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Get NC Mission Hospital Fire Drill Evaluation Form 2004-2024

Ill ILSM Pull Station #: Type of Fire Simulated: Unannounced Drill? Section 1 Immediate Staff Response R-Rescue Removed persons from immediate danger (Simulated) (5pts.) A-Alarm Notified PBX, dialed 711 & gave correct location/type of fire (5pts.) A-Alarm Pulled Fire Alarm (5pts.) C-Contain Closed doors & windows (5pts.) E-Extinguish Staff can demonstrate the fire extinguishing technique P.A.S.S. (10pts.) Were all fire doors in the area close.

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