Emergency Plan San Ramon Raptor Lacrosse Club Emergency Procedures

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					                                   Emergency Plan
                      San Ramon Raptor Lacrosse Club

                                Emergency Procedures:
                      Medical Emergency & Facility Evacuation

   - A copy of the Emergency Plan will be given to all coaches/parents and it will be reviewed
   during team meetings to make sure each person understands their role.
   - A copy of the Emergency Plan will be kept in a binder, along with copies of each
   participant’s Emergency Medical Card, the Emergency Plan Checklist and the Incident Report
   forms. This binder will be kept on hand at every practice, game and sponsored activity for
   quick access to this important information.

The Emergency Response Team

COACH: Boys U-13
NAME: Frank Abajian                            Cell PHONE: (925) 984-7935
ADDRESS: 7447 Hillsboro Avenue, San Ramon, CA 94583

COACH: Girls U-13
Name: Jeff Theibold                            Cell PHONE: 925-324-3128
ADDRESS: 545 Old Farm Ct, Danville, CA 94526

COACH: Girls U-13
Name: Razan Rasheed                            Cell PHONE: 510-331-7570
ADDRESS: 308 Pyral Court, San Ramon, CA 94582

COACH: Boys U-15
Name   Jared Gagnon                            Cell PHONE:

COACH: Boys U-15
Name: John Britton                             Cell PHONE:

Assistant COACH: Girls U-13
Name: James Abajian                   Cell PHONE: 925-997-3183
ADDRESS: 7447 Hillsboro Avenue, San Ramon, CA 94583

Assistant COACH: Boys U-15
Name: Spencer Giansante                        Cell PHONE:
Assistant COACH: Girls U-13 Team Theibold
Name: Ken Bach                                  Cell PHONE: 415 948 6394
ADDRESS: 26 Inverness Court, San Ramon, CA 94583

Assistant COACH: Boys U-13 Team Abajian
Name: Joseph Abajian                    Cell PHONE: 925-
ADDRESS: 7447 Hillsboro Avenue, San Ramon, CA 94583

Assistant COACH: Boys U-15
Name: Steve Kravariotis                 Cell PHONE: 415 948 6394
ADDRESS: 22 Playa Court, San Ramon, CA 94583

Assistant COACH: Boys U-15
Name: John Bevilacqua                   Cell PHONE: 925-451-5518
ADDRESS: 3267 Glencoe Circle, San Ramon, CA 94582

San Ramon Raptor Lacrosse Club OFFICER
NAME: Karla Wong                                Home PHONE: 925-551-8205
ADDRESS: 44 Apache Court, San Ramon, CA 94583

NAME: San Ramon Police Department               PHONE: 925-973-2779
ADDRESS: 2220 Camino Ramon, San Ramon, CA 94583

Emergency Communication
In addition to coaches’ and managers’ cell phones, list the nearest landline phone number at
the facility and indicate its location below:

ON-SITE PHONE # (LAND LINE): None accessible

Emergency Training
These members of your team/league have training or certification in the following procedures:

Procedure                 Certified Person’s Name             Position            Cell Phone #
General First Aid

CPR                       Frank Abajian                       Coach              925-984-
CPR                       Steve Kravariotis                   Assist. Coach      415-948-

Emergency Equipment
SRRLC coaches are equipped with a First Aid kit, which will be located at the scorekeeper’s table
during games.

Equipment Type                  Yes/No                  Person Responsible             Location

First Aid/Trauma Kit            Yes                     Coaches                Scorekeeper Table
Splint Kit                      No
Spine Board                     No
AED (Defibrillator)             No
EPI-Pen (Epinephrine)           No

Facility/Venue Directions
Directions to read to EMS operator or police when calling for emergency assistance:

FIELD                                           LOCATION
1. Gale Ranch Middle School                6400 Main Branch Road, San Ramon - (925) 479-1500

2. Windermere Ranch Middle School          11611 East Branch Pkwy, San Ramon, CA 94582

3. Tiffany Roberts Sports Field            5261 Sherwood Way, San Ramon, CA 94582

Participant Medical Emergency Treament info
Each player has a Medical Release Form that contains relevant info about the patient’s health
and treatment authorization from the parents. Please refer to this info in the team Medical
Emergency Plan Binder.

                                  Emergency Medical Procedures

    1. The most qualified individual(s) at the field, coaches and spectators, should provide
    immediate care for an injured or ill participant or spectator, if medical personnel are not
    2. The First Aid Kits will be with each coach during practice and at the score table during
    3. Calling for HELP:
            Call 911- The coach shall call 911 and provide the name, address, telephone
             number; information on the emergency -- number of individuals injured/ill,
             condition of individuals, first aid treatment; give specific directions to location; and
             stay on the line until EMS operator says to hang up.

    4. Providing EMS with complete directions to the scene of the emergency:
            The coach shall designate a person to flag down EMS and direct them to the scene.

   5. Crowd Management:
          The coaching staff or responsible parents shall get other participants and spectators
           to safety, if additional threat is present.
          The coaching staff shall limit the scene of emergency treatment to first aid providers

Emergency Facility Evacuation
In the event of an emergency, evacuating the premises may be necessary. Emergencies may
include, but not be limited to, fire, bomb/terrorist threat, weather emergency or person with a

1. Facility Evacuation: Pre-Emergency Planning
   A. Evacuation Alarm – A repeating, steady, rhythmic blowing of a horn shall be a signal for
   emergency evacuation
   B. Meeting Area – The parking lot at each field shall be designated as a meeting place away
   from the field where all participants will meet upon leaving.
   C. Coaches and Parents duties :
          Notify teams/attendees of evacuation procedures, in advance
          Assist in clearing facility during emergency
          Direct people to designated meeting area(s)
          Assist those with special needs
          Account for all participants at meeting area(s)
          Each member has a copy of Emergency Plan, including:
               o   maps of exit routes
               o   location of meeting areas
               o   phone numbers for Police, Fire and Hospital are provided in the emergency

2. During an Emergency: General Evacuation Procedures
       A. Do not panic
       B. All required to evacuate when alarm sounds
       C. Call for HELP (911: Fire, Police, EMS)
       D. Coaches and parents, manage the evacuation process
       F. Leave through nearest unblocked exit (check maps, if possible)
       J. Report to meeting area(s)
       K. Account for all participants and attendees

3. Special Circumstances

Bomb or Terrorist Threat
      Do not panic
      Note exact time and words used by caller
      Write down details of call as soon as possible:
          Describe threat
          If explosive, when is it set to explode?
          Where is it located?
          What does it look like?

          What will cause or trigger the explosion?
          Did caller place the bomb or device?
          What is the caller’s name?
          What is caller’s address or location?
          What is caller’s affiliation?
      Note characteristics of caller’s voice: Male/female, accent, lisp, etc.)
      Note any background noise
      If digital display/caller id, note the information on the display
      Call Police immediately - stay on the line until they tell you to hang up
      Notify Emergency Response Team
      Begin General Evacuation Plan
      If you see any suspicious package or person while leaving, inform police/security what
       you saw and where

Person with Weapon
          Do not panic
          If weapon is in immediate vicinity
              Act quickly and deliberately to evacuate through nearest unblocked exit, without
               pulling alarm
              Call 911/Police
              Go to protected meeting place away from facility
              Account for all participants
              If you are NOT able to evacuate:
                  Conceal and protect yourself and participants as much as possible
                  Hide under enclosed counters, seating, desks
                  Call 911/Police; inform them of your location and how many people are with
                  DO NOT ATTEMPT to aggressively deter unstable person with weapon
       If weapon is not in immediate vicinity:
              Call 911/Police
              Begin General Evacuation procedures without pulling alarm
              Move swiftly to protected meeting place away from facility
              Account for all participants at meeting place

                                     Incident Report
               US Lacrosse Insurance Program
It is important to have written incident reports on file regarding injuries, property damage or other
incidents that may result in a claim against your team, league and US Lacrosse. Many such claims allege
negligence, and written reports prepared immediately after an incident occurs are invaluable in defending
these types of claims. In the event of a serious injury, it is important to ask for written statements from
witnesses and individuals actually involved in the incident. One copy of the report should be sent to
Bollinger Insurance, and the league office should keep a copy of the report for their own records, since
many lawsuits are filed long after the injury occurs.

Attach any additional information that might be helpful in defense of a future claim, such as: police report,
doctor’s statement, pre-game field inspection report, routine facility maintenance report, photos taken at
the time of the incident and written statements of witnesses.

This report is to be completed by:
Coach or Official        For incidents occurring during regular, pre-season or post-season team activities
Director or Sponsor      For incidents occurring during tournaments or special events
Director or Coach        For incidents occurring during camps or clinics

1. General Information
DATE AND TIME OF REPORT: _______________________________________________________________
REPORTER’S NAME: ______________________________ POSITION: _______________________________
HOME ADDRESS: ___________________________________________________________________________
PHONE (H): __________________________________ PHONE (W): __________________________________
PHONE (CELL): __________________________________ EMAIL: ___________________________________
EVENT/ACTIVITY: __________________________________________________________________________
DATE AND TIME OF INCIDENT: ______________________________________________________________
LOCATION OF INCIDENT: _____________________________________________________________ _____

2. Provide full description of all events leading up to and including the incident:


3. Witnesses
Full Name                              Address                                Statement Attached (Y/N)

4. Who responded to the incident (include all parties - Coaches, Athletic Trainers, Campus
Security, Paramedics, Police, etc.): ___________________________________________________________

5. If an Injury is involved, please provide the following:

Injured Person’s Name: ______________________________________ Age: _________________________
Phone (H): _______________________________________________ Sex: ________Male ________ Female
Position: _____Player _____Coach _____Official _____Spectator _____Other:_________________

6. Describe injury (specify where on body, right or left side): __________________________________

7. Was First Aid treatment required? _________

8. If yes, who provided First Aid treatment? _________________________________________________

9. Please provide detailed description of surroundings, facility condition, weather condition, etc:

10. Other Comments:

11. Verification Statement: By signing this document, I verify that this report is true and correct
to the best of my knowledge.

Reporter’s Signature: _________________________________________________ Date: ____________

   Provide one copy to your league office or program administrator, and send one copy to:
  Bollinger Insurance, US Lacrosse Insurance Plan, 830 Morris Turnpike, Short Hills, NJ 07078

Phone: 800-350-8005   Fax: 973-467-0759   Web:

Map and directions to San Ramon Valley Medical Center: