Group 0 Simulation Assessment

CPC08 Construction, Plumbing and Services Training Package

Student ID: _______________________________

Student Name: _______________________________

This Workbook incorporates the following unit:

CPCCWHS2001 Apply WHS requirements, policies and procedures in the construction industry

Assessment Workbook CPCCWHS2001 Apply WHS requirements, policies and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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communicated to the public or adapted without permission. Page 1 of 19
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Assessment Workbook CPCCWHS2001 Apply OHS requirements, policies, and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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communicated to the public or adapted without permission. Page 2 of 19
 Content
Assessment Task – Simulation.....................................................................................................4
Simulation Checklist and Assessment Record................................................................................4
Simulation 1 – OHS inspection.....................................................................................................5
Simulation 2 – Simulated fire.......................................................................................................9
Simulation 3 – Emergency evacuation........................................................................................11
Simulation 1 Observation – OHS inspection.............................................................................12
Simulation 2 Observation – Simulated fire...............................................................................13
Simulation 3 Observation – Emergency evacuation..................................................................15
Simulation Assessment Record...................................................................................................16
Final Assessment Outcome Record.............................................................................................17
Agreement that competency has been achieved.........................................................................18

Assessment Workbook CPCCWHS2001 Apply OHS requirements, policies, and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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 Assessment Task – Simulation
Instructions
 Mandatory completion of all Simulation in conjunction with this Assessment task must be
conducted and deemed satisfactory to achieve competency in this task.
 All Simulation are tasks which will align to the duties performed in this capacity on site in the
workplace.
 Any machinery/equipment used during the process of the assessment tasks must be safe for
use and tagged if appropriate. All safety conditions performed under instruction by your Trainer
must be followed in line with your workplace policies and procedures; should the Trainer feel
the conditions of safety are not met for your assessment task, it may be re scheduled to a
different site or day until the safety issue is rectified. Your site supervisor may be contacted in
this event.
 If your Trainer feels the tasks has been not sufficiently covered, they may direct you to a similar
task, in line with a secondary Simulation which will be clearly advised at the time of assessment.
 Multiple assessment of the same tasks may be necessary to ensure a satisfactory standard.
 An observation checklist will be conducted during the completion of this task, your Trainer will
notify you on the tasks they will be observing for this assessment.

Refer to the Student Activity Workbook to help you answer the questions in this task.
In this task, there are a total of 3 Simulation. You must satisfactorily complete all 3 Simulation.

The Simulation within this section address the following unit: CPCCWHS2001 Apply WHS
requirements, policies and procedures in the construction industry

Simulation Checklist and Assessment Record

Instructions for the Trainer

1 Read the instructions for the Simulation to the Student

Prompt the Student to respond verbally during observation, should you need further clarity
2
for the observation. Record the Student’s verbal response in the comments boxes.

Observe all the task points in the observation tables:

 Simulation 1 Observation
3
 Simulation 2 Observation
 Simulation 3 Observation

In the comments boxes, list what the Student was observed conducting and provide an
4
example (i.e. “Student correctly disinfected the floor.”)

5 Collect all signatures

Simulation 1 – OHS inspection

Assessment Workbook CPCCWHS2001 Apply OHS requirements, policies, and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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 Objective of The purpose of this Simulation is to assess your ability to carry out OHS
the task requirements through safe work practices on the construction site.

Resources  Student Activity Workbook

include  PowerPoint Slides / Handouts
 Workplace/Simulated Workplace
 Take Pre-start safety checklist
 Lockout tags
 Machinery and equipment checklist
 Hazard report
 Simulation 1 Observation – OHS inspection

You will be Part 1: Pre-start safety check

required to Part 2: Tools and equipment
complete
Your task It is 6.45 am as you walk out of the toolbox meeting. This is your first day on the
new site.

Part 1: Pre-start safety check

You make your way to your work area and spend 5 minutes completing a pre-start
safety checklist on the work area.

Part 1: Complete the following:

 Take Pre-start safety checklist
 Simulation 1 Observation – OHS inspection

Part 2: Tools and equipment

You then move on to inspecting the work tools using the machinery and
equipment checklist. On the work bench you locate a drop saw with its guard
missing. You tag-out the drop saw and submit a hazard report to your supervisor.

Part 2: Complete the following:

 Machinery and equipment checklist
 Hazard report
 Simulation 1 Observation – OHS inspection

Simulation 1 Part 1: Take Pre-start safety checklist

Assessment Workbook CPCCWHS2001 Apply OHS requirements, policies, and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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communicated to the public or adapted without permission. Page 5 of 19
 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.

Company Name: ABC Construction

Date: 03-04-2023 Time: 8:00 AM

Specific Location: Building site B Supervisor/Team Leader: John Smith

John Smith (supervisor),

Mike
Install plumbing system in new
Task: Attendees: Johnson(Plumber)
building
, Tom
Lee(Assisstant)

Before starting work:

1 Have you received induction training? Yes No N/A

2 Do you know the company’s health & safety rules? Yes No N/A

3 Are you familiar with how to report hazards & incidents? Yes No N/A

4 Are there emergency facilities and an evacuation procedure/route for Yes No N/A
the site?

5 Do you have access to appropriate emergency and first aid equipment? Yes No N/A

6 Have you asked the person in charge about all relevant hazards? Yes No N/A

7 If the work involves a high-risk task (such as work at heights, hot-work, Yes No N/A
confined spaces), is a work permit/safe work method statement
required?

8 Do you have the correct procedures and equipment to do the work Yes No N/A
safely?

9 Is there appropriate separation of vehicles and people during the Yes No N/A
proposed work?

10 Is all required electrical/mechanical equipment in a safe condition? Yes No N/A

11 Are hazardous/dangerous substances used and stored according to Yes No N/A

their safety data sheets?

12 Have you consulted with workers about the task and the safe way to do Yes No N/A
it?

13 Do you have all necessary PPE? Yes No N/A

14 Have you got a safe way of getting in and out of your work area? Yes No N/A

15 Have any manual handling risks been identified and accessed? Yes No N/A

If you answer “no” to any of those above, you may need to follow up with the person in charge before you start work to
help ensure your safety.

At the end of work:

1 Have you left the worksite in an appropriate condition free from hazards Yes No N/A
and risks (clean-up, tools put way, housekeeping)?

Return this checklist along with your job task sheet to your manager/supervisor after work is complete or at the end of
your shift. Source: http://worksafe.tas.gov.au/__data/assets/pdf_file/0010/286939/Advisor_Safety_Management_Toolkit.pdf

Assessment Workbook CPCCWHS2001 Apply OHS requirements, policies, and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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 Simulation 1 Part 2.1: Machinery and Equipment Checklist

As part of your responsibility to ensure the safety of people in your workplace, you must make arrangements
for a safe and rapid evacuation in case of an emergency. This checklist will help you develop emergency
procedures. You should involve your workers in developing these procedures. If you share your workplace
or worksite with other businesses, you can use the checklist to co-ordinate your emergency response with
them.
If you mark any NO box on the checklist, you need to take action to make your workplace safer.
Date Checklist Completed:

Date Checklist to be Reviewed: (annually or when there is a change to the workplace):

Person who completed checklist:

Name: John Smith

Position / Title: Safety officer Company/Workplace: XYZ Construction

Safety devices
Are machine guards in place on all operating equipment? ☒ Yes  No

Are belts, pulleys and other rotating parts properly guarded? ☒ Yes  No

Are emergency stop buttons clearly marked and operational? ☒ Yes  No

Work areas

Is there sufficient clearance space around all plant? ☒ Yes  No

Are machinery and equipment areas kept clean and free from obstructions? ☒ Yes  No

Is the ventilation adequate? ☒ Yes  No

Are steps taken to reduce machinery noise (eg isolating the plant, mufflers, baffles)? ☒ Yes  No

Are tools and portable equipment stored safely? ☒ Yes  No

Safe operation

Are workers trained to operate machinery safely? ☒ Yes  No

Do they hold any necessary certificates or licences (eg forklift)? ☒ Yes  No

Is your higher hazardous plant registered (eg boilers, vehicles hoists)? ☒ Yes  No

Are workers supervised to ensure correct procedures are followed? ☒ Yes  No

Is machinery and equipment regularly inspected for damage or wear? ☒ Yes  No

Is machinery and equipment maintained according to the manufacturers’ ☒ Yes  No

instructions?
Personal protective equipment (PPE)
Do you provide adequate PPE (eg safety footwear, eye protection, hearing
protection) as required? ☒ Yes  No

Do you and your workers maintain PPE in accordance with the manufacturers’ ☒ Yes  No
instructions?
Assessment Workbook CPCCWHS2001 Apply OHS requirements, policies, and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
© ATAR Design. All rights reserved. No part of this work may be produced, published, Austral College of Technology V1
communicated to the public or adapted without permission. Page 7 of 19
 Source: http://worksafe.tas.gov.au/__data/assets/pdf_file/0010/286939/Advisor_Safety_Management_Toolkit.pdf

Simulation 1 Part 2.2: Hazard report

Use this form in your workplace to report health and safety hazards and incidents. To notify SafeWork NSW of
an incident, call 13 10 50.

Hazard/Incident

Brief description of hazard/incident: (Describe the task, equipment, tools, and people involved. Use sketches,
if necessary. Include any action taken to ensure the safety of those who may be affected.)

A worker fell from a ladder while installing roof tiles. The ladder was unstable and not secured, and
the worker did not use the appropriate fall protection equipment.

Where is the hazard located in the workplace?

The hazard occurred on the roof of the building under construction

When was the hazard identified? Date: 04/01 2023 / Time 10:30 am

Recommended action to fix hazard/incident: (List any suggestions you may have for reducing or eliminating
the problem – for example re-design mechanical devices, update procedures, improve training, maintenance
work)

Ensure that all workers are trained in the proper use of ladders and fall protection equipment, and
that ladders are secured and stable before use. Conduct regular safety inspections to identify and
address hazards before accidents occur.

Date submitted to manager: Date: 04 /04 /2023 Time 10:45 am

Action taken
Has the hazard/incident been acknowledged by management? Yes

Describe what has been done to resolve the hazard/incident:

The worker was immediately taken to the hospital for treatment. The site supervisor conducted a
safety briefing with all workers to remind them of the importance of ladder safety and the use of fall
protection equipment. A safety inspection was conducted to identify and address any other hazards.

Assessment Workbook CPCCWHS2001 Apply OHS requirements, policies, and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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communicated to the public or adapted without permission. Page 8 of 19
 Do you consider the hazard/incident fixed? No

Name: John Smith Position: Safety Officer

Signature:

Date:04/04/2023 / /

Simulation 2 – Simulated fire

Objective of The purpose of this Simulation is to assess your ability to select and use
the task firefighting equipment to extinguish a fire and report the incident.

Resources  Student Activity Workbook

include  PowerPoint Slides/Handouts
 Workplace/Simulated Workplace
 Fire fighting equipment
 Incident report
 Bollards and signage
 Simulation 2 Observation – Simulated fire
You will be Part 1: Extinguish the fire
required to Part 2: Isolate the area
complete
Your task It’s been a sweltering day on a domestic construction site. The trades have been
busy cutting timber and putting up the wall frames.

From the corner of your eye you notice smoke coming from the drop saw. You
rush over and realise the saw has caught fire. Thinking quickly, you disconnect
the power and grab the fire extinguisher.

Part 1: Extinguish the fire

Your Trainer will set up the scenario in the simulated workplace. Using a correct
Class of fire extinguisher, you will extinguish the fire.

Follow the correct steps for using a fire extinguisher:

 Pull the pin
 Aim the extinguisher at the base of the flames
 Squeeze the trigger while holding the extinguisher upright
 Sweep the extinguisher or nozzle from side to side covering the base of the
fire
 Observe the fire after initial extinguishment as it may reignite

Part 1: Complete the following:

 Simulation 2 Observation – Simulated fire

Part 2: Isolate the area

Assessment Workbook CPCCWHS2001 Apply OHS requirements, policies, and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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 Isolate the hazard and secure the area with signage and bollards. Then report
the incident to your supervisor and complete an incident report. Luckily no one
was injured as a result of the incident.

Part 2: Complete the following:

 Incident report
 Simulation 2 Observation – Simulated fire

Simulation 2 Part 2: Incident report

Incident Report Form

Incident reference number:

___________________________________________________________________________________

The incident resulted in: Injury to an individual Damage to property/environment A near miss

Personal details (of injured):

Surname: _______ First name: ________ Initial _____

Address: ____________________________

______________________________ Postcode:
_____

Male Female Date of birth: DD / MM / YY

A: Staff member: Volunteer:

Contractor: General Public:

Department:
____________________________________________________________________________________
Position:
_____________________________
Supervisor:
___________________________________
______________________________ _______________________

Incident details:
Date incident occurred:
___________________________________

Time incident occurred: _____________________________

Where did the incident occur? (Please specify)

___________________________________

_____________________________
Assessment Workbook CPCCWHS2001 Apply OHS requirements, policies, and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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communicated to the public or adapted without permission. Page 10 of 19
 ___________________________________

___________________________________
____________________________________________________________________________________

What was the nature of, and injury resulting from, this incident?
(Please explain in your own words what had happened)

___________________________________

_____________________________

___________________________________

___________________________________
____________________________________________________________________________________

Was first aid or further treatment required? Yes No

Were there any witnesses? Yes No

Name of witness/es:
_____________________________
Address: ___________________________________
_____________________________________________________________ Postcode: ______________
Position: _________ Contact details: _______________________

Signature of person completing report: ___________________________________

Name of person completing report: _______________________________________________________

Date: DD / MM / YY

A copy of this report is be forwarded to your supervisor immediately.

Supervisor’s comments: _____________________________

___________

___________

_____

_____

_____

Does this incident require further investigation? Yes No

(If yes, refer to nurse unit manager)

Does the severity of this incident require notification to Work Safe Victoria? Yes No

Assessment Workbook CPCCWHS2001 Apply OHS requirements, policies, and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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communicated to the public or adapted without permission. Page 11 of 19
 Supervisor’s signature: Date: DD / MM / YY

NB: A copy of this report is to be provided to the:

 WHS Representative (or other injured party)

 Contractor
 Site supervisor/ Manager
 OH&S Coordinator / Human Resource Department

Simulation 3 – Emergency evacuation

Objective of The purpose of this Simulation is to assess your ability to evacuate a site through
the task simulated response to an emergency, complying with workplace procedures.

Resources  Student Activity Workbook

include  PowerPoint Slides/Handouts
 Workplace/Simulated Workplace
 Worksite evacuation procedure
 Simulation 3 Observation – Emergency evacuation
You will be Part 1: Evacuate the site
required to
complete
Your task You finish the lunch break and jump back on the work tools, when the emergency
alarm sounds.

It’s a large construction site so you’re not sure what the emergency is, although
you can smell something that’s out of the ordinary.

Part 1: Evacuate the site

Follow the site safety procedures and evacuate the site to the assembly area.
 On hearing an evacuation alarm immediately cease all activity
 Assist any person in immediate danger, but only if safe to do so
 If practical, and only if safe to do so, secure any activity or process that may
become hazardous or suffer damage if left unattended as a consequence of
evacuation
 Act in accordance with directions given by emergency control personnel and
evacuate the site immediately.
 Move calmly to the nominated evacuation assembly area and do not leave the
evacuation assembly area until the all clear has been given

Part 1 Complete the following:

 Simulation 3 Observation – Emergency evacuation

Assessment Workbook CPCCWHS2001 Apply OHS requirements, policies, and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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 Simulation 1 Observation – OHS inspection

Tasks satisfactorily
I have directly observed the Student demonstrate their Date of
observed? Comments to support decision(s)
ability to: Observation
(Yes/ No)
The Student wore steel cap boots, safety
 e.g. Select PPE appropriate to the work task Yes 12/07/17
glasses and a dust mask.
Conduct a site inspection: ____/____/____
 Safety devices
 Work areas ____/____/____
 Safe operation
 PPE ____/____/____

 Tag-out the faulty power saw ____/____/____

____/____/____

____/____/____
Complete the following: ____/____/____
 Take 5 Pre-start safety checklist
 Machinery and equipment checklist ____/____/____
 Hazard report
____/____/____

Trainer Signature: Student Signature:

Assessment Workbook CPCCWHS2001 Apply WHS requirements, policies and procedures in the CPC08 Construction, Plumbing and Services Training Package
construction industry
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 Simulation 2 Observation – Simulated fire

Tasks satisfactorily
I have directly observed the Student demonstrate their Date of
observed? Comments to support decision(s)
ability to: Observation
(Yes/ No)
The Student wore steel cap boots, safety
 e.g. Select PPE appropriate to the work task Yes 12/07/17
glasses and a dust mask.
 Select the correct Class of fire extinguisher
____/____/____

____/____/____

____/____/____

Follow the correct steps for using a fire extinguisher:

 Pull the pin ____/____/____
 Aim the extinguisher at the base of the flames
 Squeeze the trigger while holding the extinguisher
____/____/____
upright
 Sweep the extinguisher or nozzle from side to side
covering the base of the fire
 Observe the fire after initial extinguishment as it may ____/____/____
reignite

 Appropriately isolate the area with signage and

bollards
____/____/____

Assessment Workbook CPCCWHS2001 Apply WHS requirements, policies and procedures in the CPC08 Construction, Plumbing and Services Training Package
construction industry
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 Tasks satisfactorily
I have directly observed the Student demonstrate their Date of
observed? Comments to support decision(s)
ability to: Observation
(Yes/ No)

____/____/____

____/____/____

 Complete an incident report

____/____/____

____/____/____

____/____/____

Trainer Signature: Student Signature:

Assessment Workbook CPCCWHS2001 Apply WHS requirements, policies and procedures in the CPC08 Construction, Plumbing and Services Training Package
construction industry
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communicated to the public or adapted without permission. Page 15 of 19
 Simulation 3 Observation – Emergency evacuation

Tasks satisfactorily
I have directly observed the Student demonstrate their Date of
observed? Comments to support decision(s)
ability to: Observation
(Yes/ No)
The Student wore steel cap boots, safety
 e.g. Select PPE appropriate to the work task Yes 12/07/17
glasses and a dust mask.
Comply with the site emergency evacuation procedure:
 On hearing an evacuation alarm immediately cease
all activity ____/____/____
 Assist any person in immediate danger, but only if
safe to do so
 If practical, and only if safe to do so, secure any
activity or process that may become hazardous or
suffer damage if left unattended as a consequence of ____/____/____
evacuation
 Act in accordance with directions given by
emergency control personnel and evacuate the site
immediately.
 Move calmly to the nominated evacuation assembly
____/____/____
area and do not leave the evacuation assembly area
until the all clear has been given

Trainer Signature: Student Signature:

Assessment Workbook CPCCWHS2001 Apply WHS requirements, policies and procedures in the CPC08 Construction, Plumbing and Services Training Package
construction industry
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 Simulation Assessment Record
Instructions for the Student
By signing the below, I hereby certify that the activities are my own work, based on my personal
study and/or research. I have acknowledged that all materials and resources used have not been
copied in part or whole, or otherwise plagiarised the work of other learning and/or other person.

Student Name:

Student Signature: Date: ____/____/____

Instructions for the Trainer

The Trainer is required to complete this Assessment Task Record Sheet once the Student has
completed and submitted all requirements for the Simulation for this unit of competency, the
Student's work has been reviewed by the Trainer, and relevant feedback has been provided.

Based on the evidence gathered during the training and assessment process we, the undersigned,
agree the assessment was valid, reliable, flexible and fair.

Assessment Activity Satisfactory Date More Evidence Date

Simulation 1 ☐ ☐
Simulation 2 ☐ ☐
Simulation 3 ☐ ☐
Context detail (Assessor to record)

Attempt 1 ____/____/____ Attempt 2 ____/____/____ Attempt 3 ____/____/____

Appeals: If you receive a Not Satisfactory assessment result you have the right to appeal. You
have three assessment attempts.
Assessor feedback to Student:

Assessor Signature: Date: ____/____/____

Group 0 Final Assessment Outcome Record

Assessment Workbook CPCCWHS2001 Apply WHS requirements, policies and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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 The following form must be used to record the assessment outcome after a Student has completed
all assessment tasks relating to the unit of competency. The outcome of each individual assessment
task is to be reported and the overall assessment decision is to be recorded as either Competent or
Not Yet Competent.

All parties (Trainer and Student) must sign in the space provided on the next page as agreement
the specified assessment outcome for this unit of competency has been achieved.

To achieve competency the Student must have satisfactorily completed the following assessment
tasks related to this unit of competency:

Assessment Outcome
S – Satisfactory NS – Not Satisfactory
Assessment Task CPCCWHS2001
Theory  S  NS

Simulation  S  NS

Project  S  NS

Attempt 1 ____/____/____ Attempt 2 ____/____/____ Attempt 3 ____/____/____

Assessor Signature: Date: ____/____/____

Workplace Assessment Task CPCCWHS2001
Workplace Logbook  S  NS

Third Party Report  S  NS

Workplace Observation Report  S  NS

Attempt 1 ____/____/____ Attempt 2 ____/____/____ Attempt 3 ____/____/____

Assessor Signature: Date: ____/____/____

The assessment outcome for this unit of competency is:
 COMPETENT  NOT YET COMPETENT
Assessor comments:

Agreement that competency has been achieved

Based on the evidence gathered during the training and assessment process we, the undersigned,
agree the assessment was valid, reliable, flexible and fair.

Assessment Workbook CPCCWHS2001 Apply WHS requirements, policies and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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 We confirm competence in the following unit: CPCCWHS2001 Apply WHS requirements, policies and
procedures in the construction industry

Trainer/Assessor Name:

Signature: Date: ____/____/____

Trainee/Student Name:

Signature: Date: ____/____/____

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.

☐ Oral Assessment ☐ Written Assessment

Comments:

Assessment Workbook CPCCWHS2001 Apply WHS requirements, policies and procedures in the CPC08 Construction, Plumbing and
construction industry Services Training Package
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