Evacuation Drill Evaluation Form - Cal State LA
Evacuation Drill Evaluation Form
California State University, Los Angeles
|Time Alarm Sounded |Date of Drill |Person Completing Form |
| | | |
|Time Building Evacuated |Building/Location |Person Assigned to Assist Handicapped |
| | | |Yes | |No |
| | | | | | |
| | | |
|Total Evacuation Time | |Name: | |
| | | | |
| | | |
|Person (s) Assigned to Evacuation Site to Handle Evacuees |Person(s) Posted at Doors to Prevent Re-Entry |
| | |
| | |
| | |
|Yes |Yes |
| | |
| | |
| | |
|No |No |
| | |
| | | |
|Name(s): | |Name(s): | |
| | | | |
| | | | |
| | | |
|Person (s) Assigned to Report to EOC |Building Checked for Occupants |
| | |
| | |
| | |
|Yes |Yes |
| | |
| | |
| | |
|No |No |
| | |
| | | |
|Name(s): | |Name(s): | |
| |Michael Obermeyer | | |
| | | | |
| | | |
|Classes in Session |People did NOT clear some Rooms |Alarm Could be Clearly Heard |
| | | |
| | | |
| | | |
|Yes |Yes |Yes |
| | | |
| | | |
| | | |
|No |No |No |
| | | |
|What went Right? |
| |
| |
| |
| |
| |
|What could be improved? |
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| |
| |
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|Other Comments… |
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|Are you confident we can clear buildings in a safe and |My level of confidence in the campus Emergency Preparedness Plan is |
|Organized manner | |Yes | |No | |
| | | | | | |
| | | | | | |
| | | | | |High |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | |Med |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | |Low |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | |I am NOT Familiar with the Plan |
| | | | | | |
General Instructions
1. Immediately begin to clear and secure building.
2. Direct people to use stairs.
3. Continually state where the assembly area [evacuation site] is located.
4. Check rooms and close all doors.
5. Ensure no one re-enters the building until authorized to do so.
6. Notify your Building Coordinator once the evacuation has been completed.
7. Drill coordinators and/or Public Safety will notify you when re-entry is allowed.
8. Complete the “Evacuation Drill Evaluation Form” and respond to the Campus Emergency Operations Center for a debriefing.
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