Aquatic Safety Quick Check
Name of Evaluator
*
First Name
Last Name
Aquatics Director Email
Enter email of Aquatics Director so they receive a copy of this form.
Pool Name
Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time
*
Hour Minutes
AM
PM
AM/PM Option
Lifeguards on Duty
*
Are a minimum of 2 guards on duty? (At least 1 on stand)
*
Yes
No
Name of Lead Guard or Shift Lead on Duty
First Name
Last Name
Swimmers in the pool
Are there distractions on the pool deck that prevents a guard from being vigilant?
Yes
No
If yes, what were the distractions and how were they handled?
Are there enough guards on duty to cover all areas of the pool?
Yes
No
Is a Lead Guard Present?
Yes
No
Comments about Lead Guard or Shift Lead
Swim Lessons
Are swim lessons occuring during observation?
Yes
No
Is a Deck Manager/ Lead Swim Instructor present?
Yes
No
Comments about Deck Manager/ Lead Swim Instructor
COVID-19 Guidelines
Lifeguards are following the current rotation steps below:
Incoming guard disinfects tube
Outgoing guard disinfects seat, railing, platform, and steps
Outgoing guard disinfects tube prior to taking over coverage
Incoming guard puts on hand sanitizer, if not wearing gloves
Outgoing guard puts on hand sanitizer, if not wearing gloves, once incoming guard takes coverages of the pool
N/A- Did not see guard rotation
Lifeguards are wearing masks when interacting with members or staff:
Yes
No
Swim Instructors are wearing face shields while conducting lessons/ interacting with members or staff:
Yes
No
Swim Instructors are disinfecting equipment between lessons:
Yes
No
Staff
Minimum of 2 guards; 1:25 ratio
Adult supervision of swimmers under the age of 6 (pink band swimmers)
Guard is alert and actively scanning
Guard can reach any area of the pool
Guard can see entire area of responsibility, including bottom of the pool
Guard exhibits professional demeaner by posture, behavior, and attentiveness
Down Guard is attentive and visible on the pool deck
Comments about Staff section
Play Features/Slides
Is play structure open?
Yes
No
N/A
Are guards stationed at the play structure?
Yes
No
Is the slide open?
Yes
No
N/A
Is there a guard at the top and bottom of the slide(s)
Yes
No
Equipment
Guard Equipment
Whistle
Fannypack (CPR masks and gloves are inside pack)
One piece bathing suit
Identifiable uniform
Rescue tube (in guard's hand, strap around chest, slack is adequately controlled)
Comments about Guard Equipment
Organization
Emergency Equipment: Backboard, Crash Bag, and First Aid Kit. (Visible and easily accessible to guards)
Safety line is in place separating the deep and shallow portions of the pool, except for end-to-end activities such as lap swimming, etc.
Deck is well maintained and free of clutter
Skill testing procedures in place
Record Keeping: Chemical log should show records of CL/BR and PH checks every hour
Lifejackets for 6-9 year olds and/ or within arms reach of a guardian 16 and over
All swimmers under 16 are banded
Emergency phones are operational
All rules are being enforced
Non-negotiables
Are all pink or red band swimmers within arms reach of a parent?
*
Yes
No
Are there any hyperventilation/ breath holding activities taking place?
*
Yes
No
Is the guard(s) able to see all areas of their zone/pool?
*
Yes
No
Are all children under 16 swim tested and banded appropriately?
*
Yes
No
Organization
Any additional comments needed about Aquatics Staff on duty?
Submit
Should be Empty: