Emergency Management Organization (EMO) Plan for East Cumberland Lodge. ABC s of Emergency Accept Nothing! Believe Nothing!

Transcription

1 Emergency Management Organization (EMO) Plan for East Cumberland Lodge A B C ABC s of Emergency Accept Nothing! Believe Nothing! Confirm Everything! ACTIVATION of the EMO Plan Based on the information available and the timelines involved, the following individual(s) will have the responsibility of activating and deactivating the EMO Plan to the appropriate level: (a) (b) Between , Monday to Friday the Administrator or designate. Between daily, on weekends and statutory holiday the RN Nursing Supervisor. 1 Revised Apr/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

2 RECORD OF EMO EXERCISES (other than monthly Fire Drills) SPECIFIC EXERCISE DATE OF EXCERISE DATE ENTERED ENTERED BY WHOM 3 year evacuation & October 6, 1998 December 21, 1998 D. Reid relocation Active expansion from January 3, 1999 January 3, 1999 D. Reid Highcrest Springhill (January 4-12, 1999) 3 year evacuation June 6, 2001 February 14, 2002 G. Boudreau 3 year exercise bomb June 2004 February 14, 2005 G. Boudreau threat Table Top Exercise April 17, 2007 January 24, 2008 G. Boudreau Mock Evacuation June 2010 March 2011 G. Boudreau Evacuation Donkin Court August 13, 2013 February 2013 G. Boudreau 2 Revised Apr/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

3 Table of Contents Distribution Route for COPIES of ECL EMO Plan Definitions, Acronyms & Emergency Codes Page(s) 6 7 EMO PLAN Purpose 8 Goal 8 Objectives 8 Emergency Color Codes 9 ORGANIZATION of EMO COMMITTEE Membership Composition Responsibilities 10 Exercising & Evaluating the Plan 11 Role of RN Supervisor in an Emergency 12 ECL Fan Out System (by NCMH) 13 ECL Staff Fan Out 14 Ongoing Communication 14 FAN OUT DUTIES BY ROLE Administrator s Duties 15 Director of Resident Care Off Duty RN Supervisor 16 Communication Form 17 All Director s, Maintenance, Recreation 18 Environmental Services, Accountant & Secretary 18 Director of Recreation 18 Family & Friends Sign In Sheet 19 Maintenance Personnel 20 Director of Environmental Services 20 Room Assignment Co-Ordinator Sign In Sheet 21 Accountant/Ex. Secretary 22 Triage Recorder 22 Triage Form 23 Relocation Site Parking & Reporting in Procedure EMERGENCY LEVEL: CODE RED Fire Plan 26 3 Revised Apr/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

4 EMERGENCY LEVEL: CODE GREEN Purpose Order to Evacuate Control Centre Communication Area Evacuation Priority of Evacuation Security Holding/Departure Area & Identification EMERGENCY LEVEL: RELOCATION Purpose Planning Response Co-Ordination of Activities Transportation Relocation Sites - Short Term Relocation Sites Long Term Communication Media Parking & Reporting in Procedures EMERGENCY LEVEL : CODE ORANGE Expansion Purpose Procedure Planning Response Basic Assumptions Co-Ordination of Activities Reception/Expansion Duties EMERGENCY LEVEL: ISOLATION Purpose 38 Planning Response 38 Communication 38 Media 339 Internal Resources EMERGENCY LEVEL: CODE BLACK (BOMB & ARSON THREAT) Person Receiving Threat by Telephone Action to be Taken Search Procedure Publicity Visitors All Clean Special Instructions Responsibilities Record of Bomb or Arson Threat 43 4 Revised Apr/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

5 EMERGENCY LEVEL: CODE YELLOW Missing Person Preamble 44 Procedure Appendix : Confirmation A Missing Resident Missing Person Profile Sheet 50 EMERGENCY LEVEL: CODE WHITE - Violent Person Preamble 51 Goal 51 Definitions PROCEDURE 53 EMERGENCY LEVEL: CODE GRAY - External Air Exclusion 54 Donkin Court HVAC System Shut-Down Directions 55 EMERGENCY LEVEL: CODE BROWN - Hazardous Substance Spill DoHW Emergency Level: Severe Weather Preparedness Checklist 58 Communication 59 Facility Preparations RECOVERY OPERATIONS RECOVERY PLAN Return to Normal Operations 61 Implementation 61 Support to Personnel 62 EMO CHECK LIST 63 EMERGENCY SUPPLIERS LISTING 64 ECL EXTERNAL RESOURCE LISTING 65 WATER USE DURING A BOIL WATER ADVISORY FLOOR PLANS FAN OUT FOR Sunset Adult Residential Facility FAN OUT FOR North Cumberland Memorial Hospital NCMH ANNAUL Sign-Off 74 ECL PREP LIST Inclement Winter Weather APPENDIX: NS Dirctor of Nursing Homes & Homes for the Aged APPENDIX: Copies of Expansion Acceptance Letters insert insert 5 Revised Apr/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

6 DISTRIBUTION ROUTE for copies of the EMO Plan: Administration Copy #1(a) & Resident Care Copy #2 #1(b) Dietary Copy #3 Environmental Copy #4 Recreation Copy #5 Maintenance Copy #6 Fire Department Pugwash Copy #7 Contact Number: 911 RCMP Pugwash Copy #8 Contact Number: 911 NS Department of Health Continuing Care Halifax Copy #9 Contact Number: hr contact opt 1 NS Department of Health Continuing Care Amherst Copy #10 Contact Number Margaret MacDonald / Patricia Harrington NS Department of Health Continuing Care Amherst Copy #11 Contact Number (Placement) 6 Revised Apr/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

7 DEFINITIONS, ACRONYMS & EMERGENCY CODES Major Emergency is a serious disruption of normal operations with little or no warning causing or threatening death or injury to the staff and/or residents in the home An emergency situation could necessitate the evacuation of the home, relocation of the residents, survival in isolation or reception of other people from outside the home. Control Centre Runner Triage Location ECL EMO Committee EMO Plan RCMP is a central location where the responsible facility authority and the operations team can evaluate the threat and control emergency operations. A person used to convey a message or package from one location to another location. An area where casualties are taken for treatment or assessed for treatment and then transported to a hospital or other facility for further medical help. East Cumberland Lodge Emergency Measures Organizational Committee Emergency Measures Plan of East Cumberland Lodge Royal Canadian Mounted Police 7 Revised Apr/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

8 EMO PLAN PURPOSE: The purpose of the EMO Plan is to prepare staff to be able to deal with an abnormal situation that requires immediate action beyond normal circumstances. The procedures outlined in this plan are established to assist staff to react quickly in order to limit damage to persons, property or the environment. It is not the intent of this plan to inhibit staff from using common sense and flexibility, but rather to assist staff by addressing abnormal situations that are most likely to occur in this type of particular facility. GOAL: To clearly and simply state the proposed route of action to be taken in the event of an emergency at the time whether it be: (a) An evacuation of the facility - partial or complete. (b) A relocation of residents to an alternate location. (c) A situation demanding isolation or survival operations when isolated from outside resources. (d) Receiving and housing persons from an external disaster or residents from another special care facility as part of in-take emergency preparedness. OBJECTIVES: To ensure that the safety and well being of the residents and staff are maintained at all times. To ensure that during an emergency, that the best possible measures are taken to prevent loss of life, injury, or prolonged discomfort. To familiarize the staff, residents, relatives, volunteers and external resources for the Home of the Home's role in the event of an emergency, and where key resources fit into the plan. To be as clear and specific as possible to avoid confusion, to educate and co-ordinate roles. 8 Revised April/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

9 EMERGENCY COLOR CODES TO KNOW Code Blue CARDIAC ARREST Will identify the need for cardiac arrest response. Code Red Code Green Precautionary Code Green STAT CODE ORANGE CODE YELLOW CODE WHITE CODE BLACK CODE BROWN CODE GRAY FIRE Will signify a fire or a fire alert situation within the building. Enact your fire procedure. EVACAUTION (Precautionary) Will indicate the need to evacuate able-bodied patients and visitors as a precautionary measure. EVACUATION (Crisis) Will indicate the need to immediately evacuate an area due to severe time limitations. EXTERNAL DISASTER Will indicate the activation of mass casualties reception. MISSING PATIENT / RESIDENT Will notify employees that a patient is missing. Report to RN Supervisor Station. VIOLENT PERSON Will notify employees of the location of a violent person. EXPLOSIVE DEVICE Will notify employee of an explosive device threat. HAZARDOUS SUBSTANCE SPILL Will notify employees of the location of a hazardous spill or release. EXTERNAL AIR EXCLUSION Will notify employees to eliminate all sources of external air into the facility. This code is used to prevent hazardous substances from entering the facility. Close all doors and hallways. CODE PINK PEDIATRIC CARDIAC ARREST *EMO Codes are in alignment with the local health authority codes 9 Revised April/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

10 ORGANIZATION of EMO COMMITTEE Membership Composition Administrator Departmental Directors 1 Maintenance Representative 2 Union Employee Representatives 1 RN Supervisor *Emergency Planning Coordinator who shall be designated from the above membership by the Administrator Responsibilities To develop a facility emergency program. In-service orientation of this plan and its subcomponents is the responsibility of the EMO Coordinator (or designate) with participation by all employees. To conduct periodic exercises ensuring that staff are aware and have practice with appropriate emergency response combined with a debriefing of the event and acceptance of participant feedback for consideration. All practices attended will be evaluated for knowledge and/or expertise by the EMO Committee. External evaluators may be invited by the EMO Committee Chair and/or Administrator as deemed appropriate. To establish and maintain regular liaison between the facility and other agencies involved in disaster planning in order to integrate disaster preparedness throughout the community. To review the plan annually or more frequently and revise as necessary. To issue the original EMO Plan and any subsequent updates to the EMO Plan as coordinated by the EMO Committee Chair and/or Administrator. 10 Revised April/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

11 Exercising and Evaluating the Plan Exercising and evaluating the plan is the responsibility of the emergency planning committee. The schedule for exercise the plan, or components thereof, shall be: TYPE OF EXERCISE Fire Drill with evacuation component included EMO Review of Fire Plan Fire Plan Training (Paper & In-Service) Fan out test Updating of fan out listing numbers Review of EMO and Fire Plan Enact part of EMO Evacuation & Relocation FREQUENCY Monthly Annually Annually Annually Quarterly Annually or as needed Annually Every 3 years 11 Revised April/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

12 The overall role of the RN SUPERVISOR in an emergency 1. Identify type of emergency. Implement appropriate plan(s) (a) Fire (b) Isolation (c) Expansion (d) Evacuation/Relocation. 2. There must be ongoing communication and co-ordination with the Administrator /Designate throughout the emergency. 3. During regular working hours the RN Supervisor will initiate the initial evacuation response. The Administrator (or designate) will then assume responsibility for implementation of the Emergency Plan. 4. (a) If needed, decide the priority in which residents will be evacuated. (b) (c) (d) (e) (f) (g) (h) If needed, implement Telephone Fan out. If evacuation or relocation - remove from RN Office the RN Triage Back Packs, Med Book and extra walkie talkies. If needed, designate LPN to be in charge at Triage Centre. If directed by Administrator meet Fire Department at Main Entrance and provide Fire Chief with information on emergency such as its location and location of residents that may require assistance to evacuate. Go to Control Centre as soon as it is set up and remain in charge until Administrator or Designate arrives. Brief Administrator. Designate someone to identify casualties at "Triage Site" and record who ambulances take to hospital and report same to Control Center. Package to be filled out is in Back Pack marked Triage Recorder. Attach cards to residents as needed noting specific medical condition, medication allergies. 5. The RN to check triage back monthly after fire drills. 12 Revised April/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

13 The FAN OUT SYSTEM FAN OUT SYSTEM done by North Cumberland Memorial Hospital The person activating the EMO plan (RN, Administrator or designate) will initiate the fan out procedure dependent upon the severity of the situation. All Department Heads and employees reached from fan out will report to the Control Center. Staff are requested to have backup for child care should they be recalled. Fan out procedure is as follows: 1. RN Supervisor on duty first calls Emergency 911 requesting identifying emergency situation type and gives your civic address as This is East Cumberland Lodge at #262 Gulf Shore Road, Pugwash, requesting RN Supervisor on duty then calls North Cumberland Memorial Hospital ( ) requesting that NCMH begin the following staff call-in procedure. NCMH Staff Directions: In the event of a fire, natural disaster or similar emergency at East Cumberland Lodge, when NCMH is contacted by ECL - the following persons are to be called in the order listed. Contact at least three staff, starting at the top of the list. POSITION INCUMBENT TELEPHONE ADDRESS Administrator Joe Gauthier Pugwash Director of Resident Eleanor Scovil, RN Amherst Care Director of Gayle Boudreau Wallace Maintenance / Food Service (EMO Coordinator) Director of Keith Rogers Amherst Environmental Services cell Director of Recreation Janice Varner Heather s Beach cell Accountant Patti Porter Pugwash Executive Secretary Cheryl Newcombe Malagash Maintenance Jim Dickson Pugwash cell Roger Williams Wentworth Bill Luddington Pugwash If requested please call R.C.M.P. at Revised April/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

14 ECL Staff once contacted by NCMH or the RN Supervisor RN Supervisor calls 911 NCMH to initiate Call out North Cumberland Memorial Hospital (NCMH) Administrator calls Director of Resident Care calls Director of Maintenance / Dietary calls Accountant calls Contacts at least 3 of the people on the aforementioned list Directors of Resident Care, and Maintenance/Dietary Director of Accountant and Director of Environmental Services Director of Recreation & at least one Maintenance staff person Executive Secretary Maintenance staff calls Whoever is contacted calls other maintenance staff personnel *IF PERSON TO BE CALLED IS NOT AT HOME Leave a message and proceed down the list FAN OUT TO ALL STAFF PERSONNEL: this decision will be made by the Administrator or person in charge. The full staff call-in listing is located in the front of this binder (inside cover). ONGOING COMMUNICATION 1. Communication will be directed by the Administrator/designate. Call-Out EMO Phone in Administrators Office Cell Phones are available in the Business Office. The RN (or designate) is to obtain the CODE YELLOW Emergency Bin from the Business Office and bring to the Control Centre location. Cell # Cell # ECL Business Cell # o NS Dept of Health & Wellness Health Services Emergency Management o option 1 or HSEM@gov.ns.ca Runners may also be used to convey communications. 3. Communication to media, families, and public will be through assigned people. 14 Revised April/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

15 FAN OUT DUTIES BY ROLE ADMINISTRATOR'S DUTIES 1. Once contacted activate administrator's portion of fan out. 2. Proceed immediately to on site Control Center and be briefed. 3. On completion of briefing, take over control of East Cumberland Lodge's interests, and direct RN Supervisor to other duties. 4. Establish a communication link with short term relocation site (PDHS or Cyrus Eaton) to onsite Control Center. 5. Decide what information can and will be given to media and families and convey same to relocation site. 6. Keep a constant, 30 minute, or as the need arise, communication link with Director of Resident Care at relocation site. 7. Provide overall co-ordination and decision making regarding staffing and operational issues. 8. Inform and update the Board of Directors on situation. 9. Provide periodic briefings to key personnel. 10. Prepare re-entry plan and implement recovery operation. 11. Follows Critical Incident Report Policy of NS Dept. Of Health & Wellness and files report and relevant updates. DIRECTOR OF RESIDENT CARE 1. Once contacted activate Director of Resident Care Portion of Fan out. 2. Proceed immediately to on site Control Center and be briefed. 3. On completion of briefing, if you arrive prior to Administrator - take over control of East Cumberland Lodge's interests until Administrator arrives. 4. Upon briefing of Administrator then proceed to relocation site to be the person in charge. Wearing an orange vest so as all staff know who is in charge (orange vest is kept in the RN kit bag). 15 Revised April/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

16 5. In co-ordination with the Sign In Center, assess staff assignments and staff needs. 6. The Director of Resident care will be responsible to see the following is completed: (a) (b) (c) (d) (e) (f) Continuously assess the best possible staff assignment. The RN Supervisor upon arrival to assist on floor with resident needs. Residents are segregated into units. Attempt to keep unauthorized persons from residents unless identified as emergency personnel. Maintain a consistent link with main or Control Center for update and further instructions and information. Other duties as may be assigned by Administrator. 7. Designate RN Supervisor/or Designate to assess medical and medication needs. OFF DUTY RN SUPERVISOR 1. Once contacted, proceed immediately to Relocation Site. Sign in for duty to be performed. 2. If filling duties of registered nurse check each resident as to the status of their health and monitor residents on an ongoing basis and keep Director of Resident Care or designate informed. 3. In the event that a resident or residents needs more medical care than can be provided, the Director of Resident Care or designate should be notified immediately. 4. Consult with hospital regarding - injury, resident profiles, pre existing condition as required. 5. Other duties may be assigned by Administrator 16 Revised April/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

17 COMMUNICATION FORM TIME COMMUNICATION FROM WHO DIRECTED TO 17 Revised April/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

18 DIRECTORS OF DIETARY, MAINTENANCE, RECREATION, ENVIRONMENTAL SERVICES PLUS ACCOUNTANT AND SECRETARY 1. Once contacted activate respective portion of fan out. 2. Proceed immediately to Relocation Site and upon arrival proceed to Sign In Center where you will be assigned to whatever position has not been filled in order of priority. When another staff is assigned to that position you can proceed with your pre-defined duties. Director of Dietary / Maintenance Director of Recreation Director of Environmental Services Accountant & Secretary Maintenance Personnel Emergency Planning Coordinator Person in charge of families & volunteers Room / Space Assignment Coordinator Persons in charge of Media & public inquiries As assigned 3. Other duties as may be assigned by Administrator. DUTIES - DIRECTOR OF RECREATION (Person in Charge of Families & Volunteers) 1. Ask that families remain in designated room and provide as much information as is available. 2. Tell families that we are in contact with the Control Center on a regular basis and as information becomes available they will be informed. 3. Direct their specific questions to the Administrator. 4. Make families as comfortable as possible. 5. Consult with person in charge to obtain approval to unite residents and families. 6. Provide a room away from main resident area for uniting. 7. Fill out family and friends sign in sheet. 18 Revised April/2016 Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

19 FAMILY AND FRIENDS SIGN IN SHEET Completed by Director of Recreation NAME PERSON SEEING PHONE # TIME 19 Revised Oct 2014 / Jun 2013/ Feb 2013/ Jan 2012 / Mar 2011 / Jan 2010 / Jan 2009 / Jan 2008 / Feb 2007 / Mar 2006 / Sep 2004 / Feb 2005 / Jan 2003 / Feb 2002 / Jan 2001 / Jan 2000 / Jan 1999 / Jan 1998 / Nov 1997

20 MAINTENANCE PERSONNEL 1. Once contacted activate maintenance portion of fan out. 2. Proceed immediately to onsite Control Centre and be briefed. 3. Assist with removal of residents. 4. Proceed to Fire Chief and be of service in case of Fire Department wanting to know location of power, oxygen, shut offs, etc. 5. Once disaster is under control and building is vacant, measures must be taken in consultation with the Administrator to secure the building from intruders and further damage. 6. Assist with co-ordination of re-entry plan and implementing recovery operation. DUTIES - DIRECTOR OF ENVIRONMENTAL SERVICES ROOM & SPACE ASSIGNMENT CO-ORDINATOR 1. Have two rooms available but yet quite a piece apart. One room for families and relatives and the other room closest to the main entrance should be for media personnel. 2. Direct families and relatives to Family Room and direct media to Media Room and tell them someone will be there to assist them. 3. Others who come will be directed after revealing the nature of their business such as police, doctors, community services, staff from the host site, etc. 4. People who are just curious will not be permitted in the building and must be directed to leave. 5. Complete Sign In Sheet on all people being allowed to enter relocation site so a record may be obtained. 20

21 DUTIES OF ROOM ASSIGNMENT CO-ORDINATOR SIGN IN SHEET Prepared by - Director of Environmental Services NAME TITLE PURPOSE TIME PHONE# 21

22 ACCOUNTANT / EXECUTIVE SECRETARY MEDIA 1. Media will have access to the relocation site under direction of the Administrator or designate through the R.C.M.P. 2. Media will be accompanied to a designated media room at the relocation site by Media Co-Ordinator. News releases will be provided on a regular basis by the Administrator/Designate and the Media Co-Ordinator. 3. Media must complete sign in form with Media Co-Ordinator so we have a record of attendance. TRIAGE RECORDER (preferably an RN or LPN) 1. Proceed immediately to area where casualties are being held pending medical attention or transportation to hospital. 2. Identify casualties for medical staff and provide some background information on casualty such as (1) does he or she talk normally, are they normally ambulatory or non ambulatory. This information will greatly help medical staff assess other needs. 3. Fill in form provided and relay this information to Administrator or designate at Control Centre. 4. It is very important that ECL know where casualty is being taken to so as we can provide hospital with a medical profile and direct family member as appropriate. 22

23 Triage form Name of Triage Recorder: Resident / staff Name Injury Taken to Where Time 23

24 RELOCATION SITE JOB ASSIGNMENTS IN PRIORITY ORDER JOBS TIME IN PERSON TIME CHANGE PERSON OTHER TIME OUT PERSON IN CHARGE SIGN IN CENTER NURSE ON FLOOR ROOMS CO- ORDINATOR MEDIA PERSON DIETARY & ENVIRONMENTAL GENERAL HELP 24

25 PARKING AND REPORTING IN PROCEDURES 1. Upon staff being called in through fan-out procedure, staff will report to the identified relocation site. If relocation site not identified, then staff are to report to ECL and await direction from the RN Supervisor. 2. Staff must then report to sign in Centre as instructed. 3. Families or friends may enter through the same door as staff of which will be posted a sign to this effect. Signage is available in the Code Yellow bin. 4. Media and others will park as instructed by officials. 5. In an internal disaster, there may be no parking on East Cumberland Lodge grounds depending on the extent of the emergency. Parking will be at the Pugwash High School or Cyrus Eaton Elementary School or other assigned area. 25

26 EMERGENCY LEVEL: CODE RED FIRE ***Follow the ECL Fire Plan**** 26

27 EMERGENCY LEVEL: CODE GREEN - EVACUATION EVACUATION 1. PURPOSE To remove persons from a place of danger to a place of safety and could involve either a partial or complete evacuation. 2. ORDER TO EVACUATE Responsibility of Administrator/Designate or Director of Resident Care. 3. CONTROL CENTRE All operations and activities will be co-ordinated by the control centre. The person in charge and the location follows: (a) Person in charge is Administrator/Designate or DoRC or RN Supervisor. (b) Primary location is the Main Office (c) Alternate location is the Pugwash District High School - if unable to reach the contact persons for the High School then proceed to Cyrus Eaton Elementary School 4. COMMUNICATION 1. Communication will be directed by the Administrator/designate. Call-Out EMO Phone in Administrators Office Cell Phones are available in the Business Office CODE YELLOW Emergency Bin. Cell # Cell # ECL Business Cell # NS Dept of Health & Wellness Health Services Emergency Management option 1 or HSEM@gov.ns.ca Runners may also be used to convey communications. 3. Communication to media, families, and public will be through assigned people. 27

28 5. AREA EVACUATION During a partial evacuation when only one unit or smaller area is affected, transfer residents horizontally from one unit to another, preferably separated by a fire door. If an entire floor has to be evacuated move downward one floor if possible. Refer to Fire Plan at front for unit by unit instruction on moving to another unit. 6. PRIORITY OF EVACUATION (a) (b) (c) (d) Residents in the danger area. Ambulatory residents. Wheelchair residents. Non-ambulatory residents. 7. SECURITY Security will be provided by the R.C.M.P., who will act as traffic controllers on East Cumberland Lodge property and Pugwash District High School or the Cyrus Eaton Elementary School. Designated entrances will be monitored and only authorized personnel will be admitted. 8. HOLDING/DEPARTURE AREAS AND IDENTIFICATION Residents designated for off-site relocation will be evacuated to the holding/departure and identification area which will be the unit's safe area. The RN/designate will immediately commence the fan out process and proceed with the RN's duties in an emergency. The Administrator/Designate or D.O.R.C. or RN Supervisor will have total authority until the Fire Chief arrives. At that time the Fire Chief will assume responsibility for Management of the disaster in and around the building. (a) (b) (c) 28 All staff will see that residents are evacuated and temporarily congregated in the holding area on lawn above top parking lot in front of East Cumberland Lodge or during inclement weather, in the Main Dining Room at East Cumberland Lodge where role call will be taken. The staff on each unit will be responsible for tagging resident with self adhesive name tags at holding areas. Larger self adhesive tags are available to mark an specific medical condition on a resident, such as blind, deaf, diabetic, etc. The RN on duty will designate staff members to stay with residents in holding area until assistance is available from East Cumberland lodge staff.

29 (d) (e) Transportation will be provided by school buses and Sunset A.R.C. vans, The Cyrus Eaton Elementary School key is kept in the RN Room in the Narcotic Cupboard Delbert Green Assigned destination: 1. Pugwash High School or 2. Cyrus Eaton Elementary School (f) (g) Normal clothing should be worn by each resident. Put a blanket around each resident if possible. Emergency supplies to be taken include: - incontinent systems (Pandemic Storage Room) * 3 cases large briefs, 3 cases medium briefs (this is a 48 supply, allowing 4 systems per resident per day) * 1 case wipes * 20 bottles isajel * isagel, disposable vinyl gloves - food, paper plates, etc. *** These supplies shall be checked annually. ADMINISTRATOR'S DUTIES - EVACUATION/RELOCATION DUTIES 1. Operate from alternate Control Center. 2. Ensure relocation facilities and suppliers are being notified. 3. Co-ordinate media releases. 4. Evaluate status of resident transfer. 5. Problem solve as indicated. 6. Request reports from key personnel. 7. Provide periodic briefings to key personnel. 29

30 EMERGENCY LEVEL: RELOCATION 1. PURPOSE To move resident to alternate accommodations when access to their normal living quarters is either restricted or prohibited. 2. PLANNING RESPONSE a) All internal operations will be co-ordinated through the control centre. b) All senior managers or the person in charge will man the centre. c) Areas to co-ordinate include: o scheduling of staff breaks - number required. o meal planning/rationing, water rationing. o resources needed (ie. blankets) o revision of routines (ie. limit baths) o plan diversionary activities for residents. o schedule external calling, ensuring one line is open. o assess the degree of all departments responsibilities (ie. housekeeping). o maintain a record of decisions and events. o do a debriefing and evaluation after the emergency is over. 3. CO-ORDINATION OF ACTIVITIES Same authority and co-ordination as for all evacuations. 4. TRANSPORTATION: - Sunset's Vans, Pugwash * Julie Matheson, Administrator E.C.L. Staff Cars 30

31 5. RELOCATION SITES (a) Short Term (12 Hours or less) Contact #1 Dennis Lawless Contact #2 Pugwash District High School 2016 Shawn Brunt, Principal Contact #3 RCMP Contact #4 George Kinnear Property Services Cyrus Eaton Elementary Contact #1 School Ron Betts 2016 Contact #2 Steve Wells Contact #3 Wallace Consolidated Elementary School 2016 Dan Spence Contact #1 Steve Wells Contact #3 Glen Stevens cell work home work / cell home cell work work work work home cell work North Cumberland Memorial Hospital 2016 Oxford E.M.O., Oxford LONGER TERM Sunset Adult Residential Centre 2016 Cedarstone Enhanced Care Vimy Court, Debert Court 2016 Wynn Park Villa 2016 Centennial Villa Amherst 2016 Carrie Dewar ext (cell) Julie Matheson ext (cell) Kim MacDonald (W); (cell) (home) Eric Gray (W) (cell) Sheila Peck Susan Collins (W) (cell) Assessed at time of event. depends on vacancies 3 resident long term for 7-10 days 10 residents short term 5 long term 31

32 Elk Court Shannex 2016 HighCrest- Springhill 2016 Gables Lodge 2016 Willow Lodge - Tatamagouche 2016 The Mira - Truro Maritime Odd Fellows Home Pictou, NS South Cumberland Community Care Northumberland Hall Bayview Memorial Health Center - Advocate Cindy MacLean (W) (cell) Stephanie Watton (cell) Erik Gray (cell) Liz Embree (W) (cell) Tabathia Rushton (W); (cell) Kathy Maltby ext 113(W) (cell) Doara Jean Crowe ext 115(W) (cell) John Sellers (W) (H) Betty Matheson (W) (H) Lynn Smith (W) (H) Pat Falconer Mike Archibald (W) (cell) Rhonda Richards Ext. 22 or Ext (cell) Ron MacCormick Anne Trottier Kim MacDonald (W) (H) (C) Eric Gray Ron MacCormick (W) 6 residents short term 3 long term Depends on vacancy at time 3 residents short term 1 long term Depends on vacancy as time. 5 residents short term 3 long term 5 residents short term 0-12 hours 2 residents for hrs 9 residents short term 3 long term 4 residents short term (2 days) 0 long term Accommodations assessed At time of event. 2 residents short term 0 long term 32

33 (H) Shelly Fulton (w) (H) 6. COMMUNICATION 7. MEDIA 1. Communication will be directed by the Administrator/designate. Call-Out EMO Phone in Administrators Office Cell Phones are available in the Business Office CODE YELLOW Emergency Bin. Cell # Cell # ECL Business Cell # NS Dept of Health & Wellness Health Services Emergency Management option 1 or HSEM@gov.ns.ca Runners may also be used to convey communications. 3. Communication to media, families, and public will be through assigned people. 1. Media will have access to the relocation site under direction of the Administrator/Designate through the R.C.M.P. 2. Media will be accompanied to a designated media room at Pugwash High School by Media Co-Ordinator. News releases will be provided on a regular basis by the Administrator/Designate and the Media Co-Ordinator. 3. Media must complete sign in form with Media Co-Ordinator so we have a record of attendance. 8. PARKING AND REPORTING IN PROCEDURES 1. Unless otherwise directed to report to East Cumberland Lodge upon staff call-in by fan out, they will go directly to Pugwash High School and park to the right as they enter the school yard. 2. Staff must then report to sign in Centre as instructed. 3. Families or friends may enter through the same door as staff of which will be posted a sign to this effect. 33

34 4. Media and other will park as instructed. 5. In an internal disaster, there may be no parking on East Cumberland Lodge grounds depending on the extent of the emergency. Parking will be at the Pugwash High School or Cyrus Eaton Elementary School or other assigned area. ADMINISTRATOR'S DUTIES - RELOCATION DUTIES 1. Operate from alternate Control Center. 2. Ensure relocation facilities and suppliers are being notified. 3. Co-ordinate media releases. 4. Evaluate status of resident transfer. 5. Problem solve as indicated. 6. Request reports from key personnel. 7. Provide periodic briefings to key personnel. 34

35 EMERGENCY LEVEL: CODE ORANGE - EXPANSION 1. PURPOSE The provision of shelter, food, and medical care to evacuees from other residential facilities or the community. 2. PROCEDURE: (on weekends, holidays, or after regular business hours) After receiving a call from a facility with an emergency situation, the following calls are to be made: - RN Supervisor calls Administrator and Director of Resident Care - Administrator calls Director of Environmental Services, Director of Food Services/Maint. and Secretary - Director of Resident Care calls Director of Recreation, and Accountant Adherence to the NS Homes for Special Care regulations is required unless a documented exception is provided by the Province. Examples of requirements include the following ( ): 45 (1) No single bedroom in a nursing home, a home for the aged, or a home for the disabled shall have a floor area of less than one hundred and twenty square feet. Sixty square feet shall be added for each resident in excess of one who is accommodated in a bedroom. (3) Notwithstanding subsections (1) and (2), no bedroom in a home for special care shall accommodate more than four residents. (5) A basement room where the floor is more than three feet below ground level shall not be used as a bedroom for a resident of a home for special care. 47 Every home for special care shall have at least one toilet and basin for each six residents and at least one bath for each ten residents. Permission for a temporary license shall be applied for from the Province for the additional long-term temporary beds. 3. PLANNING RESPONSE 1. All internal operations will be co-ordinated through the control centre. 2. All senior managers or the person in charge will man the centre. 3. Areas to co-ordinate include: - scheduling of staff breaks - number required. - meal planning/rationing, water rationing. - resources needed (ie. blankets) - revision of routines (ie. limit baths) 35

36 - plan diversionary activities for residents. - schedule external calling, ensuring one line is open. - assess the degree of all departments responsibilities (ie. housekeeping). - maintain a record of decisions and events. - do a debriefing and evaluation after the emergency is over. 4. BASIC ASSUMPTIONS Space planning for Emergency In-take Internal ECL Space Short Term (24-48 hours) Long term (7 10 days) Intake is based on an either short term or long term (not a combination all at once) Donkin Court Rec Room 6 residents Mundle Dining Room Fullerton Sun Room / respite 2 residents 2 residents and/or respite Phantom Room 1 resident 1 resident Total 9 residents 3 residents In the event of an emergency, if East Cumberland Lodge has to expand to accommodate guests or other nursing homes the following is available: EXTRA: - 6 frames in ECL lower level cage room, mattresses in cage room. - 4 rolling cots including mattresses - Palliative Care Room - linen kept in laundry -1 vacant bed is available on Main Floor of ECL in Resident Room Donkin Recreation Room can accommodate up to 6 resident; 1 in sun lounge; 1 in phantom bed. In the event of an emergency at E.C.L., our staff will be expected to assist guests in whatever way possible. 5. CO-ORDINATION OF ACTIVITIES The co-ordination of all activities to receive and house persons at the facility will be the responsibility of Administrator/Designate or RN 36

37 ADMINISTRATOR - RECEPTION/EXPANSION DUTIES 1. Ascertain the # and status of persons to be housed. 2. Brief key personnel. 3. Brief residents. 4. Co-ordinate operations. 5. Implement recovery operations. 37

38 EMERGENCY LEVEL: ISOLATION 1. PURPOSE A survival plan is required to enable the institution to survive on it's own resources. Isolation could be the result of a snow storm, strike, power failure, etc. The basis of our plan shall be to maintain the resources to provide food, shelter and medical care to the facilities total resident population and all attending staff for a period of 5 days of isolation from the community. 2. PLANNING RESPONSE 1. All internal operations will be co-ordinated through the control centre. 2. All senior managers or the person in charge will man the centre. 3. Areas to co-ordinate include: - scheduling of staff breaks - number required. - meal planning/rationing, water rationing. - resources needed (ie. blankets) - revision of routines (ie. limit baths) - plan diversionary activities for residents. - schedule external calling, ensuring one line is open. - assess the degree of all departments responsibilities (ie. housekeeping). - maintain a record of decisions and events. - do a debriefing and evaluation after the emergency is over. 3. COMMUNICATION 4. MEDIA 1. Communication will be directed by the Administrator/designate. Call-Out EMO Phone in Administrators Office Cell Phones are available in the Business Office CODE YELLOW Emergency Bin. Cell # Cell # o ECL Business Cell # o NS Dept of Health & Wellness Health Services Emergency Management option 1 or HSEM@gov.ns.ca Runners may also be used to convey communications. 3. Communication to media, families, and public will be through assigned people. 38

39 1. Media will have access to the relocation site under direction of the Administrator/Designate through the R.C.M.P. 2. Media must complete sign in form with Media Co-Ordinator so we have a record of attendance. 5. INTERNAL RESOURCES 1. FOOD A set of keys for fridges and dietary supplies are kept in the pantry. Food supplies for approximately two weeks are available, and emergency menus are in the back of this book; 2. LIGHTS There are flashlights and extra batteries in the RN Room. 2 small + 2 large flashlights in the RN Room 1 large flashlight in the RN's backpack Extra flashlights in Business Office - Code Yellow Bin 3. WATER In the event of contamination or loss of water supply, Pugwash Village Fire Department can supply water. Water can be purified by the following method - 10 drops chlorine bleach per one gallon of water or boiling for 10 minutes. Other water sources include: - O'Briens Pharmacy (E.C.L. Pick-up) - Pugwash Home Hardware (1 hour notice) - Canadian Salt (E.C.L. pick-up) 4. DRUG AND MEDICAL SUPPLIES Approximately two weeks supply on hand at all times at E.C.L. or may be provided by - O'Brien's Pharmacy, Pugwash Jonathan Kennedy Marc Blaikie and/or Fullerton Pharmacy, Tatamagouche POWER - GENERATOR Voltage, 60 HZ, 1800 rpm, 600 volt Diesel fuel, 1,000 gallon tank Uses 137 litre per hour hours/per full tank of fuel. 39

40 Superline Fuels: or (Stephen Russell) 6. BLANKETS Extra blankets are kept in the laundry. 7. LINEN A minimum amount of linen and clothes may have to be hand washed. Incontinent system is stored in Pandemic Supply Room. 8. COMMUNICATION EMERGENCY PHONE - in RN Office (ECL main # Only plug in when needed.) NOTE: Emergency Call-Out Phone in the Administrator s Office, for Outgoing calls only # ADMINISTRATOR - ISOLATION DUTIES 1. Assess situation i.e. probable time in isolation, communication, potential problems. 2. Set up in-house control center. 3. Ensure staffing schedules are set up. 4. Ensure rationing of supplies occurs. 5. Problem solve as indicated. 6. Provide periodic briefings to key personnel. 7. Implement recovery operations. 40

41 EMERGENCY LEVEL: CODE BLACK - BOMB & ARSON THREAT The Person Receiving Threat by Telephone: Ensure that, even if the caller threatens to hang up the telephone that you DO NOT hang up the telephone receiving the call. This ensures that the police and telephone department may trace the call. Note the time of the call, the exact wording of the message, peculiarities of the caller s speech and listen and note any background messages. If possible have someone immediately notify the RN on duty to call 911 on another line. Explain that you have a bomb threat and that you are holding the telephone line open so that the call may be traced and that they should inform the telephone department to do so. Also notify the Fire Department and Ambulance requesting they stand-by. Keep the caller on the line as long as possible and try to ask the following questions: Location of the bomb Type of bomb Time it is set to go off Type of container or package bomb is in Why the person is doing it Repeat the above and try to keep him on the line Do not hang up under any circumstances. Notify the following individuals: The RN Supervisor on duty and Emergency call-in list. Alert staff by calling Code Black at least three times. Action to be taken: Staff upon hearing Code Black should immediately report to the RN station. Any suspicious events of which they are aware (eg unfamiliar person in or around the building, unexplained objects in the area, etc., should be reported to the person in charge at the RN station). Residents are to be evacuated out of the building to a safe place identified by the person in charge (e.g. elementary school or as directed by the RCMP). Suspicious objects, when discovered, are to be left completely alone and left isolated. Residents are to be removed from the immediate area and notify the person in charge that a suspicious object has been found. Areas on the other floors immediately above or below the suspect object should be warned and residents should be moved from these areas as well. Search Procedure: 41

42 If a suspected bomb is found, it is not to be touched or tampered with. The area around the bomb should be isolated and all residents evacuated. RCMP will determine how the bomb is to be disposed. Publicity: No publicity is to be given to bomb or arson threat. News media will be asked to co-operate in not reporting this type of event. Visitors: All visitors will be asked to leave the premises and entry prohibited to anyone other than the recognized authorities and emergency personnel. All Clear: All clear will be given by announcing CODE BLACK IS CANCELLED three times. If an explosion were to occur: Adhere to the Evacation / Relocation section of the EMO Plan. If a fire were to occur: adhere to the Fire Plan section of the EMO Plan. Special Instructions: If a threat is received outside of the facility or by mail, then the person receiving this information should notify the Administrator or designate. Responsibilities: Administrator Coordinate with staff available and outside agencies what the course of action is to be taken during the threat. Set up the Communication Centre and be prepared to initiate Evacuation / Relocation plan. Notify insurer ASAP or within 24 hours Staff On Duty Report to the Command Centre Follow the directions of the Person in Command with the evacuation / relocation of the residents. Calm residents fears as much as possible. Staff Off Duty All department heads and Maintenance staff on call will be requested to report and assist with the emergency identified. RCMP On arrival Will assume charge of search, traffic control, and investigation. Fire Dept On arrival Will report to the Command Centre for further instruction and/or assume control in the event of a fire and assist with evacuation. Ambulance To assist in the event of evacuation 42

43 RECORD OF BOMB OR ARSON THREAT *** STAY CALM BE FRIENDLY DON T HANG UP **** Time of Call: Duration of call: Exact wording of threat: Minutes Where is bomb located: Does caller appear knowledgeable by his description of the location: What time will it occur: What type of bomb is it: What does it look like: Yes Maybe No (eg dynamic, plastic, timer.) Why is caller doing this: Is there anything we can do to No Yes stop this action: Where is the person calling from: Caller s name: Is the voice familiar: How who? Characteristics of caller: Gender: Male Female Uncertain Estimated age: Accent of language: Voice (loud, soft, etc) Diction (good, nasal, lisp, etc) Manner (calm, emotional, vulgar, etc) Background noises of caller: Additional Information / Comments: Date: Signature: 43

44 EMERGENCY LEVEL: CODE YELLOW MISSING RESIDENT PREAMBLE Every effort shall be made to ensure the safety and security of each resident. This procedure seeks to provide the actions to be taken regarding an unauthorized absence of a resident from East Cumberland Lodge. Doors are equipped with magnetic devices and individualized care plans reflect the resident s status regarding mental and physical condition, wandering behavior and measures taken to prevent unauthorized absences. A watch-mate system is available for residents at risk of elopement. The RN Supervisor will assess the need for the use of watch-mate as part of the wandering assessment of each resident. East Cumberland Lodge s (ECL) policy on Least Restraint is to be discussed by the Administrator, the Director of Resident Care, or the RN Supervisor with the resident and/or substitute decision maker on intake, and on an ongoing basis as the resident s condition indicates, including the risks inherent in restraining and non-restraining. PROCEDURE If nursing staff determine low and moderate risk residents are not accounted for at change of shift, meal hours or bedtime, the RN Supervisor shall be notified immediately who in turn will notify the Director of Resident Care and Administrator. When high risk residents are unaccounted for as per individualized plans or by staff observations, the RN Supervisor shall be notified who in turn will notify the Director of Resident Care, Administrator, and ECL s identified EMO Planner. A decision must be made by the Administrator, the Director of Resident Care, or the RN Supervisor on the intensity of search with consideration of the resident s health, time of day and weather conditions. PHASE I Search 1.1 Once the need to search is determined, the person in charge of the facility at the time shall obtain the Code Yellow Emergency bin from the Administration office and will page Code Yellow on the announcement system. All staff, regardless of department, will report immediately to the RN Supervisor office areas. (If during peak staff hours from 07h00 until 23h00) 1.2 The person in charge will delegate staff as follows and provide with a supply of sticky notes / labels to identify area search completed: 44

45 NOTE: If a search commences during a time period when Dietary, Maintenance, or Environmental Services staff are not on site then any remaining staff will be assigned to cover those designated search areas. Resident Care staff will search their own sections (inclusive of closets, under beds, etc.) while also scanning the enclosed outdoor areas of Fullerton Garden and Donkin Court). Laundry staff to return to their own area and search outward including the multipurpose room (general area inclusive of the sump pump room, heater room, and closets); Environment staff will search the janitor s closets, both old and new Recreation rooms (and closets), and smoking room. They will then assist downstairs to assist Laundry staff to ensure that the staff change/washrooms areas, staff lunchroom, and washrooms, and both stairwells are checked. Dietary staff will search the main dining room, storage areas, main kitchen and inner components, and stairwell. Maintenance staff will search the mechanical room in Donkin Court, the lower level sprinkler room, electrical room, elevator room, cage storage room, and maintenance room. Administration staff will check the administrative offices, closets, and areas of the front entrance including the elevator. 1.3 A pre-printed sticky note or alternate label will be applied to each door frame to indicate the area has been searched. 1.4 Once teams have completed their search areas they are to return to the RN Supervisor area and report to the person in charge on their results. The first individuals to return to the RN Supervisor area will be dispatched with flashlights (if reduced outside lighting) and walkie-talkies to search the following areas: o Upper parking lot & vehicles o Lower parking lot & vehicles o Inside the fully-fenced areas o Around the main building, generator shed, garage, and maintenance sheds. NOTE: Walkie-talkies are to be turned to Channel 1 with one unit being left with the person in charge. 1.5 If the resident cannot be located call 911 and report immediately. (If during off- peak staff hours from23h00 until 07h00 or during reduced staffing situations) 45

46 The person in charge will delegate staff to search the inside of the building (upper and lower levels) as indicated above but may combine search area requirements based on level of staffing available. 1.7 External area search: Call 911 to report the missing resident then dispatch any available staff to search the external areas mentioned above. 2.0 PHASE II Resident Identification & Follow Up 2.1 The Administrator, Director of Resident Care, RN Supervisor or delegate will assemble a file containing: Resident personal information sheet Resident photograph Resident Search sheet 2.2 A copy of the above documents will be provided to the authorities responding to the 911 call. 2.3 The Administrator or designate will notify the resident s next of kin (substitute decision maker), the attending physician, ECL Board Chair, and the Department of Health & Wellness Critical Incidents PHASE III Finalization & Follow-up 3.1 When the missing resident is located and returned to East Cumberland Lodge premises, an initial assessment will be conducted by the RN Supervisor with an additional assessment by the Medical Officer for East Cumberland Lodge. Should the ECL Medical Officer not be the physician of record for the resident, the Medical Officer will initiate follow-up with that physician. Should a physician not be available for assessment at ECL, the resident may be assessed by emergency medical personnel and/or transferred to a local health facility for final assessment prior to return to ECL premises. 3.2 The Administrator or designate will notify the resident s next of kin (substitute decision maker) and all other ECL personnel involved in the search. 3.3 All records of the search shall be entered in the resident s chart. 3.4 If outcome is a crisis (ie) death, life threatening injury contact clergy, crisis councilors for a staff defusing. 3.5 Coordinate an internal investigation to include: o Review of present security system and protocol ask for RCMP input o Review of the Resident Care count process by the EMO Committee 3.6 The Director of Resident Care is to coordinate the documentation from ALL staff involved in the care of the missing resident just prior to and when the absence was discovered. All staff must document the events of the hours before the resident went missing and at the time it was observed that the resident was not at ECL.

47 3.7 An ECL Incident Report must be completed. 47

48 APPENDIX 1: To be used by the Person in Charge responsible for coordinating the search: Resident Name: Search Coordinator: Date of Incident: Resident reported missing (time): By: 48 IMMEDIATELY UPON CONFIRMING A MISSING RESIDENT: Obtain Code Yellow Emergency Box from Administration offices and then page a Code Yellow for all staff to report to the RN Supervisor station area. Department Area to be Searched Time Search Completed Resident Care staff own sections (inclusive of closets, under beds, etc.) while also scanning the enclosed outdoor areas of Fullerton Garden and Donkin Court). Laundry staff return to their own area and search outward including the multi-purpose room (general area inclusive of the sump pump room, heater room, and closets); Environmental staff search the janitor s closets, both old and new Recreation rooms (and closets), and smoking room. They will then assist downstairs to assist Laundry staff to ensure that the staff change/washrooms areas, staff lunchroom, and washrooms, and both stairwells Dietary staff main dining room, storage areas, main kitchen and inner components, and stairwell Maintenance staff mechanical room in Donkin Court, the lower level sprinkler room, electrical room, elevator room, cage storage room, and maintenance room Administration staff administrative offices, closets, and areas of the front entrance including the elevator Upper & lower First person back and able Walkie Talkie #1 Parking Lot & Vehicles Around ECL main Second person back and able Walkie Talkie #2 Building, garage & sheds Fenced areas of Fullerton, Donkin, and back field Third person back and able Walkie Talkie #3 If during off- peak staff hours from23h00 until 07h00 or during reduced staffing situations allocate staff accordingly. If resident not found inside ECL during this time frame call 911 before proceeding to check upper, lower parking areas and vehicles, outside of building and other yard structures. Record time RCMP Arrived at: Resident Personal Information Gathered: Personal Information Sheet Photograph Provided to: RCMP Search & Rescue Other

49 Telephone Notifications: Attending Physician / ECL Medical Director Next-of-Kin (Substitute Decision Maker) ECL Board Chair Department of Health & Wellness Critical Incident Reporting ( ) FAXED: Department of Health & Wellness Critical Incident Reporting ( ) Time: Date: Time: Date: Time: Date: Time: Date: Time: Date: Results of Expanded Search (if applicable) Search ceased Time: Date: Final Outcome: If outcome is a crisis (ie) death, life threatening injury contact clergy, crisis councilors for a staff defusing. Coordinate an internal investigation to include: Conduct review of present security system and protocol ask from RCMP input Conduct review of the Resident Care count process by the EMO Committee The Director of Resident Care shall coordinate the documentation from ALL staff involved in the care of the missing resident just prior to and when the absence was discovered. Staff must document the events of the hours before the resident went missing and at the time it was observed that the resident was not at ECL. An ECL Incident Report must be completed. Signature (Person in Charge) : Date: Witnessed: 49

50 Female Male Ethnicity Caucasian African Canadian First Nations Asian Chinese Other Age: Missing Resident Profile Sheet Resident name: Sex Hair Color Clothing Color Blond Shirt Red Blouse Brown Dress/skirt Black Trousers Grey Coat/jacket White Pajamas Other Robe Nightgown Other Height Under 5 (153 cm) ( cm) ( cm) Over 5 10 (over 178 cm) Weight Under 100 lb (50 kg) lb (51-63 kg) lb (64-81 kg) Over 180lb (over 81 kg) Smokes? Yes No Brand Hair Style Bald Part Bald Short Long Curly Wavy Straight Well dressed Unkempt Bushy Wig Condition of Resident Alert Aggressive Impaired Confused Suicidal Oriented Violent Depressed Dangerous Uncooperative Scars, Moles, Birth Marks right side face & head left side face & head Face & Head both sides Nose (inc. broken nose) Right hand, wrist, arm Left hand, wrist, arm Both feet, legs Right foot, legs Left foot, leg Torso Describe: Deformities / Amputations Right Ear Left Ear Right arm, hand Left arm, hand Fingers, right hand Fingers, left hand Right leg, foot Left leg, foot Hunch back Left right handed Describe: Complexion: Medium Light, fair pale Ruddy, Florid Dark, Swarthy Freckled Light Black Medium Black Dark Black Pock Mocked Eye Defects Cast right eye Cast left eye Right missing, blind, artificial Left missing, blind, artificial Continually wears glasses Occasionally wears glasses Noticeably near sighted Blind Dietary / Pharmacy Last meal was: Diabetic last meds given Other meds last given When next med due Teeth Protruding uppers Protruding lowers Irregular Good Visible Decay Visible missing Gold, visible Stained Dentures Medical impact of not receiving medications: Eye Color Blue Grey Hazel Green Brown Black Ambulatory Assist Walker Cane Wheelchair Crutches 50

51 EMERGENCY LEVEL: CODE WHITE VIOLENT PERSON PREAMBLE: A Code White protocol is utilized when the safety and well being of residents, employees, or the public is at risk because of actual or impending violence or aggression. It is used when an aggressive occurrence or serious threat of injury to self or others require immediate assistance to manage the situation as safely as possible, when other forms of diffusion have failed. A Code White response is intended for situations when a resident (or visitor) is behaving, or perceived to be, in a way that threatens themselves or others. It is also intended to provide support to co-workers when situations move beyond their ability to respond safely and/or regain safe control of a situation. In these situations staff must call for assistances by calling a Code White. The purpose of the Code White GOAL: To regain control of a potentially harmful situation To provide the best care and welfare for clients and staff To prevent injury to clients and staff and others The goal of a Code White is to manage or treat the situation as safely as possible, to improve the situation to a more safe and manageable level or outcome for the resident and staff. Code White should be initiated sooner rather than later in attempt to improve the situation before actual violence happens. Decisions to initiate a Code White will be supported. DEFINITIONS: Restrain* To place the person under control by the minimal use of force (physical, mechanical, environmental or chemical) as reasonable, having regard for the physical and mental condition of the resident. Least Restraint* Places the person under control through the minimal use of physical or chemical means, monitoring devices or confining measurers, as is reasonable taking into account the person s physical and mental condition. Physical/Mechanical Restraint* In the use of any physical or mechanical device to involuntarily restrain the movement of the whole or a portion of a person s body as a means of controlling his/her physical activities. Physical restraint is used to protect a person from injury as a result of maladaptive or unsafe behavior. 51

52 Chemical Restraint* Chemical restraints are medications that are given to a resident on a short-term basis in order to immediately stop an aggressive behavior that poses an imminent risk of injury to him/herself or others. NOTE: These do not include medications used in the standard treatment for a medical or psychiatric condition. For example: if the medication is therapeutic or is ordered to assist the resident to control a paranoid idea or hallucinations, it is not considered a chemical restraint. However, if the medication is to control sudden aggressive or agitated behavior that may place others at risks it may then be considered a restraint. Environmental Restraint* Is any barrier or device that limits the locomotion of an individual and thereby confines an individual to a specific geographic area or location. Emergency Situations related to the use of restraints* An emergency situation is defined as one where immediate action is necessary to prevent serious bodily harm to the patient, resident, client or others. Substitute Decision-Maker (SDM)* For the purposes of this policy, and consistent with Nova Scotia s legislation, including the Hospitals Act, the former Medical Consent Act, the Personal Directives Act and Vital Statistics Act, the SDM is defined as a person who is given authority to made admission, care of treatment decisions on behalf of the patient. Patient* Patient refers to patient, client, or resident of the Cumberland Health Authority. Aggression Term often interchangeable with violence ; generally the term used in health care as it identifies behavior that has potential to harm. Code White Initiator The person who identifies the potentially aggressive situation and calls the Code. Code White Response Team Staff who attend the Code White may include but not limited to nursing, medical staff, and others who respond to the Code. Planned intervention: A call for assistance when there is POTENTIAL for aggressive behavior and/or client is behaving in an inappropriate or threatening manner but has not escalated to physically acting out; used when members of the health care team anticipate trouble with a client around medication administration or required activity (e.g. for a procedure such as taking blood). If time/situation allows, use of this may reduce the need for a Code White. Violence: 52

53 Any action, incident or behavior of an individual in which a person is assaulted, threatened, abused, harmed or injured and involves direct or indirect challenge to their safety, well-being or health. Workplace violence includes: Threatening behavior such as shaking fists, destroying property or throwing objects; Verbal or written threats any expression of intent to harm. Harassment any behavior that demeans, embarrasses, humiliates, annoys, alarms or verbally abuses a person and that is known or would be expected to be unwelcome. This includes words, gestures, intimidation, bullying, or other inappropriate activities. Verbal abuse swearing, insults or condescending language. Physical attacks hitting, shoving, pushing or kicking. PROCEDURE No general procedure can apply to individual situations due to the variance in individual situations. However, some training, forethoughts about performing in Code White situation and idea of potential steps to consider during Code Whites can improve the 1. If the situation warrants, the most appropriate person will page or otherwise notify staff as per facility protocol: Code White & give location. Repeat 3 times Delegate an employee to call 911 if required and request RCMP on site. Not every Code White may need police intervention. 2. All available employees report to scene for support. 3. Code White leader directly involved with the situation will give directions dependant upon the situation and the aggressiveness of the person. 4. Ensure resident and visitor safety. Responding employees may be required to remove residents and visitors from immediate area and to remove potentially dangerous objects. 5. All responding employees are to provide space between themselves and the aggressor and take direction from the Code White leader. 6 All employees involved will attend a short debriefing prior to returning to their area of work and normal duties. 7. Depending on the severity of the incident, advise Administrator and/or Director of Resident Care. The Primary Health Clinic should be notified of the event if the potential is there for the person to go next door. 8. Depending on the severity of incident, all required documentation is to be completed inclusive of an OHS form, an Incident report, and if injury is sustained the relevant WCB forms. AT NO TIME ARE EMPLOYEES TO PLACE THEMSELVES IN AN UNSAFE SITUATION. 53

54 EMERGENCY LEVEL: CODE GRAY EXTERNAL AIR EXCLUSION Code Gray is the emergency voice code used to describe a situation where a release of hazardous materials in the community could be potentially harmful to residents,staff and visitors at East Cumberland Lodge. When external air quality has been compromised, the RN Supervisor will contact the Administrator, the Director of Resident Care, and the Director of Maintenance. After discussion and confirmation, page Code Gray x 3. All windows are to be closed and all intake vents closed (inclusive of the HVAC system on the new unit. Control access to all doors. In these circumstances: Evacuation is NOT an option There will be a shut down of the air intake into the building Only the Business Office Main Entrance will be used for exiting or entering If exiting the building it is essential one set of doors must be completely closed prior to the second set being opened to limit the amount of contaminated air exchange When the situation has been resolved an announcement will be made to Cancel Code Gray ** Notify Insurer ASAP or within 24 hours. 54

55 DONKIN COURT - HVAC SYSTEM SHUT-DOWN SWITCH: Enter Donkin Court Mechanical Room - TURN RIGHT This is the panel. FOLLOW DIRECTIONS as above. 55

56 EMERGENCY LEVEL: CODE BROWN HAZARDOUS SUBSTANCE SPILL Code Brown - Hazardous Spill aims to respond to hazardous material spills in a timely and appropriate manner to protect human health, property, and the environment through an emphasis on awareness and spill prevention. Hazardous spills include the discovery of spills, contamination, leak and/or suspicious/ unusual smell of an unknown substance, liquid, powder, gas, or vapor. There are seven types of potentially hazardous substances. They can be in solid, gas, gel form and can be packaged in many different ways 1. Biological Agent Threats 2. Solid Products 3. Liquid Products 4. Gaseous Products 5. Flammable / Explosive Products 6. Radioactive Materials 7. Human Blood and Bodily Fluids Definition & Overview A minor hazardous material spill is defined as a spill of a known substance in a manageable quantity that does not cause a chemical reaction. A major spill or hazmat incident can be defined as: a known substance that cannot be contained or cleaned up a substance of significant quantity that poses an immediate risk to staff and residents the material is unknown a chemical reaction is present or incident could escalate and increase level of risk if the product is identified consult your MSDS regarding how clean up is to occur. Planning Considerations Determine what resources are needed on site to clean up the spill, such as absorbent pads and materials Contact external agencies that can assist with the mitigation and clean up of hazardous material incidents. Include this information in the communications directory Ensure all hazardous materials are securely stored and maintained Response Guidelines Assigned to/lead: Minor spill of a known substance Protect yourself avoid contact with skin, eyes and inhalation. Notify staff of the spill and cordon off area. Announce Attention All Staff, Code Brown & give location. Repeat 3 times. 56

57 Do not place yourself or others in danger Use absorbent material to clean up spill Dispose of contaminated material as per your facility policies and protocols Major Spill or unknown substance Protect yourself avoid contact with skin, eyes and inhalation. Notify staff of the spill Remove anyone in immediate danger Cordon off and secure the area to prevent re-entry Call 911 immediately if there is a risk of explosion, chemical reaction or to staff. Advise first responders of details location, type of spill and provide MSDS sheet if possible Contact emergency response contractors to assist with mitigation and clean up. Prepare for evacuation if needed In Nova Scotia If Diesel spill call: Dept. of Environment Notify insurer ASAP or within 24 hours If unknown large chemical spill call: same as above Outside Cleaning Professionals: -First On-Site Restoration Services

58 EMERGENCY LEVEL: SEVERE WEATHER Health Services Emergency Management PREPAREDNESS CHECKLIST Threat: Severe weather involving, high winds, rain or snow. Impacts: Loss of electrical power Loss of municipal utilities and services Damage to facilities Road closures Surge water in waterways and on coastlines Localized flooding The following checklist is designed to help health care facilities prepare for severe weather events that could involve high winds, rain or snow. This is not designed to be a comprehensive list but to serve as a tool to aid in facility preparations for these events. Note: Impacts of these events can range in duration from hours to days. PREPAREDNESS CHECKLIST Plans Key personnel and staff should review a facility s All Hazards Plan and Business Continuity Plan. Staff should be reminded of a facility s policies regarding reporting for work during events of this nature. Ensure that key personnel have access to the Canadian Hurricane Centre updates. The Canadian Hurricane Centre has a free registration process that will automatically send updates on storm activities at: 58

59 Ensure that individuals who have been assigned to monitor the weather event have the power to enact a facility s emergency plans and procedures. Communications: Inform staff of possible weather event and remind them to monitor weather reports. For staff on duty and those expected to report prior to storm arrival, advise staff of the ability to remain on site and that sleeping and food arrangements would be taken care of. Ensure that cellular phones, radios and other communications devices are charged and ready for use. Review key contact lists to ensure that telephone numbers are current and that the lists are distributed to key personnel. Review call back lists for staff and ensure that they are available. Establish communications with municipal emergency managers for regional updates. Ensure that a facility has the ability to listen to local radio stations that may have information on the impacts of the storm locally. District Duty Officers are reminded to report significant events, such as loss of services, significant property damages, evacuations, weather related injuries/ fatalities, etc. to the DoH Duty Officer by contacting Ensure staff that are on call and working off site, have a backup for their cell phone (ie: land line). This phone should not be cordless as cordless phones do not function during power outages. Facility Preparations Check emergency power generators for fuel levels and functionality. Secure or remove items from property grounds that can become loose in high winds and pose a danger. Ensure that exterior doors can be secured against high winds. Prepare damage control supplies that include materials that can be used to secure broken windows and doors and leaks in ceilings, and have available tools and equipment required to secure these materials in place. Prepare flood control equipment, including plastic rolls, catch buckets, wet vacuums, mops etc. to be used for flood control and clean up. Remind staff to check the operability of flashlights and availability of batteries that may be used or deployed during a power failure. Ensure that facility vehicles fuel tanks are topped up. Monitor the property during the event, especially in areas that are unoccupied for weather related damage. Ensure that appropriate levels of patient and staff supplies are available. Ensure confidential information is secured and removed from desktops, in the event of damage to windows. Health Centre Staff 59

60 Pre position staff in advance of the storm who can respond to electrical power generation needs, damage control or flood response. Do not call out staff during the impact phase of the weather event for safety reasons. Consider the need to have extra security and maintenance staff on site or on call during the event. Make preparations to have staff stay in place for extended shifts / hours. This may include feeding and sleeping arrangements depending on the duration of the event Prevent, where possible, patients, visitors and staff from venturing outside during high winds with the goal of preventing potential injury associated with the winds and flying objects Staff who may be required to work extended hours should ensure personal preparedness measures are in place for family members, dependants and pets. Promote the importance of 72 hour personal preparedness: Know the Risks, Develop a Plan, Prepare a Kit, and Plan for your Pets; Note: This document is not intended to be a comprehensive listing of all measures to be taken for this type of event, and does not replace sound judgment based on the circumstances of the event. Document produced by Health Services Emergency Management (Revised ) 60

61 RECOVERY OPERATIONS - RECOVERY PLAN 1. RETURN TO NORMAL OPERATIONS a) The recovery plan sets forth the steps and guidelines for returning the facility to normal operations after a disaster. b) The plan completes the cycle of Emergency preparedness planning and should therefore be a structured part of the written emergency plan. c) An effective recovery plan not only enables the organization to regain normal operations quickly, but also play a significant role in the long-range survival of the facility. 2. IMPLEMENTATION a) Application of the recovery plan is a necessary follow-up procedure to all of the four disaster activities, such as evacuation, relocation, isolation, and expansion. b) Implementation of the recovery plan should begin even while emergency operations are occurring and if not, immediately after the emergency. c) All recovery - related activities must be co-ordinated as thoroughly as any other component of the emergency preparedness response. d) Co-ordination of recovery operations will be the responsibility of Administrator/Designate in consultation of the Management Team and the Board of Directors. e) Factors that may have to be addressed during recovery plan activation are as follows: o Documentation. o Financial matters. o Inventory and resupply. o Record preservation. o Cleanup. o Special cleaning and deodorizing. o Hazard cleanup. o Redecorating. o Utility and equipment servicing. o Salvage. o Garbage and waste disposal. o Board-up. o Construction. o Employee debriefing/counselling. o Family and resident debriefing/planning. o Insurer notified (if required) o Dept. Of Health & Wellness notification. 61

62 3. SUPPORT TO PERSONNEL a) Consideration should be given to holding a session in which employees and others who participated in the disaster are recognized for their efforts. Employees would be given information on post traumatic stress. b) Recent evidence indicates that rescuers are subjected to the same distressing aftershocks following a disaster as the actual victims. In the facility, a particularly stressful crisis can lead to psychological trauma in staff which, in turn, can result in increased absenteeism, reduced effectiveness on the job and resignation. Some programs to consider are: Critical Incident Stress Debriefing Program which is an organization approach to the Management of stress responses in disasters. Employee Assistance Program. Group/Individual Counselling series and Family Support Programs. 62

63 EMO CHECK LIST Should there be a time when ECL may consider preparation for activation of the EMO Plan and dependent on the type of activation review the following listings for completion: Generator That fuel tank is full. Superline Fuels should be contacted to refill if necessary: Number for Superline Fuels Number for Stephen Russell Generator breakdown If the generator should fail to operate: call CAT Atlantic at or Should the above numbers not be able to respond immediately in an emergency situation contact the emergency generator mechanic at Canadian Salt Company Windows That all windows in the facility are closed and locked. Flash Lights Flash lights are in the Business Office in two locations: under the front counter and in the code yellow bin in the Business Office. Cell Phones Cell phones are in the code yellow bin in the back of the office. Cooking: Multiple bbqs are available in outside store shed (by O Hara exit door) and in the garage. 2 Propane cookers are located in the Dietary Supply Room. Sprinklers / Fire Alarms 24 hour fire panel monitoring company is Edwards Call Account # Snow Removal / Evacuation in snow storm Ground Search & Rescue Oxford Snow Plough MacAuleys Snow Removal Donald MacAulay cell Activated by calling RCMP at 911. Ground Search & Rescue have satellite phone, generator & emergency lighting. Municipality of the County of Cumberland Contact Mike Johnson School Bus Transport Delbert Green

64 Emergency Suppliers Listing TROUBLE SHOOTING CONTACT SHEETS ECL Maintenance Workers attempt to call in; if no response then Attempt to call Director of Maintenance ( ) if no response then Attempt to call Administrator ( ) if no response then Attempt to call Director of Resident Care ( ) Issue Company Contact Numbers Alarm System ADI Inc. Acct# Dishwasher / Mixer Hobart Equipment (902) (800) Electrical #1 - Blake Electric Andy Blake (902) (cell) #2 - Linair Electric Blair Aucoin Winmill Electric Bruce Winmill (electrical, air conditioners, & refrigeration) Elevator Otis Elevator Building ID # FAM (902) (shop) (home) EMO 24-hour Emergency Fire Alarm System, Sprinklers System Troy Edwards Fire & Safety (877) Generator CAT Equipment or Generator Diesel Superline Fuels Stephen Russell or Home Hardware Emergency # only Insurance Marsh Canada - (notification of Barb McGuire / Mary (902) major damage claims) Jane Hovey Oxygen Medigas Paging System S3 Solutions Scott Eckstein Power Outage NS Power Plumbing GE Spicer Gordie Spicer or (cell) Winmill Electric Bruce Winmill (shop) (home) *Directions to turn off water are posted in Sprinkler Room by large white water tank Snow Removal Brian MacAulay (cell) Telephone Outage Bell Aliant 611 UV Light Water Softner Lakeshore Water Treatment Barry Hutt (902) Washers (Laundry) East Coast Laundry (800) Waste Management Miller Group Jamie Coulter (902) (902) (cell) 64

65 EAST CUMBERLAND LODGE EXTERNAL RESOURCE LISTINGS Resource Location Contact Bus. Phone Home Phone Comments DRUGS O Briens Pugwash M. Blaikie J. Kennedy Fullertons Tatamagouche McKinnon PERSONNEL Sunset Pugwash J. Matheson Salvation Army Springhill Red Cross MEDICAL Dr. D. Forshner Pugwash Dr. P. Blaikie Wallace Dr. G. MacFarlane Pugwash Dr. T. Fashoranti Pugwash Dr. Rezvani Pugwash FOOD Co-Op Pugwash S. Arkens EMERGENCY Home Hardware Pugwash A. VanDeWiel Home Hardware Wallace C. MacKenzie Salt Mine Pugwash MED SUPPLY NS Hospital Dartmouth Ingram & Bell Dartmouth COMMUNITY SERVICES Cumberland D. Bailey DEPT HEALTH Halifax T. MacLaughlan Halifax 24 hour Option 1 65

66 Water use during a Boil Water Advisory The following information was provided by the Nova Scotia Department of Agriculture Food Protection and Enforcement Division Food Safety Section (January 2011) A Boil Water Advisory is generally issued when the quality of drinking water provided either by your well or the town/municipal water system is in question. The advisory is a preventative measure to reduce the risk of illness. Restaurants and Food Shops The following general steps must be taken to reduce the risk to both your staff and customers. Your Food Safety Specialist will provide you with any special instructions that may apply to your business. Beverage Preparation 1. Do not use any tap water for the preparation of beverages. 2. Do not use any automated beverage equipment that is connect to the water supply o Slush machines and fountain pop/soda machines utilizing the post mix (syrup in a bag system) o Empty and follow instructions for sanitizing the machine after the boil advisory is over. 3. Commercial coffee machines can be used during an advisory if they maintain temperatures within the water tank of 88C 90C, of if liquids, upon leaving the machine funnel, have a minimum temperature of 72C. 4. For customer service, use either water boiled for at least one minute, or commercially bottled water. Kitchen Food Preparation 1. Tap water may be used for the preparation of cooked foods. Vegetables may be cooked in tap water. Baked goods containing water are acceptable but the product must be fully cooked. 2. Salad greens, vegetables or fruit may only be washed with bottled or tap water boiled for at least one minute. Ice 1. Do not use ice that has been prepared from unacceptable water. Shut off the ice machine and be prepared to clean and sanitize the machine prior to future use when the boil advisory is over. 2. Use ice that has been commercially pre-packaged or that has been made from an approved source (i.e., ice made from bottled water or water boiled for at least one minute). Produce Misters 1. Discontinue use of misters immediately when the boil water advisory is issued. 66

67 2. After boil water advisory is lifted, follow manufacturers instructions to disinfect the mister system prior to operating the misters. Dish, Pot and Equipment Washing 1. Commercial dishwashing machines reaching a minimum of 180F (82C) on the rinse cycle are acceptable. Low temperature commercial dishwashers are also acceptable if the sanitizer concentration in the rinse is at or above manufacturers minimum level. 2. If dishes are normally washed in a three compartment sink, continue with this method. It is important that the sanitizer concentration in the third sink is a minimum of 100 parts per million of chlorine. Dishes must be air dried. Do not rinse with tap water. 3. Substitute bottled or tap water that has been boiled for at least one minute in all other uses in the kitchen such as washing and sanitizing cutting boards, counter tops, etc. Washrooms & Handwashing 1. Post signs in both Public and Staff washrooms indicating that the Water is Unacceptable for Drinking. 2. In the event a boil order is issued as a result of total coliform presence, water from faucets can be used for ahndwashing. Ensure handwashing supplies (liquid soap and single use paper towel both in dispensers) are available in staff and public washrooms. 3. If the boil order was issued as a result of E. coli presence, hands must be washed: a) Using commercially bottled water, or cooled water that was boiled for one minute; or b) Using tap water followed by application of greater than 60% alcohol-based hand sanitizer. It is recommended that hand sanitizers be available for customer use. Please contact your Food Safety Specialist at the following offices with any additional questions: Halifax Kentville Lunenburg Pictou Port Hawkesbury TBD Sydney Truro

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69 *Note: as of November 22, 2014 only one lower level apartment remains in use (Apartment 1 across from Maintenance Shop). However visiting family may also be in the Palliative Respite Apartment across from the domestic laundry (back stairwell). Both must be checked and occupants notified in event of an emergent situation. 69

70 FAN OUT for Sunset Adult Residential Facility - In the event East Cumberland Lodge is notified for a FAN-OUT support for an emergency at Sunset Adult Resident Facility in Pugwash East Cumberland Lodge will receive a telephone call from North Cumberland Memorial Hospital 70

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72 FAN OUT for North Cumberland Memorial Hospital - In the event East Cumberland Lodge is notified for a FAN-OUT support for an emergency at North Cumberland Memorial Hospital in Pugwash East Cumberland Lodge will receive a telephone call from North Cumberland Memorial Hospital to initiate a call out. ECL is to call the first three names on the list and relay the appropriate message. If initial contact names are not available proceed down the list vertically. 72

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