F75. Evacuation Observer Checklist

Home 9 Form 9 F75. Evacuation Observer Checklist

Unique ID

Company Details

Company Name

Company Address

Preliminary Information

Address

Floor or Area

Evacuation Sequence

TIME ALARM SOUNDED

Did person who discovered ‘fire’ act calmly and correctly?

Hrs | Mins

Was alarm sounded in accordance with plan?

Hrs | Mins

Could alert and evacuation signals be heard?

Hrs | Mins

TIME EMERGENCY COORDINATORS RESPONDED

Hrs | Mins

TIME EVACUATION COMMENCED

Was there any confusion?

Hrs | Mins

Did staff react correctly?

Hrs | Mins

Was evacuation orderly?

Hrs | Mins

Where there any obstructions or problems in the fire escape?

Hrs | Mins

Was there any crowding in the fire escape?

Hrs | Mins

Was fire-fighting equipment available?

Hrs | Mins

TIME EMERGENCY COORDINATORS REPORTED FLOOR/AREA CLEAR

Was a search made to ensure no one was left behind?

Hrs | Mins

Were persons with disabilities accounted for?

Hrs | Mins

TIME OF ARRIVAL AT ASSEMBLY AREA, SAFE PLACE

Did staff move to assembly area?

Hrs | Mins

Was roll checked in assembly area?

Hrs | Mins

Was roll call reported to chief warden and fire service?

Hrs | Mins

TIME EVACUATION COMPLETED

Comments

Observer

Attendee

Name

Date of Training

Induct

First Response

Coordination

FSA

Instructor

Instructor Certification

Trainer

Signature

Project