CHCCCS004

Student Assessment
Task Three: Observation
 Assessment Cover Sheet
This document must be signed by the student for each assessment completed. Submission of Assessments
will not be accepted for marking/review without a completed and signed Assessment Cover Sheet.

Qualification Title CHC52015 Diploma of Community Services

Unit Code CHCCCS004
Unit Title Assess co-existing needs.
Student Name
Student ID
Student Email
Assessor Name
Campus ☐ Melbourne ☐ Sydney ☐ Perth
Due Date Week 8
Submission Date
Assessment Task Task Three - Observation

Student Agreement:
By signing this Agreement, I confirm that I understand the Assessment Submission Guidelines, as detailed
in the Student Handbook and Acknowledge Education’s policies and procedures. In particular:
• The work submitted is my own and does not contain another person’s material represented in my
work.
• I understand that I must acknowledge in an appropriate manner all information and sources of
assistance used in my assessment work.
• I have followed all submission, presentation and file name guidelines outlined in the submission
guidelines. I am aware that if I do not follow the required guidelines, this could result in my
assessments being returned not assessed by my trainer/assessor.
• I understand that I must not receive undue assistance or the unauthorised help of others in the
preparation of my assessment work.
• I will not allow other students to access or copy in whole or any part of my assessment work.
• I understand that if I am dissatisfied with the way I have been assessed or with my result, I have the
right to appeal as detailed in the Student Handbook and Acknowledge Education’s policies and
procedures.

Student Declaration:
I hereby declare that I have read the above statement and that all the material I submit for assessment is
entirely my own and meets all of the college’s assessment requirements.

Student Signature
Date

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 2

 Assessment Task 3: Observation
Student Assessment Instructions
 Your assessor will explain the arrangements for this assessment, including when it will occur and how
the observation will be conducted.
 You must satisfactorily complete all sections of the assessment tasks.
 Ask your assessor to clarify any aspect you are unsure about in this assessment task.
 You may be asked to explain some parts of the demonstration if the assessor needs any clarification.
 You may need to work in groups.

Required Resources
 You will need to have access to relevant legislation, standards and codes, industry practices and
student book resources.
 You may need access to organisational documents and deliverables from previous tasks in the
assessment.

Evidence
 You must submit the completed assessment cover sheet and other evidence as outlined in the
observation instructions, by online submission within the allocated time.
 Ensure you keep a copy of your submitted work. Assessments submitted without completed cover
sheet will not be accepted.

When and where will this assessment take place?

 This assessment may be undertaken in a simulated environment/in a classroom/at home – to be
discussed with the assessor.
 Your assessor will provide you with the due date, which can be recorded in the assessment plan.
 Your assessor may also specify the length of time allowed and the expected word count, if applicable.

What if the assessment is not suitable?

 If you are unable to provide sufficient evidence within the observation assessment method, your
assessor may be able to provide you with an alternative method. Discuss this with your assessor.

What happens if your answers are not satisfactory?

 If any of the observation assessments are not satisfactory, your assessor will provide you with
feedback. You may need to resubmit some or all the assessment tasks. Your assessor will explain the
details for your reassessment.
 In most cases, you will be allowed a maximum of three attempts.
 If you are not satisfied with your assessment result, you have the right to lodge an appeal. Ask your
assessor or contact the Course Coordinator for more information.

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 3

 Observation Instructions
No. The student’s assessment shows evidence of the following:

1 Role plays
 The observation task will involve three different role plays. You will be provided with an
overview of the context for your specific role within a specific context/service within the
community services sector. You will have 20 minutes for each role play and will be assigned a
‘client’ (an assessor or another student) who will receive a Role Briefing document prior to the
assessment).

 Each of the three clients will present with different complex needs and contexts. The purpose
of the role play is to demonstrate your to:
 Assess and appropriately respond to the requirements of two people presenting with co-
existing needs
 Use analytical and critical thinking skills: to apply a strengths-based approach to
assessment; to analyse information about co-existing issues; and to make evidence-based
judgements about the person’s needs

 For EACH role play, you will need to adapt the communication and the support to meet the
particular complex needs of the individual. During each role play, you will be required to
demonstrate the following:
 Gather existing information about the person
 Organise practical aspects of assessment in consultation with the person being assessed
 Provide information about the assessment process to the person and obtain consent
 Work within scope of own role and seek assistance from colleagues and experts as required
 Empower the person to identify and prioritise their own needs
 Evaluate needs based on full range of relevant information
 Identify and analyse complex, multiple and interrelated issues
 Explain issues of urgency and eligibility
 Explain potential risk factors for service delivery
 Provide service delivery and referral options from a strengths-based perspective
 Determine best service fit for the person (based on internal and external options)
 Provide the person with service information and support their decision-making process
 Encourage the person to advocate on their own behalf to access services
 Complete an Assessment Summary Report (p. 5)

 After the roleplay session, you must request for each client to complete a Feedback form (p. 7)
evaluating the service. You must then review and integrate the feedback received, and
complete a Self-Reflection form for each roleplay (p. 8)

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 4

 Roleplay Scenarios

Roleplay #1
A-Mei Chang has been experiencing the early stages of dementia and lives at home. She wears
hearing aids due hearing impairment. A-Mei is of Chinese descent and has lived in Australia for 40
years. At home, A-Mei speaks English and she has declined interpreter services – she speaks, reads
and writes English fluently. A major service provider has conducted an assessment to determine A-
Mei’s current needs and priorities. A-Mei lives at home alone, with the assistance of daily carer
visits arranged to assist with showering. Her daughter lives close by and visits weekly. A
competency-based assessment and strengths-based questionnaire reveals that A-Mei can safely
continue to live at home, with the assistance of continued home visits from carers. However, an
interview with A-Mei reveals that she may be experiencing depression. A-Mei stated that since her
husband died six months ago, she has been feeling very down. She reported that she is sleeping for
long periods during the day, has lost interest in things that she usually enjoys and always seems to
feel sad. She described feeling as though she is walking around in a big, black cloud. A-Mei denies
suicidal thoughts or plans and says she has not attempted self-harm. She is willing to take part in
assessment and any recommended course of action that follows on

Roleplay #2
Alfred is 34 years old and has been experiencing homelessness and unemployment for the last 4
years. He has been alcohol and drug dependent during this period and has also reported episodes
of self-harming. He discloses that he has not self-harmed in the last year but still has thoughts of
harming himself from time to time. He has no contact with his family and has not seen them in the
last five years. He would like to reconnect with them but is unsure of how to go about it.

Roleplay #3
Julie is a 22-year-old woman who has been living in a community house with three other women for
some years. She has a mild intellectual disability and diabetes. She takes pride in being able to
maintain her housing but would like to consider getting a job to possibly live independently once
she has the means to do so. She says that she has completed Year 10 education.

Required Evidence
Submission of the following documents for each client:
 Completed Assessment Summary Report
 Completed Client Feedback Form
 Completed Self-Reflection Form

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 5

 Assessment Summary Form
Report prepared by: Date:

Client Name:
Gender: DOB:
Contact Number:
Address

Emergency Contact Person and Details

Health history

Home Environment

Physical Assessment

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 6

 Psychosocial Assessment

Identified Client Strengths & Resources

Recommendations and Service Options

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 7

 Other Information

Client Feedback Form

Name: Date:

Name of Service:

What would you like to tell us about the service?

What would you like to see happen? How do you think this service can be
improved?

Would you continue accessing this service? If not, please provide your
reason/s.

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 8

 Do you have any other information/feedback you would like to share?

Self-Reflection Form
Roleplay #:
Rate from 1-5
To what extent did I do the following? 1-I did not do this at all
5-I did this VERY well

1 Gather existing information about the person ☐1 ☐2 ☐3 ☐4 ☐5

What would I do differently next time? What feedback did you receive from the client, if applicable?

Organise practical aspects of assessment in consultation with

2 ☐1 ☐2 ☐3 ☐4 ☐5
the person being assessed
What would I do differently next time? What feedback did you receive from the client, if applicable?

Provide information about the assessment process to the

3 ☐1 ☐2 ☐3 ☐4 ☐5
person and obtain consent
What would I do differently next time? What feedback did you receive from the client, if applicable?

Work within scope of own role and seek assistance from

4 ☐1 ☐2 ☐3 ☐4 ☐5
colleagues and experts as required
What would I do differently next time? What feedback did you receive from the client, if
applicable?

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 9

 Empower the person to identify and prioritise their own
5 ☐1 ☐2 ☐3 ☐4 ☐5
needs
What would I do differently next time? What feedback did you receive from the client, if
applicable?

Evaluate needs based on full range of relevant information

6 ☐1 ☐2 ☐3 ☐4 ☐5

What would I do differently next time? What feedback did you receive from the client, if
applicable?

Identify and analyse complex, multiple and interrelated

7 issues ☐1 ☐2 ☐3 ☐4 ☐5

What would I do differently next time? What feedback did you receive from the client, if
applicable?

Explain issues of urgency and eligibility

8 ☐1 ☐2 ☐3 ☐4 ☐5

What would I do differently next time? What feedback did you receive from the client, if
applicable?

9 Explain potential risk factors for service delivery ☐1 ☐2 ☐3 ☐4 ☐5

What would I do differently next time? What feedback did you receive from the client, if
applicable?

Provide service delivery and referral options from a

10 ☐1 ☐2 ☐3 ☐4 ☐5
strengths-based perspective
What would I do differently next time? What feedback did you receive from the client, if
applicable?

Determine best service fit for the person (based on internal

11 and external options) ☐1 ☐2 ☐3 ☐4 ☐5

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 10

 What would I do differently next time? What feedback did you receive from the client, if
applicable?

Provide the person with service information and support

12 their decision-making process ☐1 ☐2 ☐3 ☐4 ☐5

What would I do differently next time? What feedback did you receive from the client, if
applicable?

Oral communication-use communication techniques

13 ☐1 ☐2 ☐3 ☐4 ☐5
appropriate to context and client
What would I do differently next time? What feedback did you receive from the client, if
applicable?

Problem-solving- adapt and respond to changes and adjust

14 ☐1 ☐2 ☐3 ☐4 ☐5
approach in response to new inputs.
What would I do differently next time? What feedback did you receive from the client, if
applicable?

Written question: Describe how you would maintain and store the person’s information according
to confidentiality requirements

Trainer Comments:

The student demonstrated the ability to: S NS

1 Seek feedback about assessment processes from the person and other networks ☐ ☐

Monitor processes and their outcomes in terms of success in meeting the

2 ☐ ☐
person’s needs

3 Routinely seek feedback and reflect on own ☐ ☐

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 11

4 Use feedback and own evaluation as a basis for improving ☐ ☐

Feedback

Assessor Name
Assessor Signature

Student Name
Student Signature

Observation Assessment Sheet

Observation Date:

Competency Question During the observation, the student demonstrated the S NS

No.
following:

1 Observation Record Sheet - Role Play

Has information about 1 Gather existing information about the person ☐ ☐
the person been

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 12

gathered?

Have the practical Organise practical aspects of assessment in consultation

aspects of the with the person being assessed
2 ☐ ☐
assessment been
organised?

Has the person been Provide information about the assessment process to the
advised of the person and obtain consent
3 ☐ ☐
assessment process and
consent obtained?

Has the student worked Work within scope of own role and seek assistance from
within the scope of the colleagues and experts as required
role and if necessary 4 ☐ ☐
sought advice from
colleagues or experts?
Has the person been Empower the person to identify and prioritise their own
empowered to be able 5 needs ☐ ☐
to prioritise their needs?

Have the needs been Evaluate needs based on full range of relevant information
6 ☐ ☐
evaluated?

Have complex issues Identify and analyse complex, multiple and interrelated
7 ☐ ☐
been identified? issues

Have issues of urgency Explain issues of urgency and eligibility

and eligibility been 8 ☐ ☐
explained?
Have the potential risks Explain potential risk factors for service delivery
9 ☐ ☐
been explained?
Has strength-based Provide service delivery and referral options from a
perspective been strengths-based perspective
10 ☐ ☐
considered for referral
and service delivery?
Have the best internal or Determine best service fit for the person (based on
external options been 11 internal and external options) ☐ ☐
considered?

Has the person been
supplied with service 12
information?
Has the person been
encouraged to act on 13
their own behalf?
Provide the person with service information and support
their decision-making process ☐ ☐
Encourage the person to advocate on their own behalf to
access services ☐ ☐

Has the student 14 Maintain and store the person’s information according to ☐ ☐

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 13

appropriately confidentiality requirements
documented the
person’s information and
explained to them how
this information will be
stored?
Did the student use Oral communication-use communication techniques
appropriated oral appropriate to context and client
15 ☐ ☐
communication
techniques?
Has the student Problem-solving- adapt and respond to changes and adjust
demonstrated problem- 16 approach in response to new inputs. ☐ ☐
solving?

Has self-reflection been Self-reflection - completed

17 ☐ ☐
completed?

Comments:

Additional questions: *

Student responses:

Feedback

S=Satisfactory NS=Not Satisfactory

*Record additional questions to address contingencies and further clarify student understanding

Assessor Name
Assessor Signature

Student Name
Student Signature

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 14

CHCCCS004 – Student Assessment – Task Three: Observation (V.1 – 192501) 15