HI Hurricane Daily Shelter Report Instructions.

1. General Information:
    a. Enter the date when the form is being completed.
    b. Consult with the sheltering lead to identify the Shelter Name/County.

2. Shelter Staff:
    a. Enter the name and phone number of the individuals in each of the listed positions.
    b. Enter the total number of Sheltering workers, including those listed in the Shelter Staff section

3. Other Functions or Activities Staff:
    a. Enter the number of staff members working in the shelter assigned to other functions or activities.

4. Shelter Population:
    a. Enter total individuals present, broken down by age group for each of the time periods.

5. Notes: enter high-level notes.
    Notes in this field do not replace notifications to the Sheltering lead.

6. Final Instructions:
    a. Enter the name of the individual preparing the report.
    b. Sign the report. The Originating Station / Callsign are intended for identifying stations that are voice relayed.
    c. Submit the report as instructed by the sheltering lead and according to the Job Tool: Operating a Shelter.

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    Hawaii Hurricane Daily Shelter Report                                                                                         
                                                                                                                                                  Form Info
  
Date        Shelter Name/County  
SHELTERING STAFF
POSITION NAME PHONE
 Shelter Manager
Total Number of Sheltering Workers  
OTHER FUNCTIONS OR ACTIVITIES STAFF
# Disaster Health Services   # Disaster Mental Health  
SHELTER POPULATION
Age Groups (years) 0-3 4-7 8-12 13-18 19-65 65 +
  12 Midnight Count (no later than 11:00 pm)
  12 Noon Count (no later than 11:00 am)
OPERATIONAL REPORTING

  Cots

  Blankets

  Comfort Kits

  Health Supplies

  Signage Kits
  # Needed ASAP
NOTES
Any Services Needed?   Security, Health Dept, Janitorial, Pet Shelter Staff, Nurse, Mental Health, Food, etc.
Preparer Name:      Preparer Signature:

Originating Station:     Callsign:
               Adapted from National Mass Care Strategy
    HH Daily Shelter Report [ver 1.2 2021.4.27]