Free operator template
Disaster and Evacuation Drill Record Template
Keep a consistent record of a disaster or evacuation drill and its follow-up. This blank two-page template gives assisted living operators a reusable starting point for facility drill documentation.
Download the blank template
Choose a fillable PDF for a consistent layout or Word to adapt the blank template to your facility. No sign-up required.
How to use this template
- Save a blank master copy. Review it against your facility policies and applicable requirements before use.
- For the PDF, download it and open it in a PDF reader that supports fillable forms. Save a working copy, then reopen it to check that your entries were retained. You can also print a blank copy.
- For Word, edit a copy in a compatible word processor. Check page breaks and print preview after making changes.
- Complete the record for the drill performed, then review findings and track follow-up under your facility emergency plan.
Keep completed records private
These downloads are blank operator templates. This public resource library does not accept completed records. Do not upload completed forms or send resident, staff, or other sensitive information through the public website or demo request form. Store completed copies in your facility's approved secure record system, with access limited to authorized people.
Use alongside your policies and current requirements
This is a practical starting point, not a state-approved form, legal advice, or a guarantee of compliance or survey results. Your facility is responsible for required documentation, reporting, review, and retention. A completed drill record does not replace an emergency plan, required training, or required drills.
Related guides
- Arizona Emergency Preparedness and Evacuation Drill Requirements
- Arizona Assisted Living Survey Readiness Guide
- Incident Report and Follow-Up Template
Looking for software to support daily operations? Explore Tendera or see how Tendera fits Arizona assisted living.