Evacuation Plan Template
Note to user: Team members are responsible for identified roles in evacuation procedures during an emergency
situation.
Evacuation Plan for (
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Roles and Functions:
To help prevent loss of life and minimize injury, we recommend you assign staff to the following
roles: evacuation coordinator, manager, and monitor. Your staff assignments may vary depending
on the size and structure of your organization.
The evacuation coordinator is responsible for:
1. Ensuring a safe evacuation of the entire building and directing the medical attention needed to
injured personnel.
2. Giving direction and assistance to emergency medical technicians (EMTs) if needed.
3. Reporting head count of evacuated personnel to emergency officials and to emergency
coordinator.
4. Seeing that security is established after tending to injured personnel.
The following evacuation coordinator(s) are assigned at the following facilities:
Location
Title/position held
Name
Site A
Site B
Managers are responsible for:
1. During an evacuation, managers direct their staff out of the building through the nearest exit
and to the designated safe area.
2. Reporting a head count of their team members to the evacuation coordinator.
3. If conditions allow, performing a general damage assessment of their department area and
issuing an assessment.
Monitors are responsible for:
1. Guarding all exterior doors to the facility if the building is not secure due to power loss or
other concern (after confirmation that all staff and visitors have evacuated the building).
2. Overseeing that all employees needing special assistance are tended to.
In the event of an emergency situation that warrants an evacuation, the evacuation coordinator and
all emergency officials are in charge and will need complete cooperation from everyone. Depending
on the level of urgency, the notification to evacuate may be presented verbally by the evacuation
coordinator.
Designated Safe Areas for All Staff in the Event of an Evacuation:
Business location
Site A
Site B
Designated safe area (exterior)
Evacuation Procedures
X
Emergency evacuation procedures
Note: If the fire alarm sounds without acknowledgement of a
practice drill or system test, do not question whether it’s real or
false alarm. Leave the building immediately.
Upon call for evacuation, employees remain calm and proceed
to evacuate using designated exits in their area of the building.
Employees stay to the right in the hallway and use walls to
guide them if vision is limited.
Evacuation coordinator:
 Takes the visitor log with him/her.
 Verifies that any handicapped individuals are assisted.
 Directs the evacuation of any visitors from the building.
 Checks for people in restrooms, storage rooms, and other
areas.
 Checks assigned areas to ensure everyone has evacuated
and provides assistance as needed.
 Reports medical issues and safety concerns to arriving
emergency officials.
Report the emergency by dialing 9-1-1. Provide the 9-1-1
dispatcher with the following information:
- Your name
- Building address
- Location
- Type of emergency
Once outside, everyone proceeds to the designated evacuation
safe area. Do not leave safe area until head count takes place.
Wait for further instructions from evacuation coordinator.
Secure all doors.
Secure all department records and equipment. Department
managers make sure sensitive files have not been carried out.
Receive reports of status of building and any missing persons.
Report the conditions of the building and personnel head count
to evacuation coordinator.
Responsible
party
X
Evacuation Preparation and Emergency Preparedness
Maintain the following:
First-aid kits
Battery-powered emergency lighting
Exit markings/floor plans posted throughout the building
Building safety code compliance
Flood protection: Covering for computer equipment
Fire protection: Fire extinguishers available and tested on a
regular basis
 Hazardous material storage: Hazardous materials stored on
the floor or lowest shelf away from electrical devices and
heaters
 Tool kits: Hammer, nails, saw, wrenches, wire cutter, rope
and pliers are on site
Make sure all staff are aware of evacuation procedures.
 Identify individuals who will serve as monitors and make
sure they are aware of their responsibilities.
 Rehearse evacuation yearly.
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Responsible
party