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English Instructor Manual (PDF) - Metric Version - National ...

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APPENDIX Y<br />

Facility Audit Form (cont’d)<br />

Signage<br />

Facility Operational Permit Facility Rules/Regulations Emergency Phone Numbers<br />

Lifeguard Certifications Depth Markings No Diving<br />

Caution-Chemical Storage Material Safety Data Sheets (MSDS)<br />

Maximum Occupancy/Capacity Tagging/Labeling of Operational Equipment<br />

Emergency Stuff-Off<br />

Warning on Chemical Storage Room Door<br />

Comments: ____________________________________________________________________________<br />

_____________________________________________________________________________________<br />

_____________________________________________________________________________________<br />

_____________________________________________________________________________________<br />

Safety Equipment<br />

Pool Cover Type: ___________________________________<br />

Used: Daily Seasonally<br />

Reaching Poles/Shepherd's Hooks (minimum of two) Adequate First Aid Supplies<br />

Ring Buoys/Rescue Tubes (minimum of two)<br />

Backboard with Straps<br />

Head Immobilizer Easily Accessible Telephone(s)<br />

Easily Accessible Fire Extinguisher(s) Safety Goggles<br />

Surgical Gloves (blood exposure)<br />

Resuscitation Mask<br />

Rubber Gloves (chemical handling)<br />

Dust Mask/Respirator<br />

________________________ ____________________ ________________________<br />

________________________ ____________________ ________________________<br />

Comments: ____________________________________________________________________________<br />

_____________________________________________________________________________________<br />

_____________________________________________________________________________________<br />

_____________________________________________________________________________________<br />

_____________________________________________________________________________________<br />

Documentation<br />

Facility Operating Permit Aquatic Safety Plan Facility Operations Procedures<br />

Safety Audit Checklists Maintenance Records Staff Training Records<br />

Staff Personnel <strong>Manual</strong>s Hazardous Materials Safety Plan<br />

Incident Reports<br />

Bloodborne Pathogens Exposure Control Plan<br />

Local Health Department Recreational Bathing Regs. CPO ® Certifications<br />

__________________ __________________ __________________<br />

__________________ __________________ __________________<br />

Comments: ___________________________________________________________________________<br />

_____________________________________________________________________________________<br />

_____________________________________________________________________________________<br />

© 2014 <strong>National</strong> Swimming Pool Foundation® Page 231

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