Evaluation Tool: Pool Program
February 10, 2011Version
STANDARD 1:
Regulatory
Foundation
Evaluation Criteria
Ordinances
a. Has the Board has passed
ordinances referring to statutes and
rules, as listed in the SCOPE of the
Delegation Agreement?
b. Have ordinances been revised as
needed to be consistent with current
statutes and rules?
c. If applicable ordinances were
changed since the previous program
evaluation, were they were sent to
MDH for review prior to their
passage?
d. Do ordinances describe
enforcement tools and procedures, and
grant authority for enforcement?
e. Do ordinances reference plan review
requirements?
f. (MDH only) Has MDH reviewed
and responded in writing to its
delegated partners regarding proposed
ordinances or language changes to
existing ordinances, within 30 days of
receipt of those changes?
Source
Materials
STANDARD 2:
Trained
Regulatory
Comments
Rating
(0-2)
O
Y
Y
Y
Y
Y
a. Current, signed and dated ordinances
b. Delegation Agreement application
Evaluation Criteria
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
Comments
YELLOW: Required Program Elements required by the Delegation Agreement
1
Rating
(0-2)
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: Pool Program
February 10, 2011Version
Staff
1. Inspection
Staff
2. Agreements
with Other
Qualified
Parties
3. Additional
Training
4. Staffing
Transition Plan
O
a. Does the Board employ qualified
inspection staff as defined in the
Delegation Agreement?
b. Are any less qualified staff (as
described in the Delegation
Agreement) limited to performing
inspections that are not mandated by
the Delegation Agreement?
If the Board has entered into
agreements with other qualified
persons to carry out its regular,
delegated duties, did the Board obtain
MDH’s written approval before
entering into such an agreement?
Describe the percentage of staff that
have taken ICS classes (minimum of
ICS 100 & 200.)
Describe the certification, training and
continuing education that pool
inspection staff have completed
including CPO/CTO and any MNTrac
courses completed.
a. Does the Board have a written plan
that is submitted annually to MDH, to
assure adequate program coverage and
to address staffing transition in the
event of unexpected staffing changes?
b. Has that written plan has worked
effectively during staffing transitions
within the evaluation period?
c. Has the Board notified MDH within
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
Y
Y
W
W
Y
W
Y
YELLOW: Required Program Elements required by the Delegation Agreement
2
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: Pool Program
February 10, 2011Version
10 business days of staff departures,
when staffing is insufficient to
perform the obligations of the
Delegation Agreement?
Source
Materials
STANDARD 3:
Risk-Based
Inspection
Program
1. Inspection
Forms
2. Inspection
Frequency
3. Written &
Implemented
Policies
a.
b.
c.
d.
e.
f.
Position descriptions for all program staff
Organizational chards, with RS numbers, if applicable
Staff standardization documentation
Written staffing transition plan
Staff credentials and certifications (e.g. RS/REHS, CTO, CP-FS, CEHT)
Training records (e.g. MN Train records, if used)
Evaluation Criteria
Comments
Y
a. Do the Board’s inspection
documents identify health and safety
hazards and interventions?
b. Do the Board’s inspection forms
document significant Pool Code
violations and corrective actions?
Is the inspection frequency based on
MN Statutes 157.20 being met (at
least once every 12 months)?
a. Has the Board developed a
documented procedure to address
corrective action?
b. Has the Board developed a
documented procedure that requires
discussion of options for long-term
control of health and safety hazards?
c. Has the Board developed a
documented procedure that requires
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
Rating
(0-2)
W
O
Y
W
Y
YELLOW: Required Program Elements required by the Delegation Agreement
3
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: Pool Program
February 10, 2011Version
follow-up activities on and health and
safety violations?
Source
Materials
STANDARD 4:
Uniform
Inspection
Program
1. Plan Review
2. Licensing &
Data
Management
a.
b.
c.
d.
e.
f.
Copies of inspection reports/forms
List of licensed facilities
Inspection frequency data for the past three years
Documented procedures referenced in 3. a-c above
Other compliance forms or documents
Copies of variances, as requested
Evaluation Criteria
Comments
Y
a. Are plans submitted to MDH for
construction of new pools or when
pools are modified, as required in the
Pool Code?
b. (MDH only) Does MDH perform
plan review for construction of new
pools or when pools are modified as
required in the Pool Code?
c. Does the Board license only those
pools for which plan review is
complete and approved by MDH?
d. Does the Board maintain adequate
documentation throughout the plan
review process?
e. Is documentation maintained for
water and sewer system approval as
reviewed by the appropriate authority?
a. Is the Board required by policy to
license establishments on an annual
basis?
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
Rating
(0-2)
Y
Y
W
W
Y
YELLOW: Required Program Elements required by the Delegation Agreement
4
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: Pool Program
3. Inspections
& Written
Reports
Source
Materials
STANDARD 5:
Illness & Injury
Investigation &
Response
1. Protocol for
Investigating
Complaints
2. Complaints
February 10, 2011Version
Y
b. Does the Board maintain a current
list of establishments (including
establishment name, address and risk
category)?
a. Are inspections conducted by
qualified inspection staff, as described
in the Delegation Agreement?
b. Does the Board incorporate
education into the inspection process?
c. Are written reports complete and
accurate, and do they describe
compliance activities?
d. Are statutes, rules and ordinances
interpreted accurately and
consistently?
O
Y
Y
Y
a. Files for randomly selected facilities
b. List of licensed establishments with assigned risk category
c. Description of licensing category definitions and descriptions, including for all permanent and temporary establishments
d. Relevant ordinances, policies and guidance documents
e. Plan review reports, as requested
f. Educational or training materials relevant to uniform inspection that the Board wishes reviewed
Evaluation Criteria
Comments
Y
Does the Board utilize a procedure to
investigate, respond to, and document
Pool complaints or injury?
a. Does the Board maintain a log or
database for all complaints alleging
injury, or waterborne illness, or health
and safety hazards?
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
Rating
(0-2)
W
YELLOW: Required Program Elements required by the Delegation Agreement
5
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: Pool Program
3. Program
Coverage
Source
Materials
STANDARD 6:
Compliance &
Enforcement
Compliance &
Enforcement
February 10, 2011Version
W
b. Does the Board follow-up on all
injury, waterborne illness, or health
and safety hazard complaints within
one business day?
c. Are investigation reports filed or
linked to the records of the
establishment?
d. Does the Board transmit all
waterborne illness complaints to MDH
within one business day?
e. (MDH only) Does MDH refer to its
delegated partners any complaints that
MDH receives concerning matters
under their jurisdiction?
Does the Board have qualified staff
available for emergency coverage on a
24-hour a day basis and have they
provided an after-hours contact
number to MDH?
W
Y
Y
Y
a. Procedures for responding to injury, health and safety hazards, or waterborne illness
b. Complaint log and relevant materials
c. After hours staffing policy and after-hours contact number
Evaluation Criteria
Comments
Rating
(0-2)
O
a. Does the Board identify and
document violations according to
statute, rule and ordinance?
b. Does the Board address the
identified health and safety hazards
by: (1) following up or using
appropriate enforcement tools,
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
O
YELLOW: Required Program Elements required by the Delegation Agreement
6
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: Pool Program
February 10, 2011Version
including revocation or suspension,
and (2) by maintaining adequate
documentation throughout the
enforcement process?
c. Does the Board resolve identified
violations within a reasonable time?
d. Does the Board maintain records
according to its records retention
policy?
Source
Materials
STANDARD 7:
Industry &
Community
Relations
Y
Y
a. Records for randomly selected licensed establishments
b. Enforcement policies, procedures and tools
Evaluation Criteria
Comments
Y
Does the Board participate in
workgroups, advisory boards, task
forces or committees that work to
1. Work Groups
identify, correct, and prevent health
and safety hazards in licensed
establishments?
a. Does the Board lead or participate
in activities that increase awareness of
health and safety hazards, and control
2. Educational methods to prevent illness or injury?
Outreach
b. (MDH only) Has MDH been
available to advise its delegated
partners regarding issues covered
under the Delegation Agreement.
Source
Materials
Rating
(0-2)
W
Y
Any relevant materials the Board wishes to be reviewed
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
YELLOW: Required Program Elements required by the Delegation Agreement
7
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: Pool Program
STANDARD 8:
Program
Resources
February 10, 2011Version
Evaluation Criteria
Comments
a. Describe the current ratio of
qualified inspection staff to the
number of licensed establishments.
b. (MDH only) Does MDH evaluate
1. Inspection
its delegated partners’ compliance
Ratio (sufficient
with the Delegation Agreement to
staffing)
ensure that their programs are
adequate to assure compliance by
regulated parties to requirements in
statutes and rules?
Does the Board provide the
2. Inspection
appropriate inspection equipment to
Equipment
its qualified inspection staff?
Describe the source(s) of funding for
this program. (Fees, General Fund,
3. Funding
etc.)
Does the Board maintain all licensing
and inspection information in an
4. Data Sharing
electronic format and make it
available to MDH upon request?
Is funding provided for staff training,
5. Professional
conference attendance, and other
Development
professional development activities?
Does the Board provide staff with
6. Staff Safety appropriate safety training and
equipment?
a. Electronic licensing and inspection data
Source
b. Organizational charts, with RS numbers, if applicable
Materials
c. Staff credentials and certifications (e.g., RS/REHS, CPO, CP-FS, CEHT)
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
YELLOW: Required Program Elements required by the Delegation Agreement
8
Rating
(0-2)
W
Y
W
Y
W
W
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: Pool Program
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
February 10, 2011Version
YELLOW: Required Program Elements required by the Delegation Agreement
9
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions