Fire & Evacuation Practice Record

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Personnel

Campus

Building details

• Building number

• Building Name

Evacuation Practice Start time

• Select date

  Date

Evacuate Practice Finish

• Select date

  Date

Evacuation Report

• Duration of the drill

  good

  unsatisfactory

• Training of wardens - competent?

  Yes

  No

  N/A

• Chief Warden simulated phoning QFRS to confirm a fire / incident

  Select Yes No

  • Yes
  • No

• Chief Warden's Use of Evacuation System

  Yes

  No

  N/A

• All Wardens Wearing Hats

  Yes

  No

  N/A

• Inspections by Floor Wardens

  Yes

  No

  N/A

• Floor Wardens report on WIP's

  Yes

  No

  N/A

• Floor Wardens Physically Reported

  Yes

  No

  N/A

Evacuation Co-ordination instructions given

• Procedures to escort disabled persons and visitors

  good

  unsatisfactory

• Evacuation Procedures and alarm signals identified

  good

  unsatisfactory

• Means of escape and clear paths of travel

  good

  unsatisfactory

• Location of Fire Equipment and their use

  good

  unsatisfactory

• Procedures for the conducting of staff, students & visitors to the exits and on to the Assembly Areas

  good

  unsatisfactory

Identified Procedural Short Comings

Recommendations

• Follow up required

  Yes

  No

• Completed

  Yes

  No

Sign of Chief Fire Warden

• Add signature

  Sign

Sign of Fire Safety Officer

• Add signature

  Sign