Chief Warden
The University is required under Australian Standard 3745-2010- Planning for Emergencies in Facilities, to maintain records of all emergency evacuations, including drills from University premises & buildings. These records are also used to determine the level of training and experience building occupants have with respect to emergency procedures and evacuations. Please complete all sections of the form.
General Information -
Building No: / Evacuation Date: / / / / Time / am/pm
Occupancy Status: / Administrative Student Space
Faculty Space Mixed space
Lecture Space / Type of Evacuation: / Planned Drill
False Alarm
Real
Evacuation Process:
Action / Time Taken
Alarm Raised / Alert: / Evac:
Wardens Respond
Evacuation Commenced
Wardens Report Evacuation Completed / First: / Last:
Emergency Declared Over
Re-entry to building completed
Evacuation Completed
Debrief:
Alarm
Was the evacuation alarm heard throughout the building? / Yes / No
Did the alarm system malfunction in any way? / Yes / No
Evacuation Process:
Did all floor wardens report to the Building warden to advise that their area had been evacuated? / Yes / No
If not, note which wardens did not report as per procedure -
Were external entry points guarded to prevent re-entry? / Yes / No
Was anyone left inside the building after evacuation? / Yes / No
Did Wardens identify themselves by wearing the tabards provided? / Yes / No
Did anyone refuse to evacuate the building during the evacuation? / Yes / No
Please note names (and if staff / students) if applicable
Evacuation Process cont.:
Were refusals to evacuate reported to emergency personnel? / Yes / No
Details:
Were any parts of the building not evacuated? / Yes / No
If yes, Why?
Were there any faults in the fire equipment? i.e. Exit signage, emergency exit doors, fire extinguishers etc / Yes / No
If yes, please provide a summary
Assembly Points:
Did Wardens locate the correct assembly point? / Yes / No
Did staff/students move to assembly point upon hearing the evacuation signal? / Yes / No
Did wardens direct staff/students to assembly point / Yes / No
People with Disabilities or requiring assistance to evacuate:
Were there people with a disability or who required assistance to evacuate? / Yes / No
Are there evacuation plans in place for these individuals?
If so, were you aware of them? / Yes / No
Were emergency wardens aware of these plans? / Yes / No
Were correct evacuation procedures for assisting people evacuate followed? / Yes / No
General:
Were there any deficiencies noted (e.g. procedures inadequate; response times too long etc.) / Yes / No
Comments:
Chief Warden’s
Name: / Signature:
Please forward a copy of this report with any warden reports to Emergency Management
Corrective Actions:
Action / Who’s Responsible / Due Date:
Emergency Evacuation Report – Chief Warden v 1.0 2015