VII. Response to Fire Drills (Self-Directed Evacuation) - relates to the resident's ability to leave the building as demonstrated by the resident's performance during fire drills.   It covers his or her ability to make decisions but does not relate to mobility, which is covered in a separate factor. For example, a resident may need assistance only in transferring from bed to wheelchair but otherwise can promptly initiate and complete an evacuation. Such a resident would get a "yes" for "Initiates and Completes Evacuation Promptly" (0 points) and would be rated "Needs Limited Assistance" on the "Impaired Mobility" factor (6 points).

Components of a Self-Directed Evacuation - means there are three basic tasks that a resident must perform reliably and without instructions or supervision in order to receive the most favorable rating on this factor:

(a) Initiates and Completes Evacuation Promptly - The resident must have demonstrated a proper response to an alarm or warning of a fire by starting and completing the evacuation without unnecessary delay.

(b) Chooses and Completes Back-up Strategy - The resident must have demonstrated the ability to select an alternative means of escape or take other appropriate action if the primary escape route is blocked.

(c) Stays at Designated Location - The resident must have demonstrated that he/she will stay at a designated safe location during fire drills. (The whereabouts of already evacuated residents needs to be confirmed to avoid dangerous return trips to look for residents who may have returned to buildings.)

The resident shall be credited with being able to perform a task only when the resident has been specifically trained or instructed in the desired task and has demonstrated the desired response in at least three of the last four fire drills for which the skill was tested.

When the skill has not been tested in four fire drills, the resident shall be credited only when the resident has demonstrated the desired response during the last two opportunities to test the skill.  Ratings must be based on the resident's demonstrated performance. Any resident who has not been trained using fire drills must be given the higher scores.

Residents must be rated assuming that a fire might find them in a common situation where they are least likely to respond well to an emergency. For most residents, this will be their evacuation ability after being awakened at night. The rating should not include difficulties in actually awakening the resident because of the large differences in how easy it is to wake up the same individual at various times of the night.

(a) Initiates and Completes Evacuation Promptly. Some examples of resident capabilities that score "no" for this item are:

(1) The resident may not react to the alarm until alerted by a staff member.

(2) The resident spends an excessive amount of time preparing to leave (for example, getting dressed, seeing what everyone else is doing).

(3) The resident has a hearing impairment and therefore must be alerted by a staff member.

(4) The resident is sometimes upset or confused and therefore may seek out a staff member before evacuating.

(5) The resident will reliably start an evacuation, but is easily distracted and requires some supervision.

(b) Chooses and Completes Back-up Strategy - Residents that score "no" on this item will be those unlikely to select a good course of action if the primary escape route cannot be used; that is, they have not been trained to find alternative escape routes, find an area of refuge or perform other appropriate action. An example of resident capabilities that score "no" for this item is:  The resident lacks the conceptual ability to understand about fire hazards and blocked escape routes, and therefore needs supervision.

(c) Stays at a Designated Location in a Safe Area - Some examples of resident's capabilities that score "yes" for this item are:

(1) The resident has been specifically trained to remain at a designated location in a safe area, and has demonstrated this ability without the presence of staff members in three of the last four fire drills.

(2) The resident is physically immobile, and therefore cannot leave the designated location.

(3) The group home uses a motor vehicle (for example, a van or bus) or a building that is detached and remote from the home (for example, another house or a remote garage) as the designated location, and the resident has demonstrated in three of the last four fire drills that he or she will remain there without the presence of a staff member.

(4) The resident may tend to wander, but a reliable resident has been assigned to keep the "wandering" resident at the designated location without using any force or coercion. Further, this arrangement has been demonstrated as effective in at least three of the last four fire drills.

Some examples of residents that score "no" for this item are:

(1) The resident has not been trained to stay at a designated location without any staff supervision.

(2) The resident has been trained to stay without staff supervision at a designated location, but has failed to demonstrate this capability in three of the last four fire drills.

Instruction Manual for Calculating Evacuation Difficulty Score (E-Score) (Worksheet F-2) - Requirements for Using the Evacuation Difficulty Score (E-Score).  While the use of the Evacuation Difficulty Score allows determination of the level of fire safety need for a variety of staff and resident combinations, the system is valid only when the following underlying requisites are satisfied.

(a) Has a Protection Plan Been Developed and Written and Have All Staff Members Counted in the Calculation of E-Scores Been Trained in its Implementation?

Regardless of the staff's everyday competencies, they cannot be relied on to innovate effective life safety actions under the extreme stress and time limitations of an actual fire emergency. Regardless of the building's protection features, staff must have a valid and practiced plan of action that can be immediately put into effect in an emergency. The protection plan should include the following features:

(1) a description of all available evacuation, escape and rescue routes and the procedures and techniques needed to evacuate all the residents using the various routes, and

(2) the fundamental knowledge about fire growth, containment and extinguishment needed to make reasonable judgments about action priorities and viable egress routes.

(b) Is the Total Available Staff at any Given Time Able to Handle the Individual Evacuation Needs of Each Resident Who May Be in the Board and Care Home?

In a well-protected building, it would be possible to have an E-Score which is passing in relation to the rating values for the fire protection features of the building, and still not have the total situation acceptable under this system. This would be the case where a resident is present who requires assistance from two staff members, but only one staff member is present. Thus, a facility must not only have a passing E-Score, but the situation must be such that every resident can be evacuated by available staff.