Copy and paste this form into a Microsoft Word document and save it as a Template.

 

 

Fire/Evacuation Drill

Observer’s Report

Instructions:  Please forward completed report form to the Office of Environmental Health and Safety, 

 

Drill Date:

 

Drill Time:

Drill Location:                                                            Type of Drill     r Planned    r  Alarm

 

 

List all participating departments: _______________________________________________________

Scenario or special circumstances: ______________________________________________________

Observers responsibility for the drill: ____________________________________________________
___________________________________________________________________________________

Was alarm heard throughout the building?                      Yes ____         No ___

Were all alarm devices operating correctly?                   Yes ____         No ___

If no, note locations ________________________________________________________________

Did all occupants evacuate the building?                         Yes ____         No ___

If no, note room numbers ___________________________________________________________

Did occupants assemble in designated areas?                Yes ____         No ___

Please rate the overall effectiveness of the drill:

Speed of Evacuation                           Good ____      Fair ____         Poor ____

Effectiveness of Procedures              Good ____      Fair ____         Poor ____

Communication during Drill               Good ____      Fair ____         Poor ____

Total time required to evacuate building:     _______ Minutes       _______ Seconds

Additional comments: ___________________________________________________________________
______________________________________________________________________________________

Time “All Clear” given:

 

Alarm system reset by:

Observer report completed by:

 

 

Thank you for participating in today’s drill.