|
Potential Risks
|
|
Pool (inground)_____
|
Bucket_____
|
Pond_____
|
|
Pool (above) _____
|
Canal _____
|
Ocean____
|
|
Bathtub _____
|
Spa _____
|
Toilet____
|
| |
|
Basic Safety Measures Checklist
|
|
Clear View From Residence
|
Yes____
|
No____
|
|
Supervision By A Responsible Adult
|
Yes____
|
No____
|
Child Knows How to Swim
(3 yrs. and older)
|
Yes____
|
No____
|
Child Has Taken Swimming Lessons
(3 yrs. and older)
|
Yes____
|
No____
|
|
Supervisor Knows How To Swim
|
Yes____
|
No____
|
|
Supervisor Knows CPR
|
Yes____
|
No____
|
|
Pool Has Access Door & Alarms
|
Yes____
|
No____
|
Removable Stairs On Above
Ground Pool
|
Yes____
|
No____
|
Life Ring, Rescue Rope, Reaching Pole,
Flotation Devices In The Pool Area
|
Yes____
|
No____
|
|
Fence Around Pool Or Spa Area
|
Yes____
|
No____
|
Fence Has A Self-Closing, Self-
Latching Gate
|
Yes____
|
No____
|
|
Barriers are maintained
|
Yes____
|
No____
|
|
Toys Are Removed From The Pool Area
|
Yes____
|
No____
|
Pool Area Clear Of Electrical Hazards
& Has Covered Outlets
|
Yes____
|
No____
|
Diving Board Situated Where Water
Is At Least 9' Deep
|
Yes____
|
No____
|
|
Telephone Available At Poolside
|
Yes____
|
No____
|
Family And Supervisor Are Aware Of
911 Telephone Number
|
Yes____
|
No____
|
Pool Chemicals And Supplies Stored
Securely
|
Yes____
|
No____
|
| |
|
Extra Safety Measures
|
|
Pool Alarm
|
Yes____
|
No____
|
|
Pool Cover
|
Yes____
|
No____
|
Child Knows How To Swim
(2 yr. old or younger)
|
Yes____
|
No____
|
Child Has Taken Swimming Lessons
(2 yr. old or less)
|
Yes____
|
No___
|
fire prevention and life safety