Natural disasters, severe weather events, pandemics, power outages, and other emergencies can strike without warning, and Adult Family Home (AFH) providers bear a unique responsibility to protect some of the most vulnerable members of their communities during these events. Your residents — many of whom have limited mobility, cognitive impairment, complex medical needs, or depend on electrically powered medical equipment — cannot protect themselves during an emergency. Your preparedness, planning, and ability to execute under pressure are literally matters of life and death.
Every state requires AFH providers to maintain an emergency preparedness plan, and regulatory agencies evaluate these plans during licensing inspections. But compliance with minimum requirements is not enough. A truly effective emergency preparedness program goes beyond checking regulatory boxes — it ensures that when disaster strikes, you can protect every resident, maintain essential care operations, communicate with families and authorities, and recover as quickly as possible.
Developing Your Emergency Preparedness Plan
Hazard Assessment
The foundation of emergency preparedness is understanding the specific hazards your AFH faces based on its geographic location, physical characteristics, and resident population. Conduct a thorough hazard assessment that considers natural disasters common to your region including earthquakes, hurricanes, tornadoes, floods, wildfires, severe winter storms, and extreme heat. Also evaluate technological hazards such as power outages, gas leaks, water contamination, and hazardous material spills. Consider human-caused events including fires, active threats, and civil disturbances. Finally, assess public health emergencies such as pandemics, disease outbreaks, and contamination events.
The Federal Emergency Management Agency (FEMA) provides hazard maps and risk assessment tools that can help you identify the specific threats in your area. Your local emergency management office can provide additional guidance on regional hazards and community preparedness resources.
Plan Components
Your emergency preparedness plan should be a comprehensive written document that addresses every aspect of emergency response. Essential components include an emergency contact list with current phone numbers for all residents' families and emergency contacts, physicians, pharmacies, utility companies, local emergency services, your state licensing agency, and your insurance company. Include evacuation procedures with detailed step-by-step instructions for evacuating your home, including primary and secondary evacuation routes, designated meeting points, transportation arrangements, and procedures for residents with limited mobility. Add shelter-in-place procedures for situations where evacuation is not possible or advisable. Include communication protocols specifying how you will communicate with staff, families, emergency services, and your state agency during an emergency. Detail medication and medical equipment plans for ensuring residents have access to essential medications and medical equipment during an emergency. Address food and water provisions for maintaining adequate supplies during disruptions. Cover utility failure procedures for responding to loss of electricity, gas, water, or telecommunications. Include financial preparedness with access to emergency funds and important business documents. Finally, establish recovery procedures for returning to normal operations after an emergency.
Plan Accessibility and Distribution
Your emergency plan is useless if no one can find it during a crisis. Maintain copies of your plan in multiple accessible locations — a binder at the main caregiver station, a copy in the administrator's office, and a portable copy in your emergency supply kit. Ensure all staff know where to find the plan and are familiar with its contents. Provide abbreviated quick-reference cards that summarize the most critical steps for immediate response.
Store digital copies of your plan and important documents in a cloud-based system or on a USB drive in your emergency kit so you can access them even if your physical copies are destroyed. AFH Manager and similar platforms can help you maintain accessible digital records that can be retrieved from any location.
Evacuation Planning
When to Evacuate
The decision to evacuate is one of the most consequential decisions an AFH provider will make. Evacuate when there is a fire in or immediately threatening your home, when authorities issue a mandatory evacuation order for your area, when structural damage makes the building unsafe for occupancy, when hazardous materials release poses an inhalation or contamination risk, and when flooding threatens to make roads impassable if you delay.
Evacuation Procedures
Develop detailed evacuation procedures that account for every resident's specific needs. Assign specific staff responsibilities — who assists which residents, who grabs the emergency supply kit, who calls 911, who ensures all rooms are checked. Account for residents who use wheelchairs, walkers, or other mobility aids and plan how they will be moved safely and quickly. Practice evacuating at different times of day, including during nighttime hours when residents may be sleeping and fewer staff may be present.
Transportation Planning
Pre-arrange transportation for evacuation. If your AFH has a vehicle, ensure it is regularly maintained and has adequate fuel. Identify backup transportation options such as staff personal vehicles, arrangements with local transportation companies, or agreements with other AFH providers for mutual aid. Ensure you have enough vehicle capacity to transport all residents simultaneously, including space for wheelchairs and medical equipment.
Evacuation Destinations
Identify at least two evacuation destinations — a primary and a backup — where you can temporarily relocate your residents. Options include other AFH or care facilities that have agreed to accept your residents during an emergency, hotels or motels that can accommodate your residents' needs, community shelters designated for individuals with special needs, and family members' homes if residents' families are willing and able to provide temporary care.
Contact your evacuation destinations in advance to confirm their willingness to accept your residents and discuss logistical arrangements. Share information about your residents' care needs so the receiving location can prepare appropriately.
Resident Emergency Information
Prepare a portable emergency file for each resident that contains their current photograph and physical description, emergency contact information, current medication list with dosing instructions, medical conditions and allergies, advance directives and code status, insurance information, and any special care needs or behavioral considerations. Keep these files in a single portable container — a waterproof bag or a dedicated section of your emergency kit — that can be grabbed quickly during an evacuation.
Shelter-in-Place Protocols
When to Shelter in Place
Shelter-in-place is appropriate when hazardous materials are released outside your home, during severe weather events like tornadoes when going outside is more dangerous than staying inside, during active threat situations in your area, and when roads are impassable or conditions make evacuation more dangerous than remaining.
Shelter-in-Place Procedures
Move all residents to the safest location within your home. For severe weather, this is typically an interior room on the lowest floor, away from windows. For hazardous materials, close all windows and doors, turn off HVAC systems, and seal gaps around doors and windows with wet towels or plastic sheeting. Ensure all residents are accounted for and are as comfortable as possible. Monitor news and emergency alerts for updates on when it is safe to resume normal activities.
Emergency Supply Stockpile
Essential Supplies
Maintain an emergency supply stockpile sufficient to sustain your household — residents and staff — for a minimum of 72 hours, though seven days is recommended. Essential supplies include water stored at one gallon per person per day for drinking and basic hygiene, non-perishable food that requires minimal preparation and accommodates residents' dietary needs, a manual can opener and basic food preparation supplies, medications with at least a seven-day backup supply of all essential medications for each resident, a first aid kit with supplies appropriate for your resident population, flashlights and batteries with one flashlight per resident and staff member, a battery-powered or hand-crank radio for receiving emergency information, extra blankets and warm clothing, personal hygiene supplies including toilet paper, hand sanitizer, soap, and disposable gloves, garbage bags and ties, and a basic tool kit.
Medical and Care Supplies
In addition to general supplies, stockpile care-specific supplies including incontinence supplies with a seven-day backup, wound care supplies, oxygen tanks if any residents require supplemental oxygen, battery backup or manual alternatives for electrically powered medical equipment, extra eyeglasses and hearing aid batteries, and any resident-specific medical supplies such as diabetic testing supplies or catheter supplies.
Supply Management
Rotate your emergency supplies regularly to prevent expiration. Check food and water every six months. Verify medication backup supplies quarterly and replace as they approach expiration. Test flashlights and replace batteries at least annually. Conduct a complete inventory of your emergency supplies at least twice per year and after any emergency where supplies were used.
Power Outage Preparedness
Impact of Power Loss on AFH Operations
Power outages pose particular risks for AFH providers because many residents depend on electrical equipment for their health and safety. A power outage affects lighting and safety systems, heating and cooling, refrigeration of food and medications, medical equipment including oxygen concentrators, CPAP machines, and electric beds, communication systems, water supply if you use a well pump, and security systems and door alarms.
Backup Power Options
Evaluate backup power options for your AFH. A portable generator can power essential systems during an outage, but it must be used safely — never operate a generator indoors or in an enclosed space due to carbon monoxide risk. Battery backup systems, also called uninterruptible power supplies, can maintain critical medical equipment during brief outages. Solar-powered chargers can keep phones and small devices functional. Manual alternatives should be available for equipment that normally runs on electricity, such as manual blood pressure cuffs and manual suction devices.
If any resident depends on electrically powered life-sustaining equipment, contact your utility company to register your AFH as a medical priority facility. Many utilities offer priority restoration service for facilities serving medically fragile individuals. The Department of Energy provides resources on emergency power planning for facilities serving vulnerable populations.
Communication During Emergencies
Communication Plan
Develop a communication plan that specifies how you will reach key contacts during different types of emergencies. Maintain updated contact lists for all resident family members and emergency contacts, your staff, physicians and pharmacies, local emergency services, your state licensing agency, utility companies, and your insurance company.
Identify primary and backup communication methods. Cell phones may not work during widespread emergencies due to network congestion. Consider alternatives such as landline phones that do not require electricity, two-way radios for local communication, text messages which often go through when voice calls cannot, social media or email for non-urgent updates to families, and a designated family communication point person who can relay information to other family members.
Family Communication
Families need timely, accurate information about their loved one's safety during an emergency. Establish a protocol for notifying families as quickly as possible when an emergency affects your AFH. Provide regular updates as the situation evolves. Designate a single point of contact for family inquiries so that information is consistent and caregivers can focus on resident care. Consider establishing a phone tree or group text system for efficient mass communication.
Reporting to Regulatory Agencies
Know your state's requirements for reporting emergencies to your licensing agency. Most states require notification within a specified timeframe — often 24 hours — for events that significantly disrupt operations, require evacuation, or result in injury to residents. Report promptly and provide updates as the situation develops.
Training and Drills
Staff Training
All staff should receive emergency preparedness training at orientation and at least annually thereafter. Training should cover the location and contents of the emergency plan, specific responsibilities during different emergency scenarios, evacuation procedures including assisting residents with mobility limitations, use of fire extinguishers and emergency equipment, basic first aid and CPR, communication procedures during emergencies, and use of the emergency supply stockpile.
Emergency Drills
Conduct regular emergency drills to test your plan and identify weaknesses. State regulations typically require a minimum number of fire drills per year, often monthly. Beyond fire drills, practice other emergency scenarios including evacuation drills at different times including nighttime, shelter-in-place drills, communication drills testing your ability to reach all contacts, power outage simulations, and tabletop exercises discussing response to specific disaster scenarios.
After each drill, conduct a debriefing to identify what went well, what needs improvement, and what changes should be made to your plan. Document all drills including the date, time, scenario, participants, observations, and any plan modifications resulting from the drill.
Pandemic Preparedness
Lessons from Recent Experience
The COVID-19 pandemic demonstrated the devastating impact infectious disease outbreaks can have on residential care settings and the critical importance of pandemic preparedness. AFH providers should maintain specific pandemic preparedness measures including a stockpile of personal protective equipment such as masks, gloves, gowns, and face shields, infection control protocols that can be rapidly escalated, isolation procedures for residents with suspected infectious illness, communication plans for families when visitation must be restricted, staffing contingency plans for situations where multiple staff members are ill simultaneously, telehealth capabilities for physician consultations without in-person visits, and mental health support for residents isolated from family and social activities.
The Centers for Disease Control and Prevention (CDC) provides pandemic preparedness guidance specifically for residential care settings that should inform your planning.
Recovery and Continuity
Post-Emergency Recovery
After an emergency, your focus shifts to recovery — restoring normal operations as quickly and safely as possible. Assess your facility for damage or hazards before allowing residents to return or resume normal activities. Document all damage with photographs for insurance claims. Contact your insurance company promptly to initiate the claims process. Communicate with families about the timeline for return to normal operations. Debrief with your staff about the emergency response and identify improvements for the future. Replenish emergency supplies that were used during the event. Update your emergency plan based on lessons learned.
Business Continuity Planning
Plan for the financial impact of emergencies by maintaining adequate insurance coverage for property damage and business interruption, keeping emergency funds available for immediate expenses, protecting important business documents through digital backup, and understanding your insurance policy's requirements for filing claims and documenting losses.
Conclusion
Emergency preparedness is not a one-time planning exercise — it is an ongoing commitment to protecting the people who depend on you for their safety and well-being. By conducting thorough hazard assessments, developing comprehensive plans, stockpiling essential supplies, training your staff, practicing through regular drills, and learning from every emergency experience, you build the resilience your Adult Family Home needs to weather any crisis. Your residents trust you with their lives every day, and that trust extends to the extraordinary moments when disaster strikes. The preparation you do today determines whether you can fulfill that trust when it matters most.
Build the plan from local hazards and resident dependencies
Identify credible hazards, warnings, decision authority, staff roles, resident mobility and communication, medications, oxygen and powered equipment, food and water, building systems, shelter, evacuation, transportation, destinations, records, contacts, reunification, vendors, and recovery. The AFH business-continuity guide provides the companion operating and recovery analysis for extended outages.
Frequently asked questions
Can an AFH use a generic county emergency template unchanged?
A template can organize work, but the home must adapt it to current local hazards, building, residents, staff, services, contacts, equipment, transportation, and applicable requirements, then test it.
Should emergency supplies use one fixed quantity forever?
Set quantities from resident and staff needs, duration assumptions, storage, expiration, climate, equipment, medication and vendor continuity, then inspect and rotate supplies on schedule.
What should a drill correction include?
Identify the observed gap, immediate control, owner, due date, resources, affected residents or systems, completion evidence, approver, and retest rather than simply marking the drill complete.
Turn the written plan into tested resident protection
Explore AFH Manager with synthetic emergency drills to evaluate resident profiles, staff roles, supply tasks, protected documents, notifications, corrections, and review dates.