Employee Emergency Preparedness Survey Outline

Posted June 14, 2017

The worst scenario in a time of emergency is one where there is confusion/lack of direction in response and action in resolving the issue at hand. Use this survey to evaluate your employees’ ability to respond should an emergency occur, thus knowing areas in which you could improve as an employer to safeguard your workforce and workplace.

 

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(Your Company) is conducting an anonymous survey about our emergency preparedness. The intent of this survey is to gather information to evaluate our employees’ ability to respond should an emergency or disaster occur. The results will help us determine what additional training may be necessary.

Your input is important to us. Please take a few moments to complete this survey and return to (insert name) by (insert date). Thank you!

 

1. I know where the fire extinguishers are and have been trained to use them.

oxa0xa0xa0xa0xa0xa0xa0xa0 Yes

oxa0xa0xa0xa0xa0xa0xa0xa0 No

2. If the building is evacuated, I know where to report.

oxa0xa0xa0xa0xa0xa0xa0xa0 Yes

oxa0xa0xa0xa0xa0xa0xa0xa0 No

3. I know where to go in the event of a tornado.

oxa0xa0xa0xa0xa0xa0xa0xa0 Yes

oxa0xa0xa0xa0xa0xa0xa0xa0 No

4. I know how to respond in case of fire.

oxa0xa0xa0xa0xa0xa0xa0xa0 Yes

oxa0xa0xa0xa0xa0xa0xa0xa0 No

5. I know what to do if there is a chemical spill.

oxa0xa0xa0xa0xa0xa0xa0xa0 Yes

oxa0xa0xa0xa0xa0xa0xa0xa0 No

6. I know who to alert if an emergency occurs.

oxa0xa0xa0xa0xa0xa0xa0xa0 Yes

oxa0xa0xa0xa0xa0xa0xa0xa0 No

7. I know the emergency exits in the building and how to determine which one to take.

oxa0xa0xa0xa0xa0xa0xa0xa0 Yes

oxa0xa0xa0xa0xa0xa0xa0xa0 No

8. I know where emergency supplies are stored at work and/or in my vehicle.

oxa0xa0xa0xa0xa0xa0xa0xa0 Yes

oxa0xa0xa0xa0xa0xa0xa0xa0 No

 

I would like to receive training in: _____________________________________________________________________________________

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I would like to receive more information on: ______________________________________________________________________________

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