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CAQA Summit Sport and Recreation · Simulated workplace

Incident, Rescue and First Aid Report Form

FormControlled document
SMT-FRM-001
v2.2
Document ownerCustomer Experience and Safety Manager
Version2.2
Approved6 February 2026
Next review6 February 2027
StatusCurrent

Purpose. This form is completed for every injury, illness, rescue or assist, first aid treatment, near miss, hazard, child safety concern or behavioural incident at a Summit site or program.

1.When to use this form

Complete this form on the day the event occurs. Use it for injuries to staff, members, participants or visitors, medical episodes, water rescues and assists, first aid treatment, near misses, hazards, equipment failures, contamination events, behavioural incidents and child safety concerns. Child safety concerns are marked confidential and go directly to the Customer Experience and Safety Manager.

2.Who completes it

The staff member who responded or witnessed the event completes the first sections. The duty manager completes the immediate action section and enters the report in the incident, rescue and first aid register within two hours. The Customer Experience and Safety Manager assigns the review and closes the record.

3.Injuries to members and participants

Record the person's name and contact details with their consent, what they say happened, the first aid given and whether they went to hospital or home. For a child, record the parent or guardian contacted and when. Do not admit liability or discuss compensation; refer the person to the site manager.

4.Notifiable incidents

A death, serious injury or illness, or a dangerous incident such as a chemical release or plant failure must be reported to the regulator immediately by the site manager or the Customer Experience and Safety Manager and the site preserved until the regulator advises otherwise.

5.Follow-up

Every report receives a risk rating, a review proportionate to the risk and corrective actions with an owner and due date. The reporter will be told what action was taken and offered a debrief where the event was distressing. Trends are reviewed at the quarterly safety committee.

6.Complete the form

SMT-FRM-001 v2.2 · CAQA Summit Sport and RecreationUncontrolled when printed. Simulated document created by CAQA for training and assessment.