Personal Emergency Evacuation Plan

• PEEP Record for:

• Conducted on

  Date

• Prepared by

• Other Personnel involved

• A Personal Emergency Evacuation Procedure ( known as a PEEP), is a procedure designed to outline the emergency requirements of a member of staff or student who may require assistance where theirs affects their method of egress in an emergency.
  
  Heart of Worcestershire College accepts that during the course of work or study, there are members of staff/students on campus who are able bodied and also those who are less able bodied. The College actively promotes studying for all persons and therefore does not discriminate. To ensure that those persons who require assistance can safely leave College buildings in an emergency, a PEEP must be completed. this process ensures that tutors, line mangers and individuals discuss and take into account specific needs and produce a plan to ensure their safety is provided for in the event of an emergency.

General

• Where are you based for most of your time at College?

  insert details below

• On which days are you expected in College?

  insert details below

• Are you aware of the emergency procedures for the areas where you are based?<br>

  Yes

  No

  N/A

• Can you hear the fire alarm in the areas where you work or are based?

  Yes

  No

  N/A

• Can you move quickly in the event of an emergency?

  Yes

  No

  N/A

• Are you able to use stairs to enter/leave buildings without difficulty?

  Yes

  No

  N/A

• Could you raise the alarm if you discovered a fire?

  Yes

  No

  N/A

• Are you able to leave your work area without assistance in the event of an emergency?

  Yes

  No

  N/A

• If assistance is needed, do you have a nominated person to help you in an emergency?

  Yes

  No

  N/A

• Is this arrangement a formal one?

  Yes

  No

  N/A

• Are you always in easy contact with those who are designated to help you?

  Yes

  No

  N/A

Hearing impairment

• Can you hear the fire alarm under normal circumstances?

  Yes

  No

  N/A

• Do you have adequate devices to allow you to hear the alarm clearly? <br><br>If 'no', please make a note below of any special or purpose designed device that could assist you in hearing the alarm more clearly.

  Yes

  No

  N/A

• Are there sufficient measures in place that would assist you in leaving the building safely in the event of an emergency?<br><br>If 'no', please make a note below of what additional measures could help:<br>For example:<br>Would visual alarm indicators help?<br>Would written emergency procedures help?<br>Would emergency procedures with BSL interpretation help?<br>Would an assistant/buddy system help?

  Yes

  No

  N/A

• Are you happy that all issues are covered above?<br>If 'no', please make a note of any additional concerns below

  Yes

  No

  N/A

Visual impairment

• Are you able to leave the area/building safely in the event of an emergency?

  Yes

  No

  N/A

• Are you able to move around the building without aids or assistance?<br>If 'no', please make a note of the equipment or support that you have access to - this could include use of a cane, guide dog, support worker etc

  Yes

  No

  N/A

• Under normal circumstances, how long does it take you to leave the area/building using your current support methods?

  insert details below

• Are there sufficient measures in place to assist you in leaving the area/building in the event of an emergency?<br>If 'no', make a note below of any additional measures that may be of assistance. <br><br>These could include:<br>Emergency procedures in Braille, audible methods, large print, tactile floor surfaces, signage etc

  Yes

  No

  N/A

• Are you happy that all issues have been covered above? <br>If 'no', please make a note of any additional concerns below

  Yes

  No

  N/A

Mobility impairment

• Can you leave the building unassisted?<br>If 'no' what support is necessary to assist you?<br>This could include:<br>Use of a wheelchair, or use of a support person etc

  Yes

  No

  N/A

• If you use a wheelchair, are you able to leave the chair and move short distances if required?

  Yes

  No

  N/A

• Is your wheelchair a standard size and able to fit through standard size doors?

  Yes

  No

  N/A

• Have you ever been shown how an evac chair operates to assist you in leaving the area in an emergency?<br>If 'no', please make a note below to provide information about:<br>Would you be able to use a chair if required?<br>Would you like a familiarisation session to show you how they work?

  Yes

  No

  N/A

• Has the concept of 'fire refuge points' been explained to you?

  Yes

  No

  N/A

• If necessary, would you find it acceptable to use a fire refuge point?

  Yes

  No

  N/A

• Do you have access to a support person or buddy who would assist you and stay with you in an emergency?

  Yes

  No

  N/A

• Are there sufficient measures in place to assist you in leaving the area in the event of an emergency? If 'no', please make a note below of any additional measures that you feel would assist you.<br><br>These could include: relocation of the class to a ground floor level, implementing buddy systems, provision of emergency procedures in a format suitable to the individual, per-planning emergency evacuation routes.

  Yes

  No

  N/A

• Are you happy that all issues have been covered above?<br>If 'no', please make a note below of any additional concerns that you may have.

  Yes

  No

  N/A

Tour of the work area/building that you most commonly use.

• Is the directional and instructional signage adequate and relevant?

  Yes

  No

  N/A

• (if you have a hearing impairment) - are there illuminated alarm devices within the toilet areas that you would use?

  Yes

  No

  N/A

• (if you have a partial mobility or visual impairment) - do you routinely negotiate stair wells and/or lifts?<br>

  Yes

  No

  N/A

• If you use stairs, are the edges of the treads of the stairs adequately identified?

  Yes

  No

  N/A

• If you use lifts, is there easy access/egress from the lift and is the lift easy to operate?

  Yes

  No

  N/A

• If you use a lift, is there an emergency telephone or other communication method installed in the lift?

  Yes

  No

  N/A

• There will be fire doors with self closing devices on your exit routes - are you able to negotiate these doors without too much hindrance?

  Yes

  No

  N/A

• If there are internal or external steps on your exit route, can you negotiate these without too much hindrance?

  Yes

  No

  N/A

• If at this stage you have decided that you do not want a Personal Emergency Evacuation Plan please sign the statement below:

• Staff Member

• Student

• Type name and sign

  Sign

• PEEP - summary

• This PEEP belongs to: (include the staff/student ID number, contact details and the course being studied)

• I will be informed of an evacuation by:
  
  Existing alarm
  Visual alarm system
  Buddy/support system
  Other..............

• Select Existing audible alarms and strobe lights Pager Device Other please specify

  • Existing audible alarms and strobe lights
  • Pager Device
  • Other please specify

• The following persons have been designated to provide assistance to help me exit the building in an emergency:

• The following procedure will be followed: ( from the discovery of a fire - to the alarm activation - to leaving the work area - to arriving at the refuge point or assembly point)

• Draw escape route if that helps

  Drawing

• The following training/practice requirements have been identified:

• A copy of my PEEP has been provided too:

  Sign

• PEEP accepted by:

  Sign