Drill Feedback Form

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DRILL FEEDBACK FORM
Name ______________________________
Room Number/ Location___________
Optional
Optional
Type of Drill
Drill Date
Which of the following categories best describes your position or role?
Administrative support staff
Nurse
Teaching Staff
Substitute
Non Teaching Staff(Cafeteria, Maintenance)
Other, please specify: __________________
Before The Drill
1. Do you feel you received enough information and/or training to
perform this drill?
□Yes
□No
2. Did you know the drill was happening, in advance?
□Yes
□No
a.
If so, how many days/hours in advance were you notified?
_______d _______h
3. Did students know the drill was happening, in advance?
□Yes
□No
a.
If so, how many days/hours in advance were they notified?
_______d _______h
During The Drill
1. Could you clearly hear the announcement for the drill?
□Yes
□No
a.
If no, what area of the school were you located in?
2. Did you understand the instructions that were announced?
□Yes
□No
If code was used, did you (check one):
a.
□ Immediately know what the code instructed you to do
□ Had to think about it, first. Then remembered
□ Referenced your classroom guide to remind you
□ Did not know what to do
3. Did students understand what the emergency notification meant?
□Yes
□No
4. Did you or other staff follow procedures for students and staff in
hallways, bathrooms and open areas?
□Yes
□No
a.
Did you pull any students into your classroom?
□Yes
□No
b. Were the hallways clear?
□Yes
□No
5. Were you able to lock your classroom doors during a
lockdown?
□Yes
□No
a.
Was everyone out of sight from the door during the drill?
□Yes
□No
□Yes
□No
6. If you evacuated did students remain quiet and calm?
a.
Did you bring necessary items with you?
□Yes
□No
DRILL FEEDBACK FORM
Name ______________________________
Room Number/ Location___________
Optional
Optional
Type of Drill
Drill Date
Which of the following categories best describes your position or role?
Administrative support staff
Nurse
Teaching Staff
Substitute
Non Teaching Staff(Cafeteria, Maintenance)
Other, please specify: __________________
Before The Drill
1. Do you feel you received enough information and/or training to
perform this drill?
□Yes
□No
2. Did you know the drill was happening, in advance?
□Yes
□No
a.
If so, how many days/hours in advance were you notified?
_______d _______h
3. Did students know the drill was happening, in advance?
□Yes
□No
a.
If so, how many days/hours in advance were they notified?
_______d _______h
During The Drill
1. Could you clearly hear the announcement for the drill?
□Yes
□No
a.
If no, what area of the school were you located in?
2. Did you understand the instructions that were announced?
□Yes
□No
If code was used, did you (check one):
a.
□ Immediately know what the code instructed you to do
□ Had to think about it, first. Then remembered
□ Referenced your classroom guide to remind you
□ Did not know what to do
3. Did students understand what the emergency notification meant?
□Yes
□No
4. Did you or other staff follow procedures for students and staff in
hallways, bathrooms and open areas?
□Yes
□No
a.
Did you pull any students into your classroom?
□Yes
□No
b. Were the hallways clear?
□Yes
□No
5. Were you able to lock your classroom doors during a
lockdown?
□Yes
□No
a.
Was everyone out of sight from the door during the drill?
□Yes
□No
□Yes
□No
6. If you evacuated did students remain quiet and calm?
a.
Did you bring necessary items with you?
□Yes
□No
DRILL FEEDBACK FORM
After the Drill
1. Was there an “All Clear” message delivered to terminate the drill?
□Yes
□No
a. Could you clearly hear the “all clear” announcement?
□Yes
□No
2. What was the most valuable part of this drill/exercise?
3. Is there anything your class did exceptionally well that you would like to share with us?
4. Were any weakness identified that we should reassess or address more
carefully to assist in keeping everyone safe?
□Yes
□No
If so, explain.
5. Did anyone (i.e: staff, students, visitors) have any new idea’s that you would like to share with us on
how better to respond?
Strongly
Strongly
Agree
Disagree
N/A
I am confident…
Agree
Disagree
a.
In my knowledge of the emergency response plan for my
school
b.
In my knowledge of my responsibilities during an
emergency
Any additional comments or concerns?
Thank you for your comments and for participating in the exercise.

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