Mock Drill Observers Checklist Form Number: {form_number} Date(Required) MM slash DD slash YYYY Fire / emergency noticed at timeTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Emergency was declared at time Time(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Audibility of the fire / emergency siren Time(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Fire / emergency noticed at timeTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)The first person reached the Assembly Point at timeTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)The last person reached the Assembly Point at timeTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Did the security help in regulating the people? Time(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Emergency / safety indications / stickers existed at the Assembly PointTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)The evacuation route was blocked / clear/ Indicated as appropriate. Time(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Was the nearest exit door in normal conditionTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Fire fighting vehicle arrived at the site at timeTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Head Count was taken at assembly pointTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Head count matched with the number of employees present in officeTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)If the head count did not match, the search for the missing person started at timeTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Identified the missing person at timeTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Head count tallied with the number of employeesTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Emergency contained/ at time All clear siren activatedTime(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Employees returned back to workplace at time Time(Required)OK / Not OK/ NA(Required)Remarks/ Other Conditions(Required)Details of observation(Required)Name of the Observer:(Required)Reviewed By HSSE section:(Required)Details of observation(Required)HSSE comments(Required)Actions Closed out Details: Details of Recommendations(Required)Completion Proposed Date(Required)Actual Completion Date(Required)
