Title Page

  • Site

  • Date and Time of Drill

  • Weather

  • Safety Coordinator

  • Document ID number

COMMUNICATION

  • Method of Drill Activation

  • Please specify

  • Drill preannounced

  • Fire department present for drill

  • Alarm monitoring company notified

EVACUATION ASSESSMENT

  • Evacuation routes posted

  • Evacuation signs are in good condition

  • Exits are clearly marked

  • Exit signs are properly illuminated

  • Exit doors operating properly

  • Egress routes free of obstructions

  • Egress routes properly lighted

FIRE ALARM SYSTEMS

  • Fire alarms are working properly and clearly heard in all areas

  • Alarm monitoring company received alert

UTILITIES

  • Electrical appliances were turned off

  • Lights were turned off

  • Smoke detectors are in good condition

EVACUATION

  • All occupants participated and evacuated

  • Restrooms were checked for occupants

  • Evacuation was orderly

  • Visitors escorted and accounted for

  • Special needs persons accommodated

FIRE CONTAINMENT

  • Doors and windows closed

  • Rooms checked prior to closing doors

  • Doors left unlocked

  • Fire extinguisher taken to location of fire

PLAN ASSESSMENT

  • Evacuation performed according to plan

  • Occupants met at designated meeting places according to the plan

  • Designated meeting place(s) located at safe distance from building

  • Fire drill/incident response team(s) responded according to plan

  • Fire drill/incident response team(s) carried out assigned duties

  • Fire department "mock" notified according to plan

COMPLETION

  • Overall response of occupants

  • Noise level of evacuation

  • Total number of occupants evacuated

  • Recommendations

  • Name and signature of safety coordinator

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