PEMERINTAH KOTA DEPOK

DINAS KESEHATAN
UPTD PUSKESMAS KALIMULYA
Jl. Kampung Jati RT 004 RW 004 Kel. Jatimulya, Kec.Cilodong Kota Depok 16413
Telp. ( 021 ) 8763354 email: pkmkalimulya01@gmail.com

HAZARD AND VULNERABILITY ASSESSMENT TOOL

NATURALLY OCCURRING EVENTS
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
EVENT IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE

Time, Community/
Likelihood this will Possibility of Physical losses Interuption of Relative
Preplanning effectivness, Mutual Aid staff
occur death or injury and damages services threat*
resouces and supplies

0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A

1 = Low 1 = Low 1 = Low 1 = Low 1 = High 1 = High 1 = High
SCORE
2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate
0 - 100%
3 = High 3 = High 3 = High 3 = High 3 = Low or none 3 = Low or none 3 = Low or none

ANGIN TOPAN 1 2 1 1 3 3 3 24%

GUNTUR YG
2 1 2 0 0 0 0 11%
PARAH
BANJIR
1 1 2 2 3 1 3 22%
EKSTERNAL
GEMPA BUMI 2 3 3 3 2 2 1 52%

KEBAKARAN
1 3 3 3 2 2 1 26%
EKSTERNAL

CUACA
1 1 1 1 2 1 2 15%
EKSTREM
WABAH 1 3 1 1 2 1 2 19%
AVERAGE
1,14 1,57 1,71 1,43 1,71 1,29 1,43 25%
SCORE
*Threat increases with percentage.
8 RISK = PROBABILITY * SEVERITY
64 0,25 0,43 0,59

Mengetahui, Depok,
Kepala UPTD Puskesmas Kalimulya Penanggung Jawab MFK

drg.Agustina Ika Damayanti Fiani Nurbaeti,Amd.K.L

NIP.197908312010012005 NIP.199702082020122010

Natural Hazards : 1.4.4 ep a HVA

 PEMERINTAH KOTA DEPOK
DINAS KESEHATAN
UPTD PUSKESMAS KALIMULYA
Jl. Kampung Jati RT 004 RW 004 Kel. Jatimulya, Kec.Cilodong Kota Depok 16413
Telp. ( 021 ) 8763354 email: pkmkalimulya01@gmail.com

HAZARD AND VULNERABILITY ASSESSMENT TOOL

TECHNOLOGIC EVENTS
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY INTERNAL RISK
HUMAN PROPERTY BUSINESS PREPARED- EXTERNAL
RESPONS
EVENT IMPACT IMPACT IMPACT NESS RESPONSE
E
Time, Community/
Likelihood this Possibility of Physical losses Interuption of Relative
Preplanning effectivness, Mutual Aid staff
will occur death or injury and damages services threat*
resouces and supplies
0 = N/A
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = High
1 = Low 1 = Low 1 = Low 1 = Low 1 = High 1 = High 0-
SCORE 2 = Moderate
2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 100%
3 = Low or
3 = High 3 = High 3 = High 3 = High 3 = Low or none 3 = Low or none
none

GAGAL LISTRIK 2 1 2 3 2 1 1 37%

GAGAL AIR 1 1 1 2 1 1 1 13%

GAGAL
PEMBUANGAN 0 0 0 3 0 2 1 0%
LIMBAH PADAT

GAGAL
PEMBUANGAN 3 1 1 1 1 1 3 44%
LIMBAH CAIR

GAGAL
1 1 1 1 1 2 1 13%
KOMUNIKASI

GAGAL GAS
0 1 1 1 1 1 1 0%
MEDIS

GAGAL SISTEM
1 1 1 1 1 1 1 11%
INFORMASI

KEBAKARAN
3 1 1 1 3 1 3 56%
INTERNAL

KERUSAKAN
1 1 1 1 1 1 1 11%
STRUKTUR

AVERAGE
1,33 0,89 1,00 1,56 1,22 1,22 1,44 18%
SCORE
*Threat increases with percentage.
12 RISK = PROBABILITY * SEVERITY
66 0,18 0,44 0,41

Mengetahui, Depok,
Kepala UPTD Puskesmas Kalimulya Penanggung Jawab MFK

drg.Agustina Ika Damayanti Fiani Nurbaeti,Amd.K.L

NIP.197908312010012005 NIP.199702082020122010

Technological Hazards : 1.4.4 ep a HVA

 PEMERINTAH KOTA DEPOK
DINAS KESEHATAN
UPTD PUSKESMAS KALIMULYA
Jl. Kampung Jati RT 004 RW 004 Kel. Jatimulya, Kec.Cilodong Kota Depok 16413
Telp. ( 021 ) 8763354 email: pkmkalimulya01@gmail.com

HAZARD AND VULNERABILITY ASSESSMENT TOOL

HUMAN RELATED EVENTS

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILIT HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
Y
EVENT IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE

Time, Community/
Likelihood this Possibility of Physical losses Interuption of Relative
Preplanning effectivness, Mutual Aid staff
will occur death or injury and damages services threat*
resouces and supplies

0 = N/A
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = High
1 = Low 1 = Low 1 = Low 1 = Low 1 = High 1 = High 0-
SCORE 2 = Moderate
2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 100%
3 = Low or
3 = High 3 = High 3 = High 3 = High 3 = Low or none 3 = Low or none
none

INSIDEN
KORBAN
0 1 1 2 1 1 0 0%
MASSAL
(TRAUMA)

INSIDEN
KORBAN
MASSAL 0 1 1 2 1 1 0 0%
(MEDIS/INFEKSI
US)

AKSI
0 1 2 2 1 1 0 0%
DEMONSTRASI

TAWURAN
0 1 2 2 1 1 0 0%
MASSAL

KOMPLAIN
2 1 1 1 1 3 0 26%
PELAYANAN

AVERAGE 0,40 1,00 1,40 1,80 1,00 1,40 0,00 5%

*Threat increases with percentage.

2 RISK = PROBABILITY * SEVERITY
33 0,05 0,13 0,37
Mengetahui, Depok,
Kepala UPTD Puskesmas Kalimulya Penanggung Jawab MFK

drg.Agustina Ika Damayanti Fiani Nurbaeti,Amd.K.L

NIP.197908312010012005 NIP.199702082020122010

Human Hazards : 1.4.4 ep a HVA

 PEMERINTAH KOTA DEPOK
DINAS KESEHATAN
UPTD PUSKESMAS KALIMULYA
Jl. Kampung Jati RT 004 RW 004 Kel. Jatimulya, Kec.Cilodong Kota Depok 16413
Telp. ( 021 ) 8763354 email: pkmkalimulya01@gmail.com

HAZARD AND VULNERABILITY ASSESSMENT TOOL

EVENTS INVOLVING HAZARDOUS MATERIALS
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILI HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
EVENT TY IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE
Time, Community/ Relativ
Likelihood this Possibility of Physical losses Interuption of
Preplanning effectivness, Mutual Aid staff e
will occur death or injury and damages services
resouces and supplies threat*

0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A

1 = Low 1 = Low 1 = Low 1 = Low 1 = High 1 = High 1 = High 0-
SCORE
2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 100%
3 = High 3 = High 3 = High 3 = High 3 = Low or none 3 = Low or none 3 = Low or none

PAPARAN
KIMIA
EKSTERNAL 0 0 0 0 0 0 0 0%

TUMPAHAN
INTERNAL
UKURAN
1 1 0 0 0 0 0 2%
KECIL-
MENENGAH

TUMPAHAN
INTERNAL 1 1 0 0 0 0 0 2%
BESAR
PAPARAN
LIMBAH B3
DARI 3 1 1 1 1 1 1 33%
FASKES KE
LINGKUNGA
N
PAPARAN 1 1 1 1 1 1 1 11%
HAZMAT
INTERNAL
EKSTERNAL
PENCEMAR
AN LIMBAH
INFEKSIUS
FASKES KE 1 1 1 1 1 1 1 11%
LINGKUNGA
N

AVERAGE 1,17 0,83 0,50 0,50 0,50 0,50 0,50 7%

*Threat increases with percentage.
7

20 RISK = PROBABILITY * SEVERITY

0,07 0,39 0,19

Mengetahui, Depok,
Kepala UPTD Puskesmas Kalimulya Penanggung Jawab MFK

drg.Agustina Ika Damayanti Fiani Nurbaeti,Amd.K.L

NIP.197908312010012005 NIP.199702082020122010

Hazardous Materials : 1.4.4 ep a HVA

 PEMERINTAH KOTA DEPOK
DINAS KESEHATAN
UPTD PUSKESMAS KALIMULYA
Jl. Kampung Jati RT 004 RW 004 Kel. Jatimulya, Kec.Cilodong Kota Depok 16413
Telp. ( 021 ) 8763354 email: pkmkalimulya01@gmail.com

SUMMARY OF MEDICAL CENTER HAZARDS ANALYSIS

Total for Facility

Technological

Hazmat
Natural

Human

Probability 0,43 0,44 0,13 0,39 0,18

Severity 0,59 0,41 0,37 0,19 0,19

Hazard
0,25 0,18 0,05 0,07 0,03
Specific

Hazard Specific Relative Risk to Medical Center

1,00
0,90
Relative Threat to Facility

0,80
0,70
0,60
0,50
0,40
0,30
0,20
0,10
0,00
Natural Technological Human Hazmat

Probability and Severity of Hazards to Medical Center

1,00
0,90
Relative Impact on Facility

0,80
0,70
0,60
0,50
0,40
0,30
0,20
0,10
0,00
Probability Severity

Mengetahui, Depok,
Kepala UPTD Puskesmas Kalimulya Penanggung Jawab MFK

drg.Agustina Ika Damayanti Fiani Nurbaeti,Amd.K.L

NIP.197908312010012005 NIP.199702082020122010

1.4.4 ep a HVA Summary