• Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Audit team

  • Audit team leader


  • Drill start time

  • Drill end time

Evacuation signal

  • Was signal heard at all places?

  • Was the signal understood?

  • Did the employees respond to the signal?


  • Did all employees evacuate?

  • Did all employees go to the assembly point?

  • Did employees take their essential belongings only?

Assembly point

  • Do all persons congregate at the assembly point?

  • Does the safety team congregate at the assembly point?

  • Does the medical team congregate at the assembly point?

  • Does the safety team do accountability report?

  • Is accountability report communicated to incident commander and other response teams?

  • Is appropriate action taken on accountability report?


  • Does medical team setup triage zone?

  • Does medical team have appropriate equipment?

Fire / evacuation

  • Does fire team evacuate the workplace?

  • Are all areas checked to ensure that they are clear?

  • Are persons assisted to evacuate?

Persons with disabilities

  • Are persons with disabilities identifed?

  • Is an appropriate guide or assistant provided for evacuation?

  • Can disabled persons access the assembly points?


Signal media

  • Pictures of signalling equipment

  • Diagram of signalling equipment location

Assembly points

  • Pictures of assembly point

  • Diagrams of assembly points


  • Pictures of persons during evacuation

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.