Critical Response and School Emergency Management Guide – SY 2015-16 School Drill and Evacuation Log School Name and Number : _________________________________________________________________ Weather Radio Used by the Main Office Staff: Yes: No: Record all drills and evacuations for your school. Contact the School Police Office prior to activating the fire alarm. Completed copies of this form must be provided to your Network Liaison in November and April of year school year. I. Fire Drills (note changes to prior year requirements): a. Schools that are fully protected by an Automatic Sprinkler System must conduct 5 fire drills during the school year. Two out of the 5 must be conducted in the first 4 months of the school year. b. Schools that are not fully protected by an Automatic Sprinkler System must conduct 8 fire drills during the school year. Three out of the 8 must be conducted in the first 4 months of the school year. Date Conducted Weather Conditions Number of Occupants Time Signature: Conducted: Principal or Asst Prin 1st Sept: 2nd Oct.: 3rd Nov.: 4th Dec.: 5th 6th 7th: 8th: II. Bus Evacuation Drills –Two Per School Year (September and February – flip over for additional columns) 1) Date: Time: Bus Contractor and Bus #: Signature: Bus Driver 2) Date: Time: Bus Contractor and Bus #: Signature: Bus Driver III. Additional Drills – One Per School Year. For Guidance, See Section 3 1) Evacuation Date Held: Time Occurred: Signature, Principal or AP: 2) Shelter-In-Place Date Held: Time Occurred: Signature, Principal or AP: 3) Reverse Evacuation/Alert Status Date Held: Time Occurred: Signature, Principal or AP: 4) Lockdown Date Held: Time Occurred: Signature, Principal or AP: 5) Severe Weather/ Safe Area Date Held: Time Occurred: Signature, Principal or AP: 6) Drop, Cover, and Hold On Date Held: Time Occurred: Signature, Principal or AP: Appendix-Page 1 Critical Response and School Emergency Management Guide – SY 2015-16 II. additional columns for Bus Evacuations, if required Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Date: Time: Bus Contractor and Bus Number: Bus Driver, Signature: Appendix –Page 2