Incident and
Investigation Report
General Incident Information
ID No:
1299253
Incident Date:
12 Sep 2022
Title of
3 yr old stuck in ramp - part 2
Incident:
Event Type:
Near Miss
Site:
PSR Pools:Keith Spry
Incident
Injury Illness
Location:
Teaching Pool
Category:
Reporting
Keith Spry Operations 10689
Main
Unassigned
Line:
Contractor:
Details of the Incident
Details of
Parent came to me (LG) very upset. She had witnessed another child asking for help. She was venting to me
Incident:
(LG) about how the interaction between herself and other instructors (Swimwell). Saying that when she went
over to ask for help the instructors didn't help. Asking for help to grab a child, then asked for a pole as she
was told it (wasn't their job) and turned their backs on her. Father of the child ended up getting in the water.
Both her and the father were extremely upset as the child has previous anxiety around water. They were
wanting to know what we where going to do about this so it doesn't happen again. I encouraged them to
write and lay a complaint about what happened. She also wanted to have a chat with Supervisor, so I handed
her over to Supervisor to take over.
Immediate
After talking with the parents went and talked Supervisor
action
undertaken:
Near, on, or in
Parent bystander/family
Hazard Source:
Key Person
Other People
water
Public
friend of child involved
Involved:
Involved:
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 17:16:40
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 17:16:40
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 17:16:40
Incident and
Investigation Report
Photos attached
Caption
Attached Photos
Page 4 of 4
Report generated :Friday, 16 September, 2022 17:16:40
