📋 TEMPLATE INSTRUCTIONS
This is a fill-in-the-blank template. Replace all GREEN HIGHLIGHTED FIELDS with your specific information.
Print this document and fill in by hand, OR edit digitally and save as your customized plan.
✅ Step 1: Complete all company/facility information
✅ Step 2: Add your emergency contacts and phone numbers
✅ Step 3: Customize procedures for your specific workplace
✅ Step 4: Train all employees on the completed plan
✅ Step 5: Review and update annually
📄 Document Control & Approval
| Company Name: |
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| Facility/Location: |
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| Plan Version: |
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| Effective Date: |
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| Next Review Date: |
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| Approved By: |
Signature: Date:
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👥 Emergency Response Organization
Emergency Response Team Structure
COMMUNICATIONS COORDINATOR
📋 Roles & Responsibilities
INCIDENT COMMANDER
- Overall emergency response coordination
- Decision making and resource allocation
- Communication with external agencies
- Emergency termination decisions
EVACUATION COORDINATOR
- Evacuation route management
- Assembly point coordination
- Headcount and accountability
- Missing person reports
FIRST AID COORDINATOR
- Medical emergency response
- First aid and CPR administration
- Coordination with EMS
- Injury documentation
COMMUNICATIONS COORDINATOR
- Internal emergency notifications
- External stakeholder communication
- Media relations coordination
- Emergency system activation
🏃♂️ Evacuation Procedures
🚨 General Evacuation Procedure
- ALARM ACTIVATION: Upon hearing the evacuation alarm or receiving evacuation instructions, stop all work immediately
- SECURE AREA: Shut down equipment safely if time permits (max 30 seconds)
- ASSIST OTHERS: Help visitors and coworkers, especially those needing assistance
- USE NEAREST EXIT: Proceed to nearest exit route - DO NOT use elevators
- STAY LOW: If smoke is present, stay low and cover nose/mouth
- GO TO ASSEMBLY POINT: Report to designated assembly area
- REPORT TO WARDEN: Check in with floor warden for headcount
- REMAIN AT ASSEMBLY POINT: Do not leave until all-clear is given
📍 Evacuation Routes & Assembly Points
| Area/Floor |
Primary Exit Route |
Secondary Exit Route |
Assembly Point |
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Special Considerations
- Mobility-Impaired Persons:
- Visitors:
- After Hours:
- Weather Considerations:
🔥 Fire Emergency Procedures
🔥 Fire Emergency Response
- DISCOVER FIRE: Anyone discovering a fire should remain calm
- ACTIVATE ALARM: Pull nearest fire alarm to alert building occupants
- CALL 911: Call fire department immediately - provide location and details
- ATTEMPT SUPPRESSION: If fire is small and you're trained, use appropriate extinguisher
- EVACUATE IF NEEDED: If suppression fails or fire spreads, evacuate immediately
- CLOSE DOORS: Close doors behind you to contain fire and smoke
- ACCOUNT FOR PERSONNEL: Ensure all personnel evacuate safely
- MEET FIRE DEPARTMENT: Provide information to arriving firefighters
🧯 Fire Equipment Locations
| Location |
Equipment Type |
Fire Class |
Last Inspection |
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🏥 Medical Emergency Procedures
🩺 Medical Emergency Response
- ASSESS SITUATION: Determine severity - is person conscious and breathing?
- CALL FOR HELP: Serious injuries: Call 911 immediately
- DO NOT MOVE: Do not move injured person unless in immediate danger
- PROVIDE FIRST AID: Trained personnel provide appropriate first aid
- NOTIFY MANAGEMENT: Inform emergency coordinator and management
- SECURE AREA: Keep area clear for emergency responders
- DOCUMENT INCIDENT: Complete incident report forms
- FOLLOW UP: Arrange return-to-work or accommodation as needed
🩹 First Aid Equipment & Personnel
Trained First Aid Personnel:
AED (Automated External Defibrillator) Information
AED Location:
AED Trained Personnel:
🌪️ Severe Weather Emergency Procedures
⛈️ Severe Weather Response (Tornado/Severe Thunderstorm)
- WEATHER WATCH: Monitor weather conditions and warnings
- SHELTER ACTIVATION: Move to designated shelter areas immediately
- AVOID WINDOWS: Stay away from windows, glass, and large roof areas
- TAKE COVER: Get under sturdy furniture or against interior walls
- PROTECT HEAD: Cover head and neck with hands and arms
- REMAIN CALM: Stay in shelter until all-clear is given
- ASSESS DAMAGES: Check for injuries and structural damage after event
- EVACUATE IF UNSAFE: If building is damaged, evacuate to safe area
🏠 Shelter Areas
| Building Area |
Primary Shelter Location |
Capacity |
Shelter Supplies |
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🎓 Emergency Response Training Schedule
📅 Required Training Programs
| Training Program |
Target Audience |
Frequency |
Last Completed |
Next Due Date |
| General Emergency Response |
All Employees |
Annual |
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| Evacuation Drills |
All Employees |
Quarterly |
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| Fire Extinguisher Training |
Selected Personnel |
Annual |
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| First Aid/CPR |
Emergency Team |
Every 2 Years |
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| Emergency Coordinator Training |
Response Team Leaders |
Annual |
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Training Record Keeping
Training records must be maintained for all emergency response training. Records should include:
- Employee name and position
- Training program and date completed
- Trainer name and qualifications
- Training evaluation results
- Next training due date
💼 Business Continuity Planning
🔄 Critical Business Functions
| Business Function |
Priority Level |
Recovery Time |
Alternate Location/Method |
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🏢 Alternate Facilities
Primary Alternate Location:
Secondary Alternate Location:
Remote Work Capabilities:
🚀 Need Professional Emergency Planning Support?
HSE Advisor Canada specializes in comprehensive emergency response planning, training, and regulatory compliance for Canadian businesses.
✅ FREE EMERGENCY PREPAREDNESS ASSESSMENT
Our Emergency Planning Services Include:
- Custom emergency response plan development
- Emergency response team training and certification
- Evacuation route planning and optimization
- Emergency drill planning and execution
- Business continuity planning and risk assessment
- Regulatory compliance verification and documentation
EXPERT CONSULTATION AVAILABLE 24/7
📞 Contact Information:
Phone: (647) 620-5278
Website: hseadvisor.ca/contact | Email: info@hseadvisor.ca
CRSP Certified · COR & ISO 45001 Lead Auditors