Emergency and Evacuation Drill Record

Emergency and Evacuation Drill Record
Use this form to record a completed emergency and evacuation rehearsal. Follow your service’s current EMP, procedures, risk assessment and individual plans.
Service Name
Date of Drill

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Responsible person present during the rehearsal

First NameLast Name
Start Time of Drill

Hour Minutes

AM/PM Option
End Time / All Clear

Hour Minutes

AM/PM Option
Total Time Taken to Secure/Evacuate
e.g., 2 mins 15 secs
Drill Emergency/Scenario
Examples: "Fire in the kitchen," "Snake near the sandpit," "Unidentified dog in the yard," "Severe asthma attack."
Location of Emergency/Scenario
Method Used to Raise Alarm
e.g., Whistle, Verbal.
Emergency Response Type
Location of Emergency Response (Muster Point/Safe Area)
Number of ADULTS present (Staff)
e.g., 4.
Number of VISITORS / STUDENTS / VOLUNTEERS / CONTRACTORS present
Number of CHILDREN present
e.g., 22
Did all staff members, volunteers, children and the responsible person present participate in the rehearsal?
Did the total headcount match the daily attendance roll/sign-in system?
Were all individuals (including visitors / students / volunteers / contractors) safely accounted for?
Did the service EMP or drill scenario require a simulated 000 communication step?
Did anyone require an individual support arrangement during this rehearsal?
What went well? What were our strengths?
What can we work on?
Do we need to change our procedures or update our Emergency Floor Plan?
Were any physical hazards or bottlenecks identified during the drill (e.g., locked gates, blocked pathways, trip hazards)?
Hazard Details/Fixes (If yes above)
Is any follow-up action required?
If you selected Yes, record the action needed, who will complete it, and when it is due. Significant safety concerns must also be reported directly to the Education Manager. Submitting this form is not the escalation.
Action required
Person responsible
Due date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
What feedback, reactions, or questions did the children have after the drill? How were they reassured?
Any other important information?
Person Completing Report

First NameLast Name
Service Email
example@example.com
Date of Report

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate

Post-drill checks

Rows	Yes	No	Not applicable
Required emergency equipment was taken and checked in accordance with the service EMP
Any required corrective action has been recorded
The next due rehearsal has been scheduled

Confirmation
Should be Empty: