Trellis Foster Care - Emergency Evacuation / Fire Drill Report

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1. Family Name (Required.)

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2. Date of drill (Required.)

Date

Date

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3. Observations/Notes/Action Taken: (Required.)

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4. Smoke Detector Checked (Required.)

Yes

No

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5. Carbon Monoxide Detector Checked (Required.)

Yes

No

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6. Fire Extinguisher Checked (Required.)

Yes

No