CPCCCM2010B Work Safely at Heights - Mechanics
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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 Title CPC30211 Certificate III in Carpentry
Unit Code and Title CPCCCM2010B Work Safely at Heights
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
Document Title: Student final assessment submission evidence
Document Subtitle: CPCCCM2010B Work safely at heights
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RTO Name: Trinity Institute (Australia)
RTO NO: 41310
CRICOS NO: 03556F
RTO Address: Level 7, 16-18 Wentworth Street Parramatta NSW 2150
RTO suburb: Parramatta 2150
Copyright:
Universal Training Solutions
Developed by:
Universal Training Solutions and validated by Trinity Institute (Australia)
Acknowledgement:
Thanks to Universal Training Solutions and Trinity Institute (Australia) staff for their consultation and development work.
Version:
Trinity Institute (Australia) V1
Table of contents
STUDENT DETAILS
4
Declarations
5
SUBMISSION EVIDENCE ASSESSMENT TASK 1 KNOWLEDGE QUESTIONNAIRE
7
RECORD OF ASSESSMENT TASK 1 KNOWLEDGE QUESTIONS
14
SUBMISSION EVIDENCE - ASSESSMENT TASK 2 PROJECT
16
PART 1 APPENDIX 1 Fall Protection Glossary
16
PART 2 APPENDIX 2 Fall Protection Plan
20
RECORD OF ASSESSMENT TASK 2 PROJECT
26
SUBMISSION EVIDENCE - ASSESSMENT TASK 3 SIMULATED PRACTICAL AND/OR WORKPLACE OBSERVATION
28
Appendix 1 Quality requirements
28
Appendix 2 Safety checklist
31
Appendix 3 Tool List & Condition requirement
36
Appendix 4 Faults report
Error! Bookmark not defined.
Appendix 5 Working at heights safety checklist
36
APPENDIX 6 – ASSESSOR OBSERVATION CHECKLIST
45
ASSESSOR OBSERVATION CHECKLIST – CRITERION 1
46
ASSESSOR OBSERVATION CHECKLIST – CRITERION 2
50
ASSESSOR OBSERVATION CHECKLIST – CRITERION 3
55
RECORD OF ASSESSMENT TASK 3 SIMULATED PRACTICAL AND/OR WORKPLACE OBSERVATION
59
STUDENT DETAILS
Please complete this declaration with the student
Unit of competency:
Unit Code
CPCCCM2010B
Unit Title
Work safely at heights
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: ……………/……………. /…………….
Declarations
Task
Declaration:
Signature
Date
Task 1 Knowledge Questionnaire
I confirm that I have read and understood the 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 and/or workplace observation
I confirm that I have read and understood the instructions, my responsibilities and requirements 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 the job.
☐Yes
☐No
I confirm that I am a qualified workplace assessor and will be conducting the assessment for this unit and student
☐Yes
☐No
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 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.
☐Yes
☐No
I have explained the requirements for reasonable adjustment as a result of workplace constraints
☐Yes
☐No
I confirm that I have explained and confirmed all of the above items with the student.
Assessor Signature
Date
____/____/____
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? If yes, what are they?
☐Yes
☐No
Do you understand your rights to appeal the decisions made in an assessment?
☐Yes
☐No
I understand I have three attempts to complete each task satisfactorily. If after the third attempt I am deemed ‘Not Yet Competent’, I will be required to do further training before reattempting this unit
☐Yes
☐No
Reasonable adjustment: If you require any adjustments to accommodate a need in order to complete this assessment, please talk to your assessor. Arrangements 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.
☐Yes
☐No
I agree to comply with all rules, regulations, policies and procedures provided as part of the simulated environment.
☐Yes
☐No
I give permission for the RTO to use my assignment at the workplace for assessment moderation / validation purposes.
☐Yes
☐No
I confirm that I have read and understood my responsibilities and requirements for assessment.
Student Signature
Date
____/____/____
SUBMISSION EVIDENCE ASSESSMENT TASK 1 KNOWLEDGE QUESTIONNAIRE
Q
Questions
S
NS
1
Define ‘working at heights’.
☐ ☐
2
An employer or self-employed person must not perform high risk construction work if there is a risk to the health or safety of any person arising from the work unless: (tick one of the following)
☐ ☐
☐
A SWMS has been prepared before the work commences
☐
A SWMS is being prepared as the work is being conducted
☐
A SWMS is prepared after the work has been completed
☐
None of the above
3
Other than a worker falling, list 4 risks of working at heights.
☐ ☐
4
The location of any work that’s going to be carried out at height should be identified during the planning stage of a task or project. Where can you find information about where you will be working? List 3 sources.
☐ ☐
5
Before work commences, the employer or person who has control of a workplace and employees should ensure that there is safe access to and egress from the work area. What should this include? List 3 things.
☐ ☐
6
How can you eliminated or reduce the risk of tools and materials falling from heights? Give 4 examples.
☐ ☐
7
List 6 fall prevention devices.
☐ ☐
8
Define the following terms.
☐ ☐
Term
Meaning
Fall injury prevention system
Anchorage
9
Explain the difference between a static restraint system and a travel restraint system.
☐ ☐
Static restraint system
Travel restraint system
10
Name 2 types of falls arrest systems.
☐ ☐
11
What is the diagram below of?
☐ ☐
12
Write 4 key points on the use of a fall injury prevention system.
☐ ☐
13
Which of the below diagrams show an unacceptable use of a restraint system? Explain why.
☐ ☐
A ☐
B ☐
C ☐
Name of document: Student Final Assessment Version 1 Page 1 of 2
Name of the RTO: Trinity Institute (Australia) RTO No: # 41310 CRICOS: #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
14
Safety equipment is installed to reduce the risks of an existing site hazard like working at heights, but what other hazards must you consider? Give 2 examples.
☐ ☐
15
True or false. There are significant legal penalties if an accident occurs and it’s found that the safety equipment was incorrectly installed.
☐ ☐
16
Detail 6 safe work practices to follow when conducting work from a ladder.
☐ ☐
17
No matter what safety equipment you’re using, you must: (tick those that are applicable)
☐ ☐
☐
Remove safety equipment briefly for convenience
☐
Adjust it as necessary (using recommended standards and safe work practices) if something changes
☐
Change the type of equipment or add new equipment as necessary if the job changes
☐
Leave scaffolding and edge protection in place at all times
☐
Use it according to the manufacturer’s specifications, regulations, codes of practice and Australian Standards
☐
All of the above
18
Write 5 safety tips for leaving the elevated work area.
☐ ☐
RECORD OF ASSESSMENT TASK 1 KNOWLEDGE QUESTIONS
To be completed by the assessor
Learner details
Assessor details
Name
Name
Unit Code
CPCCCM2010B
Unit Title
Work safely from heights
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 performance criteria by clicking on the link https://training.gov.au/Training/Details/CPCCCM2010B. Marking should be in line with the model answers required as the performance criteria (PCs) is underpinned by this assessment task. All questions 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 completed all the assessments requirements for this unit of competency and has been deemed
Outcome
Date of outcome
Task 1– Knowledge Questionnaire
☐Satisfactory ☐ Not satisfactory
Attempts -
Attempt 1
…../……/…….
Attempt 2
…../……/…….
Attempt 3
…../.…../…..
Not satisfactory (NS) Outcomes
Question number
Record in detail the reason for the NS outcome applied
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
Assessor Intervention
(if applicable) - did you need to assist the student in this assessment. If so please explain:
Assessor Name
Assessor Signature
Date
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 signature
Date
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