UNIT: SITXWHS003 Implement and monitor work health and safety practices

Student Name: _____________________________ Student ID: ___________________________
Received by Australian College of Trade:
NAME: ______________________________ Signature: _________________________ Date: __________
UNIT: SITXWHS003 Implement and monitor work health and safety practices
Unit Result Record Sheet
SITXWHS003
Implement and monitor work health and safety practices
Student Name:
BLOCK Print
Student Number:
BLOCK Print
Assessment
Completed
(Evidence must be
in students file)
Result
Date
Assessed
Reassessment
Completed
(If required)
(Evidence must be in
students file)
Result
Date
Reassessed
Satisfactory
Not Yet
Satisfactory
Satisfactory
Not Yet
Satisfactory
Written Assessment
Questions
Summative Written
Assessment Questions
Summative Practical
Demonstration of Skills
Result for unit Competent Not Yet Competent
Assessor Name:
& Signature
Signature:
Date result
reached:
Comments:
Student Declaration:
I declare that:
• I was made aware of all assessment requirements for this/these unit/s
• I have received feedback from my assessor on the results of each individual assessment task and my overall result
for this/these unit/s
• I have been made aware of the reassessment policy for any assessment tasks and/or units that I have not yet
satisfactorily completed
• All work for assessment tasks submitted for this unit is my own with no part of any assessment being
copied/plagiarised from another person’s work, except where authorized and listed/referenced
Student Signature:
Kavitaben Patel
Kavitaben Patel 0720SIT40516
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VCID. ACOT Training and Assessment/SITXWHS003/Learner Workbook/V1.2/August 2019
SITXWHS003
Implement and monitor work
health and safety practices
Learner Workbook
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Table of Contents
Table of Contents …………………………………………………………………………………………………………. 2
Instructions to Learner …………………………………………………………….. Error! Bookmark not defined.
Assessment instructions ………………………………………………………… Error! Bookmark not defined.
Assessment requirements ……………………………………………………… Error! Bookmark not defined.
Observation/Demonstration …………………………………………………….. Error! Bookmark not defined.
Third Party Guide ……………………………………………………………………. Error! Bookmark not defined.
Third party details (required information from the learner) ……….. Error! Bookmark not defined.
Activities ……………………………………………………………………………………………………………………. 4
Activity 1A ……………………………………………………………………………………………………………………… 9
Activity 1B ……………………………………………………………………………………………………………………. 10
Activity 2A ……………………………………………………………………………………………………………………. 11
Activity 2B ……………………………………………………………………………………………………………………. 12
Activity 2C ……………………………………………………………………………………………………………………. 13
Activity 3A ……………………………………………………………………………………………………………………. 14
Activity 3B ……………………………………………………………………………………………………………………. 15
Activity 3C ……………………………………………………………………………………………………………………. 16
Activity 3D ……………………………………………………………………………………………………………………. 17
Activity 4A ……………………………………………………………………………………………………………………. 18
Activity 4B ……………………………………………………………………………………………………………………. 19
Activity 4C ……………………………………………………………………………………………………………………. 20
Activity 4D ……………………………………………………………………………………………………………………. 21
Activity 4E…………………………………………………………………………………………………………………….. 22
Activity 5A ……………………………………………………………………………………………………………………. 23
Activity 5B ……………………………………………………………………………………………………………………. 24
Activity 5C ……………………………………………………………………………………………………………………. 25
Activity 6A ……………………………………………………………………………………………………………………. 26
Activity 6B ……………………………………………………………………………………………………………………. 27
Summative Assessments ……………………………………………………………………………………………… 28
Section A: Skills Activity …………………………………………………………………………………………………. 29
Section B: Knowledge Activity (Q & A) ……………………………………………………………………………… 31
Section C: Performance Activity………………………………………………………………………………………. 35
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Workplace Documentation – for learner …………………………………………………………………………. 36
Workplace documents checklist ……………………………………………………………………………………… 36
Supplementary Oral Questions (optional) – for assessor ……………………………………………………. 37
Competency record to be completed by assessor ……………………………………………………………… 40
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Instructions to Learner
Assessment instructions
Overview
Prior to commencing the assessments, your trainer/assessor will explain each assessment task and
the terms and conditions relating to the submission of your assessment task. Please consult with
your trainer/assessor if you are unsure of any questions. It is important that you understand and
adhere to the terms and conditions, and address fully each assessment task. If any assessment task
is not fully addressed, then your assessment task will be returned to you for resubmission. Your
trainer/assessor will remain available to support you throughout the assessment process.
Written work
Assessment tasks are used to measure your understanding and underpinning skills and knowledge of
the overall unit of competency. When undertaking any written assessment tasks, please ensure that
you address the following criteria:
➢ Address each question including any sub-points
➢ Demonstrate that you have researched the topic thoroughly
➢ Cover the topic in a logical, structured manner
➢ Your assessment tasks are well presented, well referenced and word processed
➢ Your assessment tasks include your full legal name on each and every page.
Active participation
It is a condition of enrolment that you actively participate in your studies. Active participation is
completing all the assessment tasks on time.
Plagiarism
Plagiarism is taking and using someone else’s thoughts, writings or inventions and representing them
as your own. Plagiarism is a serious act and may result in a learner’s exclusion from a course. When
you have any doubts about including the work of other authors in your assessment, please consult
your trainer/assessor. The following list outlines some of the activities for which a learner can be
accused of plagiarism:
➢ Presenting any work by another individual as one’s own unintentionally
➢ Handing in assessments markedly similar to or copied from another learner
➢ Presenting the work of another individual or group as their own work
➢ Handing in assessments without the adequate acknowledgement of sources used, including
assessments taken totally or in part from the internet.
If it is identified that you have plagiarised within your assessment, then a meeting will be organised
to discuss this with you, and further action may be taken accordingly.
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Collusion
Collusion is the presentation by a learner of an assignment as their own that is, in fact, the result in
whole or in part of unauthorised collaboration with another person or persons. Collusion involves
the cooperation of two or more learners in plagiarism or other forms of academic misconduct and,
as such, both parties are subject to disciplinary action. Collusion or copying from other learners is
not permitted and will result in a “0” grade and NYC.
Assessments must be typed using document software such as (or similar to) MS Office. Handwritten
assessments will not be accepted (unless, prior written confirmation is provided by the
trainer/assessor to confirm).
Competency outcome
There are two outcomes of assessments: S = Satisfactory and NS = Not Satisfactory (requires more
training and experience).
Once the learner has satisfactorily completed all the tasks for this module the learner will be
awarded “Competent” (C) or “Not yet Competent” (NYC) for the relevant unit of competency.
If you are deemed “Not Yet Competent” you will be provided with feedback from your assessor and
will be given another chance to resubmit your assessment task(s). If you are still deemed as “Not Yet
Competent” you will be required to re-enrol in the unit of competency.
Additional evidence
If we, at our sole discretion, determine that we require additional or alternative
information/evidence in order to determine competency, you must provide us with such
information/evidence, subject to privacy and confidentiality issues. We retain this right at any time,
including after submission of your assessments.
Confidentiality
We will treat anything, including information about your job, workplace, employer, with strict
confidence, in accordance with the law. However, you are responsible for ensuring that you do not
provide us with anything regarding any third party including your employer, colleagues and others,
that they do not consent to the disclosure of. While we may ask you to provide information or
details about aspects of your employer and workplace, you are responsible for obtaining necessary
consents and ensuring that privacy rights and confidentiality obligations are not breached by you in
supplying us with such information.
Assessment appeals process
If you feel that you have been unfairly treated during your assessment, and you are not happy with
your assessment and/or the outcome as a result of that treatment, you have the right to lodge an
appeal. You must first discuss the issue with your trainer/assessor. If you would like to proceed
further with the request after discussions with your trainer/assessor, you need to lodge your appeal
to the course coordinator, in writing, outlining the reason(s) for the appeal.
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Recognised prior learning
Candidates will be able to have their previous experience or expertise recognised on request.
Special needs
Candidates with special needs should notify their trainer/assessor to request any required
adjustments as soon as possible. This will enable the trainer/assessor to address the identified needs
immediately.
Assessment requirements
Assessment can either be:
➢ Direct observation
➢ Product-based methods e.g. reports, role plays, work samples
➢ Portfolios – annotated and validated
➢ Questioning
➢ Third party evidence.
If submitting third party evidence, the Third Party Observation/Demonstration document must be
completed by the agreed third party.
Third parties can be:
➢ Supervisors
➢ Trainers
➢ Team members
➢ Clients
➢ Consumers.
The third party observation must be submitted to your trainer/assessor, as directed.
The third party observation is to be used by the assessor to assist them in determining competency.
The assessment activities in this workbook assess aspects of all the elements, performance criteria,
skills and knowledge and performance requirements of the unit of competency.
To demonstrate competence in this unit you must undertake all activities in this workbook and have
them deemed satisfactory by the assessor. If you do not answer some questions or perform certain
tasks, and therefore you are deemed to be Not Yet Competent, your trainer/assessor may ask you
supplementary questions to determine your competence. Once you have demonstrated the
required level of performance, you will be deemed competent in this unit.
Should you still be deemed Not Yet Competent, you will have the opportunity to resubmit your
assessments or appeal the result.
As part of the assessment process, all learners must abide by any relevant assessment policies as
provided during induction.
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If you feel you are not yet ready to be assessed or that this assessment is unfair, please contact your
assessor to discuss your options. You have the right to formally appeal any outcome and, if you wish
to do so, discuss this with your trainer/assessor.
Observation/Demonstration
Throughout this unit, you will be expected to show your competency of the elements through
observations or demonstrations. Your trainer/assessor will have a list of demonstrations you must
complete or tasks to be observed. The observations and demonstrations will be completed as well as
the activities found in this workbook.
An explanation of observations and demonstrations:
Observation is on-the-job
The observation will usually require:
➢ Performing a work-based skill or task
➢ Interaction with colleagues and/or customers.
Demonstration is off-the-job
A demonstration will require:
➢ Performing a skill or task that is asked of you
➢ Undertaking a simulation exercise.
Your trainer/assessor will inform you of which one of the above they would like you to do. The
observation/demonstration will cover one of the unit’s elements.
The observation/demonstration will take place either in the workplace or the training environment,
depending on the task to be undertaken and whether it is an observation or demonstration. Your
trainer/assessor will ensure you are provided with the correct equipment and/or materials to
complete the task. They will also inform you of how long you have to complete the task.
You should be able to demonstrate the skills, knowledge and performance criteria required for
competency in this unit, as seen in the Learner Guide.
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Third Party Guide
You should supply details of the third party to the assessor before you commence the activities (see
below), unless the assessor has already selected a third party themselves. The assessor can then
contact the third party in instances where they require more evidence to determine competency, or
they cannot observe certain tasks themselves.
The reasons to use a third party may include:
➢ Assessment is required in the workplace
➢ Where there are health and safety issues related to observation
➢ Patient confidentiality and privacy issues are involved.
If you are not employed, or able to complete demonstrative tasks in the workplace, you will need to
inform the assessor. They will be able to provide you with a simulated environment in which to
complete these tasks.
We would prefer that, wherever possible, these be “live” issues for your industry and require
application of the principles that you are learning as part of your training. Where this is not possible,
you and your third party should simulate the activity tasks and demonstrations that you believe
would be likely to arise in your organisation or job role.
Third party evidence can also be used to provide “everyday evidence” of tasks included in your work
role that relate to the unit of competency but are not a part of the formal assessment process.
The third party is not to be used as a co-assessor – the assessor must make the final decision on
competency themselves. Documents relevant to collection of third-party evidence are included in
the Third Party section in the Observations/Demonstrations document.
Third party details (where required from the learner)
A third party may be required for observations or demonstrations; please provide details below of
your nominated third party and obtain their signature to confirm their agreement to participate. This
information will be required by your trainer/assessor in advance of arranging any future
observations or demonstrations.
Third party name: ______________________________________________________________
Position of third party: ______________________________________________________________
Telephone number: ______________________________________________________________
Email address: ______________________________________________________________
Declaration for nominated third party
I declare my intention to act as third party for (learner’s name here) __________________________
Third party signature: _____________________________________ Date: ___________________
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Activities
Complete the following activities individually or in a group (as applicable to the specific activity
and the assessment environment).
Activity 1A
Estimated Time 20 Minutes
Objective To provide you with an opportunity to describe how to explain relevant WHS
information to personnel.
1. What types of WHS information should be explained to personnel?
2. What methods can you use to explain WHS information to personnel?
3. Describe aspects of WHS particular to your organisation that should be explained to
personnel
➢Methods used for work health and safety consultation
o group meetings
o one-to-one meetings
o conference calls
o surveys and questionnaires
➢Emergency evacuation plans
➢Codes of conduct
➢Location of first aid kits
➢Employee roles and responsibilities in work health and safety management practices
➢WHS training information and updates
➢Legal obligations and ramifications of failure to comply
➢Newspaper, magazine and journal articles
➢Team meetings
➢Conference/presentation
➢Training day
➢Email
➢Website link
➢Posters
➢Signs
➢Booklets and leaflets
➢Training manuals
➢A safe layout of the workplace
➢Safe design and maintenance of facilities and equipment
o including cleanliness
o regular checks of equipment/facilities safety
➢Good lighting that allows workers to move around and complete their work without
risk and safe evacuation of the premises
➢Employer should also provide plans of what to do in an emergency, first aid kits and
trained first aiders and personal protective equipment.
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Activity 1B
Estimated Time 20 Minutes
Objective To provide you with an opportunity to describe how to make all current WHS
information readily accessible to staff.
1. Identify methods you can use to provide staff with WHS information
➢Promotion of WHS information during training
➢Group meetings
➢Formal and informal discussions
➢Electronic via your organisation’s website, sent via email, printed and stored in a designated place
➢Posters and information booklets specific to each area of work and the hazards involved.
➢Safety signs
➢Work instructions.
Following methods we can use
Relevant WHS information may include:
➢WHS policies and procedures
➢Work instructions
➢WHS legislation.
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Activity 2A
Estimated Time 20 Minutes
Objective To provide you with an opportunity to describe how to monitor adherence to
organisational WHS procedures and monitor ongoing compliance with safe
work practices.
1. In what ways can you ensure ongoing compliance with safe work practices?
2. What factors should you consider when monitoring compliance?
3. Describe particular WHS procedures staff need to follow specific to your organisation
We should assess and maintain the ongoing compliance with OHS or WHS legislation. we should
regularly check that we meet these.
We should check that:
➢WHS documents are updated
➢You consult all personnel according to legislation requirements
➢You include self-employed/contracted workers and visitors in your policy
➢All staff are fully trained and regularly refreshed with compliance
➢Any accidents/incidents (including near misses) are analysed to find the cause and rectified.
The WHS procedures and work instructions that are in place within your organisation should be
identified and implemented by every worker. They should comply with the relevant legislation,
regulations and codes of practice.
The WHS Act 2011 sets out a consistent framework that must be complied with in order to secure
the health and safety of workers.
The WHS Act 2011:
➢Protects workers from harm by eliminating or minimising risks
➢Provides effective workplace representation
➢Encourages organisations to help achieve a safe workplace
➢Promotes the use of health and safety advice, information, education and training
➢Uses compliance and enforcement measures effectively and appropriately
➢Monitors and reviews people with duties and power
➢Ensures continuous improvement and higher standards.
The following factors I would consider:
➢Objectives
➢Timing
➢Scale
➢Who performs the monitoring
➢Metrics
➢Outcomes
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Activity 2B
Estimated Time 20 Minutes
Objective To provide you with an opportunity to explain how to take prompt action to
address non-compliance with procedures and safe work practices.
1. Identify reasons for non-compliance that would need to be addressed
2. What steps can you take to address non-compliance?
Following reasons for non-compliance:
➢Lack of time
➢Perception that using PPE interferes with the ability to perform the job
➢Physical discomfort/difficulty communicating when using equipment or performing work
➢PPE not available when needed
➢Lack of skills or knowledge in certain area
➢Develop a compliance policy – Having a policy manual or handbook employees can refer to defines
expected behaviour and gives them a reference to know when they have not met that behaviour so
they know they are not being singled out, but their behaviour is
➢Be consistent in enforcing non-compliance/disciplinary action – Everyone should be treated the
same when enforcing rules, regulations and procedure
➢Consider the type of action required – Actions to address non-compliance should be corrective,
rather than punitive. The goal is to change behaviour, not punish people
➢Consider the strength of action required – Progressive actions to address non-compliance might
include informal talks, verbal counselling, written procedures (and warnings) or more severe
disciplinary actions such as suspension or termination for severe reoffenders or dangerous situations.
Actions should be progressive, with a series of steps of increasing severity
➢Record non-compliance – Actions taken by and against staff should be recorded in employee files.
This way repeat poor behaviour can be identified
➢Have a complaints/grievances system – This helps address staff complaints and grievances. This not
only reduces the number of non-compliance cases, but helps in reviewing the organisations procedures,
but having a method of reply helps staff feel more fairly treated.
The following reasons I can take to address non-compliance:
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Activity 2C
Estimated Time 20 Minutes
Objective To provide you with an opportunity to describe how to monitor day-to-day
effectiveness of WHS practices in maintaining the health, safety and security
of personnel.
1. In what can you assess the effectiveness of WHS practices day to day?
2. What factors should you consider when assessing the effectiveness of WHS practices?
Assessing effectiveness of WHS management practices may involve:
➢Monitoring the ongoing effectiveness of risk control methods
➢Self-monitoring
➢Continuous monitoring
➢Observations
➢Assessments and checklists for procedures
➢Reviewing:
o incidents or accidents, near misses
o work health and safety reports
o work health and safety statistics.
The following factor I should consider when assessing the effectiveness of WHS
practices:
➢The frequency of the practice occurrence – The more often a practice occurs, the
harder that monitoring the activity each time becomes.
➢The cost of monitoring – Money, staffing and other resources.
➢The ease of monitoring – For example, where management can employ technology to
automate and expedite monitoring, this makes the overall process simpler.
➢The risk of non-compliance – Both its seriousness and likelihood. Serious consequences
of non-compliance may encourage pre-transaction approval and non-compliance that
is more likely to occur can suggest a need for more monitoring of practice
➢Motives for operating staff not to comply – Where staff may benefit from
non-compliance (such as taking less time), it is the responsibility management to
consider more strict monitoring.
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Activity 3A
Estimated Time 20 Minutes
Objective To provide you with an opportunity to identify how to coordinate the
operation of all consultative processes.
1. What consultative processes does your organisation use to coordinate operations?
2. What aspects of operations are influenced by consultative processes?
Consultative processes may involve:
➢A diary, whiteboard or suggestion box used by staff to report issues of concern
➢Fact sheets to fully inform personnel about work health and safety rights and
responsibilities
➢Formal WHS representatives and committees
➢Formal meetings with agendas, minutes and action plans
➢Informal meetings with notes
➢Involving personnel in:
o conducting hazard identification and risk assessment
o making decisions on how to eliminate or control risks
➢Work health and safety discussions with employees during the course of each business
day
➢Recording issues in a management diary
➢Regular staff meetings that involve work health and safety discussions
➢Seeking staff suggestions for content of work health and safety policies and procedures
➢Special staff meetings or workshops to specifically address work health and safety
issues
➢Staff handbook which includes work health and safety information
➢Induction programs
➢Training programs
➢Hazard and incident reporting
➢Equipment maintenance
➢Job procedures
➢Work instructions
➢Waste management
➢Security
➢Personal protective equipment (PPE).
The following aspects :
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Activity 3B
Estimated Time 20 Minutes
Objective To provide you with an opportunity to identify how to provide opportunities
for staff members to contribute their views on current and future WHS
management practices.
1. What things should you consider to help staff to contribute their views?
2. What methods can you provide for staff members to contribute their views?
Things to consider for contributing views include:
➢Ensure consultation takes place during a suitable time within normal work hours.
➢Ensure views are allowed to be expressed during workplace meetings.
➢Provide different methods for staff to contribute feedback.
➢Workplace Health and Safety Officers (WHSO)
➢Workplace Health and Safety Representatives (WHSR)
➢Workplace Health and Safety Committees (WHSC)
WHS management practices with appropriate people methods can we provide for staff
members to contribute their views.
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Activity 3C
Estimated Time 20 Minutes
Objective To provide you with an opportunity to identify how to resolve or refer issues
raised through WHS consultation to the appropriate person.
1. What steps can you take to help raise and resolve WHS issues?
2. What should you to when deciding to refer WHS issues?
When deciding to refer issues:
➢Schedule a meeting for a time in the future when there has had sufficient time to
implement the changes or resolve the issues that came about as a result of WHS
consultation.
➢This meeting could be with management, supervisors or other persons involved in the
area.
➢At this meeting raise the issue and any attempted resolution, plus possible steps to be
taken.
➢If the issue is not progressing as anticipated, the meeting can help provide strategies
to reinvigorate the process or seek advice. It can also be an opportunity to discuss new
possibilities for consultation and development.
➢Decide what the problem you are trying to solve is.
➢Develop a plan -You need to work out how you are going to resolve the issue. Think of all
the possible strategies for identifying what causes the issue and how it can be resolved.
➢Choose a strategy – Review all the strategies you thought of and decide which will be
most effective.
➢Put your plan into action – This step involves implementation of all the steps necessary to
carry out your plan.
➢Monitor the effectiveness of the solution – Make sure that it actually solved the issue.
During this stage of the process, ask yourself the following questions:
When resolving issues:
➢You may need to investigate the issue further and ask other workers if they are
experiencing similar problems.
➢Contact appropriate staff to promote awareness of the issue.
➢You should keep employees updated with the progress of your investigation into the issue.
➢Communicate any possible options and encourage input from workers.
When raising issues:
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Activity 3D
Estimated Time 20 Minutes
Objective To provide you with an opportunity to describe how to provide timely staff
and own feedback on WHS management practices to the designated person.
1. What information from WHS management practices can you provide to staff or designated
persons and how can you provide it?
2. How can you ensure the feedback on WHS management practices is good quality?
➢Email notification
➢Noticeboards
➢Meetings
➢Website e.g. articles or factsheets
➢Newsletters.
We may need to provide information through a variety of different means:
➢Minutes from WHS committee meetings.
➢Minutes from group meetings.
➢Flyers.
The following information provide to staff or designated person.
➢Observe behaviour:
Concentrate on the behaviour. Why is it wrong for the organisation, team, individuals,
etc.; not why you personally dislike it. Your judgment needs to come from a
professional opinion, not a personal one.
o concentrate on pointing out the exact cause of poor performance. If you cannot
determine an exact cause, then it is probably subjective and should be ignored.
➢Treat others as you would want to be treated:
Before giving the feedback, frame the feedback within your mind.
o it might help to ask yourself, “how would I like to be corrected?”
o what tones and gestures would best communicate your message? Remember,
you want the recipient to consider your message. If you are aggressive or passive
in what you say, they might be dismissive of it.
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VCID. ACOT Training and Assessment/SITXWHS003/Learner Workbook/V1.2/August 2019
Activity 4A
Estimated Time 20 Minutes
Objective To provide you with an opportunity to identify how to coordinate scheduled
hazard identification activities, ensuring hazards are identified at times
designated by legislation.
1. What tools can you use to coordinate hazard identification activities?
2. What information should be included on hazard identification forms?
3. What methods can you use to identify hazards?
➢The identification of the hazard – e.g. what the hazard is and why it is a hazard.
➢The assessment of the hazard – e.g. its potential consequences and the severity of
those
➢The control measures that need to be introduced – e.g. the short term and long term
actions.
➢Self-designed tools developed for the organisation as part of a work health and safety
management system
➢Checklists
➢Tools and templates developed:
o by external consultancy services
o by industry associations for use of member businesses
o for public use by, and found within, business management publications, including
those developed by work health and safety government regulators.
➢Inspecting the workplace – Observe the performance of work tasks
➢Consulting workers- Talk about any health and safety issues they have encountered
➢Analysing your records – Workplace incidents, near misses and worker complaints that
are recorded can demonstrate patterns and highlight areas of interest
➢Reviewing information and advice – Hazards and risks relevant to your particular
industry or the type of work that you do such as information provided by industry
associations, manufacturers or suppliers.
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Activity 4B
Estimated Time 20 Minutes
Objective To provide you with an opportunity to identify any hazards on an ongoing
basis during own day-to-day workplace operations.
1. What types of workplace hazards could you come into contact with?
2. Where are common locations for workplace hazards?
Hazards can come from areas including:
➢The physical work environment
➢Equipment, materials and substances used
➢How work tasks are performed
➢Design and management of work.
➢Physical hazards – Arguably the most common type of hazard, and many can be easily
corrected. E.g. Frayed electrical cords, loose wires, unguarded machinery, exposed
moving parts, constant loud noise, vibrations, scaffolding or heights, spills, tripping
hazards.
➢Ergonomic hazards – Hazards that occur because of your working conditions and strain
on your body. Many of these hazards can be unseen in that they don’t affect your
health immediately, but in the long term. E.g. Poor lighting, frequent, heavy or
improper lifting, repetitive or awkward movements, incorrectly adjusted workstations
and chairs.
➢Chemical hazards – Hazards that come from working with chemicals. E.g. Cleaning
products and solvents, vapours and fumes, carbon monoxide or other gases, gasoline
or other flammable materials.
➢Biological hazards – Hazards that come from working with people, animals or other
infectious materials. E.g. blood or other bodily fluids, bacteria and viruses, insect bites,
animal and bird droppings.
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Activity 4C
Estimated Time 20 Minutes
Objective To provide you with an opportunity to describe how to react to reports of
hazards by other workers, and coordinate and participate in risk assessments.
1. When should risk assessments be performed?
2. What should you consider when performing risk assessments?
Risk assessments should be performed when:
➢There is uncertainty about how a hazard may result in injury or illness
➢There are a range of different hazards involved in the work activity and it is not fully
understood how the hazards may interact with each other to produce new or greater
risks
➢There have been changes at the workplace occur that may impact on the
effectiveness of control measures.
➢When any new information relating to health and safety risks becomes available
➢A risk assessment is mandatory under the Work Health and Safety Regulations 2012
(the WHS Regulations) for high risk activities, such as entry into confined spaces, diving
work and live electrical work.
Performing risk assessments involves considering:
➢How severe the potential harm caused by the hazard could be, including:
o what type of harm could occur? e.g. Muscular strain, fatigue, burns, chemical
exposure
o what category of harm could occur? E.g. Death, serious injury or illness, or only
minor injury
o how many people are at risk of exposure to the hazard?
➢How hazards may cause harm, including:
o the effectiveness of currently existing control measures – Do they account for all
types of harm
o how work is actually done – Are written manuals and procedures followed? Are they
fit for purpose?
o the likelihood of infrequent or abnormal situations – Are people prepared in
comparison to how things are normally meant to occur?
o maintenance and cleaning processes, as well as breakdowns of equipment and
failures of health and safety controls.
➢The likelihood of harm occurring, including:
o how frequently the task is performed
o how frequently people are near the hazard
o if harm has happened before – Either in your workplace or somewhere else, and
how frequently.
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Activity 4D
Estimated Time 20 Minutes
Objective To provide you with an opportunity to describe how to implement any risk
control methods or refer to appropriate person if control is outside scope of
responsibility.
1. What is the hierarchy of control?
2. What is your workplace system for reporting hazards?
Our workplace may have a system for reporting hazards such as:
➢Reporting hazards to your supervisor or a designated WHS person
➢Completing a Hazard Report form
➢Consulting your Workplace Health and Safety Officer or Representative on the issue
➢Bringing the issue up at a safety meeting or a staff meeting.
The hierarchy of control is:
➢Eliminate – Complete removal of the hazard from the workplace e.g. Removing trip
hazards on the floor or disposing of unwanted chemicals. This is the most effective
control measure and must always be considered before anything else.
➢Substitute – Substitute or replace the hazard with a less hazardous work practice
e.g. replace solvent-based paints with water-based paints.
➢Isolate – Separate the hazard or hazardous work practice from people by distance or
using barriers as much as possible e.g. Placing guards around moving parts of
machinery.
➢Engineering controls – Physical control measures e.g. using a trolley to lift heavy loads.
➢Administrative controls – Work methods or procedures that are designed to minimise
the exposure to a hazard e.g. Developing a procedure on how to operate machinery
safely or use signs to warn people of a hazard.
➢Personal protective equipment (PPE) – PPE, such as ear muffs, hard hats, gloves and
protective eyewear, relies on the proper fit and use of the PPE to control risk, but does
nothing to change the hazard itself.
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Activity 4E
Estimated Time 20 Minutes
Objective To provide you with an opportunity to identify how to monitor effectiveness
of control measures, promptly identify any inadequacies, and resolve or
report them to the appropriate person.
1. In what situations should control measures be reviewed?
2. Who are the appropriate persons in your organisation to report control measure
inadequacies to?
➢Health and safety officers
➢Health and safety representatives
➢Managers and supervisors
➢Other persons authorised or nominated by the organisation
➢PCBUs or their officers
➢Team leaders
➢Union officers
➢WHS inspectors
➢WHS permit entry holders.
Situations when we should review our control measures include:
➢When the control measure is not effective in controlling the risk, e.g. when an incident
occurs.
➢Before a change at the workplace that is likely to give rise to a new or different health
and safety risk that the control measure may not effectively control.
➢When any new information relating to health and safety risks becomes available.
➢When a new hazard or risk is identified.
➢If the results of consultation indicate that a review is necessary.
➢If a Health and Safety Representative requests a review.
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Activity 5A
Estimated Time 20 Minutes
Objective To provide you with an opportunity to identify WHS training needs based on
regular staff monitoring.
1. What training needs would staff in your organisation have?
2. How can WHS training needs be identified?
➢First aid training
➢Safety committee training (if you have one)
➢Safety representative training (if you have one)
➢Forklift driver training
➢Crane operator training
➢Return to work coordinator training
➢Construction induction training
➢Manual handling training
➢Confined space entry training
➢Hazardous substances training if you handle chemicals in the workplace and many
others.
➢A training matrix (identifies WHS skills required for employees and their respective
job position)
➢Job safety analyses (includes training and competency for each task)
➢Specific hazard risk assessments (e.g. manual handling-safe lifting technique training)
➢WHS audits
➢Observation of working practice
➢Legislation requirements (e.g. plant operator certification)
➢Investigation of incidents.
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Activity 5B
Estimated Time 20 Minutes
Objective To provide you with an opportunity to identify how to make arrangements
for fulfilling training needs.
1. What steps can you take to make arrangements for fulfilling training needs?
2. What methods can you use for WHS training?
➢Create a plan to cover all the training needs in your workplace.
➢Work out what the aims of the training are and over what timescale.
➢Plan what sort of training would be most appropriate, and so who should be
responsible for implementation.
➢Plan how you will monitor and review the effectiveness of the training.
➢Plan for the specific needs of your workforce, such as language and literacy needs by
utilising interpreters, translated information, multilingual signs, literacy training or
appropriate methods where necessary.
WHS training can use various methods, such as:
➢Group or individual exercises.
➢Explanations and demonstrations.
➢Role-playing.
➢Case studies.
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Activity 5C
Estimated Time 20 Minutes
Objective To provide you with an opportunity to identify how to monitor effectiveness
of training and make required adjustments.
1. What methods can you use to monitor the effectiveness of training?
2. What should you consider discussing when making adjustments following training?
➢Assessment tools – used by the employer, the individual themselves, etc.
➢Checklists – Can be completed by supervisor, manager or the employee themselves.
➢Observing learners in real work situations.
➢Recording changes in results – e.g. Sales figures, jobs completed.
➢Collecting feedback on performance –
E.g. Customer satisfaction surveys, consulting with colleagues.
When discussing assistance, consider if the individual:
➢Requires critical information and facts
➢Wants to know your opinion or has potentially valuable input
➢Needs help in finding a solution to a problem
➢Wants input on reasoning or processing for a task.
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Activity 6A
Estimated Time 20 Minutes
Objective To provide you with an opportunity to explain how to complete WHS records
and reports accurately and legibly and store according to organisational and
legal requirements, and use data and reports to provide reliable and timely
input into the management of workplace health, safety and security.
1. What WHS records and reports does your organisation require?
2. How can you ensure accuracy in completing WHS records?
Ensuring accuracy
As supervisors are expected to understand how to complete the necessary WHS records,
they may also be responsible for reviewing records (their own or others) to ensure they
are accurate and thorough.
This may involve checking that:
➢The correct form or record has been completed
➢Any forms are completed fully and signed
➢The information is accurate in terms of content, spelling and grammar (especially the
spelling of people’s names, and that dates and times are correct)
➢Any attachments have been completed correctly and are attached
➢Records are completed within specified time lines (usually as soon as possible after
an incident) and forwarded to the relevant person or agency.
➢Hazard reports
➢Incident reports
➢Risk assessments
➢Procedures for different types of work
➢Audit reports
➢Workplace inspections
➢WHS meeting minutes, such as from committees and representatives
➢Emergency evacuation reports
➢Health monitoring reports
➢Inspection testing and monitoring reports
➢Equipment maintenance records
➢Induction and training records
➢Safety data sheets
➢Hazchem information
➢Records relating to chemical use, such as spray records and storage
➢Plant or biological organisms registers
➢Consultation:
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Activity 6B
Estimated Time 20 Minutes
Objective To provide you with an opportunity to explain how to minimise use of printed
materials and maximise electronic transmission and filing of all documents to
reduce waste.
1. What steps can you use to minimise printed materials and reduce waste?
The following steps I can use to minimise printed materials and reduce waste
➢Only print materials when complete necessary
➢Printing on both sides of a piece of paper cuts the cost of paper in half
➢Sending correspondence via email instead of postal mail reduces the cost of paper
and postage
➢Using ceramic coffee cups and dishes in the break room in place of paper cups and
plates saves money as well as trees.
➢Use scrap paper to take notes
➢Minimise misprints by posting a diagram on how to load special paper like
letterheads so they are printed correctly.
➢Shred used paper and use it as packing material
➢Use old boxes to store documents
➢Practice efficient copying— use the size reduction feature offered on many copiers.
Two pages of a book or other item can often be copied onto one standard sheet.
➢Use two-way or send-and-return envelopes. Your outgoing envelope will be reused
for its return trip.
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Summative Assessments
The summative assessments are the major activities designed to assess your skills, knowledge and
performance, as required to show competency in this unit. These activities should be completed
after finishing the Learner Guide. You should complete these as stated below and as instructed by
your trainer/assessor.
Skills, knowledge and performance may be termed as:
➢ Skills – skill requirements, required skills, essential skills, foundation skills
➢ Knowledge – knowledge requirements, required knowledge, essential knowledge,
knowledge evidence
➢ Performance – evidence requirements, critical aspects of assessment, performance
evidence.
Section A: Skills Activity
The Skills Activity is designed to be a series of demonstrative tasks that should be assessed by
observation (by the assessor or third party, depending on the circumstances).
It will demonstrate all of the skills required for this unit of competency – your assessor will provide
further instructions to you, if necessary.
Section B: Knowledge Activity (Q & A)
The Knowledge Activity is designed to be a verbal questionnaire where the assessor asks you a series
of questions to confirm your competency for all of the required knowledge in the unit of
competency.
Section C: Performance Activity
The Performance Activity is designed to be a practical activity performed either in the workplace or a
simulated environment. You should demonstrate the required practical tasks for the unit of
competency and be observed by the assessor and/or third party, as applicable to the situation. If the
third party is required to observe you, you will need to make the required arrangements with them.
If necessary for the activities, you should attached completed written answers, portfolios or any
evidence of competency to this workbook.
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Section A: Skills Activity
Objective: To provide you with an opportunity to show you have the required skills for this unit.
This activity will enable you to demonstrate the following skills:
➢ Reading
o interpret unfamiliar and complex materials describing regulatory requirements for WHS
management and organisational policies and procedures
➢ Writing
o write high level reports about the effectiveness of WHS management practices, making
recommendations for change and complete accurate records for regulatory compliance
➢ Oral communication
o discipline non-compliant personnel
o conduct sometimes complex WHS consultation activities
o explain all WHS procedures and information on safe work practices
➢ Problem solving
o incorporate the views of other people consulted in the workplace
o analyse WHS system deficiencies and recommend required change
➢ Teamwork
o monitor staff members’ daily compliance with WHS management practices and counsel
on non-compliance.
Answer the activity in as much detail as possible, considering your organisational requirements.
In a workplace situation, carry out (or simulate carrying out) the following skills:
1. Over the course of one month, identify, read and interpret three unfamiliar and complex
materials describing regulatory requirements and organisational policies and procedures for
WHS management.
Write a one-two page report outlining the materials you have consulted and three points of
information you gained from each.
1. Over the course of one month, analyse and write one report about the effectiveness of WHS
management practices, making recommendations for change. You do not have to address all
aspects of WHS management. Rather, you should address three specific aspects. Be sure to
consult your colleagues during this task, soliciting their observations, thoughts and ideas.
Specifically, you may address:
➢ Hazard report practices
➢ Incident report practices
➢ Risk assessment practices
➢ Procedures for carrying out different types of work
➢ Procedures for carrying out workplace inspections
➢ Emergency evacuation report practices
➢ Health monitoring report practices
➢ Equipment maintenance report practices
➢ WHS induction and training practices
➢ Practices for completing safety data sheets
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➢ Practices for handling chemicals.
The report should be between two and three pages long. It should include three observations
or points of information about current WHS management practices and three
recommendations for the future.
2. Over the course of one month, monitor staff members’ daily compliance with WHS
management practices and identify one employee who is failing to comply with work health
and safety procedures and practices. Organise a half hour one-to-one meeting with them to
discuss this issue.
Specifically, you should:
➢ Discuss the reasons for the employee’s failure to comply with WHS practices
➢ Remind the employee of the importance of adhering to WHS practices
➢ Remind the employee of the WHS practices they need to follow
➢ Discipline the employee appropriately (remember, these actions should be corrective
rather than punitive)
➢ Develop a compliance plan with the employee.
Throughout the discussion, make sure that you maintain a professional and helpful tone that
is firm as well as fair. Your primary goal should be to encourage the employee to act correctly
and adhere to all WHS practices, rather than embarrass or belittle them.
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Section B: Knowledge Activity (Q & A)
Objective: To provide you with an opportunity to show you have the required knowledge for this
unit.
The answers to the following questions will enable you to demonstrate your knowledge of:
➢ Primary components of relevant state or territory OHS or WHS legislation:
o actions that must be taken for legal compliance
o employer responsibilities to provide a safe workplace
o requirement to consult, and acceptable consultation mechanisms
o requirements for the use of WHS representatives and committees, and their roles and
responsibilities
o requirements for hazard identification, risk assessment, risk control and acceptable
mechanisms
o requirements for record keeping and acceptable record keeping mechanisms
o requirement to provide information and training
o employee responsibilities to ensure safety of self, other workers and other people in the
workplace
o employee responsibility to participate in WHS practices
o ramifications of failure to observe OHS or WHS legislation and organisational policies and
procedures
➢ Specific organisation:
o full content of WHS policies and procedures; and consultation, hazard identification, risk
assessment and reporting documents
o methods used for WHS consultation, hazard identification and risk assessment
o options for the provision of training:
▪ coaching or mentoring in safe work practices
▪ formal training programs in safe work practices
o hazard identification, risk assessment and control
o WHS policy and procedure induction
o WHS representative or committee
o provision of information, fact sheets and signage to ensure safe work practices
➢ WHS information:
o consultative arrangements for WHS
o employee roles and responsibilities in WHS management practices
o legal obligations and ramifications of failure to comply
o location of first aid kit and emergency evacuation plan
o WHS training information and updates
o policies:
▪ overall approach of organisation to WHS
▪ participation of personnel in WHS management practices
▪ responsibilities of employees to ensure safety
o procedures
o specific risk control measures relevant to the workplace
o specific regulations and codes of practice
o use of:
▪ hazard identification reporting documents
▪ risk assessment template documents
➢ Consultative processes:
o a diary, whiteboard or suggestion box used by staff to report issues of concern
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o fact sheets to fully inform personnel about WHS rights and responsibilities
o formal WHS representatives and committees
o formal meetings with agendas, minutes and action plans
o informal meetings with notes
o WHS discussions with employees during the course of each business day
o recording issues in a management diary
o regular staff meetings that involve WHS discussions
o seeking staff suggestions for content of WHS policies and procedures
o special staff meetings or workshops to specifically address WHS issues
o staff handbook containing WHS information
o surveys or questionnaires that invite staff feedback on WHS issues
➢ Time requirements for hazard identification:
o when changes to the workplace are implemented:
▪ before the premises are used for the first time
▪ before and during the installation or alteration of any plant
▪ before changes to work practices are introduced
o when any new information relating to health and safety risks becomes available
➢ Required WHS records and reports:
o consultation
o hazard identification
o incident and accident notifications to WHS regulatory authorities
o incident or accident, near miss reports and related statistics
o monitoring reports and recommendations for change:
▪ agendas for and minutes of meetings
▪ committee members
▪ consultation decisions and follow-up actions
▪ consultation processes
▪ diaries of meetings
▪ WHS information provided to personnel
▪ risk controls
▪ safe work practices
o risk assessments
o risk control actions
o training action plans
o training undertaken.
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Answer each question in as much detail as possible, considering your organisational requirements
for each one.
1. List seven primary components of state or territory WHS legislation.
2. Identify and read your organisation’s work health and safety policies and procedures.
Write a two-three page report detailing:
➢ Three methods used for work health and safety consultation
➢ Three methods used for identifying hazards
➢ Three methods used for conducting risk assessments.
Your report should be clear, informative and free from spelling and grammar errors.
3. Identify and read your organisation’s work health and safety policies and procedures.
Write a two-three page report detailing:
➢ The location of the first aid kid
➢ The emergency evacuation plan
➢ Three responsibilities every employee has when it comes to ensuring safety.
Your report should be clear, informative and free from spelling and grammar errors.
o actions that must be taken for legal compliance
o employer responsibilities to provide a safe workplace
o requirement to consult, and acceptable consultation mechanisms
o requirements for the use of WHS representatives and committees, and their roles and
responsibilities
o requirements for hazard identification, risk assessment, risk control and acceptable
mechanisms
o requirements for record keeping and acceptable record keeping mechanisms
o requirement to provide information and training
o employee responsibilities to ensure safety of self, other workers and other people in the
workplace
o employee responsibility to participate in WHS practices
Primary components such as the:
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4. List five consultative processes you could use to discuss work health and safety issues in the
workplace.
5. Identify and read your organisation’s work health and safety policies and procedures.
Write a two page report detailing your organisation’s time requirements for hazard inspection
when changes to the workplace are implemented:
➢ Before the premises are used for the first time
➢ Before and during the installation or alteration of any plant
➢ Before changes to work practices are introduced
➢ When any new information relating to health and safety risks becomes available.
If this information is unavailable, you should speak to your manager/supervisor and solicit
their ideas and recommendations. Then write your report accordingly.
Your report should be clear, informative and free from spelling and grammar errors.
6. Explain why it is important to maintain work health and safety records and list five different
types of WHS records you may complete.
➢A diary, whiteboard or suggestion box used by staff to report issues of concern
➢Fact sheets to fully inform personnel about work health and safety rights and responsibilities
➢Formal WHS representatives and committees
➢Formal meetings with agendas, minutes and action plans
➢Informal meetings with notes
Following important reasons to maintain work health and safety records
➢Equipment maintenance records
➢Induction and training records
➢Safety data sheets
➢Hazchem information
➢Records relating to chemical use, such as spray records and storage
Five types of records:
>> It ensures key information is easily retrievable, and can be passed on from one person to
another, ensuring consistency and continuity;
>> It ensures that the Company can demonstrate (internally and externally) compliance with
our legal duties under health and safety law;
>> It makes the job of Health & Safety r easier if he/she knows what needs to be done and
when;
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Section C: Performance Activity
Objective: To provide you with an opportunity to demonstrate the required performance
elements for this unit.
This activity will enable you to demonstrate the following performance evidence:
➢ Implement and monitor adherence to workplace health and safety procedures in three of the
following real or simulated situations:
o evacuation of staff and customers
o security management of cash, documents, equipment, keys or people
o handling chemicals and hazardous substances
o hazard identification and reporting
o incident and accident reporting
o risk assessment and reporting
➢ Coordinate consultative processes for managing the above workplace health, safety and security
issues
➢ Coordinate risk assessments, WHS training, and the maintenance of records relating to above
situations
➢ Monitor the effectiveness of the WHS system and identify:
o required adjustments
o staff training needs
➢ Demonstrate management practices that must be implemented for compliance with state or
territory occupational health and safety (OHS) or WHS legislation during above situations.
Answer the activity in as much detail as possible, considering your organisational requirements.
1. Over the course of six weeks, implement and monitor adherence to workplace health and
safety procedures in three of the following real or simulated situations.
➢ Evacuation of staff and customers
➢ Security management of cash, documents, equipment, keys or people
➢ Handling chemicals and hazardous substances
➢ Hazard identification and reporting
➢ Incident and accident reporting
➢ Risk assessment and reporting.
For each situation, be sure to provide staff with all work health and safety information they
need.
During the task, make a record of things that went well and things that could be improved.
Then, coordinate a consultative process (e.g. a formal meeting with agendas, minutes and
action plans) during which you and your colleagues can discuss the issues that have arisen.
You should also take this opportunity to provide staff members with feedback on their
performance.
Write a three-four page report outlining the conclusions you have come to and three
recommendations on how to improve WHS management in the future through training in line
with state or territory WHS legislation.
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Workplace Documentation – for learner
Workplace documents checklist
To demonstrate and support workplace knowledge, workplace documents can be submitted to the
assessor or third party. Indicate in the table below the documents that have been provided. Please
refer to your trainer/assessor if clarification is required or if you have any further questions on what
you are able to provide or use.
Document name/description Document attached
Yes No (Please circle)
Yes No (Please circle)
Yes No (Please circle)
Yes No (Please circle)
Yes No (Please circle)
Yes No (Please circle)
Yes No (Please circle)
Yes No (Please circle)
Yes No (Please circle)
Yes No (Please circle)
Yes No (Please circle)
Yes No (Please circle)
Yes No (Please circle)
Yes No (Please circle)
For RTO use only
Have originals or digital copies been supplied for the workplace
documents?
Yes No (Please circle)
If not originals, have the originals been validated or checked? Yes No (Please circle)
Learner’s signature
Assessor’s signature
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Supplementary Oral Questions (optional) – for assessor
The below table is for you to document any supplementary verbal questions you have asked the
learner to determine their competency. For example, if you are unsure of their answer to a question
in the Learner Workbook, you may choose to ask them a supplementary question to clarify their
understanding of the relevant criteria.
Learner’s name
Assessor’s name
Unit of Competence
(Code and Title)
Date of assessment
Question:
Learner answer:
Assessor judgement: Satisfactory Not Satisfactory
Question:
Learner answer:
Assessor judgement: Satisfactory Not Satisfactory
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Question:
Learner answer:
Assessor judgement: Satisfactory Not Satisfactory
Question:
Learner answer:
Assessor judgement: Satisfactory Not Satisfactory
Question:
Learner answer:
Assessor judgement: Satisfactory Not Satisfactory
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Feedback for the learner
I have read, understood, and am satisfied with the feedback provided by the assessor.
Learner’s name
Learner’s signature
Assessor’s name
Assessor’s signature
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Competency as recorded by assessor
This should be used by the trainer/assessor to document the learner’s skills, knowledge and
performance as relevant to the overall unit. Indicate in the table below if the learner is deemed
competent or not yet competent for the unit or if reassessment is required.
Learner’s name
Assessor’s name
Unit of Competence
(Code and Title)
Date(s) of assessment
Activities List 1A-1B, 2A- 2C, 3A – 3D, 4A – 4E , 5A – 5C , 6A – 6B S NS
Have the activities been answered and performed fully, as required to assess
the competency of the learner?
Yes No
(Please circle)
Has sufficient evidence and information been provided by the learner for the
activities?
Yes No
(Please circle)
Comments from trainer/assessor:
Summative Assessments: Section A checklist S NS
Has the activity been answered and performed fully, as required to assess the
competency of the learner?
Yes No
(Please circle)
Has sufficient evidence and information been provided by the learner for the
activity?
Yes No
(Please circle)
Comments from trainer/assessor:
Summative Assessments: Section B checklist S NS
Has the activity been answered and performed fully, as required to assess the
competency of the learner?
Yes No
(Please circle)
Has sufficient evidence and information been provided by the learner for the
activity?
Yes No
(Please circle)
Comments from trainer/assessor:
Summative Assessments: Section C checklist S NS
Has the activity been answered and performed fully, as required to assess the
competency of the learner?
Yes No
(Please circle)
Has sufficient evidence and information been provided by the learner for the
activity?
Yes No
(Please circle)
P a g e | 41
VCID. ACOT Training and Assessment/SITXWHS003/Learner Workbook/V1.2/August 2019
Comments from trainer/assessor:
Unit Result
Has the learner completed all required assessments to a satisfactory
standard?
Yes No
(Please circle)
Has sufficient evidence and information been provided by the learner to
prove their competency across the entire unit?
Yes No
(Please circle)
Has the learner completed all required assessments to a satisfactory
standard?
Yes No
(Please circle)
Has sufficient evidence and information been provided by the learner to
prove their competency across the entire unit?
Yes No
(Please circle)
Comments from trainer/assessor:
The learner has been assessed as competent in the elements and performance criteria and the evidence has
been presented as:
Authentic
Yes No
(Please circle)
Valid
Yes No
(Please circle)
Reliable
Yes No
(Please circle)
Current
Yes No
(Please circle)
Sufficient
Yes No
(Please circle)
The learner is deemed: Not yet Competent Competent
If not yet satisfactory, date for reassessment:
Comments from trainer/assessor:
Learner’s signature
Assessor’s signature
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