Staff Forms

Facility(Required)

Reported by / Site Contact (Employee name)(Required)

Name

Reported by Email (optional)

Receive a copy of the maintenance request.

Exact Location(Required)

If "Other", please describe below

Further details of location, equipment and fault details(Required)

Urgency(Required)

Hazard(Required)

How did you control the hazard?(Required)

Single Image Upload

Max. file size: 100 MB.

Multi Image upload

Drop files here or

Max. file size: 100 MB.

Facility(Required)

Feedback relevant to:(Required)

If "Other", please explain below:

Nominee Name (Employee you are nominating)(Required)

Feedback Type

CARES Values Demonstrated

Customer

Accountability

Respect

Excellence

Safety

Feedback(Required)

Image Upload

Drop files here or

Max. file size: 100 MB.

Reported by (Employee name, leave blank if you wish to be anonymous)

Name

CAPTCHA

All incident reports must be stored securely, and password protected to maintain confidentiality. Please advise your Direct Line Leader when lodging this incident report. If you believe a child is at immediate risk of abuse phone 000.

Incident details

Date of incident

MM slash DD slash YYYY

Time of incident

Hours

Minutes

AM/PM

Location of incident

Date Identified (if different from date of incident)

Name(s)/Detail of child/children involved

Name(s) of staff/student/volunteer involved:

Please categorise the incident and/or provide comments below

Physical violence

Sexual offence

Sexual misconduct

Serious emotional or psychological abuse

Serious neglect

Grooming

Breach of the University’s Child Safe Code of Conduct

Reportable Conduct

Comments

Does the child identify as Aboriginal or Torres Strait Islander?

Yes, Aboriginal

Yes, Torres Strait Islander

(Mark with an ‘X’ as applicable)

Is the child from a culturally or linguistically diverse background?

Yes

(Mark with an ‘X’ as applicable)

If yes, please provide details

Does the child have a disability?

Yes

A disability can be any physical, sensory, neurological disability, acquired brain injury, intellectual disability, or developmental delay that affects a child’s ability to undertake everyday activities (Mark with an ‘X’ as applicable).

If yes, please provide details

Please describe the incident

Overview

When did it take place & what were the circumstances?

Who was involved?

What did you see/hear?

Other information

Proposed corrective action & mitigation plan

Action

Responsible Person

Date (Completion)

MM slash DD slash YYYY

Status

Action

Responsible Person

Date (Completion)

MM slash DD slash YYYY

Status

Action

Responsible Person

Date (Completion)

MM slash DD slash YYYY

Status

Details of person reporting the incident

Department of reporter

(if/where applicable)

Contact details of reporter

Name of person reporting the incident

Office use only

Date incident report received

Staff member managing incident

Incident ref. number

Has the incident been reported?

Child Protection

Date Notified

MM slash DD slash YYYY

Comments

Police

Date Notified

MM slash DD slash YYYY

Comments

Commission for Children and Young People

Date Notified

MM slash DD slash YYYY

Comments

Another third party (please specify)

Date Notified

MM slash DD slash YYYY

Comments

Use this form when a facility or service is closed for public use for greater than 15 mins without prior notice or when a Wave Session is cancelled. Examples not to be reported: FCI- Use FCI report form, Slide closed for 10 mins to cover Wave session or one treadmill out of order.

Name (Supervisor, Rec Attendant or Leadership Team Member Only)(Required)

Other staff, please report fault or outage to Supervisor, Rec Attendant or Leadership Team Member.

Facility(Required)

Date(Required)

DD slash MM slash YYYY

Service/Facility Closed(Required)

Reason for closure(Required)

Planned Maintenance

Equipment Fault

Safety Hazard

Staffing Shortage

Chemical Imbalance

Other- provide detail below

Reason for closure- More detail

Closure Duration(Required)

Cancelled Wave session

15 mins to 1 hour

1 hour to 2 hours

2 hours to 4 hours

4+ hours

Remains unavailable at end of shift

Immediate and corrective actions(Required)

CAPTCHA

Duty Supervisor (Employee Name)*

*Mandatory items

Time*

Date*

DD slash MM slash YYYY

Free Chlorine*

pH*

Water Balance

Total Chlorine

Alkalinity

Calcium Hardness

Cyanuric Acid

Chemicals Added (If Any)

Controller- Free Chlorine*

Controller- pH*

Controller Image*

Max. file size: 100 MB.

Main Pump 1 Pressure*

Main Pump 2 Pressure*

Filter 1 Inlet*

Filter 1 Outlet*

Filter 2 Inlet*

Filter 2 Outlet*

Filter 3 Inlet*

Filter 3 Outlet*

UV Output mJ/cm2*

Balance Tank Level*

Chlorine Vat Level*

Manual Makeup*

On/ Open

Off/ Closed

Clean Sample Pot*

Yes

Clean H/L Pot*

Yes

Backwash (if any)

Filter 1

Filter 2

Filter 3

Makeup Valve Image*

Max. file size: 100 MB.

UV panel status*

Max. file size: 100 MB.

Daily Waterland checklist*

Max. file size: 100 MB.

We understand that not all tasks will be completed prior to submission of this online form.

Upper Splash Pad Image*

Max. file size: 100 MB.

After leaves cleared & pressure cleaned.

Lower Splash Pad Image*

Max. file size: 100 MB.

After leaves cleared & pressure cleaned.

Upper Booking Area Image*

Max. file size: 100 MB.

Handover Notes

Inspected by (Employee name)(Required)

Name

Facility(Required)

Exact Location(Required)

Change Room Gender(Required)

Male

Female

Accessible/Family

Change Room Location(Required)

Aquatic Indoor

Aquatic Hydro

Aquatic Outdoor

Stadium

Function

Health Club / Gym

Group Fitness

Quality of Cleaning(Required)

Excellent

Satisfactory

Requires Improvement

Details of cleaning quality, issues or faults

Single Image Upload

Max. file size: 100 MB.

Multi Image upload

Drop files here or

Max. file size: 100 MB.

RISE/MSRC End of Shift Checklist

Please fill out the below form and submit it at the end of each shift.

Name

Date

MM slash DD slash YYYY

Shift Time

Site

Core Tasks (RISE)

Emails in inbox actioned

Scoresheets Prepared (Monday & Thursdays)

Teams Contacted for Forfeits (If required)

Check all Functions for next 7 days have paid a bond and have a DCC form

Function Setup Completed

Pre & Post function Checklists Complete

Screens Turned Off

Doors locked and windows closed

Set up Courts for next day/shift

Have put ALL staff keys back in lockbox

Maintenance issues reported

Check function of outdoor lights after sun down

Events cafe spreadsheet (Fridays)

Does not include all daily tasks, just key task reminders.

Core Tasks (MSRC)

Function Setup Completed

Pre & Post function Checklists Complete

Screens Turned Off

Doors locked and windows closed

Set up Courts for next day/shift

Have put ALL staff keys back in lockbox

Maintenance issues reported

Stock from Deliveries put away

Kiosk cleaned and everything switched off

Coffee Machine Cleaned

Taking out Recycling

Does not include all daily tasks, just key task reminders.

Incident/Accident Reports

Is the Incident/Hazard reported on Donesafe? (if required)

Please describe the incident(s) in detail (if applicable)

Please upload any supporting documents or photos related to the incident (if applicable)

Max. file size: 100 MB.

Declaration

I have completed the tasks on my shift to the best of ability.

Handover Notes

Maintenance Notes

I have reported the listed maintenance issues on the maintenance log

Please let staff know what you have reported for maintenance

Date(Required)

MM slash DD slash YYYY

Time(Required)

Hours

Minutes

AM/PM

Checked by(Required)

Shot Clock Power on(Required)

Yes

Scoreboard Power on(Required)

Yes

No missing pixels/sections on screen(Required)

Yes

Main display clearly visible(Required)

Yes

Shot Clock horn working(Required)

Yes

Scoreboard horn working(Required)

Yes

Score can be added/removed corrrectly(Required)

Yes

Game Clock starts/stops corrrectly(Required)

Yes

Period/Quarter can be changed(Required)

Yes

Shot Clock starts/resets corrrectly(Required)

Yes

Team Fouls reset correctly(Required)

Yes

Control Console responding properly(Required)

Yes

All connections/cables secure and undamaged(Required)

Yes

No delay between input and display(Required)

Yes

Shot Clocks positioned correctly and stable(Required)

Yes

Any issues identified?(Required)

Yes

Scoreboard structure looks secure(Required)

Yes

Anything showing signs of wear or likely to fail?(Required)

Yes

If yes, has this been escalated to the line leader?(Required)

Yes

Photos of Scoreboard Working

Drop files here or

Max. file size: 100 MB.

Photos of Shot Clock Working

Drop files here or

Max. file size: 100 MB.

Incident details

Please describe the incident

Proposed corrective action & mitigation plan

Details of person reporting the incident

Office use only

Has the incident been reported?

Child Protection

Police

Commission for Children and Young People

Another third party (please specify)

RISE/MSRC End of Shift Checklist

Bayswater Waves

The Rise

Morley Sport & Recreation

Maylands Waterland

CONTACT

Visit

Facilities

Bayswater Waves
Aquatics

Bayswater Waves
Health Club

The RISE
Stadium

The RISE
Health Club

Morley Rec
Stadium

Maylands Waterland

Opening Hours	Pool	Gym
Monday - Friday	5.30am-8:30pm	5.30am-9.00pm
Saturday	7.30am-7:00pm	7.30am-6.00pm
Sunday	7.30am-7:00pm	7.30am-6.00pm
Public Holidays	7.30am-7:00pm	7.30am-6.00pm
ANZAC Day	1:00pm-7:00pm	1:00pm-6:00pm
Christmas Day & Good Friday	Closed	Closed

Opening Hours	Stadium	Gym
Monday - Friday	6:00am-10.00pm	6:00am-9.00pm
Saturday	8:00am-6:00pm	8:00am-6:00pm
Sunday	8:00am-6:00pm	8:00am-6:00pm
Public Holidays	9:00am-6:00pm	9:00am-6:00pm
ANZAC Day	12:00pm-6:00pm	12:00pm-6:00pm
Christmas Day & Good Friday	Closed	Closed

Opening Hours	Stadium
Monday - Friday	7:30am-10.00pm
Saturday	7:30am-6:00pm
Sunday	7:30am-6:00pm
Public Holidays	10:00am-4:00pm
ANZAC Day	12:00pm-6:00pm
Christmas Day & Good Friday	Closed

Incident details

Please describe the incident

Proposed corrective action & mitigation plan

Details of person reporting the incident

Office use only

Has the incident been reported?

Child Protection

Police

Commission for Children and Young People

Another third party (please specify)

RISE/MSRC End of Shift Checklist

Visit

Facilities

Bayswater Waves Aquatics

Bayswater Waves Health Club

The RISE Stadium

The RISE Health Club

Morley Rec Stadium

Maylands Waterland

Bayswater Waves
Aquatics

Bayswater Waves
Health Club

The RISE
Stadium

The RISE
Health Club

Morley Rec
Stadium