Republic of the Philippines

DEPARTMENT OF EDUCATION
Regional Office No. 02 (Cagayan Valley)
SCHOOLS DIVISION OFFICE OF CAGAYAN
Regional Government Center, Carig Sur, Tuguegarao City, 3500

EARTHQUAKE DRILL EVALUATION FORM A

SCHOOL ID :__300438___________ SCHOOL NAME:_Cabatacan National High School_____________
DATE AND TIME: ______________ ______ PLACE OF DRILL:__ Cabatacan National High School __________
EVALUATOR :_________________________ LOCATION DURING THE DRILL:__School__________________

1. Is the siren loud enough to be heard by the drill participants?

Yes/No If NO, please elaborate __YES______________
2. Did the drill participants practice the “Duck, Cover and Hold” technique during the Alarm Phase ( while the siren
is being sounded)? Yes/No
If NO, please elaborate ___YES_______________
3. Did the drill participants a.) evacuate during the alarm phase b. waited for the Alarm Phase to stop before
evacuating c. others, please elaborate __B____________
4. Did the drill participants follow their designated routes to evacuation area?
Yes/No If No, please elaborate ____YES____________________
5. Did the drill participants a) run b) walk casually or c) walk faster than normal during the evacuation phase?
Please specify, a , b, or c ___C___
6. Did the drill participants bring any first aid kit or any item noticeable during the evacuation phase? Yes/No
If NO, please elaborate ____YES__________________
7. Did the drill participants conduct the headcount during the headcount phase? Yes/ No
If NO, please elaborate ___YES__________
8. Is the evacuation area big enough to accommodate the evacuees? Yes/No
If NO please elaborate ____YES______________
9. Any other problem observed during the drill that might need to be addressed?
Please elaborate __NONE__________
10. How long did it take for all the drill participants to vacate the building and time to reach the designated
evacuation area?____2 MINS_________
11. Did the drill participants a) stay in the evacuation area b) move to other place c) go back to the building without
instruction? Please specify a, b or c ____C_____
12. Observed number of drill participants (estimate will do) _______________
13. Any untoward incident observed during the drill? NONE _ __
14. Coordinated with Local Disaster Risk Reduction Management Council on the conduct of the drill? Yes/No
15. Conducted orientation on earthquake and preparedness measures before the drill? Yes/No
16. Conducted post evaluation after the drill? Yes/No

__________________
Signature of Evaluator
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