Title Page
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Site conducted
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Group
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Business name
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Manager/proprietor
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Telephone number
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Email address
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Premises address
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Conducted on
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Prepared by
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INSTRUCTIONS
1. Answer the questions below by selecting the most appropriate response.
2. Add photos and notes as necessary evidences
3. To add a corrective measure, click ""Add Action"", provide a description, assign to a member, set priority, and due date
4. Complete the audit by providing a digital signature
Pool Barrier
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1 Fence damaged or compromised
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2 Pool gate self closes from all open positions
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3 No climbable objects within 1m of fence
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4 No spaces >100mm under or between fence
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5 Pool barrier complies with AS 1926.1-1993
Pool Surface
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6 Smooth, good condition and free from damage
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7 Clean and free from algae
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8 No visible scum line to promote biofilm growth
Pool Concourse
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9 Non-slip and free from trip hazards
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10 Depth markings compliant with Code (contrasting colour, ≤7.5m apart, ≥90mm height, vertical and horizontal)
Lighting
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11 Pool body and concourse illuminated min. 30 lux
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12 Signage to indicate use after dark
Signage
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13 Hours of operation sign min 100mm font
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14 First aid sign complies with AS 1319
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15 Resuscitation notice
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16 Pool rules
First Aid Facility
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17 Resuscitation notice
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18 Examination couch and work bench
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19 Hand wash basin with potable water supply
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20 Communications system
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21 One GPO outlet with electricity supply
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22 Storage for first aid supplies and equipment
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23 Washable flooring
First Aid Equipment
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24 Resuscitation equipment
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25 First aid kit
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26 Spinal board and extrication collars
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27 Pillows and blankets
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28 Pocket mask and disposable gloves
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29 Stretcher
Rescue Equipment
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30 Type of equipment (reaching pole, rescue tube, life jacket, throwing rope or bag)
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31 Clearly visible and readily accessible
Pool Chemistry
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32 Temperature
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33 Free Chlorine 2ppm unstabilised 3ppm stabilised measurement (1ppm lower complies when water temperature <26°C)
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34 Cyanuric acid 20-100 mg/L measurement
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35 pH 7.2-7.8 measurement
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36 Alkalinity 60-200 mg/L measurement
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37 Calcium hardness 50-400 mg/L measurement
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Water Balance Calculations
Calculation
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Table extracted from Royal Life Saving Society Safe pool operations for group 2, 3 and 4 pools in Western Australia course manual dated January 2015
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Calcium hardness factor
- 1.0
- 1.2
- 1.3
- 1.4
- 1.5
- 1.6
- 1.7
- 1.8
- 1.9
- 2.0
- 2.1
- 2.2
- 2.3
- 2.4
- 2.5
- 2.6
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Total alkalinity factor
- 1.0
- 1.2
- 1.3
- 1.4
- 1.5
- 1.6
- 1.7
- 1.8
- 1.9
- 2.0
- 2.1
- 2.2
- 2.3
- 2.4
- 2.5
- 2.6
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pH
- 6.8
- 6.9
- 7.0
- 7.1
- 7.2
- 7.3
- 7.4
- 7.5
- 7.6
- 7.7
- 7.8
- 7.9
- 8.0
- 8.1
- 8.2
- 8.3
- 8.4
- 8.5
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Sum of above three parameters
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Table extracted from Royal Life Saving Society Safe pool operations for group 2, 3 and 4 pools in Western Australia course manual dated January 2015
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38 Water clear and free of turbidity
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39 Brand of pool test kit
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40 Type of pool test kit
Documentation
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41 Logbook up to date
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42 Measurements recorded four times daily
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43 Personnel qualifications sighted
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44 Operations manual up to date
Miscellaneous
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45 Pool closed when electric pool cleaner operates
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46 Top up water added pre disinfection
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Other comments
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Please attend to any outstanding items by the due date. For enquiries contact the officer on the number below.
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Reinspection date
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I have read and I understand the contents of this assessment. Proprietor/staff name and signature
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Officer name and signature
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Officer contact number
