Children’s Division

Situation Report for County/ Building or Site

Date/Time:	Emergency/Disaster Designation:

OFFICE STATUS

Office is unaffected

Office is affected (check all that apply):

Office is closed

Office has no power

Office has no water

Office has no phone service

Other (please describe):

COMMUNICATIONS STATUS (check all that apply)

Landlines are operable

Cell phones are operable

Please describe the availability of communication services in your area (e.g., widespread outages, spotty cell coverage):

STATUS OF STAFF

Number of staff in the office:

Number of staff personally affected by disaster:

Give details, if known

Number of staff able to report for work:

Number of staff unable to report for work:

Assistance is needed to maintain office functions

(Please specify assistance needed):

Impacted staff need assistance

(Please specify assistance needed):

RESOURCE HOME CHECK

Number of resource homes in the county:

Number of foster children in the county:

Resource family checks are being completed

Number of families contacted:

Number of foster children accounted for:

Number of resource families affected:

Give details, if known

Resource families’ needs are being met

Resource families have unmet needs

(Please specify):

Number of resource families that have relocated:

Contact information for relocated resource families has been secured

RESIDENTIAL FACILITY CHECK (to be completed by RPU staff)

Number of residential facilities in the county:

Number of foster children in the county’s residential facilities:

Residential facilities are being contacted

Number contacted:

Number of foster children accounted for:

County residential facilities are affected by the disaster

(Please list affected facilities and briefly describe the degree to which they are affected):

Residential facilities are able to continue operations

(Please list):

Residential facilities must be evacuated

(Please list):

Residential facilities have unmet needs

(Please specify):

Private child-placing agencies are being contacted:

Number contacted:

Number affected:

(Please specify the agency and its affects):

INVESTIGATION STAFF CHECK

Investigations being completed according to CD protocols

Investigations staff unavailable to complete hotlines; assistance is required

(Please specify needs):

CD STAFF RESPONSE EFFORTS

Staff have been in contact with FSD coordinator regarding sheltering activities

Staff are able to assist in response efforts

(Please describe briefly):

CRITICAL NEEDS:

Date/Time Completed:

Submitted by:

Contact Number:

Submit this form daily, before 1 p.m., to the following people:

Your Field Support Manager/Program Manager

Your Regional Director

Sara Linenfelser – Sara.Linenfelser@dss.mo.gov

Melody Yancey – Melody.Yancey@dss.mo.gov

Christina Hug – Christina.M.Hug@dss.mo.gov