Use this form to report on outcomes of the emergency preparedness
Complete all appropriate fields
Clearly explain the recommended corrective actions to be taken (if issues were noted)
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Title Page
Site conducted
Date of Emergency Preparedness Drill
Work Groups Involved
Location
Simulate a Emergency Evacuation with Employees
Observations & Results
Type of Emergency Preparedness Drill
Site Evacuation - General
General First Aid (Cut, Burn, Bump)
Chemical Spill
Fall from Height
Hit by Plant or Tools
Electric Shock
Dust Exposure (Major - Silicosis)
Eye Injury
Other
Time Drill Started
Total elapsed time (mins)
Steps to Simulate the Emergency
Steps taken to resolve the Emergency
Did the workers follow the evacuation instructions?
Did the workers follow the most direct route to the meeting point ?
Was the evacuation orderly, with no congestion at exits?
Was everyone participating accounted for?
Was their any worker feedback or comments?
Overall Results of the Emergency Drill
Time Drill Ended
Workers involved in the Emergency Drill
Actions resulting from the Emergency Drill
Record the Meeting Drill
Name of Emergency Preparedness Co-Ordinator
Anonymous
HR FOCUS Company - Emergency Preparedness Drill
Use this form to report on outcomes of the emergency preparedness
Complete all appropriate fields
Clearly explain the recommended corrective actions to be taken (if issues were noted)
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.
