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  • Evaluation Form Quake Drill

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    Jeffrey Han Sy Vanbelgica
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    The document is a fire/earthquake drill evaluation form from the Bureau of Fire Protection in Alaminos City, Pangasinan. It contains 13 questions to evaluate various aspects of how a drill was conducted at a particular place on a given date, including whether participants followed proper safety procedures during alarm and evacuation phases, the time it took to evacuate, and any issues observed. The evaluator is asked to provide details for any questions answered "no" to help identify areas for improvement.

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    EVALUATION FORM QUAKE DRILL

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    The document is a fire/earthquake drill evaluation form from the Bureau of Fire Protection in Alaminos City, Pangasinan. It contains 13 questions to evaluate various aspects of how a drill was conducted at a particular place on a given date, including whether participants followed proper safety procedures during alarm and evacuation phases, the time it took to evacuate, and any issues observed. The evaluator is asked to provide details for any questions answered "no" to help identify areas for improvement.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    14 views1 page

    Evaluation Form Quake Drill

    Uploaded by

    Jeffrey Han Sy Vanbelgica
    The document is a fire/earthquake drill evaluation form from the Bureau of Fire Protection in Alaminos City, Pangasinan. It contains 13 questions to evaluate various aspects of how a drill was conducted at a particular place on a given date, including whether participants followed proper safety procedures during alarm and evacuation phases, the time it took to evacuate, and any issues observed. The evaluator is asked to provide details for any questions answered "no" to help identify areas for improvement.

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    © All Rights Reserved
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    Republic of the Philippines

    Department of the Interior and Local Government


    BUREAU OF FIRE PROTECTION
    ALAMINOS CITY FIRE STATION
    #001 G. Montemayor St., Poblacion, Alaminos City, Pangasinan
    Tel. No. 551-4584/Telefax: 632-3619/CP No. 0919-3304090

    FIRE/EARTHQUAKE DRILL EVALUATION FORM

    PLACE OF DRILL: _______________________________________


    DATE: ___________________________
    TIME EVALUATION STARTED: ________________
    TIME EVALUATION ENDED: ________________
    EVALUATOR: _______________________________________________
    LOCATION DURING THE DRILL: ________________________________

    1. IS THE SIREN LOUD ENOUGH TO BE HEARD BY ALL THE DRILL PARTICIPANTS?


    YES/NO _______
    IF NO, PLS ELABORATE _______________________________________________________________

    2. DID THE DRILL PARTICIPANTS PRACTICE THE “DUCK, COVER & HOLD” TECHNIQUE DURING
    THE ALARM PHASE? (WHILE THE ALARM IS BEING SOUNDED) YES/NO _______
    IF NO, PLS ELABORATE_______________________________________________________________

    3. DID THE DRILL PARTICIPANTS EVACUATE DURING THE ALARM PHASE OR WAITED FOR THE
    SIREN TO STOP BEFORE EVACUATING? YES/NO _______
    IF NO, PLS ELABORATE_______________________________________________________________

    4. DID THE DRILL PARTICIPANTS FOLLOW THEIR DESIGNATED ROUTES TO EVACUATION


    AREA? YES/NO ______
    IF NO, PLS ELABORATE_______________________________________________________________

    5. DID THE PARTICIPANTS (A) RUN, (B) WALK CASUALLLY OR (C) WALK FASTER THAN NORMAL
    DURING THE EVACUATION PHASE? YES/NO _________________________________
    IF NO, PLS ELABORATE_______________________________________________________________

    6. DID THE DRILL PARTICIPANTS BRING ANY FIRST AID KIT OR ANY ITEM NOTICEABLE DURING
    THE EVACUATION PHASE? YES/NO _______
    IF NO, PLS ELABORATE_______________________________________________________________

    7. DID THE DRILL PARTICIPANTS CONDUCT THE HEADCOUNT DURING THE HEADCOUNT
    PHASE? YES/NO _______
    IF NO, PLS ELABORATE_______________________________________________________________

    8. IS THE EVACUATION AREA BIG ENOUGH TO ACCOMMODATE THE EVACUEES?


    YES/NO ____ IF NO, PLS ELABORATE___________________________________________________

    9. ANY OTHER PROBLEM OBSERVED DURING THE DRILL THAT MIGHT NEED TO BE
    ADDRESSED? YES/NO ____
    IF NO, PLS ELABORATE_______________________________________________________________

    10. HOW LONG DID IT TAKE FOR ALL THE DRILL PARTICIPANTS TO VACATE THE BUILDING AND
    TIME TO REACH THE DESIGNAYED EVACUATION AREA? _______________________________

    11. DID THE DRILL PARTICIPANTS (A) STAY IN THE EVACUATION AREA, (B) MOVE TO OTHER
    PLACE, (C) GO BACK TO THE BUILDING WITH NO INSTRUCTION? ________________

    12. NUMBER OF DRILL PARTICIPANTS (ESTIMATES WILL DO) _______________________

    13. ANY UNTOWARD INCIDENT OBSERVED DURING THE DRILL?____________________________


    ____________________________________________________________________________________

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