1. School Preparedness Plan
Name of school :
Number of registration :
Name of principal :

2. A. RISK MAPPING/IDENTIFICATION FORM
This form is used to help you design safe setting room and create a school evacuation map.
This form consists of 2 components:
1. Risk mapping/identification for school environment
2. Risk mapping/identification for class room (all class must fill in)
1. Risk mapping/identification for school environment
Hazard mapping
1. Is there any hazards that can harm students/teachers in the school environment when a
disaster strikes? [tick () one answer]
Yes No
Please list all the hazards and what action you will undertake to minimize the risk of hazards?
No Name of hazards Short-term action plan Long-term action plan

3. (Continue in a separate sheet if necessary)
Capacity mapping
2. Is there any capacity in the school environment that can support you in evacuation when
a disaster strikes?
Yes No
Please list all the capacities and explain your plan in order to use it when a disaster strikes?
No Name of capacity Plan of usage
(Continue in a separate sheet if necessary)

4. 2. Risk mapping/identification for classroom
This section if risk mapping/identification of hazards and capacity in the classroom. All
classroom teachers have to fill this form.
Class/grade :
Name of responsible teacher :
Hazard mapping
1. Is there any hazards that can harm students/teachers in the classroom when a disaster
strikes? [tick () one answer]
Yes No
Please list all the hazards and what action you will undertake to minimize the risk of hazards?
No Name of hazards Short-term action plan Long-term action plan
(Continue in a separate sheet if necessary)

5. Capacity mapping
2. Is there any capacity in the classroom that can support you in evacuation when a
disaster strikes?
Yes No
Please list all the capacities and explain your plan in order to use it when a disaster strikes?
No Name of capacity Plan of usage
(Continue in a separate sheet if necessary)
Now that you have identified hazards and capacities in your class, you can start arranging the
classroom setting to be safer to disaster. Remember, disaster does not kill people. Poor building
and room arrangement do!

6. B. SCHOOL EVACUATION MAP
Based on hazard and capacity mapping of the school that you have made previously, now you
can make an evacuation map. How to do it?
1. Make a map of the school complete with the information of the hazards and capacities.
2. Mark the hazards using red marker, this is to indicate that the hazards are dangerous.
3. Mark the capacities using green marker, this is to indicate that the capacities are useful
to support you in evacuation when a disaster strikes
4. Indicate the meeting point. Meeting point is a safe place where all people in the school
can take shelter during a disaster.
5. Last, draw a line from EACH classroom into the meeting point (evacuation point). Use
blue marker or any other marker if you like.
Example of School Evacuation Map

8. C. IDENTIFICATION OF STUDENTS WITH SPECIAL ASSISTANCE
In this section, we will identify students in each classroom who needs special assistance in accessing DRR information/safety
procedure and doing evacuation and plan of action to assist these students. All classroom teachers have to fill this form.
Class/grade :
Name of responsible teacher :
No Name of student Can understand
DRR information
(safety procedure,
etc)?
Action Plan Can evacuate
when a
disaster
strike?
Action Plan
Yes No Yes No
(Continue in a separate sheet if necessary)

9. D. PREPAREDNESS CHECK LIST
This section is check list on what you should prepare to be ready before disaster happen. This
is to be filled by the school principal. This is not an exhaustive list, you can add as necessary.
No. Question
Answer Please Describe (how it was
done or not done?) Action Plan
Yes No
1 Have you taught your
student about safety
procedure according to
the existing hazard in
your area?
2 Have you performed
evacuation drill with all
students at school?
3 Have you identify any
hazard and capacities at
your school’s
environment?
4 Have you identify any
hazard and capacity at
your school’s class
room?
5 Have you determine
action plan for any
identified hazard in all
classes and school’s
environment?
6 Have you determined an
assembly point?
7 Have you prepare a
school evacuation map?
8 Have you communicated
school evacuation plan to
parents?
9 Have you updated list of
students’ emergency
contact?
10 Have you updated list of
public emergency contact
(fire brigade, police, etc..)

10. 11 Have you identified any
students who need
special assistance in
each class?
12 Have you prepared an
emergency bag in each
room in the class?
13 Have you checked the
completeness and the
expiry date of first aid kit,
food, and beverage inside
the emergency bag
regularly? (once every
three months)