ANNEX 1

Survey Form

ONLINE SURVEY ON THE EARLY PREPAREDNESS ACTIONS FOR MAYORS

OF THE OPERATION L!STO PROTOCOLS DISASTER PREPAREDNESS
MANUAL FOR TYPHOON v.3

LGU Name : _________________________________

Province : _________________________________

Date Accomplished : _________________________________

=============================================================================

Instructions:

Below are the series of codes/indicators indicating the LGUs early preparedness actions. The
respondent will have to write their corresponding answer on the box provided on the side of the
code/indicator. You may respond with:

● 1- the said code/indicator is already present or already being executed in their

respective levels; or
● 0- if the said code/indicator is yet to be executed or is not applicable in the said
level.

Answer the unshaded codes/indicators ONLY.

1. Create and Institutionalize Structures, Systems, Policies and Plans

CODE INDICATOR ANSWER

Create and establish the following organizations in the LGU:
1.1 Local Disaster Risk Reduction and Management Council (LDRRMC)
1.1.1 Pass an executive order creating the LDRRMC
1.2 Local Disaster Risk Reduction and Management Office (LDRRMO)
Pass an ordinance for the plantilla positions of an LDRRM officer and 3
1.2.1
LDRRMO staff as required by R.A. 10121
1.3 Incident Command System (ICS)
1.3.1 Pass an executive order adapting an ICS
Pass an executive order requiring the LDRRMO to assign or organize an
1.3.2 Incident Management Team (IMT) with the appropriate qualifications to handle
specific incidents
1.3.3 Pass an executive order assigning key positions in the IMT
1.3.4 Conduct training on ICS for LDRRMC members
1.4 Community Disaster Volunteers
1.4.1 Issue standard guidelines on the accreditation of volunteers
Pass an executive order establishing a Response Cluster System
1.5 following the Department of Social Welfare and Development (DSWD)
Cluster System
1.5.1 SRR - Security and Search, Rescue, and Retrieval

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 Health – with subclusters on Water, Sanitation and Hygiene (WASH); Psycho-
Social Integration (PSI); Municipal Public Health Services (MPHS); Nutrition,
1.5.2
Sexual and Reproductive Health, and Medical; Camp Coordination and Camp
Management (CCCM)
1.5.3 MDM - Management of the Dead and Missing
1.5.4 LOG - Logistics
1.5.5 F/NFi - Food and Non-Food Items
Through an executive order, assign teams led by the LDRRM officer to
1.6
conduct a risk assessment as part of preparing the following plans:
Local Disaster Risk Reduction and Management Plan (LDRRMP). In
reviewing the Barangay Disaster Risk Reduction and Management Plan
1.6.1
(BDRRMP), use the quality assurance tool (see Quality Assurance System in
annex).
1.6.2 Local Climate Change Action Plan (LCCAP)
1.6.3 Contingency Plan (per hazard)
1.6.4 Public Service Continuity Plan
1.6.5 Evacuation Plan
Through an executive order, assign a team to prepare, update, and integrate
1.6.6 the DRRM plan in the Comprehensive Land Use Plan (CLUP) and
Comprehensive Development Plan (CDP)
Through an executive order, assign a team to prepare, update, and
1.7 integrate the DRRM plan in the Comprehensive Land Use Plan (CLUP)
and Comprehensive Development Plan (CDP)
1.8 Other assignments and tasks
1.8.1 Establish and designate an operation center (OpCen)
1.8.2 Establish or designate temporary shelters
1.8.3 Designate warehouse for food and non-food items
1.8.4 Designate temporary burial sites and morgues
Develop and disseminate a community and family guide for disaster
1.8.5
preparedness and response (see Gabay at Mapa in annex)
1.8.6 Develop standard operation procedures that are relevant to the LGU
Establish service delivery network and health referral systems for
1.8.7
emergencies
1.8.8 Check baseline health data and statistics. Focus on vulnerable groups.
1.9 Related assignments for:
1.9.1 Administrator
In coordination with the LDRRM office, prepare the SRR insurances with
1.9.1.1
hazard pay
Coordinate with the LDRRM office to create and designate public weather
1.9.1.2
bulletin boards and an area for press conferences and briefings
Prepare the following templates: Announcement and subsequent
1.9.1.3
cancellation of:
1.9.1.3.1 Travel advisories
1.9.1.3.2 Suspension of classes
1.9.1.3.3 Suspension of work
1.9.1.3.4 Prohibition of water-related activities
1.9.1.3.5 Prohibition of sea voyage
1.9.1.4 Implementation of preemptive or mandatory evacuation

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1.9.1.5 Declaration of state of calamity
1.9.1.6 Post-disaster plan:
1.9.1.7 Temporary closure of tourist spots
1.9.1.8 Temporary suspension of mining operations
1.9.2 City or Municipal Engineer
Coordinate with LDRRM office about the strategic locations where directional
1.9.2.1
signs to evacuation centers will be mounted
Put up landslide, storm surge signages (see guidelines on the installation of
1.9.2.2
signages in annex)
Coordinate with the local Philippine National Police (PNP) in setting up
1.9.2.3
security posts
1.9.2.4 Designate shelter for livestock and animal relief park
1.9.2.5 Designate a boat garage for coastal communities
1.9.2.6 Designate an evacuation center for prisoners in high risk areas
Coordinate with the LDRRM office and the Traffic Management Office (or
1.9.2.7 similar office) in designating a network of entry points and staging areas for
supplies and experts
1.9.2.8 Conduct infrastructure audit
1.9.3 Punong Barangay
Create and strengthen the Barangay Disaster Risk Reduction and
1.9.3.1
Management Council (BDRRMC)
Formulate and implement the BDRRMP. Use the BDRRMP template and
1.9.3.2
quality assurance tool (see Quality Assurance System in annex)
1.9.3.3 Formulate a contingency plan for each hazard
Create and enact barangay ordinances on disaster risk ordinances on disaster
1.9.3.4
risk reduction-climate change adaptation (DRR-CCA)
1.9.3.5 Conduct regular declogging of canals
Issue an executive order establishing a memorandum of agreement or
understanding between and among the appropriate agencies.
1.10
Agreements that involve purchases must comply with Commission on
Audit and Procurement Law guidelines.
1.10.1 Agency or Organization
1.10.1.1 Supermarkets
Hospitals and other health care providers such as private clinics, lying-in and
1.10.1.2
birthing facilities
1.10.1.3 Pharmacies, laboratories, blood banks
1.10.1.4 Volunteer groups
1.10.1.5 Transport groups
1.10.1.6 Telecommunications companies
1.10.1.7 Local construction companies
1.10.1.8 Humanitarian organizations
1.10.1.9 Faith-based organizations with structures
1.10.1.10 Funeral parlor and mortuary associations
1.10.1.11 Neighboring LGUs
1.10.1.12 Local chambers of commerce, business groups
1.10.1.13 Gas stations
1.10.1.14 Academic institutions, learning research institute (LRIs)

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2. Build Competencies

CODE INDICATOR ANSWER

2.1 Conduct Training
2.1.1 DRRM Office Personnel
2.1.1.1 DRRM Office Competency Building and Development
2.1.1.2 Incident Command System
2.1.1.3 LDRRM Planning
2.1.1.4 LCCAP Planning
2.1.1.5 Community-Based Monitoring System
2.1.1.6 Alliance Building
2.1.1.7 Risk Assessment
2.1.1.8 Pre-Disaster Risk Assessment
2.1.1.9 Public Service Continuity Plan
2.1.1.10 Basic Life Support
2.1.1.11 Contingency Plan Formulation
2.1.1.12 Hazard Mapping
2.1.2 Security, Law, and Order, SRR Personnel
2.1.2.1 Flood and Swift Water
2.1.2.2 Search and Rescue
2.1.2.3 High Angle Search and Rescue Operation
2.1.2.4 Emergency Response
2.1.2.5 Law Enforcement
2.1.2.6 Mountain Search and Rescue
2.1.2.7 Incident Command System
2.1.2.8 Basic Life Support
2.1.3 Health Personnel
2.1.3.1 Basic Life Support, First Aid Training
2.1.3.2 Advanced Life Support
2.1.3.3 Emergency Medical Technician - Basic and Advanced Training
2.1.3.4 Disaster Risk Reduction and Management-Hospital Planning
2.1.3.5 Health Emergency Response
2.1.3.6 Mountain Search and Rescue
2.1.3.7 Incident Command System
2.1.3.8 Hazardous Materials Handling
Minimum Initial Service Package (MISP) for Sexual and Reproductive Health
2.1.3.9
Training
2.1.3.10 WASH in Emergencies
2.1.3.11 Nutrition in Emergencies
2.1.3.12 Mental Health and Psychosocial Support (MHPSS)
2.1.4 Camp Coordination and Camp Management Personnel
2.1.4.1 Gender and Development Sensitive Camp and Coordination
2.1.4.2 Incident Command System
2.1.4.3 Basic Life Support
2.1.4.4 Mental Health and Psychosocial Support

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2.1.5 Personnel for Management of the Dead and Missing
2.1.5.1 Incident Command System
2.1.5.2 Management of the Dead and Missing
2.1.5.3 Emergency Medical Technician
2.1.5.4 Psychological First Aid
2.1.6 Logistics Personnel
2.1.6.1 Warehouse Management
2.1.6.2 Financial Management
2.1.6.3 Logistics Management
2.1.6.4 Supply Chain Management
2.1.6.5 Inventory Management
2.1.6.6 Incident Command System
2.1.7 Communication and Public Awareness Personnel
Basic Orientation on Community-Based Disaster Risk Reduction and
2.1.7.1
Management (CBDRRM)
2.1.7.2 Climate and Disaster Risk Assessment (Hazard and Risk Assessment)
2.1.7.3 Climate and Weather Forecast
2.1.7.4 Early Warning Systems and Monitoring
2.1.7.5 Infrastructure Audit
2.1.7.6 Risk Communication
2.1.7.7 Media Relations
2.1.7.8 ICS
2.1.8 Post-Disaster Response
2.1.8.1 Post-Disaster Livelihood Recovery
2.1.8.2 Rapid Damage Assessment and Needs Analysis
2.1.8.3 Post-Disaster
2.1.8.4 Assessment and Needs Analysis
2.1.8.5 Emergency Response
2.1.8.6 Incident Command System
2.1.8.7 Basic Life Support
2.1.9 Food and Non-Food Item Personnel
2.1.9.1 Relief Goods Management
2.1.9.2 Incident Command System
2.1.9.3 Nutrition in Emergencies

3. Mobilize Resources

CODE INDICATOR ANSWER

ACQUIRING RESOURCES FOR SECURITY, LAW AND ORDER, SEARCH
3.1
AND RESCUE, MANAGEMENT OF THE DEAD AND MISSING, CLEARING
3.1.1 Tasks
Instruct the LDRRM office to purchase disaster response resources (refer to
3.1.1.1
the Supplies column)
Instruct the punong barangays to ensure that every household has an
3.1.1.2
emergency balde or kit (see emergency balde in annex)
3.1.1.3 Direct the city or municipal social welfare and development office

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 (C/MSWDO) to pack relief goods and to prepare community kitchen supplies
and equipment
Direct the administrator to coordinate with LDRRM offices in purchasing or
3.1.1.4 borrowing a mobile community kitchen from organizations during or in the
aftermath of disasters
Instruct the LDRRM office to prepare the needed supplies, equipment, and
3.1.1.5
stockpile (refer to the Supplies column)
3.1.2 Supplies
3.1.2.1 First aid kits, medicines, vaccines
3.1.2.2 Cadaver bags - minimum of 50 pcs
3.1.2.3 Face masks
3.1.2.4 Gloves
3.1.2.5 Caution tape
3.1.2.6 Registration logbook
3.1.2.7 Pens
3.1.2.8 Sanitation kits
3.1.2.9 Cooking kits
Cotrimoxazole, amoxicillin, mefenamic acid, paracetamol, oresol, lagundi and
3.1.2.10
skin ointment (CAMPOLAS)
3.1.2.11 Trauma kits
3.1.2.12 WASH requirements (biohazard trash bags)
3.1.2.13 Clean delivery kits (emergency birthing kits)
3.1.2.14 Dignity kits for women
3.1.2.15 Registration logbook
3.1.2.16 Pens
3.1.2.17 Cooking kits
3.1.2.18 Sanitation kits
3.1.2.19 Information board
3.1.3 Equipment
3.1.3.1 Trucks, vans, buses
3.1.3.2 Backhoe, grader, tractor, scoop
3.1.3.3 Loader, bulldozer
3.1.3.4 Drill
3.1.3.5 Concrete cutter
3.1.3.6 Defibrillator and nebulizer
3.1.3.7 Ladders
3.1.3.8 Floodlight
3.1.3.9 Stretchers and spine boards
3.1.3.10 Siren
3.1.3.11 Megaphone
3.1.3.12 Whistle
3.1.3.13 Two-way radio, GPS device, and other communication tools
3.1.3.14 Ropes and throw bags
3.1.3.15 Searchlight
3.1.3.16 Protective gears: helmets and life vests

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3.1.3.17 Bolo, shovels
3.1.3.18 Water pump
3.1.3.19 Water treatment
3.1.3.20 K9 unit
3.1.3.21 Barricade
3.1.3.22 Assistive materials: wheelchairs, crutches
3.1.3.23 Water rescue kit: rope, floatation ring, life jacket
3.1.3.24 Reflectorized vests
3.1.3.25 Extrication kits
3.1.3.26 Standby vehicles
3.1.3.27 Megaphone
3.1.3.28 Whistle
3.1.3.29 Two-way radio and other communication equipment
3.1.3.30 Flashlight and extra batteries
3.1.3.31 Tents (temporary shelters)
3.1.3.32 Portable generator, solar-powered panels
3.1.3.33 Water pump
3.1.3.34 Water tank storage, bladder
3.1.3.35 Portable water purifier
3.1.4 Stockpile
3.1.4.1 Batteries
3.1.4.2 Potable water
3.1.4.3 Portable generator, solar-powered generator, flashlights
Food packs: rice, canned goods, noodles, ready-to-eat meals (minimum of
3.1.4.4
10% of population at risk, good for 3 days)
3.1.4.5 Tires for emergency vehicle
Fuel and gasoline (in coordination with the Bureau of Fire Fuel and gasoline
3.1.4.6
(in coordination with the Bureau of Fire
3.1.4.7 Clean delivery kits (emergency birthing kits)
3.1.4.8 Dignity kits for women
3.1.4.9 First aid kit, medicines
3.1.4.10 Food packs: rice, canned goods, noodles, ready-to-eat meals
3.1.4.11 Potable water
Hygiene kit: soap, shampoo alcohol, toothbrush, alcohol, toothbrush,
3.1.4.12
deodorant
3.1.4.13 Sanitation kits
3.1.4.14 Clothing: jacket, raincoat, hard hat, boots
3.1.4.15 Gasoline and extra batteries
3.1.4.16 Beds and beddings
3.1.4.17 Portable toilets
3.1.4.18 Mosquito nets
3.1.4.19 Clean delivery kits
ACQUIRING COMMUNICATION AND PUBLIC AWARENESS
3.2
RESOURCES
3.2.1 Tasking

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 Instruct the LDRRM office, city or municipal engineer, and administrator to
3.2.1.1 prepare the necessary early warning equipment (refer to the Supplies
column)
3.2.2 Supplies
3.2.2.1 Rain gauge (coordinate with PAGASA)
3.2.2.2 Water level marks
3.2.2.3 Wind vane
3.2.2.4 Bells (use of local resources such as church bells is also advisable)
Centralized hotline operated and monitored by the command center (must
3.2.2.5
use 911 as the emergency hotline number
3.2.2.6 Satellite phones
3.2.2.7 Vehicles
3.2.2.8 Siren, batingaw
3.2.2.9 Visible warning signs (color-coded flags)
3.2.2.10 Centralized hotline
3.2.2.11 Centralized hotline
3.2.2.12 Telephone, fax machine, internet connection
3.2.2.13 Megaphone
Two-way radio, GPS device, and other Two-way radio, GPS device, and
3.2.2.14
other
3.2.2.15 Flashlight and extra batteries
3.2.2.16 Transistor radio
3.2.3 Stockpile
3.2.3.1 Batteries
3.2.3.2 Potable water
3.2.3.3 Portable generator, solar-powered generator
3.2.3.4 Flashlights

Remarks:

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Accomplished by:

Name : ___________________________

Position : ___________________________

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