Learner Name________________________________    Date Completed________________________________

1. On Thursday afternoon, while applying shampoo to “Charlie”, some of the shampoo lather got on your sleeve. What should you do?
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  ___________________________________________________________________________
2. At the same time, your co-worker Cindy got splashed with the shampoo and some went in her eye. What first aid procedure needs to be followed?
  ___________________________________________________________________________
  ___________________________________________________________________________
3. What precautionary measures should you and your co-worker have taken when using the shampoo so as to avoid this situation?
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  ___________________________________________________________________________
4. Complete the form below to report this incident:
Grooming Place Incident Report
Employee Reporting: Date: Time:
Person(s) involved in incident:
Nature of incident:
Injuries sustained:
First Aid applied:
Employee Signature: Supervisor Signature:
5. Shortly after bathing him, Charlie begins to itch and his skin looks very red. What should you do?
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6. What important information do you need to record on Charlie’s Client Information card?
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