Hawaii Hurricane Daily Shelter Report                                                                                         
  
Date      Shelter Name/County  
SHELTERING STAFF
POSITION NAME PHONE
 Shelter Manager
Total Number of Sheltering Workers  
OTHER FUNCTIONS OR ACTIVITIES STAFF
# Disaster Health Services   # Disaster Mental Health  
SHELTER POPULATION
Age Groups (years) 0-3 4-7 8-12 13-18 19-65 65 +
  12 Midnight Count (no later than 11:00 pm)
  12 Noon Count (no later than 11:00 am)
OPERATIONAL REPORTING

  Cots

  Blankets

  Comfort Kits

  Health Supplies

  Signage Kits

  # Needed ASAP
NOTES
Any Services Needed?   Security, Health Dept, Janitorial, Pet Shelter Staff, Nurse, Mental Health, Food, etc.
{var Notes}
Preparer Name:     Preparer Signature:

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    HH Daily Shelter Report [ver 1.2 2021.4.27]