HomeMy WebLinkAboutStaff Report 2602-5930CITY OF PALO ALTO
CITY COUNCIL
Special Meeting
Monday, March 23, 2026
Council Chambers & Hybrid
5:00 PM
Agenda Item
3.Approval of a Facility Agreement and Pet Addendum between the City of Palo Alto and
the American Red Cross for the use of designated city facilities during disasters. CEQA
Status – Not a Project Supplemental Report added
City Council
Staff Report
From: City Manager
Report Type: CONSENT CALENDAR
Lead Department: Office of Emergency Services
Meeting Date: March 23, 2026
Report #: 2602-5930
TITLE
Approval of a Facility Agreement and Pet Addendum between the City of Palo Alto and the
American Red Cross for the use of designated city facilities during disasters. CEQA Status – Not
a Project
RECOMMENDATION
Staff recommends that Council approve and authorize the City Manager to execute the Facility
Use Agreement (Attachment A) and the Pet Addendum (Attachment B) with the American Red
Cross to authorize the use of the Cubberley Community Center, Mitchell Park Community
Center, and Lucie Stern Community Center facilities, grounds and equipment for emergency
congregant shelters required during disasters and to meet the mass care needs of disaster
survivors. The Red Cross survey documents are included for the above, with the exception of
Lucie Stern, since that facility is not anticipated to be used for sheltering near-term, but could
have other supportive roles.
BACKGROUND
In 1973 the City of Palo Alto entered into an agreement with the American Red Cross to provide
disaster shelter at the Cubberley Community Center. This agreement benefited both the
City and Red Cross by providing City staff assistance and a City facility to serve the residents of
Palo Alto as a shelter during a disaster. The City updated this agreement in 20041 and again in
2008. It has not been updated since that time.
The identification and evaluation of all potential sheltering facilities and locations to serve as an
emergency congregant center was an objective listed in the City of Palo Alto’s Emergency
1 City Council, June 28, 2004; CMR: 300:04
https://recordsportal.paloalto.gov/WebLink/DocView.aspx?id=77210&dbid=0&repo=PaloAlto&cr=1b
Management Plan3 ). Each update of the City’s Emergency Operations Plan has identified
Shelter and Mass Care services as an emergency function the City should be ready to provide.
Since that time Cubberley Community Center has been the only city-owned property with a
facility agreement with the Red Cross for use as a disaster shelter.
The Cubberley Community Center served as an emergency congregant shelter during the 1998
flood, sheltering approximately 200 residents in the Pavilion building. There has not been a
significant disaster since 1998 requiring the activation of an emergency shelter, although there
have been times since then where small numbers of individuals have been housed in hotels
following periodic residential fires and flooding in 2023.
The American Red Cross maintains a national shelter database of all the facilities in the United
States with a facility agreement. This is known as the National Shelter System (NSS) and in Palo
Alto it includes not only city-owned properties, but also facilities owned by other agencies who
also have existing agreements.
ANALYSIS
4. When the need to establish Red Cross shelters arises, the City and the Red
Cross will coordinate the mass care needs of the community. When activated by the City’s
Director of Emergency Services, this agreement will allow the Red Cross the use of Cubberley
Community Center, and the Mitchell Park Community Center facilities, grounds and equipment
as an emergency congregant shelter and to support mass care needs for disaster survivors. This
agreement is inclusive of an addendum that grants permission to the Red Cross to permit its
clients while occupying a portion of the Premises (“Client”) to keep only those pet(s) as
specified in the addendum and in compliance with its terms and conditions.
3City Council, January 11, 1999; CMR: 379:98
https://recordsportal.paloalto.gov/WebLink/DocView.aspx?id=64162&page=1&dbid=0&repo=PaloAlto&searchid=
91162235-a12a-47b1-b282-5e8fcd36b79b&cr=1
4 City of Palo Alto Emergency Operations Plan, 2025;
https://www.paloalto.gov/files/assets/public/v/1/oes/plans/palo-alto-2025-emergency-operations-plan-final.pdf
The operation of emergency shelter locations is a joint responsibility of the City of Palo Alto and
the Red Cross. The Red Cross designates a Red Cross official to manage the activities at the
facility. The City of Palo Alto designates a Facility Coordinator to coordinate with the Red Cross
Manager. The City of Palo Alto will also provide staff and volunteer support within capabilities,
to augment the efforts of Red Cross volunteers.
The Red Cross agrees to reimburse the City for any damage to the facility during use and
replace foods or supplies that may be provided by the City and used by
the Red Cross in the conduct of its relief activities as a shelter.
The Memorandum of Understanding shall remain in effect until terminated with written notice
of non-renewal by either the City or the American Red Cross.
FISCAL/RESOURCE IMPACT
STAKEHOLDER ENGAGEMENT
ENVIRONMENTAL REVIEW
ATTACHMENTS
APPROVED BY:
LOG Facility Use Agreement Form V.6.0 2024-04-11 1
Facility Use Agreement
The American National Red Cross (“Red Cross”), a non-profit corporation chartered by the United States
Congress, provides services to individuals, families, and communities when disasters strike. The disaster
relief activities of the Red Cross are made possible by the American public, who support the Red Cross
with generous donations. The Red Cross’s disaster services are also supported by facility owners who
permit the Red Cross to use their buildings as shelters and other service delivery sites for disaster
victims. This agreement is between the Red Cross and a facility owner (“Owner”) so the Red Cross can
use the facility to provide services during a disaster. This agreement only applies when Red Cross
requests use of the facility and is managing the activity at the facility.
Parties and Facility
Owner:
Full Name of Owner
Address
24-Hour Point of Contact
Name and
Title Work
Address for Official
Notices (only if
Red Cross:
Chapter Name
Chapter Address
24-Hour Point of Contact
Name and
Title Work
Address for Official
Notices
American Red Cross, Disaster Cycle Services Logistics, 8550 Arlington
Blvd., Fairfax, VA 22031
Facility:
Insert name and complete street address of building or, if multiple buildings, write “See attached
facility list,” and attach facility list, including complete street address of each building that is part
of this agreement. If the Red Cross will use only a portion of a building, then describe the portion
of the building that the Red Cross will use.
City of Palo Alto
250 Hamilton Ave
Nathan Rainey
OES Coordinator
650-444-5350
250 Hamilton Ave, Palo Alto, CA 94301
American Red Cross Silicon Valley Chapter
2731 N. 1st Street, San Jose, CA 95134
Red Cross 24-Hr. Activation Line 866-272-2237
Cubberly Community Center, 4000 Middlefield Road, Palo Alto, CA 94303
Mitchell Park Community Center, 3700 Middlefield Road, Palo Alto, CA 94303
Lucie Stern Community Center, 1305 Middlefield Road, Palo Alto, CA 94301
* Refer to the latest shelter surveys for details on the spaces at these sites that can be used in a shelter operation.
LOG Facility Use Agreement Form V.6.0 2024-04-11 2
Terms and Conditions
1. Use of Facility: Upon request and if feasible, Owner will permit the Red Cross to use and
occupy the Facility on a temporary basis to conduct emergency, disaster-related activities. The
Facility may be used for the following purposes (both parties must initial all that apply):
Facility Purpose Owner Initials Red Cross
Initials
Intake)
2. Facility Management: The Red Cross will designate a Red Cross official to manage the
activities at the Facility (“Red Cross Manager”). The Owner will designate a Facility Coordinator
to coordinate with the Red Cross Manager regarding the use of the Facility by the Red Cross.
3. Condition of Facility: The Facility Coordinator and Red Cross Manager (or designee) will jointly
conduct a survey of the Facility before it is turned over to the Red Cross. They will use the first
page of the Red Cross’s Facility/Shelter Opening/Closing Form to record any existing
damage or conditions. The Facility Coordinator will identify and secure all equipment in the
Facility that the Red Cross should not use. The Red Cross will exercise reasonable care while
using the Facility and will not modify the Facility without the Owner’s express written approval.
4. Food Services (This paragraph applies only when the Facility is used as a shelter or service
center.): Upon request by the Red Cross, and if such resources are available, the Owner will
make the food service resources of the Facility, including food, supplies, equipment and food
service workers, available to feed the shelter occupants. The Facility Coordinator will designate a
Food Service Manager to coordinate meals at the direction of and in cooperation with the Red
Cross Manager. The Food Service Manager will establish a feeding schedule and supervise meal
planning and preparation. The Food Service Manager and Red Cross Manager will jointly
conduct a pre-occupancy inventory of the food and food service supplies before the Facility is
turned over to the Red Cross. When the Red Cross vacates the Facility, the Red Cross Manager
and Facility Coordinator or Food Service Manager will conduct a post-occupancy inventory of the
food and supplies used during the Red Cross’s activities at the Facility.
5. Custodial Services (This paragraph applies only when the Facility is used as a shelter or service
center.): Upon request of the Red Cross and if such resources are available, the Owner will make
its custodial resources, including supplies and workers, available to provide cleaning and
sanitation services at the Facility. The Facility Coordinator will designate a Facility Custodian to
coordinate these services at the direction of and in cooperation with the Red Cross Manager.
6. Security/Safety: In coordination with the Facility Coordinator, the Red Cross Manager, as he or
she deems necessary and appropriate, will coordinate with law enforcement regarding any
security and safety issues at the Facility.
7. Signage and Publicity: The Red Cross may post signs identifying the Facility as a site of Red
Cross operations in locations approved by the Facility Coordinator. The Red Cross will remove
such signs when the Red Cross concludes its activities at the Facility. The Owner will not issue
press releases or other publicity concerning the Red Cross’s activities at the Facility without the
ES CC
ES CC
ES CC
ES CC
LOG Facility Use Agreement Form V.6.0 2024-04-11 3
written consent of the Red Cross Manager. The Owner will refer all media questions about the
Red Cross activities to the Red Cross Manager.
8. Closing the Facility: The Red Cross will notify the Owner or Facility Coordinator of the date when
the Red Cross will vacate the Facility. Before the Red Cross vacates the Facility, the Red Cross
Manager and Facility Coordinator will jointly conduct a post-occupancy inspection, using the
second page of the Shelter/Facility Opening/Closing Form, to record any damage or conditions.
9. Fee (This paragraph does not apply when the Facility is used as a shelter. The Red Cross does
not pay fees to use facilities as shelters.): Both parties must initial one of the two statements
below:
a. Owner will not charge a fee for the use of the Facility.
Owner Initials _______ Red Cross Initials ______
b. The Red Cross will pay $ per: for the right to use and occupy the Facility
Owner Initials ________ Red Cross Initials ______
10. Reimbursement: Subject to the conditions in paragraph 10(e) below, the Red Cross will
reimburse the Owner for the following:
a. Damage to the Facility or other property of Owner, reasonable wear and tear excepted,
resulting from the operations of the Red Cross. Reimbursement for facility damage will
be based on replacement at actual cash value. The Red Cross, in consultation with the
Owner, will select from bids from at least three reputable contractors. The Red Cross is
not responsible for storm damage or other damage caused by the disaster.
b. Reasonable costs associated with custodial and food service personnel and supplies
which would not have been incurred but for the Red Cross’s use of the Facility. The
Red Cross will reimburse at per-hour, straight-time rate for wages actually incurred
but will not reimburse for (i) overtime or (ii) costs of salaried staff.
c. Reasonable, actual, out-of-pocket costs for the utilities indicated below, to the extent
that such costs would not have been incurred but for the Red Cross’s use of the
Facility. (Both parties must initial all utilities that may be reimbursed by the Red Cross):
Owner Initials Red Cross Initials
d. The Owner will submit any request for reimbursement to the Red Cross within 60 days
after the occupancy of the Red Cross ends. Any request for reimbursement must be
accompanied by supporting invoices. Any request for reimbursement for personnel
costs must be accompanied by a list of the personnel with the dates and hours
worked.
e. If the disaster is a Federally declared disaster and Owner is a municipal, county,
parish, or state government entity, then the Owner will work with appropriate
emergency management agencies to seek cost reimbursement through the Federal
Emergency Management Agency’s program for administering Public Assistance
Category B under the Robert T. Stafford Act. The Red Cross is not obligated to
ES CC
ES
ES CC
ES CC
ES CC
ES CC
LOG Facility Use Agreement Form V.6.0 2024-04-11 4
reimburse the Owner for costs covered by Public Assistance Category B.
11. Insurance: The Red Cross shall carry insurance coverage in the amounts of at least $1,000,000
per occurrence for Commercial General Liability and Automobile Liability. The Red Cross shall
also carry Workers’.
a. Compensation coverage with statutory limits for the jurisdiction within which the facility
is located and $1,000,000 in Employers’ Liability.
12. Indemnification: The Red Cross shall defend, hold harmless, and indemnify Owner against any
legal liability, including reasonable attorney fees, in respect to claims for bodily injury, death, and
property damage arising from the negligence of the Red Cross during the use of the Facility.
13. Term: The term of this agreement begins on the date of the last signature below and ends 30
days after written notice by either party.
Digital Signature: Each party agrees that either part's execution of this agreement by DIGITAL signature
(whether ELECTRONIC or encrypted) is expressly intended to authenticate this AGREEMENT and to
have the same force and effect as manual signatures. The term DIGITAL signature means any electronic
sound, symbol, or process attached to or logically associated with a record and executed and adopted by
a party with the intent to sign such record, including facsimile or email electronic signatures. The use of
digital signatures is intended to facilitate more efficient execution and delivery of signed documents.
The American National Red Cross
Owner (Legal Name) (Legal Name)
By (Signature) By (Signature)
Name (Printed) Name (Printed)
Title Title
Date Date
City of Palo Alto
Ed Shikada
City Manager
Casey Copp Digitally signed by Casey Copp
DN: cn=Casey Copp, o=American Red Cross, ou=NCCR,
email=casey.copp@redcross.org, c=US
Date: 2026.02.10 15:31:20 -08'00'
Casey Copp
Community Disaster Program Manager
2/11/2026
Page 1 of 3
PET ADDENDUM TO FACILITY USE AGREEMENT
This Pet Addendum to Facility Use Agreement (“Addendum”) is hereby annexed to and made a part of the
Facility Use Agreement (“Agreement”) having an effective date of ______, 20___, and entered into
between ________________ (“Owner”) and The American National Red Cross, a nonprofit corporation,
a Federally chartered instrumentality of the United States, and a body corporate under the laws of the
United State (36 U.S.C. §§ 300101-300111 (2007) (“Red Cross”). Owner and Red Cross are each sometimes
referred to herein as a “Party” and collectively, as “Parties”, as the context requires. Capitalized terms
used, but not defined herein have the meanings set forth in the “Agreement”.
Owner hereby grants permission to the Red Cross to permit its clients while occupying a portion of the
Premises (“Client”) to keep only those pet(s) described below upon the terms and conditions in this
Addendum. All pets are subject to the following general policies:
1. Clients’ household pets, including assistance/therapy animals (each as defined by
applicable law) are permitted to be kept on and in the area of the Facility designated on Exhibit A of
this Addendum (“Pet Area”), or other areas (designated by Owner) in the building.
2. Clients’ service and/or guide animals (as defined by applicable law) are permitted to be
kept in the same area of the Facility as the Client.
3. At all times when a client’s pet is outside the Pet Area, the pet must be secured by either
a leash, or in a carrier or other container and restrained in such a way so as not to cause any damage to
people or the Facility. Except for service and/or guide animals, no pet is permitted in any part of the
Facility, other than the Pet Area, or other areas designated and approved by Owner.
4. Owner’s personnel shall avoid physical contact with any pet and shall enter the Pet Area
only accompanied by the Red Cross Representative (identified in the Agreement) or Animal Welfare
Organization (AWO) providing care and/or support of the pet.
5. Red Cross agrees that it, acting through the AWO, shall be responsible for sheltering,
feeding, maintaining, and overseeing the welfare of the pets in compliance with all applicable laws and
regulations, including but not limited to all state law and local ordinances regarding pet ownership and
liability.
6. The Parties may execute and deliver this Addendum in counterparts.
7. Except as otherwise set forth in this Addendum, the terms of the Agreement remain in
effect.
8. The term of this Addendum shall be coterminous with the term of the Agreement.
The Parties have executed and delivered this Addendum as of the Effective Date.
[Signatures follow on next page]
City of Palo Alto, CA
26
Page 2 of 3
IN WITNESS WHEREOF, the Parties, acting through their duly authorized officers, have executed
this Contract, which shall come into force as of the latest date of the signatures below.
OWNER RED CROSS
Name: ____________________________
By: _____________________________________
Signature
Print Name: _____________________________
Title: ___________________________________
The American National Red Cross
By: _____________________________________
Signature
Print Name: _____________________________
Title: ___________________________________
City of Palo Alto
Ed Shikada Casey Copp
City Manager Community Disaster Program Mgr
Casey Copp
Digitally signed by Casey Copp
DN: cn=Casey Copp, o=American
Red Cross, ou=NCCR,
email=casey.copp@redcross.org,
c=US
Date: 2026.02.11 11:19:33 -08'00'
Page 3 of 3
Exhibit A
Diagram of Pet Area (include location of pet waste disposal bins/areas)
Shelter Facility Survey
BASIC SHELTER INFORMATION
Red
Cross
Site Name/
School District NSS ID#Date
Building #Name of
building of
Shelter address
Town/
City
County/
Parish State
Mailing Address
(if different)
FEMA DHS TSA SBC
Red Cross
managed
Red Cross
partner
Red Cross
supported Independent
Evacuation General Medical
Shelter Capacity (See Surveyor Instructions #1)
Total sq feet
Sq feet usable for
sleeping space
Other
Other
Evacuation
Post Impact
Other
usable sq ft ÷ 20 sq ft/person =
usable sq ft ÷ 40 sq ft/person =
usable sq ft ÷ sq ft/person =
person capacity
person capacity
person capacity
Shelter Capacity
Phone #WebsiteFax #
Shelter Facility Survey 1
General facility notes
Agency operating shelter
(check one)
Shelter agency type
(check one)
Shelter type (check all that apply)
Geographic Information
Latitude Longitude Elevation
Use major landmarks (e.g. highways, intersections, rivers, railroad crossings, etc.) that will be easily recognizable in a disaster.
Latitude and longitude coordinates can be found at online web sites, using a global positioning system device, or will auto
populate when the address is entered into the National Shelter System.
No NoYes Hurricane category or
evacuation areaYesIn storm surge/
evacuation
In flood
plain
year flood
impact
Directions to facility
Zip
Code
Town/
City
County/
Parish State Zip
Code
Use the calculations to calculate the capacity for sleeping space.
Rev. 8-15-2011
Cubberly Community Center 53635 2/19/2026
4000 Middlefield Road
Palo Alto Santa Clara CA
25,870
9,800
13,160
9,800
658
245
https://www.cityofpaloalto.org/Departments/
Community-Services/Facility-Rentals/
Community-Centers/CUBB
This site has several long-term tenants, including PAUSD, that occupy most of the rooms. See the facility
map for those spaces that are so occupied and unavailable for use. The main spaces that are available for use in supporting a disaster
are detailed starting on page 7.
37.4165045 -122.1071228 19 feet
Exit highway 101 onto San Antonio Road heading west. Turn right onto Middlefield Road (north). Cubberly
Community Center will be on the left at Montrose Ave.
94303
Rooms H6 and/or L6 with tarps and kennels
Community Services Senior Manager
Recreation Coordinator
L
Chase Hartmann Facilities Manager
aines
3/26/2008
Attached to the NSS Survey fax
Jim Mollerus
Chase Hartmann
Sheltering Coordinator
Facilities Manager
American Red Cross SVC
City of Palo Alto
There are other areas of the facility that are leased by other organizations and these spaces are generally
not available except in extreme emergencies. These spaces have been excluded from this survey write-up. See site map for details.
1
No sprinklers in any of the buildings.
T-2 Office and the Theatre
Nathan Rainey Emergency Services Coordinator
Shelters are a top priority for city building inspectors after a disaster.
15 17
There is no longer a mens shower/locker room on site. Women's showers may be used
for mens during specific time windows or showers arranged for at a local gym. See page 8 for more info on local gyms.
120
3
120
Until Gym A and/or Gym B are returned to service, feeding should be conducted in a dedicated area of the Pavilion.
Pavilion concession room off the lobby has 3 refrigerators that can be used to store perishables.
There is only one accessible shower on
end of the wand. These will need to be installed to make them usable. The women's accessible shower can be used by males during
the premises located in the Women's shower. At the time of the inspection it was missing the control lever and shower head off the
pre-designated male showering times.
0 0
Many Many
GYM B (100' x 56' = 5,600 sqft): Feeding in a max-sized shelter. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no
sprinklers.
GYM A (100' x 56' = 5,600 sqft): Secondary dormitory. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no sprinklers.
(Note: no restrooms inside Gym A or B)
WOMEN'S SHOWERS (located on the back-side of Gym A): 4 sinks, 4 stalls (including 1 accessible stall), 15 showers (including 1 accessible).
MEN'S SHOWERS: removed in 2019.
NOTE ON SHOWERS: a work-around to having only one accessible shower in the women's restroom is to designate male shower times
using the women's showers. Sewer hook-ups for portable showers are in the rear parking lot near Building I and between rooms
G7 and J5. Another option is to use nearby gyms for showers. The best options are the following:
smoke detector, but no sprinklers. Heating, but no A/C.
PAVILLION (102' X 105', 10,710 square feet): Primary dormitory & feeding space. The main hall has no windows. There is a fire alarm &
PAVILLION LOBBY (43' x 18' = 774 square feet): Use for registration area and dormitory access control
PAVILLION MEN'S REST REOOM: 3 sinks, 2 urinals, 3 stalls (including 1 accessible stall)
Palo Alto YMCA (NSS #75765) 3412 Ross Road, Palo Alto, CA 650-856-9622
Oshman Family JCC: 3921 Fabian Way, Palo Alto, CA 650-223-8680
The following spaces are also available, though do require walking through the areas of the campus that house the school. These
spaces should not be used for general dormitory or client services. See the accompanying notes on how they can be used.
Has heating, tile floor, sink, but no A/C.
ROOM H1 (24' x 27' = 648 sq. ft. excluding tiered seating area): use as an isolation room or shelter worker break room.
ROOM H6 (48' x 27' = 1,296 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, tile floor, sink, but no A/C.
ROOM L6 (46' x 27' = 1,242 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, laminated floor, but no A/C.
COT SPACE: 60% 16,310 sq. ft. Dormitory Space = ~9,800 sq. ft. (Note: 40% of Dormitory Space is reserved for isles and doorways)
DORMITORY SPACE: 10,710 sq. ft. Pavilion + 5,600 sq. ft. Gym A = 16,310 sq. ft.
EVACUATION SPACE: 9,800 sf Cot Space + 3,360 sf of Gym B = 13,160 sf (Note: 40% of space is reserved for isles and doorways)
TOTAL SPACE: 10,710 Pavilion + 11,200 Gyms A&B, 774 Pavilion Lobby+ 648 Rm H1 + 1,296 Rm H6 + 1,242 Rm L6 = 25,870 sq. ft.
SUPPORTING OUTDOOR POPULATIONS:
Cars & RV's: South lot (next to the Pavillion) but in the rows furthest from the building
Tents: Soccer Field 2 on the back-side of the facility
Shelter Facility Survey
Shelter Facility Survey 2
Pet Shelter
No nearest locationanswer questions below
No NoCement or tile
floors with drains NoOutdoor space
to relieve pets
Agency that will
operate the pet shelter 24 hour #
Contact notes
Alternate Point of Contact
Name Title
24 hour #EmailFax #
Alternate Point of Contact
Point of Contact to Open Facility
Name Title
24 hour #Email
Contact notes
Fax #
Yes
Yes Yes Yes
Pet shelter space
available on site
Separate
ventilation system
Point of Contact to Authorize Use of Facility
Name Title Phone #
24 hour #Email
Contact notes
Fax #
ADDITIONAL INFORMATION
No Date signed Notes
NoPre-designated shelter
team assigned Team name
NoCurrent facility floor
plans available Location of copies
Yes
Yes
Yes
Shelter agreement
signed
NoYesInternational Association of Venue Managers (IAVM) facility
NoYesShelter can be a hurricane evacuation shelter Notes
Phone #
Phone #
Phone #
Use the Standards for Selection of Hurricane Evacuation Shelters to select hurricane evacuation shelters. In this document, you
will find a planning process that involves many factors (e.g. technical information for storm surge and flood mapping). This
process requires close coordination with local officials for technical information to make decisions about hurricane shelter
suitability. Use the Facility Construction section to assist with determining whether this can be a hurricane evacuation shelter.
Rev. 8-15-2011
Cubberly Community Center 53635 2/19/2026
4000 Middlefield Road
Palo Alto Santa Clara CA
25,870
9,800
13,160
9,800
658
245
https://www.cityofpaloalto.org/Departments/
Community-Services/Facility-Rentals/
Community-Centers/CUBB
This site has several long-term tenants, including PAUSD, that occupy most of the rooms. See the facility
map for those spaces that are so occupied and unavailable for use. The main spaces that are available for use in supporting a disaster
are detailed starting on page 7.
37.4165045 -122.1071228 19 feet
Exit highway 101 onto San Antonio Road heading west. Turn right onto Middlefield Road (north). Cubberly
Community Center will be on the left at Montrose Ave.
94303
Rooms H6 and/or L6 with tarps and kennels
Community Services Senior Manager
Recreation Coordinator
L
Chase Hartmann Facilities Manager
aines
3/26/2008
Attached to the NSS Survey fax
Jim Mollerus
Chase Hartmann
Sheltering Coordinator
Facilities Manager
American Red Cross SVC
City of Palo Alto
There are other areas of the facility that are leased by other organizations and these spaces are generally
not available except in extreme emergencies. These spaces have been excluded from this survey write-up. See site map for details.
1
No sprinklers in any of the buildings.
T-2 Office and the Theatre
Nathan Rainey Emergency Services Coordinator
Shelters are a top priority for city building inspectors after a disaster.
15 17
There is no longer a mens shower/locker room on site. Women's showers may be used
for mens during specific time windows or showers arranged for at a local gym. See page 8 for more info on local gyms.
120
3
120
Until Gym A and/or Gym B are returned to service, feeding should be conducted in a dedicated area of the Pavilion.
Pavilion concession room off the lobby has 3 refrigerators that can be used to store perishables.
There is only one accessible shower on
end of the wand. These will need to be installed to make them usable. The women's accessible shower can be used by males during
the premises located in the Women's shower. At the time of the inspection it was missing the control lever and shower head off the
pre-designated male showering times.
0 0
Many Many
GYM B (100' x 56' = 5,600 sqft): Feeding in a max-sized shelter. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no
sprinklers.
GYM A (100' x 56' = 5,600 sqft): Secondary dormitory. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no sprinklers.
(Note: no restrooms inside Gym A or B)
WOMEN'S SHOWERS (located on the back-side of Gym A): 4 sinks, 4 stalls (including 1 accessible stall), 15 showers (including 1 accessible).
MEN'S SHOWERS: removed in 2019.
NOTE ON SHOWERS: a work-around to having only one accessible shower in the women's restroom is to designate male shower times
using the women's showers. Sewer hook-ups for portable showers are in the rear parking lot near Building I and between rooms
G7 and J5. Another option is to use nearby gyms for showers. The best options are the following:
smoke detector, but no sprinklers. Heating, but no A/C.
PAVILLION (102' X 105', 10,710 square feet): Primary dormitory & feeding space. The main hall has no windows. There is a fire alarm &
PAVILLION LOBBY (43' x 18' = 774 square feet): Use for registration area and dormitory access control
PAVILLION MEN'S REST REOOM: 3 sinks, 2 urinals, 3 stalls (including 1 accessible stall)
Palo Alto YMCA (NSS #75765) 3412 Ross Road, Palo Alto, CA 650-856-9622
Oshman Family JCC: 3921 Fabian Way, Palo Alto, CA 650-223-8680
The following spaces are also available, though do require walking through the areas of the campus that house the school. These
spaces should not be used for general dormitory or client services. See the accompanying notes on how they can be used.
Has heating, tile floor, sink, but no A/C.
ROOM H1 (24' x 27' = 648 sq. ft. excluding tiered seating area): use as an isolation room or shelter worker break room.
ROOM H6 (48' x 27' = 1,296 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, tile floor, sink, but no A/C.
ROOM L6 (46' x 27' = 1,242 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, laminated floor, but no A/C.
COT SPACE: 60% 16,310 sq. ft. Dormitory Space = ~9,800 sq. ft. (Note: 40% of Dormitory Space is reserved for isles and doorways)
DORMITORY SPACE: 10,710 sq. ft. Pavilion + 5,600 sq. ft. Gym A = 16,310 sq. ft.
EVACUATION SPACE: 9,800 sf Cot Space + 3,360 sf of Gym B = 13,160 sf (Note: 40% of space is reserved for isles and doorways)
TOTAL SPACE: 10,710 Pavilion + 11,200 Gyms A&B, 774 Pavilion Lobby+ 648 Rm H1 + 1,296 Rm H6 + 1,242 Rm L6 = 25,870 sq. ft.
SUPPORTING OUTDOOR POPULATIONS:
Cars & RV's: South lot (next to the Pavillion) but in the rows furthest from the building
Tents: Soccer Field 2 on the back-side of the facility
Survey Conductors (List all who participated in the survey)
Name Title Organization Phone #
Shelter Facility Survey 3
LIMITATIONS OF FACILITY USE
Check one This facility will be available for
use at any time during the year
This facility is only available for use
during the time periods listed below
This facility is not available for use
during the time periods listed below
Dates (mm/dd/yyyy)Times (hh:mm)
From AM PM
AM PM
Dates (mm/dd/yyyy)Times (hh:mm)
AM PM
AM PM
From
ToTo
List any recurring dates that the facility
is not available (e.g. every sunday)
Areas of the facility that
are restricted during use
Shelter Facility Survey
FACILITY CONSTRUCTION & SAFETY
Facility Construction
Wood Construction
material
Masonry/Brick Pre-fab Bungalow Concrete Metal Trailer Pod
# stories/
floors Notes
NotesNoElevatorLocationYes
NoOpen roof-spans (see Standards for Selection of
Hurricane Evacuation Shelters for current standards) LengthYes
NoWindows in
sleep area Yes NoIf yes, shatter
protected Yes NoIf yes, protected
with shutter Yes
Other
Fire & AED Safety
Fire alarms & systems
(check all that apply)
Working smoke
detectors
Inspected fire
alarm system
Functional
sprinkler system
Functional direct fire
department alert
Comments from
fire department
AED(s) on site NoYesLocation
Some facilities may not meet fire codes based on building capacity. The questions below are a general reference. Contact your
local fire department with questions or for more information.
Rev. 8-15-2011
Cubberly Community Center 53635 2/19/2026
4000 Middlefield Road
Palo Alto Santa Clara CA
25,870
9,800
13,160
9,800
658
245
https://www.cityofpaloalto.org/Departments/
Community-Services/Facility-Rentals/
Community-Centers/CUBB
This site has several long-term tenants, including PAUSD, that occupy most of the rooms. See the facility
map for those spaces that are so occupied and unavailable for use. The main spaces that are available for use in supporting a disaster
are detailed starting on page 7.
37.4165045 -122.1071228 19 feet
Exit highway 101 onto San Antonio Road heading west. Turn right onto Middlefield Road (north). Cubberly
Community Center will be on the left at Montrose Ave.
94303
Rooms H6 and/or L6 with tarps and kennels
Community Services Senior Manager
Recreation Coordinator
L
Chase Hartmann Facilities Manager
aines
3/26/2008
Attached to the NSS Survey fax
Jim Mollerus
Chase Hartmann
Sheltering Coordinator
Facilities Manager
American Red Cross SVC
City of Palo Alto
There are other areas of the facility that are leased by other organizations and these spaces are generally
not available except in extreme emergencies. These spaces have been excluded from this survey write-up. See site map for details.
1
No sprinklers in any of the buildings.
T-2 Office and the Theatre
Nathan Rainey Emergency Services Coordinator
Shelters are a top priority for city building inspectors after a disaster.
15 17
There is no longer a mens shower/locker room on site. Women's showers may be used
for mens during specific time windows or showers arranged for at a local gym. See page 8 for more info on local gyms.
120
3
120
Until Gym A and/or Gym B are returned to service, feeding should be conducted in a dedicated area of the Pavilion.
Pavilion concession room off the lobby has 3 refrigerators that can be used to store perishables.
There is only one accessible shower on
end of the wand. These will need to be installed to make them usable. The women's accessible shower can be used by males during
the premises located in the Women's shower. At the time of the inspection it was missing the control lever and shower head off the
pre-designated male showering times.
0 0
Many Many
GYM B (100' x 56' = 5,600 sqft): Feeding in a max-sized shelter. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no
sprinklers.
GYM A (100' x 56' = 5,600 sqft): Secondary dormitory. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no sprinklers.
(Note: no restrooms inside Gym A or B)
WOMEN'S SHOWERS (located on the back-side of Gym A): 4 sinks, 4 stalls (including 1 accessible stall), 15 showers (including 1 accessible).
MEN'S SHOWERS: removed in 2019.
NOTE ON SHOWERS: a work-around to having only one accessible shower in the women's restroom is to designate male shower times
using the women's showers. Sewer hook-ups for portable showers are in the rear parking lot near Building I and between rooms
G7 and J5. Another option is to use nearby gyms for showers. The best options are the following:
smoke detector, but no sprinklers. Heating, but no A/C.
PAVILLION (102' X 105', 10,710 square feet): Primary dormitory & feeding space. The main hall has no windows. There is a fire alarm &
PAVILLION LOBBY (43' x 18' = 774 square feet): Use for registration area and dormitory access control
PAVILLION MEN'S REST REOOM: 3 sinks, 2 urinals, 3 stalls (including 1 accessible stall)
Palo Alto YMCA (NSS #75765) 3412 Ross Road, Palo Alto, CA 650-856-9622
Oshman Family JCC: 3921 Fabian Way, Palo Alto, CA 650-223-8680
The following spaces are also available, though do require walking through the areas of the campus that house the school. These
spaces should not be used for general dormitory or client services. See the accompanying notes on how they can be used.
Has heating, tile floor, sink, but no A/C.
ROOM H1 (24' x 27' = 648 sq. ft. excluding tiered seating area): use as an isolation room or shelter worker break room.
ROOM H6 (48' x 27' = 1,296 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, tile floor, sink, but no A/C.
ROOM L6 (46' x 27' = 1,242 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, laminated floor, but no A/C.
COT SPACE: 60% 16,310 sq. ft. Dormitory Space = ~9,800 sq. ft. (Note: 40% of Dormitory Space is reserved for isles and doorways)
DORMITORY SPACE: 10,710 sq. ft. Pavilion + 5,600 sq. ft. Gym A = 16,310 sq. ft.
EVACUATION SPACE: 9,800 sf Cot Space + 3,360 sf of Gym B = 13,160 sf (Note: 40% of space is reserved for isles and doorways)
TOTAL SPACE: 10,710 Pavilion + 11,200 Gyms A&B, 774 Pavilion Lobby+ 648 Rm H1 + 1,296 Rm H6 + 1,242 Rm L6 = 25,870 sq. ft.
SUPPORTING OUTDOOR POPULATIONS:
Cars & RV's: South lot (next to the Pavillion) but in the rows furthest from the building
Tents: Soccer Field 2 on the back-side of the facility
Shelter Facility Survey
Shelter Facility Survey 4
Facility Inspection Point of Contact
If requested, who would inspect this facility post-impact to determine it is safe to occupy?
Name Title
24 hour #Email
Contact notes
Fax #
Sanitation, Utilities & Power
SANITATION, FEEDING & UTILITIES
Natural
GasHeating Electric Propane Fuel
Oil
Natural
GasCoolingElectric Propane
NoShowers available # of showersYes NoToilets available Yes # of toilets
NoSelf-sufficient power Yes Type
Emergency
generator on site NoYes Notes
Check all that apply
Check all that apply Natural GasCooking Electric Propane Well(s)Water Municipal Trapped
Total estimated seating
capacity for eating
Feeding
Food Prep (check all that apply)Warming oven kitchen Full service Central kitchen (delivery)
Food stock
stored on site NoRefrigeration
units on site YesNoYes# meal can
be served # units
Seating
capacity Cafeteria Snack
Bar
Other indoor
seating
Notes on
feeding
Phone #
ACCESSIBILITY
Facility
Construction
Facility built in 1993 or later, or extensively altered in 1992 or later.
Parking Areas
NoAccessible parking
space(s)Yes
Parking available.
Notes
NoVan accessible
parking space(s)Yes Notes
See accompanying Shelter Facility Survey-Accessibility Instructions.
Answer below if parking is available
Drop-off/
Loading Area
Permanent drop-off area/loading zone with marked access aisle or space available to
designate as temporary drop-off area/loading zone.
NoYes
Yes No
NoYes
The recommended ratio for toilet facilities is a minimum of 1 toilet for 20 people. The optimum scenario for showers is 1 shower
for every 25 residents. Count all facilities that will be available to shelter residents and staff.
Note fuel requirements, generator capacity, facility areas supported by generator(s), and other relevant information.
Rev. 8-15-2011
Cubberly Community Center 53635 2/19/2026
4000 Middlefield Road
Palo Alto Santa Clara CA
25,870
9,800
13,160
9,800
658
245
https://www.cityofpaloalto.org/Departments/
Community-Services/Facility-Rentals/
Community-Centers/CUBB
This site has several long-term tenants, including PAUSD, that occupy most of the rooms. See the facility
map for those spaces that are so occupied and unavailable for use. The main spaces that are available for use in supporting a disaster
are detailed starting on page 7.
37.4165045 -122.1071228 19 feet
Exit highway 101 onto San Antonio Road heading west. Turn right onto Middlefield Road (north). Cubberly
Community Center will be on the left at Montrose Ave.
94303
Rooms H6 and/or L6 with tarps and kennels
Community Services Senior Manager
Recreation Coordinator
L
Chase Hartmann Facilities Manager
aines
3/26/2008
Attached to the NSS Survey fax
Jim Mollerus
Chase Hartmann
Sheltering Coordinator
Facilities Manager
American Red Cross SVC
City of Palo Alto
There are other areas of the facility that are leased by other organizations and these spaces are generally
not available except in extreme emergencies. These spaces have been excluded from this survey write-up. See site map for details.
1
No sprinklers in any of the buildings.
T-2 Office and the Theatre
Nathan Rainey Emergency Services Coordinator
Shelters are a top priority for city building inspectors after a disaster.
15 17
There is no longer a mens shower/locker room on site. Women's showers may be used
for mens during specific time windows or showers arranged for at a local gym. See page 8 for more info on local gyms.
120
3
120
Until Gym A and/or Gym B are returned to service, feeding should be conducted in a dedicated area of the Pavilion.
Pavilion concession room off the lobby has 3 refrigerators that can be used to store perishables.
There is only one accessible shower on
end of the wand. These will need to be installed to make them usable. The women's accessible shower can be used by males during
the premises located in the Women's shower. At the time of the inspection it was missing the control lever and shower head off the
pre-designated male showering times.
0 0
Many Many
GYM B (100' x 56' = 5,600 sqft): Feeding in a max-sized shelter. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no
sprinklers.
GYM A (100' x 56' = 5,600 sqft): Secondary dormitory. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no sprinklers.
(Note: no restrooms inside Gym A or B)
WOMEN'S SHOWERS (located on the back-side of Gym A): 4 sinks, 4 stalls (including 1 accessible stall), 15 showers (including 1 accessible).
MEN'S SHOWERS: removed in 2019.
NOTE ON SHOWERS: a work-around to having only one accessible shower in the women's restroom is to designate male shower times
using the women's showers. Sewer hook-ups for portable showers are in the rear parking lot near Building I and between rooms
G7 and J5. Another option is to use nearby gyms for showers. The best options are the following:
smoke detector, but no sprinklers. Heating, but no A/C.
PAVILLION (102' X 105', 10,710 square feet): Primary dormitory & feeding space. The main hall has no windows. There is a fire alarm &
PAVILLION LOBBY (43' x 18' = 774 square feet): Use for registration area and dormitory access control
PAVILLION MEN'S REST REOOM: 3 sinks, 2 urinals, 3 stalls (including 1 accessible stall)
Palo Alto YMCA (NSS #75765) 3412 Ross Road, Palo Alto, CA 650-856-9622
Oshman Family JCC: 3921 Fabian Way, Palo Alto, CA 650-223-8680
The following spaces are also available, though do require walking through the areas of the campus that house the school. These
spaces should not be used for general dormitory or client services. See the accompanying notes on how they can be used.
Has heating, tile floor, sink, but no A/C.
ROOM H1 (24' x 27' = 648 sq. ft. excluding tiered seating area): use as an isolation room or shelter worker break room.
ROOM H6 (48' x 27' = 1,296 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, tile floor, sink, but no A/C.
ROOM L6 (46' x 27' = 1,242 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, laminated floor, but no A/C.
COT SPACE: 60% 16,310 sq. ft. Dormitory Space = ~9,800 sq. ft. (Note: 40% of Dormitory Space is reserved for isles and doorways)
DORMITORY SPACE: 10,710 sq. ft. Pavilion + 5,600 sq. ft. Gym A = 16,310 sq. ft.
EVACUATION SPACE: 9,800 sf Cot Space + 3,360 sf of Gym B = 13,160 sf (Note: 40% of space is reserved for isles and doorways)
TOTAL SPACE: 10,710 Pavilion + 11,200 Gyms A&B, 774 Pavilion Lobby+ 648 Rm H1 + 1,296 Rm H6 + 1,242 Rm L6 = 25,870 sq. ft.
SUPPORTING OUTDOOR POPULATIONS:
Cars & RV's: South lot (next to the Pavillion) but in the rows furthest from the building
Tents: Soccer Field 2 on the back-side of the facility
Shelter Facility Survey
Shelter Facility Survey 5
Facility
Entrance
Routes to
Service
Delivery Areas
Sidewalk connects parking area and any drop-off area to at least one facility entrance.
Route from accessible parking spaces and any drop-off area/loading zone to at least one
facility entrance has no steps or curbs without curb cuts.
Where route crosses curb, curb cuts are at least 36” wide.
Automatic doors or doors without knob hardware.
Doorways at least 32” wide when door is open.
Using a yard stick held horizontally at your waist level, walk from the facility entrance to
each service delivery area, as well as restrooms and showers. Except at doorways
(which must be only 32” wide), no part of the route is less than 36” wide.
Level landings on interior and exterior sides of entry door.
No objects protrude from the side more than four inches into the route to the facility
entrance.
No objects protrude from the side more than 4” into the routes to the various service
delivery areas.
If the main facility entrance does not appear to be accessible, another entry is
accessible.
A sign identifies the location of the accessible entrance.
A route without steps is available to access each service delivery area, as well as
restrooms and showers or service can be provided in area that can be accessed by
route with no steps.
Automatic doors or doors without knob hardware.
Route has vertical clearance of at least 80”.
Doorways at least 32” wide when door is open along routes to each service.
If a service delivery area is accessible only by elevator, there is back-up power for the
elevator(s).
Ramps
If yes, type of ramp
Ramps are at least 36” wide, have handrails on both sides 34”-38” above the ramp
surface, and have level landings at least 60” long.
If ramps are longer than 30 feet, a level landing at least 60" long is provided every 30
feet.
Fixed Portable Not provided
Restrooms
Toilet seat is 17"-19" high. Flush control is automatic or manual control on the open side
of the toilet and no higher than 48".
Space at least 9" high is provided beneath the front and one side of the stall.
Stall at least 60" wide and 56" deep (wall-mounted toilet) or 59" deep for (floor mounted
toilet).
Toilet's centerline is 16"-18" from the nearest side wall.
Area where person in a wheelchair can turn around (60-inch diameter circle or T-shape
turn area).
Doorways at least 32" wide when door is open.
Doors without knob hardware.
Appropriate grab bars.
Toilet paper dispenser is within 36" of the rear wall.
At least one accessible sink.
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
Yes No
NoYes
NoYes
NoYes
NoYes
Rev. 8-15-2011
Cubberly Community Center 53635 2/19/2026
4000 Middlefield Road
Palo Alto Santa Clara CA
25,870
9,800
13,160
9,800
658
245
https://www.cityofpaloalto.org/Departments/
Community-Services/Facility-Rentals/
Community-Centers/CUBB
This site has several long-term tenants, including PAUSD, that occupy most of the rooms. See the facility
map for those spaces that are so occupied and unavailable for use. The main spaces that are available for use in supporting a disaster
are detailed starting on page 7.
37.4165045 -122.1071228 19 feet
Exit highway 101 onto San Antonio Road heading west. Turn right onto Middlefield Road (north). Cubberly
Community Center will be on the left at Montrose Ave.
94303
Rooms H6 and/or L6 with tarps and kennels
Community Services Senior Manager
Recreation Coordinator
L
Chase Hartmann Facilities Manager
aines
3/26/2008
Attached to the NSS Survey fax
Jim Mollerus
Chase Hartmann
Sheltering Coordinator
Facilities Manager
American Red Cross SVC
City of Palo Alto
There are other areas of the facility that are leased by other organizations and these spaces are generally
not available except in extreme emergencies. These spaces have been excluded from this survey write-up. See site map for details.
1
No sprinklers in any of the buildings.
T-2 Office and the Theatre
Nathan Rainey Emergency Services Coordinator
Shelters are a top priority for city building inspectors after a disaster.
15 17
There is no longer a mens shower/locker room on site. Women's showers may be used
for mens during specific time windows or showers arranged for at a local gym. See page 8 for more info on local gyms.
120
3
120
Until Gym A and/or Gym B are returned to service, feeding should be conducted in a dedicated area of the Pavilion.
Pavilion concession room off the lobby has 3 refrigerators that can be used to store perishables.
There is only one accessible shower on
end of the wand. These will need to be installed to make them usable. The women's accessible shower can be used by males during
the premises located in the Women's shower. At the time of the inspection it was missing the control lever and shower head off the
pre-designated male showering times.
0 0
Many Many
GYM B (100' x 56' = 5,600 sqft): Feeding in a max-sized shelter. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no
sprinklers.
GYM A (100' x 56' = 5,600 sqft): Secondary dormitory. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no sprinklers.
(Note: no restrooms inside Gym A or B)
WOMEN'S SHOWERS (located on the back-side of Gym A): 4 sinks, 4 stalls (including 1 accessible stall), 15 showers (including 1 accessible).
MEN'S SHOWERS: removed in 2019.
NOTE ON SHOWERS: a work-around to having only one accessible shower in the women's restroom is to designate male shower times
using the women's showers. Sewer hook-ups for portable showers are in the rear parking lot near Building I and between rooms
G7 and J5. Another option is to use nearby gyms for showers. The best options are the following:
smoke detector, but no sprinklers. Heating, but no A/C.
PAVILLION (102' X 105', 10,710 square feet): Primary dormitory & feeding space. The main hall has no windows. There is a fire alarm &
PAVILLION LOBBY (43' x 18' = 774 square feet): Use for registration area and dormitory access control
PAVILLION MEN'S REST REOOM: 3 sinks, 2 urinals, 3 stalls (including 1 accessible stall)
Palo Alto YMCA (NSS #75765) 3412 Ross Road, Palo Alto, CA 650-856-9622
Oshman Family JCC: 3921 Fabian Way, Palo Alto, CA 650-223-8680
The following spaces are also available, though do require walking through the areas of the campus that house the school. These
spaces should not be used for general dormitory or client services. See the accompanying notes on how they can be used.
Has heating, tile floor, sink, but no A/C.
ROOM H1 (24' x 27' = 648 sq. ft. excluding tiered seating area): use as an isolation room or shelter worker break room.
ROOM H6 (48' x 27' = 1,296 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, tile floor, sink, but no A/C.
ROOM L6 (46' x 27' = 1,242 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, laminated floor, but no A/C.
COT SPACE: 60% 16,310 sq. ft. Dormitory Space = ~9,800 sq. ft. (Note: 40% of Dormitory Space is reserved for isles and doorways)
DORMITORY SPACE: 10,710 sq. ft. Pavilion + 5,600 sq. ft. Gym A = 16,310 sq. ft.
EVACUATION SPACE: 9,800 sf Cot Space + 3,360 sf of Gym B = 13,160 sf (Note: 40% of space is reserved for isles and doorways)
TOTAL SPACE: 10,710 Pavilion + 11,200 Gyms A&B, 774 Pavilion Lobby+ 648 Rm H1 + 1,296 Rm H6 + 1,242 Rm L6 = 25,870 sq. ft.
SUPPORTING OUTDOOR POPULATIONS:
Cars & RV's: South lot (next to the Pavillion) but in the rows furthest from the building
Tents: Soccer Field 2 on the back-side of the facility
Shelter Facility Survey
Shelter Facility Survey 6
Showers
Roll-in showerTransfer stallStall type
Assessment
Adjustments for Accessibility (Identify any adjustments or enhancements that
should be made to make the relevant areas of the facility accessible during a disaster)
Showers available.
At least one accessible shower stall with appropriate grab bars.
Shower seat 17"-19" high. If in transfer stall, seat is on the wall opposite the shower
controls. If in roll-in shower, seat is on wall adjacent to the shower controls.
Hand-held shower spray with ability to mount at 48" (typically via a mount that can be
adjusted along a fixed vertical bar), or alternatively a fixed shower head at 48".
Controls do not require tight grasping, pinching or twisting and are mounted 38"-48" high
and no more than 18" from the front of the shower.
Answer below if showers are available
Facility has at least one accessible entrance and one accessible restroom, and
otherwise is capable of being made accessible during a disaster with minor adjustments.
Facility would require extensive adjustments to be accessible during a disaster.
Relevant areas of the facility are accessible to people with disabilities without
adjustments.
Not provided
Eating areas At least some tables have tops 28"-34" high and space underneath at least 27" high, 30"
wide and 19" deep.
Serving line or counter no higher than 34".
OTHER CONSIDERATIONS
Special conditions or
restrictions for laundry
Isolated care
areas Yes
Laundry
facilities NoYes # of
washers
# of
dryers
Who can access the
laundry facilities
Shelter
residents
Shelter
workers
Additional Facilities & Space
Shelter
area
Type
of area Rooms Separate
facility/area
Shelter
registration area NoYesNo
Available Materials
Cots
available NoYes# of cots Location
LocationBlankets
available NoYes# of
blankets
Notes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
One cot and two blankets per shelter resident is recommended. Note all available materials for shelter use in the notes section.
Chairs & tables
available NoYes# of
chairs
# of
tables
Children's supplies (e.g.
cribs & changing table)NoYes
Rev. 8-15-2011
Cubberly Community Center 53635 2/19/2026
4000 Middlefield Road
Palo Alto Santa Clara CA
25,870
9,800
13,160
9,800
658
245
https://www.cityofpaloalto.org/Departments/
Community-Services/Facility-Rentals/
Community-Centers/CUBB
This site has several long-term tenants, including PAUSD, that occupy most of the rooms. See the facility
map for those spaces that are so occupied and unavailable for use. The main spaces that are available for use in supporting a disaster
are detailed starting on page 7.
37.4165045 -122.1071228 19 feet
Exit highway 101 onto San Antonio Road heading west. Turn right onto Middlefield Road (north). Cubberly
Community Center will be on the left at Montrose Ave.
94303
Rooms H6 and/or L6 with tarps and kennels
Community Services Senior Manager
Recreation Coordinator
L
Chase Hartmann Facilities Manager
aines
3/26/2008
Attached to the NSS Survey fax
Jim Mollerus
Chase Hartmann
Sheltering Coordinator
Facilities Manager
American Red Cross SVC
City of Palo Alto
There are other areas of the facility that are leased by other organizations and these spaces are generally
not available except in extreme emergencies. These spaces have been excluded from this survey write-up. See site map for details.
1
No sprinklers in any of the buildings.
T-2 Office and the Theatre
Nathan Rainey Emergency Services Coordinator
Shelters are a top priority for city building inspectors after a disaster.
15 17
There is no longer a mens shower/locker room on site. Women's showers may be used
for mens during specific time windows or showers arranged for at a local gym. See page 8 for more info on local gyms.
120
3
120
Until Gym A and/or Gym B are returned to service, feeding should be conducted in a dedicated area of the Pavilion.
Pavilion concession room off the lobby has 3 refrigerators that can be used to store perishables.
There is only one accessible shower on
end of the wand. These will need to be installed to make them usable. The women's accessible shower can be used by males during
the premises located in the Women's shower. At the time of the inspection it was missing the control lever and shower head off the
pre-designated male showering times.
0 0
Many Many
GYM B (100' x 56' = 5,600 sqft): Feeding in a max-sized shelter. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no
sprinklers.
GYM A (100' x 56' = 5,600 sqft): Secondary dormitory. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no sprinklers.
(Note: no restrooms inside Gym A or B)
WOMEN'S SHOWERS (located on the back-side of Gym A): 4 sinks, 4 stalls (including 1 accessible stall), 15 showers (including 1 accessible).
MEN'S SHOWERS: removed in 2019.
NOTE ON SHOWERS: a work-around to having only one accessible shower in the women's restroom is to designate male shower times
using the women's showers. Sewer hook-ups for portable showers are in the rear parking lot near Building I and between rooms
G7 and J5. Another option is to use nearby gyms for showers. The best options are the following:
smoke detector, but no sprinklers. Heating, but no A/C.
PAVILLION (102' X 105', 10,710 square feet): Primary dormitory & feeding space. The main hall has no windows. There is a fire alarm &
PAVILLION LOBBY (43' x 18' = 774 square feet): Use for registration area and dormitory access control
PAVILLION MEN'S REST REOOM: 3 sinks, 2 urinals, 3 stalls (including 1 accessible stall)
Palo Alto YMCA (NSS #75765) 3412 Ross Road, Palo Alto, CA 650-856-9622
Oshman Family JCC: 3921 Fabian Way, Palo Alto, CA 650-223-8680
The following spaces are also available, though do require walking through the areas of the campus that house the school. These
spaces should not be used for general dormitory or client services. See the accompanying notes on how they can be used.
Has heating, tile floor, sink, but no A/C.
ROOM H1 (24' x 27' = 648 sq. ft. excluding tiered seating area): use as an isolation room or shelter worker break room.
ROOM H6 (48' x 27' = 1,296 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, tile floor, sink, but no A/C.
ROOM L6 (46' x 27' = 1,242 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, laminated floor, but no A/C.
COT SPACE: 60% 16,310 sq. ft. Dormitory Space = ~9,800 sq. ft. (Note: 40% of Dormitory Space is reserved for isles and doorways)
DORMITORY SPACE: 10,710 sq. ft. Pavilion + 5,600 sq. ft. Gym A = 16,310 sq. ft.
EVACUATION SPACE: 9,800 sf Cot Space + 3,360 sf of Gym B = 13,160 sf (Note: 40% of space is reserved for isles and doorways)
TOTAL SPACE: 10,710 Pavilion + 11,200 Gyms A&B, 774 Pavilion Lobby+ 648 Rm H1 + 1,296 Rm H6 + 1,242 Rm L6 = 25,870 sq. ft.
SUPPORTING OUTDOOR POPULATIONS:
Cars & RV's: South lot (next to the Pavillion) but in the rows furthest from the building
Tents: Soccer Field 2 on the back-side of the facility
Shelter Facility Survey
Shelter Facility Survey 7
Facility Ownership & Proximity Considerations
Does the entity that plans to manage the shelter own the building?
If no, is there a current written plan?NoYes
Is this facility within five miles of an evacuation route?
Is this facility within ten miles of a nuclear power plant?
Groups Associated with the Facility & Training
Facility staff required when using facility?
Paid feeding staff required when using facility?
Church auxiliary required when using facility?
Fire auxiliary required when using facility?
Other required?
Will any of the above groups be trained or experienced in Red Cross shelter operations or support?
If yes, describe
capabilities
Has the facility been trained in Red Cross sheltering (if not Red Cross managed)?
If yes, describe
capabilities
Training requested by facility or group
ADDITIONAL NOTES & INFORMATION
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
Other
# of staff to be trained
Rev. 8-15-2011
Cubberly Community Center 53635 2/19/2026
4000 Middlefield Road
Palo Alto Santa Clara CA
25,870
9,800
13,160
9,800
658
245
https://www.cityofpaloalto.org/Departments/
Community-Services/Facility-Rentals/
Community-Centers/CUBB
This site has several long-term tenants, including PAUSD, that occupy most of the rooms. See the facility
map for those spaces that are so occupied and unavailable for use. The main spaces that are available for use in supporting a disaster
are detailed starting on page 7.
37.4165045 -122.1071228 19 feet
Exit highway 101 onto San Antonio Road heading west. Turn right onto Middlefield Road (north). Cubberly
Community Center will be on the left at Montrose Ave.
94303
Rooms H6 and/or L6 with tarps and kennels
Community Services Senior Manager
Recreation Coordinator
L
Chase Hartmann Facilities Manager
aines
3/26/2008
Attached to the NSS Survey fax
Jim Mollerus
Chase Hartmann
Sheltering Coordinator
Facilities Manager
American Red Cross SVC
City of Palo Alto
There are other areas of the facility that are leased by other organizations and these spaces are generally
not available except in extreme emergencies. These spaces have been excluded from this survey write-up. See site map for details.
1
No sprinklers in any of the buildings.
T-2 Office and the Theatre
Nathan Rainey Emergency Services Coordinator
Shelters are a top priority for city building inspectors after a disaster.
15 17
There is no longer a mens shower/locker room on site. Women's showers may be used
for mens during specific time windows or showers arranged for at a local gym. See page 8 for more info on local gyms.
120
3
120
Until Gym A and/or Gym B are returned to service, feeding should be conducted in a dedicated area of the Pavilion.
Pavilion concession room off the lobby has 3 refrigerators that can be used to store perishables.
There is only one accessible shower on
end of the wand. These will need to be installed to make them usable. The women's accessible shower can be used by males during
the premises located in the Women's shower. At the time of the inspection it was missing the control lever and shower head off the
pre-designated male showering times.
0 0
Many Many
GYM B (100' x 56' = 5,600 sqft): Feeding in a max-sized shelter. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no
sprinklers.
GYM A (100' x 56' = 5,600 sqft): Secondary dormitory. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no sprinklers.
(Note: no restrooms inside Gym A or B)
WOMEN'S SHOWERS (located on the back-side of Gym A): 4 sinks, 4 stalls (including 1 accessible stall), 15 showers (including 1 accessible).
MEN'S SHOWERS: removed in 2019.
NOTE ON SHOWERS: a work-around to having only one accessible shower in the women's restroom is to designate male shower times
using the women's showers. Sewer hook-ups for portable showers are in the rear parking lot near Building I and between rooms
G7 and J5. Another option is to use nearby gyms for showers. The best options are the following:
smoke detector, but no sprinklers. Heating, but no A/C.
PAVILLION (102' X 105', 10,710 square feet): Primary dormitory & feeding space. The main hall has no windows. There is a fire alarm &
PAVILLION LOBBY (43' x 18' = 774 square feet): Use for registration area and dormitory access control
PAVILLION MEN'S REST REOOM: 3 sinks, 2 urinals, 3 stalls (including 1 accessible stall)
Palo Alto YMCA (NSS #75765) 3412 Ross Road, Palo Alto, CA 650-856-9622
Oshman Family JCC: 3921 Fabian Way, Palo Alto, CA 650-223-8680
The following spaces are also available, though do require walking through the areas of the campus that house the school. These
spaces should not be used for general dormitory or client services. See the accompanying notes on how they can be used.
Has heating, tile floor, sink, but no A/C.
ROOM H1 (24' x 27' = 648 sq. ft. excluding tiered seating area): use as an isolation room or shelter worker break room.
ROOM H6 (48' x 27' = 1,296 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, tile floor, sink, but no A/C.
ROOM L6 (46' x 27' = 1,242 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, laminated floor, but no A/C.
COT SPACE: 60% 16,310 sq. ft. Dormitory Space = ~9,800 sq. ft. (Note: 40% of Dormitory Space is reserved for isles and doorways)
DORMITORY SPACE: 10,710 sq. ft. Pavilion + 5,600 sq. ft. Gym A = 16,310 sq. ft.
EVACUATION SPACE: 9,800 sf Cot Space + 3,360 sf of Gym B = 13,160 sf (Note: 40% of space is reserved for isles and doorways)
TOTAL SPACE: 10,710 Pavilion + 11,200 Gyms A&B, 774 Pavilion Lobby+ 648 Rm H1 + 1,296 Rm H6 + 1,242 Rm L6 = 25,870 sq. ft.
SUPPORTING OUTDOOR POPULATIONS:
Cars & RV's: South lot (next to the Pavillion) but in the rows furthest from the building
Tents: Soccer Field 2 on the back-side of the facility
Shelter Facility Survey
Shelter Facility Survey 8
Chapter Category / Priority of Use: Designated by chapter leadership after the survey is completed.
OFFICE USE ONLY (Do not fill out box during survey)
This is a primary shelter for
(check one)
Evacuation
Center
General
population
Shelter cannot be used for
(check all that apply)
Evacuation
Center
General
population
This is a priority shelter for the
following events (check all that apply)EarthquakeHurricane Large Scale Fire / Flood /
ADDITIONAL NOTES & INFORMATION, continued
Rev. 8-15-2011
Cubberly Community Center 53635 2/19/2026
4000 Middlefield Road
Palo Alto Santa Clara CA
25,870
9,800
13,160
9,800
658
245
https://www.cityofpaloalto.org/Departments/
Community-Services/Facility-Rentals/
Community-Centers/CUBB
This site has several long-term tenants, including PAUSD, that occupy most of the rooms. See the facility
map for those spaces that are so occupied and unavailable for use. The main spaces that are available for use in supporting a disaster
are detailed starting on page 7.
37.4165045 -122.1071228 19 feet
Exit highway 101 onto San Antonio Road heading west. Turn right onto Middlefield Road (north). Cubberly
Community Center will be on the left at Montrose Ave.
94303
Rooms H6 and/or L6 with tarps and kennels
Community Services Senior Manager
Recreation Coordinator
L
Chase Hartmann Facilities Manager
aines
3/26/2008
Attached to the NSS Survey fax
Jim Mollerus
Chase Hartmann
Sheltering Coordinator
Facilities Manager
American Red Cross SVC
City of Palo Alto
There are other areas of the facility that are leased by other organizations and these spaces are generally
not available except in extreme emergencies. These spaces have been excluded from this survey write-up. See site map for details.
1
No sprinklers in any of the buildings.
T-2 Office and the Theatre
Nathan Rainey Emergency Services Coordinator
Shelters are a top priority for city building inspectors after a disaster.
15 17
There is no longer a mens shower/locker room on site. Women's showers may be used
for mens during specific time windows or showers arranged for at a local gym. See page 8 for more info on local gyms.
120
3
120
Until Gym A and/or Gym B are returned to service, feeding should be conducted in a dedicated area of the Pavilion.
Pavilion concession room off the lobby has 3 refrigerators that can be used to store perishables.
There is only one accessible shower on
end of the wand. These will need to be installed to make them usable. The women's accessible shower can be used by males during
the premises located in the Women's shower. At the time of the inspection it was missing the control lever and shower head off the
pre-designated male showering times.
0 0
Many Many
GYM B (100' x 56' = 5,600 sqft): Feeding in a max-sized shelter. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no
sprinklers.
GYM A (100' x 56' = 5,600 sqft): Secondary dormitory. Wood floors need to be tarped. No heat or A/C. Fire extinguisher, no sprinklers.
(Note: no restrooms inside Gym A or B)
WOMEN'S SHOWERS (located on the back-side of Gym A): 4 sinks, 4 stalls (including 1 accessible stall), 15 showers (including 1 accessible).
MEN'S SHOWERS: removed in 2019.
NOTE ON SHOWERS: a work-around to having only one accessible shower in the women's restroom is to designate male shower times
using the women's showers. Sewer hook-ups for portable showers are in the rear parking lot near Building I and between rooms
G7 and J5. Another option is to use nearby gyms for showers. The best options are the following:
smoke detector, but no sprinklers. Heating, but no A/C.
PAVILLION (102' X 105', 10,710 square feet): Primary dormitory & feeding space. The main hall has no windows. There is a fire alarm &
PAVILLION LOBBY (43' x 18' = 774 square feet): Use for registration area and dormitory access control
PAVILLION MEN'S REST REOOM: 3 sinks, 2 urinals, 3 stalls (including 1 accessible stall)
Palo Alto YMCA (NSS #75765) 3412 Ross Road, Palo Alto, CA 650-856-9622
Oshman Family JCC: 3921 Fabian Way, Palo Alto, CA 650-223-8680
The following spaces are also available, though do require walking through the areas of the campus that house the school. These
spaces should not be used for general dormitory or client services. See the accompanying notes on how they can be used.
Has heating, tile floor, sink, but no A/C.
ROOM H1 (24' x 27' = 648 sq. ft. excluding tiered seating area): use as an isolation room or shelter worker break room.
ROOM H6 (48' x 27' = 1,296 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, tile floor, sink, but no A/C.
ROOM L6 (46' x 27' = 1,242 sq. ft.): use as a co-located pet shelter or isolation room. Has heating, laminated floor, but no A/C.
COT SPACE: 60% 16,310 sq. ft. Dormitory Space = ~9,800 sq. ft. (Note: 40% of Dormitory Space is reserved for isles and doorways)
DORMITORY SPACE: 10,710 sq. ft. Pavilion + 5,600 sq. ft. Gym A = 16,310 sq. ft.
EVACUATION SPACE: 9,800 sf Cot Space + 3,360 sf of Gym B = 13,160 sf (Note: 40% of space is reserved for isles and doorways)
TOTAL SPACE: 10,710 Pavilion + 11,200 Gyms A&B, 774 Pavilion Lobby+ 648 Rm H1 + 1,296 Rm H6 + 1,242 Rm L6 = 25,870 sq. ft.
SUPPORTING OUTDOOR POPULATIONS:
Cars & RV's: South lot (next to the Pavillion) but in the rows furthest from the building
Tents: Soccer Field 2 on the back-side of the facility
G5
PAUSD
O ce Hours: Monday - Thursday 8:30am to 5:30pm
with
tables
Without
tables
D-6, D-7, E-5 Classroom 36 45 23'x30'700 10 20 Carpet ✓ ✓UP, E-5 has a counter with
sink
P-2 Classroom 18 26 19x21 400 7 20 UP Carpet ✓ ✓UP, Counter with sink
U-7 Activity Room 40 67 32x36 1150 20 60 UP Tile ✓UP, Counter with sink
H-1 Lecture Room 40 125 40x48 1900 15 136 UP Carpet ✓ ✓ ✓UP, Counter, with sink, TS,
Upright Piano
H-6 Activity Room 75 100 30x48 1400 19 60 M Tile ✓ ✓ ✓M, Counter with sink,
Microwave
L-6 Dance Studio 35 35x47 1650 1 10 M Marley ✓ ✓Portable Dance Bars
Gym A Gynasium 100 345 55x100 5500 2 20 M Wood ✓Bleachers
Gym B Gynasium 130 450 72x100 7200 3 30 M Wood ✓Bleachers
Pavilion Gynasium 770 1600 108x180 11700 13 240 M Wood ✓Bleachers
Theater 317 28x35 1000 8 317 FS Wood ✓ ✓
M- metal chairs TS- tiered seating UP- upholstered chairs FS- fixed seating OC- orchestra chairs
Room Ta
b
l
e
s
Ch
a
i
r
s
Floor
Type Wh
i
t
e
b
o
a
r
d
Wi
-
F
i
Mi
r
r
o
r
s
Sc
r
e
e
n
Cubberley Community Center
Capacity
Room Type Di
m
e
n
s
i
o
n
s
Sq
u
a
r
e
F
o
o
t
a
g
e
Room Rental Amenities
To Be Used by Red Cross Surveyor
MC Red Cross On-Site Shelter Survey Form V.1.0 2024-08-26
Red Cross On-Site Shelter Survey Form
The Red Cross surveyor records the information on this form. (Instructions and definitions below form.)
Site Name: Address:
Red Cross representative: Red Cross contact info:
Person completing form: Date completed:
Check and describe all modifications that may be required to use this site as a shelter. Refer to the last
page for definitions.
☐Accessible Parking 1 ☐Accessible Sidewalk or Walkway 2
☐Accessible Entrance 3 ☐Accessible Route to Service Areas 4
☐Accessible Toilets 5 ☐Distraction Reduced Area 6
☐Accessible Sinks 7 ☐Accessible Shower Facilities 8
☐Power Supply Access 9
Other Needs and Details:
☐Refrigeration 10
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name 11: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge 12 ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
Mitchell Park Community Center 3700 Middlefield Rd. Palo Alto, CA
Jim Mollerus
Jim Mollerus Feb. 19, 2026
n
n
n
Modern facility with heat & A/C throughout. No showers on site.
El Palo Alto West 50'32' 1,600
4 men & 7 women (11 tot)1M & 1 W (2 tot)
0 0
2M & 2 W (4 tot)1M & 1W (2 tot)
To Be Used by Red Cross Surveyor
MC Red Cross On-Site Shelter Survey Form V.1.0 2024-08-26
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
Please print additional pages for each area being surveyed.
n
n
n
n
El Palo Alto East & Kitchen 50 32 1,548
0 0
0 0
1 1
Matadero 37 21 777
0 0
0 0
2 1
To Be Used by Red Cross Surveyor
MC Red Cross On-Site Shelter Survey Form V.1.0 2024-08-26
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
Please print additional pages for each area being surveyed.
n
n
n
n
n
Oak 45 23 1,035
1 0
0 0
1 1
Teen Center 45 32 1,440
0 0
0 0
0 0
To Be Used by Red Cross Surveyor
MC Red Cross On-Site Shelter Survey Form V.1.0 2024-08-26
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
Please print additional pages for each area being surveyed.
n
n
Adobe North and South 43 36 1,548
0 0
0 0
1 1
0
To Be Used by Red Cross Surveyor
MC Red Cross On-Site Shelter Survey Form V.1.0 2024-08-26
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
Please print additional pages for each area being surveyed.
To Be Used by Red Cross Surveyor
MC Red Cross On-Site Shelter Survey Form V.1.0 2024-08-26
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
Please print additional pages for each area being surveyed.
0
To Be Used by Red Cross Surveyor
MC Red Cross On-Site Shelter Survey Form V.1.0 2024-08-26
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
AREA INFORMATION:
Most facilities have multiple, separate spaces available that can be used. Record details about each area.
Area Name: Length: Width: Sq Ft of Area:
Intended Uses: ☐ Dormitory ☐ Feeding ☐ Safest Refuge ☐ Reception ☐ Client Meeting Areas ☐ Pet Shelter
☐Administration/Storage ☐ Client Isolation Area
Windows in the Area: ☐ Y ☐ N Long or Open Roof Spans in Dormitory: ☐ Y ☐ N
If any of the items below are accessible to multiple areas, please split them up amongst the areas.
Total Number of toilets: Number of Accessible toilets:
Total Number of showers: Number of Accessible showers:
Total Number of bathroom sinks: Number of Accessible bathroom sinks:
Please print additional pages for each area being surveyed.
To Be Used by Red Cross Surveyor
MC Red Cross On-Site Shelter Survey Form V.1.0 2024-06
INSTRUCTIONS
This PDF form provides a paper-based method for the Red Cross to capture necessary shelter survey information
when not making direct electronic entry into the National Shelter System (NSS). Once information is recorded on this
worksheet, a qualified Red Cross worker enters it into the National Shelter System.
Use this form in conjunction with the Shelter Facility Owner Pre-Survey Form, completed by the facility owner or their
representative prior to Red Cross scheduling the survey.
The identified Red Cross relationship manager may send the Shelter Facility Owner Pre-Survey Form to the facility
owner or their representative by email with the below language:
Subject: Red Cross shelter survey
Body: <Greetings>
Thank you for agreeing to have your site identified as a potential disaster shelter. Included with this email is a
fillable PDF that Red Cross would like for you to fill out. Once completed, please email it back to <insert
name and email address of Red Cross POC>. Our team will review the information and then schedule a time
for Red Cross to visit in-person and collect additional information and photographs. Either myself or one of
my colleagues will be contacting you to schedule a time for us to complete the survey. All of these details will
then be recorded in the National Shelter System which disaster managers use when considering potential
shelters and their suitability for particular emergencies. When a disaster occurs and your ownership is
supportive of the Red Cross using your facility, we will work with your representative to complete a facility
use agreement and opening inspection form.
<Insert the language in this paragraph when the facility may serve as a hurricane evacuation shelter
or delete this section if the site will never be considered during a hurricane evacuation.> As the facility
may be opened to serve clients during hurricane evacuations, we would like for you to advise if the site has
hurricane safe windows and if the facility has a wind load certification. You can include those details in the
email when you return the completed PDF.>
I look forward to answering any questions you have or that arise as you complete this form.
Thank you,
<Name>
<Signature Line>
When completing the shelter survey and site visit, photographs, diagrams and floor plans of various entrances and
areas of the shelter may be captured and uploaded into the NSS.
Refer to the final page for definitions and explanation associated with the survey form.
Contact sheltering@redcross.org with any questions.
To Be Used by Red Cross Surveyor
MC Red Cross On-Site Shelter Survey Form V.1.0 2024-08-26
DEFINITIONS
1 Accessible Parking - The parking space surface appears level and is marked with an accessibility symbol. It is
adjacent to an accessible walkway, is at least 96-inches wide and there is at least 98-inches of overhead clearance.
2 Accessible Sidewalk or Walkway - At least 36-inches wide, level surface without hazards on the route or overhead
that does not require any steps or curb to the walkway.
3 Accessible Entrance - Entrance connected to an accessible route with a 32-inch-wide passage when the door is
open. Door hardware is usable with one hand (lever, pull).
4 Accessible Route to Service Areas - Hallways and corridors at least 36-inches wide with level surface, and no
hazards on the route or overhead to all service areas. Elevator access is available when above and below ground.
5 Accessible Toilets - Accessible entrance to the toilet area. The stall must be at least 60-inch wide and 59-inch deep
with a door that swings out from the stall, grab bars, and toilet seat 17 to 19 inches above the floor.
6 Distraction Reduced Area - Separate area from main sleeping and service areas with space for physical distancing
and low lighting.
7 Accessible Sinks - Sinks and countertops no more than 34-inches above the floor, with mirrors no more than 40
inches above the floor. There must be an open space below the sink for knee clearance at least 27-inches high and
8-inches deep
8 Accessible Shower Facilities - Entrance to shower allows roll-in, is at least 30-inches wide and 60-inches deep, with
grab bars and a seat.
9 Power Supply Access Area - Backup source of power is available for clients with life-saving equipment.
10 Refrigeration - Facility has refrigerator available to store life-saving medication for clients.
11 Area Name – The surveyor should record the name used by the facility (i.e.: East Gymnasium, Cafeteria Hall,
Conference Room 3, etc.)
12 Safest Refuge Area – The designated safest area for the population to take temporary refuge during external
threats such as gale force winds or tornado. Identify an interior, enclosed hallway or room which does not have
windows or a wide roof span.
Item No. 3. Page 1 of 1
9
6
6
0
City Council
Supplemental Report
From: Ken Dueker, Director Office of Emergency Services
Meeting Date: March 23, 2026
Item Number: 3
Report #:2603-6155
TITLE
Approval of a Facility Agreement and Pet Addendum between the City of Palo Alto and the
American Red Cross for the use of designated city facilities during disasters. CEQA Status – Not
a Project
BACKGROUND
This supplemental memo transmits a reformatted version of the staff report Attachment C
originally published with formatting errors. The revisions are limited to formatting only and do
not affect the content.
ATTACHMENTS
Attachment C: Red Cross Shelter Survey for Cubberley Community Center – corrected format
APPROVED BY:
Ken Dueker, Director Office of Emergency Services
Shelter Facility Survey
BASIC SHELTER INFORMATION
Red
Cross
Site Name/
School District NSS ID#Date
Building #Name of
building of
Shelter address
Town/
City
County/
Parish State
Mailing Address
(if different)
FEMA DHS TSA SBC
Red Cross
managed
Red Cross
partner
Red Cross
supported Independent
Evacuation General Medical
Shelter Capacity (See Surveyor Instructions #1)
Total sq feet
Sq feet usable for
sleeping space
Other
Other
Evacuation
Post Impact
Other
usable sq ft ÷ 20 sq ft/person =
usable sq ft ÷ 40 sq ft/person =
usable sq ft ÷ sq ft/person =
person capacity
person capacity
person capacity
Shelter Capacity
Phone #WebsiteFax #
Shelter Facility Survey 1
General facility notes
Agency operating shelter
(check one)
Shelter agency type
(check one)
Shelter type (check all that apply)
Geographic Information
Latitude Longitude Elevation
Use major landmarks (e.g. highways, intersections, rivers, railroad crossings, etc.) that will be easily recognizable in a disaster.
Latitude and longitude coordinates can be found at online web sites, using a global positioning system device, or will auto
populate when the address is entered into the National Shelter System.
No NoYes Hurricane category or
evacuation areaYesIn storm surge/
evacuation
In flood
plain
year flood
impact
Directions to facility
Zip
Code
Town/
City
County/
Parish State Zip
Code
Use the calculations to calculate the capacity for sleeping space.
Rev. 8-15-2011
Shelter Facility Survey
Shelter Facility Survey 2
Pet Shelter
No nearest locationanswer questions below
No NoCement or tile
floors with drains NoOutdoor space
to relieve pets
Agency that will
operate the pet shelter 24 hour #
Contact notes
Alternate Point of Contact
Name Title
24 hour #EmailFax #
Alternate Point of Contact
Point of Contact to Open Facility
Name Title
24 hour #Email
Contact notes
Fax #
Yes
Yes Yes Yes
Pet shelter space
available on site
Separate
ventilation system
Point of Contact to Authorize Use of Facility
Name Title Phone #
24 hour #Email
Contact notes
Fax #
ADDITIONAL INFORMATION
No Date signed Notes
NoPre-designated shelter
team assigned Team name
NoCurrent facility floor
plans available Location of copies
Yes
Yes
Yes
Shelter agreement
signed
NoYesInternational Association of Venue Managers (IAVM) facility
NoYesShelter can be a hurricane evacuation shelter Notes
Phone #
Phone #
Phone #
Use the Standards for Selection of Hurricane Evacuation Shelters to select hurricane evacuation shelters. In this document, you
will find a planning process that involves many factors (e.g. technical information for storm surge and flood mapping). This
process requires close coordination with local officials for information to make decisions about hurricane shelter
suitability. Use the Facility Construction section to assist with determining whether this can be a hurricane evacuation shelter.
Rev. 8-15-2011
Survey Conductors (List all who participated in the survey)
Name Title Organization Phone #
Shelter Facility Survey 3
LIMITATIONS OF FACILITY USE
Check one This facility will be available for
use at any time during the year
This facility is only available for use
during the time periods listed below
This facility is not available for use
during the time periods listed below
Dates (mm/dd/yyyy)Times (hh:mm)
From AM PM
AM PM
Dates (mm/dd/yyyy)Times (hh:mm)
AM PM
AM PM
From
ToTo
List any recurring dates that the facility
is not available (e.g. every sunday)
Areas of the facility that
are restricted during use
Shelter Facility Survey
FACILITY CONSTRUCTION & SAFETY
Facility Construction
Wood Construction
material
Masonry/Brick Pre-fab Bungalow Concrete Metal Trailer Pod
# stories/
floors Notes
NotesNoElevatorLocationYes
NoOpen roof-spans (see Standards for Selection of
Hurricane Evacuation Shelters for current standards) LengthYes
NoWindows in
sleep area Yes NoIf yes, shatter
protected Yes NoIf yes, protected
with shutter Yes
Other
Fire & AED Safety
Fire alarms & systems
(check all that apply)
Working smoke
detectors
Inspected fire
alarm system
Functional
sprinkler system
Functional direct fire
department alert
Comments from
fire department
AED(s) on site NoYesLocation
Some facilities may not meet fire codes based on building capacity. The questions below are a general reference. Contact your
local fire department with questions or for more information.
Rev. 8-15-2011
Shelter Facility Survey
Shelter Facility Survey 4
Facility Inspection Point of Contact
If requested, who would inspect this facility post-impact to determine it is safe to occupy?
Name Title
24 hour #Email
Contact notes
Fax #
Sanitation, Utilities & Power
SANITATION, FEEDING & UTILITIES
Natural
GasHeating Electric Propane Fuel
Oil
Natural
GasCoolingElectric Propane
NoShowers available # of showersYes NoToilets available Yes # of toilets
NoSelf-sufficient power Yes Type
Emergency
generator on site NoYes Notes
Check all that apply
Check all that apply Natural GasCooking Electric Propane Well(s)Water Municipal Trapped
Total estimated seating
capacity for eating
Feeding
Food Prep (check all that apply)Warming oven kitchen Full service Central kitchen (delivery)
Food stock
stored on site NoRefrigeration
units on site YesNoYes# meal can
be served # units
Seating
capacity Cafeteria Snack
Bar
Other indoor
seating
Notes on
feeding
Phone #
ACCESSIBILITY
Facility
Construction
Facility built in 1993 or later, or extensively altered in 1992 or later.
Parking Areas
NoAccessible parking
space(s)Yes
Parking available.
Notes
NoVan accessible
parking space(s)Yes Notes
See accompanying Shelter Facility Survey-Accessibility Instructions.
Answer below if parking is available
Drop-off/
Loading Area
Permanent drop-off area/loading zone with marked access aisle or space available to
designate as temporary drop-off area/loading zone.
NoYes
Yes No
NoYes
The recommended ratio for toilet facilities is a minimum of 1 toilet for 20 people. The optimum scenario for showers is 1 shower
for every 25 residents. Count all facilities that will be available to shelter residents and staff.
Note fuel requirements, generator capacity, facility areas supported by generator(s), and other relevant information.
Rev. 8-15-2011
Shelter Facility Survey
Shelter Facility Survey 5
Facility
Entrance
Routes to
Service
Delivery Areas
Sidewalk connects parking area and any drop-off area to at least one facility entrance.
Route from accessible parking spaces and any drop-off area/loading zone to at least one
facility entrance has no steps or curbs without curb cuts.
Where route crosses curb, curb cuts are at least 36” wide.
Automatic doors or doors without knob hardware.
Doorways at least 32” wide when door is open.
Using a yard stick held horizontally at your waist level, walk from the facility entrance to
each service delivery area, as well as restrooms and showers. Except at doorways
(which must be only 32” wide), no part of the route is less than 36” wide.
Level landings on interior and exterior sides of entry door.
No objects protrude from the side more than four inches into the route to the facility
entrance.
No objects protrude from the side more than 4” into the routes to the various service
delivery areas.
If the main facility entrance does not appear to be accessible, another entry is
accessible.
A sign identifies the location of the accessible entrance.
A route without steps is available to access each service delivery area, as well as
restrooms and showers or service can be provided in area that can be accessed by
route with no steps.
Automatic doors or doors without knob hardware.
Route has vertical clearance of at least 80”.
Doorways at least 32” wide when door is open along routes to each service.
If a service delivery area is accessible only by elevator, there is back-up power for the
elevator(s).
Ramps
If yes, type of ramp
Ramps are at least 36” wide, have handrails on both sides 34”-38” above the ramp
surface, and have level landings at least 60” long.
If ramps are longer than 30 feet, a level landing at least 60" long is provided every 30
feet.
Fixed Portable Not provided
Restrooms
Toilet seat is 17"-19" high. Flush control is automatic or manual control on the open side
of the toilet and no higher than 48".
Space at least 9" high is provided beneath the front and one side of the stall.
Stall at least 60" wide and 56" deep (wall-mounted toilet) or 59" deep for (floor mounted
toilet).
Toilet's centerline is 16"-18" from the nearest side wall.
Area where person in a wheelchair can turn around (60-inch diameter circle or T-shape
turn area).
Doorways at least 32" wide when door is open.
Doors without knob hardware.
Appropriate grab bars.
Toilet paper dispenser is within 36" of the rear wall.
At least one accessible sink.
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
Yes No
NoYes
NoYes
NoYes
NoYes
Rev. 8-15-2011
Shelter Facility Survey
Shelter Facility Survey 6
Showers
Roll-in showerTransfer stallStall type
Assessment
Adjustments for Accessibility (Identify any adjustments or enhancements that
should be made to make the relevant areas of the facility accessible during a disaster)
Showers available.
At least one accessible shower stall with appropriate grab bars.
Shower seat 17"-19" high. If in transfer stall, seat is on the wall opposite the shower
controls. If in roll-in shower, seat is on wall adjacent to the shower controls.
Hand-held shower spray with ability to mount at 48" (typically via a mount that can be
adjusted along a fixed vertical bar), or alternatively a fixed shower head at 48".
Controls do not require tight grasping, pinching or twisting and are mounted 38"-48" high
and no more than 18" from the front of the shower.
Answer below if showers are available
Facility has at least one accessible entrance and one accessible restroom, and
otherwise is capable of being made accessible during a disaster with minor adjustments.
Facility would require extensive adjustments to be accessible during a disaster.
Relevant areas of the facility are accessible to people with disabilities without
adjustments.
Not provided
Eating areas At least some tables have tops 28"-34" high and space underneath at least 27" high, 30"
wide and 19" deep.
Serving line or counter no higher than 34".
OTHER CONSIDERATIONS
Special conditions or
restrictions for laundry
Isolated care
areas Yes
Laundry
facilities NoYes # of
washers
# of
dryers
Who can access the
laundry facilities
Shelter
residents
Shelter
workers
Additional Facilities & Space
Shelter
area
Type
of area Rooms Separate
facility/area
Shelter
area NoYesNo
Available Materials
Cots
available NoYes# of cots Location
LocationBlankets
available NoYes# of
blankets
Notes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
One cot and two blankets per shelter resident is recommended. Note all available materials for shelter use in the notes section.
Chairs & tables
available NoYes# of
chairs
# of
tables
Children's supplies (e.g.
cribs & changing table)NoYes
Rev. 8-15-2011
Shelter Facility Survey
Shelter Facility Survey 7
Facility Ownership & Proximity Considerations
Does the entity that plans to manage the shelter own the building?
If no, is there a current written plan?NoYes
Is this facility within five miles of an evacuation route?
Is this facility within ten miles of a nuclear power plant?
Groups Associated with the Facility & Training
Facility staff required when using facility?
Paid feeding staff required when using facility?
Church auxiliary required when using facility?
Fire auxiliary required when using facility?
Other required?
Will any of the above groups be trained or experienced in Red Cross shelter operations or support?
If yes, describe
capabilities
Has the facility been trained in Red Cross sheltering (if not Red Cross managed)?
If yes, describe
capabilities
Training requested by facility or group
ADDITIONAL NOTES & INFORMATION
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
Other
# of staff to be trained
Rev. 8-15-2011
Shelter Facility Survey
Shelter Facility Survey 8
Chapter Category / Priority of Use: Designated by chapter leadership after the survey is completed.
OFFICE USE ONLY (Do not fill out box during survey)
This is a primary shelter for
(check one)
Evacuation
Center
General
population
Shelter cannot be used for
(check all that apply)
Evacuation
Center
General
population
This is a priority shelter for the
following events (check all that apply)EarthquakeHurricane Large Scale Fire / Flood /
ADDITIONAL NOTES & INFORMATION, continued
Rev. 8-15-2011