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☐ Call down roster ☐ Clinic Damage Assessment ☐ Status/Number of Participants impacted ☐ Clinic location ☐ Open Shelters ☐ Feeding Organizations ☐ Clinic closure ☐ Alternate clinic sites ☐ Request for Program assistance (waiver request) ☐ Other operating procedures Click or tap here to enter text.

vi. Does the State agency have a communication plan to notify participants and other stake holders of alternate operations? (7 CFR 246.4a(30)(vii))

☐ Yes ☐ No ☐ Other Click or tap here to enter text.

If yes, attach or list the location of the plan. Click or tap here to enter text.

vii. Does the State agency have a plan to inform receiving State agencies of where they may obtain a verification of certification for displaced participants?

☐ Yes ☐ No ☐ Other: Specify: Click or tap here to enter text. If yes, attach or list the location of the plan. Click or tap here to enter text.

viii. Does the State agency provide participants with instructions for obtaining their verification of certification?

☐ Yes ☐ No

If yes, attach or list the location of the plan. Click or tap here to enter text.

ix. Does the State agency have a plan to determine if an emergency period or supply chain disruption as declared by the Secretary of Agriculture exists? An emergency period is defined as (1) a presidentially declared major disaster as defined under Section 102 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act, 42 U.S.C. 5121 et seq.), (2) a presidentially declared emergency as defined under the Stafford Act, (3) a public health emergency declared by the Secretary of Health and Human Services under Section 319 of the Public Health Service Act (42 U.S.C. 247d), or (4) a renewal of such a public health emergency.

☐ Yes ☐ No

If yes, attach or list the location of the plan. Click or tap here to enter text.

x. Does the State agency have a plan for how it would determine if a waiver is necessary to continue WIC services?