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Assessor Marking Guide CPCWHS1001 Prepare to work safely in the construction industry (Release 2) V1.0 SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 2 Disclaimer This guide contains information that is correct at the time of printing. Changes to legislation and/or training products may impact on the currency of information included. The training provider reserves the right to vary and update information without notice. Readers are advised to seek any changed information and/or updates from the training provider. This guide has been prepared as a resource to assist assessors to understand the competency requirements of the assessment tools. All assessors must read, understand, be familiar with, and follow the instructions, policies and procedures outlined in this guide. © 2024 Copyright Coast Wide Training Solutions: ABN: 3776 4517 692. This document is protected by copyright laws. It was designed and developed by Coast Wide Training Solutions and remains the sole property of Coast Wide Training Solutions. This document may not be reproduced in any way without the prior written authorisation of Coast Wide Training Solutions. This document was originally developed by Coast Wide Training Solutions but may now be altered from the original form. Coast Wide Training Solutions does not accept any liability for these resources and tools, the content and/or any reliance thereon. Any queries can be directed to: Coast Wide Training Solutions Pty Ltd ABN: 71 674 767 447 PO Box 65 Old Bar NSW 2430 PH: 0425 353 277 E: admin@coastwidetraining.com.au www.coastwidetraining.com.au Version Control Version: Date: Details of Changes: V1.0 June 2024 Initial Release SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 3 Contents Contents ......................................................................................... 3 Assessor Marking Guide CPCWHS1001 Prepare to work safely in the construction industry (Release 2) ............................................................................ 4 General Instructions ........................................................................... 8 Assessment Components ..................................................................... 8 Resources Required ......................................................................... 8 Assessment Practices .......................................................................... 9 Marking Criteria .............................................................................. 9 Submission of Assessments ................................................................ 9 Plagiarism and Copyright .................................................................. 10 Feedback ..................................................................................... 10 Reassessment ............................................................................... 10 Appeals Process ............................................................................. 10 Reasonable Adjustment .................................................................... 11 Student Declaration ........................................................................... 12 Assessment 1 – Theory Questions ...........................................................13 Topic 1 – Introduction to Work Health and Safety ....................................... 13 Topic 2 – Hazards and Risk Management ................................................. 16 Topic 3 – WHS in the Workplace ............................................................ 30 Topic 4 – Incidents and Emergencies ...................................................... 45 Assessment 2 – Verbal Questions ...........................................................54 PART A – Safety Scenario: ................................................................ 55 PART B – Signs and Symbols ............................................................. 58 Assessment 3 - Practical Skills Demonstration .............................................61 Role Play Scenario .......................................................................... 63 Observation Checklist .........................................................................66 Assessor Acknowledgement ................................................................. 68 SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 13 Assessment 1 – Theory Questions Instructions This assessment has been designed to allow the student to demonstrate their knowledge and written communication skills. These questions form the underpinning theoretical knowledge of the unit of competency. Students will need to demonstrate a sound knowledge of the topic in their responses and answer all the questions provided. Students are required to answer all questions correctly to achieve a satisfactory result. They must read the questions and record their response in the space provided or indicate the correct response from a number of given options. Students are able to refer to the Learning Guide, workplace policies and procedures, workplace templates and other materials to complete this task. Topic 1 – Introduction to Work Health and Safety 1.1. What is the title of the legislation that describes the requirements for work health and safety? CPCWHS1001: 1.1 Student response must indicate: ☐ Work Health and Safety Code of Practice 2011. ☒ Work Health and Safety Act 2011. ☐ Work Safely Act 2011. ☐ Duty of Care Act 2011. 1.2. According to the WHS legislation, duty of care is… CPCWHS1001: 1.2, K.1 Student response must indicate: ☐ Being kind to your workmates. ☐ Your duty to care for an elderly person. ☐ Your duty to care for the equipment you use. ☒ A legal obligation to take a reasonable standard of care when doing acts that could foreseeably cause harm to someone else. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 14 1.3. Who, on a work site, has a duty of care? Select all that apply. CPCWHS1001: 1.1, K.1 Student response must indicate: ☒ The Person Conducting a Business or Undertaking (PCBU). ☒ The Worker. ☒ The Contractor. ☐ The Visitor. ☐ The Customer. ☒ The Designer. ☒ Any others who have an influence on the hazards in a workplace. 1.4. What is the main WHS duty of a subcontractor on a work site? CPCWHS1001: 1.1, 1.2, K.1 Student response must indicate: ☒ To take reasonable care of their own health and safety and that of others. ☐ To train labourers on how to work safely. ☐ To implement safe working systems for the site. ☐ None, subcontractors don’t have WHS duties – only their supervisors do. 1.5. In relation to workplace safety, business owners have a right to: Select all that apply. CPCWHS1001: 1.1, 1.2, K.1 Student response must indicate: ☒ Request workers follow policies and procedures that relate to workplace safety. ☒ Request that workers use safety equipment provided. ☐ Address hazards only if it doesn’t cost anything. ☒ Expect workers to take reasonable care to avoid harming themselves or others. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 15 1.6. In relation to workplace safety, business owners have a responsibility to: Select all that apply. CPCWHS1001: 1.1, 1.2, K.1 Student response must indicate: ☒ Consult with workers on safety-related issues. ☒ Provide safe equipment and systems of work. ☒ Provide a safe and healthy workplace. ☐ Meet with workers at social events outside of work. 1.7. In relation to workplace safety, workers have a right to: Select all that apply. CPCWHS1001: 1.1, 1.2, K.1 Student response must indicate: ☒ Be shown how to work safely. ☐ Refuse reasonable directions from their employer. ☒ Speak up about any safety concerns. ☒ Adequate facilities and amenities including first aid equipment. 1.8. In relation to workplace safety, workers have a responsibility to: Select all that apply. CPCWHS1001: 1.1, 1.2, K.1 Student response must indicate: ☒ Take reasonable care to avoid harming themselves or others. ☒ Ensure they are fit and well to attend work. ☒ Report any unsafe situations and hazards to their immediate supervisor. ☐ Only report hazards within their immediate work area. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 16 Topic 2 – Hazards and Risk Management 2.1. What is a “hazard”? CPCWHS1001: K.2 Student response must indicate: ☐ The likelihood of the harm happening and how severe it could be. ☐ An item of equipment in the way that prevents me from doing my work. ☒ A potential source of harm. ☐ All of the above. 2.2. What is a “risk”? CPCWHS1001: K.2 Student response must indicate: ☐ A potential source of harm. ☒ The likelihood of the harm happening and how sever it could be. ☐ An item of equipment in the way that prevents me from doing my work. ☐ All of the above. 2.3. Label the diagram below with the four (4) steps to managing workplace risks. CPCWHS1001: 2.1, K.3 Student response must indicate: Identify Hazards Assess Risks Control Risks Review and Maintain Controls SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 17 2.4. What is the risk involved when working at heights (e.g on scaffolding)? CPCWHS1001: K.5.15 Student response must indicate: The risk of falling. 2.5. What is the risk involved when working in a confined space? CPCWHS1001: K.5.2 Student response must indicate: The risk of asphyxiation due to hazardous atmosphere. 2.6. Which of the following activities and equipment require a high risk work license? CPCWHS1001: K.6 Student response must indicate: ☒ Mobile, tower or overhead gantry cranes. ☒ Dogging, rigging and scaffolding work. ☐ Electrical and plumbing work. ☒ Operating forklifts and reach stackers. ☐ Working at heights. 2.7. List three (3) ways you can find hazards in your work area. CPCWHS1001: 2.2, K.10.3 Student response must indicate: i. Inspect the site. ii. Consult other workers. iii. Review information and data. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 18 2.8. On the diagram below, circle at least five (5) hazards that are present in this work area. CPCWHS1001: 2.2, K.5 Student response must indicate five of the following: 2.9. When is a risk assessment NOT necessary? CPCWHS1001: K.3.2 Student response must indicate: ☐ When there is uncertainty about how a hazard may result in injury or illness. ☐ When the work activity involves a number of different hazards and there is a lack of understanding about how the hazards may interact with each other. ☒ When a new contractor starts work at the site. ☐ When changes at the workplace occur that may impact on the effectiveness of control measures. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 21 2.14.Using the labels below, complete the hierarchy of control by identifying the most effective to least effective hazard minimisation and risk control measures. CPCWHS1001: 2.4, K.3.4 Student response must indicate: Substitution Isolation Administrative Elimination PPE Engineering 2.15.In the table below, give examples of how an “elimination” control can be used to control hazards and minimise risks, and identify the resources that would be required to implement the controls in each case. CPCWHS1001: 2.4, PS Student response must indicate the following or similar: Hazard/Risk Elimination Control Resources Required Falling from heights. Work at ground level. Personnel to redesign the work process. Slips, trips and falls. Remove trip hazards from floor. Cleaning staff/products/ equipment. Stored chemicals and hazardous goods. Remove and dispose of unwanted chemicals and hazardous goods. Chemical disposal services. Hazardous goods disposal services. Chemical waste bin. Elimination Substitution Isolation Engineering Administrative Personal Protective Equipment SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 24 2.21.When must a consultation occur? Select all that apply. CPCWHS1001: K.3.3 Student response must indicate: ☒ Identifying hazards and assessing risks. ☒ Proposing changes to work that may affect the health and safety of others. ☐ When a WHS meeting is to be conducted. ☐ When a training session is planned. ☒ Carrying out prescribed WHS activities. 2.22.After a WHS issue is resolved, how would you communicate the outcomes and any workplace changes? Select all that apply. CPCWHS1001: K.3.3 Student response must indicate: ☐ Update the policy and expect all staff to review it. ☒ Hold a WHS meeting with key staff. ☐ Write outcomes on a post-it and put it on each supervisor’s desk. ☒ Erect signage and notices. ☒ Brief outcomes in regular WHS newsletter. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 30 Topic 3 – WHS in the Workplace 3.1. How will you access your site’s current WHS policies and procedures? CPCWHS1001: 1.3 Student response must indicate: ☒ Access them from the site office or the company intranet. ☐ Ask your work mate for his copy. ☐ I don’t need them, I already know them. ☐ It is the supervisors responsibility to provide them to me. 3.2. List three (3) policies and procedures that support safe work practices. CPCWHS1001: 1.3, K.10 Student response must describe three (3) of the following or similar: i. Emergency procedures such as firefighting, first aid and evacuation. ii. Handling hazardous materials. iii. Standard operating procedures. iv. Personal protective clothing and equipment. v. Safely using tools and equipment. vi. Operating machinery safely. vii. Identifying hazards and assessing and controlling risks. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 41 3.27.List three (3) examples of housekeeping activities that you can do to maintain the safety of your work area. CPCWHS1001: K.10.4, K.10.9 Student response must indicate three (3) of the following or similar: i. Clearing away unused equipment and material. ii. Rolling up hoses. iii. Returning tools to correct locations. iv. Putting waste into appropriate bins. v. Cleaning up spillages as they occur. vi. Keeping access ways clear. 3.28.What must you complete when you need to report a hazard and/or risk? CPCWHS1001: 3.1, 3.4, K.10.3 Student response must indicate: ☐ Motor Vehicle Incident Form. ☐ Fault Report Book/Repair Log. ☒ Hazard Report Form. ☐ Incident Notification Form. 3.29.What must you complete when you need to report a vehicle defect, fault or broken piece of equipment? CPCWHS1001: 3.1, 3.4, K.10.3 Student response must indicate: ☐ Motor Vehicle Incident Form. ☒ Fault Report Book/Repair Log. ☐ Hazard Report Form. ☐ Incident Notification Form. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 44 Hazard Example Cause Potential harm/Impact Psychosocial Excessive time pressure, bullying, violence, and work-related fatigue. Psychological or physical injury or illness. Radiation Ultraviolet, welding arc flashes, microwaves, and lasers. Burns, photo carcinogenesis, cancer, or blindness. Traffic, Machinery (plant) and equipment Being hit by moving vehicles or being caught in moving parts of machinery. Heavy and/or dangerous equipment. Fractures, bruises, lacerations, dislocations, permanent injuries, or death. Unplanned collapse Working in or near excavations or in mining, unstable ground conditions. Collapse, debris, damage to property, injuries from engulfment or falls, crush injuries. Working at Heights Working on roofs, from scaffold, at or near the edge of an excavation. Fall from heights, injury due to incorrectly built scaffold. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 45 Topic 4 – Incidents and Emergencies 4.1. The emergency plan aims to…? CPCWHS1001: 4.1 Student response must indicate: ☐ Assess the risks of common workplace hazards. ☒ Prepare the work site and its personnel for actions to take in the event of an emergency. ☐ Meet legal requirements. ☐ None of the above. 4.2. List three (3) common construction emergencies. CPCWHS1001: K.8, K.9 Student response must indicate three (3) of the following or similar: i. Chemical spill. ii. Fire. iii. Personnel injury. iv. Structural collapse. v. Toxic or flammable vapour emission. vi. Vehicle or mobile plant accident. vii. Minor construction incidents. viii. Near misses. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 50 b. Fire Response Actions  Evacuate and Alert: • Prioritise getting people away from the fire, regardless of its size. • Alert anyone nearby about the fire calmly and without panic. • Follow workplace fire evacuation procedures to ensure safe evacuation.  Contact Fire Brigade: • Call the fire brigade or ensure someone else has made the call. • Provide the fire brigade with all necessary details about the emergency. • Follow any instructions given by the fire brigade on what actions to take next. c. Injury to personnel Response Actions  Ensure Safety: • Remove the injured person from the hazardous situation, only if it is safe to do so. • Ensure the person is not moved if it could cause further harm, unless they are at immediate risk of more harm.  Administer First Aid: • Follow appropriate workplace first aid procedures. • Contact workplace first aid officers or emergency services as needed. • Provide details about the injury and follow instructions from medical professionals. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 54 Assessment 2 – Verbal Questions Instructions This assessment has been designed to assess the student’s knowledge and verbal communication skills required by this unit of competency. They will need to demonstrate a sound knowledge of the topic in their verbal responses and respond to all the questions provided. As the assessor, you must read the scenario aloud to the student and ask them a series of questions to which they must respond verbally. You will record the student’s responses in writing in the space provided and ask the student to acknowledge each response as it has been recorded to confirm it as being true, correct and an accurate reflection of their verbal response. You may elect to record the student’s responses using another recording media, such as a voice recording system. In this case, provide the student with a copy of this recording and have the student acknowledge the recording as a true reflection of their verbal responses. Students are able to refer to the Learning Guide, Coastal Construction policies and procedures, workplace templates and other materials to complete this task. Refer to Coastal Construction’s website and the Resources tab for documents relevant to this assessment for information and templates to complete the following tasks. To access the website, click on the link Coastal Construction’s website, using the password CoastwideF250! to enter the site. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 55 PART A – Safety Scenario: Read this scenario to the student: You are working on a construction site where Coastal Construction is erecting a new multi-story building. Your supervisor has assigned you the task of unloading and stacking heavy steel beams delivered by a truck. The unloading area is cluttered with tools and materials, and the weather is overcast with a light drizzle. You have noticed that the beams are wet and slippery. You have been provided with a high-visibility vest and gloves, but you are unsure if this is sufficient for the task. Ask the student the following questions and record their responses. Example responses have been provided to guide marking. A1. What two (2) questions should you ask your supervisor before starting this task to ensure your safety and the safety of others? CPCWHS1001: OC, K.10 Student response must include and be similar to: Ask About Additional PPE: Examples - • "Should I be wearing a hard hat and steel-capped boots for this task?" • "Is there any additional personal protective equipment I need to wear due to the slippery conditions?" Clarify Safe Procedures: Examples - • "What is the safest method to unload and stack these beams to prevent accidents?" • "Are there any specific safety guidelines or protocols I need to follow given the current weather conditions?" SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 61 Assessment 3 - Practical Skills Demonstration Instructions This assessment has been designed to assess the student’s practical application of the skills required by the unit of competency. The student will need to demonstrate practical skills relating to the unit in a realistic environment under the observation of a suitably qualified assessor. The student is required to demonstrate all tasks correctly whilst being observed by the assessor in order to achieve a satisfactory result. They must read the task requirements and demonstrate these skills in the timeframe required. The assessor is required to acknowledge the student’s performance using the observation checklist and discuss with the student their performance. The assessor will record their observations and feedback of the performance using the observation checklist provided. Additionally, this assessment requires the student to demonstrate a detailed knowledge of the topics in their written responses and answer all the questions provided. The student is required to complete all tasks correctly to achieve a satisfactory result. They must read the task requirements and record their response in the documents as instructed. The student is able to refer to their learning guide, Coastal Construction resources, workplace policies and procedures, workplace templates and other materials to complete this task. The practical skills demonstration will ensure the student is able to: • Identify health and safety legislative requirements of construction work. • Identify construction hazards and risk control measures." • Identify health and safety communication and reporting processes." • Identify incident and emergency response procedures. Refer to Coastal Construction’s website and the Resources tab for documents relevant to this assessment for information and templates to complete the following tasks. To access the website, click on the link Coastal Construction’s website, using the password CoastwideF250! to enter the site. SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 63 Role Play Scenario 1 – Hazard Identification and Reduction. CPCWHS1001: 2.2, 2.3, 2.4, 3.1, OC, PS, W, P.1, P.2, P.3, P.8, K.5, K.7 Read the scenario and carry out the following tasks: You are working on an outdoor construction site where Coastal Construction are building a new bridge. Your tasks today involve managing traffic in and around the site. Traffic Management Area: • Construction vehicles and site traffic are working and moving throughdesignated paths, creating dust and leaving debris.•Temporary traffic signs and barriers need to be set up to direct vehicles andpedestrians safely.•High levels of ambient noise may hinder communication and situationalawareness.Before beginning your tasks, ensure you are properly equipped with PPE and aware of potential hazards in the area. Task A – Identify at least three (3) hazards, and verbally report them to your supervisor. You also need to explain how you intend to reduce or remove the risks related to each hazard identified. Task B - Fit the required PPE correctly to prepare for work. Task C - Complete a Risk Assessment Form to document the hazards and assess the risks identified. Instructions For the purpose of the assessment, you will perform these tasks while being observed by your assessor. This role play can be conducted in a simulated work environment provided the role play is recorded and/or live streamed. To conduct the role play you must access: • Appropriate PPE.• Appropriate documentation.The role play should take no more than 10 minutes. During the role play your assessor will be looking to see that you: • Identify and orally report hazards.• Demonstrate the correct fitting of PPE.• Complete the Hazard Incident Injury Report Form.SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 68 You must complete this acknowledgement on the student’s completed assessment tasks and indicate if the assessment task was satisfactory or not satisfactory. Assessor Acknowledgement Student Name: Qualification/Program: OFFICE USE ONLY The student has satisfactorily completed the following assessment components: Yes No Assessment 1 – Theory Questions ☐ ☐ Assessment 2 – Verbal Questions ☐ ☐ Assessment 3 – Practical Skills Demonstration ☐ ☐ The student has been provided with feedback and informed of the assessment result and the reasons for the decision. Assessor Name: Assessor Signature: Assessment start Date: Assessment Outcome Date: Assessor's Feedback: Student Acknowledgement: I have been provided with feedback on the evidence I have submitted. I have been informed of the assessment result and the reasons for the decision. Student Signature: Feedback Received Date: SAMPLE

CPCWHS1001 Prepare to work safely in the construction industry (Release 2) Assessor Marking Guide © 2024 Coast Wide Training Solutions Pty Ltd | CPCWHS1001 Assessor Marking Guide CWTS V1.0 69 You must complete the Assessment Outcome Report and indicate if the student is Competent or Not Yet Competent. End of Assessor Marking Guide ASSESSMENT OUTCOME REPORT Unit of Competency: Student Name: Qualification/Program: Student Declaration By signing below, I declare that my assessor and or/other Training staff have;: ☐ Provided me with access to policies including the assessment policy/assessment appeals process; ☐ Explained the unit of competency, elements, and performance criteria that I studied in the course; ☐ Explained the assessment tasks, assessment criteria and the assessment due date(s) for this course; and ☐ Provided assistance during the study of this course (unit/s) when I requested help. By signing below, I declare that I: ☐ Hold a copy of this assignment in case the original is lost or damaged; ☐ Am submitting work for this assessment task that is my own and no other person has completed this assessment for me; and ☐ Have not copied any part of this assignment or product from any other learner’s work or from any other source, except where I have referenced any sources I used. I am submitting the following evidence to support my claim for competence. Yes No N/A Assessment 1 – Theory Questions ☐ ☐ ☐ Assessment 2 – Verbal Questions ☐ ☐ ☐ Assessment 3 – Practical Skills Demonstration ☐ ☐ ☐ Hazard Identification Form ☐ ☐ ☐ Risk Assessment Form ☐ ☐ ☐ Photographic/video documentary (if applicable) ☐ ☐ ☐ I have been provided with feedback on the evidence I have submitted. I have been informed of the assessment result and the reasons for the decision. Student Signature: Date: OFFICE USE ONLY – First Assessment Attempt The student has satisfactorily completed the following assessment components: Yes No N/A Assessment 1 – Theory Questions ☐ ☐ ☐ Assessment 2 – Verbal Questions ☐ ☐ ☐ Assessment 3 – Practical Skills Demonstration ☐ ☐ ☐ Overall, the student was assessed as: Competent Achieved (20) ☐ Competency Not Achieved (30) ☐ Recognition of prior learning (51) ☐ Credit Transfer (60) ☐ Withdrawn/ discontinued (40) ☐ SAMPLE