You will be logged out in
due to inactivity
Assessing Healthcare Facility Preparedness for COVID-19
Questions are answered “yes/no”
This tool can be completed in 2-3 minutes
This tool is based on CDC’s Checklist for Healthcare Preparedness (
This tool will enable organizations to rapidly assess their preparedness and identify areas of weakness
If you have any questions or comments, please contact:
SreyRam Kuy, MD, MHS, FACS
Baylor College of Medicine
1. How would you best describe your organization?
2. How many employees are in your organization?
3. What is the primary 5-digit zip code of your organization (e.g. 77054)
4. What is your role in your organization?
5. What is your hospital's teaching status?
6. What is your hospital's location?
7. How many beds does your facility have?
8. Does your healthcare system have availability to digital care management tools to promote patient-self management.
9. Is your facility staying up to date on the latest information about signs and symptoms, diagnostic testing, and case definitions for COVID-19?
10. Have you reviewed your facility’s infection prevention and control policies and CDC infection control recommendations for COVID-19 for (check all that apply):
11. Is your facility on high alert for patients with clinical features consistent with potentially having COVID-19, as defined by the CDC?
12. Has your facility educated its staff on who, when, and how to seek and report a potential COVID-19 case or exposure to facility infection control leads and public health officials?
13. Have you educated your staff on who, when, and how to seek evaluation by occupational health following an unprotected exposure (i.e., not wearing recommended PPE) to a suspected or confirmed COVID-19 patient?
14. Do your staff know to remain at home, and notify occupational health services, if they are ill?
15. Does your facility know how to contact and receive information from your state or local public health agency about COVID-19?
16. If you would like to be contacted and provided an analysis of the results and/or help with a strategic preparedness plan, please add your email here.
Customer Support Request
Please do NOT submit any PHI or identifying patient information through this form. If support requires this information to solve this issue we will reach out with a HIPAA secured channel to do so.