Facility Inventory

As part of the Florida Division of Emergency Management’s (FDEM) COVID19 response team, we are requesting your assistance to help identify facilities that can be considered for the State's isolation contingency planning strategies by completing and/or forwarding the survey to appropriate public agencies and private/not profit partners within your County (County/City Departments, Operating Partners, Community-Based Organizations, Chambers, Associations, etc.).

Types of facilities for consideration include but not limited to hotels, university dormitories, unused or “mothballed” hospitals/nursing homes, community group facilities, park sites/recreation centers/campground cabins, empty retail, convention or “Big Box” locations and any other facilities with lodging.

The survey responses will be used to assist FDEM’s response effort so we would appreciate all completed surveys by Friday, March 27 by 5:00 PM. We are aware that other agencies may have previously circulated similar surveys. If you have already compiled relevant data or if you are responding for multiple facilities, you may send a spreadsheet with the requested information to COVID19@acdisaster.com. Please email all questions to COVID19@acdisaster.com and copy chris.thomas@hagertyconsulting.com.

Question Title

* 1. Please select a type of facility:

Hotels

Dark Hotels (closed)

University Dormitories

Unused or “Mothballed” Hospitals

Unused or "Mothballed" Nursing Homes

Voluntary Organizations Active in Disaster (VOAD) Sites

Park Sites/Recreation Centers/Campground Cabins

Empty Retail, Convention or “Big Box” Locations

Dark Base Camps (inactive)

Any other facility with lodging

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* 2. Is this a Public or Private Facility?

Public

Private

Other (please specify)

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* 3. Please provide the physical address of the facility

County (please insert FL County)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Facility Phone Number

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* 4. Point of Contact

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 5. Is your facility vacant or partially vacant?

Yes

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* 6. Detailed Description of Facility

Square Feet

Number of Rooms

Electric

Running Water

Number of Bathrooms

Kitchen / Restaurant

Kitchen and Dining Supplies

Parking Capabilities ( paved, unpaved, parking spots )

Back up Power Capabilities (e.g. Generator on site, quick connect)

Loading Dock

Onsite Laundry

Central HVAC in Sleeping Rooms (yes or no)

Individual AC Units in Rooms (yes or no)

Internet or WiFi Access (yes or no)

ADA Accessible

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* 7. Do you have any pictures of Facility?

Please upload any form of picture of the facility that would be beneficial

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 8. Web address for facility?

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* 9. Cost if any for using the facility? (Please specify daily cost.)

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* 10. Are you able to provide any facility staff? If yes, please describe (e.g. a property manager, facility engineers, janitorial staff etc.)

Property Manager (yes or no)

Facility Engineers (yes or no)

Janitorial Staff (yes or no)

Catering / Kitchen Staff (yes or no)

Security (yes or no)

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* 11. Date and length facility is available for use?

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* 12. Will you be able to resume operations even if your facility became non-operational at any point, either by local order or any other purpose?

Yes

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* 13. If the need arises, would your facility be willing to provide accommodations throughout the entirety of the state response to COVID-19? (Please note, any sites used will be properly sanitized.)

Tested Positive for Covid-19 with mild symptoms

No Symptoms

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* 14. Do you have another facility to add?

Yes