OBO SHEM Swimming Pool Safety Checklist

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Basic information

• Pool location
  Address

• Name

• Date

Children information

• Number of resident children (0-4 YO)

  Select 1 2 3 4 5 more than 5

  • 1
  • 2
  • 3
  • 4
  • 5
  • more than 5

• Number of resident children (older than 5 YO)

  Select 1 2 3 4 5 more than 5

  • 1
  • 2
  • 3
  • 4
  • 5
  • more than 5

• Number of visiting children (0-4 YO)

  Select 1 2 3 4 5 more than 5

  • 1
  • 2
  • 3
  • 4
  • 5
  • more than 5

• Number of visiting children (older than 5 YO)

  Select 1 2 3 4 5 more than 5

  • 1
  • 2
  • 3
  • 4
  • 5
  • more than 5

Type of pool

• Residential Use Pool

• Community Pool Use

• Regular Pool

• Wading (kiddy) Pool

Safety questions

• 1. Does a 4-foot barrier surround the entire pool?

  Yes

  No

  N/A

• 2. Does the barrier around the pool limit the open area to pool related activities only? (Unrelated ancillary activities within the pool area are: food stands; play areas; picnic tables; barbecues, etc.)

  Yes

  No

  N/A

• 3. Are all gates self-latching?

  Yes

  No

  N/A

• If no, how many?

• 4. Are all gates are self-closing?

  Yes

  No

  N/A

• If no, how many?

• 5. Are all gates lockable at 4 and 1/2 feet?

  Yes

  No

  N/A

• If no, how many?

• 6. Are locks available for all gates?

  Yes

  No

  N/A

• If no, how many?

• 7. Are keys and locks kept where children cannot reach them?

  Yes

  No

  N/A

• 8. Is the wading (kiddy) pool separated from the main pool by a four-foot barrier?

  Yes

  No

  N/A

• 9. Are pH and chlorine tests kits used to test the water quality regularly?

  Yes

  No

  N/A

• 10. Are pools free of entrapment and disembowelment hazards?

  Yes

  No

  N/A

• 11. Is the pool deck non-slip and free of irregularities and fittings on walkway?

  Yes

  No

  N/A

• 12. Are pool rules posted for community use pools?

  Yes

  No

  N/A

• 13. Are depths marked at the side of the pool for each one-foot change?

  Yes

  No

  N/A

• 14. Is diving from the side of the pool prohibited where pool depths are less than 9 feet deep?

  Yes

  No

  N/A

• 15. Is diving from a diving board prohibited where pool depths are less than 11.5 feet and where the distance to the slope for the shallow end is less than 16 feet?

  Yes

  No

  N/A

• 16. Is a certified lifeguard/designated responsible person on duty whenever children 16 years or younger are within the pool area (community use pools)?

  Yes

  No

  N/A

• 17. Is the required rescue and emergency response equipment situated within the pool area?

  Yes

  No

  N/A

• 18. Is there an emergency action plan in effect including plan implementation training?

  Yes

  No

  N/A

• 19. Are all electrical outlets in the pool area covered and GFCI protected?

  Yes

  No

  N/A