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FIRe

FIRe  Fire Incident Report 

*Indicates required information













 

See Policy #tbd, regarding Code Red.

GENERAL INFORMATION


format (mm/dd/yy)

format (military time ex. 0100 or 1730)
7. Was Observer's department open at time of Code Red?*

STAFF RESPONSE

1. Did staff of Observer's department close all fire doors in the area, including patient room doors?*
2. Were the corridors of Observer's department clear & free from obstructions?*
3. Did staff of Observer's department inform patients/visitors of the alarm condition?*

EQUIPMENT PERFORMANCE

1. Was the page audible within Observer's department?*
2. Did all automatic doors within Observer's department close and latch properly?*
3. Were fire alarm devices (strobes, etc.) within Observer's department functioning properly?*
Date Observer completes form:
7/17/2018
Time Observer completes form:
5:59:18 AM