Aquatic Facility Risk Assessment Form
Use this form to comprehensively assess safety risks, facility condition, staffing, equipment, hazards, and emergency readiness at an aquatic facility.
Overall Facility Cleanliness and Maintenance
*
1
2
3
4
5
Condition of Pool Deck and Surrounding Areas
*
Excellent
Good
Fair
Poor
Adequacy of Lifeguard Staffing During Operating Hours
*
More than sufficient
Sufficient
Marginal
Insufficient
Safety Equipment Availability and Condition
*
Rows
Present and in good condition
Present but needs repair
Not present
Rescue tubes
1
2
3
First aid kits
4
5
6
Automated External Defibrillator (AED)
7
8
9
Emergency phone
10
11
12
Visibility of Safety Signage (Rules, Depth Markers, Emergency Procedures)
*
1
2
3
4
5
Potential Hazards Observed (Check all that apply)
*
Wet/slippery surfaces
Obstructed walkways
Unsecured chemicals
Damaged equipment
Other
Emergency Action Plan Accessibility and Staff Training
*
Plan accessible and all staff trained
Plan accessible, some staff trained
Plan not accessible
Functionality of Emergency Exits and Lighting
*
Fully functional
Partially functional
Non-functional
How would you rate the overall risk level at the facility today?
*
Low risk
1
2
3
4
High risk
5
1 is Low risk, 5 is High risk
Additional Observations or Recommendations
Submit Assessment
Should be Empty: