Skip to main content

Emergency Response Evaluation

An evaluation form to ensure that your department and area is in accordance with OSHA action plans and fire prevention requirements.
Instructions:
In accordance with OSHA mandated emergency action plan and fire prevention training requirements, please print and complete the following Emergency Response Evaluation form. Indicate the appropriate answers to the following questions, sign, fold and return the form to the BYU-Idaho Safety Office, 363 Rigby -TFO (Zip 4: 4530). Please use an ink pen as the form will constitute part of a permanent training record.

1. What is the emergency phone number for summoning police, fire or ambulance services?

_______________________________________________________________

2. Where is the closest fire extinguisher to your classroom or work area?

_______________________________________________________________

3. Where is the closest fire alarm pull station to your classroom or work area?

_______________________________________________________________

4. What are the four basic steps of fire extinguisher operation?

A. _______________________________________________________________

B. _______________________________________________________________

C. _______________________________________________________________

D. _______________________________________________________________

5. Where is the college Intranet site which lists emergency procedures?

_______________________________________________________________

6. List the title of any of the safety procedure sections listed on this Intranet site? 

_______________________________________________________________

7. Who is the emergency building coordinator for your work area? 

_______________________________________________________________

8. Where is your evacuation meeting location?

_______________________________________________________________

9. Where is the closest external wall-mounted emergency telephone to your work area?  See Inside back cover page of BYU-Idaho Telephone Directory

_______________________________________________________________

10. List the three steps for operating an external wall-mounted emergency telephone? 

_______________________________________________________________

11. To what college entity do you report potential fire or safety hazards?  How?

_______________________________________________________________
12. To what college entity should you report work-related injuries or illnesses?  How?

_______________________________________________________________

13.  To what college entity should you report work campus incidents/accidents (non-work-related)?  How?

_______________________________________________________________

14. To what college radio station should you tune for major emergency or disaster information?

_______________________________________________________________