Item Parameters Yes No Remarks

1 Fire alarm clearly heard in all areas

2 Public address system clearly heard in all areas

3 Electro-magnetic locks operated appropriately (if

applicable)

4 Occupants met at designated meeting places

according to the plan

5 Were the designated meeting areas located at a

safe distance from the building

6 Have procedures for the handicapped been

addressed

7 Was an accurate count taken of each evacuation

group

8 Did all equipment function properly? (e.g. stairwell

doors)

9 Fire drill/incident response team(s) responded

according to plan

10 Fire department “mock” notified according to plan

1. Identity of the person conducting the drill (BA or Facility)

2. Date and time of the drill
3. Notification method used
4. Number of occupants evacuated
5. Special conditions simulated
6. Problems encountered
7. Weather conditions when occupants evacuated
8. Time required to accomplish complete evacuation
9. Results and recommendations of BFP (if available)
10. Over-all evaluation and recommendations of Synerquest