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Home My WebLink AboutBUSINESS PLAN02/27/92 KERN VIEW HOSPITAL INC 215-000-000505 Page 1 Overall Site with 1 Fac. Unit General Information Location: 3600 SAN DIMAS ST Map: 103 Hazard: Low Community: BAKERSFIELD STATION 04 Grid: 19B F/U: 1AOV: 0.0 Contact Name Title Business Phone 24-Hour Phone- DEIRDRE TERLESKI (805) 327-7621 x (805) 872-1510 Administrative Data Mail Addrs: 3600 SAN DIMAS ST D&B Number: City: BAKERSFIELD State: CA Zip: 93301- Comm Code: 215-004 BAKERSFIELD STATION 04 SIC Code: 8063 Owner: KERN VIEW HOSPITAL INC Phone: (805) 327-7621 Address: 3600 SAN DIMAS State: CA City: BAKERSFIELD Zip: 93301- Summary MAR n ~ 1~2 HA7 ~&T. ~!V. I, ~,',Z,,~-Y~j/F',f Do hereby ~.~y that I have reviewed the attaChed hazardous materials manage- /I/~F.__~ ~ Z/-,~-p__,~and that it along with merit plan for (Name of 8u~lne~ · any corrections constitute a complet~ and correct man- sgement plan for my facility. Signature - ' Date 02/27/92 KERN VIEW HOSPITAL INC 215-000-000505 Page 2 02 - Fixed Containers.on Site Hazmat Inventory Detail in Reference Number'Order 02-001 DIESEL FUEL Liquid 300 Low · Fire, Immed Hlth, Delay Hlth GAL CAS #: 68476-34-6 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL300 I Daily Average150.00GAL I Annual Amount300.00GAL Storage Press T Temp Location UNDER GROUND TANK IBelow ~Below lUNDERGOURND STORAGE --ConcI Components i MCP iLis.t 100.0% Diesel Fuel No.1 Low -- Notes 02/27/92 KERN VIEW HOSPITAL INC 215-000-000505 Page 3 00 - Overall Site <D> Notif./Evacuation/Medical ~!%c~-~/~~ ~ <1> Agency Notification ~,5co;C~ CALL 911 <2> Employee Notif./Evacuation ~5-~-~n~,~,~ EVACUATION PROCEEDURE IN PLACE, CALL 911. <3> Public Notif./Evacuation 2%~ W~ KERN VIEWS PUBLIC ADDRESS SYSTEM WOULD BE UTILIZED TO WARN THE PUBLIC IN THE EVENT OF AN EVACUATION. <4> Emergency Medical Plan ~- A~'~ RN ON DUTY 24HRS A DAY (ON SITE). MEMORIAL HOSPITAL - 420 34TH ST - 327-1792 - ADJACENT TO THE SITE AND IS USED FOR EMERGENCY MEDICAL SERVICES. 02/27/92 KERN VIEW HOSPITAL INC 215-000-000505 page 4 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention ~[~ ~'~'~ ALL MATERIAL PROPERLY STORED AND IN SAFE CONTAINERS. NOTIFY PROPER AUTHORITIES IF MATERIAL IS ACCIDENTLY RELEASED. <3> Clean Up <4> Other Resource Activation 02/27/92 KERN VIEW HOSPITAL INC 215-000-000505 Page 5 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs LIST OF ALL UTILITY SHUT-OFFS AVAILABLE 24HRS A DAY AT NURSES STATION. <3> Fire Protec./Avail. Water PRIVATE-FIRE PROTECTION - 25 FIRE EXTINGUISHERS LOCATED THROUGHOUT THE FACILITY FIRE HYDRANT - AT THE ENTRANCE TO FACILITY AND AT SOUTH SIDE OF FACILITY ON MEMORIAL HOSPITAL PROPERTY NEXT TO CHAIN LINK FENCE. <4> Building Occupancy Level 02/27/92 KERN VIEW HOSPITAL INC 215-000-000505 Page 6 00 - Overall Site <G> Training <1> Page 1 WE HAVE 160 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: EMPLOYEES RECEIVE TRAINING IN HAZARDOUS MATERIALS WHEN HIRED AND WHEN A NEW SUBSTANCE IS INTRODUCED. NEW MATERIALS INTRODUCED MUST FIRST HAVE APPROVAL OF MEDICAL STAFETY COMMITTEE FOLLOWED BY TRAINING IN MSDS BEFORE SUBSTANCE IS USED. <2> Page 2 as needed <3> Held for Future Use <4> Held for FutUre Use NON '- ~E SEC~T : ':.":" ,'.-',: ~'( ;.~,~'.'f,,:~:[': · . ~ . . ,~...~.. .:.. ~,~' ,<.,~. ~ . .~. . LOCATION~ 3 ~O0 ~ ~/~f S~-' ~u~--. ~ ~= .... · · ": ....... ' CITY, 1 2 3 ' 4 5 6 7 8 9 .10 11 12 . . . , :+ -, 13 ~.. ~ ~ ~--.. ~......... ~.~ so- so"' so.~ ~.~_. .~fiff: ~;~.~. :..~,..?, See Inet~~ C~e c~e ~t 2 ~t unite ~e Press ~ c~o~,- ..... [' ~ - -- ~ 7 ] -- Ph~ical a~d H~lth ~'za~ 'C.[.S. N~er ~,~4~--'~ Co,orient , 1 N~ ~ C~.8. N~'~ (Check ~11 ~ appl~) ~: ~ : ' " " .. ..~ ;:.'~ -.. ?' . . I I I I I I I . I. I I I · · "' ~lt[" ~ C.~.8. N~ '. Co~on~t g 1 N~& C.~.S. Ph~ical and ' "::d : r3 F~ ,az~d ~ .udd.. ~iease '~ D.c~v~y ~ Z~ta~e' D'ela~ . . ., .?... -. t · "~ .~',:. of Pressure .:. ~l~h ~l~h 'Co~onen~ ~ 3 ~ '~ C.~,8, N~ I " " I I I I I I I I I .I I .-' Ph~tcal' and H~lth ~ C.A.S. N~er .:," Co~onent ~ 1 N~ ~'C.A.S. N~ ': " (Check all t~ apply) . ., .. '~:,~ Co~onent ~ 2."N~ ~' C.A;S. N~~' off Pressu~ H~h ~h ~o~onen~ ~ 3 N~'~ C.~,~' ~ I I I I I- I I I I I I Ph~;calx 'and ~lth ~ C.[.S. N~er .. ' Co~onen~ ~ 1 N~ &., C.~.8. (Check all t~t apply) Co~onmt. ~ 2 N~'& C.A.S. N~ ' ~ F*~ Hazed' ~ Sudden ~lease ~ R~c~*vity ~ Z~*ate ~ Dola~ . of Pressure E~lth ~ealth '' , Co~onent ~ 3 N~ & C'.~.S. N~ E~RGENCY CONTACTS ~1~ ~2 . Title 24 ~ Phone ~ Title 24 ~. Phone N~e . ';,,,. C~tftcatt~ . (~ ~ SIGN AFTER COPuv~mv~ ~T.T. ~2~T~Mg~ . ] =~[~ ~de= ~.1~ of lw t~t I ~ve= ~=~onall~ ~in~ ~d ~ [~1t~ ~tth the ~fom~tton ~u~itted in '~t~ ~d~ all attached d~ta t~d1vtd~l. :"~i~le f~ o~tfl.g the t. fomtion. I believe t~t ~e ~u~t~d 1~fomatton t~ t~e, acetate, and cmplete....,."-., · '~ -~". ~':,~ CITY of BAK£RSFIELD ~,,~ ,.~ ~',,~ ~~ .~,~ "~'E CARE" ,', ~_ .~'z ~ ~ ,,,'~ ..... ::::,. '~'..~,...-.~- .... y (ts~e or prin~ name RECEIVED ~o h~b~~ e~t~M that ~ ~ve ~ev~l~ed the JAN2Q 1989 ~tt~c~e6 ~aza~6ous name of business and that it along with the attached additions or corrections constitute a complete and correct Business Plan for mM facilit.v. sz~nanure date BUSINESS NAME KERN VIEW HOSPITAL INC ID NUM Z1S-800-~SOS LOCATION 3888 SAN DIMAS ST HIGH HAZARD RATING Z 1. OVERVIEW LAST CHANGE OB/Z1/88 8Y ESl'ER JURIS CODE 21S-804 JURIS BAKERSFIELD STATION 04 MAP PAGE 103 GRID 19B FACILITY UNITS ! HAZARD RATING Z RESPONSE SUMMARY ZA SEC 4) SAFETY COMMITTEE IS RESPONSIBLE FOR ISSUES RELATEO TO HAZARDOUS MATERIALS. EMERGENCY CONTACTS ZA SEC Z> DEIRDRE TERLESKI - 327-76Z! OR 872-1S10 UTILITY SHUTOFFS ZR SEC LIST OF ALL UTILITY SHUT-OFFS AVAILABLE Z4HRS R DRY AT NURSES STATION. < NO INFORMRTION RECORDED FOR THIS SECTION > PAGE 1 t2/23/88 17:03 MATERIAL SAFETY DATA SYSTEMS, INC. (885) G48-G800 BUSINESS NAME KERN VIEW HOSPITAL INC ID NUMt LOCATION 3600 SAN DIMAS ST HIGH HAZARD RATING L~ST CHANGE / / BY 4. LOCRL EMERGENCY MEDICAL flSSISTflNCE [.fiST CHRNGE O9/~/8B BY ESTER SEC S) RN ON DUTY Z4HRS A DAY (ON SITE), MEMORIAL HOSPITAL - 4Z0 34TH ST - 327.-179Z - ADJACENT TO THE SITE AND IS USED FOR EMERGENCY MEDICAL SERVICES. PAGE Z 1Z/Z3/88 17:03 MATERIAL SAFETY DATA SYSTEMS, INC. (80S) 648-6800 BUSINESS NAME KERN VIEW HOSPITAL INC ID NU ZtS-(~0-000S(~S LOCATION 3GOO SAN DIMAS ST HIGH HAZARD RATING Z FACILITY UNIT O1 A, OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE OB/Z1/88 BY ESTER ID TYPE NAME MAX AMT UNIT HAZARD LOCATION CONTAINMENT L/SE 1 PURE DIESEL FUEL 300 GAL MODERATE UNOERGOURND STORAGE UNDERGROUND TANKS FUEL ID PERCENT COMPONENTS HAZARD LIST 1178.03 100.0 DIESEL FUEL NO.1 MODERATE LAST CHANGE 09/Z1/B8 BY ESTER < NO INFORH~TION RECORDED FOR THIS SECTION ) PAGE 3 1Z/Z3/88 17:03 MATERIRL SRFETY DATR SYSTEMS, INC. (805) G48-G8(~ BUSINESS NAME KERN VIEW HOSPITAL INC ID Z~$-OOO-OOOSOS LOCATION 3$OO SAN DIMAS ST HIGH HAZARD RATING O. EMPLOYEE NOTIFICATION / EVACUATION LAST CHANGE 0B/21/88 BY ESTER SEC Z) EVACUATION PROCEEDURE IN PLACE, CALL E. MITIGATION / PREVENTION / ABATEMENT LAST CHANGE OB/Zl/88 BY ESTER SEC I) ALL MATERIAL PROPERLY STORED AND IN SAFE CONTAINERS. NOTIFY PROPER AUTHORITIES IF MATERIAL. IS ACCIDENTLY RELEASED. PAGE 4 lZ/Z3/88 17:03 MATERIAL. SAFETY DATA SYSTEHS, INC. <805> G48-G800 CITY of BAKERSFIELD NON--TRADE SECRETS LOCATION: ~O ~ b/~ ' ADDRESS: of P~ ~lth ..................... With of ~ ~l~h ...... _-L_I t L I :I ....... I I 1 I., I ..... ' ....................... E-~ -~ _ _ _ ~lth of Pmsuro ~lth '-- ~ i~i (C~k iii t~t rely) -- -- -- C~t H~lth of Prflsu~e Mlth Cert~ficaCi¢ (Read and sJ~ after coepJetJnE al] sections) cer~?y ~der ~lty of 1~ t~t ] ~ve ~es~allyexam~n~ ~ aB f~tl~ar with t~ tnfomt~ su~tt~ 4n th~s ~ ill IttK~ ~ts. ~ t~t ~sff ~ ~ ~tW of t~e f~tv~ls ~s~ble BAKERSFIELD, CA 93301 (805) 326-3979 l OFFICIAL USE ONLY USINESS NAME HAZARDOUS MATER I ALS BUSINESS PLaN AS a WHOLE FORM 2 A 000505 INSTRUCTIONS: 1. To avoid further action, return this foem by 2. TYPE/PRINT ANSWERS IN 3. Answer the questlons belo~ ~oe the business as a ~hole. 4. Be as brie~ and concise as possible. SECTION 1: BUSI~SS IDE~IFICATION DATA B. LOCATION / STREET ADDRESS: ~00 ~~1 SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND 2ITLE DURING BUS. HRS. AFTER BUS. HRS. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A Wll0LE A. NAT. GAS/PROPANE: ' ' B. ELECTRICAL: c. WATER: / D. SPECIAL: _..~.. E. LOCK BOX: YES IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - 2A - SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL-E~RGENCY ~ED[CAL ASS[ST~CE FOR YOUR BUSINESS AS A WHOLE " ' O / ' SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS NO , , NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... ~ NO ~Y~_~ NO C. PROPER USE OF SAFETY EQUIPMENT: .................. (?~S. NO ~.eS~ NO D. EMERGENCY EVACUATION PROCEDURES: ................. ~j_E_~) NO '~' NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... ~,~ NO ~ NO SECTION ?: HAZARDOUS MATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A YES NO SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:..dA~. I I, J.)~.?CC3t4*'E.. tO-y~cT-~,pE~ , certify that the above information is accurate. I understand that this information will be used to fulfill my firm's obliEations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. a$$00 Et Al.) and that inaccurate information constitutes perjury. BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY ID# BUSINESS NAME: BUS I NESS PLAN SINGLE FACILITY UNIT FORM 8A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as ~possible. FACILITY UNIT~ FACILITY UNIT N~%ME: SECTION 1: MITIGATION, PREVENTIONr ABATEMENT PROCEDb~RES SECTION 2: NOTIFICATION .~%q] EVACUATION PROCEDb-RES AT THIS b~'IT ONLY - 3A - SECT!OY 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... YES NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES NO If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form ~4A-1) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form ~4A-2) in addition to the non-trade secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION 8: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPON~ERS SECTION 6: LOCATION OF UTiLiTY SHUT-OFFS AT THIS b%'IT OSTY. A. NAT. GAS/'PROPAN£'% B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES ./ NO IF YES, LOCATION: , ~ ^ iF YES SiTE PLANS? YES / ~'10 .lSI3.~s., YES ." 5:0 FLOOR pr.A×S? YES / NO KEYS? ',.'ES ./ ¥O - 313 - BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORM 4A-1 Page _~of F NON--TRADE SECRETS HAZARDOUS I~IATER I ALS INVENTORY BUSINESS NAME: ///~/'/d. ~/f/~'~ /Z-//~ff..,~/,,~/ O~NER NAME: FACILITY UNIT ~: .. ADDRESS: ~~ ~ ~~c ADDRESS: FACILITY UNIT NAME: CITY, Z I'~ :~~ .~/~ ~, ~~ CITY,ZIP: PHONE ~: ~-~/ PHONE ~: OFFICIAL USE CFIRS CODE '"1 2 3 4 5 6 7 8 9 10 TYPE ~AX ANNUAL CONT USE LOCATION IN THIS · BY HAZARD D.O. CODE A~OUNT A~OUNT UNIT CODE CODE FACILITY UNIT WT. CHEmiCAL OR COMMON NA~E CODE 6UIO ' ~ ..~ ~ .... ~ee /~ '" W~w' ~ ~t'~'~ , ~ .... i~o~ ~/~ ,- ......... TIT~: SI ~TBRE EHERBENCY CONTACT: TI, E: PHONE ) AFTER BUS HRS: EMERGENCY CONTACT: TITLE: PHONE [ BUS HOURS: ' P~INCIPAL BUSINESS ACTIVITY:__ AFTER BUS. HRS.: . ,, BAKERSFIELD CITY FIRE DEPARTMENT [ .D. ~ FORM 4A-1 Page ___of NON--TRADE SECRETS HAZARDOUS IViATER I ALS 1' NVENTORY BUSINESSJ NAME: :,::KERN VIEW HOSPI-TAL~ INC. OWNER NAME: FACILITY UNIT .#:, ADDRESS: ]600 San Dimas Street ADDRESS: FACILITY UNIT NAME: CITY, ZIP: Bakersfield, Ca. 93301 CITY,ZIP: PH~ONE *: (805) 327-7621 PHONE ~: IOFFICIAL USE CFIRS CODE 1 2 3 4 5 6 ~ ' 7 8 9 10 'YPE MAX ANNUAL CeNT USE .-LOCATION IN THIS · BY HAZARD D.O.T :ODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAM~ COD~ GUIDF M ~ I gal 09 08 print room-south east ,]':~ Ink Roller Desentisjzer-contain$ , corner of building copper saIt.gyorocn~or~c ac~o,g~yco~ ~rr~.~ m qn~venrs - . . CRMT M ~ ] gal 13 08 pK'i:n~ room-southeast '-:' =:- G~2~¢Bem°vc'E~Re~tm°~egm"D~st"ttlate:;"; CMLQ corner of building 75% P ~ 1 qal 10 08 same as above 6% Ink Roller Condi~oneE-contains~ ~ q~ ~ ;~ R'~ ~,, ~ ~ r~' C RMT M ~ 4 gal 10 08 same as above 20% Master eleaner-contains Propyl Alcoh>l,:~ Ko,a} D kto] D vel per- o talns g ~ ~ ~a] 10 ~ same as above 60~ ~c e hy~amlnop~eno? sulfate g 2 20 ~al 1~ 08 same as above 100~ ~1 Cleaner-contains Hydrocarbons ~ 2 20 ~al ~ ~ same as above 2~ []~c~rostat[c Congers~on Solut[on- g 1 10 gal 10 ~ same as above 80g Offset Etch-contains Phosphoric Acid~, , , ~rc~y] Alcohol P 2 20 gal 10 (~ same as above 3% OTF~fo~nta'[n~Coficeutrate~conta'~n~ M ~ 4 gal 10 same as above 42% Plate Cleaner-contains Petroleum ....~,~,~'. '~,ST~,~ , ~,Phospher~c~ A. cTd M 2 10 gal ]3 08 same as above 82% Blanket Wash-contains Petroleum Dis- CMLQ ie~ L;ii~L~ ~,C ..... ,~2,~ ..... +~:~k] M 1 20 gal lO ~ same as above tha~v Offset Developer-contains Sodium Hyrrox- ': --~ lde,Hyd, u. ul,,O,'le . CR~I , P ~ ...3~: gal 10 ~ same as above 50% Of~setL[acqU~.~5~*P~S~C~~[eCMLQ M 1 '20 gal 10 ~? same as above 60% Io~eE Concentrate-contains Carbon B~ack, Ros i'n .. Es t~ ~/~ ~ ~y'] ~ ~ .~es i"~ :iN } ~:~s i ne9MLQ same as above lOOg cop~er ~speranr-conra~ns ~etroleum AME :_muvy~ .... F.I~ER TITLE: PRINTFR .SIGNATUREl-){st~. . I, lates,.. CS,CiO,eli ' DATE:5 9_-2_-87 HEROENCV CONTACT: JOHN ~tELCH TITLE: MAINTFNANCE SUPERVISOR PRONE * BUS HOURS :'. 327-7621 7:30a.m.-4:30p.m AFTER BUS HRS: 'MEBOENCV CONTACT: CLAIR BR~DSH~ TITLE:. PUBLIC REkgTIO~5/PRIRI{~BONE ~ BU9 HOURS: ~ · 'RINCIPAL BUSINESS ACTIVITY:MENTAL SERVICES AFTER BUS, HRS: ... PLANT OPERATIONS ORIENTATION CHECKLIST NAME: DATE: POSITION: The.following has been explained to me: 1. Job description 2. Work schedule 3. Purchasing and ordering procedures ~. Location and use of material safety data sheets 5. Important telephone numbers tother staff, repairs, etc.) ?. Location of supplies and equipment 8. LocatiOn and use of Housekeeping Manual 9. Use of gloves!handwashing procedures; possible exposure to AIDS My supervisor has explained the use ~nd care of the following equipment: Vacuum MAINTENANCE STAFF: Carpet Cleaner Extractor/Piggy Back Inspection of fire safety systems Mops/Brooms (alarms, smoke detectors, sprinklers, Buffer exit signs, extinguishers, etc.) Trash Cans/Dumpster Table Saw Electrical Distribution system Drill (shutoffs, testing, whom to call Drill Press for repairs) Emergency Generator Kern View Vehicles Plumbing system (minor repairs, Lawn Sprinklers maintenance, whom to call for other Cooling Tower repairs) Boilers Other Equipment (specify): DATE: Signature of Employee Signature of Plant Manager 06/88 KERN ¥1EW MEMORANDUM HOSPITAL, INC. ,. DATE: 29 December 1988 CATEGORY: Facilities Operations TO:. NUMBER: 480.23 FROM: Safety Committee SU~JECT: POLICIES AND PROCEDURES FOR UTILITY SYSTEMS Critical utility systems are (i) those systems legally required to.continue hospital operations in an emergency, and (2) communication systems to summon assistance in a.life threatening situation. No utility systems are needed for life support or infection control purposes. These systems include': - Emergency generator at Kern View Hospital - Battery-powered emergency lights at Alta Vista - Paging systems at Kern View and Alta Vista Hospitals - Nurses' call system at Kern View and Alta Vista Hospitals - Emergency radio at Kern View Hospital The emergency generator is tested weekly and under full'load once per month; preventive maintenance is performed annually. Records are maintained by the Plant Manag.er. Emergency corridor lights for Alta Vista Hospital are operated by battery ~ packs and are checked quarterly. Records are kept at Alta Vista. Executone Company provides an annual maintenance for the paging and call button systems at Kern View HosPital; Serban Sound ComPanY provides this 'serVice for Alta Vista Hospital. Repairs are also provided by 'the~e companies, and.records are kept at the respective hospitals. The emergency radio at Kern View Hospital is repaired and serviced by Maple Leaf Communications; preventive maintenance is provided semi-annually as required by the County of Kern. Records are kept by the Plant Manager. Maintenance and inspection records for other utility systems (i.e., HVAC, J' boilers,/and plumbing) are kept at the respective hospitals. Alternative systems, if needed, are specified in the hospital's Disaster Plah. (See also "Whom to Contact in Case of Equipment Breakdown", 480.3.) Effec~ve Do~ 29 December 1988 Sourc~ Safety Committee KV Oate of / 8 6 KERN VIEW MEMORANDUM HOSPITAL, INC. DATE: 29 December 1988 CATEGORY: ~acilities Operations TO: NUMBER: 480.21 F~C)M: Safety Committee SUBOEOI: POLICIES & PROCEDURES FOR FIRE EQUIPMENT (KERN. VIEW AND ALTA VISTA HOSPITALS) I. PORTABLE FIRE EXTINGUISHERS The location of the portable fire extinguishers is identified in the hospital's Disaster Plan. The location of the extinguishers is determined by the fire marshall, and extinguishers are not to be relocated without the · aPproval of the local fire marshall. Ail extnguishers are "ABC" for use on any any type of fire, and are clearly labeled as such. Extinguishers are activated by pulling the safety pin, and squeezing the handle, while moving the extinguisher in a fanning motion toward the base of the fire. Annual training is provided for all staff on the use of portable extinguishers. Extinguishers are inspected monthly/bY maintenance staff;which is documented on the tag attached to it. Chemicals are changed and the units are serviced on an annual basis by a licensed service, at which time the tags are changed. Independent Fire and Safety Company (589-9091) repairs and maintains the portable fire extinguishers. II. AUTOMATIC FIRE EXTINGUISHING SYSTEMS *- ,.,t? 2~i:~i~~ ,' ~ ' ' ....................... The chemical system~-~-d-~er-~h~'~{~e~"~anges at Alta Vista and Kern View Hospitals are serviced semi-annually by Independent Fire And Safety Company (license #1495966). The systems are tagged to verify this maintenance. The automatic fire sprinkler systems are serviced annually by Boyance Auto- matic Sprinkler Company. In addition, the sprinklers are inspected quarterly by maintenance staff. Records are kept by the Plant Manager. III. FIRE ALARM AND DETECTION SYSTEMS ADT Security Systems (CCA License #LA73; CCL #20146) provides quarterly inspecting, testing and preventive maintenance for the fire alarm systems at Kern View Hospital and Alta Vista. Records are maintained by the Plant Manager. Effoc~vo D~t~ 29 December 1988 Soun:~ Safety Committee KV 7/~2 Date of Review: ~ / 8 6 KERN VIEW HOSPITAL, INC, SAFETY PROGRAM I. Safety Policy II. Procedures III. Safety Rules and Regulations APPENDIX: Emergency Removal of Nonambulatory Patients Revised: December 1988 Approved by: ~~~-~~~ Walter ~eid, Chief Executive O~f~cer Ras~mikant Shah, M.D., Chair, Executive Committee of Medical Staffs SAFETY PROGRAM I. SAFETY POLICY A. Ail operational procedures at Kern View facilities shall be conducted in the safest manner possible toprotect employees, patients, the public, and to preserve our facilities. B. Safety shall take precedence over expediency or short-cuts. C. Every attempt shall'be made to remove conditions that could cause accidents. D. Ail supervisors and employees shall comply with all applicable safety laws, standards and ordinances. E. Employees failing to comply with rules and procedures of Kern View's Safety Program will be subject to disciplinary action or dismissal. F. The Chief Executive Officer (or designee) shall be responsible for com- pliance with the Occupational Safety and Health Act as an integral part of his loss prevention duties. II. PROCEDURES A. Safety rules and regulations governing operational procedures for all services shall be written and included in the safety program of Kern View. Development, implementation and review of the safety program is the responsibility of the Safely Committee. This program shall be reviewed and revised on an annual basis. B. Regular performance evaluations, preemployment physical examinations.and re-examinations shall be required of employees to assure that they are physically and mentally qualified for the work environment and require- ments of their particular job. C. Employees shall be informed of Kern View's Safety Program and the safety standards applicable to their job through the Personnel packet given to each employee at the time of employment. Any changes in safety standards will be announced through memos, postings on bulletin boards, training classes and/or revisions of the Personnel packet and Administrative Manuals. D. Training shall be provided each year for all staff on fire procedures and the use of fire extinguishers. Additional training shall be, provided in response to committee recommendations. E. Ail accidents involving patients, employees or visitors shall be reported to the supervisor and proper incident report forms completed immediately. The report forms shall indicate the nature and seriousness of the accident, the supervisor's evaluation, conclusion, recommendations and any action taken, and will be used for review by the Safety Committee. F. Incident reports include employee, patient and visitor accidents, but, may also include property damage, security, or other safety issues related to equipment and/or utilities. Each month the Safety Committee will review accidents and incidents reported, noting whether safety procedures had been followed and whether additional recommendations shall be made con- cerning the employee's compliance with safety procedures or whether there is a need to establish additional safety procedures. The Committee's find- ings, recommendations, and actions taken shall be recorded in the Safety Committee Minutes. G. Immediate attention shall be given to all recommendations made by the Safety Committee or by compliance office,rs. The chair of the Safety Committee shall have the authority to take action when conditions exist that pose an immediate threat to life or' health or pose a threat of damage to equipment or buildings. H. Immediate attention shall be given by the supervisor, Plant Manager, chair of the Safety Committee, and the Chief Executive Officer to valid employee complaints concerning unsafe acts or unsafe conditions. Employees shall report unsafe acts and conditions immediately to their supervisor. I. The Safety Committee will conduct monthly safety inspections. The chair of the committee will conduct facility-wide inspections twice per year. J. Appropriate first aid shall be provided to any injured employee by qualified staff members. In addition, the injured staff member shall seek immediate medical attention. K. The Chair of the Safety Committee shall review loss trends, actions and safety recommendations and evaluate the effectiveness of the Safety Pro- gram. The committee chair shall provide annual statistical reports and analyses to the Chief Executive Officer, the Clinical Director, the CDRH Director, and other members of the committee. Quarterly reports are pro- vided to the CEO, members of management team, and to all department heads. L. The following shall be on file in the Chief Executive Officer's office: 1. Safety Program 2. Minutes of the Safety Committee. 3. Safety inspections, recommendations and action taken. 4. Workers' Compensation procedures. 5. Any other required records. M. The Safety Committee maintains reference materials in the Kern View Hospi- tal library. These include numerous selections from the National Fire Pro- tection Association. N. Binders with material safety data sheets for products purchased by Kern View are available in the office of the Safety Committee chair, and in locations convenient to those who use the product. Kern View's programs for hazardous materials and waste are reviewed at least annually by the Safety Committee. III. SAFETY RULES AND REGULATIONS A. Fire Prevention and Fire Protection Every effort should be made to prevent the start of fire. The most important preventive measure is maintaining good housekeeping in all departments and enforcing the rules for fire safety. 1. Keep all storage areas uncluttered. The lowest shelves in storage areas shall either be sealed to the floor or have sufficient space underneath to allow for cleaning. Do not store objects near ceilings; allow for clearance of at least 18 inches. 2. Smoking is disqouraged at Kern View f~acilities and is unlawful except in designated areas. -2- DESIGNATED AREAS: KERN VIEW HOSPITAL a) West half of the dining room b) Patio areas and outside of the buildings c) Nurses' staff room d) Clinical and administrative offices and Living Center at the discretion of the person in charge. Exceptions: Group sessions for inpatients shall not allow smoking unless all those present agree to allow smoking. e) Designated inpatient lounge. f) Recreation room and adjoining corridor All other areas are "no smoking" areas. COUNSELING CENTERS at Taft and Delano No smoking is allowed. ALTA VISTA HOSPITAL a)Those tables adjacent to the northern wall of the dining room. Smoking is allowed during Community meetings, if smoking is approved by the meeting chairperson. If smoking is permitted, the air purifiers MUST be used. c) Clinical, administrative and conference rooms at the discretion of the Director of Alta Vista Hospital. d) Outside of the building. Ail other areas of Alta Vista, including the patient lounge and mobile unit are "NO SMOKING" areas. ADDITIONAL SAFETY PRECAUTIONS RELATED TO SMOKING: 1) Patients shall not smoke even in designated smoking areas if they are heavily sedated, except in the presence of a staff member. 2) Unsupervised smoking by patients who are not mentally or physically responsible for their actions is prohibited. 3) A patient confined to bed shall be discouraged from smoking. An exception may be allowed if: a) the smoking is supervised by a responsible adult; b) another patient occupying the room gives explicit permission; and c) the patient is mentally and physically responsible for his actions. 4) Wastebaskets and ashtrays shall be made of noncombustible materials. Wastebaskets shall not be used as ashtrays. 5) Combustible gas or oxygen shall be properly labeled and stored in designated rooms. Under no circumstances is smoking allowed in rooms where combustible gas or oxygen is stored or in use. 3. Ail flammable liquids shall be kept in tightly closed or sealed con- tainers when not in use, shall be stored in quantities and locations approved by the fire department, and shall not be accessible to patients. Under no circumstances should flammable liquids be kept near open flames or heating devices. Do not store combustible items (e.g., paper, rags, etc.) with flammable items, like aerosol cans. Do not store flammables or combustibles near water heaters. --3-- 4. Exit doors must be kept clear at all times. 5. All staff members are required to participate in fire safety training and to participate in fire drills. Questions regarding the fire safety program shall be directed to the Safety Committee. B. General Rules for Proper Lifting for Ail Departments and Services (Also, see Appendix-Emergency Removal of Patients). 1. First, be sure you have good footing. Spread your feet naturally and comfortably before you lift any object. 2. Bend at the knee to grasp the weight. One should squat rather than stoop when lifting heavy objects. 3. Keep the center of gravity of the object close to you. At arm's length, even a medication tray is heavy. 4. Get a firm hold. 5. Never try to lift from a position where your spine is twisted, or a position that does not feel comfortable. 6. Lift gradually by straightening the legs. 7. If the weight is too heavy or bulky to lift comfortably -- get help. 8. Similar safety procedures should be followed when putting down a load, for this may be as dangerous as lifting. 9. TO INSURE SAFETY IN THE PROPER HANDLING OF PATIENTS, YOU MUST THINK OUT YOUR ACTIONS BEFORE YOU BEGIN TO MOVE HIM. FOR EXAMPLE: - Is there a mechanical device that can help you do the job more safely and easily? - Doyou need help? - Make sure you have the room to move freely. On the other hand, make sure that everything is secure (bed, wheelchair, stretcher). - Make sure the patient knows what you are doing. - Make sure you report any defective equipment immediately to the supervisor. - Be sure to know the proper techniques for the emergency removal of patients as outlined in the appendix to these rules and regula- tions. C. Tips for Food Service Safety (Dietary Departments) 1. Pots, pans and equipment around the steam tables should always be treated as though they were exceedingly hot. Handle them with tongs, proper tools or suitable pads. Always clear a space to receive them before removing them from the range. 2. Tilt pot lids when removing them so that steam will be directed away from your face. Open steamers so that steam will be directed away from from your face. 3. Turn the handles of cooking utensils so they do not stick out over the edge of the stove. 4. The guards on meat slicers, bread cutters, vegetable slicers, etc., are for protection purposes. Keep them in place at all times. --4-- 5. Keep hands out the hoppers of meat grinders, choppers, mixing machines, etc. Use the wooden or plastic pushers provided for that purpose. 6. Turn the switch off and pull the plug out before cleaning or adjusting power equipment, especially slicers. 7. Keep exhaust hoods clean to reduce danger of fire. 8. Mop up spills immediately. Pick up debris such as produce leaves, peelings and paper. They can cause slips and falls. 9. Let falling knives fall. Never try to catch anything that is sharp. 10. Cut away from your hands and body. Never hack or chop with the knife. 11. Check to see that all power equipment is properly grounded and UL listed. 12. Never put hands into garbage disposal units. 13. Keep cutlery in good condition. Dull knives tend to slip. Do not leave them on tables or blocks. 14. Do not store dishes, glassware or other non-food articles on shelves or on tables where food items are present. 15. When using coffee urns, use suitable steps to ensure safe footing and do not overreach; when filling the urn, use a container that can be handled easily. 16. Keep glassware out of pot sink; set glassware and china in the wash rack securely. 17. If glassware breaks in sink, drain the sink and remove the pieces of glass so that you will have a safe place in which to work. Throw broken glass into an empty container; place container in a plastic bag and throw outside. 18. If glass falls on floor, pi .... it up a~ once usin~ dust pan and brush or dampened paper. Avoid any contact with your hands. Discard chipped and cracked glass and china as outlined in #17 above. 19. Food carts should be wheeled slowly through corridors. To'avoid injuring hands, use the handles. Food carts should be placed alongside a wall and always away from corridor intersections. 20. At Alta Vista, dietary staff are not to lift, unassisted, items in excess of 15 pounds from the range oven. 21. Use protective gloves and/or safety glasses when recommended or required by a product's safety data sheet. 22. Use rubber gloves when washing dishes. 23. Wear shoes that enclose the foot completely and have a non-slip sole. D. Tips for Maintenance Safety 1. Keep all cutting tools sharp. Be sure that tools are clean and free from damage by corrosion. --5-- 2. Hammers, screwdrivers, and similar tools snou±d handles that are sound and should fit tightly. Chisels and similar tools should be dressed smooth and should be free from mushroom heads. 3. Use only nonsparking tools in the presence of flammable or explosive vapors and dust. 4. Do not use stepladders as straight ladders. Be sure that the straight ladder has safety feet. When setting up a straight ladder, its base should stand approximately 1/4 the length of the ladder away from the wall. 5. When working on steam and hot water pipe lines, place warning tags on the closed valves so that others will not open them. 6. Dry your hands before you handle electrical equipment. Pull cord out by the plug; never yank the cord. Think before your begin moving heavy equipment. Roll it slowly and keep to the right. 7. Ventilation, heating and air conditioning systems at Kern View Hospital are maintained by the Plant Manager on a preventive maintenance pro- gram. Filters are checked regularly, and a record kept of changes. 8. Safety goggles shall be used when operating power equipment causing sparks or flying particles. Shields and guards shall be in place at all times when operating power equipment. E. Housekeeping Safety Housekeeping is a vital part of the business operation. You can make your job easier and safer by following these suggestions. 1. Always remove broken glass from the floor with a dust pan and brush. 2. Floors must be thoroughly rinsed and dried after cleaning. 3. When washing floors, always leave a dry area for persons to walk on by cleaning a small surface at a time. Stay on the job until the floor is is dry and safe. Direct all people to the dry side. "Caution" signs shall be used to indicate hazardous walking areas. 4. Keep power equipment and cords out of passageways. 5. Put on gloves before using steel wool. Use holder if one is provided. 6. Place equipment or supplies so they do not block exits or halls. 7. Empty waste containers regularly and place waste in proper containers for sanitation pickup. Use liners for all waste receptacles. 8. Ail housekeeping chemicals that are not intended for patient use shall be stored in a locked cabinet or closet in an area not accessible to patients. 9. Wash cleaning rags after each use. I0. Use protective gloves and/or eye protection when recommended or required by a product's safety data sheet. -6- 11. Do not move furniture without assistance. 12. Ail cleaning products are to be clearly labeled. F. Tips for Handling Linen and Laundry 1. Be careful handling dirty laundry, dumping bags rather than reaching into them. 2. Shake laundry out thoroughly~ watching for needles, glass, etc. 3. Wash hands before you handle clean linen, and after handling dirty linen. 4. Dirty laundry is to be covered or bagged when transporting. 5. Use closed cart to transport clean linens. 6. Push, do not pull, laundry carts. 7. Cover clean linens in the storage z'oom with plastic to minimize contamination from surface or airborne contact. 8. Clean laundry room used by patients daily and disinfect at least bi- weekly. Disinfect laundry carts after each use. 9. Clean lint and grease from machines in laundry room regularly. Keep them clean. G. How to Handle Hazardous Gases Many hospitals face the handling problem of inflammable or explosive~ gases. Here are some tips on the proper storage, handling and control of hazardous gas: 1. Dropping cylinders or allowing them to strike against each other may cause a mishap° Hold cylinders in place with chains or other suitable method to prevent toppling. Gas cylinders shall not be positioned near flame or heat sources. 2. Oxidizing gases such as oxygen, nitrous oxide, and chlorine must never be stored with the easily oxidized gases such as acetylene, hydrogen, methyl chloride, ammonia or liquified petroleum gas. Combustible materials shall not be stored with flammable gases. 3. Keep outlet valves on cylinders tightly closed, even when you think they are empty. Use only tools and wrenches provided by the supplier of the cylinder valves~ 4. Electrical equipment should not be stored in areas where combustible gas or oxygen is stored. 5. Oxygen tanks shall be properly secured with chains in the treatment or exam room and properly secured to the emergency cart with a bolted clamp device. H. General Nursing Department Safety Rules 1. When liquid, food, or foreign matter has been spilled, see that it is removed as soon as possible. --7-- 2. When inserting glass tubes into rubber tubing, always moisten the glass ends first and be sure to place a piece of gauze over glass tubing to protect your hands. When removing glass tube from rubber tubing, use a twisting motion. If broken glass is inside the tubing, remove it with tweezers or push it out with another tube--not your fingers. If appro- priate, cut tubing off just above the point of broken glass. 3. Use the handles when closing doors and drawers. 4. Handles should not protrude beyond the frame of "gatch beds". 5. Electric fans and other electrical appliances shall be safely located to avoid being tipped over. 6. Be sure that stretchers, examining tables, etc., are properly secured when assisting patients onto them° 7. When pushing stretchers or chairs through doorways, grasp it at the end rather than the sides, to protect your hands. 8. Oxygen cylinders should always be transported on carriers designed for this purpose and placed in locations where they cannot be tipped over. 9. Glass, broken bottles, etc., shall be placed in a designated waste container (in the Medication Room) for proper disposal. 10. Ail biohazardous waste, including needles, shall be disposed of in designated containers and barrels° Dispose of needles promptly after use; do not break the needle! Use a tray with sides to prevent needles from rolling off° 11. Paper and other non-hazardous w~stes shall be discarded in regular waste baskets. 12. Instruct patients to wear proper foot attire on hospital premises to avoid falls and other injuries° I. Auto Safety Tips (Refer also to the Personnel Manual and Administrative Manual Book IV for transportation policies and procedures) 1. Ail speed and highway laws shall be observed. Vehicle codes require that the driver check the vehicle, before using it, to insure its safe condition. The driver is required to complete an entry in the daily log in the vehicle. 2. Drivers shall use seat belts and shall request that passengers wear seat belts. 3. Driving should be smooth, avoiding sudden stops, starts, or fast cornering. 4. Each driver shall be responsible to be aware of the comfort of all passengers, which includes NO smoking° 5. No food or drinks shall be consumed in the vehicles. 6. After the trip, the driver is responsible to supervise the picking up of any. debris that may be in the vehicle. 7. It is the driver's responsibility to be certain that patients receive appropriate assistance when entering or getting out of a vehicle. 8. It is the driv~ responsibility to have all windrows rolled up when parking the vehicle, and to lock the vehicle. 9. The driver is responsible to report any car trouble immediately to the Plant Manager, and to document problem(s) in the driver's daily log. 10. The driver of the vehicle is responsible for payment of traffic or parking violations~ 11. The driver is responsible for filling the vehicle with gas at the end of the trip if the vehicle has 1/4 of a tank or less. 12. A first aid kit may be checked out with the vehicle keys for outings (e.g., trips to parks, river, mountains~ etc.). Please return the kit with the keys. J. Electrical Safety Tips (Refer also to Administrative Manuals, Book IV, Memorandum 480~2) 1. The Plant Manager (or his assistant) is responsible for the inspection and testing of appliances, instruments, and installations for current leakage and proper grounding. This may include personal electrical equipment of staff members. 2. A record shall be kept of all electrical appliance and equipment inspections, noting necessary correctioms implemented after each inspection. 3. Routine daily operation of electrical equipment shall not entail the use of an extension cord or adapter° If an extension cord is needed to temporarily operate equipment (e.go, a power drill), the cord can be obtained from the Plant Manager° 4. Octopus outlets are prohibited. Extension outlets, with circuit breakers and overload protection, may be obtained from the Plant Manager if ha deems the intended use to be safe. 5. The use of portable heaters is prohibited. 6. Any trouble lamps should have guards to prevent the hot bulb from accidentally brushing against a combustible~ 7. Electrical power distribution equipment shall be tested when installed and at least annually thereafter. 8. Electrical circuit or wiring systems shall never be installed without proper automatic overload protection~ 9. Never overfuse a circuit because there ate frequent interruptions caused by a blo~ fuse or tripped breaker. These are danger signals and should not be ignored. 10. The Plant Manager should take the following steps to provide proper maintenance for electrical protective devices: a. Keep them clean. Remove dust, dirt, water, metal filings, or any foreign material. b. Tighten bolted, screwed, welded, or soldered connections. c. Lubricate to. prevent frozen mechanical joints. d. Make sure ratings or setting on fuses, circuit breakers, relays, or other protective devices meet the design specifications of the circuits. --9-- 11. Privately-owne~ectrical equipment shall not b in the diagnosis, treatment or monitoring of patients. K. General Environmental and Patient Safety Tips (for all departments and services) 1. Do not move heavy furniture without help. Do not move patient beds from room to room. 2. Glass, broken bottles, etc., shall be placed in covered waste receptacles. 3. An insect and rodent control program shall be maintained. Window screens will be kept in good repair. 4. Employees noting an insect or rodent problem shall immediately notify the Plant Manager or supervisor. 5. Emergency power for Kern View Hospital is provided by a generator, which supplies lighting and electrical outlets in certain patient care areas of the facility. The emergency generator equipment shall be tested and inspected at least monthly by the Plant Manager. 6. The hot water supply for patient, employee and public use shall be at or less than 120 degrees Fahrenheit. Water temperatures in the dietary department at Kern View Hospital may be higher at the discretion of the Dietetic Service Supervisor or Dietitian. At Alta Vista the dietary department utilizes a chemical sanitation system requiring water temp- peratures to be a minimum ~f 120 degrees Fahrenheit. The Plant Manager shall maintain records of water temperatures as tested at the faucet and/or the water heaters. 7. Ail exit doors shall be properly labeled, easily opened, and have' illuminated signs with emergency power. 8. The Health Department shall inspect the facilities periodically to determine that all safety and sanitation precautions are being observed. 9. Any toys or equipment used by patients shall be in good repair and safe for use. Promptly report broken activity equipment to the department supervisor or Director of Activities. 10. Seeing-eye dogs are permitted in Kern View facilities. Small pets may be kept in the classroom by the Phoenix Learning Center teacher. With these two exceptions, pets are not allowed inside Kern View facilities. 11. Hazard or recall notices from manufacturers or government agencies shall be directed to the attention of the Plant Manager and Chair of the Safety Committee for immediate action. L. Activities Safety Rules 1. Swimming Pool Rules The swimming pool is intended for the use of patients, under staff supervision. Any request for non-patient use of the pool is to be directed to the Chief Executive Officer through the Assistant Administrator~ -10- The following are to be observed: a. Any time the pool is used, a staff member must be present who holds, at a minimum, a current certificate in Advanced Lifesaving. b. No one may swim alone. c. No diving. d. No dunking, pushing or splashing. e. No underwater contests. f. No running in the pool area. g.No glassware, drinks nor food in the pool area. Smoking is restricted to designated deck area. h. No radios, tape decks, etc. i. Shower before entering the pool. j. Use suntan lotion - no oil. k. Patients at risk for seizures may not use the pool. 1. Appropriate swim attire is required. Any questions about proper swim attire should be directed to the staff member in charge. 2. The therapist in charge of Activities groups is responsible for safety practices in arts and crafts, cooking, physical activities and outings. Statements of caution and prevention are encouraged at the.beginning of the activity and patients who are uncooperative or use poor judgement should be dealt with immediately° If in doubt of patient's capability, the therapist should make a conservative decision as to patient's level of involvement. 3. The eye wash kit, aprons, safety glasses and gloves are available to patients and staff as various activities require protection, i.e., gloves for work with etching creme, in the Arts and Crafts Room, these materials are kept in the brown cabinet on the sink side where the tools are stored. In the Living Center, these items are kept in the top right-hand drawer on the refrigerator side of the preparation island. -11- APPENDIX EMERGENCY REMOVAL OF NONAMBULATORY PATIENTS KNEEL DROP The kneel drop is a valuable technique for removing the patient from danger when there is no one to assist you. 1. To begin the kneel drop, a technique especially useful for heavy patients, completely remove the top bed covers and get them well out of your way so there will be no possibility of slipping on them as you are moving the patient. 2. If you have time, make sure that the bed brakes are locked, since it will be it will be easier to remove the patient if the bed is stabilized. 3. Remove the patient's pillow and place it so that his feet will fall on it, rather than on the floor, as he is pulled off the bed. 4. Pull the patient's feet to the edge of the bed. 5. Standing with your legs firmly against the bed, slip one arm under the patient's neck and grip his shoulder. 6. Reach across him with the other arm, grasp his hip and pull him to the edge of the bed. 7. Bracing your knee firmly against the mattress to protect him from falling, turn the patient on his side. 8. Shift to a kneeling position, with both knees on the floor. 9. Keeping one arm firmly under his shoulders bring the other up higher across his back, so that you will be able to support his upper torso as you remove him from the bed. 10. Now, lean against the bed and roll the patient's body close, making sure that his shoulders rest firmly against you~ Hold him closely as you pull him off the bed. 11. Let his body slide down to rest on your lap. 12. Lower him to a supine position on the floor, and prepare to drag him to him to safety. Remember, to perform the kneel drop, place the pillow for the patient's feet, pull him to edge of the bed, hold him closely, and pull him off the bed letting him slide to your lap. CRADLE DROP 1. Completely remove top bed covers, slip one arm under the patient's neck, grasp the shoulders, and slip the other arm under the knees. 2. Brace your knee against the bed for stability and support. Pull, rather than lift the patient to the. edge of the bed. -12- 3. Now shift to an upright kneeling position, kneeling on the leg nearest the ' ' patient's head, keeping the other knee elevated. 4. Brace the elevated knee against the bed, keeping the thigh and calf of the leg at right angles and your foot directly beneath your knee. 5. Now pull the patient off the bed, supporting the patient's main weight on your raised knee. 6. Then, still supporting his neck and legs, let the patient's body slide to the floor. REMOVAL OF SEMIAMBULATORY & AMBULATORY PATIENTS The semiambulatory patient will also need assistance in an emergency, and even fully ambulatory patients may sometimes need help. Frightened by smoke, flames, and heat, some patients freeze and are unable to move. Others may become frantic or aggressive and may resist efforts to help them. Begin every rescue effort by reassuring the patient that you are going to move him to safety. Reassurance and a confident attitude may be all that is needed to calm a frightened patient so that he can be led to safety. It may be necessary, however, to control the patient's movements, and walk him to safety. This same technique is used for the semiambulatory patient who simply needs additional support. 1. First position yourself behind the patient. 2. Putting one arm around the patient, grasp his wrist, and bring his arm across his body. With your other hand gripping his shoulder firmly, you can give him strong support. 3. Now, move slightly to one side so that you will not trip over his feet and maintain a wide stance for added stability. 4. Walk the patient to a safer area. THE THREE-MAN HORIZONTAL CARRY The three-man horizontal carry can be used for certain difficult to move patients when a gurney or stretcher is not available. The obese or paralyzed patient, or one who is in a large body cast can be safely removed with this carry. 1. With one person standing at the patient's knees, waist and shoulders, remove the covers. 2. Slip your arms under the patient, gripping him firmly. Then, working in unison, in one continuous movement, pull the patient to the edge of the bed. 3. Lift patient, and turn him facing you. Now, holding the patient close, and coordinating your movements, carry him to a safe area. -13- ~WO-MAN EXTREMITY CARRY The two-man extremity carry can be used when there are two rescuers available and if it is suitable for the particular patient's condition. Teams of rescuers can evacuate large areas quickly with this carry. Because you will be walking single file, this carry can be effectively used in narrow spaces and down stairs. 1. To begin the carry, position yourself at the patient's head, as your teammate removes the covers. 2. Support the patient around the shoulders, while your teammate grasps his wrists. 3. Bring patient to a sitting position. 4. Stand behind patient, put your arms around his chest and lock the hold by gripping your wrist. 5. Your teammate now brings the patient's feet to the side of the bed and pulling the outer leg over the edge of the bed. 6. Your teammate steps around into position and grips both of the patient's legs, holding them at the same place to distribute his weight evenly. weight evenly. 7. At a signal, swing the patient off the bed and carry him to safety. Remember, to perform the two-man carry, bring the patient to a sitting position, lock your arms around his chest, have your teammate grip both legs, and swing him off the bed at a signal. THE BEDDING LIFT The bedding lift can also be used when two rescuers are available. It is especially suitable for post-operative patients, those with extensive burns or abdominal wounds, or for any patient whose condition precludes the extremity carry. 1. Loosen the patient's bedding completely. 2. Using the bedding as a stretcher, gently lower the patient to the floor. 3. One rescuer can then drag the patient to safety, thus, freeing the other rescuer to move other patients. -14- KERN VIEW HOSPITAL, INC. DISASTER PLAN DECEMBER 1988 DISASTER PLAN Outline I. OBJECTIVES ........................ 1 II. INTRODUCTION ....................... 1 III. ORGANIZATION .................... 1 IV. EMERGENCY TELEPHONE NUMBERS ................ 2 V. EMERGENCY ALERT AND NOTIFICATION SYSTEM .......... 4 ~I. INTERNAL DISASTERS ..................... 6 A. Response ....................... 6 ~ B. Authority ...................... 6 ' C. Evacuation ...................... 6 ~D. Notification ..................... 7 E. Fire (or Explosion) Procedures ........... 7 Fire Alarm System .................. 8 ~ Fire Extinguishers ................. 9 F. Earthquake Procedures ............... 10 G. Bomb Threat Procedures ............... 11 H. Internal Civil Riot or Disturbance Procedures . . 13 VII. EXTERNAL DISASTERS ................... 14 A. Response ...................... 14 B. Authority ..................... 14 .... C. Procedures ..................... 14 D. Responsibilities and Assignments .......... 14 Administration ................... 15 Medical Staff ................... 16 Business Office .................. 16 Maintenance and Housekeeping ............ 17 Medical Records .................. 18 Nursing ...................... 19 Activities Services ................ 20 Dietary ...................... 20 Non-Medical Professional Staff ........... 20 Pastoral Services ................. 21 E. Outline of Casualty Flow .............. 21 Receiving ..................... 21 Treatment .................... 22 Discharge or Transfer ............... 22 Expirations .................... 23 DISASTER PLAN OUTLINE (continued) F. Additional Information ............... 23 Physical Supplies Needed .............. 23 Medications and Medical Supplies .......... 23 Food ........................ 24 Communications .................. 24 Security ...................... 24 Medical Records Charts .............. 24 Waiting Room = ~' ~o~ Relatives ............. 25 Press ........................ 25 Staff Breaks .................... 25 Confidentiality .................. 25 Evacuation Route for Flood ............. 25 VIII. ADOLESCENT DAY TREA'FMENT DISASTER. ?LAN ........ 25 A. External and Internal Disasters .......... 25 internal Riot ................... 26 C. Exnarnal Riot ................... 26 D. Instructions .................... 27 IX. ATTAC~NTS ...................... Kern View Map ................... 28 B. Administration Mobile Unit Map ........... 29 C. False Alarms: Turning off Alarm, Sprinkler System, and Resetting Air Handler ............. 30 ii KERN VIEW 3600 San Dimas Street Bakersfield, California 93301 DISASTER PLAN I. OBJECTIVES 1. To provide emergency services to casualties. 2. To develop and maintain an organizational pattern that facilitates the treatment of persons. 3. To provide for the safety and well being of patients and staff during disaster situations. 4. To develop and maintain a prepared staff. 5.' To become effective partners in a community-wide plan for medical services in.periods of disasters. II. INTRODUCTION Both natural disasters and disasters caused b~~ the acts of men could affect the Bakersfield community at any time. It is the inherent obligation of those charged with responsi- bility for the care of the sick, injured and infirm to provide an effective disaster preparedness program. Each employee of Kern View is expected to be familiar with the contents of this disaster plan in order to carry out his or her responsibilities during an emergency. Walter Reid, Chief Executive Officer III. ORGANIZATION A. Disaster Plan in Cooperation with Greater Bakersfield Hospital Kern View's disaster plan is considered to be an integral part of the disaster plan of the Greater Bakersfield Memorial Hospital. Kern View will serve as the treatment area for psychiatric casualties, and will also provide back-up treatment and bed space for casualties trans- ferred from Memorial Hospital. -1- B. Disaster Plan.Committee The Center's Disaster Plan committee is the Safety Committee, in consultation with the Medical Committee. C. Disaster Plan Advisors The following community service has served as advisor in the development and review of the disaster plan for Kern View: City of Bakersfield Fire Department Fire Prevention and Arson Investigat ion Division ~~. ~~ IV. EMERGENCY TELEPHONE NUMBERS Fire Department ............... 911 or 324-4542 Bakersfield City Police ........... 911 or 327-7111 Kern County Sheriff's Department .... 911 or 861-3110 California Highway Patrol .......... 911 or Ask Operator for Zenith 12000 American Red Cross, Bakersfield Chapter '. . . 324-6427 Kern County Emergency Services ........... 861-2491 Director of Medical Services (Physician appointed by · the Kern County Medical Society) ....... 325-9025 Hospitals: Greater Bakersfield Memorial Hospital . . #103 or 327-1792 Kern Medical Center ........... #105 or 326-2000 T T Y .................. 326-2880 Mercy Hospital .............. #104 or 327-3371 Bakersfield Community Hospital ...... #107 or 399-4461 San Joaquin Community Hospital ...... #106 or 327-1711 T T Y .................. 323-7629 -2- ADT/Crime Control (alarm system) ........ #100 or 322-1961 Cincinnati Time Equipment (repairs to alarm system). . 326-1300 Utilities: Pacific Gas and Electric Company ........... 324-3981 Southern California Gas Company ........ (800) 752-2820 California Water Service Company ........... 324-6011 Pacific Telephone Company Line Repair Service .... 611 AT&T Telephone Equipment Repair ......... (800) 242-2121 Servisoft (emergency water supply) .......... 327-2704 after hours ................ 324-3234 San Joaquin Valley Sanitation (chemical toilets)... 322-1828 Ambulance: Hall Ambulance Service ............. 911 or 327-4111 Golden Empire Ambulance Service ........ 911 or 327-9000 Radio and Television Stations: refer to yellow pages 625 and 775 for listings of radio and television stations. K U Z Z (Frequency 55) at 326-1011 has been designated as the Emergency Broadcasting System for the Kern County area for the purpose of dissemination of emergency information in the event of a national alert. Pharmacy: Medical Pharmacy ................ #108 or 372-7524 Greater Bakersfield Memorial Hospital Pharmacy.. . 327-1792 Gregg's Pharmacy ................... 327-9749 Vest Drug, Inc .................... 324-9662 Nearest Outside Pay Telephones: -- 7-Eleven Food Store (Front Entrance), Corner of San Dimas and Columbus -- Southeast Corner of 34th Street and "Q" Street -- K-Mart Store (Front Entrance), 401 34th Street -3- EMERGENCY ALERT AND NOTIFICATION SYSTEM (To be used evenings, weekends, and holidays for external disasters) Receptionist (or Psychiatric Nurse in charge) -- Chief Executive Officer -- Administrative Assistant I If a person you are responsible to contact is unavailable, be Clinical Director prepared to make that individual's --Secretary to Clinical Director calls. Director of Phoenix Learning Center / ~--PLC Staff ~-Director of Inpatient Services LIP//~T Clinicians --Plant Manager -Building/Grounds Staff %-Housekeeping Staff Medical Records Administrator Medical Records Staff ~Word Processing Staff . Director of Finance Business Office Staff Foundation Director -Director of Admitting/Referral Services fEntry Coordinator Admissions Clerk ~--Rec~ptionist Director of Activities ! ~..Activities Staff Assistant Administrator Personnel Secretary ~---Dietary Staff (off duty) .Psy~hiatric NUrse in Charge --Director of Nursing .~--Contract Psychiatrists -- Mental Health Workers & Aides (on duty) Nurses (off duty) Ten Mental Health Workers & Aides (off duty) LVN & Psychiatric Technicians (off duty) ~_.RN'S (on duty) D±etary Staff (on duty) Note #1: Additional clinical and nursing staff are available and would be contacted, if needed, by the Chief Executive Officer. They are not called on a routine basis. Note #2: In the event a major disaster is severe to the extent that telephones become inoperable, Kern View. will rely on its employees to report for duty as soon as possible. Every effort will be made to also notify personnel by way of any operating communications media. List of persons you are to notify: Name Home Telephone # NOTE: In the event of an external disaster, it is understandable that an employee's first concern will be the protection of his family. If your family cannot be sheltered at a locat£o~ near. your home, you can bring them to Kern View. They can be housed in the classroom until they can be · directed to more appropriate accommodations. As a health. factor, it is extremely important that you do not bring pets onto the hospital grounds. -5- VI. INTERNAL DISASTERS A. Response Evacuation of patients, visitors, and personnel from threatened or affected areas in as rapid and safe a manner as possible under the existing disaster situation. Patients, regardless of condition, are moved to a safe location. B. Authorit~- a. Authority to initiate evacuation procedures is vested in the person in charge within the area involved in the disaster. The person in charge becomes responsible for making immediate staff assignments in that specific area. The person in charge in the inpatient area is the head nurse on duty on the adult unit. b. The head nurse on duty at the time of the disaster becomes the coordinator in carrying out the disaster plan and is responsible for making staff assignments in inpatient section. c. Authority to order total evacuation procedure (off grounds) is vested in the Chief Executive Officer, Clinical Director, or their designee, in that order. d. The designated staff member in charge will determine and advise those involved of any need for partial or total evacuation to safer areas to begin without delay if the need arises. e. Full authority shall be given to the ranking official of the fire or police department upon their arrival, in liaison with the person in charge. f. Designation of specific patients for evacuation to their homes or other agencies should be given by the Inpatient psychiatrist or, in his absence, any other physician member of the Medical Staff present at the time. C. Evacuation The evacuation route is via the nearest, safe exit to the north lawn, beyond the parking lot. " The alternate area is the volleyball court by the east · : parking lot. Evacuate most hazardous areas first--often those farthest from exits or nearest to the danger. Evacuate least serious cases first--ambulatory, then wheelchair, then stretcher cases. When facility evacuation occurs, stay as far away from the building as possible. Keep driveways and parking lots clear for access and use by emergency vehicles. --6-- In the event of total premise emergency evacuation, family members and relatives of patients will be called to take designated patients to their homes. Where great distances are involved, staff and volunteers will be notified to assist in providing temporary shelter for patients while relatives are in transit. Those patients who are serious suicidal risks or otherwise cannot be managed by relatives alone, will be given staff super- vision while the patient is transferred to another appropriate facility. Destination of evacuees will be announced or individually determined. Transportation may require the use of employees' vehicles. D. Notification The nurse in charge is responsible for notifying the following: 1. Clinical Director (if not available, notify one of the following in this order: Inpatient Psychiatrist, President of the Medical Staff, any other physician staff members). 2. Chief Executive Officer (If not available, notify Assistant Administrator). 3. Plant Manager (If not available, notify maintenance person). 4. Director of Nursing. 5. If unable to reach the above, notify (a) State Department of Health Services Licensing & Certification 1 - 564-1247 Monday - Friday: 8:00 a.m. - 5:00 p.m. or (b) State Office of Emergency (916) 427-4990 if hospital operations are disrupted or discontinued. In case of commercial power failure, ONLY 5 Telephone Extensions will remain in operation. They are: (1) Admissions Office Extension 251 (2) Nurses' Station Extension 221 (3) Administration Office Extension 218 & 259 (4) Kitchen Extension 219 To activate the phone, place the modular clip into the phone jack labeled "PF". E. Fire (Or Explosion) Procedures 1. Person in charge within area affected: - Remove patients and visitors from danger - Sound alarm by pulling nearest alarm box - Be sure all doors are closed, but unlocked - Notify receptionist or nurse in charge as to the nature and location of the disaster - Direct people to the designated evacuation area - If possible, without endangering yourself, use the nearest fire extinguisher to put out a small fire. --7-- 2. Nurse in~'"narge: - If safe to do so, report to nurses' station (adult unit) to give directions. - If the receptionist is not on duty, notify the fire department (911) as to the location and nature of the disaster. - Station someone at the driveway where the driveway divides to assist the Fire Department to the scene of the fire. - Assign personnel to make room checks in the entire facility. - Direct all occupants to the designated evacuation area. - Designate staff member(s) to take the Cardex and Census Sheet (also flashlight if necessary) to the assembly point for roll call of patients. - Station a staff member at each exit door, when sufficient staff allows, to prevent re-entry into any building. - In the event of total premise evacuation and if circumstances allow, current records should be removed from threatened area. - Emergency discharge forms should be used or treat- ment cards sent with patients in case of total premise evacuation. 3. Ail Other Staff Members: - The receptionist, after being notified of the disaster, shall immediately notify the fire depart- ment as to the location and nature of the disaster. - Staff members in building or area affected shall assist the staff person in charge in carrying out his/her delegated responsibilities. - Staff members located in the inpatient area when the alarm rings shall check with the nurse on duty at the Nurses' Station (adult unit) to determine the need for their services in relation to patients. - Staff members not located in the inpatient wing Or affected area shall gather with the patients in the designated evacuation area. 4. The Fire Alarm System The Kern View fire alarm system is directly connected with Crime Control. They notify the Fire Department. Fire alarm boxes (to activate the fire alarm) are located: (1) In the Adult Inpatient Unit: (a) the end of the north, south, west and east halls (b) at the Nurses' Station (2)~ In the Adolescent Inpatient Unit: (a) at the nurses' station (b) at the end of the hall by the east exit -8- (3) In ~reation Building (a) on the north wall of the Dining Room (b) in the hallway (4) In the Butler Building/Living Center (a) on the north wall of the Living Center (5) In Buildin$ A: (a) in the lobby (6) In Buildin~ B: (a) in the lobby (7) In the Phoenix Building (a) on the east wall (8) In the Reception & Admissions Building: (a) in the lobby (9) In the Administration Mobile Units: The security control panel is by the southwest exit. Press the numbers "1" and "7" at the same time to activate the fire alarm. Note: A horn will sound if an alarm is activated in the mobile units. This alarm will not register on the annunciator nor will it activate the fire alarm system in the other parts of the hospital. The lamp-type annunciator located at the Nurses' Station (adult unit) indicates the zone in which the fire alarm box was pulled. These zones are specified on a legend by the annunciator. 5. Fire Extinguishers a. ALL fire extinguishers at Kern View are the "all purpose" type (ABC) and can be used on any kind of fire, e.g., electrical, wood, flammable liquids, et b. Locations of fire extinguishers: (1) In Inpatient Area: (a) Nurses' Station (b) north hall (¢) air handler room (d) in the middle of the hallway of the south wing (e) by the restrooms in the south wing (2) In Adolescent Inpatient Area: (a) in the lobby, by the utility room (b) at the east end of the hallway (3) In the Recreation Building (a) in the Dining Room by dishwashing room window (b) in.hallway between public restroom doors (c) in Crafts Room near the sink (d) in Kitchen by the walk-in cooler (e) in Standby Generator Room (f) in Boiler Room (g) in Maintenance Shop (4) ~Buildin~ B: (a) in the lobby (5) In the Butler Building/Living Center: (a) on north wall next to door of Living Center (b) on east wall of the printshop (c) Medical Records storage room (d) Kiln Room (6) In General Storage Room: (a) on west wall next to double door (7) In Buildin~ A: (a) in hallway (8) In Phoenix Building: (a) on north wall (9) In Reception & Admissions Buildins: (a) in the lobby (10) In Administration Mobile Units: (a) north and south hallways (b) east wall of computer room F. Earthquake Procedures 1. Protect patients -- instruct persons to keep away from windows and outside walls, move out from under light fixtures, and, if possible, take shelter in areas such as under tables or desks for protection from falling objects or debris. 2. Nurse in charge: (a) After initial tremor, carry out evacuation procedures as in the case of fire or explosion. (b) Prevent re-entry into any building until it has been determined by the fire department or civil officials that the building may be reoccupied. (c) If the disaster is major, proceed with carrying out those procedures and instructions listed under EXTERNAL DISASTERS. 3. Ail other staff members: (a) Staff members shall assist the staff member in charge of the area in which they are located, in carrying out his/her responsibilities. (b) Medical and nonmedical staff members shall check with the nurse in charge to determine the need for their services. (c) Render first aid where necessary. 4. Additional Instructions (a) Remain indoors until signal to evacuate buildings is given. (b) Persons out of doors should.be instructed to move as soon~as possible away from buildings, trees, and power lines. -10- ~ ' (c) Avoid touching electrical wires that may have fallen. (d) Turn off all utilities. (e) Do not use open flame illumination. (f) If you smell gas, open all doors. (g) In most parts of California, the initial earth shock is the most severe; however, in some areas the subsequent shocks may be more severe than the initial tremor. In such areas this should be taken into consideration when determining how soon buildings may be reoccupied. G. BOMB THREAT PROCEDURES 1. Persons receiving bomb threat (receptionist, nurse, ward clerk, etc.) (a) Obtain as much information as possible. Request the following information, writing it down as soon as possible, and quoting as much of the conversation as possible. (1) What time is bomb set to detonate? (2) How many bombs are involved? (3) Where is the bomb located? (4) What type of bomb? (Give description) (5) Any other information that can be obtained. (6) Name of caller. (7) Exact time call received, time call terminated (8) Background noises--music, traffic, laughter, TV broadcast, etc. (b) In the event a note is used to make threat: (1) Obtain as complete description as possible of the person passing note. (Sex, height, weight, hair, eyes, nationality, how dressed, anything unusual--scars, birthmarks, tattoos, prominent features, etc.) (2) Do not handle or let anyone else handle the note more than necessary. Remember who has handled the note for the purpose of elimination of fingerprints. (3) Notify nurse in charge who has authority to carry out initial assignments 2. Nurse in charge: (a) Remove all patients and visitors from danger. (b) Initiate evacuation by pulling nearest alarm box. (c) Proceed with evacuation procedures as in case of fire. (d) Notify the Police Department. (e) Upon arrival of police: (1) Be available for conference. (2) Have the person receiving the bomb threat available for an interview. (3) Have a facility map and necessary keys available. (4) Report any suspicious looking objects sighted. -11- (f) Prevent re-entry of patients or unauthorized persons into building until an "all clear" signal has been given by the ranking officer of the law enforcement agency. 3. Ail other staff members: (a) Staff members located in the inpatient wings when the alarm rings shell check with the nurse in charge at the Nurses' Station (adult unit) to determine the need for their services in relation to patient evaluation problems. (b) Staff members not located in the Inpatient wings shall gather with the patients in the designated evacuation area and be available to assist in .whatever way needed. (c) Staff shall respond to instruction given by officers of the law enforcement agency after their arrival until an "all clear" signal is given. 4. Additional Instructions: (a) Search of Premises: A thorough search will be directed by law officers and employee may be used to conduct the search. Employees (preferably maintenance and custodial employees) know the facility and are aware of what items should be and should not be in various places. Ranking members of the bomb team will advise when search is completed and the results of the search. (b) If a bomb or suspicious looking object is found: (1) DO NOT TOUCH OR DISTURB ITEM REGARDLESS OF HOW HARMLESS OR HOW INNOCENT IT MAY APPEAR. It may be armed with an antidisturbance device or timing mechanism. (2) Immediately contact a member of the bomb team or an officer who will make contact with a member of the bomb team. (3) When a bomb or suspicious item is found, members of the bomb team immediately assume full command of the situation. They will evaluate the time, may order partial or complete evacuation of the area, make a decision on how to handle the bomb--disarm at location, move the bomb, detonate at scene, etc. (c) Things to remember: (1) There is no set appearance for a bomb. (2) A bomb may have an antidisturbance device so that it will detonate if moved. (3) A bomb may have two fuses, and the use of electric blasting caps may have a secondary power source. -12- (4) A partially burned fuse might be obvious so that it will be assumed the bomb is not dangerous; however, it may contain an anti- disturbance or timing device. (5) DO NOT TAKE ANYTHING FOR GRANTED. IF YOU DON'T KNOW, DON'T ACT. H. RIOT OR DISTURBANCE PROCEDURES 1. Staff member in charge of area affected: (a) For any situation requiring immediate assistance, the staff member in charge shall dial 399 and say in a clear, calm manner, "Code 2" and give your location, e.g., "Code 2, Dining Room." Staff members are to respond to the page immediately. (b) In the event of an out-of-control riot situation: (1) Notify staff by issuing Code 2 page, and giving location of disturbance. (2) Remove all patients and visitors from danger. (3) Keep and promote a calm attitude. (4) Notify receptionist or nurse in charge. He/she shall immediately.notify the police department of location and nature of disturbance. 2. Nurse in Charge--when notified of disturbance shall: (a) Call law enforcement agency if warranted. (b) Send assistance to disturbance area. (c) Check Quiet Room and have it available for out- of-control patients. 3. Ail other staff members: (a) Ail personnel on duty, at the sign of a dis- turbance or in response to a page, should make themselves available until the situation is under control. (b) When law enforcement personnel arrive, the ranking officer shall be in charge. Ail orders are to be followed. 4. Additional Instructions (a) Make all attempts to keep disturbance in an enclosed area and centralized. This may require locking of interior or exterior doors. (b) Since the news media monitors calls made to law enforcement and fire departments, it is extremely important that confidentiality laws are not violated if any reporter appears on the scene. -13- VII. EXTERNAL DISAS~S A. Response 1. Minor--Community Disaster involving relatively small number of casualties such as storm, fire, flood, plane wreck, etc. Expansion of treatment areas to care for any walk-ins until they can be transferred to general hospitals. 2. Major''Community Disaster involving large number of casualties such as storm, flood, epidemic, earthquake, mass food poisoning, etc. Expansion of reception and treatment areas to care for casualties. Evacuation or discharge of inpatients to free beds for casualties. 3. Disaster Threats--Either the facility or the whole community such as impending flood, enemy attack, nuclear attack, etc. Precautionary evacuation, partial or total. "Alert" notification to staff and volunteers. 4. Disaster in other communities nearby. Expansion to receive casualties and/or inpatients transferred from stricken community. Send personnel and supplies to stricken communities upon request. B. Authority The Mass Casualty Captain (Inpatient Psychiatrist) together with the Chief Executive Officer and the Greater Bakersfield Memorial Hospital Casualty Captain will institute the disaster program in case of external disaster. The Mass Casualty Captain is to serve as the- coordinator of the mass casualty plan working closely with the Chief Executive Officer. C. Procedures Ail personnel are cautioned to use standard operating procedures whenever possible and are to vary from these procedures only when called to do so by the mass casualty plan or where necessary because of the emergency condition of the care provided under a physician's order. Personnel are also reminded to maintain a high level of professional ethics by not discussing patients with non-Kern View or medical treatment personnel. D. Responsibilities and Assignments The responsibilities listed on the following pages are in addition to daily responsibilities in non-disaster periods. Key persons are persons appointed to delegate the work within the department. -14- 1. Administration Key Person: Chief Executive Officer (Alternate - Assistant Administrator) Personnel Included: Chief Executive Officer, Assistant Administrator, Receptionist, Director of Public Information, Secretaries, and Administrative Assistant. Meeting Place: Inpatient classroom (#50). If not available, meet in any other area not immediately affected by disaster. Responsibilities and Assignments: a. Coordination of mass casualty plan by working closely with the Mass Casualty Captain (Inpatient Psychiatrist). Determine what Kern View programs (outpatient, day treatment) are to modified or discontinued during the disaster. b. Administer disaster program; notify key persons or their designees of disaster situation: (1) Director of Finance (2) Plant Manager (3) Medical Records Administrator (4) Director of Nursing (5) Nurse in Charge (6) Director of Activities (7) Dietetic Services Supervisor (8) Clinical Director c. Initiate, if necessary, Kern View's Emergency .. Alert and Notification System to notify personnel to report to duty. d. Establish a public and press relations system (suggest a room in Building A) e. Act as communication clearing center. Issue walki-talkies (in file cabinet in Plant Manager's office) for internal communications. Set up radios to monitor civil defense frequency. Assign a nursing staff member to monitor the County Emergency Radio (in Nurses' staff room). f. Assign liaison person(s) for Greater Bakersfield Memorial Hospital, to keep in touch with the ' administrator of Memorial Hospital. g. Assign secretarial staff as needed to medical and non-medical professional staff. h. Determine need for volunteers. Assign Administra- tive Assistant to contact volunteers and make appropriate assignments. Designate an area for volunteers to report and receive assignments and instructions. Possible volunteer assignments: -15- (1) Call needed persons. (2) Assist in escorting patients~ (3) Assist in tagging process. (4) Assist in keeping coffee and juices available. (5) Assist in errands. (6) Assume duties related to the temporary morgue. i. Assign receptionist to operate switchboard or emergency telephone. j. Assign personnel secretary to issue keys necessary during an emergency situation. k. Notify State Department of Health Services of discontinuance or disruption in services. 2. Medical Staff Key Person: Inpatient Psychiatrist (Mass Casualty Captain) (Alternate: any in-house psychiatrist) Personnel Included: In-house psychiatrists, physician members of medical staff*, physicians assigned to Kern View by Memorial Hospital. Responsibilities and Assignments: a. Decide with Administration and the Greater Bakersfield Memorial Hospital Casualty Captain to institute disaster program in case of external disaster. b. Coordination of mass casualty plan by working closely with the Chief Executive Officer. ¢. Assist in administering the disaster program. '~ ~ d. Develop needed emergency medical treatment facilities. e. Work closely with nursing staff and attending physicians to determine which inpatients are to be discharged to allow space for casualty patients. f. Supervise receiving area. g. Supervise medical care at Kern View Hospital. ~ h. Coordinate with non-medical professional staff a plan to deal with traumatic neurosis-type after- care problems. 3. Business Office Key Person: Director of Finance (Alternate: Accountant) *In the event of a major disaster, each physician in the Greater Bakersfield area is to report to the hospital as assigned by the Kern County Medical Society. Therefore, the services of Kern View's physicians may be required elsewhere. -16- Personnel Included: Ail Business Office Staff and Admissions Clerk Responsibilities and Assignments: a. Develop and implement system of accounting for charges for supplies and nursing care ~o casualty victims. b. Assist Administration in developing emergency telephone coverage and prohibit unauthorized use of emergency phones and coin operated phones. c. Develop system of admission, discharge, and transfer. d. Supervise admitting staff. e. Initiate, with the assistance of the Nursing Staff, a tagging process (if not already tagged by Memorial) with name, address and pertinent informa- tion for each patient. Note descriptive items about any patient who cannot provide identifying informa- tion. f. Designate responsibility to check and log patients' valuables to one person. g. Establish log points at Nurses' Station (adult unit) and all exterior doors of Dining Room and Recreation Room to show entrance and disposition of patients. h. Record all persons treated and discharged to their homes, transferred or expired. i. Record name and address of responsible person (next of kin, etc.). 4. Maintenance and Housekeeping Key Person: Plant Manager (Alternate: General Maintenance) Personnel Included: Ail building and grounds staff Responsibilities and Assignments: a. Regulate traffic flow (preferably two people should be assigned to this station): (1) Keep entrance route open. (2) Prevent entry of unauthorized persons on Kern View g?ounds. Direct press to Building A, injured to triage area, and employees to triage area if they'have not received an assignment. If employee is accompanied by family, direct family members to PLC classroom. (3) Define parking areas. -17- b. Work sely with the Mass Casualty Captain for rearrangement of furnishings and setting up of necessary equipment in receiving and treatment areas. c. Survey the need for additional emergency equipment and make contact with Kern County Emergency Services or other sources which may have the needed equipment available. d. Se~'that all buildings have adequate supplies and clean linens. Check nursing units and dietary department to make sure lanterns and flashlights are operable. e. Survey and record any damages that may have affected the hospital and specify what safety precautions should be taken. f. Keep the hospital lighted and comfortable. For power failures in excess of 24 hours, obtain additional diesel fuel through Sullivan's Standard or other available supplier. g. Make provisions in the~Living Center for its use by employees for rest breaks. Supply it with 4 cots if possible. h. Make provisions in Storage Room for its use as a temporary morgue and keep vehicle entrance route to this area clear. i. Obtain water from swimming pool, if needed for non- potable uses (e.g., flushing toilets if water main is broken). j. Contact San Joaquin Valley Sanitation (or other supplier) if chemical toilets are needed. 5. Medical Records Key Person: Medical Records Administrator (Alternate: Transcriber II) Personnel Included: Ail Medical Records and Word Processing Staff Responsibilities and Assignments: a. Provide emergency medical record processing: 1) Emergency charts. 2) Record of all treatment provided and dis- position of patient. 3) Supervise and insure the continuity of medical records for all disaster patients. b. Assist Business Office personnel in obtaining admission information on those treated at Kern View. 18 · c. In case of fire or f]ood, move existing records for protection if possible. 6. Nursing Key Person: Director of Nursing (Alternate: RN in charge) Personnel Included: R.N.'s, LVN's, LPT's, Mental Health Workers & Aides Responsibilities and Assignments: a. Provide nursing care under physicians' orders. 1) Patient care 2) Administration of drugs and treatment. Note immediately in emergency chart the administration of medication. 3) All physicians orders are to be recorded on patients's ID tag. b. Coordinate, under physicians' orders, the discharge of all patients able to leave the hospital c. Maintain patient records. 1) Assist Business Office personnel in admitting process. 2) Keep records of all discharges. d. Be sure all transfers back to Greater Bakersfield Memorial Hospital have an escort who will stay with the patient until admitted by Greater Bakersfield Memorial Hospital. (May utilize employee pool or volunteers.) e. Assign a Worker the responsibility to keep the Mass Casualty Captain informed of available beds. f. Supervise equipment and supply utilization. g. Staff as follows: (1) 2 nurses in the receiving area (dining room) (2) 3 nurses in the hospital ward (3) 5 Workers or Aides in the inpatient ward (4) 2 Workers or Aides in the dining room (5) 1 Worker or Aide to assume duties related to temporary morgue--may utilize volunteer (6) 2 Workers or Aides to transport patients between Triage and ward h. Call nursing personnel from ward phone or phone booth "B". i. Supervise compulsory rest breaks for each employee at least every 3 hours. The Living Center is to be used as a staff lounge. -19- 7. Activities~Services . Key Person: Director of Activities (Alternate: designated Activities Therapist) Personnel Included: Ail Activities Staff Responsibilities and Assignments: a. Help provide control in casualty receiving area. b. Help staff emergency telephones in receiving and casualty areas. c. Work directly with nurse in charge or Plant Manager in requisitioning and delivering drugs and supplies from Medical Pharmacy, the Greater Bakersfield Memorial Hospital, and other sources. d. Assist nursing in record keeping. e. In long-term disaster, provide diversional activities. 8. Dietary Key Person: Dietetic Service Supervisor (Alternate: Assistant Dietetic Service Supervisor) Personnel Included: Ail Kitchen Staff Responsibilities and Assignments: a. Provide simple foods such as sandwiches, coffee, tea, continuously at the cafeteria serving tables. b. Create an emergency employee pool for the kitchen. c. Call in all needed personnel in the department. d. Provide means of serving nonambulatory patients. e. Provide food and beverages on carts/tables in hall near Activities Offices. f. Provide drinking water. Contact Servisoft Company to supply potable water, if our main supply is contaminated or interrupted. 9. Non-medical Professional Staff Key Person: Clinical Director (Alternate: Outpatient Director) Personnel Included: Clinical Social Workers, Clinical Psychologists, Clinical Counselors -20- , Responsibilities and Assignments: a. Form crisis intervention teams. The Recreation Room shall be designated as the organizing location. Assign clinicians to monitor and assist in triage area, as requested by the Chief Executive Officer or Mass Casualty Captain. b. Deal with relatives (keep them away from treatment areas and provide general information). Waiting area for relatives is the lobby (Admission & Reception Building). c. Do not neglect patients. Help relieve anxiety · created. Assist in disposition of inpatients who can be discharged as determined by Kern View psychiatrists, to make beds available for casualty patients. Assist in disposition of outpatients and day treatment patients, keep them away from treatment areas. d. Together with the Mass Casualty Captain, coordinate a plan to deal with traumatic neurosis-type after care problems. e.As available and needed, individual offices may be utilized by clinicians for patients. 10. Pastoral Services Key Person: CEO Personnel Included: Volunteer clergy from the community Responsibilities and Assignments: a. Obtains the services of priests, ministers, and rabbis to assist in meeting the pastoral needs of patients and families during the crisis. E. Outline of Casualty Flow (Whether major or minor, the casualty flow depends upon the initiation of the mass casualty plan by the Greater Bakersfield Memorial Hospital.) 1. Receiving a. The receiving area for patients to be treated at Kern View is the Dining Room. This area should be cleared of all persons immediately upon the initiation of a mass casualty plan at Greater Bakersfield Memorial Hospital. (Physicians, nurses and secretaries from Medical Records and Business Office may be assigned from Memorial.) -21- b. In a casualty of a major nature, Greater Bakersfield Memorial Hospital Triage Center will be · responsible for the direction of patient flow to Kern View. The majority of patients coming to Kern View will already have had a medical determination made as to the type of treatment needed and should have a tag bearing this information. c. Kern View will be available to admit patients discharged from Memorial Hospital to make space available for the more critically injured at the general hospital. d. Kern View will also be available to hold patients transferred from Memorial Hospital, who have been discharged to make space available for the more critically injured persons, but whose familie~ have not been able to pick them up. Memorial Hospital expects to be able to discharge patients from the back door and direct family members to Kern View. e. The Central Receiving Area will be the front Emergency Entrance of Greater Bakersfield Memorial Hospital. 2. Treatment a. Ambulatory patients (not requiring further treat- ment) will be directed to the Recreation Room by the receiving area staff where there will be a crisis intervention team. b. Nonambulatory patients and patients requiring further treatment will be taken to the inpatient wing of Kern View where they will receive medical and nursing care. Receiving physician's orders shall be recorded on the patient's tag before the patient is transferred to the inpatient area. c. Hospitalization (1) Mass casualty patients will be assigned to available vacant beds. (2) If there is need for emergency expansion, the lounges and group rooms can be utilized. (Kern View is responsible for making arrangements for additional beds/cots.) (3) For additional space, Kern View will cooperate with Greater Bakersfield Memorial Hospital to use nearby health facilities or Garces High School. 3. Discharge or Transfer Mass casualty patients will be released following crisis intervention and/or first aid treatment on the -22- order of attending physician. A log shall be main- tained on the disposition of each patient discharged or transferred. Mass casualty patients assigned by the Triage Center of Greater Bakersfield Memorial Hospital to Kern View may be retransferred to Greater Bakersfield Memorial Hospital if a medical crisis arises. 4. Expirations The Storage Room shall be designated as a temporary morgue. Each corpse shall bear a tag clearly documenting identification. Notification of next-of- kin shall be made as soon as possible. Instructions shall be obtained from next-of-kin as to the dis- position of the body. Information on the disposition shall be forwarded to Medical Records. F. Additional Information 1. Physical Supplies Needed a. Call Kern Count% Emergency Services or other sources that may have the additional physical supplies needed. b. Kern View must be prepared to obtain its own supply of beds/cots, medical equipment and supplies. Greater Bakersfield Memorial Hospital is not expected to supply Kern View during emergency set- up. For example, be prepared to develop make-shift standards for IV fluids. 2. Medication and Medical Supplies: a. Kern View must keep on file at Medical Pharmacy a list of all medications and supplies needed by Kern View in times of emergency to be filled on notifi- cation from Kern View. b. ~[ern View must also have a second source of medica- tions and supplies. This is the Memorial Hospital Pharmacy. Telephone #103. Medical Supplies - Disaster Plan 5% dextrose in H20 Intracaths 5% dextrose in normal saline Oxygen Narmal Saline Solution Local Anesthetic - Dextran Xylocaine 1 and 2% with Cortisone Sol. I.V. and without adrenalin Valium 5mg. and 10m P.O. Minor suture sets I.V. and transfusion sets Splints - cardboard (leg Standards and arm size) Needles - all sizes Emesis basins Syringes - all sizes Wash basins TAT with gas gangrene and tetanus toxoid -23- Dressings Gauze bandages - 2 inch & Alcohol 3 inch 4 x 4" sterile gauze pads Phisohex Elastic bandages - 2" & 4" Biased cut stockinette Telfa pads - all sizes Vaseline gauze - sterile Cotton balls Cellulose cotton pads 3. Food a. Sandwiches, coffee, tea and juices are sufficient food items in time of emergency. This is particu- larly true due to the possibility of not having electricity available for food preparation at Kern View. b. Dietary Department shall maintain at least a 3 day supply of nonperishable foods for disaster purposes. Supply sources should be notified immediately of the projected needs of the Dietary Department when disaster plan is implemented. 4. Communications a.Radio and television stations to be called to notify employees are listed on Page 3. b. KUZZ (Frequency 55) has been designated as the Emergency Broadcasting System for the Kern County area for the purpose of disseminating emergency information in the event of a national alert. c.The inpatient classroom will be used for Kern View's communication center. d. Establish and maintain communication with the County's Emergency Operations Center, via radio in nurse's staff room. 5. Security a.To aid in securing grounds, call city police, sheriff's department or highway patrol. b. Employee identification: Each employee should have an identification card to be used in permitting him/her to come to the hospital in times of emergency or civil disturbance. 6. Medical Records Charts If patients need to be evacuated in time of emergency from Kern View'to Memorial Hospital, the entire medical records chart may be transferred with the patient. -24- 7. Waiting Room for Relatives a. To be set up in space available. Relatives of patients may use the lobby in the Reception/ Admissions Building; families of staff are to use the classroom. b. To be staffed by clinical staff if possible. 8. Press Public and press relations shall be the responsibility of Administration. Building A is the suggested location for this function. 9. Staff Breaks The Living Center shall be designated as the Staff Lounge for rest breaks. 10. Confidentiality It remains important for staff members and volunteers to remember the commitment to laws relating to confi- dentiality. Inquiries regarding casualty patients, and incidents shall be referred to the Public and Press Relations Center operated by the Administrative staff. 11. Evacuation Route for Flood For a total evacuation of the facility, in the event of a flood, the designated route of travel is Columbus Avenue to Garces High School. · VIII. ADOLESCENT DAY TREATMENT DISASTER PLAN A. External And Internal Disasters 1. Secretary is to call parents and the California Highway Patrol in case of external disaster for busing information. If students cannot be bused home, bus to Garces High School with Kern View patients, if total premise, evacuation is deemed necessary. 2. The'teacher and an aide are to stay with the students. a. Take roll call before leaving class. b. Turn off lights. c. Close doors and lock. 3. Students are.to go to the north parking lot, keeping the drive clear for emergency vehicles. Students are to remain independent of other patients and staff. -25- 4. The Service Director is to circulate among students in case clinical assistance is needed. The aide is to take students to the Nursing Station if injured. B. Internal Riot 1. Service Director is staff member in charge (alternate is the teacher). If law enforcement is called, the ranking officer is in charge upon his/ her arrival. 2. Objectives: Separate and contain. a. Contain the riot to one area if possible. If incident begins in classroom, close doors and send aide for help. Notify director. b. Service Director may call other staff to assist. c. If more help is needed, call the Nursing Station and additional help will respond. The emergency paging system can also be used by the Secretary. d. Director may ask Nursing staff to make quiet room available. C. External Riot 1. Notify the Service Director. 2. Try to separate students not involved by taking them to the classroom. 3. Bus students home as soon as possible; Secretary is · . to call all parents. 4. Director and teacher are in charge. If more help is needed, call the Nursing Station and additional help will respond. The emergency paging system can also be used by the Phoenix Secretary. 5. Nurse in charge: a. Response to a call for assistance from the Phoenix Learning Center is to offer assistance and make the Quiet Room available if someone is brought onto the ward. b. When sending nursing personnel to the designated area for assistance: (1) Notify the Clinical Director. If not available, notify one of the following in this order~ Inpatient Psychiatrist, President of medical staff, and other physician staff members. (2) Notify the Director of Nursing. -26-