Nothing Special   »   [go: up one dir, main page]

Fire Drill Evaluation Form: I. DRILL EXECUTION (Alarm Phase)

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 1

Republic of the Philippines

Department of the Interior and Local Government


Bureau of Fire Protection, Region 7
FIRE DRILL EVALUATION FORM
Date/Time of Drill : __________________________________________RATING: ________
Name of Establishment : __________________________________________________________
Type of Occupancy : __________________________________________________________
Evaluator’s Name/Agency : __________________________________________________________
Actual Location during the Drill : __________________________________________________________

I. DRILL EXECUTION (Alarm Phase):


1. Was the alarm audible/loud enough to be heard by the occupants? (YES/NO) If not audible,
please elaborate: ____________________________________________________________
2. Was there a continuity ringing of the alarm/bell until all occupants evacuated the building?
(YES/NO) If not, please elaborate: _______________________________________________

II. DRILL EVACUATION PHASE:


1. When did the participants evacuate? (a) During the alarm phase: (b) Waited for the alarm to
stop: (c) others, please specify: _________________________________________________
2. Did the occupants follow their designated evacuation routes with assistance of the building
floor marshals? (YES/NO) If not, please elaborate: __________________________________
3. Did the occupants (a) run; (b) walk casually; (c) walked in the double time manner? If not,
please elaborate: ____________________________________________________________
4. Was a first-aid kit available and being brought by respective medical teams? (YES/NO) If not,
please elaborate: ____________________________________________________________
5. Are the designated evacuation areas safe and large enough to accommodate the number of
evacuees? (YES/NO) If not, please elaborate: ______________________________________
6. Was a head count conducted by the marshals at the evacuation areas? (YES/NO) If not,
please elaborate: ____________________________________________________________
7. How long did it take for the occupants to evacuate the building(s)? ____________________
8. Did the occupants remain in the evacuation area(s) until instructions were given either to go
back to the building(s) or go home? (YES/NO) ______________________________________
9. Estimated number of occupants: ________________________________________________

III. RESPONSE PHASE:


1. Does the establishment have an organized Emergency Management and Response Team?
(YES/NO) ___________________________________________________________________
2. Did the member of the EMT and ERT perform their assigned task and established the
Incident Command System (ICS)? ________________________________________________
3. What incident facilities were established under ICS concept (ICP, Treatment Area, Staging
Area, etc…)? ________________________________________________________________
4. Was the Incident Command Post established in a safe area but visible to the incident?
(YES/NO)? If not, please elaborate: ______________________________________________
5. Was command presence of the Incident Commander felt at the ICP (YES/NO)? If not, please
elaborate: __________________________________________________________________
6. Was fire fighting and suppression conducted and utilized the available fire protection
equipment? (YES/NO) If not, please specify: _______________________________________
7. Were search, rescue, triage, treatment and transport performed to manage Mass
Casualties? (YES/NO) If not, please elaborate: ______________________________________
8. Was there an occupant or designated person to call for assistance, especially to the nearest
Fire Station and other Government response agency such as (PNP, DSWD, DRRMO, Fire
Volunteer Brigade, etc…)? (YES/NO) If not, please elaborate: __________________________
___________________________________________________________________________
9. Time of Call: _________________Time Arrival of the First responding unit: ______________
Response time: ___________________ (Including road traffic).
10. Any untoward incident observed during the drill? __________________________________
IV. Recommendations: __________________________________________________________________
__________________________________________________________________
V. RATING: 10 – Excellent, 8 – Very Satisfactory, 6 – Satisfactory, 4 - Failed

You might also like