Incident and
Investigation Report
General Incident Information
ID No:
1299248
Incident Date:
12 Sep 2022
Title of
3yr old stuck in ramp
Incident:
Event Type:
Near Miss
Site:
PSR Pools:Keith Spry
Incident
Injury Illness
Location:
Main Pool
Category:
Reporting
Keith Spry Operations 10689
Main
Unassigned
Line:
Contractor:
Details of the Incident
Details of
(LG) saw a child crying near the railing on main pool far side. Later saw adult yelling at (SW) from a far 'get
Incident:
my kid out of pool' which he responded that it wasn't my job. I (LG) went over and asked what had happened.
So when I (LG) went over to this adult , she was gone but I (LG) talked to someone else. It seemed she had
gotten upset with how he (SW) said 'it wasn't my job'. I (LG) let her know it was my responsibility not
Swimwells. I informed Supervisor
Immediate
Went over to try talk to the woman to find out what had happened
action
undertaken:
Informed Supervisor
Near, on, or in
parent bystander/family
Hazard Source:
Key Person
Other People
water
Public
friend of child
Involved:
Involved:
Swimwell
Consequence Assessment
Actual Safety
Consequence
Consequence:
description:
Risk
Potential
Likelihood of
Rating:
Consequence:
reoccuring:
Security
Environment
Sub Category:
Sub Category:
Abatement
No
External
Notice Issued:
Regulation:
Issued Date:
Internal Policy:
Description of
Impact:
External Agency
Notified:
Complainant
Details:
Notification
Date:
Vehicle
Sub Category:
Describe
Vehicles/Public
Involved:
Page 1 of 4
Report generated :Friday, 16 September, 2022 17:16:44
Incident and
Investigation Report
Injury Details
Injured Person
Injury Type
Part of Body
Severity
Treatment
Investigation Details
Investigator:
Date Completed:
Background/
Introduction:
Events leading
up to the
incident:
Full Incident
Description:
Post Incident
Response:
Investigation
Findings:
Key Learnings:
Other
Observations:
Summary of
Recommendations:
Date Closed:
Signature:
Page 2 of 4
Report generated :Friday, 16 September, 2022 17:16:44
Incident and
Investigation Report
Causation Analysis
Category
Factor
Description
Corrective Action Details
Action Title
Description
Date Due
Person responsible
Date Closed
Page 3 of 4
Report generated :Friday, 16 September, 2022 17:16:44
Incident and
Investigation Report
Photos attached
Caption
Attached Photos
Page 4 of 4
Report generated :Friday, 16 September, 2022 17:16:44
