Hospital Name and Location:
Date:
Rooms
Capacity
In Use
Available
1
Adult ICU
2
Adult Medical/Surgical
3
Burn Unit
4
PICU(Pediatric ICU)
5
Pediatrics Medical/Surgical
6
Maternity(OB)
7
Psychiatric-Adult
8
Psychiatric-Pediatric
9
Psychiatric-Substance Abuse
10
Negative Pressure/Isolation
11
Ventilator
12
Operating Rooms
13
Triage Tag- Green
14
Triage Tag- Yellow
13
Triage Tag- Red