Information
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PEEP Record for:
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Conducted on
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Prepared by
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Other Personnel involved
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A Personal Emergency Evacuation Procedure ( known as a PEEP), is a procedure designed to outline the emergency requirements of a member of staff who may require assistance where theirs affects their method of egress in an emergency.
General
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Where are you based for most of your time at work?
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On which days are you expected in work?
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Are you aware of the emergency procedures for the areas where you are based?<br>
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Can you hear the fire alarm in the areas where you work or are based?
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Can you move quickly in the event of an emergency?
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Are you able to use stairs to enter/leave buildings without difficulty?
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Could you raise the alarm if you discovered a fire?
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Are you able to leave your work area without assistance in the event of an emergency?
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If assistance is needed, do you have a nominated person to help you in an emergency?
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Is this arrangement a formal one?
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Are you always in easy contact with those who are designated to help you?
Hearing impairment
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Can you hear the fire alarm under normal circumstances?
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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.
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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 an assistant/buddy system help?
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Are you happy that all issues are covered above?<br>If 'no', please make a note of any additional concerns below
Visual impairment
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Are you able to leave the area/building safely in the event of an emergency?
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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
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Under normal circumstances, how long does it take you to leave the area/building using your current support methods?
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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
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Are you happy that all issues have been covered above? <br>If 'no', please make a note of any additional concerns below
Mobility impairment
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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
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If you use a wheelchair, are you able to leave the chair and move short distances if required?
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Is your wheelchair a standard size and able to fit through standard size doors?
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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?
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Has the concept of 'fire refuge points' been explained to you?
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If necessary, would you find it acceptable to use a fire refuge point?
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Do you have access to a support person or buddy who would assist you and stay with you in an emergency?
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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 work desk to a ground floor level, implementing buddy systems, provision of emergency procedures in a format suitable to the individual, per-planning emergency evacuation routes.
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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.
Tour of the work area/building that you most commonly use.
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Is the directional and instructional signage adequate and relevant?
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(if you have a hearing impairment) - are there illuminated alarm devices within the toilet areas that you would use?
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(if you have a partial mobility or visual impairment) - do you routinely negotiate stair wells and/or lifts?<br>
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If you use stairs, are the edges of the treads of the stairs adequately identified?
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If you use lifts, is there easy access/egress from the lift and is the lift easy to operate?
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If you use a lift, is there an emergency telephone or other communication method installed in the lift?
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There will be fire doors with self closing devices on your exit routes - are you able to negotiate these doors without too much hindrance?
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If there are internal or external steps on your exit route, can you negotiate these without too much hindrance?
Declaration
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If at this stage you have decided that you do not want a Personal Emergency Evacuation Plan please sign the statement below:
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Staff Member
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HS&S Specialist
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Staff Member: Type name and sign
Summary of arrangements
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PEEP - summary
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This PEEP belongs to: (include the SESA number, contact details and Job role)
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I will be informed of an evacuation by:
Existing alarm
Visual alarm system
Buddy/support system
Other.............. -
- Existing audible alarms and strobe lights
- Pager Device
- Other please specify
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The following persons have been designated to provide assistance to help me exit the building in an emergency:
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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)
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Draw escape route if that helps
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The following training/practice requirements have been identified:
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A copy of my PEEP has been provided too: My Manager and Peoplelink
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PEEP accepted by: Staff Member:
