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Emergency Drill Evaluation Form - PDF - Rev.00

This document is an evaluation form for earthquake drills conducted at a business unit. It contains sections to rate communication of warnings, evacuation procedures, firefighting response, rescue operations, medical response, security and traffic control, and overall organization. Ratings are on a scale of 1 to 5. The form collects details of the drill such as date, address, and evaluator name and provides space for comments. It states that tampering with the form's information is not allowed.

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Nelz Pelaez
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1K views2 pages

Emergency Drill Evaluation Form - PDF - Rev.00

This document is an evaluation form for earthquake drills conducted at a business unit. It contains sections to rate communication of warnings, evacuation procedures, firefighting response, rescue operations, medical response, security and traffic control, and overall organization. Ratings are on a scale of 1 to 5. The form collects details of the drill such as date, address, and evaluator name and provides space for comments. It states that tampering with the form's information is not allowed.

Uploaded by

Nelz Pelaez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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DOCUMENT: DOCUMENT NO.

: HRC-SHES-FM-_ _ _- _ _ _-_ _
FORM DATE OF EFFECTIVITY: 01-Sep-22
Superseded: N/A
SUBJECT:
Revision No.: 00
DRILL EVALUATION FORM
Date Revised: -
This form is an internally regulated document.Tampering of information written in this form is not allowed.
All information be written in this form shall be considered void if without signature or tampered.
Page 1 of 1

DRILL TYPE: EARTHQUAKE DRILL DATE CONDUCTED:

BUSINESS UNIT: DRILL FREQUENCY: SEMI-ANNUAL

ADDRESS:

NAME OF EVALUATOR:

RATING
EVALUATION PARAMETERS
5 4 3 2 1 Ave. Rate

1.1 WARNING/COMMUNICATION
1.1.1 Was the fire alarm audible enough in all areas of the premises?
1.1.2 Did the occupants react immediately upon hearing the alarm?
1.1.3 Did the communication team immediately inform the nearest fire station?
1.2 EVACUATION
1.2.1 Did the occupants walk faster than usual?
1.2.2 Did the occupants follow their evacuations routes?
1.2.3 Did all the occupants assembled at designated evacuation areas?
1.2.4 Was the designated evacuation area free from any danger?
1.2.5 Did the Safety Officer conduct the head count?
1.2.6 Was there any assigned floor captains? (optional)
1.3 FIRE FIGHTING
1.3.1 Did the fire fighting team locate immediately the origin of fire?
1.3.2 Did the fire fighter execute the proper handling of fire fighting equipments?
1.4 RESCUE /SALVAGE
1.4.1 Did the rescue group perform search and rescue operations?
1.4.2 Did the rescuers execute proper handling of the victims?
1.4.3 Did the rescuers perform Maximum Observance of Safety (MOS)?
1.4.4 Did the salvage team apply color coding/priority to transfer properties?
1.5 MEDICAL
1.5.1 Did the medical team establish casualty collecting point (Triage/Treatment/Transportation)?
1.5.2 Was the established medical post free from any danger?
1.5.3 Was there any available first aid kit/equipment/transportation?
1.5.4 Was there any available transporation?
1.6 SECURITY/TRAFFIC CONTROL
1.6.1 Was there security provided and controlled the crowd in the following areas?
1.6.1.1 Evacuation Area
1.6.1.2 Salvage Area
1.6.1.3 Entrance/Exit
1.6.1.4 Treatment Area
1.6.1.5 Staging Area
1.7 ORGANIZATION
1.7.1 Was the incident command post established/visible?
1.7.2 Did the team leaders of different action group report/coordinate to the incident commander?
1.7.3 Was there any proper turn-over of command upon arrival of BFP Incident Commander

RATINGS:

Excellent = 5 Very Satisfactory = 4 Satisfactory = 3 Fair = 2 Needs Improvement = 1

Comments/Remarks:
Evaluated by: Received by:

(NAME/SIGNATURE/DATE) (NAME/SIGNATURE/DATE)

CORPORATE SAFETY, HEALTH, ENVIRONMENTAL & SECURITY UNIT DRILL EVALUATION FORM

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