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Swimming Pool Safety Plan Adapted for Hotel, Motels & Campgrounds Supervision Level IV Name of Facility: Site Address: Telephone: Prepared by: Title: Signature: Date: New York State Sanitary Code 6-1 requires that swimming pool operators develop, update and implement a written safety plan. This plan must be submitted to your local health department for their review and approval. The plan must include procedures for daily bather supervision, injury prevention, reacting to emergencies, injuries and other incidents, providing first aid and summoning help. Please review and complete this document. Include any attachments (i.e. photos), as necessary. Once completed, it will serve as your facility’s comprehensive written safety plan, which will meet the requirements of the State Sanitary Code (SSC). This plan must meet the specific conditions of your facility and operations, as well as serve as a training and reference document for you and your staff. Local rescue, police and fire personnel should be consulted when developing your pool safety plan. Additional information may be obtained at www.nyhealth.gov Please send a copy to: Cortland County Health Department Environmental Health Division 60 Central Ave. Cortland, NY 13045 And, please retain a copy of this document for your use. For LHD use only Approved: Yes No Reviewer: Title: Date: June 2010 ---PAGE BREAK--- June 2010 2 Table of Contents Topic Pages Pool Characteristics 3 Bather Supervision 4 - 6 • Supervision Levels III or IV 4 - 6 Certifications Injury Prevention 8 - 12 • Waterfront Hazards 8 - 9 • Lighting and Electrical 9 • Maintenance 10 • Rules and Regulations 10 • Diving Areas 11 • Environmental Conditions and Weather 11 - 12 Illness Prevention 13 • Fecal, Vomit and Blood Contamination Incidents 13 Chemical Storage and Handling 13 - 14 • Spas 14 Emergency Response 15 • Search Procedures 15 • Communication 16 - 17 • Reporting 17 -18 • Training 18 - 19 Sketch/Diagram of Pool 20 ---PAGE BREAK--- June 2010 3 Swimming Pool Safety Plan Pool Characteristics Name of Facility: 1. Please indicate what your swimming pool operation is associated with: Homeowner Association Campground Temporary Residence Municipality School Other 2. Please fill in the table below for each pool. Pool # Type of Bathing Facility: {Outdoor Pool, Indoor Pool, Outdoor Spa, indoor Spa, Wading Pool) Square Footage Minimum Depth (Feet) Maximum Depth (Feet) Bather Capacity Diving Allowed (Y/N) Slides (Y/N) Supervision Level (IIa, IIb, III, IV) 1 2 3 4 5 ---PAGE BREAK--- June 2010 4 Swimming Pool Safety Plan Bather Supervision Swimming Pool Safety Plan Bather Supervision – Supervision III or IV Do you provide Supervision Level IV at your facility? Yes No If “yes” to question above, please continue with questions 18 - 70. The effective supervision of all bathers is essential to safety. Inadequate supervision has been determined to be a contributing cause in over half of all drownings at regulated bathing facilities in New York State. A system is to be established that allows for continuous supervision and adequate visual surveillance of the bathers. This system will vary depending on the level of supervision required at each facility type. When a swimming pool, spa pool or wading pool is part of a temporary residence or campground as defined in SSC Subparts 7-1 and 7-3, the operator must provide either Supervision Level IIa, IIb, lll, or lV aquatic supervision, as defined in SSC Subpart 6-1. Supervision Level III or IV Are supervisory staff, provided by the facility, who possess certain skills and requirements per Section 6-1.31. May be selected when the bathing facility is part of a temporary residence or campground. If part of a temporary residence or campground, when Supervision Level III or IV is selected, on-premise CPR is not required. If a temporary residence or campground operator allows persons other than registered overnight patrons and their guests to use the pool, then the operator must provide a leveI of supervision during that period of use which is consistent with the pool characteristics. (Please refer to Subpart 6-1.23(a)(2).) • Pools with surface area greater than 2000 square feet, water depth 5 feet or more, diving boards, flotation devices (other than U.S. Coast Guard Type I - III Label), or pool deck slides must provide Supervision Level II, a lifeguard. • When a pool otherwise qualifies for Supervision Level III or IV, on-premise CPR certified staff are required. Supervision Level IV • Supervision Level IV may be selected if the water depth within the designated bathing area is less than five feet and the surface area of the pool is less than or equal to 2000 square feet. • At Supervision Level IV, the aquatic staff shall be on premises at all times the pool or spa is in use with periodic visual checks of the pool or spa conducted and logged. ---PAGE BREAK--- June 2010 5 Swimming Pool Safety Plan Swimming Pool Safety Plan Bather Supervision – Supervision III or IV 18. Is your bathing facility part of a temporary residence or campground? Yes No (If “Yes”, please complete a. Do you allow persons other than registered overnight patrons to use your pool? If "Yes", and you are required to provide Supervision Level II, Yes No (See text box above), please complete the Supervision Level II questions. 19. Is your facility required to provide on-premise CPR certified staff? Yes No (If "Yes", please complete a, b, and a. Who is the on-premise CPR certified staff? Owner/Operator Facility Manager Other (specify) b. How is this person summoned to the emergency? This person is always within hearing distance of the pool area. By telephone Cell phone that the person carries at all times Other (specify) c. What is the response time for this person in the event of an emergency at the pool area? Within 1 minute 1 - 3 minutes Other (specify) If the pool is part of a temporary residence or campground, when Supervision Level III or IV is selected, the operator shall not allow the use of the pool by persons other than registered overnight patrons of the temporary residence or campground and their guests. If a temporary residence or campground operator allows persons other than registered overnight patrons and their guests to use the pool, then the operator must provide a leveI of supervision during that period of use which is consistent with the pool characteristics. (Please refer to Subpart 6-1.23(a)(2).) • Pools with surface area greater than 2000 square feet, water depth 5 feet or more, diving boards, flotation devices (other than U.S. Coast Guard Type I - III Label), or pool deck slides must provide Supervision Level II, a lifeguard. • When a pool otherwise qualifies for Supervision Level III or IV, on-premise CPR certified staff are required. Please refer to the Emergency Response section on Pages 25 - 29 for additional information. A drowning victim has the greatest chance of survival if CPR is initiated immediately. If a drowning victim is rescued and effective ventilation and circulation is restored within 0 - 3 minutes of submersion, the victim has an excellent chance of normal survival. The longer the time period, the more probable it is that permanent neurological damage or death will occur. ---PAGE BREAK--- June 2010 6 Swimming Pool Safety Plan Bather Supervision – Supervision III or IV Daily Monitoring 20. Who is the Supervision Level III or IV staff who provides visual surveillance/periodic supervision and is on the premises during the times the pool or spa is in use? Owner/Operator Facility Manager Other (specify) 21. How often does the Level III or Level IV staff monitor the bathing facilities throughout the day? 1-2 times/day 2-5 times/day more than 5 times/day Other (specify) Supervision IV Daily Monitoring 22. Who monitors to see that the rules are being followed? Owner/Operator Maintenance Staff Facility Manager Other (specify) 23. Who is responsible for performing the daily compliance check (including safety equipment, water conditions, and hazard checks), prior to the pool opening each day? Owner/Operator Maintenance Staff Facility Manager Other (specify) 24. Who maintains the daily log? Owner/Operator Maintenance Staff Facility Manager Other (specify) Supervision Level IV includes a combination of daily monitoring, posting required warning signs, providing patrons with the required rules in writing, enforcing all rules, providing conveniently located emergency communication and providing required safety equipment. To be in compliance with Supervision Level IV requirements, all of these components must be in place. (Please refer to SSC Section 6-1.23(a)(10).) Supervision Level III aquatic staff must be at pool side, providing direct supervision of pool patrons. At spa pools, the Supervision Level III aquatic staff must be on the premises and provide periodic supervision as specified in the safety plan. ---PAGE BREAK--- June 2010 7 Swimming Pool Safety Plan Bather Supervision – Supervision IV Rules and Regulations Required Sign 25. Where is the required sign located? Pool Entrance Poolside Other (specify) Required Notification of Patrons 26. Is a written statement or brochure indicating the required rules provided to all patrons? Yes 27. How and when is this information provided? (Check all that apply.) At the front desk at the time of check-in Patrons must sign saying they have received it Other (specify) Please enclose a copy of this brochure. Certifications – Supervision IIa, IIb, III, IV Supervision Level IV facilities must post specific pool rules which state: • Two or more adults (18 years or older) must be present at the pool when pool is in use, with at least one adult on the pool deck. • Children less than 16 years must at all times be accompanied by a parent or guardian or similar adult responsible for their safety and behavior while at the bathing facility. • Shallow Water – No Diving (for pools with water depths less than 8 feet.) • Method of summoning on-premise CPR staff (only where CPR trained staff is required.) • Location of free telephone and emergency numbers It is the responsibility of the facility owner/operator to make sure that the supervisory aquatic staff they hire have the proper skills and certifications. Copies of these certifications must be maintained on-site and be available for inspection by DOH staff. (Please contact your LHD for a list of acceptable courses.) Please refer to Section 6-1.31 for aquatic supervisory skill requirements. Patrons must be provided with a written statement or brochure before they use the bathing facility. (Please refer to SSC Section 6-1.23(a)(10)(vii).) It is recommended that patrons be provided this information at the front desk at the time of check-in or at the time a lease agreement is signed with periodic reminder notices. In drowning investigations at Supervision Level IV facilities, failing to provide patrons with the written statement or brochure has been documented in many of the incidents. ---PAGE BREAK--- June 2010 8 Swimming Pool Safety Plan Injury Prevention Waterfront Hazards 28. Are there any potentially hazardous areas at your pool? Entrance Areas Diving boards Other (Please specify) Deck slides Starting blocks Underwater slopes Fill spouts The most important responsibility of a bathing facility operator and supervisory staff is the prevention of injuries at the facility. There should be an on-going comprehensive safety program at your facility. Identify potentially hazardous areas such as entrance areas to pools, which can be slippery, diving boards, deck slides, starting blocks, fill spouts, etc. Such areas should be eliminated, marked to help patrons avoid the areas, or additional supervision provided for these areas. Voluntary Hyperventilating and Extended Breath Holding The practice of voluntarily hyperventilating (taking a series of deep breaths in rapid succession and forcefully exhaling) followed by underwater swimming or holding your breath for extended periods of time is dangerous and has led to deaths. • When you hyperventilate, you lower the percentage of carbon dioxide in the air that always remains in your lungs. • The carbon dioxide in the bloodstream is what triggers that part of the brain that controls breathing to initiate taking a breath. • By decreasing the available carbon dioxide, you can remain underwater because you delay the point at which the brain signals the need to take a breath. • When the oxygen level in the blood runs low before the carbon dioxide level rises to the point that triggers the breathing reflex, the swimmer loses consciousness. • The swimmer never actually feels as though a breath is needed. Shallow Water Blackout • Swimmers who practice prolonged underwater breath-holding are at risk for Shallow Water Blackout (SWB). • SWB results from an insufficient amount of carbon dioxide to activate the body's natural impulse to breathe. Victims of hyperventilation and SWB are often skilled swimmers. Victims can also be children and others who participate in 'hold your breath' games. Lifeguards and other supervisory staff should be alert for this safety hazard and should discourage this behavior. Operators should consider posting a sign explaining this hazard and prohibiting it at their pool. ---PAGE BREAK--- June 2010 9 Swimming Pool Safety Plan Injury Prevention Waterfront Hazards 29. What are your plans for controlling or eliminating the hazards associated with these areas? (Please specify hazards and how you will eliminate or control, ex. Slide - Put an additional lifeguard here.) Eliminate Hazard(s) Specify how Mark Hazard(s) Specify how Supervise Hazard(s) Specify how Other Hazard(s) Specify how 30. Who is responsible for addressing the hazards listed above? Owner/Operator Maintenance Staff Other (specify) Facility Manager Lifeguard Lighting and Electrical 31. Do you allow night swimming at your facility? Yes No 32. Does your pool have underwater lights? Yes No 33. What do you have for emergency lighting? Mounted lights Flashlight Other Any defects in the electrical system, including underwater or overhead lights must be immediately repaired. Portable electrical devices, such as radios and announcing systems within reach of the bathers are prohibited. Underwater lights must allow an observer on deck to clearly see the whole pool, including the bottom. If night swimming is allowed, lighting must be sufficient to allow an observer on deck to clearly see the pool bottom. Adequate emergency lighting must be provided at swimming pools where night swimming is allowed and at indoor pools where no natural light is present. For outdoor pools, a portable battery powered artificial light source (i.e. flashlight) is acceptable if adequate and maintained to assist during pool evacuation. ---PAGE BREAK--- June 2010 10 Swimming Pool Safety Plan Injury Prevention Maintenance 34. Who is responsible for performing the daily compliance check (including safety equipment, emergency lighting, water conditions, and hazard checks), prior to the pool opening each day? Owner/Operator Maintenance Staff Other (specify) Facility Manager Lifeguard 35. To whom will maintenance issues and unsafe conditions be reported? Owner/Operator Maintenance Staff Other (specify) Facility Manager Lifeguard 36. How is the main drain grate inspected each day? Visually Reach pole Other (specify) Rules and Regulations 37. Where are your rules posted? (Check all that apply.) Pool Entrance Poolside Near spa Other (specify) 38. Who is responsible for enforcing the rules at your bathing facility? Owner/Operator Maintenance Staff Other (specify) Facility Manager Lifeguard Daily inspections of the facility are necessary to assure that adequate safety levels are maintained. Any problems, such as unsafe water conditions, broken equipment, loose ladders, electrical equipment malfunctions, broken/loose main drain grates, etc. are to be reported and immediately corrected. If the problem cannot be immediately corrected, the specific area or entire bathing facility should be closed, as appropriate. Operators must post signs stating the maximum capacity of the pool, hours during which the pool is open and that swimming at other times is prohibited. Signs stating general rules must be posted conspicuously at the pool, dressing rooms and facility offices. These rules should prohibit urination, discharge of fecal matter, spitting and nose blowing, as well as govern the use of diving boards and slides. These rules may also include prohibitions against running, horseplay, the use of alcohol, etc. Spas have additional requirements including that warning signs stating specific cautionary statements must be conspicuously posted in the vicinity of the spa. (Please refer to SSC Section 6-1.29, item 14.13.) ---PAGE BREAK--- June 2010 11 Swimming Pool Safety Plan Injury Prevention Diving Areas 39. Do you allow diving at your pool? Yes No a) If no, are warning signs stating “No Diving” clearly posted? Yes b) Where are the diving rules clearly posted? c) Who enforces these rules? Owner/Operator Maintenance Staff Other (specify) Facility Manager Lifeguard Swimming Pool Safety Plan Injury Prevention Environmental Conditions and Weather Diving areas require extra attention due to the potential for serious injury. Rules for the use of diving equipment should be developed, posted at the diving area and enforced. Diving from the pool deck is prohibited in water less than 8 feet deep except during competitive swimming or swimmer training activities. (Please refer to SSC Section 6-1.10(l).) Warning signs stating “No Diving” must be clearly posted in areas where diving is not allowed. Environmental conditions must be constantly evaluated at all bathing facilities. Conditions which may require that the pool be cleared of bathers include: unsanitary water conditions, inadequate disinfection levels, cloudy pool water, glare, spa water temperature over 104°F, power outages, and thunderstorms. Each facility should have procedures in place for clearing the water when necessary. These procedures should include who is responsible for monitoring pool closure and what type of communication system will be used. Most spinal cord injuries associated with diving incidents occur in water depths less than 6 feet. ---PAGE BREAK--- June 2010 12 42. When unsafe conditions occur, who is responsible for monitoring pool closure at your facility? Owner/Operator Maintenance Staff Other (specify) Facility Manager Lifeguard 43. When will you close the pool for thunderstorms? At the first sign of thunder or lightning Other (specify) Swimming Pool Safety Plan Injury Prevention Environmental Conditions and Weather 44. What communication system is used for clearing the pool? Whistle (specify signal) Bullhorn (specify signal) Voice (specify) Other (specify) 45. When will you allow re-entry into the water? After at least 30 minutes without any thunder or lightning Other (specify) Lightning Tips The National Lightning Safety Institute (NLSI) recommends closing both indoor and outdoor bathing facilities during a thunderstorm. The NLSI recommends that bathing facilities monitor storm activities, suspend swimming activities when lightning is within 6-8 miles and wait until 30 minutes after lightning has been observed before resuming water activities. • Designate a responsible person as the weather safety lookout. That person should keep an eye on the weather. Use a "weather radio" or the Weather Channel or other TV program to obtain good localized advanced weather information. • When thunder and/or lightning are first noticed, use the Flash-To-Bang (F-B) method to determine its rough distance and speed. This technique measures the time from seeing lightning to hearing associated thunder. For each five seconds from F-B, lightning is one mile away. Thus, a F-B of 10 = 2 miles; 15 = 3 miles; 20 = 4 miles; etc. At a F-B count of thirty, the pool should be evacuated. People should be directed to safe shelter nearby. • Swimming activities should remain suspended until thirty minutes after thunder or lightning were last observed. ---PAGE BREAK--- June 2010 13 Illness Prevention Fecal, Vomit, Blood Contamination Incidents Chemical Storage and Handling Swimming Pool Safety Plan Chemical Storage and Handling 46. What type of disinfection do you use in your pools/spas? (Check all that apply.) Sodium Hypochlorite (liquid) Chlorine Gas Other (Please specify) Calcium Hypochlorite: Bromine (solid) Powder Tablet Fecal, vomit and blood incidents which occur at pools pose a potential risk of infection to bathers. Feces, vomit and blood may contain pathogenic or harmful bacteria, viruses and parasites that are resistant to chlorine at concentrations found in a pool under normal operating conditions. Special precautions must be taken to ensure that the water is made safe for bathers. Swimming pool operators must respond differently to formed stool vs. diarrhea in the swimming pool. Diarrhea may be an indication that the person is ill with pathogens such as the highly chlorine-resistant parasite, More stringent measures must be taken to sanitize the pool when diarrhea discharges occur. Please refer to the NYS DOH fact sheets, "Fecal Incident Response Recommendations for Pool and Spray Ground Staff" at: http://www/nyhealth.gov/environmental/outdoors/swimming/docs/fs_fecal_incident.pdf and "Vomit and Blood Contamination of Pools and Spray Grounds" at: http://www.nyhealth.gov/environmental/outdoors/swimming/docs/fs vomit blood contamination.pdf Improper handling of pool chemicals can result in explosions, fires or poisonous gas. Procedures for safe storage and handling must be developed and staff trained in safe practices. Safety rules should be prominently posted in the chemical use area. Safety rules should include: • Follow manufacturer’s Instructions. • Never add water to chemicals. Always add chemicals to water. • Wear eye protection when handling chemicals and breathing protection for chlorine gas. • Never mix any chemical with chlorine products. A dangerous chlorine gas could develop immediately. • Always use a clean scoop when dispensing powdered chlorine as a potential fire hazard exists. • All chemicals, including dispensing crocks, must be clearly labeled. • An evacuation plan for facilities using chlorine gas. ---PAGE BREAK--- June 2010 14 47. How are chemicals for pH adjustment added to the pool/spa? Mechanical Feed Equipment By hand when the pool is closed with the pool, remaining closed until chemicals are evenly distributed and the pH is acceptable and determined by testing. 48. Where do you store your chemicals? 49. Is this storage area inaccessible to the public and kept locked? Yes No a. If No, please explain how unauthorized access is prevented? 50. Do you have established safety rules and are they posted in the storage area? Yes 51. Who is responsible for maintaining the chemical levels in you pool/spa? Owner/Operator Maintenance Staff Other (specify) Facility Manager Lifeguard 52. How often is the spa drained and cleaned? N/A Once/2 weeks Once/week Other (specify) 53. How often is the spa chlorinated to 10 mg/L? N/A Once/week Twice/week Other (specify) Swimming Pool Safety Plan Emergency Response An effective prevention program will greatly reduce the occurrence of injuries. Any delay in response may increase the degree of injury or lead to death. A written procedure responsive to potential incidents or emergency situations must be developed and practiced. An emergency should be considered as any situation that jeopardizes the health and safety of a patron or diverts the supervisor’s attention from general supervision of bathers. The facility name and street or 911 number should be clearly posted for emergency personnel to easily identify the address. Local rescue, fire and police personnel should be consulted when developing an emergency response plan. Spas must be chlorinated to 10 mg/L at least once a week when the pool is not is use. • This is true for spas using either chlorine or bromine as the disinfectant. Spas must be drained and cleaned when needed, and at least once every two weeks. • The need to replace the water is based on bather load. • This water replacement interval can be calculated as follows: Water Replacement Interval (days) = Spa Gals ÷ 3 ÷ Average Users per Day Example: 600 gallons ÷ 3 = 200 ÷ 25 (average users per day) = 8 days (water replacement interval) ---PAGE BREAK--- June 2010 15 Search Procedures Swimming Pool Safety Plan Emergency Response Search Procedures 54. Who is responsible for performing a lost bather search at your facility? (Please answer b, if applicable.) b) Supervision Level III or IV Facilities/Homeowner Associations Owner/Operator Facility Manager Maintenance Staff Other (specify) 55. Describe your lost bather search procedure. Time can be critical when searching for a lost bather. Lifeguards are trained in proper search methods and these can vary depending on the facility characteristics. Specific water search procedures should be established. Obtain a description of the missing individual and last location seen. A simultaneous land and water search should be initiated immediately. Emergency response procedures must include: • Clearing the waterfront area • Emergency care of the victim • Contacting emergency personnel • Crowd control • Meeting and guiding emergency personnel to the site and/or victim • Directing traffic • Drills for emergency response situations Seizures Any person who suffers a seizure in the water and submerges should be transported to a medical facility regardless of apparent recovery. They should not be allowed back in the water for the rest of the day. ---PAGE BREAK--- June 2010 16 Communication 56. Is there a chain of command established for your facility during an emergency? Yes 57. Is a telephone or other means of communication readily accessible at the pool? Yes a) Describe other Swimming Pool Safety Plan Emergency Response Communication 58. Where is the emergency phone with emergency numbers located? Pool Area Bathhouse Facility Office Other (specify) 59. How far is the emergency phone from the pool area? Poolside 51 – 100 feet More than 200 feet 5 - 50 feet 100 – 200 feet Other (specify) Communication is essential during an emergency. A chain of command should be developed as part of an emergency response plan. A phone or other acceptable means of communication must be provided at a convenient location at all pools. All staff should know the location of the nearest telephone. Emergency phone numbers must be prominently posted at the telephone(s). A method of communication between staff such as whistles or hand signals should be established and staff should be familiar with it. In a near-drowning emergency, the sooner the rescue and first aid begin, the greater the victim's chance of survival. If a drowning victim is rescued and effective ventilation and circulation is restored within 0 – 3 minutes of submersion, the victim has an excellent chance of normal survival. Within 3 – 5 minutes, survival may be likely, but the more probable it is that permanent neurological damage will occur. 5 minutes or more, normal recovery is uncommon unless the water temperature is below 70°F. ---PAGE BREAK--- June 2010 17 60. Please indicate the emergency numbers 61. Where is the first aid room or first aid kit located? Poolside Bathhouse Facility Office Other (specify) 62. Who is responsible for performing crowd control duties in the event of an emergency at the pool? Owner/Operator Maintenance Staff Other (specify) Facility Manager Lifeguard Swimming Pool Safety Plan Emergency Response Communication 63. What is your planned route to be used for emergency response and evacuation at your facility? 64. Who is responsible for meeting the emergency vehicle and directing it to the site? Owner/Operator Maintenance Staff Other (specify) Facility Manager Lifeguard Reporting Usually a large number of people congregate at the scene of an emergency. The emergency plan must include crowd control and on-going supervision of the facility. Access for emergency personnel should be evaluated with an access route pre-determined. During an emergency it is extremely important to provide rescue personnel with detailed directions to your bathing facility. The operator must keep daily records which indicate the number of bathers, number of lifeguards on duty, weather conditions, water clarity, water quality, any reported rescues, injuries and illnesses. These records must be available for review by the Permit Issuing Official for at least 12 months. ---PAGE BREAK--- June 2010 18 65. Who is responsible at your facility for maintaining the required daily records, including the injury/illness log? Owner/Operator Maintenance Staff Other (specify) Facility Manager Lifeguard 66. Who is responsible at your facility for reporting any of the above to the PIO? Owner/Operator Maintenance Staff Other (specify) Facility Manager Lifeguard Training Swimming Pool Safety Plan Emergency Response Training 67. How often do staff practice the emergency response drills? Once/week Twice/month Other (specify) 68. Who is responsible for conducting these trainings? Owner/Operator Maintenance Staff Other (specify) Facility Manager Lifeguard 69. Who participates in this training? (Please list job titles.) 1) 2) 3) 4) 5) 6) If you provide AEDs at your pool: All staff involved in emergency response must be trained. Frequent training to reinforce the principles and rehearse the plan must be conducted. Supervisory staff must also practice their lifesaving skills regularly to remain proficient and able to perform rescues when required. It is the responsibility of the facility operator to report all incidents occurring at his or her bathing facility to the Permit Issuing Official (PIO) as soon as possible, but within 24 hours. Reportable incidents include those which result in death, require resuscitation, require referral to a hospital or other facility for medical attention or is a bather illness associated with bathing water quality. Local Health Department # [PHONE REDACTED] after hours 753-3313 ---PAGE BREAK--- June 2010 19 Please attach a copy of the signed Collaborative Agreement with the appropriate Regional Emergency Medical Services Council (REMSCO) as defined in the PAD program requirements. Please indicate any attachments with this document: AED Collaborative Agreement Staff Certifications/Credentials Facility sketch Additional Emergency Procedures Level IV Patron Notification Statement/Brochure Other (specify) Please indicate the number of additional pages attached. ---PAGE BREAK--- June 2010 20 Swimming Pool Safety Plan 70. Sketch below or attach a diagram or photograph(s) of the pool(s). Sketch must include: • If you provide lifeguards, show the location of lifeguard positions and areas of lifeguard coverage for each position. Indicate how you adjust for factors which could affect adequate supervision and coverage, such as glare, blind spots, bather load and density. • If you use a Level III aquatic supervisory staff, please show the location for this person(s) position. • Areas of responsibility for patron surveillance • Float line placement • Diving boards and slides • Access points and sign locations • First aid stations, emergency/lifesaving equipment and telephone locations Please attach additional pages, if necessary. June 2010