Template for discussing, drawing up and disseminating

Personal Emergency Evacuation Plan (PEEP)

Name:
Student ID (if applicable):
Faculty/Office:
Programme Leader/Line Manager:
Campus/Building/Room locations above the ground floor and requiring PEEP
Offices, teaching rooms, laboratories, libraries, computer labs, student accommodation all need to be included if assistance would be required to leave the building in an emergency evacuation.
(Add details of all relevant locations, delete or add more lines as necessary or attach extract from the timetable if appropriate)
Campus/Building/Room no / *Day to day/Timetabled
Campus/Building/Room no / *Day to day/Timetabled
Campus/Building/Room no / *Day to day/Timetabled
Campus/Building/Room no / *Day to day/Timetabled
Additional ground floor locations noted for information but not requiring PEEP:
Campus/Building/Room no / *Day to day/Timetabled
Campus/Building/Room no / *Day to day/Timetabled

Awareness of the general fire alarm and emergency arrangements:

(* Typical options listed. Delete or add details as appropriate)

·  I am aware of the general fire alarm and emergency arrangements for the buildings I routinely use.
·  I am made aware of a fire alarm and emergency evacuation by: The standard evacuation signal/ A paging device/ A visual alarm/ My carer/ Other means (Please Specify)

Ability to leave the building from upper floors in the event of a fire alarm or other emergency evacuation:

(* Typical options listed. Delete or add details as appropriate)

·  I do not require assistance to leave the building in an emergency evacuation.
·  I may sometimes require assistance to leave the building in an emergency evacuation.
·  I always require assistance to leave the building in an emergency evacuation.
·  I walk slowly/with a stick/with crutch(es)/with a walking frame.
·  I use a manual/powered wheelchair.
·  I must stay in my wheelchair.

Evacuation Procedure, including evacuation routes:

(* Typical options listed. Delete or add details as appropriate)

·  If I am on the ground floor of any building when I hear the fire alarm sounding, I will proceed to the nearest available fire exit and then go to the Fire Assembly Point shown on the Fire Action Notices in the building.

If I am able to use the stairs to leave the building in an emergency evacuation:

·  If I am on an upper floor when I hear the fire alarm sounding, I will move down the stairs slowly and carefully at my own pace. I may need to wait for people to go first so that the stairs are clear.

·  I may need to have assistance from my designated person(s) [add names] or a friend from my class or a colleague if necessary.

·  I may need specific assistance [add details, for example I will tell people how they should help me at the time. /My designated helper/friend/Security should/must not …]

·  I will then proceed to the nearest available fire exit and then go to the Fire Assembly Point shown on the Fire Action Notices in the building.

If I am unable to use the stairs to leave the building in an emergency evacuation:

·  If I am on an upper floor when I hear the fire alarm sounding, I will proceed to the nearest refuge at [add refuge location for each building/floor/room listed above (normally at or adjacent to lift lobbies)]

·  I may ask a designated person(s) [add names] or a friend from my class or a colleague to stay with me at the refuge.

·  At the refuge I will use the dedicated refuge phone to contact Campus Security, tell them which refuge I am in, and receive instruction.

·  If the alarm is a known drill, false alarm or malicious activation, Security will inform me to remain at the refuge until the cessation of the alarm and people return to the building. I will then return to the office/lecture.

·  If the fire alarm is being investigated, Security will inform me to await further instruction from them via the refuge phone.

·  I am aware that I can obtain a small supply of ear plugs from the campus Student Centre/Student Wellbeing Coordinator for use at the refuge if the alarm is uncomfortable. [Student Centre/Student Wellbeing Coordinator provided with further supplies by the E&F Compliance Manager on request]

If evacuation is essential

·  If it is necessary for me to move from the refuge to an alternative safe location (‘horizontal evacuation’), Security will come and assist me.

·  If it is essential for me to leave the building, Security will come and inform me.

·  If a lift is available that can be used manually as a fire lift, Security will come and take me down in it.

·  If I can, I will move down the stairs slowly and carefully at my own pace.

·  I may need specific assistance to get downstairs and out of the building. [Add details].

·  If an evacuation chair is available, and I am able to use it, Security will come and take me downstairs and out of the building in it.

·  If I can, I will move myself to the evacuation chair.

·  I may need specific assistance to get into an evacuation chair [Add details]

·  I understand that, if the Fire and Rescue Service is present, their personnel may provide assistance.

PEEP agreement and distribution
This PEEP was drawn up in discussions between individual, Programme Leader/Line Manager on [date], and agreed by all parties by email. (If necessary) Health & Safety Unit and the E&F Compliance Manager was consulted for advice.
PEEP distributed to (date): …………………….
·  Individual
·  Programme Leader/Line Manager for forwarding to relevant colleagues and any designated person(s) involved in PEEP arrangements
·  E&F Compliance Manager () for forwarding to Campus E&F and Security and for E&F record
·  ILS H&S Manager () for forwarding to relevant Library and Computer lab staff
·  For student PEEPs only - Student Affairs Wellbeing Coordinator (Disability & Dyslexia) for Student Affairs record
PEEP review required at the start of the 2015-16 academic year, or sooner if necessary.
·  It is the responsibility of the individual to inform the University of problems with the PEEP or changes in their condition which may require adjustments to their PEEP.
·  The PEEP should be reviewed and if necessary a new PEEP drawn up when living/studying/working locations change, for example at the start of each academic year or when office relocations occur.
PEEP Review Due (date):
(No more than 12 months from date of this PEEP)
PEEP Revised Reviewed Cancelled and above notified (date):