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REGISTRATION & REFERRALS Participant Guide September 2015
Copyright 2007, Province of BC. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic of mechanical, including photocopy,
recording, or any information storage and retrieval system, without permission in writing from the publisher. Requests for permission to make copies of any part of this work should
be directed to the publisher. Additional copies of the work may be obtained from the publisher: Emergency Management Division Justice Institute of British Columbia 715 McBride Boulevard
New Westminster, BC V3L 5T4 Phone: 604.528.5590 E-mail: emergency@jibc.ca Website: http://www.jibc.ca/emergency Published 2007. Revised 2014. Revised 2015. Printed in Canada.
PAGE 3 Preface .................................................................................................................................. 5 Standards Of Conduct For ESS Responders
............................................................................................. 7 Responsibilities Of ESS Responders ...................................................................
....................... 7 Rights Of ESS Responders ............................................................................................................... 8 Course Outline ...................
............................................................................................................ 9 Module 1 Introduction ..................................................................
.......................................... 13 Reception Centre Organization Chart – Fully Expanded .................................................................. 15 Sample ESS Reception
Centre Floor Plan ........................................................................................ 16 What Is Registration & Referrals For Food, Clothing And Lodging? .......................
.......................... 17 Introduction To Registration? ................................................................................................... 17 Registration Worker
Position Description ........................................................................... 18 Registration Worker Function Checklist ...........................................................
................... 19 Referrals Worker Position Description ................................................................................ 20 Referrals Worker Function Checklist ..................
................................................................. 22 Registration Supervisor Function Checklist .........................................................................
24 Referrals Unit Supervisor Function Checklist ...................................................................... 27 How Is Registration & Referrals Provided?...................................
................................................... 30 Option 1 – One Stop .................................................................................................................
30 Option 2 – Two Stop ................................................................................................................. 31 What About Inquiry, Search And Reply? ....................
..................................................................... 31 Module 2 Interviewing Skills .................................................................................................
...... 33 Interviewing Skills Tips ................................................................................................................... 35 Listening ...................................
............................................................................................... 36 Ways To Improve Your Listening Skills ..............................................................
.................. 36 The Interviewing Process ................................................................................................................ 37 Module 3 Forms And
Paperwork ................................................................................................. 41 General Instructions For Completing Forms .............................................
...................................... 43 ESS File – Registration and Services Record .................................................................................... 44 ESS File
– Registration And Services Record Instruction Guide ................................................. 46 ESS File – Registration And Services Record – Completed Sample .............................
............... 54 Follow The ESS File Form .......................................................................................................... 56 Table of Contents REGISTRATION
& REFERRALS Table of Contents
PAGE 4 REGISTRATION & REFERRALS Table of Contents Table of Contents Change of Information Form ........................................................................................................
.. 57 Change of Information Form Instruction Guide ........................................................................ 58 Change of Information Form – Completed Sample ..........................
......................................... 59 Referral Form ................................................................................................................................
60 Referral Form Instruction Guide ............................................................................................... 62 Referral Form – Completed Sample For Sparksville
Evacuation Scenario .................................. 68 ESS Rates Sheet ........................................................................................................................
69 Billeting Invoice Form ............................................................................................................... 70 Follow The Referral Form ................................
......................................................................... 71 Tracking Record Of Resources .............................................................................................
..... 72 Module 4 Scenario & Challenges ................................................................................................. 73 Sparksville Evacuation Scenario ..........................
............................................................................ 75 Sparksville Evacuation Scenario – One Day Later ......................................................................
76 Challenges – What If...? .................................................................................................................. 77 Module 5 Appendices ................................
............................................................................. 85 Appendix 1: Acronyms .................................................................................................
................... 87 Appendix 2: Suggested Answers To Challenges – What If...Questions ............................................. 88
PAGE 5 REGISTRATION & REFERRALS Preface PREFACE
PAGE 7 REGISTRATION & REFERRALS Preface Standards of Conduct for ESS Responders RESPONSIBILITIES OF ESS RESPONDERS Commitment. Responders shall have a commitment to serve their community
and the ESS mission to the best of their abilities, assuring the integrity of the program. Confidentiality. Responders shall respect the confidentiality of information received during
an emergency response to anyone other than authorized emergency responders. If necessary, clarification should be sought from appropriate authority. Confidential information must not
be used for personal gains. Quality of Service. Responders shall provide service to individuals affected by disasters in a manner that is courteous, caring, and professional, while
respecting the dignity of people receiving services. Behaviour. Responders shall: ■ Conduct themselves in a manner that meets acceptable social standards and contribute to an environment
of mutual respect and dignity, free from discrimination or harassment. ■ Follow operational guidelines and established reporting structures. ■ Exercise discretion with comments made
in public about an incident, people, or other organizations involved. ■ Self Care. Responders shall: ■ Take care of their own physical and emotional health and support team members
to do the same. ■ Report unsafe conditions to their supervisor, ensuring the safety of themselves and others. Media Statements. Responders shall direct all enquiries from the media
to the designated Information Officer.
PAGE 8 REGISTRATION & REFERRALS Preface Rights of ESS Responders Orientation and Training. Responders shall have access to the appropriate training to ensure efficient and effective
performance of duties. Forum for Input. Responders shall be made aware of, and have access to, the proper chain of command for handling suggestions and complaints. Support. Responders
shall receive support from the local, regional, and provincial levels of the ESS Program. Safe Conditions. Responders shall have a safe working environment, understanding that there
is some inherent risk in responding to disasters. Supplies and Equipment. Wherever possible, responders shall be equipped to do their job.
PAGE 9 REGISTRATION & REFERRALS Preface Course Outline Page 1 Date of Last Course Outline Revision: COURSE OUTLINE JIF 200 Course Outline Form Version 15 Form last Revised July 15 15
Course Code: EMRG-1615 Short Title: Registration & Referrals Long Title: Registration & Referrals Prerequisites: EMRG-1610 Introduction to Reception Centres Co-requisites: N/A School:
Public Safety Division/Academy/Centre: Emergency Management Division Previous Code & Title: ESS113 and ESS206 Registration and Referrals Course First Offered: July 2007 Credits: 0 Course
Description Registration and Referrals describes the process for registering evacuees and for providing them with referrals for food, clothing, and lodging. It also covers basic interviewing
skills. The course includes completion of the ESS File (Registration and Service Record) and Referral forms. Course Goals To give participants the skills and knowledge required to work
in the registration and referrals functions in a Reception Centre. Learning Outcomes Upon successful completion of this course, the learner will be able to: 1. Describe the registration
and referrals for food, clothing, and lodging functions 2. Collect accurate and reliable information 3. Complete the ESS File (Registration and Services Record) and Referral forms accurately
and completely 4. Demonstrate effective interviewing skills 5. Address unusual requests and challenges Course Topics/Content 1. Introduction to Registration and Referrals • Position
descriptions • Function checklists • Provision of services 2. Interviewing skills • Ways to improve listening skills • The interviewing process 3. Forms and paperwork
PAGE 10 REGISTRATION & REFERRALS Preface Page 2 Date of Last Course Outline Revision: COURSE OUTLINE JIF 200 Course Outline Form Version 15 Form last Revised July 15 15 • ESS File (Registration
and Services Record) form • Referral form • ESS Rates Sheet • Tracking Record of Resources 4. Challenges Text & Resource Materials Province of BC. (2010). Registration & Referrals Participant
Guide. New Westminster, BC: Emergency Management Division, Justice Institute of British Columbia. Equivalent JIBC Courses None. Instructional Method(s)* (select all that apply) Total
Hours Instructional Factor Total Factored Hours ☒Direct Instruction (lecture, seminar, role plays, independent study, etc.) 7 1 7 ☐Supervised Practice (includes simulations & labs)
.5 ☐Practice Education, Field Placement, Internship or Co-op .33 Totals 7 7 *Refer to http://www.jibc.ca/sites/default/files/governance/policies/pdf/Procedure_Credit-Value.pdf Course
Evaluation The evaluation criteria used for this course are represented below. Specific course evaluation information will be provided by the instructor at the start of the course.
Criterion % of Final Grade (may be represented as a range) Course work (activities, assignments, essays, reports, etc.) Quizzes and exams Simulations/Labs Attendance/Participation (in
class or online) 100% Practice Education/Internships Total 100% Comments on Evaluation Course Grading Scheme* ☐JIBC1 (A to F) ☐JIBC2 (MAS/NMA) ☒JIBC3(CM/IN) ☐JIBC4 (P/F)
PAGE 11 REGISTRATION & REFERRALS Preface Page 3 Date of Last Course Outline Revision: COURSE OUTLINE JIF 200 Course Outline Form Version 15 Form last Revised July 15 15 (* http://www.jibc.ca/policy/3
304 Grading policy) Other Course Guidelines, Procedures and Comments View official versions of related JIBC academic regulations and student policies in the JIBC Calendar on the following
pages of the JIBC website: Academic Regulations: http://www.jibc.ca/programs-courses/jibccalendar/academic-regulations Student Policies: http://www.jibc.ca/about-jibc/governance/policies
Student Academic Integrity Policy Academic Progression Policy Admissions Policy Academic Appeals Policy Evaluation Policy Grading Policy Access Policy Harassment Policy – Students Student
Records Policy Student Code of Conduct Policy JIBC Core Competencies The JIBC promotes the development of core and specialized competencies in its programs. Graduates of our programs
will demonstrate high levels of competence in the following areas: ☐ Critical thinking: Identify and examine issues and ideas; analyze and evaluate options in a variety of fields with
differing assumptions, contents and methods. ☒ Communication, Oral and written: Demonstrate effective communication skills by selecting the appropriate style, language and form of communication
suitable for different audiences and mediums. ☐ Leadership: Inspire individuals and teams to reach their potential by embracing innovation through strategic thinking and shared responsibility.
☐ Independent learning: Show initiative by acting independently in choosing effective, efficient and appropriate applied learning, research and problem solving strategies. ☐ Globally
minded: Self-aware of own identity and culture, recognize the interconnectedness of world events and issues; interact respectfully and authentically across cultures; value multiple
perspectives; utilize curiosity to learn with and from others. ☐ Problem solving: State problems clearly; effectively and efficiently evaluate alternative solutions; choose solutions
that maximize positive and minimize negative outcomes. ☒ Interpersonal relations: Know and manage ourselves; recognize and acknowledge the needs and emotions of others including those
with diverse cultures, backgrounds and capabilities. ☐ Inter-professional teamwork: Understand and work productively within and between groups, respect others’ perspectives and provide
constructive feedback with special attention to inter-professional relationships. ☒ Information literacy: Recognize and analyze the extent and nature of an information need; efficiently
locate and retrieve information; evaluate it and its sources critically, and use information effectively and ethically.
PAGE 12 REGISTRATION & REFERRALS Preface
PAGE 13 REGISTRATION & REFERRALS Module 1 MODULE 1 Introduction
PAGE 15 REGISTRATION & REFERRALS Module 1 Reception Centre Organization Chart – Fully ExpandedReception Centre Manager Liaison Information Safety Planning Logistics Operations Finance
Referrals for Food, Clothing & Lodging Inquiry Registration On-Site Goods Distribution Meet & Greet Pet Recreation Multicultural Transportation Child Care Emotional Support First Aid
Special Needs Advance Planning Demobilization Documentation Recovery Transition Situation Primary Services Specialized Services Health Services Donated Goods Resource Acquisition Shipping/Receiving
Supply Time Cost Compensation & Claims Runner Food Facility Reception Centre Support Volunteer/Staff Management Clerical Security Computer Systems Communications Information Technology
Procurement Search & Reply ESS Director/ESS Branch Coordinator (EOC) Section Branch Unit
PAGE 16 REGISTRATION & REFERRALS Module 1 Sample ESS Reception Centre Floor Plan Search & Reply Documentation Resource Acquisition Shipping & Receiving On-Site Goods Distribution & Donated
Goods Waiting Area Child Care Multicultural Services Transportation Recreation Volunteer/Staff Management Registration & Referrals for Food, Clothing & Lodging Registration Only Inquiry
About Family & Friends Loading Dock Information Sign In/Out Security Information Technology -Amateur Radio -Communications Staff Quiet Area RC Manager Officers Section Chiefs First
Aid Health Services Emotional Support Pet Services Support -Food -Runner -Facility -Clerical Situation Advance Planning Demobilization Recovery Transition Meeter & Greeter Emergency
Exit
PAGE 17 REGISTRATION & REFERRALS Module 1 What is Registration & Referrals for Food, Clothing and Lodging? The purpose of this course is to provide ESS teams with the knowledge and skills
necessary to effectively source and manage the three primary ESS resources: food, clothing, and lodging. Upon completion of this course, participants will be able to: ■ Identify required
ESS resources ■ Describe the role and responsibilities of the Registration & Referrals worker and Registration & Referrals Supervisor ■ Develop plans for acquiring ESS resources ■ Generate
a plan to manage ESS resources during a response INTRODUCTION TO REGISTRATION? Registration is the beginning of the family reunification process. This process reunites loved ones who
have been separated because of a disaster. Family reunification methods include direct telephone contact (an evacuee contacts a person outside the disaster area who in turn contacts
all other family members and friends); Red Cross message forms (available from Central Registry and Inquiry Bureau) completed by the evacuee and sent to Red Cross offices outside the
disaster area where volunteers contact family members; internet web page listing survivors; email (when operational and phone lines are down); and ESS File – Registration and Service
Records. This latter registration method involves recording necessary information regarding the identity and location of displaced people due to a disaster on an ESS File – Registration
and Service Record. This information is then shared with family and friends inquiring about the safety and whereabouts of those displaced. The appropriate family reunification methods
for each response are decided in collaboration between the Registration, Inquiry and Search & Reply Supervisors and Reception Centre Management. While the primary purpose of registration
is for family reunification, another purpose for registering evacuees on an ESS File – Registration and Service Record is to develop an accurate list of those who have been evacuated.
This list enables relief agencies to locate evacuees to provide information, answer questions, address property issues, etc. and to provide emergency services such as food, clothing
and lodging.
PAGE 18 REGISTRATION & REFERRALS Module 1 Registration Worker Position Description Reports to Registration Supervisor Description Trained volunteers interview and complete the registration
portion of the ESS File -Registration and Services Record. This assists in reuniting families and answering inquiries about the whereabouts of missing persons. Duties During a response,
follow Registration function checklist for Registration Workers, found in the Reception Centre Operational Guidelines. Knowledge, Skills and Abilities* ■ Knowledge of registration purpose
and process. ■ Knowledge of ESS Reception Centre operations an asset. ■ Ability to complete forms accurately and print legibly. ■ Ability to communicate effectively with evacuees, responders
and other visitors. ■ Organized, adaptable, calm and physically able to function in a high stress environment. ■ Ability to work as part of a team and take direction from a supervisor.
Suitability ■ At least 19 years of age (16-18 years with parental consent). ■ Available to respond on short notice. ■ Able to work long shifts as required. ■ Desire to be of assistance
to others. General ■ Be honest and open with other volunteers regarding your intent, needs and skills. ■ Work in a professional manner and be respectful to evacuees and team members.
■ Follow and adhere to written policies, procedures and guidelines. ■ Seek clarification of policies and procedures from supervisor as required. ■ Respect the confidentiality of evacuees
and responders. ■ Adhere to the ESS Standards of Conduct at all times.
PAGE 19 REGISTRATION & REFERRALS Module 1 * On-site orientation, online training and specific training will be provided whenever possible. Registration Worker Function Checklist Section
2 – Reception Centre Function Checklists Reception Centre March 2014 2 -29 Operational Guidelines Registration *** Read This Entire Checklist Before Taking Action *** Reports to: Registration
Supervisor Title (if this function is staffed): Registration Worker Note: This function is normally combined with the "Referrals for Food, Lodging and Clothing" function; one responder
at one desk handles both registrations and referrals. Responsibilities: 1. Explain the purpose of registration to evacuees. 2. Register evacuees on the registration flimsies of the
ESS File – Registration and Services Record. Activation Phase: Check in with Volunteer/Staff Management Branch and sign the (EMBC) Task Registration Form. Obtain identification.
Report to assigned supervisor to obtain current status and specific instructions. Establish workspace. Determine resource needs, such as people, equipment, phones, checklist copies,
and other reference documents. Notify supervisor of any resource requirements. Obtain equipment, supplies and required forms. Operational Phase: Maintain communication with assigned
supervisor. Interview evacuees and complete the flimsy portion of the ESS File – Registration and Services Record. Ensure that the "restriction" question is read to evacuees and
if an evacuee restricts their information continue to complete the registration portion and then give the ESS File directly to the Registration Supervisor. Forward completed ESS Files
to the Documentation Unit as soon as possible. Attend briefings as required. Brief replacement for the next shift and identify outstanding action items or issues. RC Function Checklists
can be found in the Reception Centre Operational Guidelines
PAGE 20 REGISTRATION & REFERRALS Module 1 Section 2 – Reception Centre Function Checklists 2 -30 March 2014 Reception Centre Operational Guidelines Demobilization Phase: Complete all
required forms, reports, and other documentation. All forms should be submitted through the supervisor to the Planning Section, as appropriate, prior to departure. Clean up work area
before leaving. Sign out with Volunteer/Staff Management Branch. Leave a forwarding number. Access critical incident stress debriefing as needed. Be prepared to contribute to
any post event processes (e.g., debriefs, reports etc.). Function Aids: – Change of Information Form & Instruction Guide – ESS File – Registration and Services Record – ESS File – Registration
and Services Record Instruction Guide – ESS File Restricted Registrations Guide – Standards of Conduct for ESS Responders INTRODUCTION TO REFERRALS Issuing Referral forms for food,
clothing, lodging and other immediate needs is the process used to provide emergency social services. Evacuees are interviewed in order to determine their immediate emergency needs
and referred to identified suppliers who can meet their needs within established rates and guidelines. Referrals Worker Position Description Reports to Referrals Unit Supervisor Description
Trained volunteers interview family representatives to determine the immediate needs of the family and record this information on the ESS File form Registration and Services Record.
Working from established rates and guidelines, the Referrals Worker will refer the family to identified suppliers who can meet the family’s needs as indicated on Referral forms. Duties
During a response, follow the Referrals function checklist for Referral Workers found in the Reception Centre Operational Guidelines.
PAGE 21 REGISTRATION & REFERRALS Module 1 Knowledge, Skills and Abilities* ■ Knowledge of referrals purpose and process. ■ Ability to interview effectively, allowing the family to tell
about their experience. ■ Ability to complete forms accurately and print legibly. ■ Ability to communicate effectively with evacuees, responders and other visitors. ■ Organized, adaptable,
calm and physically able to function in a high stress environment. ■ Ability to work as part of a team and take directions from a supervisor. ■ Ability to speak other languages is an
asset. Suitability ■ At least 19 years of age (16 to 18 years with parental consent). ■ Must be available to respond on short notice. ■ Must be able to work long shifts as required.
■ Desire to be of assistance to others. General ■ Be honest and open with other volunteers regarding intent, needs and skills. ■ Work in a professional manner and be respectful to evacuees
and team members. ■ Follow and adhere to written policies, procedures and guidelines. ■ Seek clarification of policies and procedures from supervisor as required. ■ Respect the confidentiality
of evacuees and responders. * On-site orientation, online training and specific training will be provided whenever possible.
PAGE 22 REGISTRATION & REFERRALS Module 1 Referrals Worker Function Checklist Section 2 – Reception Centre Function Checklists Reception Centre March 2014 2 -35 Operational Guidelines
Referrals for Food, Clothing & Lodging *** Read This Entire Checklist Before Taking Action *** Reports to: Referrals Unit Supervisor Title (if this function is staffed): Referrals Worker
Note: This function is normally combined with the "Registration" function; one worker at one desk handles both registrations and referrals. Responsibilities: 1. Interview evacuees to
determine their immediate needs. 2. Refer evacuees to suppliers by completing ESS Referral forms. 3. Refer evacuees with special requirements within the Reception Centre as needed.
Activation Phase: Check in with Volunteer/Staff Management Branch and sign the (EMBC) Task Registration Form. Obtain identification. Report to assigned supervisor to obtain current
status and specific instructions. Establish workspace. Determine resource needs, such as people, equipment, phones, checklist copies, and other reference documents. Notify supervisor
of any resource requirements. Obtain equipment, supplies and required forms. Obtain (EMBC) Task Number from supervisor. Obtain a list of resources/suppliers that are able to assist
evacuees with immediate needs (e.g., accommodations, meals, clothing). Operational Phase: Maintain communication with assigned supervisor. Indicate the services requested by completing
the lower portion of the ESS File – Registration and Services Record. Interview evacuees to determine their immediate needs (e.g., food, lodging etc.). Refer evacuees to community
suppliers or resources using ESS Referral forms. Maintain a record of resources/suppliers used (e.g., hotel rooms, restaurants) and request additional resources/suppliers from supervisor
as needed. Seek assistance from Referrals Unit Supervisor for questions or special needs requests (e.g., medications over $50.00). Respect the privacy of evacuees. Ensure that
completed ESS Files and Referrals are forwarded to Documentation Unit for processing as soon as possible. Return unused, voided, and cancelled Referral forms to the Documentation
Unit. Brief replacement for the next shift and identify outstanding action items or issues.
PAGE 23 REGISTRATION & REFERRALS Module 1 Section 2 – Reception Centre Function Checklists 2 -36 March 2014 Reception Centre Operational Guidelines Demobilization Phase: Complete all
required forms, reports, and other documentation. All forms should be submitted through the supervisor to the Planning Section, as appropriate, prior to departure. Clean up work area
before leaving. Sign out with Volunteer/Staff Management Branch. Leave a forwarding number. Access critical incident stress debriefing as needed. Be prepared to contribute to
any post event processes (e.g., debriefs, reports etc.). Function Aids: – ESS Rates Sheet – ESS Referral Form – ESS Referral Form Instruction Guide – Evacuee Information Sheet – Standards
of Conduct for ESS Responders – Tracking Record of Resources SUPERVISION OF FUNCTIONS Regardless of whether the Registration and the Referral functions are combined “1 Stop” model or
left separate “2 Stop” model, separate supervisors for the registration function and the referrals function exist. The Registration Unit Supervisor is a well-trained volunteer who is
responsible for any questions and procedures regarding the Registration function and forms. The Referrals Unit Supervisor is a well-trained volunteer who is responsible for any questions
and procedures regarding the referrals function and form. The respective checklists are outlined on the following pages.
PAGE 24 REGISTRATION & REFERRALS Module 1 Registration Supervisor Function Checklist Section 2 – Reception Centre Function Checklists 2 -26 March 2014 Reception Centre Operational Guidelines
REGISTRATION *** Read This Entire Checklist Before Taking Action *** Reports to: Primary Services Branch Coordinator Title (if this function is staffed): Registration Supervisor Note:
While this function is normally combined with the "Referrals for Food, Lodging, Clothing" function, separate supervisors are recommended. Responsibilities: 1. Oversee the implementation
and operation of the Registration function. 2. Ensure that the Registration flimsies on the ESS File – Registration and Services Record are completed correctly by the responders. 3.
Provide direction and support to responders registering evacuees. Activation Phase: Check in with Volunteer/Staff Management Branch and sign the (EMBC) Task Registration Form. Obtain
identification. Report to assigned supervisor to obtain current status and specific instructions. Establish workspace. Determine resource needs, such as people, equipment, phones,
checklist copies, and other reference documents. Notify Logistics of any resource requirements. Obtain equipment, supplies and required forms. Establish and maintain a position
log to list the actions taken during the shift. Working in conjunction with the Referrals Unit Supervisor, establish several tables where this service can be delivered to evacuees.
Determine if a “Registration Only” desk for those who do not require ESS is needed for this event. Review checklist with responders. In a “one-stop model” where Registration and
Referrals are combined (e.g., one worker registers the family and provides referrals for their immediate needs such as lodging and/or meals) do the following: – Meet with the Referrals
Unit Supervisor to discuss the supervision of the Registration and Referrals area. – Set up a fast track Registration Only area (optional). In a “two-stop model” where Registration
and Referrals are provided separately (e.g., a registration worker registers an evacuee family, and sends the family to see a second worker to obtain Referral forms) do the following:
– Meet with the Referrals Unit Supervisor to ensure that the Registration area is located close to the Referrals area, and discuss how evacuees will be processed from the Registration
area to the Referrals area.
PAGE 25 REGISTRATION & REFERRALS Module 1 Section 2 – Reception Centre Function Checklists Reception Centre March 2014 2 -27 Operational Guidelines Operational Phase: Maintain communication
with assigned supervisor. Maintain position log in chronological order describing actions taken during the shift. Ensure Registration & Inquiry policies and procedures are followed.
Ensure that all responders who are registering evacuees have received adequate training on the registration flimsies of the ESS File – Registration & Services Record. Supervise
“Registration Only” tables if activated. Ensure that RESTRICTED ESS Files are delivered by hand to the Search & Reply Supervisor. Ensure complete ESS Files – Registration & Services
Records are forwarded to Documentation Unit ASAP for further processing. Initiate request to assigned supervisor for call-out of ESS Support Organizations to assist if required.
Attend briefings as requested. Provide status report information to Section Chief prior to management team meetings. Brief responders within the Unit as needed. Prepare shift
schedules as needed. Assist, support and provide direction to responders. Monitor unit personnel to ensure appropriate worker care is implemented. Brief replacement for the next
shift and identify outstanding action items or issues. Demobilization Phase: Complete all required forms, reports, and other documentation. All forms should be submitted to the Planning
Section, as appropriate, prior to departure. Demobilize assigned position and close logs when authorized by the Reception Centre Manager. Submit a list to the supervisor, for delivery
to the appropriate section, of the following: – Status of all borrowed equipment – All ESS equipment and supplies needing restocking – Names of personnel and hours worked Clean up
work area before leaving. Sign out with Volunteer/Staff Management Branch. Leave a forwarding number. Access critical incident stress debriefing as needed. Be prepared to contribute
to any post event processes (e.g., debriefs, reports etc.).
PAGE 26 REGISTRATION & REFERRALS Module 1 Section 2 – Reception Centre Function Checklists 2 -28 March 2014 Reception Centre Operational Guidelines Function Aids: – Change of Information
Form & Instruction Guide – ESS File Form Restricted Registrations Guide – ESS File Instruction Guide – ESS File – Registration and Services Record – ESS Personnel Request Form – ESS
Resource Request Form – Position Log – Shift Schedule – Standards of Conduct for ESS Responders – Status Report
PAGE 27 REGISTRATION & REFERRALS Module 1 Referrals Unit Supervisor Function Checklist Section 2 – Reception Centre Function Checklists Reception Centre March 2014 2 -31 Operational
Guidelines REFERRALS FOR FOOD, CLOTHING & LODGING *** Read This Entire Checklist Before Taking Action *** Reports to: Primary Services Branch Coordinator Title (if this function is
staffed): Referrals Unit Supervisor Note: While this function is normally combined with the "Registration" function, separate supervisors are recommended. Responsibilities: 1. Oversee
the implementation and operation of the Referrals function. 2. Ensure proper completion of Referral forms. 3. Provide direction and support to Referrals workers 4. Under the direction
of the Operations Section Chief, communicate with the ESS Branch Coordinator at the PREOC or the (EMBC) Regional Manager for: – addressing questions or concerns regarding completion
of Referral forms or the ESS Payment Process, and – requesting authorization for Referral expenditures beyond those services already described on the ESS Rate Sheet. 5. Liaise with
the Resource Acquisition Unit and ensure Referrals Workers are kept advised of available resources (e.g., lodging spaces). Activation Phase: Check in with Volunteer/Staff Management
Branch and sign the (EMBC) Task Registration Form. Obtain identification. Report to assigned supervisor to obtain current status and specific instructions. Establish workspace.
Determine resource needs, such as people, equipment, phones, checklist copies, and other reference documents. Notify Logistics of any resource requirements. Obtain equipment, supplies
and required forms. Establish and maintain a position log to list the actions taken during the shift. Working in conjunction with the Registration Supervisor, establish several
tables where this service can be delivered to evacuees. Review checklist with volunteers. In a “one-stop model” where Registration and Referrals are combined (e.g., one volunteer
registers the family and provides referrals for their immediate needs such as lodging, meals etc.) do the following: – Meet with the Registration Supervisor to discuss the supervision
of the Registration and Referrals area.
PAGE 28 REGISTRATION & REFERRALS Module 1 Section 2 – Reception Centre Function Checklists 2 -32 March 2014 Reception Centre Operational Guidelines In a “two-stop model” where Registration
and Referrals are provided separately (e.g., a registration worker registers an evacuee family, and sends the family to see a second worker to obtain Referral forms) do the following:
– Meet with the Registration Supervisor to ensure that the Referrals area is located close to the Registration area, and discuss how evacuees will be processed from the Registration
area to the Referrals area. Obtain the (EMBC) Task Number for the event and post or distribute to volunteers. Make contact with Resource Acquisition Supervisor and request lists
of food, clothing and lodging suppliers that volunteers can refer evacuees to. Operational Phase: Maintain communication with assigned supervisor. Maintain position log in chronological
order describing actions taken during the shift. Acquire lists of available resources/suppliers for evacuees from the Resource Acquisition Supervisor and distribute to volunteers
as required. Oversee volunteers as they interview evacuees to determine immediate needs (e.g., food, lodging etc.). Ensure that Referral forms filled out are completed correctly.
Monitor resources/suppliers used and request additional lists of resources/suppliers from Resource Acquisition as required. Request authorization from the (EMBC) Regional Manager
(or ESS Branch Coordinator at the PREOC if activated) on reasonable but unusual requests by evacuees for services/goods. Ensure that completed Referral forms are forwarded to the
Documentation Unit for processing as soon as possible. Reply to inquiries from suppliers about the ESS payment process. Attend briefings as requested. Provide status report information
to Section Chief prior to management team meetings. Brief responders within the Unit as needed. Prepare shift schedules as needed. Assist, support and provide direction to volunteers.
Monitor Unit personnel to ensure appropriate worker care is implemented. Brief replacement for the next shift and identify outstanding action items or issues.
PAGE 29 REGISTRATION & REFERRALS Module 1 Section 2 – Reception Centre Function Checklists Reception Centre March 2014 2 -33 Operational Guidelines Demobilization Phase: Complete all
required forms, reports, and other documentation. All forms should be submitted to the Planning Section, as appropriate, prior to departure. Demobilize assigned position and close
logs when authorized by the Reception Centre Manager. Submit a list to the supervisor, for delivery to the appropriate section, of the following: – Status of all borrowed equipment
– All ESS equipment and supplies needing restocking – Names of personnel and hours worked Clean up work area before leaving. Sign out with Volunteer/Staff Management Branch. Leave
a forwarding number. Access critical incident stress debriefing as needed. Be prepared to contribute to any post event processes (e.g., debriefs, reports etc.). Function Aids: –
ESS Personnel Request Form – ESS Rates Sheet – ESS Referral Form – ESS Referral Form Instruction Guide – ESS Referral Payment Process (refer to ESS Field Guide – Section 6 – ESS Expenditure
Policy and Payment Process) – ESS Resource Request Form – Invoice for Host Family (Billeting) – Shift Schedule – Standards of Conduct for ESS Responders – Status Report – Tracking Record
of Resources
PAGE 30 REGISTRATION & REFERRALS Module 1 How is Registration & Referrals provided? Although the recommended provincial model for providing services to evacuees is the “1 Stop” model,
there may be times when ESS teams want to move to a “2 Stop” model. Considerations may be: size of the community; number of evacuees compared to number of ESS responders; number of
walkin volunteers; available space, etc. Your ESS Team will need to decide which model will be most effective, given the circumstances of the incident – either option is viable. OPTION
1 – ONE STOP 1 Stop When evacuees come to a Reception Centre, they are greeted by an ESS “Meeter and Greeter” who will assess their needs and send them to the appropriate station in
the Reception Centre. If an evacuee or family requires registration and referrals (food, lodging and/or clothing), a Meeter and Greeter sends them to a Registration & Referrals Worker
who will register them on the ESS File and complete the appropriate Referral forms as needed. One responder completes both the Registration and Referrals at one station or “1 Stop”.
(Evacuees needing to inquire about family members would be sent to the Inquiry station.) If the evacuee or family does not require any assistance with food, lodging and/or clothing,
and only needs to register or make inquiries, then the Meeter and Greeter sends them to the Registration Only or Inquiry stations. Registration Only is an express line that can fast-track
evacuees who only need to register.
PAGE 31 REGISTRATION & REFERRALS Module 1 OPTION 2 – TWO STOP 1 Stop 2 Stop There may be situations where a community ESS Team decides to move to a modified version of the “1 Stop” model.
This “2 Stop” model works as follows: 1st Stop All evacuees will be sent to the Registration station to register their safety and whereabouts on the ESS File. (Evacuees needing to inquire
about family members would be sent to the Inquiry station.) 2nd Stop Following registration, only those evacuees requiring assistance with food, lodging and/or clothing will be sent
to a second station to be interviewed by a Referrals Worker, who in turn provides referrals to local suppliers. What about Inquiry, Search and Reply? While Registration will be needed
in any Reception Centre no matter how small, a formal Inquiry process will normally only be required when family members are unable to connect through conventional means (i.e. phone
or email), when there are fatalities, or when there is media interest that prompts out of area inquiries (i.e. a cruise ship incident). The Inquiry Card is used to record the necessary
information from inquirers regarding missing persons and to trace and positively identify the persons missing if they have registered. Search and Reply is the process of matching registrations
with inquires, and then responding to inquiries. No other component of the operation may respond to inquiries for consistency of information and confidentiality reasons. In larger disasters
where registration is taking place at more than one location, the Central Registry and Inquiry Bureau (CRIB) may be activated to centralize the searching and matching process. Copies
of the ESS File – Registration and Services Record, Change of Information, and the Inquiry Cards are forwarded to the CRIB for filing, searching, matching and informing inquirers of
the results of the searches.
PAGE 32 REGISTRATION & REFERRALS Module 1
PAGE 33 REGISTRATION & REFERRALS Module 2 MODULE 2 Interviewing Skills
PAGE 35 Interviewing Skills Tips ■ Registration and Referrals work is about helping people in need not just completing forms. ■ The needs of evacuees are first and foremost not our need
to gather information. ■ The role of an ESS responder is to empower those impacted by an emergency not rescue them. ■ Interviewing is a two-way process. Evacuees may have as many ques-tions
for you as you have for them. ■ Listen to their story. ■ Explain how you can assist them. ■ Explain the procedures they must follow to obtain services. ■ Show empathy and patience.
■ Respect everyone’s priorities. ■ The interaction you have with evacuees will have a direct impact on their emotional and physical recovery. ■ Quality of service, not quantity of evacuees
processed, is the objective. REGISTRATION & REFERRALS Module 2
PAGE 36 REGISTRATION & REFERRALS Module 2 LISTENING Ways to Improve Your Listening Skills 1. EMPATHIZE. Try to put yourself in the speaker’s place so you can see their point of view.
2. PUT THE SPEAKER AT EASE. Encourage him/her to talk freely. 3. BE PATIENT. Don’t show impatience. Allow plenty of time for each person even when you’re rushed. 4. SHOW YOU WANT TO
LISTEN. Look and show interest. 5. DON’T TALK TOO MUCH. You cannot listen if you are talking. 6. PARAPHRASE. Paraphrase the content and feeling of what the speaker has said. 7. ASK
QUESTIONS. This helps to understand needs.
PAGE 37 The Interviewing Process BUILD RAPPORT ■ Introduce yourself ■ How are you doing? ■ Use name of person ■ Give full attention ■ Eye contact ■ Handshake, pat on back if appropriate
■ Make sure that they are seated comfortably before you sit PROTECT ■ See to their immediate needs ■ Cup of tea ■ Warm blanket ■ Dry socks ■ Medical services ORIENT (ASK ABOUT OR MENTION)
■ Time ■ Date ■ Place ■ Family members ■ Friends ■ Who brought them ■ Location of different services, washrooms etc. ■ Register WHAT HAPPENED ■ “Tell me what happened.” YOU ARE NORMAL
■ Validate their experience ■ Their reactions are very much like others who have experienced the same situation ■ They may expect to feel . . . ■ Everyone deals with things at their
own speed REGISTRATION & REFERRALS Module 2
PAGE 38 REGISTRATION & REFERRALS Module 2 MEET SURVIVAL NEEDS ■ Food ■ Clothes ■ Shelter ■ Medications ■ Information Brochures MAKE A PLAN ■ Things to do today ■ Things to do this week
■ Need to come back . . . ■ Who to contact re: – insurance – credit cards – banks etc. ■ Forms to get ■ Childcare ■ Be good to yourself -eat nutritiously, exercise, rest, talk about
frustra-tion, spend time with family (3T’s -time, talk, tears) LINK WITH OUTREACH ■ Emotional health ■ Homemakers ■ Public health ■ Church groups ■ Doctor ■ Meals on wheels ■ Support
group ie. phone family to pick up NOTE: The Emotional Support Unit coordinates all counseling and mental health referrals. Evacuees needing this assistance should go through them.
PAGE 39 REGISTRATION & REFERRALS Module 2 FOLLOW UP (determine if person would like or would benefit from the following) ■ a follow up phone call ■ a follow up home visit (if available)
■ a further appointment ■ assistance for the disabled ■ assistance for alcohol/drug dependency ■ assistance for families in crisis * Source: Delaine Milette (modified version)
PAGE 40 REGISTRATION & REFERRALS Module 2
PAGE 41 REGISTRATION & REFERRALS Module 3 MODULE 3 Forms and Paperwork
PAGE 43 REGISTRATION & REFERRALS Module 3 General Instructions for Completing Forms PEN Always use pen (black or dark blue). Never use red pen or pencil. PRINT Your writing must be legible,
so please PRINT. You will fill in the forms FOR the evacuee. Do not let the evacuee fill in their own forms. CHECK and DOUBLE CHECK spelling, addresses and phone numbers. Don’t assume.
Many names have several different spellings. You may never see these forms again. Other people will interpret it. The successful matching of registrations and inquiries depends on accuracy
and clarity. Make sure all the information is complete. To make a match, as much information as possible is needed to be sure the correct person is identified. PRESS You are making
four (4) copies! PATIENT Be PATIENT. Take your time. You may be the first person the evacuees have had a chance to speak with. They may need to tell their stories. Begin by asking the
evacuees how they are doing. Offer them something to drink. Listen. Show empathy.
PAGE 44 REGISTRATION & REFERRALS Module 3 ESS File – Registration and Services Record Personal information is collected under the authority of the Emergency Program Act and may be shared
with other organizations to enable the provision of emergency services. Questions regarding the collection, use or disclosure of this information should be directed to: ESS Office,
Emergency Management BC, Ministry of Justice, P.O. Box 9201 STN PROV GOVT, Victoria, B.C. V8W 9J1 Phone: 1-800-585-9559 1. RESTRICTION "Concerned family and friends may inquire about
you and your family because of the emergency. We would like to provide these people with some information about you. May we disclose your location and the contact information for you
and your family members? Yes E.S.S. FILE REGISTRATION AND SERVICES RECORD 2. ESS FILE # 3. TASK # T 123456 4. LAST NAME (family representative) 5. FIRST NAME 6. AGE 7. GENDER 8. NICKNAME
9. PLACE OF REGISTRATION M F (Circle one) FACILITY COMMUNITY PERMANENT ADDRESS POST DISASTER ADDRESS 10. APT# & STREET ADDRESS 17. APT# & STREET ADDRESS 11. COMMUNITY 18. COMMUNITY
12. PROVINCE 19. PROVINCE 13. COUNTRY 20. COUNTRY 14. POSTAL CODE 21. POSTAL CODE 15. TELEPHONE 22. TELEPHONE ( ) ( ) 16. ALTERNATE # 23. E-MAIL ADDRESS ( ) “PLEASE NOTIFY THE RECEPTION
CENTRE IF YOU CHANGE YOUR LOCATION.” RECEPTION CENTRE CONTACT INFORMATION: LAST NAME FIRST NAME INITIAL RELATIONSHIP GENDER AGE 24. FAMILY INFORMATION “What are the names of family
members who live within the same household whom you know are safe?” 25. ADDITIONAL COMMENTS Use this area to add any information that may help to identify this person if an inquiry
is made or that will help explain this persons situation. OFFICE USE ONLY: 34. CHANGE OF INFORMATION FORM INSIDE FILE 35. CROSS REFERENCE 36. FOLLOW UP REQUIRED 37. CLOSED DATE LAST
NAME FIRST NAME ESS FILE # YES (see details below) COMPLETED 26. SIGNATURE OF FAMILY REPRESENTATIVE 27. INTERVIEWER’S FIRST NAME AND INITIAL OF LAST NAME (PLEASE PRINT) TIME: OF INTERVIEW
(24 HOUR CLOCK) DATE White Copy – Registration Pink Copy – Documentation Unit Yellow Copy -Evacuee Card Copy – Documentation Unit NOTE TO EVACUEE: PLEASE RETAIN THIS COPY AS PROOF OF
REGISTRATION M F M F M F M F M F M F M F M F M F No INITIAL YYYY MM DD YYYY MM DD Ministry of Justice
PAGE 45 REGISTRATION & REFERRALS Module 3 28. BRIEF STATEMENT OF HOW THE PERSON/FAMILY WAS AFFECTED IN THE DISASTER. (Interviewer or evacuee may wish to begin with this statement.) “DO
YOU HAVE INSURANCE TO COVER YOUR IMMEDIATE NEEDS?” “DO YOU HAVE FRIENDS OR FAMILY THAT YOU CAN STAY WITH?” (IF NO, PROVIDE SERVICES. IF YES, ASSIST THEM IN CONTACTING THEIR INSURANCE
AGENT TO CONFIRM COVERAGE FOR THIS EVENT) YES NO YES NO 30. SPECIAL NEEDS MEDICAL • “Do you or any others registering with you take medications?” If “yes” then, • “Do you have sufficient
supply for the next 72 hours?” If “no”, refer to Health Services for assistance. YES NO YES NO DIETARY • “Do you or any others registering with you have special dietary requirements/food
allergies?” If “yes”, please specify YES NO 31. OTHER AGENCY REFERRALS MADE OUTSIDE RECEPTION CENTRE (e.g. Community services) 32. FAMILY RECOVERY PLANS (Immediate and long term) (“ESS
provides short term assistance to give you and your family a chance to recover. Have you thought about what you will do after that time?”) 33. FOLLOW-UP REQUIRED (If more space is required,
write on the back of this folder) 29. SERVICES REQUIRED RESTAURANT MEALS OR GROCERIES CLOTHING TRANSPORTATION LODGING (TICK ONE) HOTEL/MOTEL BILLETING STAYING WITH FAMILY/FRIENDS INCIDENTALS
Please specify__________________________________________________________ _______________________________________________________________________ GROUP LODGING (name)_________________________________
_____________
PAGE 46 REGISTRATION & REFERRALS Module 3 ESS FILE – REGISTRATION AND SERVICES RECORD INSTRUCTION GUIDE March 2013 Section Seven 7-9 C. Emergency Social Services File Registration and
Services Record (EMBC2576) Completed by ESS responders Available from Contained in ESS File Kit Additional copies available from the ESS Office by E-mail note: ess@gov.bc.ca , by phone
toll-free at: 1-800-585-9559 or Fax: 250-952-4888. Purpose The ESS File Registration and Services Record is used to record necessary information regarding the identity, location and
needs of persons who are affected as a result of an emergency. This form is completed by a Registration worker and is designed to guide the interviewer through an interview with evacuees
to identify their immediate needs and provide services. If evacuees only need to register and require no other services, such as food, clothing or lodging, the ESS File may be completed
by a trained ESS responder in the “Registration Only” function area. Procedure for Processing Distribution: White Copy – Registration & Inquiry – Reception Centre Pink Copy – Documentation
Unit Yellow Copy – Evacuee Card Copy (file) –Documentation Unit Once the file is completed and the family representative has received the yellow copy of the registration form, the rest
of the file is forwarded intact to the Documentation Unit. An ESS responder removes the top stub, separating the card copy from the flimsies. The card copy becomes a file to hold all
documentation relating to that family. The two flimsies are forwarded to the Screening Unit in the Search and Reply area. Once the cross-referencing is done (if applicable) at the Search
and Reply area, the new flimsies are separated, with the pink copy and card copy going to the Documentation Unit, and the white copy staying with Search and Reply Unit. The pink copy
retained by the Documentation Unit may be forwarded to the Recovery Transition Unit as required. RC Function Aids can be found in the Reception Centre Operational Guidelines
PAGE 47 REGISTRATION & REFERRALS Module 3 March 2013 Section Seven 7-10 Instructions for Completing ESS File Form – General IMPORTANT: Because of the sensitive nature of this responsibility,
the ESS file should only be completed by ESS responders who have been specifically trained for this task. The ESS File is Completed for People Affected by the Disaster who: a) are at
a Reception Centre or ESS Services location, who require emergency services; b) are already lodged at a private or commercial location and wish to inform Central Registry of their present
whereabouts; c) have no firm plans as to where they will stay, but wish to leave the name, address and telephone number of a contact person (friend, relative, employer, etc.) whom they
will inform of their eventual emergency address; d) phone in to register that they are safe and away from the disaster area. One ESS File is used to register all those immediate family
members who live within the same household, whose whereabouts and safety are known. Once the Screening Unit, Search and Reply receives the flimsies, ESS responders there will check
for family members with different last names, and complete another ESS File for each family member with a different last name. Key points for completing the ESS File are: Use a ballpoint
pen (preferably black ink) and press firmly. All pages are self-duplicating. Registration Supervisor should check the card for completeness, ensuring all necessary services available
within the Reception Centre are provided, before evacuees leave the Centre. Strive for quality of service and not quantity. Take the time required (20-25 minutes) to complete the
form and identify the needs of the evacuees. Ask each question and put a diagonal line over any box number being left blank, indicating the question has been asked. Freedom of Information
Statement at the top of the form does not need to be read to the evacuee by ESS responders. However, upon completion of the form, the evacuee will be asked to review and sign the completed
form, including the FOI Statement.
PAGE 48 REGISTRATION & REFERRALS Module 3 March 2013 Section Seven 7-11 Instructions for Completing ESS File Form – Specific Information should be recorded by Registration worker or
in extreme circumstances, a family representative: Freedom of Information and Protection of Privacy Statement This statement provides evacuees with information about: the authority
under which the information is collected; how the information will be used and who it will be shared with; who evacuee can call with questions regarding the collection, use or disclosure
of the information. Although this statement does not need to be read to evacuees, it should be drawn to their attention prior to them signing at the bottom. Block 1 (Restriction) Because
of personal or family concerns, some evacuees will not want their registration information given to anyone. This decision rests entirely with the person who is registering. Read the
information in the restriction box to the evacuee EXACTLY THE WAY IT IS WRITTEN. Ensure the evacuee has listened and clearly understands the implications of the restriction box. “Concerned
family and friends may inquire about you and your family because of the emergency. We would like to provide these people with some information about you. May we disclose your location
and the contact information for you and your family members?” If the evacuee says yes, mark the “YES” box in the restriction block with a large “”. The file IS NOT restricted. If the
evacuee says no, mark the “NO” box in the restriction block with a large “”. Tell the evacuee that the file is now restricted. This means that no information on their whereabouts will
be given out to anyone. If an inquiry is received about the evacuee, the evacuee will be contacted and given the name and phone number of the inquirer to respond to. Advise the evacuee
that if they require additional assistance at a later date they must tell the responder their file is restricted so it can be obtained from the Search and Reply Supervisor. Note: Once
a restricted registration is completed, hand-deliver it to the Registration Supervisor, who will pass it on to the Search & Reply Supervisor (if Search and Reply Unit is activated).
Block 2 (ESS File Number) This number is used to cross-reference the file to other forms. It is already preprinted.
PAGE 49 REGISTRATION & REFERRALS Module 3 March 2013 Section Seven 7-12 Block 3 (EMBC Task Number) Every disaster is issued a task number by Emergency Management BC. The task number
permits emergency responders to make approved expenditures on the disaster relief effort. Be sure this number appears in Block 3. You will receive this number at the Reception Centre.
Block 4 & 5 (Name) Family name/First name (family representative). This is the person registering the family. Print one letter per block. Block 6 – 8 (Age/Gender/Nickname of Family
Representative) These blocks must be completed in order to help make a positive identification. If someone doesn’t want to give out their age, put a line through the block. Block 9
(Place of Registration) The facility or name of the Reception Centre or specific place, such as a hospital, where the registration is taking place, and the community where the facility
is located. Block 10 – 16 (Permanent Address) This is the permanent address of the evacuee. If the evacuee is a tourist/visitor, record their home address (even if outside the disaster
area). Use the street address. Enter additional address information (e.g., mailing address, box number or location where tourist/visiting person was staying) in Block 25 “Additional
Comments.” Block 17 – 23 (Post Disaster Address) This is where the person will be staying until they can return to their home. For Registration workers only (when Registration and Referrals
are separate functions). If the evacuee needs lodging, write “L” (for lodging) in the margin beside Block 17. This will indicate to Search and Reply volunteers that they will need to
find the completed form in the files to fill in Blocks 17-23. Impress upon evacuees that if they change their post-disaster address (evacuees may move from a hotel to a friend’s home,
or return home etc.), they must phone or go to the Reception Centre, or call the Central Registry and Inquiry Bureau’s 800 number. People may be inquiring about them and if they move
without letting us know, we cannot tell friends and relatives where they are. A separate “Change of Information” form must be completed. You will receive the forms at the Reception
Centre. Block 24 (Family Information) Read the statement exactly as it is written on the form. List immediate family members who live in the same household and whose whereabouts and
safety are known. Full addresses need to be recorded including the Road, Crescent, Place, Way, Drive, Street, etc.
PAGE 50 REGISTRATION & REFERRALS Module 3 March 2013 Section Seven 7-13 List all family members on the same card regardless of their family name. The information will be separated onto
different forms later. If you have any doubt whether someone should be included on the same form (e.g., student, boarders), fill out a separate registration form for that person. Do
not register a person twice. Block 25 (Additional Comments) It is not always necessary to use this space. Include information that will assist in identifying the evacuee if address
or phone number is not available (e.g., treaty number, PO Box, physical description), and assist the ESS responder to understand their needs. Block 26 (Signature of Family Representative)
The ESS File – Registration and Services Record includes text related to the collection, use, and disclosure of information gathered during the registration process. Information is
collected under the authority of the Emergency Program Act and may be shared with other organizations. Evacuees should read and understand all of the information on the registration
form, including the Freedom of Information (FOI) text in the top centre of the form prior to signing their name in “Block 26.” The person registering the family should sign the ESS
File – Registration and Services Record once it has been completed. Upon completion of “Block 25” (additional comments), the registration worker should turn the record around so that
it faces the evacuee. The responder should ask the evacuee to review the record, check that the documented information is correct, and ask if there are any questions about the information
contained on the record. Once the information has been reviewed, the evacuee should sign his or her name. Further questions from the evacuee about the collection, use or disclosure
of their personal information should be referred to the ESS Office at EMBC HQ in Victoria. Give evacuee the yellow copy of the ESS File – Registration and Services Record. Note: Refusal
to sign the form does not mean service will be denied. ESS will still provide service and reunite loved ones. However, the file will be restricted because it cannot be certain an evacuee
who refuses to sign the form has understood how the information will be used. While a restricted form won't prevent family reunification, it may slow down the process. Block 27 (Interviewer)
Print your FIRST name only and the initial of your last name and the time and date of the interview.
PAGE 51 REGISTRATION & REFERRALS Module 3 March 2013 Section Seven 7-14 Block 28 Brief statement of how the person was affected in disaster. Does family have friends or other family
that they can stay with? Yes/No. Does the family have insurance to cover immediate needs? Yes/No. An ESS responder may decide to start the interview with this question, since it gives
the family a chance to debrief. It gives the family the opportunity to explain how they were affected by the disaster and helps the ESS responder assess the immediate needs of the family,
such as if they have friends or family to stay with and/or if the person/family has insurance coverage for temporary lodging, food and clothing replacement. If time permits, try to
include: where family members were at time of disaster; if any injuries were sustained; what they were able to retrieve; how they got to the Reception Centre; what instructions
or information they received from first responders; what they perceive to be their immediate needs. This is a good chance to assess the emotional state of the person and suggest Emotional
Support if necessary. If the family has insurance that can cover their costs, instruct them to make necessary purchases, keep all receipts and contact their insurance agent immediately
to arrange for payment of services. If their home is unfit to live in, they will want to confirm their coverage for additional living expenses. Where the evacuee is denied access to
their home by civil authorities, for instance under a mass evacuation order, they should ask their agent specifically if they have prohibited access coverage. if they have difficulties
contacting their insurance agent or are uncertain about their coverage, services should be provided as usual, pending clarification of insurance. Assistance in resolving insurance related
concerns is available by calling the Insurance Bureau of Canada Consumer Information Line at 604 684-3635 ext. 222, or toll free at 877-772-3777. Note: EMBC does not have the ability
to be reimbursed by an evacuee’s insurance plan/company. Block 29 (Services Required) Identify whether the person/family requires restaurant meals or groceries, clothing, transportation,
or incidentals such as personal hygiene products. Place a “” in appropriate boxes. Depending on availability of accommodation, indicate where the person/family will be staying. The
hotel name and address or friend’s name and address should be added to the top section “Post Disaster Address”
PAGE 52 March 2013 Section Seven 7-15 Boxes 17 to 23. If Group Lodging is provided, the name and location of the Group Lodging Facility should be noted in Box 17, as well as Box 29,
as indicated. Pre-authorization must be obtained from the RM or ESS Office at EMBC in regards to any unusual items, services or amounts in excess of those listed on the ESS Rate Sheet.
Block 30 (Special Needs) Medical – Some people may be reluctant to explain their medical concerns to an ESS responder, but need to be referred to Health Services Branch. As well, they
may not have necessary medication with them or enough to last for 72 hours. Use the questions on the form to try to determine their medical needs and refer them to Health Services Branch
if assistance is required. Dietary – Make note of any dietary restrictions the person or any members of their family may have. This will be especially important if they are referred
to a Group Lodging facility. Block 31 (Other Agency Referrals Made Outside Reception Centre) A person may require services not available within the Reception Centre. Examples of this
may be a family resource centre, Mental Health or other community agencies. The ESS responder should make note in this space what agencies the person was referred to and any follow-up
needed. Block 32 (Family Recovery Plans – immediate and long range) This section helps the family representative focus on what other needs they may have in the short-term, and then
what recovery plans they need to make for the long-term. This may include getting in touch with their insurance agents, getting the children back to school as soon as possible, arranging
for contractors or clean-up, contacting relatives and friends to let them know they are safe. Block 33 (Follow-up Required) The Registration worker should give detailed information
about the followup requirements. For example, the family may have been referred to community services and the ESS responder may want to follow-up to ensure the family needs were addressed.
This would be the appropriate place to note this on the file. If all immediate needs of the family are met, the ESS responder should write in this space: “Evacuee states that all immediate
needs have been met. Recommend file be closed.” REGISTRATION & REFERRALS Module 3
PAGE 53 REGISTRATION & REFERRALS Module 3 March 2013 Section Seven 7-16 The Registration Supervisor will review file and if everything is satisfactory, will close the file by adding
the date in the top section of the form. Office Use Only Block 34 (Change of Information Form Inside File) If the family moves from one post-disaster address to another, they should
immediately contact either the Reception Centre where they registered or Central Registry. An ESS responder will complete a Change of Information form (EMBC2622), with one copy for
the Search & Reply Unit at the Reception Centre, one copy for Central Registry, and the third copy to be added to the family’s ESS file at the Documentation Unit. When a Change of Information
form is added to the file, an “X” should indicate this in Box #35 on the top part of the ESS File. Block 35 (Cross Reference) For use by Search and Reply Area only. When an immediate
family member living in the same household, such as a spouse, child, stepchild or accompanying dependent, has a different last name on the Family Information List, the Intake Unit (Search
and Reply) will complete a new card for each person with a different last name. This box is then used to indicate the last name, first name and ESS File # of the family representative
for this person. This will help to facilitate the Inquiry task and reunite families more quickly. Block 36 (Follow-up Required) When follow-up is required as indicated at the bottom
of the form (Box 34) an “X” should be added to the “yes” box in this box at the top of the form. This will alert ESS responders in the Documentation Unit that follow-up is required
and a Follow-up Card will be added to the File prior to it being placed in the Master File. Block 37 (Closed Date) Once all immediate needs of the person/family are met and no follow-up
is required, the Registration Supervisor adds the closed date to the file. Close of Reception Centre Once the Reception Centre is closed, all ESS Files and all copies of Referrals and
Change of Information forms must be delivered to EMBC to be stored according to standard government procedures. Contact your Regional EMBC Office for instructions or contact the ESS
Office at 1-800-585-9559. For files that have been forwarded to the Recovery Transition Unit, the Local Authority retains possession of the files and all associated documentation until
no longer required by the Recovery Centre.
PAGE 54 REGISTRATION & REFERRALS Module 3 ESS FILE – REGISTRATION AND SERVICES RECORD – COMPLETED SAMPLE Personal information is collected under the authority of the Emergency Program
Act and may be shared with other organizations to enable the provision of emergency services. Questions regarding the collection, use or disclosure of this information should be directed
to: ESS Office, Emergency Management BC, Ministry of Justice, P.O. Box 9201 STN PROV GOVT, Victoria, B.C. V8W 9J1 Phone: 1-800-585-9559 1. RESTRICTION "Concerned family and friends
may inquire about you and your family because of the emergency. We would like to provide these people with some information about you. May we disclose your location and the contact
information for you and your family members? Yes E.S.S. FILE REGISTRATION AND SERVICES RECORD 2. ESS FILE # 3. TASK #T 123456 4. LAST NAME (family representative) 5. FIRST NAME 6. AGE
7. GENDER 8. NICKNAME 9. PLACE OF REGISTRATION M F (Circle one) FACILITY COMMUNITY PERMANENT ADDRESS POST DISASTER ADDRESS 10. APT# & STREET ADDRESS 2629 Ash Street 11. COMMUNITY 18.
COMMUNITY 12. PROVINCE 19. PROVINCE 13. COUNTRY 20. COUNTRY 14. POSTAL CODE 21. POSTAL CODE 15. TELEPHONE 22. TELEPHONE ( 250 ) ( 250 ) 16. ALTERNATE # 23. E-MAIL ADDRESS ( ) “PLEASE
NOTIFY THE RECEPTION CENTRE IF YOU CHANGE YOUR LOCATION.” RECEPTION CENTRE CONTACT INFORMATION: LAST NAME FIRST NAME INITIAL RELATIONSHIP GENDER AGE 24. FAMILY INFORMATION “What are
the names of family members who live within the same household whom you know are safe?” 25. ADDITIONAL COMMENTS Use this area to add any information that may help to identify this person
if an inquiry is made or that will help explain this persons situation. OFFICE USE ONLY: 34. CHANGE OF INFORMATION FORM INSIDE FILE 35. CROSS REFERENCE 36. FOLLOW UP REQUIRED 37. CLOSED
DATE LAST NAME FIRST NAME ESS FILE # YES (see details below) COMPLETED 26. SIGNATURE OF FAMILY REPRESENTATIVE 27. INTERVIEWER’S FIRST NAME AND INITIAL OF LAST NAME (PLEASE PRINT) TIME:
OF INTERVIEW (24 HOUR CLOCK) DATE White Copy – Registration Pink Copy – Documentation Unit Yellow Copy -Evacuee Card Copy – Documentation Unit NOTE TO EVACUEE: PLEASE RETAIN THIS COPY
AS PROOF OF REGISTRATION M F M F M F M F M F M F M F M F M F No INITIAL YYYY MM DD YYYY MM DD Ministry of Justice F I S H E R L E S L I E J 4 6 Les 142231 345-1st Street Sparksville
BC BC Canada Canada V9B 1B4 V9V 6M2 848-1234 847-2622 Smith Smith Fisher Fisher Smith Molly Tim Sarah Tommy Pat TNDDB Mother Son Step-Daughter Step-Son Husband 14 19 71 47 Les Fisher
Vicki B. 1700 10 2014 20 01 Sparksville Sparksville Community Hall Sparksville
PAGE 55 REGISTRATION & REFERRALS Module 3 28. BRIEF STATEMENT OF HOW THE PERSON/FAMILY WAS AFFECTED IN THE DISASTER. (Interviewer or evacuee may wish to begin with this statement.) “DO
YOU HAVE INSURANCE TO COVER YOUR IMMEDIATE NEEDS?” “DO YOU HAVE FRIENDS OR FAMILY THAT YOU CAN STAY WITH?” (IF NO, PROVIDE SERVICES. IF YES, ASSIST THEM IN CONTACTING THEIR INSURANCE
AGENT TO CONFIRM COVERAGE FOR THIS EVENT) YES NO YES NO Family left quickly after mandatory evacuation order was given for their area. They left with their dog, some clothes & personal
hygiene items. They will be staying at a friend’s home. Alternate accommodations needed for pet dog as host family has pet allergies 30. SPECIAL NEEDS MEDICAL • “Do you or any others
registering with you take medications?” If “yes” then, • “Do you have sufficient supply for the next 72 hours?” If “no”, refer to Health Services for assistance. YES NO YES NO YES
NO 31. OTHER AGENCY REFERRALS MADE OUTSIDE RECEPTION CENTRE (e.g. Community services) 32. FAMILY RECOVERY PLANS (Immediate and long term) (“ESS provides short term assistance to give
you and your family a chance to recover. Have you thought about what you will do after that time?”) Family will contact relatives for future assistance if required 33. FOLLOW-UP REQUIRED
(If more space is required, write on the back of this folder) Evacuee states that all immediate needs have been met. Worker recommends file be closed 29. SERVICES REQUIRED RESTAURANT
MEALS OR GROCERIES CLOTHING TRANSPORTATION LODGING (TICK ONE) HOTEL/MOTEL BILLETING STAYING WITH FAMILY/FRIENDS INCIDENTALS Please specify__________________________________________________________
_______________________________________________________________________ GROUP LODGING (name)______________________________________________ DIETARY • “Do you or any others registering
with you have special dietary requirements/food allergies?” If “yes”, please specify
PAGE 56 REGISTRATION & REFERRALS Module 3 FOLLOW THE ESS FILE FORM Follow the ESS File Form ESS Documentation Unit Worker: ‐ distributes ESS File Forms to R&R Workers START ESS Team:
‐ obtains supply of ESS File Forms from the ESS Office, EMBC, which are given to the Documentation Unit Registration & Referrals Workers: ‐ interview evacuees ‐ complete ESS File Forms
Card File, White, & Pink Copies: ‐ stay attached ‐ send completed Card File, white, & pink copies back to Documentation Unit Yellow Copy: ‐ give to evacuee Documentation Unit Worker:
‐ reviews Referral Forms for accuracy & completeness ‐ separate the white & pink copies ‐ record info on the Statistics Record ENDNo No Card File, when finished at the other station(s)
White & Pink Copies (AKA flimsies): ‐ stay attached; remove and send to Search & Reply Yes Is a referral made within the RC? 20151027 Card File: ‐ send evacuee & Card File to another
station ESS File Form Card File: ‐ file alphabetically in ESS File box Detailed info on Documentation Unit functions can be found on the JIBC YouTube Channel
PAGE 57 REGISTRATION & REFERRALS Module 3 Change of Information Form EMERGENCY SOCIAL SERVICES CHANGE OF INFORMATION EFFECTIVE DATE OF CHANGE The personal information is collected on
this form under the authority of the Emergency Program Act and is necessary for administrative purposes and may be shared with other public bodies, organizations and/or agencies to
enable the provision of emergency services. Disclosure of personal information is subject to the provision of the Freedom of Information and Protection of Privacy Act. Questions regarding
the collection, use or disclosure of the information should be directed to the Emergency Social Services Office, Emergency Management BC, PO Box 9201 Stn Prov Govt, Victoria, B.C. V8W
9J1 Phone: 1-800-585-9559 CHANGE OF INFORMATION TAKEN: IN PERSON BY PHONE AT: RECEPTION CENTRE CENTRAL REGISTRY CHANGE OF INFORMATION: ADD CHANGE DELETE EMBC2622(08/13) 7530906061 WHITE
– REGISTRATION YELLOW – DOCUMENTATION UNIT /SEARCH & REPLY PINK -DOCUMENTATION UNIT LAST NAME (FAMILY REPRESENTATIVE) FIRST NAME (FAMILY REPRESENTATIVE) ESS FILE # LAST NAME (PERSON
REPORTING CHANGE IF DIFFERENT FROM ABOVE) FIRST NAME (PERSON REPORTING CHANGE) PLACE OF REGISTRATION PRE-DISASTER ADDRESS POSTAL CODE TELEPHONE ( ) CHANGE OF ADDRESS: CHANGE OF CONTACT
NUMBERS: ( ) ( ) OTHER CHANGES: POSTAL CODE INTERVIEWER’S FIRST NAME AND LAST INITIAL (PLEASE PRINT) DATE E-MAIL ADDRESS
PAGE 58 REGISTRATION & REFERRALS Module 3 CHANGE OF INFORMATION FORM INSTRUCTION GUIDE Registration & Referrals Participant Guide Section 3 – Forms and Paperwork 43 Change of Information
Form (HR2622) Completed by ESS responder, either by telephone or in person at the Reception Centre, or Central Registry by telephone. Available from Contained in ESS File Kit Additional
copies available the ESS Office by Email note to ess@gov.bc.ca, by phone toll-free at: 1-800-585-9559 or Fax: 250-952-4888. Purpose This form is used to record any changes of information
after the person or family has already registered at a Reception Centre. Changes will usually involve relocation (addresses, contact phone numbers) but could also be adding a family
member’s name, or updating a referral to an outside agency. Procedure for Processing Distribution: White Copy – Registration & Inquiry – Reception Centre Yellow Copy – Central Registry
Pink Copy –Documentation Unit Evacuees can report changes of information either directly to a Reception Centre (preferably the one where they registered) in person or by phone, or to
Central Registry by phone. The three-part form is completed by an ESS responder and then distributed as indicated, above. } keep these two copies together Registration & Referrals Participant
Guide Instructions for Completing Change of Information Form Identifying Information Complete as much information as possible, to ensure the correct ESS File is changed: Effective
date of change: this may be different from the date the information is taken; Change of Information taken: mark either “in person” or “by phone”; At: mark either Reception Centre
or Central Registry; Name of Family Representative: as noted on ESS File; ESS File #: enter if person has the pink copy of the ESS File; Enter Name of person reporting change:
if different from above; Place of Registration: this is the name of the facility where they first registered; Enter Pre-Disaster Address, Postal Code, Telephone. Information to
be Changed Indicate whether this is to “add,” “change” or “delete” information; If change of post-disaster address, be sure to get as much information as possible, (e.g., name of
hotel or c/o relative's name); If changing contact numbers, be sure to add area code; Other changes add as much detail as possible; Interviewer’s First Name and Last Initial –
enter name of ESS responder recording this information and date the information was received.
PAGE 59 REGISTRATION & REFERRALS Module 3 CHANGE OF INFORMATION FORM – COMPLETED SAMPLE Registration & Referrals Participant Guide 46 Section 3 – Forms and Paperwork Change of Information
Form – Completed Sample
PAGE 60 REGISTRATION & REFERRALS Module 3 Referral Form REFERRAL PLEASE PRESS HARD -YOU ARE MAKING 4 COPIES NOTE TO SUPPLIER: Please attach itemized receipts and invoices providing specific
details of goods and/or services along with the original (white) copy of this Referral form and submit to Emergency Management BC. See reverse for more detailed information and billing
instructions. If no Emergency Social Services (ESS) Rates sheet is attached to this Referral form, call 1-800-663-3456 NOT REDEEMABLE FOR CASH 3. NAME OF SUPPLIER 4. ADDRESS OF SUPPLIER
5. CITY 6. POSTAL CODE 7. TELEPHONE 8. FAX ( ) ( ) 1. TASK # Referral # VALID ONLY From To HH /MM (24 hour clock) HH /MM (24 hour clock) YYYY MM DD YYYY MM DD At the request of the
Community or District of Please provide the following goods and services in accordance with the Emergency Social Services Rates attached, to the following person(s): 14. NAME OF FAMILY
REPRESENTATIVE (family name, first name) 15. NAME OF PERSON PURCHASING GOODS (if different from family representative) Number of Adults or Youths (13 -18): Number of Children (12 &
under): Names: Names: NOTE TO ESS RESPONDER: Use one form for each different supplier AND Tick “YES” or “NO” for each category below FOOD YES NO Restaurant Meals OR Groceries # persons:
Total # of meals per person during “Valid Only” period: # of Breakfasts: # of Lunches: # of Dinners: NOTE: Alcohol, tobacco and gratuities are not eligible expenses Refer to attached
ESS Rates sheet for maximum allowable rates LODGING Hotel/Motel OR Billeting OR Group Lodging # of nights authorized: (maximum 3) Refer to attached ESS Rates sheet for maximum allowable
rates YES NO CLOTHING # of people: Extreme winter conditions: Refer to attached ESS Rates sheet for maximum allowable rates YES NO YES NO The personal information requested on this
form is collected under the authority of the Emergency Program Act and is necessary for administrative purposes and may be shared with other public bodies, organizations and/or agencies
only to enable the provision of emergency services. Disclosure of personal information is subject to the provisions of the Freedom of Information and Protection of Privacy Act. Questions
regarding the collection, use or disclosure of this information should be directed to the Manager, Training , Exercise & Volunteer Programs, Emergency Management BC, PO Box 9201 Stn
Prov Govt, Victoria, B.C. V8W 9J1 Phone: 1-800-585-9559 23. Signature of Family Representative 24. Interviewers first name and initial of last name (please print) 25. Date (YYYY MM
DD) NOTE TO SUPPLIER -Send original (white copy) of Referral form and itemized invoices to: EMBC2395 7530906047 (100/pak) (13/06/01) White copy -Supplier Yellow Copy -Evacuee Pink Copy
-ESS Office, EMBC (Victoria) Green Copy -Documentation Unit NOTE: If more than one Referral form is issued for incidentals, the total of all Referral forms must not exceed maximum allowable
rate. Comments: INCIDENTALS # of people: Specify approved items: Refer to attached ESS Rates sheet for maximum allowable rates YES NO Emergency Management BC PO Box 9201, STN PROV GOVT
Victoria BC V8W 9J1 PHONE FAX 1-800-585-9559 (250) 952-4888 2. ESS File # (if applicable) 123456 Ministry of Justice TRANSPORTATION Specify Mode of Travel: From (address) To (destination)
YES NO 9. 11. 12. 10. 13. 16. 17. 18. 19. 20. 21. 22.
PAGE 61 REGISTRATION & REFERRALS Module 3Information for Suppliers and ESS Responders IMPORTANT: An ESS Rates sheet must be attached. If no Rates sheet is provided, please confirm current
rates prior to providing services by contacting Emergency Management BC (EMBC), Emergency Coordination Centre (ECC) at 1-800-663-3456. General Information • Refer to the attached ESS
Rates sheet for a description of eligible goods/services and maximum rates. • Charges for goods and services, including all applicable taxes, must not exceed the attached Emergency
Social Services rates. • Ensure that services are provided only to those individuals listed on the Referral form. • Check “Valid Only” dates carefully. Services provided outside the
time period will not be covered. • Make note of any additional instructions that may be provided in the “Comments” section. • An invoice is required with each Referral form, in addition
to the corresponding itemized original receipts or till tapes. • Alcohol, tobacco and gratuities are not covered. • Groceries, clothing and incidentals are “one-time only” purchases.
• It is recommended that the supplier make copies of all documentation for their records. Additional Lodging Information • Other than the basic room charge and applicable taxes, all
extra costs -including but not limited to, phone calls, movies, parking, damage or theft -are the responsibility of the evacuee. • If the evacuee can bill meals to their room, please
ensure the restaurant has an ESS Rates sheet and is aware of the meal allowances and restrictions. Itemized bills for meals provided must be included with the invoice. • Billeting rate
does not include meals. A Referral form for either groceries or restaurant meals may be issued. Additional Restaurant Information • Maximum meal allowances are set per meal, not per
day. Meal allowances for the entire day cannot be combined into one large food order, unless prior authorization is obtained from EMBC. • An itemized bill for each meal must be included
with your invoice. For Use of Supplier Invoice Checklist The following checklist is provided for your convenience to ensure your invoice documentation is complete and accurate prior
to forwarding to Emergency Management BC (EMBC) for payment. Original (white) copy of Referral form received from evacuee. Invoice includes supplier’s name and address, and original
itemized receipts/till tapes. Write Referral # on upper right hand corner of all invoices and documents. Goods or services rendered only to those people listed on the Referral. Goods
or services rendered are eligible items as listed on the ESS Rates sheet. Goods or services rendered are within maximum rates as listed on the ESS Rates sheet. Any exceptions have been
authorized by EMBC and documented. Make copies of invoices and receipts for your records. Send original invoices and itemized receipts with white copy of Referral form to EMBC for payment.
EMBC2395(13/06/01) --PLEASE READ --
PAGE 62 REGISTRATION & REFERRALS Module 3 REFERRAL FORM INSTRUCTION GUIDE Registration & Referrals Participant Guide Section 3 – Forms and Paperwork 47 ESS Referral Form (EMBC2395) Completed
by Referrals workers at Reception Centre or Level One ESS Responders Available from The ESS Office by E-mail note to: ess@.gov.bc.ca or by phone toll-free at: 1-800-585-9559 or Fax:
250-952-4888. Purpose Referral forms are given to evacuees to provide for their immediate needs, such as food, clothing and lodging. At a Reception Centre, ESS responders register evacuees
and provide ESS by completing and issuing Referral forms in accordance with rates set out on the ESS Rates sheet. The forms are then taken to merchants, restaurants or lodging facilities
for goods or services. If additional assistance is required that cannot be covered by a Referral form, evacuees should be referred to the Referrals Unit Supervisor. The Referral form
is not intended for bulk purchases. If no other payment option is available, pre-approval must be obtained from the ESS Office or PREOC for any bulk purchases. Procedures for Processing
Distribution: White Copy – Supplier Yellow Copy – Evacuee Pink Copy – ESS Office, EMBC Green Copy – Documentation Unit Once a Reception Centre is set up and prior to serving evacuees,
each Referrals worker will report to the Documentation Unit to sign out a supply (10 to 20) of Referral forms. Once the Referrals worker has completed an ESS File with a family representative,
the necessary Referral forms are filled out. If the family has insurance that can cover their costs, instruct them to make necessary purchases, keep all receipts and contact their insurance
agent immediately to arrange for payment of services. If their home is unfit to live in, they will want to confirm their coverage for additional living expenses. Where the evacuee is
denied access to their home by civil authorities, for instance under an evacuation order, they should ask their agent specifically if they have prohibited access coverage. if they have
difficulties contacting their insurance agent or are uncertain about their coverage, services should be provided as usual, pending clarification of insurance. Assistance in resolving
insurance related concerns is available by calling the Insurance Bureau of Canada Consumer Information Line at 604 684-3635 ext. 222, or toll free at 1 877 772-3777. Note: EMBC does
not have the ability to be reimbursed by an evacuee’s insurance plan/company.
PAGE 63 REGISTRATION & REFERRALS Module 3 Registration & Referrals Participant Guide 48 Section 3 – Forms and Paperwork Use of Referral Form Use one Referral form for each different
supplier, indicating by checking the “YES” boxes for those goods or services to be provided by that supplier. Be sure to check the “no” boxes for those goods and services NOT to be
provided by that supplier. The evacuee receives the top two copies (white and yellow), the pink copy and the green copy stay in the ESS File which is sent to the Documentation Unit.
In turn, the pink copy is forwarded to the ESS Office at EMBC and the green copy is kept in the ESS File for that family. Voiding a Referral Form If an error is made when completing
the Referral form (e.g., the wrong supplier is written in), void all four copies by putting a line diagonally through the middle and write “VOID” in large letters. Only use “VOID” when
all four copies are still intact. Cancelling a Referral Form If a Referral form has already been issued to the evacuee but they return to have it changed, this should be “CANCELLED.”
An example of this would be if a family was unable to obtain the goods from a particular supplier. The evacuee must bring in two copies of the Referral form, which are matched with
the copy in their file. (The fourth copy is already on its way to the ESS Office at EMBC.) Put a line diagonally through the middle and write, “CANCELLED.” Write on the new Referral
form “Replacing Referral form #----, issued to (Family Rep’s Name)” so that EMBC can match those two documents. There may also be situations where evacuees are not able to obtain all
goods from one supplier and return to the Reception Centre to be referred to another supplier. An example of this would be when a family of four people is unable to get necessary sizes
for one family member. When they return to the Reception Centre, complete an additional Referral form, documenting in the “Comments” section the reason for the additional Referral form.
General Procedure for Reimbursement to Suppliers Once evacuees have received the goods or services, suppliers send invoices to: Emergency Social Services Office Emergency Management
BC PO Box 9201 STN PROV GOVT Victoria BC V8W 9J1 Invoices must be supported by: original copies of Referral forms; description of goods or services provided (take from supplier
consent); original itemized invoice/till tape; GST Exempt #; and/or total costs. Incomplete or incorrect invoices received by EMBC may result in payment delay.
PAGE 64 REGISTRATION & REFERRALS Module 3 Instructions for Completing -Specific Registration & Referrals Participant Guide Section 3 – Forms and Paperwork 49 Instructions for Completing
ESS Referral Form Press hard – you are making 4 copies. Block 1 (EMBC Task Number) This is the identity number assigned to a particular incident. Since all response costs are billed
to this number it is important the correct number be placed in this block. Block 2 (ESS File #) If an ESS File has been completed for this individual or family, enter the File # here
to ensure the Referral form copies are filed in the correct ESS File. Block 3 -8 (Name and Address of Supplier) Fill in the full name of the company, (e.g., Best Western, Coquitlam)
and the full address, phone and fax numbers. Block 9 -12 (Valid Only) The period of eligibility for ESS begins on the date and time that the actual incident began, and extends for a
maximum of 72 hours (e.g. from 1100 hrs 2005/06/24 to 1100 hours 2005/06/27) unless the ESS Office has pre-approved a longer period of service. When an incident is known to be short-term,
sometimes only 24 or 48 hours may be approved. Using the 24 hour clock, insert in the “from” fields (Box 9 and 10) the time and date that the services are requested (e.g. if the evacuee
does not contact the ESS responder until the next day to request services, enter the time and date that contact is made). In the “to” fields (Box 11 and 12), insert the time and date
that eligibility for ESS ends, which is a maximum of 72 hours after the actual incident began, unless a different period of eligibility was approved by EMBC at the beginning of the
incident. If an extension of services is being done a new referral form should be completed. For the period of eligibility insert in the “from” field the time the previous referral
ended and in the “to” field the date at which the extension of service that has been approved ends. Contact commercial lodging suppliers to confirm with them that service has been extended
and to confirm that rental accommodation is available for the period of the extension. In short, in any given incident, the “from” date may vary from one evacuee to another, depending
on when service is requested, but the “to” date will remain the same for all people receiving services as a result of the same incident.
PAGE 65 REGISTRATION & REFERRALS Module 3 Registration & Referrals Participant Guide 50 Section 3 – Forms and Paperwork Block 13 (Community or District of) This identifies the local
authority responsible for managing the response, but in no way holds them responsible to reimburse the supplier. Box 14 (Name of Family Representative) This is the person designated
to make decisions on behalf of the family. Block 15 (Name of Person Purchasing Goods) (If different from family representative) A person other than the family representative may be
doing the shopping for the family’s needs. For example, the mother may be the family representative but the grandmother may be doing the shopping. If the family representative is purchasing
the goods, enter “N/A” in the “Name of Person Purchasing Goods” box. Block 16 (Number of Adults, Youths and Children) Insert the number of adults and youths 13 and over (including the
family representative), and number of children 12 and under who are to receive services on this Referral form. When entering the number write it out in full (e.g., “two” rather than
“2”) in order to prevent unauthorized alterations. List the names of all persons in the family unit who are to receive services. If the surname of other adults in the party differs
from that of the designated family representative, please include those surnames in the listing (you may use an extra line to do this, if necessary). Surnames of children or dependent
youths are not required, but may be entered if known. This will help ESS responders and suppliers to keep track of the individuals who have been approved to receive services, particularly
where no ESS File is completed. Please indicate “N/A” in each unused name space. DO NOT list different family units on the same Referral form. Block 17 -21 Use One Form for Each Different
Supplier A separate Referral form needs to be completed for each different supplier. It may be necessary to complete five different Referral forms for one family, if they require all
the services. Wherever possible, use only one supplier for each of the required services. If it is absolutely necessary to use more than one supplier for the same service (i.e., the
family will be eating at a restaurant, but their newborn infant requires a separate food Referral for baby formula), please document the circumstances in the Comment section. Referral
forms are not redeemable for cash. Block 17 -21 Tick Either “YES” or “NO” for Each Category Check “YES” for the items the supplier noted on the form will provide for that family, and
then check “NO” for everything else. For example, if the supplier is the Holiday Inn, providing lodging and restaurant meals, then check “YES” for those two services. For all other
services, check “NO.” Note: Do not assume that the hotel also owns the restaurant that is on site. If the restaurant is under different ownership, you will need to complete a separate
Referral form for meals at the restaurant.
PAGE 66 REGISTRATION & REFERRALS Module 3 Registration & Referrals Participant Guide Section 3 – Forms and Paperwork 51 Block 17 (Food) Indicate whether you are approving restaurant
meals or groceries. Also enter the total number of meals per person during the entire “Valid Only” period (e.g., for a 72 hour period, each person would need 3 breakfasts, 3 lunches
and 3 dinners). Again, this serves to emphasize to the supplier that there are three different meal rates being approved, and will ensure the supplier has (in conjunction with the attached
ESS Rates sheet) ready access to all the information necessary to calculate the total amount authorized. Block 18 (Lodging) Indicate the type of lodging being approved, and the number
of nights authorized. Due to the method of billing for most hotels and motels, there are some circumstances where a 72-hour authorization can appear to cover four nights of accommodation,
when only 3 nights are actually approved, so it is important that this information is clear. Block 19 (Clothing) If family members require clothing to maintain health and modesty, check
“YES” in the clothing box. Clothing is issued only as required, and is not intended as a wardrobe replacement. Enter the number of people approved for clothing (this may differ from
the total number of people receiving services if some had grab–and–go bags or were able to gather a change of clothing before evacuating). If extreme winter conditions exist and the
family requires the higher rate in order to provide appropriate winter clothing, indicate approval for the higher rate by ticking “YES” in the designated box, otherwise tick “NO.” Document
rationale for the higher rate in the Comments section. Block 20 (Transportation) If the family requires assistance with transportation, check “YES” and then indicate what mode of transportation
will be used, (e.g., taxis, bus passes, etc.,) as well as stating the approved destination(s). Block 21 (Incidentals) In addition to the costs of lodging, food and clothing, other legitimate
miscellaneous costs may be incurred. The incidental amount may be used to cover items such as personal hygiene products, laundry supplies, pet food and lodging, three day supply of
medications and other immediate needs as required. Enter the number of people requiring incidental costs and list approved items in the space provided. Where ESS responders are unsure
about an expenditure, they should consult with the Referrals Unit Supervisor (RUS) if a Reception Centre has been activated; the ESS Branch Coordinator at the Provincial Regional Emergency
Operation Centre (PREOC) if a PREOC has been activated; or contact the EMBC ECC by calling 1 800 663-3456.
PAGE 67 REGISTRATION & REFERRALS Module 3 Registration & Referrals Participant Guide 52 Section 3 – Forms and Paperwork Note: If more than one Referral form is issued for Incidentals
(e.g., one for personal hygiene items and another for pet lodging), the total of all Referral forms issued must not exceed the maximum allowable rate. If you are approving less than
the maximum allowable ESS rate, enter and highlight the approved amount in either the Incidentals or the Comments section. Block 22 (Comments) Use this space to document authorizations
obtained for exceptional needs, or other pertinent messages to the supplier or EMBC staff regarding the services provided. If the space provided is insufficient, an additional sheet
of paper may be attached. Block 23 (Applicant’s Signature) Please have the family representative sign in this block. Block 24 (Interviewer’s First Name and Initial of Family Name) The
ESS responder must print their name legibly and date this form. To protect the responder's privacy, a full family name is not required. Block 25 (Date) Enter date that Referral form
was completed by ESS responder. EMBC Contact Name, Address & Contact Numbers This information is pre-printed on the Referral form as of November 2005. Note: If older Referral forms
are being used, the following address for submitting invoices must be inserted: Emergency Social Services Office Emergency Management BC PO Box 9201 STN PROV GOVT Victoria BC V8W 9J1
Phone: 1-800-585-9559 Fax: 250-952-4888 ESS Rates Sheet Once the Referral form is completed, an ESS Rates sheet must be attached to the back of the white supplier copy of the Referral
form before issuing the form to the evacuee. If no ESS Rates Sheet is attached, the supplier will not be able to provide service until they have confirmed current rates. Information
for Suppliers and ESS Responders (back of white copy of referral) Suppliers frequently require reminders of the critical information they will need when providing ESS goods and services.
ESS responders may also find some of the information to be a helpful reminder. Invoice Checklist (back of white copy of referral) This checklist reminds suppliers of steps required
before submitting the Referral for reimbursement.
PAGE 68 REGISTRATION & REFERRALS Module 3 REFERRAL FORM – COMPLETED SAMPLE FOR SPARKSVILLE EVACUATION SCENARIO See scenario for particulars regarding the date and time evacuee is requesting
food and lodging services. Registration & Referrals Participant Guide Section 3 – Forms and Paperwork 55 ESS Referral Form – Completed Sample for Sparksville Evacuation Scenario. (See
scenario for particulars regarding the date and time evacuee is requesting food and lodging services).
PAGE 69 REGISTRATION & REFERRALS Module 3 ESS RATES SHEET
PAGE 70 REGISTRATION & REFERRALS Module 3 BILLETING INVOICE FORM Emergency Social Services Revised July, 2014 BILLETING INVOICE As a host providing accommodation to those in need during
a disaster, you may be compensated for additional expenses incurred by claiming the billeting allowance. Please complete this invoice and attach it to the white copy of the ESS Referral
form issued in your name. Submit both this invoice and the white copy of the Referral form to Emergency Management BC address indicated on the bottom of the Referral form. Please keep
a photocopy of these forms for your personal records and allow 6-8 weeks for receipt of payment. Date: _________________ EMBC Task #______________________________________ (obtain from
the top of the ESS Referral Form) Name of Supplier: (your name) ____________________________________________________ Mailing Address: (your address) _________________________________________________
__ Phone Number: (your phone #) ___________________________________________________ Name of Family Representative: (same name as appears on the ESS Referral Form) Date of Accommodation
provided: From _________________________________________ To: _________________________________________ Daily Allowable Rates: $30.00 for first adult $10.00 each additional adult and
youth (13-18) $ 5.00 for each child 12 and under Accommodation provided for: ______ adults ______ youths 13 – 18 years ______ children 12 years of age and under Please pay: _______
x $30 for first adult = _______ _______ x $10.00 each additional adult/youth = _______ _______ x $ 5.00 for each child = _______ TOTAL _______________ Name: (Please print) __________________________
_________ Signature: ____________________________________________ Billing Address: Emergency Social Services Office, Emergency Management BC PO Box 9201, STN PROV GOVT, Victoria BC V8W
9J1 Phone: 1-800-585-9559 Fax: (250) 952-4888
PAGE 71 FOLLOW THE REFERRAL FORM Follow the Referral Form ESS Documentation Unit Worker distributes the following to R&R Workers: ‐ Referral Forms ‐ Current ESS Rates Sheets START ESS
Team: ‐ obtains supply of Referral Forms from the ESS Office, EMBC, which are given to the Documentation Unit Registration & Referrals Workers: ‐ Interview evacuees ‐ Complete Referrals
Forms Voided Form: ‐ send back to Documentation Unit Yellow Copy: ‐ give to evacuee White Copy: (plus current ESS Rates Sheet) ‐ give to evacuee to give to supplier Supplier: ‐ provides
services ‐ sends invoice and white copy of Referral Form to the ESS Office, EMBC for processing Documentation Unit Worker: ‐ reviews Referral Forms for accuracy & completeness ‐ record
info on the Statistics Record Voided Form: ‐ record ‐ file together with other voided forms Green Copy: ‐ file in Card File, then file alphabetically in box Pink Copy: ‐ place in box
or envelope and forward to ESS Office, EMBC ESS Office, EMBC: ‐ compares pink copy with white to ensure no discrepencies ‐ files pink copy and photocopy of invoice as a record ‐ white
copy and invoice are processed and sent to Finance, EMBC, for payment Finance, EMBC: ‐ reimburses supplier END ESS Rates Sheet Green & Pink Copies: ‐ send back to Documentation Unit
for filing in the ESS Card File Referral Form 20151027 Invoice VOIDED FORMS REGISTRATION & REFERRALS Module 3
PAGE 72 TRACKING RECORD OF RESOURCES Each Referral Worker must track the resources (i.e., hotel rooms) given to each evacuee. The following is an example of such a tracking form. Registration
& Referrals Participant Guide 58 Section 3 – Forms and Paperwork Tracking Record of Resources Each Referral Worker must track the resources (i.e. hotel rooms) given to each evacuee.
The following is an example of such a tracking form. TRACKING RECORD OF RESOURCES Resources Used * To be completed by Resource Acquisition worker when assigning resources to Referrals
workers To be completed by Referrals workers when evacuees are referred to a supplier Rhonda B. 2014/01/21_ Vicki B. 2014/01/21 Name of Resource Acq. Worker Date Name of Referrals
worker Date (YY/MM/DD) (YY/MM/DD) * Availability 78 double rooms B/L/D 80 People B/L/D Limited Supply Limited Supply Large Stock * Special Consideration Smoking Wheelchair Restaurant
Wheelchair Men/Women/child (varied sizes) Pharmacy Toiletries Pet Supplies * Address /Telephone 4450 3rd Street Sparksville, BC V9V 7B3 250 848-9316 788 – 11th Avenue Sparksville, BC
V9V 2S7 250 848-8110 Sparksville Mall 819 12th Avenue Sparksville, BC V9V 3P4 Sparksville Mall 819 12th Avenue Sparksville, BC V9V 3P4 * Supplier Sparksville Inn Fine Foods Restaurant
Clothing and More Everyone’s Drugstore Pet Foods & Supplies * Service LODGING FOOD CLOTHING OTHER REGISTRATION & REFERRALS Module 3
PAGE 73 REGISTRATION & REFERRALS Module 4 MODULE 4 Scenario & Challenges
PAGE 75 REGISTRATION & REFERRALS Module 4 Sparksville Evacuation Scenario It is 1615 hours on January 20, 2014, and a multi-vehicle accident has resulted in a toxic chemical spill along
a main street in your community. Approximately 200 residents are being evacuated from their homes and they are being told to report to the Reception Centre at the Sparksville Community
Hall. Instructions for the Registration & Referrals Worker: ■ You have taken care of your own family situation, arrived at the Reception Centre and have been put to work as a combined
Registration and Referrals Worker (1-stop service provision). A “Meeter and Greeter” directs an evacuee to your desk for services. ■ The EMBC Task Number for the incident is 142231.
■ Your team has a Pet Services team member. Instructions for the Evacuee: ■ Your name is Leslie J. Fisher and you are 46 years old. Your spouse, Pat T. Smith, age 47, is also at the
Reception Centre, along with Pat’s son, Tommy B. Smith, age 10, and daughter Sarah D. Smith, age 14. Sarah has managed to get through carrying her puppy “Puddles” hidden under her jacket.
You live at 345 -1st Street, Sparksville, BC V9V 1B4. Your telephone number is 250-848-1234. The number is unlisted number because you don’t want Pat’s former spouse to be able to locate
the family. ■ You explain that your 19 year old son, Tim D. Fisher has gone to work, however, he was with the family when they got the evacuation notice and instructions to report to
the Reception Centre. ■ Your daughter, Jane M. Fisher, 21 years old, lives and goes to school in Collegeville, BC. ■ Your mother, Molly N. Fisher, age 71, lives in your home. She is
also at the Reception Centre with the family. Molly takes medication and she has her medication with her. ■ A friend of yours on the other side of town has offered her place for you
and your family to stay. The address is 2629 Ash St. Sparksville, BC. V9V 6M2. The telephone number is 250 847-2622. You do not wish to receive a Referral form for billeting. ■ You
indicate groceries, clothing, transportation and incidental items are not required. ■ The host family member has allergies to cats and dogs; therefore, the family dog cannot stay at
the friend’s home. ■ You do not have homeowners insurance.
PAGE 76 REGISTRATION & REFERRALS Module 4 SPARKSVILLE EVACUATION SCENARIO – ONE DAY LATER Instructions for the Registration & Referrals Worker: ■ Referrals to the “Sparksville Inn” at
4450 3rd Street, Sparksville, BC V9V 7B3, phone: 250 848-9316, fax: 250 848-9300 are available to those who require accommodation. ■ Evacuee living assistance under a Task Number is
available for 72 hours effective 1615 hours yesterday. ■ The hotel has its own restaurant. Instructions for the Evacuee: ■ You have returned to the Reception Centre at 11:00 a.m. on
January 21, 2014 as you and your family are no longer able to stay in your friend’s home and you are not able to re-enter your neighborhood. You, and your family, have no place to stay.
■ You show the responder your yellow copy of the ESS File, which shows that the file is restricted.
PAGE 77 REGISTRATION & REFERRALS Module 4 Challenges – What if...? As an ESS responder, you receive a telephone call asking you to report to the Reception Centre as soon as possible.
Several individuals are being evacuated from their homes due to a toxic chemical spill in your community. You make the necessary personal arrangements, take your grab and go bag (with
your training materials), and off you go. When you arrive at the Reception Centre, you are assigned the role of a combined Registration & Referrals Worker. You sit down at your table
and… 1. You realize it has been several months since you attended training for the functions, and your recollection of how to complete the forms is sketchy. What would you do? 2. You
are registering a family and are told that their grandma is visiting from Ontario for two weeks. Do you include her on the same registration or complete a separate form? Explain. 3.
You are interviewing a family who indicates that a student has been living with them for the last year. Should we record this person on the same registration as the host family? Explain.
PAGE 78 REGISTRATION & REFERRALS Module 4 4. You are registering two non-related families who live together? Are they recorded on the same registration? Explain. 5. Grandparents are
babysitting their grandchildren for three weeks while the parents are on holidays in Mexico. Are the grandchildren registered on the same form as the grandparents? Explain. 6. A woman
who babysits four children in her home on a regular basis is being interviewed. Should the children be registered on the one form? Explain. 7. A tourist indicates that she has been
evacuated from her hotel. What address should be recorded in the “Permanent Address” block?
PAGE 79 REGISTRATION & REFERRALS Module 4 8. You have finished registering a family that has placed a restriction on the registration. What will you do with it? 9. You are interviewing
a family and learn that they have not evacuated yet, but want to register just in case they have to evacuate. What should you do? 10. At “Permanent Address” should you document the
street address or mailing address? 11. You are completing a Referral form for accommodation and do not think it is necessary to document the accommodation location on the registration
part of the form (blocks 17-23). Is it okay?
PAGE 80 REGISTRATION & REFERRALS Module 4 12. A family needs accommodations and meals. The hotel you place them in has a restaurant. Can you complete one Referral form for both services?
Explain. 13. You are interviewing an evacuee and completing Referrals for basic needs when you realize that you have run out of hotel rooms. The evacuee requires accommodation. What
would you do? 14. An evacuee indicates that he is diabetic and has run out of insulin. Explain the process you would go through to assist him. 15. You are finishing your interview with
a family who is receiving assistance with food and lodging. You have completed all of the paperwork, yet, you sense that they are uncertain about what they must do to receive these
services. How can you help?
PAGE 81 REGISTRATION & REFERRALS Module 4 16. You make a mistake on the Referral form you are completing. What would you do? 17. An evacuee returns to the Reception Centre indicating
that she was unable to obtain baby formula at the convenience store she was sent to. What would you do? 18. The hotel that is being used for your evacuees does not allow any pets in
the rooms. An elderly couple refuses to be separated from their aging Maltese. What can you do to accommodate these people? 19. You have had several requests from people to be able
to use their meal Referral forms at more than one restaurant. They say, “It’s kind of boring to eat all three meals at the same restaurant.” What would you do?
PAGE 82 REGISTRATION & REFERRALS Module 4 20. There is something very suspicious about the evacuee you are interviewing and the story that is being given to you. The request for assistance
appears questionable. You have nothing to base your feelings on except your intuition. What are your options in this situation? 21. You are interviewing an evacuee who is showing signs
of emotional distress. You try to comfort him but you do not appear to be helping. What would you do? 22. An evacuee indicates that he has friends with whom he could stay, who live
in the next town. He just needs a “tank of gas” to get there. What would you do?
PAGE 83 23. It is 0230 hours (2:30am) and you are sending evacuees to a hotel for the night. In fact, you have been told you may provide lodging for them for 72 hours. How will you indicate
this on the Referral form? 24. You have completed the ESS File and Referral forms for a family. What copies go where? What about the ESS Rates Sheet? 25. You have been working four
hours continuously. You are beginning to feel tired but no one has suggested you take a break. What would you do? REGISTRATION & REFERRALS Module 4
PAGE 84 REGISTRATION & REFERRALS Module 4
PAGE 85 REGISTRATION & REFERRALS Module 5 ■ Appendix 1: Acronyms ■ Appendix 2: Suggested Answers to Challenges – What if...QuestionsMODULE 5 Appendices
PAGE 87 REGISTRATION & REFERRALS Module 5 Appendix 1: Acronyms BCERMS BC Emergency Response Management System CRIB Central Registry and Inquiry Bureau EMBC Emergency Management BC EOC
Emergency Operations Centre EPC Emergency Program Coordinator ESS Emergency Social Services ESSD Emergency Social Services Director GL Group Lodging JIBC Justice Institute of British
Columbia MST Mobile Support Team PHAC Public Health Agency of Canada PREOC Provincial Regional Emergency Operation Centre PSC Public Safety Canada RC Reception Centre PERCS Provincial
Emergency Radio Communications Service
PAGE 88 REGISTRATION & REFERRALS Module 5 Appendix 2: Suggested Answers to Challenges – What if...Questions As an ESS responder, you receive a telephone call asking you to report to
the Reception Centre as soon as possible. Several individuals are being evacuated from their homes due to a toxic chemical spill in your community. You make the necessary personal arrangements,
take your grab and go bag (with your training materials), and off you go. When you arrive at the Reception Centre, you are assigned the role of a combined Registration & Referrals Worker.
You sit down at your table and… 1. You realize it has been several months since you attended training for the functions, and your recollection of how to complete the forms is sketchy.
What would you do? – Ask the Registration Supervisor and the Referrals Unit Supervisor for a quick refresher on the respective forms before you start. – Read the instructions in the
Reception Centre Operational Guidelines on how to complete the forms. – Review the completed sample forms in the participant guide. 2. You are registering a family and are told that
their grandma is visiting from Ontario for two weeks. Do you include her on the same registration or complete a separate form? Explain. – No. Grandma would register on a separate form.
– Block 24 clearly states the three criteria for including someone in Block 24 ● immediate family member ● same household ● safety is known – A visitor, relative, friend, etc. would
be required to complete a separate registration. In Block 25 you could indicate friend/relative is visiting and has registered. 3. You are interviewing a family who indicates that a
student has been living with them for the last year. Should we record this person on the same registration as the host family? Explain. – No. The student boarder is not a member of
the immediate family therefore does not fulfill the three criteria required to be included on the form. The student would have to register separately.
PAGE 89 REGISTRATION & REFERRALS Module 5 4. You are registering two non-related families who live together? Are they recorded on the same registration? Explain. – No. Block 24 refers
to immediate family members. Each family would register separately. In Block 25 you could indicate the name of the other family. 5. Grandparents are babysitting their grandchildren
for three weeks while the parents are on holidays in Mexico. Are the grandchildren registered on the same form as the grandparents? Explain. – No. Referring to Block 24, the criteria
are immediate family, same household, and safety known. There should be two registrations completed, one for the grandparents and one for the children. Both registrations would have
notes in Block 25 so if someone inquired about the grandparents it would be clear at a glance that the children were in their care and were registered on their own form. 6. A woman
who babysits four children in her home on a regular basis is being interviewed. Should the children be registered on the one form? Explain. – No. Each child would be registered separately,
unless they were siblings. 7. A tourist indicates that she has been evacuated from her hotel. What address should be recorded in the “Permanent Address” block? – The tourist’s home
address should be recorded. It would be useful to record the tourist’s hotel address in Block 25. 8. You have finished registering a family that has placed a restriction on the registration.
What will you do with it? – Hand deliver the restricted registration to the Registration Supervisor.
PAGE 90 REGISTRATION & REFERRALS Module 5 9. You are interviewing a family and learn that they have not evacuated yet, but want to register just in case they have to evacuate. What should
you do? – The purpose of registering is to indicate that the family is in a safe place. Pre-registering is not useful and does not indicate that the family is safe. Tell the family
to register after they have evacuated and are in a safe place. 10. At “Permanent Address” should you document the street address or mailing address? – Always ask for the street address.
There could be follow-up later and a box number isn’t useful. You can always document the box number in Block 25. 11. You are completing a Referral form for accommodation and do not
think it is necessary to document the accommodation location on the registration part of the form (blocks 17-23). Is it okay? – No. The post disaster information should always be documented
for family reunification purposes otherwise loved ones will not be connected. 12. A family needs accommodations and meals. The hotel you place them in has a restaurant. Can you complete
one Referral form for both services? Explain. – No, unless the hotel and restaurant are jointly owned and managed and they have agreed to accept one Referral form for both services.
13. You are interviewing an evacuee and completing Referrals for basic needs when you realize that you have run out of hotel rooms. The evacuee requires accommodation. What would you
do? – Notify the Referrals Unit Supervisor that you have run out of accommodations and are in need of a room ASAP. – Inform the Referrals Unit Supervisor, well in advance, that you
are starting to get low on resources so that you do not get caught short-handed.
PAGE 91 14. An evacuee indicates that he is diabetic and has run out of insulin. Explain the process you would go through to assist him. – Refer to Referrals Unit Supervisor for approval/advice.
– Will Health Services (in the Reception Centre) make arrangements for it, or does it require a Referral form to a pharmacy? If Health doesn’t make arrangements for medications, and
a Referral form to a pharmacy is required, the Referrals Unit Supervisor will need to get the authorization from the ESS Office or the PREOC. – Once a prescription is complete, the
Referrals Unit Supervisor or Referrals Workers will complete a Referral form to a pharmacy (with an existing agreement) where the evacuee can obtain their medication. 15. You are finishing
your interview with a family who is receiving assistance with food and lodging. You have completed all of the paperwork, yet, you sense that they are uncertain about what they must
do to receive these services. How can you help? – Explain, in great detail, where they go, what is included, what is not included, what they do with the copies of the Referral forms
given to them etc. – Ask them to repeat back the information you have shared to assess their understanding. 16. You make a mistake on the Referral form you are completing. What would
you do? – If it is a minor mistake – for example, a spelling mistake – make the correction and initial the change; otherwise, void all four copies by putting a line diagonally through
the middle and write “VOID” in large letters. “VOID” all four copies. REGISTRATION & REFERRALS Module 5
PAGE 92 17. An evacuee returns to the Reception Centre indicating that she was unable to obtain baby formula at the convenience store she was sent to. What would you do? – Request the
two copies back from the evacuee. Ask the Documentation Unit Worker to pull the evacuee’s file for you. Draw a line diagonally through the middle of all four copies and write the word
“CANCELLED” across the forms. Write on the new Referral form “Replacing Referral form # ----, issued to (Family Rep’s Name)” so that the ESS Office can match their copy of the new form
with the old one they would have previously received. – Do not “VOID” the form. 18. The hotel that is being used for your evacuees does not allow any pets in the rooms. An elderly couple
refuses to be separated from their aging Maltese. What can you do to accommodate these people? – Check with your supervisor, who in turn can check with the resource acquisition workers,
to see if there are any hotels/motels that will accept pets that you can send them to. – Billet with an individual/family that accepts pets. 19. You have had several requests from people
to be able to use their meal Referral forms at more than one restaurant. They say, “It’s kind of boring to eat all three meals at the same restaurant.” What would you do? – Advise them
that the resources are limited and this is all that’s available. 20. There is something very suspicious about the evacuee you are interviewing and the story that is being given to you.
The request for assistance appears questionable. You have nothing to base your feelings on except your intuition. What are your options in this situation? – Consult with your supervisor,
but remember that ESS is available to anyone who has experienced a disaster; it is not income tested, nor is identification required. REGISTRATION & REFERRALS Module 5
PAGE 93 REGISTRATION & REFERRALS Module 5 21. You are interviewing an evacuee who is showing signs of emotional distress. You try to comfort him but you do not appear to be helping.
What would you do? – Refer evacuee to the Emotional Support Unit. 22. An evacuee indicates that he has friends with whom he could stay, who live in the next town. He just needs a “tank
of gas” to get there. What would you do? – Refer to Referrals Unit Supervisor for approval. – If the Referrals Unit Supervisor approves gas, ensure that a maximum amount is indicated
on the Referral form. 23. It is 0230 hours (2:30am) and you are sending evacuees to a hotel for the night. In fact, you have been told you may provide lodging for them for 72 hours.
How will you indicate this on the Referral form? – Seek advice from the Referrals Unit Supervisor on how to complete the Referral form if uncertain. For example, how do you ensure that
evacuees receive three night’s stay at the hotel not four? – Coming in at 0230, even though a short night, constitutes one night’s stay. 24. You have completed the ESS File and Referral
forms for a family. What copies go where? What about the ESS Rates Sheet? – ESS File: ● The yellow copy is given to the evacuee to keep. ● The white and pink copies stay attached to
the card copy, which is then sent to the Documentation Unit for further processing. – Referral form: ● The white and yellow copies are given to the evacuee with instructions to keep
the yellow copy and give the white copy to the respective supplier. ● The pink and green copies are filed in the ESS File, which is then sent to the Documentation Unit for further processing.
– ESS Rates sheet: ● Attach current Rates Sheet to Referral form (white & yellow copies only) before giving to the evacuee.
PAGE 94 REGISTRATION & REFERRALS Module 5 25. You have been working four hours continuously. You are beginning to feel tired but no one has suggested you take a break. What would you
do? – Notify your supervisor that you would like a break.
PAGE 95 REGISTRATION & REFERRALS Module 5 Notes
PAGE 96 REGISTRATION & REFERRALS Module 5 Notes