HOUSEHOLD DISASTER PREPAREDNESS SURVEY

Name   Home Phone

Address   Emergency Phone(s)

Out of Area Emergency Contact   Phone
Check here if you do not wish to participate in this program

HOUSEHOLD EMERGENCY RESOURCES   Check the appropriate boxes.

First aid supplies Fire extinguisher Evacuation Vehicle* Ham radio Walkie talkies Gas grill Gasoline in containers

Portable lights Generator Chain saw Pool Portable pump Wheel barrow Other useful equipment

Over 10' ladder Crowbar/pry tools Ax Bolt cutters Heavy duty jack Winch

All-terrain vehicle 4-wheel drive RV near home Motor cycle Bicycle Ropes or cables

* Large enough to carry prone patient

HOUSEHOLDERS SKILLS   Check the appropriate boxes if any residents have named training or skills.

Medical (nurse/doctor) Emergency medical certification First aid certification Second language Emergency Response Training CERT Red Cross EP Organization Help Computer assistance

Electrical wiring and circuits Carpentry Plumbing Fire suppression Search and rescue Hazardous materials Organizing assistance Printing/Xeroxing

Amateur Radio Architecture, engineering Mental health/counseling Child care DCS Law enforcement Other Hold meeting

HOUSEHOLD SPECIAL NEEDS   Check the appropriate boxes if any residents may need special assistance.

Oxygen Dementia Other special needs

Sight impaired Hearing impaired

Disabled Elderly disabled

EMERGENCY RESPONSE TEAMS   Please check the team on which you are willing to serve.

LOGISTICS TEAM     Check all homes     Assess damage     Identify trapped people     List missing people     Relay information to         Communications Team

COMMUNICATIONS TEAM     Communicate by radio         with emergency services     Communicate by radio with         out of area contacts     Contact adjacent areas     Monitor emergency radio stations

SPECIAL NEEDS TEAM     Set up first aid station if needed     Provide emergency medical care     Assist special needs people     Take care of children     Be responsible for elderly     Assist with non-English         speaking people

LETTER TO RESIDENTS

In the event of an emergency, members of your family may be injured, your home may be damaged, emergency response may be delayed, and assistance from your neighbors will be essential. In fact, the American Red Cross indicated that after the 1994 Northridge earthquake 90% of the rescues were made by neighbors, not by first responders. This is why our Fire Department, Sheriff's Dept., and the City have all endorsed using Neighborhood Watch as the nucleus of Emergency Preparedness (EP) coordination. In addition, both the California Office of Emergency Services and Secretary of Homeland Security, Tom Ridge, have urged us to set up our EP Programs not only as a part of the country's Homeland Security, but for natural disasters such as earthquakes and wild fires, for which we are also vulnerable.

Although neighbors always help each other during a disaster, people agreed after the 1989 Loma Prieta and the 1992 Humboldt and Landers/Big Bear earthquakes, that because most of the people were not acquainted with each other before the quakes, there was wasted time and effort as people attempted to get to know one another and at the same time figure out what to do next. After the 1994 Northridge earthquake, Neighborhood Watch organizations were commended for their ability to respond much more effectively as compared with unorganized blocks. Working as teams, they had assessed the situations before the first responders arrived, and knew quickly who needed what.

After studying other city's programs, as well as recommendations from the California Office of Emergency Services, it appears that the easiest and fastest way to set up our EP system is to pattern it after our existing Neighborhood Watch network, which has already proven itself to be effective. Here are the steps.

1.   FILL OUT THE ATTACHED HOUSEHOLD DISASTER PREPAREDNESS SURVEY   This form, which has been reviewed by both the Sheriff's Dept. and Fire Dept., inventories the skills, training and resources of each person in the block that may be needed by first responders during a disaster. It also identifies residents with special needs, or problems that should be dealt with during an emergency. Please fill out this form as soon as possible and give to your Block Captain. If you do not wish to participate, please indicate so in the blank provided. You will not be contacted further.

2.   SET UP A MEETING OF ALL RESIDENTS   Your Block Captain has been given a meeting Agenda to use for that meeting which covers everything from setting up a neighborhood assembly area, to organizing response teams so everyone knows who does what before an actual disaster. However, please remember that your Block Captain already has a job. And although he or she may facilitate the EP efforts, other neighborhood residents should be prepared to help. This will be an easy job if it is a shared team effort. If it isn't, it will never get off the ground. A team effort will result in better planning, training, and education, facilitating a faster response in a disaster.

ASSISTANCE   Please offer to hold the first meeting or to train others if you have a skill that would help in a disaster. In addition, we will need computer-friendly people at both the block and area level, who can help make out spread sheets showing skills and equipment resources, for use by first responders. We will need people who can assist Block Captains with Xeroxing, printing or delivery help in your block. We need dual language people who can help communicate with non-English speaking people at the block or area level, or through organizations. Participating in Emergency Preparedness is voluntary, just as is participating in Neighborhood Watch. Nobody is going to follow up with you or bother you if you don't wish to participate. However, before you decide you're too busy, too tired or disinterested, please make a realistic evaluation of its importance. The simple decision of whether or not to participate is the difference between being concerned about your family's safety or not. It is the difference between enhancing our community response to a disaster. It is the difference between assisting our Sheriff's Dept. and Fire Dept. in a disaster. If you're concerned, please participate. If you're not, you shouldn't. It will not happen unless you make it happen!