Incident and
Investigation Report
General Incident Information
ID No:
1299318
Incident Date:
13 Sep 2022
Title of
Discussion of an incident - the day after
Incident:
Event Type:
Incident
Site:
PSR Pools:Keith Spry
Incident
Injury Illness
Location:
SwimWell Office
Category:
Reporting
KSP Programmes 10690
Main
Unassigned
Line:
Contractor:
Details of the Incident
Details of
(MOP) came into the office to talk about an incident that had happened the afternoon before that she had
Incident:
witnessed. (MOP) had seen a father trying to grab his 3yr old daughter from the railings in the ramp section of
the main pool after she became stuck. He was having trouble reaching her or getting the lifeguards attention.
A family friend went over to the 3 SwimWell Instructors who were waiting poolside for classes to start at the
deep end of pool. She asked them to help but was told "Not my job luv". This had caused the family friend to
start yelling.
Immediate
I thanked (MOP) for the information and got her details and let her know that we are taking this incident very
action
seriously.
undertaken:
I spoke to my team leader as soon as possible to update about (MOP) witness to the incident. I had already
given a brief before (MOP) came in.
Personal
Hazard Source:
Key Person
Other People
member of
confrontation
Public
Involved:
Involved:
public
Consequence Assessment
1. First aid injury/ debrief
Actual Safety
Consequence
Consequence:
description:
Risk
Potential
1. Minor (An event
Likelihood of
2. Unlikely (Event could
1. Low
Rating:
Consequence:
that requires a
reoccuring:
occur in the next one to
worker and/or other
five years)
person to seek first
aid and/or debrief)
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 17:16:37
Incident and
Investigation Report
Injury Details
Injured Person
Injury Type
Part of Body
Severity
Treatment
Public
Other
Foot - Left
3. Notifiable Event no injury in this conversation
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 17:16:37
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 17:16:37
Incident and
Investigation Report
Photos attached
Caption
Attached Photos
Page 4 of 4
Report generated :Friday, 16 September, 2022 17:16:37
