Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Document #


  • Has each duress alarm been tested that day?

  • When was the last date the alarm has been tested?

  • Are staff aware of documented procedure in testing alarms?

  • Is there a written record that all alarms are working properly?

  • Are duress alarms integrated with other security systems such as video footage?

  • Does the duress alarm automatically alert security personnell?

  • Have employees been trained on how to use duress alarms correctly?

  • Is there a formal record that training has occurred?

  • Is there routine maintenance on the duress alarm system?


  • Is there a camera footage live access to each interview room and high risk area that can be seen by staff?

  • Do all staff know who the 1st, 2nd, and 3rd responder is supposed to be?

  • Do all staff know what tasks each responder are supposed to fulfill?


  • Do staff find it easy to locate where the alarm is coming from?

  • Have staff been trained on how to identify relevent code?

  • Do staff know when to call police?

  • Is there a first aid officer on-site at all times?

  • Is there a fire warden on site at all times?

  • Are staff aware of emergency evacuation routes?

  • Do staff know when they should prevent clients entering the building?


  • Is there a staff member directly responsible for using the paging system on-site during all working hours?

  • Is staff member confident in using that paging system?

  • Does the internal paging system alert staff in a timely manner?

  • How long (in minutes) did the notification take to be sent to staff after page was sent

  • Is there a clear process for updating employees and clients on incident?


  • Is there a structured process that staff are aware of for conducting post-incident reviews following each emergency?

  • Are action items captured after reviews to improve and update emergency response?

  • Is there a standardized documentation process for recording details of the emergency response?

  • Do staff know how to easily access incident report forms?

  • Are employees involved in providing feedback of the effectiveness of the emergency response?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.