Hazard and Vulnerability Analysis

INSTRUCTIONS:

Evaluate potential for event and response among the following categories using
the hazard specific scale.

Issues to consider for probability include, but are not limited to:
1 Known risk
2 Historical data
3 Manufacturer/vendor statistics
Issues to consider for response include, but are not limited to:
1 Time to marshal an on-scene response
2 Scope of response capability
3 Historical evaluation of response success
Issues to consider for human impact include, but are not limited to:
1 Potential for staff death or injury
2 Potential for patient death or injury
Issues to consider for property impact include, but are not limited to:
1 Cost to replace
2 Cost to set up temporary replacement
3 Cost to repair
Issues to consider for business impact include, but are not limited to:
1 Business interruption
2 Employees unable to report to work
3 Customers unable to reach facility
4 Company in violation of contractual agreements
5 Imposition of fines and penalties or legal costs
6 Interruption of critical supplies
7 Interruption of product distribution
Issues to consider for preparedness include, but are not limited to:
1 Status of current plans
2 Training status
3 Insurance
4 Availability of back-up systems
5 Community resources
Issues to consider for internal resources include, but are not limited to:
1 Types of supplies on hand
2 Volume of supplies on hand
3 Staff availability
4 Coordination with MOB's

Issues to consider for external resources include, but are not limited to:
1 Types of agreements with community agencies
2 Coordination with local and state agencies
3 Coordination with proximal health care facilities
4 Coordination with treatment specific facilities

Complete all worksheets including Natural, Technological, Human and Hazmat. The summary
section will automatically provide your specific and overall relative threat.

631562851.xlsx
 HAZARD AND VULNERABILITY ASSESSMENT TOOL
NATURALLY OCCURRING EVENTS

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABIL DAMPAK RISK
ITY DAMPAK DAMPAK RESPON
PD PREPARE RESPON
PD PADA EKSTERN
BANGUNA D-NESS INTERNAL
MANUSIA BISNIS AL
KEJADIAN N

Community/
Likelihood Possibility of Physical Time,
Interuption Mutual Aid Relative
this will death or losses and Preplanning effectivness,
of services staff and threat*
occur injury damages resouces
supplies

0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A

0 = N/A
1= 1= 1= 1= 1= 1=
1 = High
Low Low Low Low High High
2
SCORE 2= 2= 2= 2= 2=
= Moderate
2= 0 - 100%
Moderate Moderate Moderate Moderate Moderate Moderate
3 = Low
3= 3= 3= 3= 3 = Low or 3 = Low or
or none
High High High High none none
Angin puting beliung 1 2 3 1 3 3 3 28%
Halilintar 1 3 1 3 3 3 3 30%
Gempa Bumi 2 3 3 3 3 2 3 63%
Abu letusan gunung 1 3 1 1 1 1 1 15%
Suhu Ektrim 0 1 0 1 1 1 3 0%
Banjir 3 3 3 3 3 1 1 78%
Longsor 0 2 2 3 2 1 3 0%
Ranting pohon jatuh 1 2 2 2 2 2 3 24%
Hujan angin 2 2 2 1 3 1 3 44%
AVERAGE SCORE 0.69 1.31 1.06 1.13 1.31 0.94 1.44 29%
*Threat increases with percentage.
11 RISK = PROBABILITY * SEVERITY
115 0.29 0.41 0.71
 HAZARD AND VULNERABILITY ASSESSMENT TOOL
TECHNOLOGIC EVENTS

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY RISK
DAMPAK PD DAMPAK PD DAMPAK PREPARED- RESPON RESPON
MANUSIA BANGUNAN PADA BISNIS NESS INTERNAL EKSTERNAL
KEJADIAN
Time, Community/
Likelihood this will Possibility of Physical losses Interuption of
Preplanning effectivness, Mutual Aid staff and Relative threat*
occur death or injury and damages services
resouces supplies
0 = N/A
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Low
1 = Low 1 = Low 1 = Low 1 = High 1 = High 1 = High 2
SCORE 2 = Moderate
2=
2 = Moderate 2 = Moderate 2 = Moderate 3 2 = Moderate = Moderate 3 0 - 100%
Moderate
3 = High 3 = High 3 = High = Low or none 3 = Low or none = Low or none
3 = High
Kegagalan listrik 2 3 2 3 1 1 2 44%
Kegagalan Genset 2 2 2 3 1 2 2 44%
Kegagalan transportasi 1 1 1 3 2 2 2 20%
Bahan bakar 2 1 1 3 2 2 2 41%
Kebocoran radiasi 0 0 0 0 0 0 0 0%
Kegagalan penyediaan
2 3 2 3 2 2 2 52%
air

Kerusakan saluran
2 2 3 3 2 2 1 48%
pembuangan limbah

Kerusakan boiler 0 0 0 0 0 0 0 0%
Fire Alarm belum
2 2 3 2 2 2 3 52%
berfungsi

Kegagalan komunikasi 1 1 1 3 2 2 1 19%

Kegagalan fungsi gas

2 3 1 3 2 2 2 48%
medis
Kegagalan vakum
2 3 1 3 2 1 1 41%
medis
Kegagalan fungsi
3 2 1 2 2 1 3 61%
SIMRS
kegagalan telpon 2 1 1 3 2 2 0 33%

Kebakaran internal 2 3 3 3 3 2 3 63%

Banjir internal 1 3 3 3 2 2 3 30%

Terpapar Bahan B3 2 2 2 2 2 2 2 44%

RSE HVA TECHNOLOGI : 631562851.xlsx

 Kerusakan struktur
3 2 2 2 2 2 2 67%
bangunan

AVERAGE SCORE 1.63 1.79 1.53 2.32 1.63 1.53 1.63 35%

AVERAGE SCORE
31 RISK = PROBABILITY * SEVERITY
198 0.35 0.57 0.61

RSE HVA TECHNOLOGI : 631562851.xlsx

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
HUMAN RELATED EVENTS

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY RISK
DAMPAK PD DAMPAK PD DAMPAK PREPARED- RESPON RESPON
MANUSIA BANGUNAN PADA BISNIS NESS INTERNAL EKSTERNAL
KEJADIAN
Time, Community/
Likelihood this will Possibility of Physical losses Interuption of
Preplanning effectivness, Mutual Aid staff and Relative threat*
occur death or injury and damages services
resouces supplies
0 = N/A 0 = N/A
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Low 1 = Low
1 = Low 1 = Low 1 = High 1 = High 1 = High 2
SCORE 2 = Moderate
2= 2=
2 = Moderate 2 = Moderate 3 2 = Moderate = Moderate 3 0 - 100%
Moderate Moderate
3 = High 3 = High = Low or none 3 = Low or none = Low or none
3 = High 3 = High
Insiden massal
2 2 2 2 2 2 2 44%
(trauma)

Insiden Massal
3 3 1 3 3 1 3 78%
(medical/infectious)

Teroris 1 2 2 2 3 3 2 26%

Penculikan bayi 2 3 0 2 2 2 2 41%

Huru Hara 1 2 2 3 3 2 2 26%

Unjuk Rasa 1 2 2 3 2 2 2 24%

Pencurian harta benda 2 3 0 2 2 2 2 41%

Perkelahian 1 2 2 2 2 2 2 22%

Ancaman bom 1 2 2 2 2 2 2 22%

AVERAGE 1.40 2.10 1.30 2.10 2.10 1.80 1.90 33%

*Threat increases with percentage.

14 RISK = PROBABILITY * SEVERITY
113 0.33 0.47 0.70

RSE HVA HUMAN HAZARD : 631562851.xlsx

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
EVENTS INVOLVING HAZARDOUS MATERIALS

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY RISK
DAMPAK PD DAMPAK PD DAMPAK PADA PREPARED- RESPON RESPON
MANUSIA BANGUNAN BISNIS NESS INTERNAL EKSTERNAL
KEJADIAN
Time,
Likelihood this will Possibility of Physical losses Interuption of Community/ Mutual
Preplanning effectivness, Relative threat*
occur death or injury and damages services Aid staff and supplies
resouces
0 = N/A
0 = N/A 0 = N/A 0 = N/A 1 0 = N/A 0 = N/A 0 = N/A
1 = Low
1 = Low 1 = Low = Low 2 = 1 = High 1 = High 1 = High
SCORE 2 = Moderate
2=
2 = Moderate Moderate 3 = 2 = Moderate 3 2 = Moderate 2 = Moderate 0 - 100%
Moderate
3 = High 3 = High High = Low or none 3 = Low or none 3 = Low or none
3 = High
Insiden besar yang
menyangkut Hazmat
2 2 2 2 2 2 2 44%

Insiden kecil yang 2 2 2 2 2 2 2 44%

menyangkut Hazmat
Terpapar bahan kimia, 2 1 2 2 1 1 2 33%
External
Tumpahan Skala Kecil- 2 3 2 3 3 1 2 52%
Sedang

1 1 1 1 2 2 2 17%
Tumpahan Skala besar
Teror yang terkait 1 2 1 2 2 2 2 20%
bahan kimia
Paparan Radiologi, 3 3 2 3 3 1 1 72%
Internal
Paparan Radiologi, 1 1 1 1 1 1 1 11%
External
Teror terkait dng 1 2 2 1 1 1 1 15%
Radiologi
AVERAGE 1.67 1.89 1.67 1.89 1.89 1.44 1.67 32%

*Threat increases with percentage.

RISK = PROBABILITY * SEVERITY
15
94 0.32 0.56 0.58

RSE HVA MATERIAL : 631562851.xlsx

 SUMMARY OF HAZARDS ANALYSIS

Total for Facility

Technological

Hazmat
Natural

Human
Probability 0.52 0.57 0.47 0.56 0.53

Severity 0.74 0.61 0.70 0.58 0.65

Hazard Specific Relative Risk:
0.38 0.35 0.33 0.32 0.34

Hazard Specific Relative Risk

1.00
Relative Threat to Facility

0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Natural Technological Human Hazmat

Probability and Severity of Hazards

1.00
0.90
Relative Impact on Facility

0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Probability Severity

631562851.xlsx Summary