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Fire Drill Form

In accordance with OAR 411-325-0250, every Northwest Care location must conduct an unannounced monthly fire drill, including one drill per year during the hours of sleep. Drills must occur at different times during day, evening, and night shifts with exit routes being varied based on the location of a simulated fire.

General Information

Date

*

Time (in 24 hour time)

*

Location of Fire

*

Exit Route

*

Fire Drill Type

*

Extinguisher Checked, Tag Signed

*

Staff Participating (First and Last Names)

*

Fire Drill Information

Number of Clients in the Home

*