Arc Human Services Fire Drill Log MH

Arc Human Services Fire Drill Log - MH
Day of Fire Drill*

SundayMondayTuesdayWednesdayThursdayFridaySaturday
Date of Fire Drill*

MonthDayYear
Date
Time of Fire Drill*

Hour Minutes

AM/PM Option
Site Location*
Site Address*
Location of Fire Announced?*

YesNo
Individual(s) sleeping?*

YesNo
Individual(s) participated in fire drill safely?*

YesNo
Smoke Detector activated (One smoke detector must be set off each drill)?*

YesNo
Individuals met at the designated meeting place?*

YesNo
Designated Meeting Place*
Exit Routes*

FrontRearSideOther
Please indicate the evacuation time below indicating minutes on the left-hand column and seconds on the right.
Evacuation time - Minutes*
Minutes
Evacuation time - Seconds*
Seconds
Name(s) of individual(s) participating in fire drill.*
Name(s) of staff participating in fire drill.*
Number of individual(s) participating in fire drill*
Name of person who conducted the fire drill.*
Title of person who conducted the fire drill.*
Were there any problems encountered during the fire drill? If yes, please list them in the comments section.*

YesNo
Comments*
Signature*

Clear
Should be Empty:

Arc Human Services Fire Drill Log - MH