| Date of Evacuation: | Time of Evacuation: | ||||||||||
| Location: | |||||||||||
| 1. Time taken to complete evacuation of the building? | |||||||||||
| 2. Was any person injured during the evacuation? (details below) | Yes | No | |||||||||
| 3. Could the evacuation alarm be heard in all areas? | Yes | No | |||||||||
| 4. Were all smoke and fire control doors closed? | Yes | No | |||||||||
| 5. Were all permanent occupants and staff familiar with the procedure? | Yes | No | |||||||||
| 6. Did all evacuation team members know their role? | Yes | No | |||||||||
| 7. Did all occupants meet at the designated assembly point? | Yes | No | |||||||||
| 8. Did person(s) with a disability understand their evacuation procedure? | Yes | No | |||||||||
| 9. Are all evacuation procedure notices in place? | Yes | No | |||||||||
| 10. Are all exits clear and all doors able to open? | Yes | No | N/A | ||||||||
| 11. Has firefighting equipment been serviced in the last 12 months? | Yes | No | |||||||||
| 12. Did the person responsible know to make the call to the fire service using 111? | Yes | No | |||||||||
| 13. Is a copy of the approved evacuation scheme available? | Yes | No | |||||||||
| 14. Did all occupants evacuate safely, promptly and efficiently? | Yes | No | |||||||||
| 15. Does the building have a current building warrant of fitness? | Yes | No | |||||||||
| Debriefing Actions | Completion Date | ||||||||||
| x | |||||||||||
| x | |||||||||||
| x | |||||||||||
| x | |||||||||||
| x | |||||||||||
| x | |||||||||||
| Fire Wardens Present at Evacuation | |||||||||||
| x | |||||||||||
| x | |||||||||||
| x | |||||||||||
| x | |||||||||||
| x | |||||||||||
| Supervisor | Signature | ||||||||||
| x | |||||||||||
If a ‘dummy’ call is to be made to switchboard/emergency services, ensure they are aware this is a drill and include an override code in case of real emergency.