Trellis Foster Care - Emergency Evacuation / Fire Drill Report

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* 1. Family Name

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* 2. Date of drill

Date

Date

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* 3. Observations/Notes/Action Taken:

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* 4. Smoke Detector Checked

Yes

No

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* 5. Carbon Monoxide Detector Checked

Yes

No

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* 6. Fire Extinguisher Checked

Yes

No