Evacuation Fire Drill Report

• Site conducted

  Select

• Conducted on

  Date

• Consultant

• LabourNet Branch

• Location
  Address

• Client

• Contact Person

PRIOR TO DRILL

• Have Fire wardens been assigned and trained?

  Yes

  No

  N/A

• Do Fire wardens have identification?

  Yes

  No

  N/A

• Have assembly areas been designated and employees trained?

  Yes

  No

  N/A

• Are “emergency plans/procedures” posted?

  Yes

  No

  N/A

DURING THE DRILL:

• Did the employees evacuate the building immediately after the evacuation was initiated?

  Yes

  No

  N/A

• Was evacuation orderly and quick?

  Yes

  No

  N/A

• Were instructions given to move to the designated assembly points?

  Yes

  No

  N/A

• Were all exits used?

  Yes

  No

  N/A

• Were all restrooms, and offices checked?

  Yes

  No

  N/A

• Did fire doors operate correctly?

  Yes

  No

  N/A

• Was everybody continuously kept informed regarding the situation?

  Yes

  No

  N/A

• Was a communication system applied during the evacuation?

  Yes

  No

  N/A

Drill Information

• Number of persons who were present during the drill

• Number of special needed employees who carried out horizontal evacuation drill

• Number of “Critical operation” employees who will carry out Ad hoc evacuation drill

AFTER THE DRILL:

• Were all employees and visitors accounted for?

  Yes

  No

  N/A

• Did all alarms work properly?

  Yes

  No

  N/A

• Was there any significant disruption of services?

  Safe

  At Risk

  N/A

• Did everyone remain outside the building and wait for further instructions?

  Yes

  No

  N/A

• Are staff members familiar with their assigned duties?

  Yes

  No

  N/A

• Evacuation Duration

• Observations

• Compliance Level

  Good

  Fair

  Poor

• LabourNet OHS Consultant

  Sign

• Contact Person

  Sign