EARTHQUAKE DRILL EVALUATION FORM MC Title: (N) Quarter NSED (Year) ‘Name of Agency/ Organization’ LGU Place of Ori Name of OCG? Date of Date of Bri Duration of Dil “Total Number of Parlicipants: Quantitative assessment of EQ dril: Rate the following parameters with one (7) being the lowest and five (5) being the highest Ifyou think that your response: needs to be qualified, please fil-up the column below. PART |- GENERAL EVALUATION: 1 |2/|3 ‘COMMENTS and OBSERVATIONS. hheard by all dil participants. The alarm system used was loud enough fo be 2. The ill participants executed the “duck, cover land hold” technique during the Alarm Phase or system to stop before evacuating | buddy” system during the evacuation phase. 3. The drill participants waited for the 4. The dil participants executed the buddy- 5. The dhil participants walked faster than normel ‘vacating the building. injury in the evacuation’ assembly area/s routes to the evacuation areas 7. The afill participants covered their heads while '8. The participants checked for any sustained '9, A headcount was conducted while in the ‘evacuation area. 10. The participants stayed in the evacuation area | until the ail was terminated, | Evaluation ofthe Disaster Conirol Group 77. The incident Commander established lear leadership during the ail, 72. The First Aid/ Medical Team immediately addressed all medical needs of the injured victims and casualties 14, The Fire Safety/ Brigade Team 1B. The Search and Rescue Team was efficiently organized in responding to the Incident onstrated proper fre suppression. % Evacuation Team properly executed _ the evacuation procedures. 46. The Site Security Team adequately Secured the perimeter forthe dil area 77. The Maintenance Team observed protocols in ensuring the building safety before re-entenng 18. The Communication ullized the equipment propery during coordination and execution of response operations, ¥8. The Transportation team ensured the availabilty of vehicles20. The Relief Team coordinated with LGU to secure relief requirements. ‘SUB-TOTAL. GRAND TOTALIOVER ALLRATING | _ RATING SCALE 90-100 points - OUTSTANDING 6069 points FAIR 80-89 points - VERY SATISFACTORY 59 &below = NEEDS IMPROVEMENT 70-79 points - SATISFACTORY PART Il- RECOMMENDATIONIS: Conforme: Evaluator ‘Signature over Printed Name ‘Agency Represented Designation Landline and Mobile Numbers E-mail Address Signature over Printed Name ‘Adepted om Ofc of Gil Defense ~ Region XI Earthquake Evaluation Form