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Department of Health Services LogoA kid with an apple in hand and a word Empower EMPOWER PROGRAM OVERVIEW & ACKNOWLEDGEMENTS: EMPOWER The owner or individual listed below has registered and is a participant with the EMPOWER Program accessible on the ADHS website at: https://azdhs.gov/prevention/nutrition-physical-activity/empower/index.php D.E.E.P The owner or individual listed below is responsible for writing and updating the Emergency Preparedness Plan and has completed/passed the Disaster Emergency Evacuation Preparedness (D.E.E.P) online training accessible on the ADHS website at: https://www.azdhs.gov/documents/licensing/childcare-facilities/training/deep-online-training.pdf Provider ID: Facility Name: I certify that I have taken the D.E.E.P online training and that I am a member of the EMPOWER program accessible on the ADHS website Date: Signed: Name: DES logo Equal Opportunity Employer / Program • Auxiliary aids and services are available upon request to individuals with disabilities • To request this document in alternative format or for further information about this policy, contact 602-542-4248; TTY/TDD Services: 7-1-1 • Disponible en español en línea o en la oficina local CCA-1291A FLYENG (08-21) SIGN