EXERCISE REPORT DGM-15
1. Subgrantee:
2. Point of Contact
Name:
Date(s) and Time of Event
Begin: Date:
Title :
Time:
Phone Number:
End: Date:
Time:
3. Grant Program
4. Type of Event
Citizen Corps (CCP)
Urban Area Security Initiative (UASI)
Metro Medical Response (MMRS)
State Homeland Security (SHSP)
Other
Actual
Seminar/Workshop
Tabletop Exercise
Drill
Functional /Command Post
Full-Scale Exercise
5. Mission Focus of
Exercise
Prevention
Protection
Response
Recovery
Mitigation
6. Hazard: (Mark appropriate blocks.)
Natural
Avalanche
Earthquake
Flood
Landslide
Subsidence
Tsunami
Hurricane
Wildfire
Winter Storm
Erosion
Other
Technological
Dam Failure
Hazardous Material-Fixed Facility
Hazardous Material-Transportation
Power Failure
Radiological-Fixed Facility
Radiological-Transportation
Structural Fires
Transportation Accident
( Air, Rail, Highway, Water)
Airport
Other
Homeland Security
Hostage
Chemical
Civil Disorder
Cyber
Biological
Radiological
Nuclear
Explosive
Other
7. Number of Participants (Enter number of participants in Jurisdiction boxes and Discipline lines.)
Federal
#
State
Discipline
Communications
Military Support
Fire
Law Enforcement
Search and Rescue
Public Information
Local
#
Discipline
EMS
Public Works
Elected Officials
Appointed Officials
Utilities
Health and Medical
Human Services
Subgrantee Official Signature and Title
Military
#
Discipline
Emergency Planning
Finance
Private Industry
Radiological
Volunteer Agencies
Other
Date
January 2013
1
EXERCISE REPORT DGM-15
Event Results
S = Satisfactory
NI = Needs Improvement
NT = Not Tested
Target Capabilities Tested
(FFY 2008 through FFY 2011)
Complete Page 2 for exercises funded with
FFY 2008 through FFY 2011 grants
S
NI
Point Value
Comments
S=4
NI = 2
NT = 0
NT
Common Capabilities
Planning
Interoperable Communications
Citizen Preparedness and Participation
Risk Analysis
Prevent Mission
Information Gathering & Threat Recognition
Intel/Information Sharing and Dissemination
Intelligence Analysis and Production
Law Enforcement Investigation and Operations
CBRNE Detection
Protect Mission
Critical Infrastructure Protection
Food and Agriculture Safety and Defense
Epidemiological Surveillance & Investigation
Public Health Laboratory Testing
Response Mission
On-site Incident Management
Emergency Operations Center Management
Critical Resource Logistics and Distribution
Volunteer Management and Donation
Worker Health and Safety
Public Safety and Security Response
Animal Health Emergency Support
Environmental Health and Vector Control
Explosive Device Response Operations
Firefighting Operations/Support
WMD/Hazardous Materials Response and
Decontamination
Citizen Protection: Evacuation and/or
In-Place Protection
Isolation and Quarantine
Search and Rescue
Emergency Public Information & Warning
Triage and Pre-hospital Treatment
Medical Surge
Medical Supplies Management & Distribution
Mass Prophylaxis
Mass Care (Sheltering, Feeding, and Related Services)
Fatality Management
Recover Mission
Structural Damage Assessment & Mitigation
Restoration of Lifelines
Economic and Community Recovery
General Comments:
January 2013
2
EXERCISE REPORT DGM-15
Core Capabilities Tested
(FFY 2012)
Complete this page for exercises funded with
FFY 2012 grants
Common Capabilities
Planning
Public Information and Warning
Operational Coordination
Event Results
S = Satisfactory
NI = Needs Improvement
NT = Not Tested
S
NI
Point Value
S=4
NI = 2
NT = 0
Comments
NT
Prevention
Forensics and Attribution
Intelligence and Information Sharing
Interdiction and Disruption
Screening, Search, and Detection
Protection
Access Control and Identity Verification
Cybersecurity
Intelligence and Information Sharing
Interdiction and Disruption
Physical Protective Measures
Risk Management for Protection Programs/Activities
Screening, Search, and Detection
Supply Chain Integrity and Security
Response
Critical Transportation
Environmental Response/Health and Safety
Fatality Management Services
Infrastructure Systems
Mass Care Services
Mass Search and Rescue Operations
On-Scene Security and Protection
Operational Communications
Public and Private Services and Resources
Public Health and Medical Services
Situational Assessment
Recovery
Economic Recovery
Health and Social Services
Housing
Infrastructure Systems
Natural and Cultural Resources
Mitigation
Community Resilience
Long-term Vulnerability Reduction
Risk and Disaster Resilience Assessment
Threats and Hazard Identification
General Comments:
January 2013
3