A swimming pool incident report template is used to record incidents such as injuries, vomit, fecal, blood contamination, near-drowning, drowning, or others. To help prevent incidents at the pool, regularly audit your lifeguards to ensure they are following pool safety compliance guidelines. Use this template to record specific details of the incident and help the establishment improve safety and security measures.
Downloaded 128 times Injured Person Background Name of Injured Person Date of Birth Select Date and Time Telephone Number Address Gender Male Female Injury Details Date and time of incident Select Date and Time Exact pool/location of incident Nature of the incident Injuries Vomit Fecal matter Blood contamination Near-drowning Drowning Others Describe in detail What part of the body was injured? Describe in detail Take photo of the body part that was injured. Annotate as required What was the nature of the injury? Describe in detail Take photo of the injury/source of blood contamination. Annotate as required Describe fully how the accident happened? What was the person doing prior to the event? Take photo of the surrounding environment the person was in prior to the event What caused the incident? Add supporting evidence of contributing factors Were safety regulations in place and used? What was wrong? Recommended preventive action to take in the future to prevent reoccurence Witness Statements Were there any witnesses? Add witness Enter witness name Contact number Witness statement Witness signature Emergency Services Person went to doctor/ hospital? Doctor's Name Hospital Name Police were called to the scene Police reference number Injured person signature Pool Operator/Manager signature Share this template: This post is also available in: DeutschA swimming pool incident report template is a form used to document any incidents that occur in a swimming pool environment. It is used by facility managers and lifeguards to record information regarding the incident, including the date and time of the incident, the location, the type of incident, and the people involved. It should also include details about the actions taken to respond to the incident and any other relevant information.
The template is designed to help pool facility staff keep a record of any incidents that occur in the pool environment. This information can then be used to evaluate the safety of the pool environment and to ensure any necessary corrective action is taken. It is important that the report is completed accurately and promptly to ensure the safety and security of everyone using the pool.
The report should include a description of the incident, including the names of any people involved and the details of their injuries. It should also include any corrective measures taken in response to the incident, such as the removal of hazardous objects or the closure of the pool. The report should also include any follow-up actions, such as training staff on proper safety procedures.
Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.