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And 88.05(4)(d)2a and b, Wisconsin Administrative Code, within 3 days of admission and must be retained in the resident’s record. Failure to complete this form could result in Department sanctions. Name – Facility Date Form Completed Address Name – Resident Apartment or Room Number Name – Evaluators The ability of residents to successfully use a means of egress depends on how they will perform in an actual emergency. This sample checklist has been adapted from the Fire Safety Evalu.

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Resident Evacuation Assessment-F-62373 - Wisconsin...
F-62373 (Rev. 04/09). RESIDENT EVACUATION ASSESSMENT. Completion of this form is required...
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As you approach the landing of each floor, allow evacuees from that level to enter the stairwell. Steer clear of hazards. If evacuation becomes difficult via a chosen route, because of smoke, flames or blockage, re-enter the facility on a safe floor. Continue evacuation via the nearest safe exit route.

A score equal to or less than 1.5 is Prompt. A score greater than 1.5 but not more than 5 is Slow. A score of greater than 5 is Impractical.

An Evacuation Score (aka: “E-Score”) is the designation of the facility's “Evacuation Capability”. The Evacuation Capability is the ability of the occupants, residents and staff, as a group, to either evacuate a building or relocate from the point of occupancy to a point of safety.

3 Categories of Fire Evacuation Vertical or horizontal evacuation. Full evacuation. Simultaneous Evacuation.

Stage four of an evacuation is a full evacuation, meaning that an entire building needs to be evacuated.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232