F75. Evacuation Observer Checklist

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