Critical Response and School Emergency Management Guide – SY 2016-17

School Drill and Emergency Evacuation Log

School Name and Number :
______
Weather Radio Used by the Main Office Staff: / Yes: / No:
Record all drills and evacuations for your school. Contact the School Police Office prior to activating the fire alarm.
  • Completed copies of this form must be provided to your Network Liaison in November and April of year school year.

  1. Fire Drills (note changes to prior year requirements):
  2. Schools that are fully protected by an Automatic Sprinkler Systemmust conduct 5 fire drills during the school year. Two out of the 5 must be conducted in the first 4 months of the school year.
  3. Schools that are not fully protected by an Automatic Sprinkler Systemmust conduct 8 fire drills during the school year. Three out of the 8 must be conducted in the first 4 months of the school year.

Date Conducted / Weather Conditions / Number of Occupants / TimeConducted: / Signature:
Principal or Asst Prin
1st Sept:
2nd Oct.:
3rd Nov.:
4th Dec.:
5th
6th
7th:
8th:
  1. Bus Evacuation Drills –Two Per School Year (September and February – flip over for additional columns)

1)Date: Time: Bus Contractor and Bus #: Signature: Bus Driver
2)Date: Time: Bus Contractor and Bus #: Signature: Bus Driver
  1. Additional Drills – One Per School Year. For Guidance, See Section 3

1) Evacuation
Date Held: / Time Occurred: / Signature, Principal or AP:
2)Shelter-In-Place
Date Held: / Time Occurred: / Signature, Principal or AP:
3)Reverse Evacuation/Alert Status
Date Held: / Time Occurred: / Signature, Principal or AP:
4)Lockdown
Date Held: / Time Occurred: / Signature, Principal or AP:
5)Severe Weather/ Safe Area
Date Held: / Time Occurred: / Signature, Principal or AP:
6)Drop, Cover, and Hold On
Date Held: / Time Occurred: / Signature, Principal or AP:
II.additional columns for bus evacuations, if required
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:
Date: / Time: / Bus Contractor and Bus Number: / Bus Driver, Signature:

Appendix –Page 1