Agency COOP Exercise Form Instructions

To be filled out by the agency Continuity Coordinator or their designee:

Please select your answer from drop-down boxes or provide a narrative where asked. The form fields will automatically expand to accommodate data input.

Targets are the key goals you hope to address during the exercise. Tasks are the actionable elements that will demonstrate whether each target can be met. Check the boxes beside each task that was successfully accomplished during the exercise. Do not check the box if the task could not be accomplished. Inability to complete a task is not a failure. It may indicate an area where plan revision or TT&E can make the program stronger, or it might just mean that time ran out before all goals could be accomplished.

Example: Task #1: Electronic data is accessible to the continuity team. The box would be checked only if IT successfully connected to the internet and/or servers, and the requested data could be retrieved within the prescribed time.

Exercise rating:

Rate the exercise and outline your reasoning for this rating. Take into consideration planning, administration of the exercise, participant interaction, attainment of goals, value of discoveries, etc. This information will provide the State Office of Risk Management (SORM) a better understanding of how you assess the usefulness of the exercise.

Observations:

As your organization’s subject matter expert, the Continuity Coordinator should complete the ‘Observations and Notes’ section, at the bottom of the form, to capture any additional information they feel is helpful to understand the exercise.

Submitting for review:

When you have completed the form save it as a Word Document and email it to SORM at COOP@sorm.texas.gov. SORM will review and respond with ideas to help with future exercise planning.

This section to be completed by SORM
Comments: Click or tap here to enter text.
Recommendations: Click or tap here to enter text.
Date next due: Click or tap to enter a date.	SORM Risk Manager: Click or tap here to enter text.

Agency COOP Exercise Form
Organization name: Click or tap here to enter text.
Organization number: Click or tap here to enter text.	Date of exercise: Click or tap to enter a date.
Head of organization (name, title & email): Click or tap here to enter text.
Name of Continuity Coordinator: Click or tap here to enter text.
Phone: Click or tap here to enter text.	Email: Click or tap here to enter text.
Joint exercise information
1. If you participated in a joint exercise with another organization, please include that information here: Click or tap here to enter text.
2. If you did not conduct a joint exercise, select “Not Applicable” from the drop-down list: Choose an item.
General exercise information
3. Name of exercise: Click or tap here to enter text.
4. Location of exercise: Click or tap here to enter text.
5. Check the continuity plan elements that were evaluated in your exercise (select all that apply):
Essential Functions	☐	Alternate Facilities & Telework	☐	Essential Records & IT Systems	☐
Human Resources	☐	Communications	☐	Reconstitution	☐
Devolution	☐	Budgeting & Acquisition	☐	Training, Testing & Exercises	☐
6. Exercise duration: Click or tap here to enter text.
Specifics of exercise
7. Type of exercise: Choose an item.
If using an actual incident, please skip to and complete the Evaluation and improvement section.
8. Nature of exercise: Choose an item.
9. Participants (select all that apply):
All Staff	☐	Continuity Team	☐	Reconstitution Team	☐
Devolution Team	☐	Executive Leadership	☐	IT Team	☐
Other: Click or tap here to enter text.
10. Objective(s) of exercise: Click or tap here to enter text.
11. Scenario: Click or tap here to enter text.
An exercise should have at least one target but may have more. Fill in all that apply.
1st Target: Click or tap here to enter text.	Check if Task Completed!
Task # 1:	Click or tap here to enter text.	☐
Task # 2:	Click or tap here to enter text.	☐
Task # 3:	Click or tap here to enter text.	☐
Task # 4:	Click or tap here to enter text.	☐
Task # 5:	Click or tap here to enter text.	☐
2nd Target: Click or tap here to enter text.
Task # 1:	Click or tap here to enter text.	☐
Task # 2:	Click or tap here to enter text.	☐
Task # 3:	Click or tap here to enter text.	☐
Task # 4:	Click or tap here to enter text.	☐
Task # 5:	Click or tap here to enter text.	☐
3rd Target: Click or tap here to enter text.
Task # 1:	Click or tap here to enter text.	☐
Task # 2:	Click or tap here to enter text.	☐
Task # 3:	Click or tap here to enter text.	☐
Task # 4:	Click or tap here to enter text.	☐
Task # 5:	Click or tap here to enter text.	☐
4th Target: Click or tap here to enter text.
Task # 1:	Click or tap here to enter text.	☐
Task # 2:	Click or tap here to enter text.	☐
Task # 3:	Click or tap here to enter text.	☐
Task # 4:	Click or tap here to enter text.	☐
Task # 5:	Click or tap here to enter text.	☐
5th Target: Click or tap here to enter text.
Task # 1:	Click or tap here to enter text.	☐
Task # 2:	Click or tap here to enter text.	☐
Task # 3:	Click or tap here to enter text.	☐
Task # 4:	Click or tap here to enter text.	☐
Task # 5:	Click or tap here to enter text.	☐
Exercise rating
How would you rate this exercise overall? Choose an item.
Please provide reasoning for rating: Click or tap here to enter text.
Evaluation and improvement
Summary of incident/exercise: Click or tap here to enter text.
Continuity coordinator observations: Click or tap here to enter text.
Participant feedback: Click or tap here to enter text.
Lessons learned and plan improvements: Click or tap here to enter text.
Goals for training, testing and exercises over the next biennium: Click or tap here to enter text.
Other comments you’d like to make about your exercise: Click or tap here to enter text.
To support strong state programming please include any suggestions you have for improving this reporting form to ensure it captures the true value and important nuances of your exercise: Click or tap here to enter text.