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?

Date & Time Completed

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

Type Name & Sign
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.