BCGCM1001B - Follow OH&amp S Policies and Procedures Assessment Tool - TPI05

Apprentice name: Group number:
Assessment tasks
You will be assessed on your knowledge and skills for this unit on a number of occasions and in
different ways.
Assessment 1 – Safety plan and standards

• You will need to prepare for this assessment by demonstrating your compliance with safety
requirements while working on a task set by your teacher/assessor.
Assessment 2 – Emergency situation requiring evacuation procedures

• You will need to prepare for this assessment by an emergency evacuation procedure role play.
Assessment 3 – Fire fighting and equipment selection activity

• You will need to prepare for this assessment by researching types of fire fighting equipment.
Assessment 4 – Simulated role play and verbal questions for a safety incident
Assessment 5 – Hazard identification and risk assessment

• You will need to prepare for this assessment by:
− researching methods of correctly identifying hazards
− gaining knowledge of risk assessment and incident reporting
− identifying appropriate control measures to eliminate/minimise the risk of injury from
hazards.
© State of Victoria 2006

Assessment BCGCM1001B Follow OHS policies and procedures
Learning checklist
Your teacher/workplace assessor will work with you to demonstrate and explain this part of your
study. You may find it helpful to tick the boxes as you experience each learning point listed.
Topic Done
1. Safety plan and standards
• Locating and researching the relevant OHS Act for the

assessment location. 
• Locating and researching the site safety plan for the assessment
location. 
2. Emergency evacuation procedure role play
• Research emergency evacuation procedures relevant to the

assessment location. 
3. Fire fighting and equipment selection activity
• Methods of correct use of fire fighting equipment. 

• Gain knowledge of fire types and relevant dangers. 
• Correct use of fire fighting equipment practised. 
• Learn process for incident reporting. 
4. Simulated role play and verbal questions for emergency evacuation
• Researching and understanding correct OHS.


5. Hazard identification and risk assessment
• Gain knowledge of risk assessment and incident reporting. 

• Identify appropriate control measures to eliminate/minimise risk
of injury from hazard. 
Produced by Training Package Implementation Projects 2005 Page 2

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Assessment 1
Title: Safety plan and standards
Assessment location:
Procedure: Demonstrate or describe correct action when carrying out a task requested by your
teacher/assessor.
The assessor will observe the following aspects of Competent

Date(s)
this task Yes No
Demonstrate knowledge of the site safety plan location within
the assessment location.  
Demonstrate and describe interpretation of the site safety plan
for the assessment location.  
Participants demonstrate knowledge of their duty of care in
relation to the OHS Act of 2004.  
Perform work activities, demonstrating a general understanding
of the OHS Act of 2004.  
Demonstrate safe operation of tools and equipment.
 
Appropriate PPE selected and correctly fitted.
 
Appropriate action demonstrated in response to site and safety
signage.  
Correct use of firefighting equipment practice completed.
 
Comments
Feedback to apprentice
Teacher’s signature: Date:
Apprentice’s signature: Date:

Assessment 2
Title: Emergency situation requiring evacuation procedures
Procedure: Your teacher/assessor will give you a workplace emergency situation to which you need
to respond with correct evacuation response.

Date(s)
this task Yes No
Appropriate personnel are identified in the event of an
emergency.  
Assist any person in immediate danger.
 
On hearing an alarm or instruction to evacuate the location,
cease activity, secure personal valuables.  
If safe to do so, secure any activity or process that may become
hazardous or suffer damage if left unattended as a consequence  
of the evacuation.
Act in accordance with given instructions.

 
Assist in the evacuation of people with a disability if necessary.
 
Move calmly to the nominated evacuation assembly area, and
do not leave the assembly area until the all clear is given by the  
appropriate personal.
Follow the instructions of relevant emergency services personal.

 
Other procedures pertaining to the site location of the
assessment adhered to with correct action.  
Note: Oral responses to the above must be documented in the section headed ‘Interview/oral
questioning assessment’.

Comments

Assessment 3
Title: Fire fighting and equipment selection
Procedure: Correct identification of extinguisher type, selection and demonstration of extinguisher use
for one of the simulated fire types listed in the table below. Your teacher/assessor will provide the
situation to which you will be required to respond.

Date(s)
this task Yes No
Demonstrate knowledge of particular location policy regarding
OHS procedures (accidents, fires, emergency).  
Identify type of fire correctly.
 
Appropriate response to fire type.
 
Effectively communicate to emergency services, via landline
phone, mobile or two way radios.  
Demonstrate effective communication methods to notify other
personnel on site.  
Electrical fire: Has de-energising the power supply been
identified?  
Chemical fire: Has emergency evacuation been suggested?
 
Gas fire: Has emergency evacuation been suggested?
 
Mechanical fire: Correct equipment type selected and
extinguish a simulated mechanical fire.  
Combustible material fire: Correct equipment type selected
and extinguish a combustible material fire.  
Demonstrate organisational policies and procedures by
obtaining and correctly completing an incident report.  

Comments

Assessment 4
Title: Simulated role play and verbal questions for a safety incident
Procedure: Your teacher/assessor will provide a work place safety incident to which you to respond.
The assessor will observe the following Competent

Comments
aspects of this task Yes No
Completion of attached Job Safety Analysis sheet
for the safety incident.  
Identify environmental requirements, which are to
include but are not limited to waste management,  
noise, dust, vibration and clean up management.
Correctly identify the risk classification for a hazard.
Hazards may include but not be limited to chemical  
spills, gases, liquids under pressure, moving
machinery and equipment, hazardous materials,
work at heights, work in confined spaces, high
temperatures, noise, dust, vapours, fires,
protrusions, sharp equipment, overhanging beams
and traffic.
Document your understanding of the Hazard
Management Process.  
Competent:
 
Comments

Job Safety Analysis Worksheet
Company name: Date: JSA no:
Site name: Permit to work requirement? Yes  No 

Contractor: Approved by:
Activity:
Activity Hazards Class Risk control measures Who is responsible

List the tasks required to perform Against each task list the hazards 1,2,or 3. List the control measures required Write the name of the person
the activity in the sequence they that could cause injury when the to eliminate or minimise the risk of responsible to implement the
are carried out. task is performed. injury arising from the identified control measure identified.
hazard.
Remember: Each JSA must be site specific. Include all workers in the development of this JSA.

Assessment record sheet*
Apprentice name: ID number:
This sheet is a summary of all the assessment you have done for this unit of competency. It will be
filled in by your teacher/workplace assessor and signed by you then taken out of this book and kept
on record by the teacher.
Competent
Summary of assessments
Yes No
Assessment 1 – Safety plans and standards.

 
Assessment 2 – Emergency situation requiring evacuation procedures.
 
Assessment 3 – Fire fighting and equipment selection activity.
 
Assessment 4 – Simulated role play and verbal questions for a safety incident.
 
Assessment 5 – Hazard identification and risk assessment.
 
Overall assessment for this unit
Comments
*Teacher/Workplace assessor will remove this sheet.


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Apprentice name: Group number:

Assessment 1 – Safety plan and standards

Assessment 2 – Emergency situation requiring evacuation procedures

Assessment 3 – Fire fighting and equipment selection activity

Assessment 5 – Hazard identification and risk assessment

© State of Victoria 2006

1. Safety plan and standards

• Locating and researching the relevant OHS Act for the

• Research emergency evacuation procedures relevant to the

• Methods of correct use of fire fighting equipment. 

• Researching and understanding correct OHS.

• Gain knowledge of risk assessment and incident reporting. 

Produced by Training Package Implementation Projects 2005 Page 2

Produced by Training Package Implementation Projects 2005 Page 3

Apprentice name: Group number:

The assessor will observe the following aspects of Competent

Teacher’s signature: Date:

Apprentice’s signature: Date:

Produced by Training Package Implementation Projects 2005 Page 4

Apprentice name: Group number:

The assessor will observe the following aspects of Competent

Act in accordance with given instructions.

Follow the instructions of relevant emergency services personal.

Produced by Training Package Implementation Projects 2005 Page 5

Teacher’s signature: Date:

Apprentice’s signature: Date:

Produced by Training Package Implementation Projects 2005 Page 6

Apprentice name: Group number:

The assessor will observe the following aspects of Competent

Produced by Training Package Implementation Projects 2005 Page 7

Teacher’s signature: Date:

Apprentice’s signature: Date:

Produced by Training Package Implementation Projects 2005 Page 8

Apprentice name: Group number:

The assessor will observe the following Competent

Teacher’s signature: Date:

Apprentice’s signature: Date:

Produced by Training Package Implementation Projects 2005 Page 9

Job Safety Analysis Worksheet

Company name: Date: JSA no:

Site name: Permit to work requirement? Yes  No 

Activity Hazards Class Risk control measures Who is responsible

Produced by Training Package Implementation Projects 2005 Page 10

Assessment record sheet*

Apprentice name: ID number:

Assessment 1 – Safety plans and standards.

Teacher’s signature: Date:

Apprentice’s signature: Date:

*Teacher/Workplace assessor will remove this sheet.

Produced by Training Package Implementation Projects 2005 Page 11

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