CRMC Fire Drill Report

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Agreement on Free Circulation of People (AFCP) between CRMC-CSDM

בס״ד

Local Rate

Toll-Free

Patients info

בטיחות הנה עדיפות כאן

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Date of drill

Time drill ended

Time Drill Commenced

Method of roll call

QR LIST IDENTIFIED

NAME LIST

Number of people present at CRMC at time of alarm

Where patients/clients present during fire drill?

Yes

Total # of CRMC areas found empty after evacuation

Number of people counted at muster point

If patients/clients present during fire drill, were they all accounted for?

Yes

N/A (no patient/client present)

Where patients/clients present during fire drill?

Satisfactory

Unsatisfactory

Recommendations

Full name of submitting fire safety officer

Thank you for submitting your report! The report has been registered. If you require a copy, please ask the Clinical Manager of CRMC.

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