Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Select date
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Time of drill (24hr)
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Did staff demonstrate knowledge of the use and function of fire alarm system?
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- yes
- no
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Did staff know location of nearest fire alarm pull station?
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- yes
- no
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Did staff know location of nearest fire extinguisher?
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- yes
- no
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Did staff demonstrate reporting of alarm by using appropriate phone number?
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- yes
- no
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Did staff identify self and area (floor, department, wing, etc.)?
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- yes
- no
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Did staff give exact location of fire (2N, 3C, IMC, L&D, etc.)?
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- yes
- no
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Did staff describe nature and extent of fire?
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- yes
- no
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Were smoke/ fire doors closed?
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- yes
- no
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Did staff know the acronym for PASS?
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- yes
- no
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Did staff know acronym for RACE?
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- yes
- no
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Did staff know specific fire responsibility for their area?
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- yes
- no
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Did staff know location of medical gas zone valve and how to shut- off oxygen supply?
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- yes
- no
- N/A
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Did staff know procedure on how to evacuate area?
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- yes
- no
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Did staff of adjacent spaces (above, below or other spaces) demonstrate knowledge of fire drill announcement?
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- yes
- no
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Did staff know horizontal/ vertical evacuation process?
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- yes
- no
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Did staff know "area of refuge" and how to get there?
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- yes
- no
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Was this an announced drill?
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- yes
- no
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Was fire extinguisher refresher training performed?
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- yes
- no
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