Daily Shelter Report                                                                                       
  
Date     Inciden t/ DR #    Shelter Name/County  
SHELTER INFORMATION
  
Shelter Address:  

Shelter Phone Number (s) :
SHELTERING STAFF
POSITION NAME PHONE
 Shelter Manager
 Day Shift Supervisor
 2nd Shift Supervisor
 Night Shift Supervisor
Total Number of Sheltering Workers 
 Day Shift   2nd Shift   Night Shift  
OTHER FUNCTIONS OR ACTIVITIES STAFF
# Disaster Health Services   # Casework and Recover Planning  
# Disaster Mental Health   # Feeding  
# Disaster Spiritual Care   Other    #  
SHELTER POPULATION
Age Groups (years) 0-3 4-7 8-12 13-18 19-65 65 +
Nighttime Population Submitted Last Night
Daytime Population Today
Total NEW Shelter Dormitory Registrations Since Last Night:  
OPERATIONAL REPORTING
 Breakfast  Lunch   Dinner  Snacks/Drinks  Cots   Blankets  Comfort Kits  Clean-up Kits  Other Bulk Items   Signage
Kits		 {var Op1} {var Op2}
# Used Today
# Available  Tomorrow
# Needed Tomorrow
NOTES
{var Notes}
Preparer Name:    Preparer Signature:       Ver 13.2
    DCS JT RES Daily Shelter Report V.1.0 2016.07.18