2. 

3. Van Buren County Emergency Management

   School Emergency Drills Documentation Form

5. * Seven-day advance notice required for proper public safety coordination. Send notice by email to [email protected]

7.  

   Type of Drill	Number/Schedule
   Fire	Five - Three drills must be completed by December 1
   Tornado	Two - One drill must be completed in March
   Safety/Security	Three - One drill must be completed prior to December 1 and one after January 1 One drill shall include security measures that are appropriate to an emergency such as the release of a hazardous material. One drill shall include security measures of a potentially dangerous individual on or near the school premises. Seek input from the administration of the school and local public safety on the nature of the drill.
   Note -At least one of the drills must be conducted during a lunch or recess period, or at another time when students are gathered but not in classrooms.

9. School:*
11. Principal:*
13. Date of Drill:*
    Date of Drill:
14. Number of Students*
15. Number of Staff*
17. Time Initiated:*
    Time Initiated:
18. Time Concluded:*
    Time Concluded:
20. Situation at Start of the Drill (Check the appropriate box)*

    1. Before School
    2. Lunch Time
    3. During Class Time
    4. Assembly

    1. Passing Time
    2. After School
    3. Recess
    4. Other (Add Details below)
22. Situation at Start of Drill Other Details:
24. Remarks
28. This report is for:*
    -- Select One --Fire DrillTornado DrillSafety/Security Drill
30. Name of person conducting Drill:*
31. Date:*
    Date:

33. If the drill was coordinated with agencies such as law enforcement, 

    fire department, or emergency management, list the agency, official's name, and title.

35. Agency:
36. Name:
37. Title:
39. Agency:
40. Name:
41. Title:
43. Agency:
44. Name:
45. Title:

47. Must post on the school's website within 30 days after completing the drill. 

    The form must be maintained on the school website for at least three years.

51. School Drill Observation Form

53. Date of Drill:
    Date of Drill:
55. Problems Encountered (Check all that apply)

    1. Congestion in hallways
    2. Alarm not heard
    3. Students unsure of proper procedures
    4. Staff unsure of proper procedures
    5. Use of personal technologies by students
    6. Use of personal technologies by staff
    7. Unable to lock doors
    8. Windows not covered
    9. Windows left open
    10. Doors left open
    11. Difficulties with evacuation of students or staff with disabilities
    12. Staff and adults unaccounted for
    13. Staff not serious about drill
    14. Students unaccounted for
    15. Radio communication problems

    1. Network/computer problems
    2. Weather-related problems
    3. Noise impedes communications
    4. Students not out of sight (safety/security drill)
    5. Long time to evacuate
    6. Students not serious about drill
    7. Frightened Students (safety/security)
    8. Improper or unavailable space
    9. Confusion
    10. Doors or exits blocked
    11. Transportation issues
    12. Interagency communications
    13. Incident command problems
    14. Other (Add details below)
57. Problems Encountered Other Details:
59. Weather Conditions

    1. Clear
    2. Cloudy
    3. Raining
    4. Rain and Wind

    1. Windy
    2. Snow/Sleet
    3. Hot (above 80 degrees)
    4. Cold (40 to 10 degrees)
61. Plans for Improvement

    1. Additional staff training
    2. Additional student training
    3. Address need for additional equipment
    4. Improved emergency supplies

    1. Cooperative planning with responders
    2. Improved communication
    3. Other (Add details below)
63. Plans for Improvement Other Details:
65. Additional Comments:
Leave This Blank:


67. 1. Receive an email copy of this form.
68. Email address

    This field is not part of the form submission.

69. Submit

* indicates a required field