Audit

Site Information

Shift

Quarter

Drill Assessment

1. Did participant of the fire drill zone staff demonstrate knowledge of the use and function of the fire alarm systm?

2. How to pull the nearest fire alarm?

3. Do staff know the appropriate # to dial to report a fire for your facility?

4. Was this # dialed?

5. Identified self and area?

6. Gave exact location of fire?

7. Described nature and extent of fire?

8. Did the participant demonstrate the knowledge of confining the area of fire?

9. Closing Doors?

10. Knew the location of the nearest fire extinguisher?

11. Knew the PASS procedure of a fire extinguisher?

12. Knew the RACE procedure?

13. Knew the specific fire responsibility to their area?

14. Knew the location of the O2 shut-off valve?

15. Knew the procedure to prepare for evacuation?

16. Did the staff of the adjacent, above, below or other areas demonstrate the knowledge of the fire drill annoucement?

17. Did the staff demonstrate knowledge of how to transfer to area of refuge?

18. Did the staff know the horizontal / vertical evacuation sequence?

19. Did the staff know how to reach an "Area of Refuge"?

Scoring:

Enter any comments along with score " Passed or Failed "

Please enter your name then sign when assessment is completed.
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.