Self Assessment Tool

Fill out our Free Assessment to help us help you identify your CMS gaps. (form below)

If you prefer, you may click View/Download/Print to fill out a PDF version and email to [email protected]





Please list information on the grid below for each location where your organization provides services.

Location # Site Address Services provided at each location # of clients served daily at each location
Location #1
Location #2
Location #3
Location #4
Location #5

1.HAZARD VULNERABILITY ANALYSIS

2.EMERGENCY MANAGEMENT COMPLIANCE SURVEYS


3.EMERGENCY MANAGEMENT PROGRAM PLAN


4.POLICIES AND PROCEDURES

5.COMMUNICATIONS PLAN


6.STAFF TRAINING AND EXERCISES

Please List all Emergency Management Exercises completed over the past 18 months:

Date of Exercise Type of Exercise How many staff participated in each exercise After action report for this exercise
Yes or No
YesNo
YesNo
YesNo
YesNo
YesNo

Professional and Business Certification and License Information Nora J. O’Brien, Chief Executive Officer Consultant, MPA, CEM has a Masters Degree in Public Affairs with a concentration in Disaster and Emergency Management and has obtained the Certified Emergency Manager status by the International Association of Emergency Managers.
Connect Consulting Services, Inc. is licensed by the City of Sacramento- #1005489, Certified as a Small Business by the California Department of General Services -Supplier #2007001, in the federal System for Award Management, DUNS- 964225895, as well as holds General Liability as well as Professional Errors and Omissions Insurance.