EMERGENCY DRILL

RECORD

Name of Facility:

Address:

DRILL DATE:

TYPE OF EMERGENCY:
DESCRIPTION OF
DRILL:

DRILL EFFECTIVENESS EVALUATION

Response Time
REMARKS
TIME
ITEMS MONITORED (IDENTIFY PROBLEMS AND AREAS OF
(hh:mm.ss)
IMPROVEMENT)
Time Drill Initiated:
Time All Occupant
Evacuated:
Total Drill Elapsed Time:
Fire Team Response
Police Response
Ambulance Response
Spill Response
Other ____________

DRILL ARRANGEMENTS:
UNSATISFACTOR REMARKS
SATISFACTORY
ARRANGEMENTS: Y (IDENTIFY PROBLEMS AND
TICK () IN THE APPLICABLE BOX AREAS OF IMPROVEMENT)
Pre-Drill Assessment
Evacuation maps posted.  
Evacuation signs are in
good condition.  

1
 EMERGENCY DRILL
RECORD

Exits are clearly marked.  

Exit door operating
 
properly.
Egress routes are free of
 
obstruction.
Communication
Drill preannounced.  
Fire department present
 
for fire drill.
Alarm monitoring
 
company notified.
Method of drill
 
activation.
Fire Containment
Rooms checked prior to
 
closing the door.
Doors locked.  
Door hold-open devices
 
operated.
Doors and windows
 
closed.
Evacuation
All occupants
participated and  
evacuated.
Restrooms were checked
 
for occupants.
Evacuation was orderly.  
Visitors are escorted and
 
accounted.
Persons with mobility
needs were   Not Applicable
accommodated.

FUNCTIONING OF EMERGENCY RESPONSE EQUIPMENT:

UNSATISFACTOR REMARKS
SATISFACTORY
EQUIPMENT: Y (IDENTIFY PROBLEMS AND
TICK () IN THE APPLICABLE BOX AREAS OF IMPROVEMENT)
Fire extinguisher
 
inspection up to date.
Provision of adequate
 
fire extinguishers.
Fire hose reel inspection
 
up to date.
2
 EMERGENCY DRILL
RECORD

Visual alarm.  
Audible alarm.  
POST-DRILL ASSESSMENT:
UNSATISFACTOR REMARKS
SATISFACTORY
OBSERVATION: Y (IDENTIFY PROBLEMS AND
TICK () IN THE APPLICABLE BOX AREAS OF IMPROVEMENT)
Overall response of
 
occupants.
Noise level of
 
evacuation.
Headcount
 
effectiveness.

GENERAL OBSERVATION:

SUMMARY OF WEAKNESSES IDENTIFIED:

SUMMARY OF RECOMMENDATIONS AND SUGGESTIONS:

SUMMARY OF GOOD PRACTICES:

DRILL PHOTOS:

Name Signature Date

PREPARED
HSE Officer Anjeh gilbert 13/07/2023
BY:

REVIEWED Head of Quality &

Ms. Prapthi Rai 13/07/2023
BY: Strategic Initiatives