• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Location/ Zone of the drill.

Shift drill was preformed on.

Did the alarm company receive a signal?

888-684-2684 Acct # A14664413

General questions

  • Can staff explain what RACE stands for?

  • Can staff explain what PASS stands for?

  • Can staff explain where the closest pull station is?

  • Can staff explain where the closest fire extinguisher is?

  • Did the fire doors operate properly?

  • Did the staff close the patient doors?

Persons responding to the drill.

Total number of persons responding to the drill.

Number of Extinguishers brought

Person doing drill.

  • Jason Sartain

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