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Appendix B – Confidential Crisis Report Part II
APPENDIX B INTERNAL USE Girl Scouts Carolinas Peaks to Piedmont CONFIDENTIAL CRISIS REPORT: PART II
To be completed by Crisis Team Member:
1. NAME of Crisis Team Member who notified attorney_________________________
DATE and TIME of the call ____________________________________________________
2. MEMBERS of CRISIS TEAM CONTACTED. (See Appendix Dfor contact information.)
Contact Date of Call Time of Call Initials of Person Who Made Call
Chief Executive Officer – Jennifer Wilcox
Chief Financial Officer – Stephanie Werner
Chief HR Officer – Kimberly Richards Chief Marketing Officer – Jaclyn Johnson Senior Director of Business Operations – Veronica Abrams Senior Director of Girl Scout Engagement – June Sisk Senior Director of Girl Scout Experience– Lydia Rozier Director of Product Program – Jeannie Brown
Director of IT & Analytics – Tonia Davis
OTHER SUPPORT TEAM MEMBERS Title Date of Call Time of Call Initials of Person Who Made Call
Board Chair – Carolyn Brickey Vice Chair – Trish Johnson Treasurer – Sarah Hudson Secretary – Tammy Virnig Council Attorney – TBD ABC Cookies – Reggie Mahoney Ashdon Farms – Insurance Agent – Jeff Smith, Palmer & Cay
3. WAS A CRISIS TEAM MEMBER DISPATCHED TO THE SITE?
Name of person sent
Date/Time Sent
Cell Contact/Pager Number
4. WAS A CRISIS TEAM MEMBER OR SUPPORT PERSON DISPATCHED TO ANY
OTHER LOCATION?
Title/Name of person sent
Date/Time Sent
Cell Contact/Pager Number
5. CRISIS TEAM MEMBER ASSIGNED TO COMPILE REPORTS 6. GSUSA NOTIFIED AS FOLLOWS:
Contact Date of Call Time of Call
Mary Kate Andris, Council Leadership Consulting Director
Christa Marie Kolodziej, Senior Director of Crisis Communications
7. TYPE OF ASSISTANCE NEEDED FROM GIRL SCOUTS OF THE USA:
8. HAVE OTHER COUNCILS BEEN NOTIFIED? Name of Council Name of Person/ Title Date/Time of the Call Initials of person who made the call
9. PARENTS OR NEXT OF KIN NOTIFIED? Child’s or Participant’s Name Parent’s or Next of Kin’s Name Date/Time of the Call or Visit Initials of the person who made the call
10. INSURANCE REPRESENTATIVE NOTIFIED? Insurance Representative’s Name Insurance Agency Name Date/Time of the Call Initials of person who made the call
11. WITNESSES – THOSE WHO WERE PRESENT OR OBSERVED OCCURRENCES (include names, addresses and telephone numbers).
12. ACTION TAKEN/PLANNED BY COUNCIL TO DATE
13. GENERAL COMMENTS
Any summons issued to any office of Girl Scouts of the USA should be sent priority mail, return receipt requested (quickest way possible) or hand delivered to the Controller, Girl Scouts of the USA, 420 Fifth Avenue, New York, NY 10018-2702.
Continue on-going written documentation. Maintain written records of all action concerning the crisis. Compile all written documentation, phone logs, statements, etc. for evaluation by Crisis Team.
CONCLUSION – Attach final report outlining how situation was resolved.
ATTACH SUPPORTING DATA. (i.e., consent forms, medical forms, police reports, telephone logs, insurance reports, media inquiries, etc.)
