Emergency / Disaster Drill – Post-Drill Debrief Form
Record of drill details, scenarios, problems encountered, improvement plans, and performance evaluation.
1. Drill Details
| Field | Details |
|---|---|
| Person Completing Form | |
| Position Title | |
| Date | DD / MM / YYYY |
2. Emergency and Disaster Scenario
| Field | Details |
|---|---|
| Location | |
| Type of Drill | ☐ Fire / Evacuation ☐ COVID-19 / Influenza ☐ Lockdown ☐ Earthquake ☐ Medical Emergency ☐ Weather Emergency ☐ Other: __________________ |
| Time Drill Called | |
| Time Drill Ended | |
| Total Time Taken to Evacuate / Respond | |
| Notification of Alert (how drill was activated) | ☐ Bell / Whistle ☐ Phone ☐ Bulk SMS ☐ Voice Notification ☐ Siren ☐ Other: __________________ |
| Weather Conditions | ☐ Clear ☐ Hot ☐ Cold ☐ Cloudy ☐ Raining ☐ Rain and Wind ☐ Windy ☐ Hail |
| Communication With Other Interested Parties (e.g. SIL, building manager, emergency services, families) Has communication between other interested parties been carried out? |
☐ Yes ☐ No Details (if applicable): |
| Comments |
3. Participants & Context
| Participants Involved (tick all that apply) | ☐ Staff ☐ Participants / Clients ☐ Visitors ☐ Volunteers ☐ Other: __________________ |
| Situation at Start of Drill | ☐ Before Business Hours ☐ During Business Hours ☐ Lunch Time ☐ After Business Hours ☐ Other: __________________ |
| Items Taken on Drill (where applicable) | ☐ Sign-in / Sign-out sheets ☐ Evacuation Kit / Bag ☐ Mobile Phone ☐ Other: ______________________________________________________ |
Sign-In Compliance
| Question | Yes | No | Comments |
|---|---|---|---|
| Were all clients / participants signed in? | ☐ | ☐ | |
| Were all visitors signed in? | ☐ | ☐ |
Next Drill
| Field | Details |
|---|---|
| Date of Next Drill | DD / MM / YYYY |
| Person Responsible to Call Next Drill |
4. Problems Encountered
(Tick all that apply and add comments if needed.)
- ☐ Congestion in hallways / exits
- ☐ Alarm not heard clearly
- ☐ Employees unsure of what to do / proper response
- ☐ Staff unsure of responsibilities / roles
- ☐ Weather-related problems
- ☐ Personnel not accounted for / attendance issues
- ☐ Difficulties evacuating people with disability or mobility needs
- ☐ Personnel unaccounted for (number: ________)
- ☐ People / clients not signed in
- ☐ Network / computer problems
- ☐ Long time to evacuate building
- ☐ Noise impeded communication
- ☐ Personnel not out of sight during lockdown drill
- ☐ Personnel not serious about drill
- ☐ Improper or unavailable supplies / equipment
- ☐ Confusion about procedures
- ☐ Doors or exits blocked
- ☐ Miscommunications
- ☐ Incident command / leadership problems
- ☐ Other: ______________________________________________________
Additional Comments on Problems Encountered:
5. Extenuating Circumstances / Special Conditions
(Include any simulated conditions, e.g. blocked exits, staff absences, injured participant scenario, etc.)
Extenuating Circumstances / Simulated Factors:
6. Plans for Improvement
(Tick all that apply and describe actions below.)
- ☐ Additional staff training required
- ☐ Need for additional / different equipment
- ☐ Improve / restock emergency supplies
- ☐ Revise emergency and disaster management plan and procedures
- ☐ Other: ______________________________________________________
Details of Improvement Actions
| Action / Improvement | Responsible Person | Due Date | Comments |
|---|---|---|---|
| DD / MM / YYYY | |||
| DD / MM / YYYY |
Follow-Up Completed By
| Field | Details |
|---|---|
| Name | |
| Signature | |
| Date | DD / MM / YYYY |
Emergency / Disaster Drill – Post-Drill Debrief
7. Debrief Summary
| Field | Details |
|---|---|
| Number of Personnel Present at Debrief | |
| Time of Debriefing | |
| Issues Identified? | ☐ Yes ☐ No |
| Risk Assessment Register Amendment Required? | ☐ Yes ☐ No |
| Strategic and Business Plan Amendment Required? | ☐ Yes ☐ No |
| Emergency and Disaster Management Plan Amendment Required? | ☐ Yes ☐ No |
| Additional Information / Notes |
8. Summary – Performance Evaluation & Residual Risk
| Field | Details |
|---|---|
| Completed By | |
| Signature | |
| Date | DD / MM / YYYY |
Attendance Sheet
| Name | Worker / Participant / Visitor / Other | Signature |
|---|---|---|
