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Safety Checklist Program for Schools

October 2003
DHHS (NIOSH) Publication Number 2004-101

Emergency Action Plan (Template)

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DISCLAIMER:

Some of the additional resources listed below were provided by other organizations; they are intended to supplement the occupational safety and health information in this product. NIOSH is not responsible for the contents or accuracy of material obtained from these organizations. Furthermore, mention of any company or product does not constitute endorsement by NIOSH. In addition, citations to Web sites do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Also, NIOSH is not responsible for the content of these Web sites.

Fire Emergency

When fire is discovered:

• Activate the nearest fire alarm (if installed)
• Notify the local Fire Department by calling .
• If the fire alarm is not available, notify the site personnel about the fire emergency by the following means (check applicable):

( )Voice Communication
( )Phone Paging

( )Radio
( )Other (specify)______________

Fight the fire ONLY if:

  • The Fire Department has been notified.
  • The fire is small and is not spreading to other areas.
  • Escaping the area is possible by backing up to the nearest exit.
  • The fire extinguisher is in working condition and personnel are trained to use it.

Upon being notified about the fire emergency, occupants must:

  • Leave the building using the designated escape routes.
  • Assemble in the designated area (specify location):

    ________________________________________________________________
  • Remain outside until the competent authority (Designated Official or designee) announces that it is safe to reenter.

Designated Official, Emergency Coordinator or supervisors must (underline one):

  • Disconnect utilities and equipment unless doing so jeopardizes his/her safety.
  • Coordinate an orderly evacuation of personnel.
  • Perform an accurate head count of personnel reported to the designated area.
  • Determine a rescue method to locate missing personnel.
  • Provide the Fire Department personnel with the necessary information about the facility.
  • Perform assessment and coordinate weather forecast office emergency closing procedures

Area/Floor Monitors must:

  • Ensure that all employees have evacuated the area/floor.
  • Report any problems to the Emergency Coordinator at the assembly area.

Assistants to Physically Challenged should:

  • Assist all physically challenged employees in emergency evacuation.

Date___/___/___

 
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  • Page last reviewed: June 6, 2014
  • Page last updated: June 6, 2014
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