* = Required Information
Fire Drill Record
Location/Site name
*
Date and time of drill
*
Name of staff conducting the fire drill
*
Were any exits (egresses) blocked?
No
Yes (please remove items blocking exit)
List the names of all residents in the building
*
Results of the drill
*
Building completely vacated in less than 2 minutes
Building completely vacated in 2-5 minutes
Building completely vacated in 5-10 minutes
Did anyone require physical assistance to vacate building? If so, put their initials below
Did anyone refuse to vacate the building? If so, put their initials below
Additional comments?
Signature of staff conducting the drill
Submit