Jenkins Academy of Applied Technology
Site plan and employee review Emergency Action Plans and Evacuation · v1.0.0 · October 22, 2026
Print / save as PDF Complete this worksheet using the actual workplace and current plan. A blank form or course score is not evidence that the action occurred. Record actual dates and observations. Print or save a completed copy before closing; entries are not automatically stored. Keep private health details out of this worksheet.
Employer, site, work area, employee role and date Applicable industry, jurisdiction, EAP trigger and additional requirements confirmed by the employer Current adopted plan title, version, date and workplace access location; written or permitted oral form Reporting method and emergency-service contact; exact site address, gate, building/floor and callback details Escape routes and evacuation types, including safe alternate arrangements Critical-operation procedures and assigned people, or confirmation that all employees immediately evacuate Employee accountability method, primary and alternate assembly points; visitor/contractor arrangements Assigned rescue/medical duties and actual responder arrangements, or no internal response role Plan information contact and backup; alarm meanings and warning coverage Initial assignment, plan development, role change or plan change triggering this review Understandable format/language, employee teach-back of actual actions, questions and corrections Trainer/reviewer, actual review date, unresolved restrictions and follow-up evidence