3>Part 2: Comments on the Alternate Care Facility Selection Tool</h3>
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<p>In the table below, you will find the complete list of the various factors that were originally selected for inclusion in the Alternate Care Facility (ACF) Selection Tool. </p>
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<ul>
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<li>The <strong>first column</strong> lists the specific factors as found in the tool.</li>
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<li>The <strong>second column</strong> provides an explanation of the intent/definition for that factor.</li>
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<li>In the <strong>third column</strong> we are asking that you please rate the importance of that factor in making a decision regarding the selection of a site for one of two types of ACF, the first being for providing "clinic" type ambulatory medical care at a shelter housing displaced persons and the second being at an ACF providing in-patient level care (as well as ambulatory care), using the following rating system:</li>
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</ul>
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<blockquote><strong>3</strong> – this factor is an essential component for selecting a site for an ACF<br />
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<strong>2</strong> – this factor is of moderate importance for selecting a site for an ACF<br />
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<strong>1</strong> – this factor is of minor importance for selecting a site for an ACF<br />
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<strong>0</strong> – this factor is unnecessary for selection of a site for an ACF</blockquote>
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<table border="1" cellspacing="0" cellpadding="2" width="90%">
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<tr valign="top" align="left">
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<th scope="col">ACF Selection Tool Factor</th>
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<th scope="col">Explanation/Definition</th>
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<th scope="col" colspan="2">Rating<br />
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(please circle)</th>
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</tr>
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<tr valign="top">
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<td scope="row"><strong>Infrastructure</strong></td>
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<td> </td>
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<td width="15%"><strong>Shelter Care</strong></td>
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<td width="15%"><strong>ACF<br />
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In-Patient<br />
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and <br />
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Ambulatory<br />
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Care</strong></td>
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</tr>
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<tr valign="top">
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<td scope="row">Doors/corridors adequate size for gurneys</td>
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<td>This factor evaluates the width of the doorways to allow for passage of gurneys and stretchers.</td>
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<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td> </tr>
|
|
<tr valign="top">
|
|
<td scope="row">Floors</td>
|
|
<td>This factor evaluates the nature of the floor in the proposed site and whether or not it is acceptable for use for gurneys and stretchers.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Loading dock</td>
|
|
<td>This factor evaluates whether or not there is a loading dock available for use to deliver supplies, equipment and patients as well as pickup patients needing transfer away from the ACF.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Parking for staff and visitors</td>
|
|
<td>This factor evaluates whether or not there is adequate parking for staff personnel and visitors.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Roof</td>
|
|
<td>This factor evaluates whether or not there is a roof on the proposed ACF site and its’ integrity to protect the housed staff and patients.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Toilet facilities/showers (#)</td>
|
|
<td>This factor evaluates if there is adequate toilet and shower capability and capacity.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Ventilation</td>
|
|
<td>This factor evaluates if there is adequate ventilation in the proposed ACF site.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Walls</td>
|
|
<td>This factor evaluates if there are adequate side walls for the protection of staff and patients.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"><strong>Additional Infrastructure Factors:</strong></td>
|
|
<td> </td>
|
|
<td> </td>
|
|
<td> </td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"><strong>Total Space and Layout</strong></td>
|
|
<td> </td>
|
|
<td> </td>
|
|
<td> </td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Auxiliary spaces (Rx, counselors, chapel)</td>
|
|
<td>This factor evaluates if there is adequate space in the proposed site to permit designated area for patient treatment and procedures, counseling and chapel.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Equipment/supply storage area</td>
|
|
<td>This factor evaluates if there is adequate space in the proposed site for equipment/supply cache and storage.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Family area</td>
|
|
<td>This factor evaluates if there is adequate space for relatives/family/friends to gather.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Food supply and prep area </td>
|
|
<td>This factor evaluates if the proposed site has adequate food preparation capability and supply.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Lab specimen handling area</td>
|
|
<td>This factor evaluates if the proposed site has adequate space to provide a lab specimen handling area.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Mortuary holding area</td>
|
|
<td>This factor evaluates if the proposed site has an area that can be used as a mortuary holding area.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Patient decontamination areas</td>
|
|
<td>This factor evaluates if the proposed site has facilities that could be used for patient/victim decontamination.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Pharmacy area</td>
|
|
<td>This factor evaluates if there is adequate space that could be used as a pharmacy area.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Staff areas</td>
|
|
<td>This factor evaluates if there is adequate space that could be used for staff rest and rehab.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"><strong>Additional Space/Layout Factors:</strong></td>
|
|
<td> </td>
|
|
<td> </td>
|
|
<td> </td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"><strong>Utilities</strong></td>
|
|
<td> </td>
|
|
<td> </td>
|
|
<td> </td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Air conditioning</td>
|
|
<td>This factor evaluates if the proposed ACF site has air conditioning capability (if needed).</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Electrical power (backup?)</td>
|
|
<td>This factor evaluates if the proposed site has adequate electrical power as well as a backup electrical power source.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Heating</td>
|
|
<td>This factor evaluates if the proposed site has adequate heating capability (if needed).</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Lighting</td>
|
|
<td>This factor evaluates if the proposed site has adequate lighting to provide for patient care needs and treatment.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Refrigeration</td>
|
|
<td>This factor evaluates if there is adequate refrigeration capability, both for food as well as lab specimen storage.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Water (hot?)</td>
|
|
<td>This factor evaluates if there is adequate water supply (in general) as well as hot water.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"><strong>Additional Utility Factors:</strong></td>
|
|
<td> </td>
|
|
<td> </td>
|
|
<td> </td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"><strong>Communication</strong></td>
|
|
<td> </td>
|
|
<td> </td>
|
|
<td> </td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Communication(# phones, local/long distance, intercom)</td>
|
|
<td>This factor evaluates if there is adequate telephone communications capability (in terms of numbers of phones, phone lines, and both local and long distance) as well as internal site communication such as intercom capability.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Two-way radio capability to main hospital</td>
|
|
<td>This factor evaluates if the proposed site can accommodate radio communication from the site to receiving hospitals.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Wired for IT and internet access</td>
|
|
<td>This factor evaluates if the proposed site is wired for IT and internet access.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"><strong>Additional Communication Factors:</strong></td>
|
|
<td> </td>
|
|
<td> </td>
|
|
<td> </td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"><strong>Other Services</strong></td>
|
|
<td> </td>
|
|
<td> </td>
|
|
<td> </td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Ability to lock down facility</td>
|
|
<td>This factor evaluates the ability for the proposed ACF site to be secured and locked down (if necessary).</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Accessibility/proximity to public transportation</td>
|
|
<td>This factor evaluates the accessibility of and proximity to public transportation of the proposed ACF site.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Biohazard and other waste disposal</td>
|
|
<td>This factor evaluates the capacity of the proposed site for appropriate management of biohazard and other medical waste disposal.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Laundry</td>
|
|
<td>This factor evaluates the capacity and capability of the proposed site to launder dirty linens.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Ownership/other uses during disaster</td>
|
|
<td>This factor evaluates the ownership of the proposed facility, the ease with which the facility can be obtained for use as an ACF and whether or not the site is slated for other uses in the event of a mass casualty incident.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Oxygen delivery capability</td>
|
|
<td>This factor evaluates the capability of the proposed site to provide oxygen to patients.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Proximity to main hospital</td>
|
|
<td>This factor evaluates the proximity of the proposed site to referral hospitals.</td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"><strong>Additional "Other Services" Factors:</strong></td>
|
|
<td> </td>
|
|
<td> </td>
|
|
<td> </td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row"> </td>
|
|
<td> </td>
|
|
<td>3 2 1 0</td>
|
|
<td>3 2 1 0</td>
|
|
</tr>
|
|
</table>
|
|
|
|
<p class="size2"><a href="dacfrep.htm#contents">Return to Contents</a><br /><a href="dacfrepappd.htm">Proceed to Next Section</a></p>
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|
|
|
<p> </p>
|
|
|
|
<div class="footnote">
|
|
<p> The information on this page is archived and provided for reference purposes only.</p></div>
|
|
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|
|
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|
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|
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