Cpccohs2001a Final Assessment Practical

Student Assessment Agreement
Make sure you read through the assessments in this booklet before you fill out and sign the agreement below.
If there is anything that you are unsure of, consult your assessor prior to signing this agreement.
Have you read the assessment requirements for this unit?  Yes  No
Do you understand the requirements of the assessments for this unit?  Yes  No
Do you agree to the way in which you are being assessed?  Yes  No
Do you have any specific needs that should be considered?  Yes  No
If so, explain these in the space below.
Do you understand your rights to re-assessment?  Yes  No

Do you understand your right to appeal the decisions made in an assessment?  Yes  No
Student name
Student number
Student signature
Date
Qualification Code and

CPC30211: Certificate III in Carpentry
Title
CPCCOHS2001A: Apply OHS requirements, policies and procedures in

Unit Code and Title
the construction industry
Assessor name
Assessor signature
Date
Assessment Task Cover Sheet
Student Declaration
To be filled out and submitted with assessment responses
 I declare that this task is all my own work and I have not cheated or plagiarised the work or colluded with
any other student(s).
 I understand that if I If I am found to have plagiarised, cheated or colluded, action will be taken against me
according to the process explained to me.
 I have correctly referenced all resources and reference texts throughout these assessment tasks.
Student name
Student ID number
Student signature
Date
Assessor declaration
I hereby certify that this student has been assessed by me and that the assessment has been carried out
according to the required assessment procedures.
Assessor name
Assessor signature
Date
Assessment outcome S NS DNS Resubmission Y N
Feedback
Student result response

My performance in this assessment task has been discussed and explained to me.
I would like to appeal this assessment decision.
Student signature
Date
A copy of this page must be supplied to the office and kept in the student’s file with the evidence
Name of document: Final Assessment PRACTICAL Version 1 Page 1 of 29

Name of the RTO: Trinity Institute (Australia) RTO No: # 41310CRICOS: #03556F Document uncontrolled when printed
©Universal Training Solutions All rights reserved. No part of this work may be produced, published, communicated to the public or adapted without
permission
permission
Document Title: Student Final Assessment PRACTICAL
Document Subtitle: CPCCOHS2001A Apply OHS requirements,
policies and procedures in the construction industry

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STUDENT DETAILS
Please complete this declaration with the student
Unit of competency: Unit Code CPCCOHS2001A Unit Title Apply OHS requirements, policies
and procedures in the construction
industry
Trainer/Assessor Name:
Student Name:
Student ID:
Time Allocation Refer to Training Plan
Due date: Refer to you student program guide (training plan). Please insert
the due date as confirmed by your assessor below:
Due Date: ……………/……………. /…………….
Disclaimer: Copyright:
This work is under copyright and Universal Training Solutions
permission is not given to make copies for
hire or resale to third parties to use the Developed by:
document for their own or commercial use. Universal Training Solutions and validated
by Trinity Institute (Australia)
Universal Training Solutions does not give
warranty or accept any legal liability in Acknowledgement:
relation to the content of this work. Thanks to Universal Training Solutions and
Trinity Institute (Australia) staff for their
Licenced to: consultation and development work.
RTO Name: Trinity Institute (Australia)
RTO NO: 41310 Version:
CRICOS NO: 03556F Trinity Institute (Australia) V1
RTO Address: Level 7, 16-18 Wentworth
Parramatta NSW 2150

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permission
Declarations Task Declaration: Signature Date
Task 1 Knowledge I confirm that I have read and understood the
Questionnaire instructions, my responsibilities and requirements
for this assessment
Task 2 project I confirm that I have read and understood the
instructions, my responsibilities and requirements
for this assessment
Task 3 Simulated Practical I confirm that I have read and understood the
and/or workplace instructions, my responsibilities and requirements
observation for this assessment
Assessor declaration
The assessor is to complete this declaration with the student.
I have acknowledged the underpinning knowledge and skills may be assessed on or off ☐Yes ☐No
the job.
I confirm that I am a qualified workplace assessor and will be conducting the ☐Yes ☐No
assessment for this unit and student
Have all aspects of the student agreement been explained and understood? ☐Yes ☐No
Does the student understand they have three attempts to complete each task ☐Yes ☐No
satisfactorily? If after the third attempt the student is deemed ‘Not Yet Competent’,
they will be required to do further training before reattempting this unit.
I have explained the requirements for reasonable adjustment as a result of workplace ☐Yes ☐No
constraints
I confirm that I have explained and confirmed all of the above items with the student.
Assessor Signature Date ____/____/____

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Student declaration
Agreement by the student: Please sign below to demonstrate that you understand
what is required of you in relation to this assessment.
Do you have any special needs or considerations to be made for this assessment? ☐Ye ☐No
If yes, what are they? s
Do you understand your rights to appeal the decisions made in an assessment? ☐Ye ☐No
s
I understand I have three attempts to complete each task satisfactorily. If after ☐Ye ☐No
the third attempt I am deemed ‘Not Yet Competent’, I will be required to do s
further training before reattempting this unit
Reasonable adjustment: If you require any adjustments to accommodate a need ☐Ye ☐No
in order to complete this assessment, please talk to your assessor. Arrangements s
will be put in place to ensure a fair and flexible approach is undertaken for this
assessment. Please note that the range or nature of the adjustment will ensure
that the outcomes of the unit are not compromised.
I agree to comply with all rules, regulations, policies and procedures provided as ☐Ye ☐No
part of the simulated environment. s
I give permission for the RTO to use my assignment at the workplace for ☐Ye ☐No
assessment moderation / validation purposes. s
I confirm that I have read and understood my responsibilities and requirements for assessment.
Student Signature Dat ____/____/____

e

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SUBMISSION EVIDENCE - ASSESSMENT TASK 3 SIMULATED
Appendix 1 Pre-start Safety Checklist
PRACTICAL AND/OR WORKPLACE OBSERVATION
This checklist will help workers and contractors who are working on new or external worksites
reduce their exposure to health and safety risks and hazards. It should take 5 minutes to
complete
Date Time
Location Construction Site Supervisor/

manager
Task Identify Hazards at construction site
Attendees
Before starting work: Yes No NA

1 Do you have to do an induction? Yes ☐ ☐

2 Do you need to be accompanied while on site? Yes ☐ ☐

3 Do you know the site’s health and safety rules? Yes ☐ ☐

4 Are you familiar with security arrangements and the system for Yes ☐ ☐
reporting incidents/near misses and hazards? 
5 Are there emergency facilities and an evacuation Yes ☐ ☐
procedure/route for the site? 
6 Do you have access to appropriate emergency and first aid Yes ☐ ☐
equipment 
7 Have you asked the person in charge about all relevant hazards Yes ☐ ☐

8 If the work involves a high-risk task (such as work at heights, Yes ☐ ☐
hot work, confined spaces), is a work permit/safe work method 
statement required?
9 Do you have the correct procedures and equipment to do the Yes ☐ ☐
work safely? 
10 Is there a requirement to lock/tag out equipment or Yes ☐ ☐
isolate/contain energy before starting work? 

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11 Is there appropriate separation of vehicles and people during Yes ☐ ☐
the proposed work? 
12 Is all required electrical/mechanical equipment in a safe Yes ☐ ☐
condition ? 
13 Are hazardous/dangerous substances used and stored according Yes ☐ ☐
to their safety data sheets? 
14 Have you consulted with workers about the task and the safe Yes ☐ ☐
way to do it? 
15 Do you have all necessary PPE? Yes ☐ ☐

16 Have you got a safe way of getting in and out of your work Yes ☐ ☐
area? 
17 Have any manual handling risks been identified and accessed? Yes ☐ ☐

If you answer “no” to any of those above, you may need to follow up wit the person in charge
before you stat work to help ensure your safety
18 Have you left the worksite in an appropriate condition free from Yes ☐ ☐
hazards and risks (clean-up, tools put way, housekeeping)? 
19 If required, have you signed out?  ☐ ☐
Return this checklist to your manager/supervisor after work is complete

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Appendix 2 Quality requirements
Refer to attachment 2 and 3 to complete this section. When completing this document complete in
the right-hand column a description of the requirement type relating to this task: For example:
safety, quality, environmental and then describe:
 Policies and procedures and standards, - Describe the references/documents you refer to
when performing this task
 Manufacturer specifications – Describe how manufacturer’s instructions would impact
constructing a wall frame
 Legislation including federal, state and local authorities administering applicable acts,
regulations and codes of practice. - List one form of legislation that may be applicable for
this task
 Australian standards® - Describe the Australian standards applicable to construction a wall
frame
 Environmental requirements
Quality Requirement Type
Policies and procedures
Describe the regulatory Set out general safety requirements for and enforcement polices
requirements
Set out safety requirements for specific industries and tasks what must be
done, but give limited details on how to make it safe.
Codes of practices and industry standards: all guidelines that give examples
on how to carry out task safety, they are minimum standard to be followed
unless are better or equal standard can be provided.
The regulator must be immediately notified if any accident occur during

task.
Written application must be submitted within 48 hours, if requested by

regulator.
Manufacturer specifications if applicable
Describe the regulatory

requirements
Operator manual are supplied by manufacturer, they have information

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relating to technical functions, operations of product, operating tools and
equipment not in accordance with site procedure and manufacturer
specifications can lead to accidents and injury or equipment failure.
Legislation List one form of legislation that may be applicable for this task in relation to
the following:
Describe the regulatory Federal/ State and local authorities administering applicable acts/
requirements Regulations/ Codes of practice/Australian standards/Environmental
requirement
Work health and safety act (2011)

As applicable
Occupational health and safety act 2004
Occupational safety and health act 1984
Occupational health and safety regulations 2017
Occupational safety and health regulations 1996
SWMS/JSEA/SDS I have sighted and read the applicable SWMS/JSEA/SDS
Date Supervisor Your

signature signature
Appendix 3 Machinery and Equipment Checklist
If you mark any NO box on the checklist, you need to take action to make your workplace safer
Date checklist
completed
Name of person who
completed checklist
Position title

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Safety devices Yes No NA
1 Are machine guards in place on all operating equipment  ☐ ☐
(according to manufacturers specifications)?
2 Are belts, pulleys and other rotating parts properly guarded?  ☐ ☐
3 Are emergency stop buttons clearly marked, operational and  ☐ ☐
accessible?
Work areas
4 Is there sufficient clearance (work) space around all plant  ☐ ☐
5 Are machinery and equipment areas kept clean and free form  ☐ ☐
obstructions?
6 Is the ventilation adequate?  ☐ ☐
7 Are steps taken to reduce machinery noise (e.g. isolating the  ☐ ☐
plant, mufflers, baffles)?
8 Are tools and portable equipment stored safely?  ☐ ☐
Safe operation
9 Are workers trained to operate machinery safely and according  ☐ ☐
to your work procedure?
10 Do they hold any necessary license to perform high-risk work  ☐ ☐
or certificates of competency (e.g. forklift)?
11 Is your higher hazardous plant registered (e.g. boilers)?  ☐ ☐
12 Are workers supervised to ensure correct procedures are  ☐ ☐
followed?
13 Is machinery and equipment regularly inspected for damage or  ☐ ☐
wear?
14 Is machinery and equipment maintained according to the  ☐ ☐
manufacturer’s instructions?
Personal protective equipment (PPE)

15 Do you provide adequate PPE (e.g. safety footwear, eye  ☐ ☐
protection, hearing protections) as required?
16 Do you and your workers maintain PPE in accordance with the  ☐ ☐
manufacturer’s instructions
Appendix 4 Hazard Report
HAZARD/INCIDENT/ACCIDENT REPORT FORM

PART A – To be completed by employee

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Name of employee Date 09 -06-2021
Time of 11.30 AM
incident/accident
Supervisor Work Construction
area
1 Describe the hazard/detail what happened – include area and task, equipment, tools and
people involved
He was hit by a electric shock during using drill machine
2 possible solutions/how to prevent recurrence – Do you have any suggestions for fixing the
problem or preventing a repeat
Make sure turn off the power in emergency.
Always use dry hands to handling cords and plugs.
Pull the plug not the cord to disconnect it form outlet.

PART B – To be completed by the supervisor
3 Results of investigations – Determine whether the hazard is likely to cause an injury and
explain what factors caused the event
It was a minor electric shock

No other individual harm by this electric shock
PART C- To be completed by the supervisor

4 Action taken – Supervisor to identify actions to prevent injury or illness
Action Responsibility Completed
date
4.1 Supervisor 09-07-21
Check the power drill machine

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Implementing EHS policies and practices and
programs
Conducting a risk assessments
Holding periodic meetings
Responding to reported employee safety and
concerns and implementing corrective action.
Feedback has been provided to person who reported the ☐
hazard/incident/accident
Employee representative (health Date 09-06-21
and safety representative)
Business Manager Date 09-06-21
Appendix 5 Incident Report
INCIDENT/ACCIDENT REPORT FORM

Personal details
Name
Occupation Construction worker
Area Construction Date 09-06-21

of
report
Accident/incident details
Date 09-06-21 Time 11.30AM Date of 09-06-21
report
Location Witness Ariya, Aron
Reported to Whom: supervisor
Full accident/incident details – what happened, or in the case of a near miss, what could have
happened
Injury – Nature of injury
☐ Contusion/crush  Burn ☐ Dislocation ☐ Amputation
☐ laceration/open ☐ Superficial injury ☐ Foreign body ☐ Internal injury

wound

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☐ Concussion ☐ Sprain/strain ☐ Fracture ☐ dermatitis
Location of injury
☐ Headache ☐ Eye ☐ Internal  Hand/fingers
organs
☐ Shoulder/arms ☐ Trunk (other than ☐ Hip/leg ☐ Foot/Toes
back)
☐ Back ☐ Other
Results of accident
Lost time injury ☐Y/☐NN No of days 1 Workers ☐y Y/☐N
compensation
Treatment received  First aid  doctor ☐Hospital
Damage to equipment/buildings/vehicles etc.
What was damaged? Had issue with Power drill machine
Extent of damage Immediately replace the power drill machine
Contributing factors
What were the contributing No

factors (if any)?
Corrective actions -immediate actions
What controls can be put in Manually check all the equipment before using if they have any
place to prevent this from faults then immediately replace the equipment with another one.
happening again?
Recommendations for action
Who is to implement these Supervisor

controls/corrective actions?
Date of which action is to be 11- 06-2021
taken
Signatures
Officer HS rep Manager
Doctor Investigating
office

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Actions ☐Yes ☐No Date Manager
completed
APPENDIX 6– ASSESSOR OBSERVATION CHECKLIST

To be completed by the assessor whist observing the student perform the task as outlined in this
document
Student Name German
Who was present for the Name Position

observation task? Please
list Construction worker
German
Note to the assessor Assessors note: You must record in detail under the explain below how the
student demonstrated their ability to satisfactorily perform this task when
participating in observation activity. Record your observations in detail
under the section labelled “Explain How”. You need to ensure that you
take detailed notes on the performance of the learner in the explanation
section provided
Is reasonable adjustment ☐Yes ☐ No If yes please explain:
required to complete this
task. If yes please explain
ASSESSOR OBSERVATION CHECKLIST – CRITERION 1

Before commencing was this observation conducted:
☐ In the workplace as a workplace observation in real time

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☐ Via simulation with access to a real workplace
☐ In a simulated classroom environment
☐Online (mainly used for meetings)
When observing the student perform this task, the student was able to demonstrate their ability
to identify and assess risks. The student can?
Criterion (All criterion must be satisfactory to pass) S NS

☐ Identify, assess and report hazards to designated personnel ☐ ☐
☐ Identify, assess and report safety risks to designated personnel ☐ ☐
☐ Follow safe work practices and instructions and duty of care ☐ ☐

requirements for controlling risks
☐ Contribute to WHS, hazard, accident or incident reports according ☐ ☐
to workplace procedures and Australian government and state or
territory WHS legislation and relevant information
Observation comments. You (assessor) must detail exactly what was observed including the
setting, people involved and how this section was performed and to what level taking into
consideration the outcome for each observable item in the checklist. Should the student receive
an NS for any of the items then arrangements must be made for reassessment. It should be
noted that one or more dates can be utilised. For example, a section of the assessment may
require a meeting so therefore that meeting can take place on line and most likely will be on a
different day to a role play observation
Write your comment here.
OBSERVATION DATE/S (AS REQUIRED) – Insert the dates all observations took place
for this section
……./……./ ……./……./ ……./……./ ……./……./ ……./……./

……. ……. ……. ……. …….
☐Simulated ☐Simulated ☐Simulated ☐Simulated ☐Simulated

☐workplace ☐workplace ☐workplace ☐workplace ☐workplace


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☐On line (mainly used for meetings)
to identify hazardous materials and other hazards on work sites. The student can?

☐ Correctly identify and, if appropriate, handle and use hazardous ☐ ☐
materials according to company and legislated procedures
☐ Apply measures for controlling risks and construction hazards ☐ ☐
effectively and immediately
☐ Secure hazardous materials that have safety implications for self ☐ ☐
and other workers using appropriate signs and symbols
☐ Identify asbestos-containing materials and report to designated ☐ ☐
personnel
for this section
……./……./ ……./……./ ……./……./ ……./……./ ……./……./

……. ……. ……. ……. …….



permission
☐On line (mainly used for meetings)
to plan and prepare for safe work practices.The student can?

☐ identify, wear, fit, use and store correct personal protective equipment and ☐ ☐
clothing for each area of construction work
☐ select tools, equipment and materials, and organise tasks inconjunction with ☐ ☐
other personnel on site and in accordance withenterprise procedures
☐ determine and erect required barricades and signage at theappropriate site ☐ ☐
location
☐ identify and apply material safety data sheets (MSDS), and jobsafety analysis ☐ ☐
(JSA) and safe work method statements relevant tothe work to be carried out
for this section
……./……./ ……./……./ ……./……./ ……./……./ ……./……./

……. ……. ……. ……. …….



permission
☐Online (mainly used for meetings)
to apply safe work practices. The student can?

☐ perform tasks in a manner that is safe for operators, otherpersonnel and the ☐ ☐
general community in accordance with legislativerequirements, and enterprise
policies and procedures
☐ use plant and equipment guards in accordance with manufacturer ☐ ☐
specifications, work site regulations and Australian Standards®where
applicable
☐ use procedures and relevant authorities for reporting hazards,incidents and ☐ ☐
injuries
☐ recognise and not use prohibited tools and equipment in areas withidentified ☐ ☐
asbestos
☐ identify and follow work site safety signs and symbols ☐ ☐
☐ clear and maintain work site area to prevent and protect self andothers from ☐ ☐
incidents and accidents and to meet environmentalrequirements
for this section
……./……./ ……./……./ ……./……./ ……./……./ ……./……./

……. ……. ……. ……. …….

permission

☐ Online (mainly used for meetings)
to follow emergency procedures. The student can?

☐ identify designated personnel in the event of an emergency forcommunication ☐ ☐
purposes
☐ follow safe workplace procedures for dealing with accidents, varioustypes of ☐ ☐
fire and other emergencies, including identification or use,if appropriate, of
fire equipment within scope of responsibilities
☐ know, practise and carry out emergency response and evacuationprocedures ☐ ☐
when required
☐ carry out emergency first aid treatment of minor injuries correctlyand report ☐ ☐
details of any treatment administered accurately todesignated personnel as
soon as possible
require a meeting so therefore that meeting can take place online and most likely will be on a
for this section
……./……./ ……./……./ ……./……./ ……./……./ ……./……./

……. ……. ……. ……. …….

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ASSESSOR OBSERVATION CHECKLIST – SKILLS AND KNOWLEDGE

☐ Online (mainly used for meetings)
to:

☐ identify and accurately report any faults in tools, equipment or ☐ ☐
materials to appropriate personnel
☐ use organisational skills, including the ability to plan and set out ☐ ☐
work
☐ use teamwork skills to work with others to action tasks and relate ☐ ☐
to people from a range of cultural and ethnic backgrounds and with
varying physical and mental abilities
☐ use a range of mobile technology, such as two-way radio and ☐ ☐
mobile phones
☐ use safe manual handling techniques ☐ ☐
☐ use safety equipment, policies, and requirements for working in ☐ ☐

confined spaces and at height, including on roofs
☐ correctly locate, interpret and apply relevant information, standards ☐ ☐
and specifications
☐ effectively communicate and work safely with others ☐ ☐
require a meeting so therefore that meeting can take place online and most likely will be on a

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for this section
……./……./ ……./……./ ……./……./ ……./……./ ……./……./

……. ……. ……. ……. …….

RECORD OF ASSESSMENT TASK 3 SIMULATED PRACTICAL AND/OR

WORKPLACE OBSERVATION
To be completed by the assessor
Learner details Assessor details
Name Name
Unit CPCCOHS2001A Unit Title Apply OHS requirements, policies and procedures in
Code the construction industry
Record of assessment results (please tick appropriate box).

ASSESSORS NOTE: Before making a final judgement on this assessment task, you must
determine if the student is able to satisfactorily apply and perform the following criteria. Review
the knowledge evidence by clicking on the link
https://training.gov.au/Training/Details/CPCCOHS2001A. Marking should be in line with the
guides to completing the appendixes and/or attachments provided as the performance evidence,
performance criterion and foundation skills is underpinned by this assessment task. All
assessment tasks or parts for each section must be deemed satisfactory to achieve a satisfactory
outcome for this task. If a NS is provided for any section or questions relating to this task then
the task outcome should be treated as NS and the reassessment process should be applied. If a
NS (not satisfactory) outcome is applied then you must inform the student in detail as to “why”
this outcome was provided. Record your reasons in the section labelled “Not satisfactory (NS)
outcomes”. See below for recording appropriate information
Assessment activity - The learner has Final outcome Date of

completed all the assessments requirements for final
this unit of competency and has been deemed outcome
Task 3 – Simulated practical and/or workplace ☐Satisfactory ☐ Not satisfactory
observation – Part 1 OHS Inspection (Appendix
1, 2, 3, 4, 6)

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observation – Part 2: Simulated Fire (Appendix 5,
6)

observation – Part 3: Emergency Evacuation
(Appendix 6)
Assessor submission – assessor observation ☐Satisfactory ☐ Not satisfactory
checklist
Attempts
Attempt 1 …../……/……. Attempt 2 …../……/……. Attempt 3 …../.…../…..
Not satisfactory (NS) Outcomes

Part Record in detail the reason for the NS outcome applied
number
Appeals – refer to the complaints and appeals policy and procedure

If you receive a Not Satisfactory assessment result you have the right to appeal. You have three
assessment attempts. After the third attempt arrangements for payment will be made for reassessment
purposes. Refer to your student hand book for more details on the complaints and appeals process.
Assessor Feedback to learner:
The assessor must write full feedback to the learner that is constructive and not generic
Reasonable Adjustment
(if applicable) explain why reasonable adjustment has been applied and the tasks it was applied to

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Assessor Intervention
(if applicable) - did you need to assist the student in this assessment. If so please explain:
Assessor Name Assessor Date

Signature
Student declaration - I hereby certify that this assessment is my own work, based on my personal
study and/or research. I have acknowledged all material and resources used in the presentation of this
assessment whether they are books, articles, reports, internet searched or any other document or
personal communication. I also certify that the assessment has not previously been submitted for
assessment in any other subject or any other time in the same subject and that I have not copied in
part or whole or otherwise plagiarised the work of other learning and/or other persons. I confirm that I
understand that I must complete this assessment on my own. I confirm that I will not cheat or
plagiarise or copy from another student during the completion of this assessment.
Student name Student Date
signature

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CPCCOHS2001: Apply OHS Requirements, Policies and Procedures in the Construction Industry
Task 3 – Direct Observation
Student Name Student ID Number
Unit Start Date Unit End Date
Assessment Due Date Date Submitted

This cover sheet is to be completed by the student and assessor and used as a record to determine student
competency in this assessment task
The assessment process and tasks were fully explained. Yes / No
I am aware of which evidence will be collected and how. Yes / No
I am aware of my right to appeal an assessment decision. Yes / No
I am aware that I can locate The RTO Complaints and Appeals Policy and Procedureon their Yes / No
website at (https://trinityinstitute.edu.au/wp-content/uploads/2020/09/SC4-I-Complaints-and-
Appeals-PP-v2.0.pdf)
I have discussed any additional educational support or reasonable adjustments I require in
order to undertake this assessment with the Student Support Services Officer and Trainer /
Yes / No
Assessor, (if applicable). e.g.Student Handbook and Access and Equity
Policyhttps://trinityinstitute.edu.au/student-handbook-policies/
I have access to all required resources via Moodle? Yes / No
Cheating & Plagiarism Declaration
Student Declaration: In accordance with The RTOPlagiarism Policy, I hereby acknowledge by signing this
declaration that I have not cheated or plagiarised any work regarding the assessment tasks undertaken in
this unit of competency except where the work has been correctly acknowledged.
NOTE: Student must sign this prior to submitting their assessments to the assessor
Signature Date: ______ / ______ / 20___
Assessment Satisfactory or Not YetSatisfactory

Results
(Please circle the assessment result for this task)
Feedback to Student - Please provide general feedback on the student’s performance

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Student Declaration: - I verify that the work Assessor Declaration: - I verify that I have
completed is my own and that I was adequately adequately explained and negotiated the
informed of the assessment process prior to assessment tasks with the student prior to
commencing this assessment task. commencing assessment.
Student Name: Assessor Name:
Student Signature Date Assessor Signature Date
Assessor Guide for Practical Assessment

Assessor Instructions to include, but not limited to:
Instructions 1. Assessors will observe the student completing the tasks.
2. Students may work individually or in pairs depending on class size.
3. Assessment is based on the Assessment Requirements of each unit.
4. At any time, students may refer to manuals and their learning guides or Textbooks for
further information if needed.
5. If there is a clear breach of safety, assessors MUST intervene immediately and advise
the student of the breach.
6. Students MUST successfully follow environmental and sustainability best practice in a
carpentry workplace before competency can be achieved for the practical component.
7. Observable behaviors and answers to oral questions MUST be recorded on this
document.
8. If reassessment is required, this must be done after further study and discussion with
the student.
Task/s to be The tasks you will be observing is what the student will be undertaking:
assessed The student MUSTfollow best practice in a carpentry workplace for specific applications that
safely follows workplace procedures to meet required outcomes.
Oral questioning During the practical demonstration you will ask the student observation questions that will
address the skills and knowledge aspects of the unit of competency. The student will respond
orally, and you will record the student’s response.
Time allowed On average, the Assessments should take 2 – 4 hours to complete.
Location Assessment will take place in a simulated workshop environment relevant to the trade stream
being studied.
Decision making To achieve a satisfactory outcome, the student MUSTfollow and complete all tasks before
rules competency can be achieved for the practical component, and answer all questions presented by
the Assessor.
Expected answers to oral questions are indicative of the correct answer.
Performance The assessment methods MUST be by direct observation of tasks on required skills and
Observation knowledge to ensure correct interpretation and application.
Criteria for
Assessment Task
Assessment Assessors MUSTsatisfy NVR/AQTF assessor requirements.
conditions Competency is to be assessed in the workplace or a simulated environment that accurately
reflects performance in a real workplace setting.
Assessment MUSTinclude direct observation of tasks.
Where assessment of competency includes third-party evidence, individuals MUSTprovide
evidence that links them to having followed best practice in their carpentry workplace.
Assessors MUSTverify performance evidence through questioning on skills and knowledge to
ensure correct interpretation and application.
Resources The following equipment MUST be made available to students:
required The students MUST be wearing the correct PPE.
This is to include:
 Safety boots/shoes,
 Protective clothing,
 Safety glasses, and
 Gloves as required
The students MUST have the practical assessment sheet and a pen to complete each task.
Results/Re-  You will grade either S – Satisfactory or NS – Not Satisfactory for the assessment. In all
assessment

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cases you will provide the student with feedback.
 Only when all assessment tasks have been graded as S – Satisfactory the student will
be deemed C – Competent in the final result of the unit of competency; if the student
dose not satisfactorily complete all the assessment tasks the student will be deemed
NYC – Not Yet Competent.
 If the evidence is graded as NS – Not Satisfactory the student will be required to re-
submit the evidence. In this case, the student will be provided with clear and
constructive feedback based on the assessment decision so that they can improve your
skills / knowledge prior to reassessment.
 Where a ‘NS – Not Satisfactory’ judgement is made, the student will be given guidance
on steps to take to improve your performance and provided the opportunity to resubmit
evidence to demonstrate competence. You will determine and discuss the reasons for
NS – Not satisfactory on any of the criteria and will assess the student through a
different method of assessment e.g. verbal/oral questioning, problem solving exercises.
Reasonable You may adjust assessment conditions (vehicles, tools, analysis required) to suit workplace
Adjustment objectives provided that the integrity of the task is maintained.

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Cpccohs2001a Final Assessment Practical

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Student Assessment Agreement

Do you understand your rights to re-assessment?  Yes  No

Qualification Code and

CPCCOHS2001A: Apply OHS requirements, policies and procedures in

Assessment outcome S NS DNS Resubmission Y N

Student result response

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Time Allocation Refer to Training Plan

Due Date: ……………/……………. /…………….

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Assessor Signature Date ____/____/____

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Student Signature Dat ____/____/____

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Location Construction Site Supervisor/

Before starting work: Yes No NA

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Quality Requirement Type

Policies and procedures

The regulator must be immediately notified if any accident occur during

Written application must be submitted within 48 hours, if requested by

Manufacturer specifications if applicable

Describe the regulatory

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Work health and safety act (2011)

Occupational safety and health act 1984

Occupational health and safety regulations 2017

Occupational safety and health regulations 1996

SWMS/JSEA/SDS I have sighted and read the applicable SWMS/JSEA/SDS

Date Supervisor Your

Appendix 3 Machinery and Equipment Checklist

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Personal protective equipment (PPE)

Appendix 4 Hazard Report

HAZARD/INCIDENT/ACCIDENT REPORT FORM

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He was hit by a electric shock during using drill machine

Make sure turn off the power in emergency.

Always use dry hands to handling cords and plugs.

Pull the plug not the cord to disconnect it form outlet.

It was a minor electric shock

PART C- To be completed by the supervisor

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Appendix 5 Incident Report

INCIDENT/ACCIDENT REPORT FORM

Occupation Construction worker

Area Construction Date 09-06-21

Reported to Whom: supervisor

☐ laceration/open ☐ Superficial injury ☐ Foreign body ☐ Internal injury

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Damage to equipment/buildings/vehicles etc.

What was damaged? Had issue with Power drill machine

Extent of damage Immediately replace the power drill machine

What were the contributing No

Who is to implement these Supervisor

Officer HS rep Manager

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APPENDIX 6– ASSESSOR OBSERVATION CHECKLIST

Who was present for the Name Position

ASSESSOR OBSERVATION CHECKLIST – CRITERION 1

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Assessor Signature Date //

Student Signature Dat //

Signature Date: __ / / 20_