SITXWHS004 Assessment Booklet V4.20

SITXWHS004 Establish and maintain a work health and safety system
SITXWHS004
Establish and maintain a work health and safety system
Assessment Tool
STUDENT COPY
Student Name:
Student copy
Assessment Booklet -SITXWHS004 Version 4.20 Copyright Pax Institute CRICOS No. 03152D RTO No. 22207 Page 1
Student ID No:
Table of Contents
How Do I Use This Book? ................................................................................................................................. 3
Assessment Resource Summary ........................................................................................................................ 4
Section 1: General Instructions to Student .................................................................................................... 5
General information on Assessment Methods ................................................................................................. 10
Learner Declaration .......................................................................................................................................... 12
Assessment 1 – Case Study/Scenario ............................................................................................................... 14
Consultative Process ........................................................................................................................................ 14
Assessment 1 -Assessor Checklist ................................................................................................................... 19
Assessor Use ONLY ........................................................................................................................................ 19
Assessment 2 - Project ..................................................................................................................................... 22
Workplace Health and Safety -Policy and Procedures Manual ....................................................................... 22
Assessment 2 – Assessor Checklist ............................................................................................................ 24
Assessor Use ONLY ....................................................................................................................................... 24
Assessment 3 -Project -Hazard Analysis ......................................................................................................... 28
Workplace Safety Audit and Risk Assessment Project.................................................................................... 28
Hazard Analysis / Workplace Inspection Checklist ......................................................................................... 30
Risk MATRIX/Risk Assessment Form ............................................................................................................ 32
Assessment 3 – Assessor Checklist ............................................................................................................ 36
Assessment 4 – Role Play -Evaluation ............................................................................................................ 40
Assessment 4 – Observation Checklist ...................................................................................................... 42
Student copy
How Do I Use This Book?
This Handbook is divided into

two sections:
 Section 1 -The introduction –

which provides general
information about the unit(s)
of competency you, will be
assessed in.
 The second section contains

specific detailed information
of the assessment
component activities. You
will need to complete each
assessment activity
completely and to the
required standard explained
to you by your trainer and in
this handbook in order to
Your assessor will go through this handbook and the assessment achieve competence in this
activities with you in detail, before the assessment process begins. assessment process
Student copy
Welcome to your assessment on the following unit(s) of competency
Assessment Resource Summary

Unit Details SITXWHS004 Establish and maintain a work health and safety system
Assessment Type This is a summative assessment, which requires each student being able to
practice prior to undertaking this assessment.
Assessment 1
Case Study/Scenario
Case study with questions – Establish WHS
framework and consultative processes
Project
Assessment 2
Policies and Procedures Manual
Assessment Methods
Project Assessment 3
Identify Hazards and controlling risks
Assessment 4
Role Play
Role play -Evaluation processes and
Consultative processes
Assessment 5
Written Assessment (Refer to separate Written Assessment
document)
Unit Summary
This unit describes the performance outcomes, skills and knowledge required to develop, implement and
sustain effective, professional and contemporary work health and safety (WHS) management practices.
It requires the ability to establish and review systems, policies and procedures designed to ensure a safe
workplace.
The unit applies to all tourism, travel, hospitality and event sectors and to any small, medium or large
organisation.
It applies to those senior managers who operate with significant autonomy and are responsible for
making a range of strategic management decisions.
This unit incorporates the requirement, under state and territory WHS legislation, for businesses to take
a systematic approach to managing the safety of their workers and others in the workplace.
No occupational licensing, certification or specific legislative requirements apply to this unit at the time
of publication.
Unit Code Title Training package code and title

SITXWHS004 Establish and maintain a work health Work Health and Safety - Cross-
and safety system Sector
Student copy
*Prerequisite Unit Nil
Section 1: General Instructions to Student

Please read all the information before you proceed to complete the assessment tasks. If you do not
understand any part of these instructions, please ask your trainer/assessor.
Objective of Assessment
The primary objective of assessment is to support and encourage the students learning outcomes. The
assessment results give the assessor an indication of how well the students have learnt in class and or areas
they may need extra support with. The assessments are intended to be equitable, fair and flexible. All the
information, skills and knowledge being assessed by the assessments have been based on theory, practical
and skills delivered by the trainer/assessor during classes, and or during self-directed study and meet the
requirements of the unit of competency.
Assessment Feedback and Support throughout the Assessment Process
Students are encouraged to reflect on key observations and issues encountered during their studies to
encourage learning. Knowing what you understand or have mastered and identifying where you need to
improve the critical skills for successful learning.
The assessor will give student feedback throughout the duration of the unit they are studying and after
assessment results. The feedback given to the student will always be to support their achievements and to
monitor student progress throughout their studies.
Reasonable Adjustment or Special Needs
In the situation where you or your student feel that extra support needs to be given, you should organise a
time to meet with your student and discuss the options you can offer. Your aim is to ensure the students
successful completion of their course with the least amount of difficulty.
Reasonable adjustment will be provided for students with a disability or learning difficulty according to the
nature of the disability or difficulty. Reasonable adjustments are made to ensure that the student is not
presented with artificial barriers to demonstrating achievement in the program of study. Reasonable
adjustments may include the use of adaptive technology, educational support and alternative methods of
assessment such as oral assessment.
In assessing the competence of individuals, assessors must provide for reasonable adjustments to ensure the
assessment principles of fairness and flexibility are addressed. However, assessors must be confident that
reasonable adjustments do not compromise the outcomes of the unit and the integrity of the qualifications
and Statements of Attainment issued as certification of achievement.
Achieving a Satisfactory Result and Reassessment
Student copy
This qualification is based on Competency based training.
There are two outcomes for each assessment task level:
S (S) = Satisfactory
Or: (NS) = Not Satisfactory (requires more training and experience or evidence to complete the assessment).
Students must achieve a Satisfactory result (S) for all components of the unit tasks to be deemed overall
Competent (C) in this unit.
 Should you not be successful in your attempt your assessor will provide directive feedback to guide to
success in your second attempt; i.e. reassessment.
 You will be given two (2) re-assessment opportunities of which one will be at no cost to you but the second
one will incur a fee. Please refer to the fee schedule located on the website.
 Assessment reasonable adjustment may be exercised by your assessor at their discretion.
Appeal an Academic Decision
Where a student does not agree with the Assessors decision they should first discuss the issue with the
Assessor and try to reach an understanding of the decision and a way forward to get the issue resolved.
If the student still wishes to pursue the matter further - they may then lodge an appeal following the College’s
Complaints and Appeals process. Please refer to the PAX Institute of Education Complaints and Appeals Policy
for further details.
Cheating and Plagiarism
PAX Institute of Education will not tolerate Cheating and plagiarism from any student. Evidence of
plagiarism and cheating are treated seriously. The Institute imposes severe penalties on students who
cheat and plagiarise. Consequences for students engaging in such practices may include but not limited
to being deemed Not Yet Satisfactory in the assessment or Not Yet Competent in the unit or exclusion
from the course. If you are caught cheating, you will be required to re-enrol in the unit, which will incur a
fee. Please refer to the schedule of fees on the PAX website. Assessors must ensure that students’ work
is genuine and produced by the student.
Student copy
Submitting Assessment Tasks
Students must submit all assessment tasks together with the provided cover sheet. Work submitted without a
coversheet will not be accepted.
ALL tasks must be completed in Intelligible English. It is preferable that tasks are typed, where this is not
possible or where room is provided on a paper for short answers, you must write clearly.
Copy of students work

Students are required to hold a copy of their submitted assessment task prior to their submission to PAX
Institute of Education.
Cover sheets
Student must submit a completed coversheet with all assessment tasks, ensuring the student declaration
section is signed. Assessment cover sheets are available from the front office.
Due dates
Submissions must be made by the due date. Late submissions will be treated as reassessment unless the
student is granted pre-approval. For the procedure on how to obtain extensions, refer to the Due Date
Extensions section.
Referencing
All information taken from the internet or from another source must be properly cited using an in-text
citation or footnote citation and include the full source in the reference list.
Student Access to Records

Students have the right to access current and accurate records of their participation and results at any time.
Students can see their results by requesting the information from a direct request contacting the relevant
member of the Academic Department
Due Date Extensions
Students must submit all tasks on or before the due date set for each Unit of Competency. Should students
need extensions, students must consult with the Academic Manager. Extension can only be obtained if the
need is genuine, or under compassionate circumstances.
Students are required to submit your request for extension in writing to the Academic Manager and attach
any supporting documents.
Student copy
Achieving a Satisfactory Result and Reassessment
This qualification is based on Competency based training.
There are two outcomes for each assessment task level:
S (S) = Satisfactory
Or: (NS) = Not Satisfactory (requires more training and experience or evidence to complete the
assessment).
You must achieve a satisfactory result for all components of the unit tasks to be deemed overall
Competent (C) in this unit.
 Should you not be successful in your attempt your assessor will provide directive feedback to guide
to success in your second attempt; i.e. reassessment.
 You will be given two (2) re-assessment opportunities of which one will be at no cost to you but the
second one will incur a fee. Please refer to the fee schedule located on the website.
 Assessment reasonable adjustment may be exercised by your assessor at their discretion.
Appeal an Academic Decision
Where a student does not agree with the Assessors decision they should first discuss the issue with the
assessor and try to reach an understanding of the decision and a way forward to get the issue resolved.
If this informal approach does not lead to a satisfactory result for the student and he/she believes is unfair,
then they may ask for another trainer/assessor to objectively re-mark their submission.
If the result and feedback from the 2nd re-marking is consistent with the first marking – yet the student still
wishes to pursue the matter further - they may then lodge an appeal following the College’s Complaints and
Appeals process. Please refer to the PAX Institute of Education Complaints and Appeals Policy for further
details.
Cheating and Plagiarism
PAX Institute of Education will not tolerate Cheating and plagiarism from any student. Evidence of
plagiarism and cheating are treated on a case by case basis and consequences for students engaging in
such practices may include being deemed Not Yet Satisfactory in the assessment or Not Yet Competent in
the unit or exclusion from the course If you are caught cheating, you will be required to re-enrol in the unit
which will incur a fee. Please refer to the schedule of fees on the Pax website.
Student copy
Assessment Booklet SITXWHS004 Version 4.20 Copyright Pax Institute CRICOS No. 03152D RTO No. 22207 Page 8
Submitting Assessment Tasks
You must submit all assessment tasks together with the provided cover sheet. Work submitted without a
coversheet will be returned unmarked. ALL tasks must be completed in legible English. It is preferable that
tasks are typed where this is not possible or where room is provided on a paper for short answers, you
must write clearly.
Cover sheets
Student must submit a completed coversheet with all assessments tasks, ensuring the student declaration
section is signed. Assessment cover sheets are available from the front office.
Due dates
Submissions must be made by the due date. Late submissions will be treated as reassessment unless the
student gets the pre-approval from the trainer.
Referencing
All information taken from the internet or from another source must be properly cited using an in-text
citation or footnote citation and include the full source in the reference list
Student Access to Records

Students have the right to access current and accurate records of their participation and results at any
time. Students can see their results by requesting the information from their trainer/assessor or can
request a copy of records by contacting student administration.
Due Date and Extensions
Submit the task before or on due date. If you need extensions consult your trainer/assessor. Remember
extension is a mutual agreement between you and your trainer/assessor and this can be obtained if the
need is genuine or under compassionate circumstances. You will be required to submit your request for
extension in writing to your trainer and attach any supporting documents.
Student copy
General information on Assessment Methods

Assessment tasks may be structured with any combination of
a) Written tasks assignment/projects.
b) open book tests
c) closed book exams
d) role plays,
e) Practical demonstrations.
Each unit will clearly show

1. How many tasks there are
2. What the nature of the task is – (see above)
You must complete all of these units and gain a satisfactory result in all tasks in order to be deemed
competent in the unit.
Assignment Activity/Reports/Role Play
 Ensure you are clear on the topic. If you are unsure please ask questions to your trainer/assessor.
 If it is an open book test: -You will have to bring your own books for reference
 If this is a closed book exam – No books or smart phones will be allowed on your desk.
 Ensure you know what date and what time the test will start and what the duration is allowed to
complete the test.
 In your responses please ensure you print clearly
 In order to achieve satisfactory , ALL questions MUST be answered CORRECTLY
 Use a pen. Assessments written in pencil or red pen will not be accepted.
 If your writing is illegible your trainer may request, you to type your written task. You will then
need to sign the student declaration of authenticity. Your trainer at their discretion may also quiz
you with verbal questions for deeming authenticity.
 Ask your assessor if you do not understand a question. Whist your assessor cannot tell you the
answer, he/she may be able to re-word the question for you.
 Do not talk to your classmates. If you are caught talking, you will be asked to leave and your
assessment will not be marked.
 Do not cheat. Anyone caught cheating will automatically be marked Not Satisfactory (NS) for this
assessment.
Student copy
Practical Tasks:
Your trainer will:

• Set a date for each task.
• Set a preparation time to deliver your dishes – this is to reflect the realistic commercial time
constrains and pressures.
• Advise students of the topic.
• Allow opportunities for the student to ask questions
• Provide you with standard recipes for the assessment task
• The trainer will demonstrate how to prepare and present the dish.
• You will also be given time to practice the dishes prior to practical observation of the task.
Practical units of competence offer the opportunity for the student to be graded on their competence at
each class by what they have prepared and how they have prepared it. For a student to be competent - the
final product should be one that could be sold in a commercial situation and purchased by a happy
customer. If you would send it back if you were given the dish at a restaurant then quite clearly
competence has not been achieved.
Student copy
Learner Declaration
I understand what is required to be completed in this assessment. I have been fully informed and I am
confident to proceed.
Learner Name: Learner Signature: Date:
Student copy
This page is left intentionally blank
Student copy
Assessment 1 – Case Study/Scenario

Consultative Process
For this assessment you will be demonstrating your ability to

develop a logical evaluation of the characteristics and needs of
an organisation in order to design a tailored WHS system. You
will demonstrate the importance of consulting with key
personnel and incorporating their views to develop an effective
WHS system.
Read the scenario and answer the following questions.
Scenario
You have been hired as the new Workplace Health and Safety Manager for a large catering operation.
Your first job is to consult with the key personnel and assess the WHS framework of the workplace.
You decide to observe the team in the commissary kitchen to assess the skills and the current WHS
practices. You observe an apprentice chef using a dangerous piece of electrical equipment unsafely and
determine that there is an issue with staff training.
On further investigation you identify that the policies and procedures are old and have not been updated.
There seems to be a lack of organisational hierarchy. There are 6 chefs and no appointed leader or
supervisor, and no one holds any safety qualifications or first aid experience.
The team comprises of 2 apprentice chefs – Tom a first year and Sandy a second-year level. A newly
qualified commis chef (Rick), 2 x chefs – Matt and Dillan that have 4 years’ experience. Peter another chef
that has been with the company for 6 years. Then there is Bob who is friend of the owner has been there
for 10 years doesn’t enjoy the work and tends to conflict with a lot of the staff Although Bob is not
qualified or trained as a chef tends to want to take short cuts and sees training as a waste of time and is
very impatient /aggressive with the rest of the team particularly the apprentices.
Student copy
On Monday evenings shift the 2 apprentices are left unsupervised in the kitchen as the rest of the staff
take their RDO.
There are no designated responsibilities for the staff. There have not been any meetings or methods of
sharing information, there is also no standard forms to complete for various safety incidents.
Your initial checks show that the fire extinguishers have not been serviced. You look to locate the first aid
kit as there is no signage. You find it in a cupboard in the back store, but it has not been stocked and
missing many items. The emergency exits are often blocked with boxes from deliveries.
Using the scenario, you decide that you will need to design a new WHS management system to suit the
characteristics and needs of the organisation
1 Your first task is to restructure the team and create appropriate roles and responsibilities relating
to WHS.
Insert your new organisation chart here.
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2 Decide which staff member you will appoint as a team leader/supervisor.
Give reasons for your choice.
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3 Next you will define and allocate health, safety and security responsibilities to the relevant job
descriptions Based on this: which staff will you allocate what duties to?
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4 How do you plan on consulting with your team on all WHS issues?
Give at least three (3) examples of communication and consultative techniques.
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5 What training do you plan to provide to the staff and why?
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6 Will you choose internal training or external training?
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7 Do some research on various types of specialised external WHS training courses that are available
Provide 2 external sources of specialist training?
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8 Which of the staff members will you allocate/recommend for completing this specialist training?
Give reasons for your decision.
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Student copy
Assessment 1 -Assessor Checklist

Assessor Use ONLY
This checklist is to be used when assessing the students in the associated task. This checklist is to be
completed for each student. Please refer to separate mapping document for specific details relating to
alignment of this task to the unit requirements.
Please complete below

Student Name:
Student ID No:
Did the student: Satisfactory
Student demonstrates communication skills to:

 consult with a range of personnel to elicit feedback on work health and
safety policies, procedures and practices  Yes  No
 discuss training needs with key supervisory and management personnel
 interview personnel about incidents or accidents, near misses
Student displays critical thinking skills to:
 allow for a rational and logical evaluation of the characteristics and needs
of the organisation in order to design a tailored work health and safety  Yes  No
system
 evaluate and review the system
Student displays literacy skills to:
 read and interpret unfamiliar and complex materials describing regulatory
requirements for work health and safety management systems and internal
reports providing operational feedback about the effectiveness of practices
 Yes  No
 develop comprehensive yet easily accessible work health and safety
policies, procedures and template documents
 write high level reports about the effectiveness of work health and safety
management practices and rationale for change
Student demonstrates planning and organising skills to plan for, establish and
regularly monitor all components of a work health and safety management  Yes  No
system
Student copy
Student demonstrates problem-solving skills to:
 take a lead role in controlling risks, including implementing interim or  Yes  No
emergency solutions
 manage the response to any incident or accident
Student demonstrates self-management skills to take responsibility for work

 Yes  No
health and safety management
Demonstrates how to access and interpret key legislative documents to ensure

 Yes  No
WHS system complies with regulatory requirements, standards and codes.
Plan for and ensure that consultation is conducted at times designated by

 Yes  No
legislation
Demonstrated the importance of resolving issues raised through consultation.
 Yes  No
Described methods of providing employees with accessible information on the

 Yes  No
outcomes of consultation.
Considered the elements involved in designing a WHS management system to

suit characteristics and needs of the organisation, in consultation with  Yes  No
appropriate personnel
Identify and provide adequate financial, human and specialist external resources
 Yes  No
to address WHS management practices.
Develop and clearly articulate WHS policies and procedures in a format readily
 Yes  No
accessible to all personnel.
Defined and allocated health, safety and security responsibilities within relevant
 Yes  No
job descriptions.
Consulted with key personnel, and develop and implement a plan for WHS
 Yes  No
training requirements
Establish and monitor a system for keeping WHS records.  Yes  No
Establish and maintain systems to ensure communication of WHS information to

 Yes  No
personnel
Establish and maintain appropriate consultative processes to suit characteristics

 Yes  No
and needs of organisation.
Did the candidate’s overall performance meet the standard?  Yes  No
Student copy
Student Declaration: I declare that I have Name: ________________________

been assessed in this unit, and I have been
Signature: ________________________
advised of my result. I also am aware of my
appeal rights. Date: ____/_____/_____
Assessor Use Only
Comments
Result
Satisfactory Not Satisfactory Incomplete
(Please Circle)
Name: ________________________
Assessor: I declare that I have conducted a fair, valid,
reliable and flexible assessment with this student, and I Signature: ________________________
have provided appropriate feedback
Date: ____/_____/_____
Student copy
Assessment 2 - Project
Workplace Health and Safety -Policy and Procedures Manual
This task requires to build on your knowledge gained in

assessment 1 (consultative process) to establish and
implement a complete work health and safety (WHS)
system that covers the following components:
 Adequate facilities for the welfare of employees.
 Appropriate management of incidents or

accidents and notification to WHS government
regulators
 Availability of information, instructions, training

and supervision that ensure employees’ health
and safety
 Safe:
 Machinery, equipment and materials
 Premises
 Provision of entrances and exits that are safe
 Systems of work
 Work environment
For this assessment you will need to create a Workplace Health and Safety Policies and procedures manual.
A written health and safety policy helps promote an effective WHS/OHS program. You must research and
develop the policy you wish your organisation to comply with as well as the standard operating procedures
(SOP’s) for carrying out the various aspects of the nominated tasks.
It is recommended that you stay with the same business that you have used to create your business plans
marketing plans and operational plans to help compound your overall learning outcomes.
Student copy
Your policy and procedure must include the following components:
 An overview of the reason for having the policy (the company’s commitment to and compliance to
Health and Safety legislation)
 The responsibilities of various staff under the policy
 The process for identifying hazards and the procedure for dealing with any hazards once they have
been identified (what happens if a hazard is identified? Who should be told, what should be done?)
 What to do if there is an issue relating to OHS (issue resolution procedure)
 Your policy must follow the same structure discussed in class, including having the following
components –
 Title
 Table of contents
 Date of issue
 Authority
 Review date
 You must also cover how you will communicate this policy to your staff (will you run a training session,
have a briefing etc)
 Describe in detail the process of evaluating and improving this policy and procedure
There is no specific word count for this manual these are often extensive documents.
You may include chapters, headings, sub headings, graphs charts, tables, diagrams etc.
Use Times New Roman and font size 12.
Ensure you address all of the criteria in the instructions
Please note
A submission of a previously supplied WHS Policies and procedures manual/case study may be grounds
for plagiarism as deemed by your assessor and will be dealt with according to the policies included in
section 1 of this booklet.
Please ensure your work is original and responds directly to the criteria.
Student copy
Assessment 2 – Assessor Checklist

Assessor Use ONLY
This checklist is to be used when assessing the students in the associated task. This checklist is to be completed for each
student. Please refer to separate mapping document for specific details relating to alignment of this task to the unit
requirements.

Student Name:
Student ID No:
Did the student: Satisfactory
Student demonstrates communication skills to:

 consult with a range of personnel to elicit feedback on work health and
safety policies, procedures and practices  Yes  No
 discuss training needs with key supervisory and management personnel
 interview personnel about incidents or accidents, near misses
Student displays critical thinking skills to:
 allow for a rational and logical evaluation of the characteristics and needs
of the organisation in order to design a tailored work health and safety  Yes  No
system
 evaluate and review the system
Student displays literacy skills to:
 read and interpret unfamiliar and complex materials describing regulatory
requirements for work health and safety management systems and internal
reports providing operational feedback about the effectiveness of practices
 Yes  No
 develop comprehensive yet easily accessible work health and safety
policies, procedures and template documents
 write high level reports about the effectiveness of work health and safety
management practices and rationale for change
Student demonstrates planning and organising skills to plan for, establish and
regularly monitor all components of a work health and safety management  Yes  No
system
Student copy
Student demonstrates problem-solving skills to:
 take a lead role in controlling risks, including implementing interim or  Yes  No
emergency solutions
 manage the response to any incident or accident
Student demonstrates self-management skills to take responsibility for work

 Yes  No
health and safety management
Accessed and interpreted key legislative documents to ensure WHS system

 Yes  No
complies with regulatory requirements, standards and codes.
Designed a WHS management system to suit characteristics and needs of the

 Yes  No
organisation, in consultation with appropriate personnel.
Identified and provided adequate financial, human and specialist external

 Yes  No
resources to address WHS management practices.
Developed and clearly articulated WHS policies and procedures in a format

 Yes  No
readily accessible to all personnel.
Defined and allocated health, safety and security responsibilities within relevant
 Yes  No
job descriptions.
Consulted with key personnel, and developed and implemented a plan for WHS
 Yes  No
training requirements
Established and monitored a system for keeping WHS records.  Yes  No
Establish and maintain systems to ensure communication of WHS information to

 Yes  No
personnel.
Did the candidate’s overall performance meet the standard?  Yes  No
Student copy
Comments
Student copy

Signature: ________________________
Assessor Use Only
Comments
Result
(Please Circle)
Name: ________________________
Date: ____/_____/_____
Student copy
Assessment 3 -Project -Hazard Analysis

Workplace Safety Audit and Risk Assessment Project
You are required to complete an WHS/OHS Hazard
analysis and risk assessment/audit of an area decided by
your assessor using the worksheet included in this
booklet.
For this assessment you will demonstrate your ability to
Establish and maintain practices for identifying

hazards, and assessing and controlling risks
This assessment may be done during class using the

campus as a scenario to conduct the hazard/risk
analysis.
Alternately you can conduct this at your workplace providing you record on your risk analysis template the
areas that you identify as a potential or realised hazard or risk.
Walk through your chosen area and go through each item on the list and record what you observe.
The hazard /risk analysis template is included on the next pages. You may use this template if you wish, or
any other that your assessor provides.
You will need to identify at least three (3) items of potential danger.
Record your findings and detail what you would do, to remove the danger, reduce the danger or share the
risk.
Submit all of the necessary WHS forms along with your responses to all of the questions to your assessor
by the due date.
Student copy
Part 1
1. You must inspect the chosen area using the worksheet and assess the area to see if you can identify
any potential hazards.
2. If you identify any hazards, you must recommend the suggested action to be taken to resolve the
hazards in the best possible, way using the ‘Hierarchy of controls’.
Part 2
1. Select one (1) of the hazards you have identified and complete a full risk assessment on this hazard
using the Risk assessment form /Risk MATRIX included.
Part 3
1. Identify certain types of staff training that is required

2. Find two different types of WHS/OH&S training and provide the name of the company and a quote
for the price of the training
3. Answer all of the questions.
Part of your risk assessment must be to identify what steps must be taken to manage the risk (e.g. training,
changes to policy and procedures, etc)
You will be assessed on
 Your identification of any risks in the workplace

 Your corrective action ideas
 Your ability to choose a task to risk assess that poses a real risk to workers
 Your ability to follow risk assessment principles (as outlined in class)
 Identification of training needs
 And the validity of your recommended actions
Student copy
Hazard Analysis / Workplace Inspection Checklist

Item Yes No N/A
1 Fire
- Extinguishers are in place
- Are clearly marked
- Have been serviced in the past 6 months
- Area around extinguisher is clear for a 1-meter radius
- Fire exit signs are in working order
- Exit doors are not blocked
- Exit doors can easily be opened
- Fire alarm is in working order
- Emergency plan is displayed
- Emergency drill carried out within the last 6 months
2 Electrical
- No broken plugs, sockets or switches
- No frayed or damaged leads
- Portable power tools in good condition
- No temporary leads on the floor
- Testing and tagging of electrical items has been attended within the last 12
months
3 General Lighting
- There is adequate illumination in working areas
- There is good natural lighting
- There is no direct or reflected glare
- Light fittings are in good working condition and are clean
- Emergency lighting is operational
4 Walkways
- No oil or grease
- Walkways are clearly marked
- Walkways are clear of obstructions
- There is unobstructed vision at intersections
- Stairs not blocked and are in good condition
5 Rubbish
- Bins are located at suitable points
- Bins are not overflowing
- Bins are emptied regularly
6 Work Benches
- Clear of rubbish
- Tools are stored properly
- Adequate work height
- No sharp edges
7 Storage
- Materials stored in racks in a safe manner
- Pallets are in good condition (no broken wood)
- Floor around racking is clear of rubbish or obstacles
- Racking is in good condition, no damaged uprights, beams etc.
8 Chemicals
- SDS for all chemicals
- SDS Register is available and up to date
- Containers are clearly and accurately labelled
- All chemicals are stored in accordance with the SDS
9 First Aid
Student copy
- First aid kits and contents clean and orderly
- First aid kit is adequately stocked (as per the Schedule in the kit)
- Easy access to first aid kits
- All employees are aware of location of first aid kits
- At least one worker on site with current Senior First Aid cert
10 Floors
- Even surface with no large cracks, holes or trip hazards
- Floors are not obstructed
- Floors are free from grease, oil, etc.
11 Office
- No exposed leads
- Air conditioning working adequately
- Filing cabinets are stable and in good repair
- Workers' chairs at correct height (knees at right angles, feet flat)
- Workers' monitors correct distance (arm’s length away when seated)
- Workers' monitors correct height (eyes in line with top of screen)
- Workers' mouse located beside keyboard (allows relaxed arms and wrists)
- Workers' keyboard located near edge of desk (allows relaxed arms)
12 Machines
- Power equipment maintenance carried out
- Power equipment clean?
- All guarding in place and interlocks working
13 Display Material
- WHS policy statement signed by Managing Director and displayed on
notice boards
- Return to work program signed by Managing Director and displayed on
notice boards
- "No smoking" signs are displayed
- "Staff only" or "Restricted area" signs are displayed in relevant areas
- "Report that Hazard" poster displayed
- "Manual Handling" poster is displayed in warehouse area
- Safety noticeboard is available and up to date
14 WHS Information
- WHS Manual available to workers
- Incident report form available
- Hazard report forms available
- Emergency evacuation plan displayed
- Training records up to date
Additional comments or actions required:
Signed: Date: Copies sent to:
Student copy
Risk MATRIX/Risk Assessment Form
Department ____________________________________________________
Date _________________________________________________________
Details of the Hazard:
Location of the hazard
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Description of the hazard:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Reported to _____________________________________________________________________________
1 What is the likeliness of the risk to occur:
 Almost Certain
 Likely
 Possible
 Unlikely
 Rare
2 If the risk was to occur what would be the consequences of it occurring:
 Negligible
 Minor
 Moderate
 Major
 Severe
Student copy
3 Using the included Risk Matrix chart and your responses from the above assessment, what would
you rate your risk as:
 Low
 Medium
 High
 Very High
4 Recommendations of Action to be taken

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
5 What specific steps will you take to manage this risk

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Student copy
6 Refer to the ‘hierarchy of control’, identify which segment of the hierarchy you will be basing your
actions and response upon. Explain your decision in as much detail as possible.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Student copy
7 Explain why you believe your responses are appropriate to the level of risk identified from the
matrix completed.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
8 After you have implemented the new changes how will you ensure you monitor and evaluate these
changes to ensure that they have had the intended result?
Provide at least three (3) specific examples in your answer.

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Student copy
Assessment 3 – Assessor Checklist

Assessor Use ONLY
requirements.

Student Name:
Student ID No:
Whilst undertaking the hazard and risk

Satisfactory Comments
assessment, did the student ensure:
Considered hazards and risks associated with
 Yes  No
each task
Rated each risk in terms of probability and level  Yes  No
Identify / develop control actions per task  Yes  No
Ensure control hazards are in line with hierarchy
of control (including elimination, substitution,  Yes  No
isolation, engineering, administration, PPE)
Implement temporary measures when
 Yes  No
immediate fix not available
Document control processes and advise related
 Yes  No
staff
Identify non-task related risks and control as
 Yes  No
appropriate
Checklist completed correctly  Yes  No
Team members consulted with openly  Yes  No
All issues raised taken on board and assessed for

 Yes  No
associated risks
Team members advised of outcomes for all
 Yes  No
issues raised and identified
All recommendations are suitable to hazards
 Yes  No
and tasks
This task is completed in a safe and logical
 Yes  No
manner
Student followed up on identified items to
ensure rectification was undertaken and  Yes  No
appropriate where applicable.
Student copy
Developed or accessed hazard identification and
risk assessment templates that incorporate  Yes  No
criteria for assessing risks
Planned for and ensured a systematic hazard
 Yes  No
identification at times designated by legislation.
Developed procedures for the ongoing
identification of types of hazards designated by  Yes  No
legislation.
Developed procedures for the assessment and
control of risks associated with identified  Yes  No
hazards.
Nominate within procedures the roles and
responsibilities of personnel for hazard  Yes  No
identification, risk assessment and risk control.
Take a lead role in controlling risks, including
 Yes  No
implementing interim or emergency solutions.
Manage the response to any incident or
accident and follow legislative requirements for
 Yes  No
notifying and cooperating with WHS
government regulators.
The Hazard and Risk Assessment is completed
 Yes  No
and attached to this document.
Student copy
Comments

Signature: ________________________
Student copy
Assessor Use Only
Comments
Result
(Please Circle)
Name: ________________________
Date: ____/_____/_____
Student copy
Assessment 4 – Role Play -Evaluation
For this assessment you will participate in a role play to elicit

feedback on your WHS policies, procedures and practices.
The aim of this task is to demonstrate your skills in evaluating

and maintaining ongoing compliance with occupational health
and safety (OHS) or WHS legislation and regulatory
requirements, standards and codes.
This may be played by your assessor if available or another

colleague – (in which case you will take turns playing the Manager and the Auditor whilst your assessor
observes you.)
You will need to print out your policy and procedures manual from Assessment 2 as well as your completed
hazard checklist and risk assessment for Assessment 3. Information from Assessment 1 may also assist
questions that may be raised during the role play.
Scenario:
The role play will involve you playing the manager of your chosen business consulting with a local council
WHS auditor/Inspector.
The council inspector/auditor has arrived at your workplace and asks to see your:
 workplace health and safety policies and procedures manual.

 Your hazard and risk analysis process and documents
 How you train your staff
 What documents or record keeping processes you have in place
 How you communicate and consult with key personnel
 How you monitor and evaluate your processes.
Student copy
The auditor (Your assessor) may have feedback on your policy and procedure manual as well as your
hazard and risk analysis /accident reporting documents.
As part of the process you will record the feedback from the auditor and incorporate the changes into your
WHS system.
You may need to adjust your P&P Manual where necessary and resubmit.
Student copy
Assessment 4 – Observation Checklist

Assessor Use ONLY
requirements.

Student Name:
Student ID No:
During the role play did the student: Satisfactory Comments
Participated in the role play  Yes  No

Behaved professionally and acted within the
 Yes  No
scenario with appropriate responses
Prepared for the role play by having all of the
 Yes  No
relevant documents on hand
Communicated well and demonstrated
 Yes  No
understanding of the underpinning knowledge
Assess and maintain ongoing compliance with
occupational health and safety (OHS) or WHS
 Yes  No
legislation and regulatory requirements,
standards and codes.
Consulted with a range of personnel to elicit
feedback on WHS policies, procedures and  Yes  No
practices.
Assessed effectiveness of WHS management
practices and develop, implement, document
 Yes  No
and communicate improvements and changes
to the WHS system.
Evaluated organisational health, safety and
 Yes  No
security system.
Student copy
Comments

Signature: ________________________
Student copy
Assessor Use Only
Comments
Result
(Please Circle)
Name: ________________________
Date: ____/_____/_____
Student copy

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SITXWHS004 Establish and maintain a work health and safety system

How Do I Use This Book?

This Handbook is divided into

 Section 1 -The introduction –

 The second section contains

Assessment Resource Summary

Unit Code Title Training package code and title

Section 1: General Instructions to Student

Assessment Feedback and Support throughout the Assessment Process

Reasonable Adjustment or Special Needs

Achieving a Satisfactory Result and Reassessment

There are two outcomes for each assessment task level:

Appeal an Academic Decision

Cheating and Plagiarism

Submitting Assessment Tasks

Copy of students work

Student Access to Records

Due Date Extensions

Achieving a Satisfactory Result and Reassessment

This qualification is based on Competency based training.

There are two outcomes for each assessment task level:

Appeal an Academic Decision

Cheating and Plagiarism

Student Access to Records

Due Date and Extensions

General information on Assessment Methods

Each unit will clearly show

Assignment Activity/Reports/Role Play

Your trainer will:

Learner Name: Learner Signature: Date:

This page is left intentionally blank

Assessment 1 – Case Study/Scenario

For this assessment you will be demonstrating your ability to

Read the scenario and answer the following questions.

Insert your new organisation chart here.

2 Decide which staff member you will appoint as a team leader/supervisor.

Give reasons for your choice.

Give at least three (3) examples of communication and consultative techniques.

5 What training do you plan to provide to the staff and why?

6 Will you choose internal training or external training?

Provide 2 external sources of specialist training?

Assessment 1 -Assessor Checklist

Please complete below

Did the student: Satisfactory

Student demonstrates communication skills to:

Student demonstrates self-management skills to take responsibility for work

Demonstrates how to access and interpret key legislative documents to ensure

Plan for and ensure that consultation is conducted at times designated by

Described methods of providing employees with accessible information on the

Considered the elements involved in designing a WHS management system to

Establish and monitor a system for keeping WHS records.  Yes  No

Establish and maintain systems to ensure communication of WHS information to

Establish and maintain appropriate consultative processes to suit characteristics

Did the candidate’s overall performance meet the standard?  Yes  No

Student Declaration: I declare that I have Name: ________________________

Assessor Use Only

This task requires to build on your knowledge gained in

 Adequate facilities for the welfare of employees.

 Appropriate management of incidents or

 Availability of information, instructions, training

Your policy and procedure must include the following components:

 The responsibilities of various staff under the policy

 What to do if there is an issue relating to OHS (issue resolution procedure)