Evacuation Plan Template

An evacuation plan template is used by employers to guide them in writing their evacuation plans. It ensures that all of the essential elements of an evacuation plan are covered. Employers can use this evacuation plan template to do the following: (1) Establish a clear chain of command by assigning evacuation officers, wardens, and assistants; (2) Choose an internal emergency alert system for employees and add measures in case of system failure; (3) Determine the primary and alternative methods of emergency communication; (4) Specify evacuation procedures for each area in the workplace; and (5) Add floor plan diagrams to illustrate exit routes.

Title Page

Location
Updated on
Prepared by
Evacuation for
Evacuation Officer 1
Evacuation Officer 2
Evacuation Officer 3
Evacuation Wardens:
Assistants:
Department name
Contact number

Evacuation Plan

Emergency alert system for employees
Measures in case of emergency alert system failure
Primary method of communication
- PA System
- Portable Radio Unit
- Mobile Messaging
- Others, please specify.
Alternative method of communication
Area description
Specific Evacuation Procedure
Exit Routes (text description)
Exit Routes (floor plan)
Designated safe area or assembly point
Photo of landmark
What to Do After Arriving at the Designated Safe Area:

Final page

Evacuation plan requires translation for employees not fluent in English
Procedures have been established for assisting employees not fluent in English during evacuation
Evacuation plan requires translation into Braille for employees with vision impairment
Procedures have been established for assisting employees with disabilities during evacuation
Evacuation plan has been reviewed with employees
Employees have been trained in the evacuation plan
Signature of Employer or Head Manager