Terly for each shift. Records shall be maintained and available for review by the State Fire Marshal. Facility Name: Address: Date: Shift: Day Time: a.m. Time Drill Concluded: p.m. a.m. Swing Night Name of Person Conducting Drill: p.m. Simulated Fire Drill Location of simulated incident: Type of alarm device initiated: Yes No Alarm monitoring company notified before initiation of fire alarm? Fire alarm system functioned properly Fire alarm system reset and back in service? If no, de.

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How to fill out the WA 3000-420-150 online

The WA 3000-420-150 form, also known as the Fire Drill Record, is essential for documenting fire drills conducted within care facilities. Filling out this form accurately ensures compliance with state regulations and supports effective fire safety management.

Follow the steps to complete the WA 3000-420-150 online.

  1. Click the ‘Get Form’ button to obtain the form and open it in your online document editor.
  2. Enter the name of the facility in the designated field, ensuring it matches the official name used in registration.
  3. Fill in the facility address, including street address, city, state, and zip code, ensuring all information is accurate.
  4. Specify the date on which the fire drill took place using the provided date field.
  5. Indicate the shift during which the drill was conducted by selecting from the options provided: Day, Swing, or Night.
  6. Record the start time of the fire drill in the a.m./p.m. sections for clarity.
  7. Complete the ‘Time Drill Concluded’ field with the appropriate end time, using both a.m. and p.m. options as needed.
  8. Enter the name of the person conducting the drill in the specified field to ensure accountability.
  9. Document the location of the simulated incident and the type of alarm device initiated, selecting 'Yes' or 'No' for relevant questions.
  10. Provide details on whether the alarm monitoring company was notified prior to the alarm activation.
  11. Confirm whether the fire alarm system functioned properly and if it was reset and back in service after the drill.
  12. If the alarm system did not function properly, describe the actions taken in the space provided.
  13. Ensure all other fields regarding residents' safety measures and staff actions during the drill are filled out accurately.
  14. Review the critique of the fire drill, using additional pages if necessary, to offer feedback on effectiveness and participation.
  15. Complete the employee participation log, listing names and shifts of individuals who actively participated in the drill.
  16. Once you have filled out all relevant sections, save your changes, and download or print the form for your records.

Complete your fire drill documentation online today!

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