Information
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Document No.
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Conducted on
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Lifeguard on Duty:
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Swimming Pool Name:
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Conducted By:
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Location
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Lifeguard Certificates on site?
Lifeguard Professionalism
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Lifeguard Performing Patron Surveillance?
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Lifeguard seated in proper position for patron surveillance?
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Lifeguard is vigilant and alert?
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Lifeguard is enforcing pool rules?
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Lifeguard is in proper uniform, including whistle?
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Uniform is clean and presentable?
Safety Equipment
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Rescue tube is in proper position?
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Backboard, head immobilizers, first aid kit, CPR mask in proper position?
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Rescue Equipment is in good working condition?
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Water Quality tests completed and current?
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Logsheet is complete and current?
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Water Quality board updated and accurate?
Pool Appearance
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Deck is clean and free from debris?
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Water is clear and free from debris?
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Bathrooms are clean and free from debris?
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Garbage cans have been recently emptied?
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Cleaning Equipment is stored out of sight or neatly on deck?
Additional Notes / Skills Assessed
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