Emergency Evacuation - Rehearsal Record

• First Steps Pre Kindy

  Select

• Type of Drill

• Details of the Drill

• Date and Time of Drill

  Date

• Safety Coordinator

• Location
  Address

Log Report

• Weather

  Cold

  Warm

  Hot
Participant

• Name and Signature

  Sign

Completion

• Total Number of Occupants Evacuated

• Total Number of Visitors

• Name of all Educators/Staff

• Time of Drill

• Type of drill

• All inside area's checked?

  Yes

  No

  N/A

• What exit was used?

• Was medication taken?

  Yes

  No

  N/A

• Was a role call conducted and all persons accounted for?

  Yes

  No

  N/A

• Emergency evacuation bag taken?

  Yes

  No

  N/A

• Were emergency services contacted?

  Yes

  No

  N/A

• Time taken to complete drill?

• Reflection/Future Modifications:

• Name and Signature of Safety Coordinator

  Sign