REVIEWED BY FIRE SAFETY COMMITTEE ON _____________________
1. Did the staff properly respond to initiate the alarm within 30 seconds?
2. Was the overhead page announcement of the location heard?
3. Was the alarm seen and heard in all areas?
4. Was the back-up phone call made (simulated) to the fire department?
5. Did the staff know the location of the fire extinguisher?
6. Did a staff member (person in charge) provide adequate leadership in area?
7. At least verbally (simulated) did the person in charge identify which patients need to be evacuated?
8. Were all doors closed?
9. Were patients in corridors placed into rooms?
10. Was equipment cleared from the corridors?
11. Did the fire/smoke doors close automatically?
12. Were patients in rooms being checked by staff periodically?
13. Did staff use proper judgement?
14. Were exits monitored by staff? (psych only)
15. Did staff responding to the scene do so immediately?
16. Did staff responding to the scene understand their role upon arrival?
Resolution (name & date)