TrainingSafetyPrograms
SwimPoolFacility
SafetyChecklist
REVISION (PF-E)
DATE REVISED: 20 OCT 2015
TableofContentsPageNumber(s)
Table of Contents …………………………………………………………………………………… i
Notice ………………………………………………………………………………………………………………… i References and Definitions …………………………………………………………… ii & iii Command Contact Information ………………………………………………………… iiii
Swim & Pool Facility Safety ………………………………………………………… 1 - 15
*** Notice: This checklist is developed asa reference and guide intended for Swim and Pool Facility guidance when conducting swim/swim testing training. For a comprehensive review of the command’s High Risk Training Program, this
checklist must be utilized in conjunction / with the / NavalSafety Center’s High Risk Training Safety / Program
checklist. ***
i
References
(a) OPNAVINST 3500.39C, Operational Risk Management (ORM) (b) OPNAVINST 1500.75C, Safety Policies and Procedures for
Conducting High-Risk Training
(c) NETCINST 5100.1A, Safety and Occupational Health, and High-Risk
Training Safety Program Manual, Appendix 9-BB
(d) Naval Education and Training Command (NETC) NETC P1552/16,
(07-07), Navy Swimming and Water Survival Instructor’s Manual
(e) NAVMED P5010-4 (Chapter 4), Manual of Naval Preventive Medicine
Definitions
1. Formal Training - Training conducted in a classroom, laboratory, or field exercise for which a CIN is assigned.
2. High-risk training - All basic or advanced, individual or collective training in a traditional or non-traditional environment which exposes the crew, staff, students and/or
assets to the potential risks of death, permanent disability, or
loss during training. For the purpose of this instruction, an
assignment of any risk assessment code (RAC) of 1 or 2, as well as an assignment of RAC 3 in Severity Level I (death or loss of asset) or Severity Level II (severe injury, damage), although
the "Probability" of an injury or loss is "Unlikely (D)" or "May
occur-in-time (C)," must be considered high-risk training. A RAC 3 in Severity Level III (minor injury, damage) or Severity Level IV (minimal threat) should receive a cognizant authority review to confirm the assessment and reduce any ambiguity about the subjectivity of the assessment (i.e., an event scored as a
C, II is a RAC 3 and is a high-risk event, while an event scored as
B, III is also a RAC 3, not high-risk by definition, but
should be closely reviewed by cognizant authority due to the frequency of minor injuries or minimal threats to ensure that the proper "Severity Level" assigned is not really an A, III -
RAC 2 due to the interpretation of "Likely" versus "Probable" by
the assessor during the risk assessment). Some examples of
where high-risk training may be found are: survival, parachute, fire-fighting, damage control, jungle, desert, small arms, law
enforcement and physical security, disaster preparedness, blaster, diver, EOD, basic underwater demolition, sea-air-land, aircrew, survival escape and resistance, aviation water survival, and rescue swimmer schools, etc.
Definitions (Continued)
3. Training Mishap - Any mishap that occurs to instructors, students, or assets while conducting formal, traditional, nontraditional, or unit level training as a result of the curriculum or the environment (including training devices, materiel, or equipment, etc.) as identified in reference (b), OPNAVINST 1500.75B.
4. Yes - In compliance with applicable instruction(s).
5. No- Not in compliance with applicable instruction(s).
6. Not Applicable (N/A) - Does not apply.
7. Remarks – Amplifying comments.
TrainingCommandandSchoolContactInformation
COMMAND / NAME / COMMERCIAL / DSNEMAILorWEB
Commanding Officer
ExecutiveOfficer
SafetyOfficer
Command
Address
School
TITLE / NAME / COMMERCIAL / DSNEMAIL or WEB
Training Safety
Officer
DivisionOfficer
Course(s)
CIN / COURSENAME / COURSESUPERVISOR / COMMERCIAL / DSNEMAIL or WEB
Naval Safety Center Surveyors
TITLE / NAME / COMMERCIAL / DSN(757)444-3520 x7174 / 564
(757)444-3520 x7175 / 564
(757)444-3520 x7176 / 564
564
InBriefDate
OutBriefDate
iiii
A.FacilityRequirementsMaintenance and Operation, Instructor’s Responsibility
1.Hastheswimminginstructorensuredthefollowingactionsare completed?
a.Ensuredthatthefacilitymeetsthecurrenthealthandsafety standards.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.2] / Yes
No
N/A
Remarks:
b.Keepthepoolandadjoiningdeckareafreeofphysicalormechanical hazardssuchasslipperysurfaces,projectingobjects,andfloatingor underwaterobstructions.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.2] / Yes
No
N/A
Remarks:
c.Ensurethatthepooldeckandadjoiningareasareclean. Ref:NETCP1552/16(07-07)[Chapter4,Para4.2] / Yes
No
N/A
Remarks:
d.ThewaterqualitymustbemaintainedperthecurrentManualofNaval
PreventiveMedicine(NAVMEDP-5010-4).
Ref:NETCP1552/16(07-07)[Chapter4,Para4.2] / Yes
No
N/A
Remarks:
e.Ensurethatwhenevertemperature,turbidity,orchemicalcontentof thepoolareinquestion,theinstructorshouldconsultwiththelocal NavyHospital/BranchClinic(OccupationalHealthorPreventiveMedicine Department)orequivalentcivilianagency.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.2] / Yes
No
N/A
Remarks:
f.Istheminimumwaterdepth(shallowend)atleast3feet? Ref:NAVMEDP-5010[Chapter4,Para4-8.b(2)] / Yes
No
N/A
Remarks:
Maintenance and Operation, Instructor’s Responsibility
g.Are1-footwaterdepthvariationsmarkedonthepooldeck(indoor poolmarkingsmayalsobelocatedonadjacentwalls;outdoorspooldepth markingsmaybemountedontheperimeterfences)?
Ref:NAVMEDP-5010[Chapter4,Para4-8f(1)] / Yes
No
N/A
Remarks:
h.Iseitherthemaindrainorgratingconspicuouslymarkedwith coloredtileorpaint?
Ref:NAVMEDP-5010[Chapter4,Para4-8f(3)] / Yes
No
N/A
Remarks:
B.Militaryplatforms;
Do Military platforms;
a.Haveaminimumof15feetofunobstructedheadroom? Ref:NAVMEDP-5010[Chapter4,Para4-8h] / Yes
No
N/A
Remarks:
b.Haveaminimumseparationof10feetbetweenitselfandother platformsandsidewalls?
Ref:NAVMEDP-5010[Chapter4,Para4-8h] / Yes
No
N/A
Remarks:
c.Clearlymarked"NotForRecreationalUse"? Ref:NAVMEDP-5010[Chapter4,Para4-8h] / Yes
No
N/A
Remarks:
d.Madeinaccessibletorecreationaluse?
Ref:NAVMEDP-5010[Chapter4,Para4-8h] / Yes
No
N/A
Remarks:
Do Military platforms; (Continued)
e.Arethefollowingminimumwaterdepthsmetforthecorresponding heightsoftheplatforms(0-6''depth,6-10'ht@10'depth, andabove10''depth)?
Ref:NAVMEDP-5010[Chapter4,Table4-2] / Yes
No
N/A
Remarks:
f.Ataminimum,areladdersprovidedattheshallowendandoneach sideofthedeepend(minimumof3ladders)ofthepool?
Ref:NAVMEDP-5010[Chapter4,Para4-8d] / Yes
No
N/A
Remarks:
g.Doallladdershavehandrailsonbothsides? Ref:NAVMEDP-5010[Chapter4,Para4-8d] / Yes
No
N/A
Remarks:
h.Dothetreadsoftheladdershavenon-sliptopsurfaces?
Ref:NAVMEDP-5010[Chapter4,Para4-8d] / Yes
No
N/A
Remarks:
i.Dotheladdersmeettherecommendedclearancesof3to6inches betweentheladderandthepoolwall?
Ref:NAVMEDP-5010[Chapter4,Para4-8d] / Yes
No
N/A
Remarks:
j.Doesthedeckareaextendallthewayaroundthepool? Ref:NAVMEDP-5010[Chapter4,Para4-8e] / Yes
No
N/A
Remarks:
k.Isthedecksmooth,withanon-slipsurface? Ref:NAVMEDP-5010[Chapter4,Para4-8e] / Yes
No
N/A
Remarks:
C.ChlorineGasRoom:
1.Arechlorinegascylindersenclosedinaroomtoprotectagainst accidentalleakage?
Ref:NAVMEDP-5010[Chapter4,Para4-8.j] / Yes
No
N/A
Remarks:
2.Doestheexitdooropentotheoutside? Ref:NAVMEDP-5010[Chapter4,Para4-8.j] / Yes
No
N/A
Remarks:
3.Isthereatleastoneobservationwindowforviewingtheinteriorfrom theoutside?
Ref:NAVMEDP-5010[Chapter4,Para4-8.j] / Yes
No
N/A
Remarks:
4.Doesthefloorhaveanon-slipfinish? Ref:NAVMEDP-5010[Chapter4,Para4-8.j] / Yes
No
N/A
Remarks:
5.Isthereapotablewateroutletandaneyewash/delugeshowerlocatedin theimmediatearea?
Ref:NAVMEDP-5010[Chapter4,Para4-8.j] / Yes
No
N/A
Remarks:
6.Firedepartmentandotheremergencynumbersposted? Ref:NAVMEDP-5010[Chapter4,Para4-8.j] / Yes
No
N/A
Remarks:
Chlorine Gas Room: (Continued)
7.Havelifeguardsandothersupervisorypersonnelreceivedindoctrination intheprocedurestobefollowedincaseofachlorineincident?
Ref:NAVMEDP-5010[Chapter4,Para4-8.j.2] / Yes
No
N/A
Remarks:
8.Arethereprocedurestobefollowedintheeventofachlorinegas incident,setforthinaSOPmanual?
Ref:NAVMEDP-5010[Chapter4,Para4-8.j.2] / Yes
No
N/A
Remarks:
9.Isthereabuoyline(dividingthedeependfromtherestofthepool andlocated1to2feetfromthebreakpointovertheshallowportionof thepool)stretchedacrossthepool?
Ref:NAVMEDP-5010[Chapter4,Para4-12.a] / Yes
No
N/A
Remarks:
D.SafetyandRescueEquipment,Instructor’s
Responsibility
1.Hastheswimminginstructorensuredthefollowingsafetyandrescue actionsarecompleted?
a.Anadequateselectionofsafetyandrescueequipmentisreadily available.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.3] / Yes
No
N/A
Remarks:
b.Athrowableringbuoysattachedtoa1/4"polypropyleneretrieving linelongenoughtoreachacrossthepool.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.3] / Yes
No
N/A
Remarks:
Safety and Rescue Equipment, Instructor’s Responsibility
(Continued)
c.Istheringbuoywithlineattachedshouldbemountedonthewallin suchamannerthatitisreadyforinstantuse.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.3] / Yes
No
N/A
Remarks:
d.Ensurebackboardsorspineboardsareavailableatpoolside. Ref:NETCP1552/16(07-07)[Chapter4,Para4.3] / Yes
No
N/A
Remarks:
e.Ensurethatqualifiedpersonnelandsafetyandrescueequipmentare available.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.3] / Yes
No
N/A
Remarks:
f.EnsurethatTheequipmentmustbeinspecteddailytoensurethatit isingoodworkingcondition.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.3] / Yes
No
N/A
Remarks:
g.Ensurethatspecificsafetyequipmentandproceduralguidelinesfor theFirst,Second,andThirdClassSwimTestsarefollowed,whichare foundinChapter12ofNETCP1552/16(07-07).
Ref:NETCP1552/16(07-07)[Chapter4,Para4.3] / Yes
No
N/A
Remarks:
h.Ensurethatspecialrequirementsfortrainingprogramsare delineatedintheappropriatecurricula.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.3] / Yes
No
N/A
Remarks:
i.EnsurethatNETC1552.16ortheappropriatecurriculashouldbe consultedtoensurethatequipmentandpersonnelrequirementsaremet priortocommencementofwateractivities.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.3] / Yes
No
N/A
Remarks:
Safety and Rescue Equipment, Instructor’s Responsibility
(Continued)
j.Ensureallinstructorsassignedtothefollowingareascomplete basicfirst-aidtraining:high-riskdutiesinvolvingswimming,water survival,rescueswimmer,diver,SEAL,SERE,firefighter,RHIB,Coxswain, electrician/electronics,orsmallarmstraining.
Ref:NETCINST5100.1A[Chapter9,Para0902.8.u] / Yes
No
N/A
Remarks:
k.Ensureemergencyoxygenisavailableonsceneduringallaquaticand firefightertraining.
Ref:NETCINST5100.1A[Chapter9,Para0902.8.ll] / Yes
No
N/A
Remarks:
l.Isacorpsman,paramedic,EMT,orotherpersonqualifiedto administersupplementaloxygenpresentduringtheseevolutions?
Ref:NETCINST5100.1A[Chapter9,Para0902.8.ll,Note] / Yes
No
N/A
Remarks:
m.Isthefollowingemergencylifesavingequipmentlocatedateach lifeguardstation:
(1)Rescuetubeorcam?
Ref:NAVMEDP-5010[Chapter4,Para4-12.d] / Yes
No
N/A
Remarks:
(2)Highreachingpoleorshepard'scrook? Ref:NAVMEDP-5010[Chapter4,Para4-12.d] / Yes
No
N/A
Remarks:
(3)Aringbuoywiththrowlineattached? Ref:NAVMEDP-5010[Chapter4,Para4-12.d] / Yes
No
N/A
Remarks:
Safety and Rescue Equipment, Instructor’s Responsibility
(Continued)
(4)Whistle?
Ref:NAVMEDP-5010[Chapter4,Para4-12.d] / Yes
No
N/A
Remarks:
(5)Bullhorn?
Ref:NAVMEDP-5010[Chapter4,Para4-12.d] / Yes
No
N/A
Remarks:
E.FirstAidEquipment
1. Does the pool have the following minimumfirst aid
equipment available:
(a)Stretcher?
Ref:NAVMEDP-5010[Chapter4,Para4-12.e] / Yes
No
N/A
Remarks:
(b)Blankets?
Ref:NAVMEDP-5010[Chapter4,Para4-12.e] / Yes
No
N/A
Remarks:
(c)Firstaidkitapprovedbylocalmedicaltreatmentfacility(kit mustincludebloodbornepathogenprotectiveequipment(e.g.,masks, shields,latexgloves)?
Ref:NAVMEDP-5010[Chapter4,Para4-12.e] / Yes
No
N/A
Remarks:
(d)Drinkingwater?
Ref:NAVMEDP-5010[Chapter4,Para4-12.e] / Yes
No
N/A
Remarks:
Does the pool have the following minimum first aid equipment
available: (Continued)
(e)Firstaidcot?
Ref:NAVMEDP-5010[Chapter4,Para4-12.e] / Yes
No
N/A
Remarks:
(f)Pillow?
Ref:NAVMEDP-5010[Chapter4,Para4-12.e] / Yes
No
N/A
Remarks:
(g)Telephonew/emergencynumberslisted? Ref:NAVMEDP-5010[Chapter4,Para4-12.e] / Yes
No
N/A
Remarks:
(h)Splints?
Ref:NAVMEDP-5010[Chapter4,Para4-12.e] / Yes
No
N/A
Remarks:
(i)BackBoards?
Ref:NAVMEDP-5010[Chapter4,Para4-12.e] / Yes
No
N/A
Remarks:
F.EmergencyActionPlan
1.Doesthefacilitythatconductswatersurvivaltraininghavea writtenplanofactionforon-siteaccident/injurymanagement?
Ref:NETCP1552/16(07-07)[Chapter4,Para4.4]and
OPNAVINST1500.75C[Enclosure1 Para 6] / Yes
No
N/A
Remarks:
Emergency Action Plan: (Continued)
2.Theplanmustbepostedinaconvenientplace,andincludeemergency telephonenumbers,meansoftransportationfortheinjured,andlocation
ofemergency/firstaidequipment.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.4]and
OPNAVINST1500.72C[Enclosure1, Para 6] / Yes
No
N/A
Remarks:
G.PoolRegulations
1. Is a placard, containing pool regulations, posted in
a prominent location and does it contain all of the following required information:
(a)Complywithdirectionsandsignals? Ref:NAVMEDP-5010[Chapter4,Para4-12.g.1] / Yes
No
N/A
Remarks:
(b)Showerpriortoenteringpool.
Ref:NAVMEDP-5010[Chapter4,Para4-12.g.2] / Yes
No
N/A
Remarks:
(c)Noskindiseases,sores,bandages? Ref:NAVMEDP-5010[Chapter4,Para4-12.g.3] / Yes
No
N/A
Remarks:
(d)Nospitting,urinating?
Ref:NAVMEDP-5010[Chapter4,Para4-12.g.4] / Yes
No
N/A
Remarks:
Is a placard, containing pool regulations, posted in a prominent
location and does it contain all of the following required
information: (Continued)
(e)Noeating,drinking,smoking?
Ref:NAVMEDP-5010[Chapter4,Para4-12.g.5] / Yes
No
N/A
Remarks:
(f)Nopets?
Ref:NAVMEDP-5010[Chapter4,Para4-12.g.6] / Yes
No
N/A
Remarks:
(g)Noroughhousing?
Ref:NAVMEDP-5010[Chapter4,Para4-12.g.7] / Yes
No
N/A
Remarks:
(h)Norafts,detachablefloatdevices? Ref:NAVMEDP-5010[Chapter4,Para4-12.g.8] / Yes
No
N/A
Remarks:
(i)Non-swimmers-shallowendonly
Ref:NAVMEDP-5010[Chapter4,Para4-12.g.9] / Yes
No
N/A
Remarks:
(j)Divingindesignatedareasonly?
Ref:NAVMEDP-5010[Chapter4,Para4-12.g.10] / Yes
No
N/A
Remarks:
(k)Nogymnasticsondivingboards?
Ref:NAVMEDP-5010[Chapter4,Para4-12.g.11] / Yes
No
N/A
Remarks:
Is a placard, containing pool regulations, posted in a prominent
location and does it contain all of the following required information: (Continued)
(l)Noswimmingindivingareanodoublebouncingondiving boards?
Ref:NAVMEDP-5010[Chapter4,Para4-12.g.12] / Yes
No
N/A
Remarks:
(m)Nofraternizationwithlifeguards? Ref:NAVMEDP-5010[Chapter4,Para4-12.g.13] / Yes
No
N/A
Remarks:
(n)Noclimbingonlifeguardtowersorusinglifesavingequipment forotherthanemergencyuse?
Ref:NAVMEDP-5010[Chapter4,Para4-12.g.14] / Yes
No
N/A
Remarks:
H.HealthandSanitation
1. Are the following Health and Sanitation regulations
posted in a prominent location and enforced?
(a)Poolregulations(NAVMEDP5010-4)whichrequirethatswimmers takehotsoapyshowersinthenudebeforeenteringthewater.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.5] / Yes
No
N/A
Remarks:
(b)Personnelwithopensores,fever,cough,colds,inflamedeyes, nasaloreardischarge,oranycommunicablediseaseshouldnotbeallowed tousethepoolunderanycircumstances.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.5] / Yes
No
N/A
Remarks:
Are the following Health and Sanitation regulations, posted in a
prominent location and enforced? (Continued)
(c)Spittingorurinatinginthepooloradjoiningareasis prohibited.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.5] / Yes
No
N/A
Remarks:
(d)Swimmersarerequiredtotakeacleansingshowerandshoulduse earwashsolution(2%AceticAcid,95%IsopropylAlcohol,3%Distilled Water)orequivalentafterswimmingtopreventearinfection.
Ref:NETCP1552/16(07-07)[Chapter4,Para4.5] / Yes
No
N/A
Remarks:
I.AquaticProgramsandFacilitiesHealthand
Sanitation
1.Doallaquaticfacilitiesandprogramsthatareoperatedonnaval installationsundertheauspicesoftheChiefofNavalPersonneladhereto policyandguidancesetforthinBUPERSInstruction1710.19?
Ref:NETCP1552/16(07-07)[Chapter4,Para4.6] / Yes
No
N/A
Remarks:
2.Hasthetrainingagencypublishamplifyingproceduraldirectivesfor trainingsafetyrelativetopoolandwaterbornehigh-riskevents.
Ref:OPNAVINST1500.75C[Para5.b.1] / Yes
No
N/A
Remarks:
3.Havepooloperatorsandlifeguards:
(a)Beentrainedandcertifiedinbasicrescueandlife-saving techniques(i.e.:certificationbytheAmericanRedCross)?
Ref:NAVMEDP-5010[Chapter4,Para4-12.f.1] / Yes
No
N/A
Remarks:
Aquatic Programs and Facilities Health and Sanitation
(Continued)
(b)Receivedblood-bornepathogentraining? Ref:NAVMEDP-5010[Chapter4,Para4-12.f.2] / Yes
No
N/A
Remarks:
(c)Receivedhazardcommunicationtrainingandstoragepracticesfor poolchemicals?
Ref:NAVMEDP-5010[Chapter4,Para4-12.f.3] / Yes
No
N/A
Remarks:
3.IsthepoolinspectedatleastmonthlybyaMedicalDept. representativeandpoolmanager(ordesignatedrepresentative)?
Ref:NAVMEDP-5010[Chapter4,Para4-13.a] / Yes
No
N/A
Remarks:
4.Havepoolpersonnelbeentrainedtoperformfieldtestsforchlorine, pH,etc.?
Ref:NAVMEDP-5010[Chapter4,Para4-13.b] / Yes
No
N/A
Remarks:
5.IsthereaD.P.D.(Diethyl-p-phenylenediahine)chlorinetestkiton hand?
Ref:NAVMEDP-5010[Chapter4,Para4-13.b] / Yes
No
N/A
Remarks:
6.Isthewatertemperaturemaintainedbetween65and82degrees? Ref:NAVMEDP-5010[Chapter4,Para4-9.j(2)] / Yes
No
N/A
Remarks:
7.Arepoolandfacilityrecordsmaintainedbythepoolmanagerand examinedaspartofthepoolsanitationinspection?
Ref:NAVMEDP-5010[Chapter4,Para4-15] / Yes
No
N/A
Remarks:
J.MedicalScreeningProcedures
1.ArethemedicalscreeningformsinNETC1552.16AppendixCutilized toscreenstudentstoconduct3rd/2nd/1stclassswimtest.
Ref:NETCP1552/16(07-07)[AppendixC,pageAPP3-2] / Yes
No
N/A
Remarks:
2.Hasthetrainingagency/agentand/orfacilityensuredphysical screeningandbasicswimmingqualificationsareestablishedbeforea studentparticipatesintraining.
Ref:OPNAVINST1500.75C[Para5.c.26] / Yes
No
N/A
Remarks:
K.DroponRequest(DOR)
1.Hasthetrainingagency/agentand/orfacilityestablishedandadhere totheDroponRequest(DOR)policy?
Ref:NETCP1552/16(07-07)[AppendixC,pageAPP3-3] OPNAVINST1500.75C[Para5.b.15]&[Enclosure1 Para 5] / Yes
No
N/A
Remarks:
L.TrainingTimeOut(TTO)
1.Hasthetrainingagency/facilityestablishedandadheretothe
TrainingTimeOut(TTO)policy?
Ref:NETCP1552/16(07-07)[AppendixC,pageAPP3-3] OPNAVINST1500.75C[Para5.b.15]&[Enclosure1 Para 49] / Yes
No
N/A
Remarks:
AdditionalRemarks/Notes: