CODE GREY MOCK DRILL CHECK LIST

Area:

Date:

Time:

S.NO Element Remarks

1. Was the employee in the area
aware about Code Grey

2. Did the employee know how to

alert in case of Code Grey

3. Did the communications staff pick

the call for request to page within
20 seconds?
4. Did the communications staff
page immediately after getting
the request?
5. Was Code Grey paging heard in
the area

6. Did the Security team arrive at

the scene within 2 minutes

7. Was the patient secured quickly

and calmly using the least
possible force

8. Was the patient given Physical or

Chemical restraint without delay

Comments if any:

Name of the Auditors with Designation and Signature: