• Location

  • Conducted on

  • Exercise Coordinator

  • What Happened

Staff Response Checklist

Staff Response: Marshalling and Searching for cause of alarm

  • Did all staff report to the marshalling point quickly

  • Were all areas checked for fire and smoke

  • Were detectors checked (ie did staff look at the detectors in the ceiling to see if the red light was flashing)

  • Were rooms with closed doors checked for heat before entering (with back of hand)

Staff Response: Upon Discovery of fire or smoke (RACE principle)

  • R: were all people removed from immediate danger

  • A: Did staff alert the warden and other staff in the area of the fire/smoke

  • C: Did staff contain the fire / smoke by closing the door (and windows if applicable)

  • E : Did staff make the correct decision to extinguish or not to extinguish

Staff Response: Evacuation response

  • Evacuate patients in the correct order

  • Select the most appropriate evacuation equipment

  • Competently use the evacuation equipment

  • All rooms checked for people

  • Suitable objects left outside all checked rooms (Such as bins, folders, etc.)

  • Were any essential secondary items evacuated if safe to do so

  • All doors closed

  • Did staff evacuate to a safe place (as directed by warden)

  • Did staff remain at assembly point under wardens directions until stand down

Warden Response Checklist

Warden Response: Code Red Procedures

  • Ensure Warden Vest worn

  • Ensure staff are kept quiet and are close enough to hear instructions

  • Ensure a search of area coordinated to find cause of fire alarm

  • Instructed searchers to "Search for fire and smoke"

  • Instructed searchers to "Check closed doors with back of hand for heat before entering"

  • Instructed searchers to "Check detectors- If the red light is flashing, the detector has been activated"

  • Instructed searchers to "If you find a fire or smoke, remember the RACE principle"

  • Ensure Controller notified of search results (via WIP phone or other methods)

  • Ensure traffic control organised to prevent persons entering area

Warden Response: Code Orange Procedures

  • Ensure Controller notified of the need to evacuate and evacuation location (via WIP phone or other methods)

  • If evacuation required, ensure the appropriate evacuation stage selected (immediate area only, lateral, outside, etc)

  • Ensure patients evacuated in correct order (Independent - able to assist - not able to assist)

  • Ensure all rooms checked for occupants and appropriate objects left outside checked room (bins, folders, etc.)

  • Ensure doors and windows closed (to contain spread of fire and smoke)

  • Ensure final sweep of area done (with or without help) to check that all occupants evacuated, by looking for objects outside each room

  • If time permits, ensure any essential materials evacuated

  • Once evacuated, ensure Controller notified of evacuation status (Via WIP Phone, runner or other methods)

Controller Response Checklist

Controller Response: Code Red Procedures

  • Check phone when alarm received

  • Go to fire panel, press buttons labelled A and B to acknowledge alarm and display location

  • Assume manual control of EWIS panel, and turn keyswitch from auto to manual (Button 1)

  • Silence Alert tone- Press Buzzer Mute button (Button 2) & Master Reset button (Button 3)

  • Use the p.a system (Press All PA button 4) to ensure site notified " respond red standby (location) including room or corridor number

  • Don Emergency Controller vest

  • Nominate a scribe and ask them to complete scribe log (page 2 of emergency response report form)

  • Contact warden via WIP phone or runner to determine fire or false alarm and details (location, has fire been extinguished )

  • If fire, announce "respond red confirmed (location)"

  • Ensure fire brigade called (simulated 000 call)

  • Ensure Frankston Hospital switch called via7222

  • Ensure traffic control initiated at relevant entrance points

Controller Response: Code Orange Procedures

  • Contact warden via WIP phone or runner to determine if evacuation is required, (location, has fire been extinguished )

  • Determine where warden(s) are evacuating to

  • Announce "respond orange confirmed (location)"

  • Announce "respond orange standby" for other areas potentially at risk

  • Request assistance from other units (if required)

  • Ensure contact established with relevant wardens to determine evacuation status

  • Ensure succinct situation report provided to fire brigade

  • Announce stand - down after authorisation from fire brigade , including call to FH switch 7222

  • Ensure Emergency Response Report Form completed


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Recommendation 5

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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.