How to Conduct Fire Drills That Meet OSHA Requirements (29 CFR § 1910.39(c))

OSHA’s Fire Prevention Plan standard under 29 CFR § 1910.39(c) requires employers, including small healthcare practices, to designate and train staff to control fire hazards and respond safely during emergencies. Conducting compliant fire drills is not optional; it is a regulatory obligation that ensures employees know how to act swiftly and effectively. For small clinics, regular fire drills minimize confusion, reduce risks to patients, and prevent fines. Meeting this requirement demonstrates a proactive approach to workplace safety while protecting both human life and healthcare operations.

In small healthcare practices, fire risks may arise from oxygen tanks, electrical equipment, or the presence of vulnerable patients who cannot evacuate quickly. OSHA’s Fire Prevention Plan standard (29 CFR § 1910.39) outlines the requirements for maintaining safety by training staff and conducting drills. Fire drills serve as the most practical way to test whether staff are prepared for emergencies. Compliance is essential not just for meeting legal obligations, but for safeguarding lives and maintaining patient trust.

Understanding Fire Drill Requirements Under 29 CFR § 1910.39(c)

According to OSHA, an employer’s Fire Prevention Plan must designate personnel responsible for fire prevention duties. Section 1910.39(c) specifically requires that employers:

• Identify major fire hazards.

• Provide names or job titles of employees responsible for maintaining equipment and fire prevention procedures.

• Outline proper handling of flammable materials.

• Ensure staff are trained to understand their duties during an emergency.

Fire drills, while not explicitly mandated as separate events, are the most effective way to demonstrate compliance with this training requirement. They provide real-world testing of staff readiness and confirm that responsibilities are clearly understood. Clinics that fail to conduct drills risk both citations and dangerous chaos during a real emergency.

Although OSHA is the primary enforcement body for workplace safety, the Department of Health and Human Services Office for Civil Rights (OCR) may review emergency preparedness as part of broader compliance investigations. If patients with disabilities are not accommodated during fire drills, OCR could investigate possible violations of the Americans with Disabilities Act or Section 504 of the Rehabilitation Act. Triggers for investigation include:

• Patient complaints regarding unsafe conditions during drills.

• Staff reports of unsafe or discriminatory practices.

• Broader compliance reviews where fire preparedness is assessed alongside HIPAA and patient safety.

This makes it clear that fire drills protect not just regulatory compliance but also civil rights obligations.

Small clinics can conduct OSHA-compliant fire drills efficiently by following these steps:

1. Develop a Written Fire Prevention Plan: Document responsibilities, hazards, and evacuation routes. Ensure staff have access to the plan.

2. Assign Fire Safety Roles: Designate fire wardens, evacuation leaders, and backup staff to account for patients.

3. Schedule Regular Drills: Conduct drills at least annually, and more frequently if the clinic handles high-risk patients or equipment.

4. Simulate Real Conditions: Include patients, simulate blocked exits, or test alarms to ensure realistic practice.

5. Document Each Drill: Keep written records of dates, participants, observed gaps, and corrective actions.

6. Review and Improve: Hold a short debrief after each drill to identify weaknesses and update the plan.

Following these steps ensures small practices meet OSHA’s expectations while creating safer environments.

Case Study

A small physical therapy clinic failed to comply with OSHA’s fire prevention requirements, assuming that formal drills were unnecessary given its modest size and only eight employees. Management believed that simply pointing out exits during orientation was sufficient preparation. This complacency was tested when a minor fire broke out in the electrical closet during business hours. Instead of reacting quickly, staff members hesitated, unsure of which exit routes to use or who was responsible for assisting patients, many of whom had limited mobility due to therapy treatments. The lack of coordination delayed evacuation, increased confusion among patients, and created unnecessary risk. Although the fire was eventually extinguished without severe injuries, OSHA investigated following the incident and issued citations totaling $4,500 for failing to implement and document a fire prevention program in line with 29 CFR 1910.39. The incident also caused reputational harm, with patients questioning the clinic’s ability to maintain safety in emergencies.

By contrast, a small pediatric clinic in the same region demonstrated how proactive compliance can make a critical difference. Leadership had developed a written Fire Prevention Plan, clearly posted evacuation maps, and conducted documented fire drills every six months. Each drill was treated as a serious exercise, with designated staff responsible for guiding patients, securing hazardous materials, and contacting emergency services. Training emphasized the importance of remaining calm and ensuring that children, particularly those with disabilities, were assisted first.

When a small electrical fire occurred in one of the treatment rooms, staff followed procedures precisely as practiced. Patients were evacuated quickly and safely, hazardous materials were secured, and emergency responders were contacted without delay. The incident resulted in no injuries, minimal disruption, and no damage to critical equipment. During the subsequent OSHA inspection, the clinic produced drill records and training documentation, demonstrating full compliance. Inspectors issued no citations, and the clinic’s reputation for professionalism and preparedness was reinforced within the community.

This comparison highlights how even small practices must take fire prevention seriously. Ignoring basic requirements can result in fines, reputational damage, and risks to patient safety, while implementing structured drills and written plans ensures regulatory compliance, protects lives, and builds trust with staff and patients alike.

Common Pitfalls to Avoid Under 29 CFR § 1910.39(c)

• Skipping Written Plans: Verbal instructions alone do not meet OSHA requirements.

• Failing to Assign Responsibilities: Without designated leaders, drills collapse into disorganization.

• No Documentation: OSHA inspectors require proof of training and drills.

• Ignoring Patient Needs: Failing to consider immobile or special-needs patients creates safety and civil rights risks.

• Conducting Unrealistic Drills: Rushed or superficial drills fail to prepare staff for real emergencies.

Avoiding these pitfalls reduces both regulatory and practical risks.

• Incorporate fire drills into regular staff meetings to reduce disruption.

• Rotate drill scenarios to cover multiple risks (e.g., chemical fire, blocked exit).

• Partner with local fire departments to enhance training quality.

• Use sign-in sheets to verify employee participation.

• Keep both paper and digital records of drill outcomes for quick retrieval during inspections.

Implementing these practices ensures continuous improvement and strong compliance.

Compliance is most effective when integrated into daily culture. Clinics can:

• Include fire safety duties in job descriptions.

• Reward staff who demonstrate leadership during drills.

• Make emergency readiness part of annual performance reviews.

• Share lessons learned from drills across teams.

• Create a patient communication plan to keep families informed about safety efforts.

This approach ensures fire preparedness becomes part of the clinic’s identity.

OSHA’s Fire Prevention Plan requirements under 29 CFR § 1910.39(c) are vital for protecting patients, staff, and facilities. Fire drills bring these requirements to life, ensuring employees know their roles and can act decisively in an emergency.

Advisers: Small practices can strengthen compliance by using affordable compliance software that tracks drills, staff training, and updates to fire prevention plans. Free resources from OSHA, HHS, and OCR provide templates and guidance, making it possible for small clinics with limited budgets to meet all regulatory requirements without expensive investments.

• 29 CFR 1910.39, Fire Prevention Plans (eCFR)

• OSHA Fire Safety, Overview

• HHS Office for Civil Rights, Emergency Preparedness Guidance

• Federal Register, OSHA Fire Prevention Standards