SOP_NUMBER: 511.09-att-1
TITLE: Emergency Response Plan Fire Safety Checklist
REFERENCE_CODE: IVN06-0001
DIVISION: Facilities
TOPIC_AREA: 511 Policy-Fire Services
EFFECTIVE_DATE: 2020-09-23
WORD_COUNT: 263
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/105857
URL: https://gps.press/sop-data/511.09-att-1/

SUMMARY:
This is an annual checklist form used to document coordination between Georgia Department of Corrections facilities and local fire departments regarding fire safety and emergency response readiness. The non-departmental Fire Chief completes this form by verifying facility information, reviewing evacuation plans, assessing firefighting capabilities, and identifying key contacts and staging areas. Completed forms must be retained for two years with the facility's emergency plan and also filed with the local fire service jurisdiction.

KEY_TOPICS: fire safety checklist, emergency response plan, evacuation plan, fire department coordination, firefighting capability, emergency lighting, fire extinguishers, hydrants, facility staging area, emergency contact procedures, fire safety inspection, local fire chief, facility administrator

ATTACHMENTS:
  1. Emergency Response Plan Fire Safety Checklist
     URL: https://gps.press/sop-data/511.09-att-1/
  2. Institutional Fire Incident Report
     URL: https://gps.press/sop-data/511.09-att-2/

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FULL TEXT:
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SOP 511.09
Attachment 1

9/23/20
Page 1 of 2

**GEORGIA DEPARTMENT OF CORRECTIONS**
**EMERGENCY RESPONSE PLAN**
**FIRE SAFETY CHECKLIST**

**I** **`.`** **Correctional Facility:**

**Name**

**Address**

**Phone**

**Administrator**

**Fire Safety Inspector**

**II.** **Local Fire Department:**

**Name**

**Address**

**Phone**

**Distance from Facility**

**Fire Chief**

**III.** **Date of Orientation Visit to Facility:**

**IV.** **Checklist** (initialed by the Non-Departmental Fire Chief having local jurisdiction):

**A. Meeting with Facility Administrator**

**B. Relevant Organizational Chart of Facility**

**C. Floor Plan of Facility**

**D. Evacuation Plan of Facility**


**E. Tour of Facility**

**F. Firefighting Capability of Facility:**

**1) Personnel**


Retention schedule: Upon completion, a copy of this form shall be retained with the Facility Fire Safety/Emergency
and Evacuation Plan for two (2) years and then shall be destroyed. This form shall also be retained with the Plan on
file at the fire service location having local jurisdiction.


SOP 511.09
Attachment 1

9/23/20
Page 2 of 2

**2) Hydrants**

**3) Extinguishers**

**4) Emergency Lighting**

**G. Utility Master Controls:**

**1) Gas**

**2) Water**

**3) Electricity**

**H. Staging Area upon Arrival**

**I. Facility Staff to Contact upon Arrival**

**J. Accessibility Routes for Local Firefighting**

**K. Discussion of Facility Emergency Plans**

**L. Date of Meeting to Update Emergency Plans**

**_______** **________________**
**Facility Administrator** **Date**

**_______** **________________**
**Fire Chief** **Date**

**This form is to be completed annually.**


**Send one copy to:**

Manager, GDC Fire Services and Life Safety

P. O. Box 1529
300 Patrol Road
Forsyth, Ga. 31029
Phone (478) 992-5291

Fax (478) 992-5292


Retention schedule: Upon completion, a copy of this form shall be retained with the Facility Fire Safety/Emergency
and Evacuation Plan for two (2) years and then shall be destroyed. This form shall also be retained with the Plan on
file at the fire service location having local jurisdiction.