Information

NOTE: This form is ONLY to be completed by either the Chief Area Warden, Assistant Area Warden or an Area Warden.

  • Document No.

  • MRI Site

  • Date Emergency Evacuation Drill Held

ITEMS TO CHECK

PRIOR TO THE EMERGENCY EVACUATION DRILL

  • Do all Area's have a Fire Warden assigned?

  • What area's need a Fire Warden assigned?

  • Have all assigned Area Fire Wardens been Trained?

  • Who still needs training?

  • Do all Area Fire Wardens have Identifiable PPE (eg, Hard Hat or Cap, Coloured Vest, etc.)?

  • Who doesn't have Identifiable PPE and Why?

  • Has an Assembly Areas been designated?

  • Why Not?

  • Have all Employees been informed as to where the Assembly Areas is?

  • Why Not?

  • Has the Site Emergency Plan (or Procedure) been displayed for access by all Staff and Visitors?

  • Why Not?

  • Describe Emergency Evacuation Drill Scenario:

  • Was there also a First Aid Scenario?

  • Describe the First Aid Scenario:

  • Were all employees and guests accounted for?

  • Who was missing and why?

  • Was the Missing Person part of the Emergency Evacuation Drill Scenario?

DURING THE EMERGENCY EVACUATION DRILL

  • Time the Evacuation Started?

  • What alarm system was used?

  • Was alarm heard throughout building?

  • What area(s) was the alarm Not heard?

  • Did the alarm system function correctly?

  • What Happened? Why did the alarm not function correctly?

  • Did all Employee's, Contractor and Visitor evacuate the Building as soon as the Alarm was Activated?

  • List who did not leave and why?

  • Was evacuation orderly and quick?

  • List what happended

  • Did ALL evacuated Personnel assembly in the designated Assembly Area?

  • List what happended

  • Were instructions given move to another location because the Designated Assembly Point was not safe?

  • List where everybody evacuated to

  • Were all areas checked (including Offices, Restrooms, Conference Rooms, Storage areas, etc)?

  • What area was Not Checked and Why?

  • Did all Area Wardens check in with the Chief Area Warden?

  • Who did not check in with the Chief Area Warden and Why?

  • How would you rate the overall total time of the Emergency Evacuation Drill went?

  • How would you rate the Effectiveness of MRI Emergency Procedures during the Emergency Evacuation Drill?

  • How would you rate the overall Communication during the Emergency Evacuation Drill?

  • Was a Communication System used during the Emergency Evacuation Drill?

AFTER THE EMERGENCY EVACUATION DRILL

  • Did everyone remain at the Assembly Point, in an orderly fashion and wait for further instructions?

  • Time the "All Clear" was given?

  • Time the Evacuation Was Completed?

  • Who reset the Alarm?

COMMENTS / NOTES

  • List any problems observed during the Emergency Evacuation Drill?

  • Entre any Other Comments or Notes you might have:

COMPLETED BY

  • Signature:

Emergency Evacuation Drill Attendees

  • I was present during the evacuation drill

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  • Is there more personnel that attended the Emergency Evacuation Drill?

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Please FORWARD (or email) this Completed Document to either; * The Operations Assistant, * Nicole Garaty for ACT & NSW, or * Tracy Bracken for QLD & VIC

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