• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Enter Event Name

  • Enter Date & Time of Event

Disaster Drill Evaluation

  • Did employees respond appropriately when alerted?

  • Were patients and visitors correctly informed of the emergency?

  • If involved calling in outside agency (i.e.: gas, phone, water, police, fire dept.) did they respond quickly?

  • Did in-house Plant Services respond appropriately?

  • Were all staff moved to an appropriate location?

  • Were all patients / visitors accounted for?

  • Was the level of command followed and the incident leader identified either formally or non-formally?

  • Was there a plan in place for handling this emergency?

  • Is staff oriented to plan?

  • Did this event succeed in increasing awareness and response to emergency situations?

Disaster Drill After Action

  • Enter any opportunities noted during the event

  • Enter Corrective Action Taken

  • Comments

  • Print Your Name then Sign when completed

  • Attach or take Photos of Event if available

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.