Information

  • Lifeguard Name Who You Are Observing

  • Conducted on

  • Completed By

Lifeguard Performance Assessment

Performance Assessment Information

  • Full Name Of Lifeguard: -

  • Activity Within Pool At Time Of Assessment: -

  • Observed From

  • Observed Until

  • Quarter Observed In

Visual Observation - Any No's - Provide Details

  • Which Site Are You Completing The LPA

  • Lifeguarding Position At Time Of KPI

  • Lifeguarding Position At Time Of KPI

  • Are they in the correct lifeguarding location?

  • Are they standing straight / sitting upright?

  • Are they wearing or within reaching distance of a torpedo buoy?

  • Is the lifeguard wearing the correct uniform?

  • Are they adopting the correct change over / rotation?

  • Are they wearing only appropriate jewellery?

  • Did they intervene appropriately in any incident/hazard?

  • Are they wearing the correct uniform?

Non-Visual - Any No's - Provide Details

  • Are they aware of the zone they are responsible for when asked?

  • Are they in possession of a whistle?

  • Are they aware of their responsibilities as the Lifeguard in that position?

Completion

  • Date & Time Completed

  • Ensure this is completed on the excel spreadsheet
    Ensure the PDF is saved onto the QMS

  • Type Name & Sign

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.