Excursion Planning Form A:

Derby DHS Proposal for Local Area Excursion

➢ The authorised excursion leader completes the following information for the proposed excursion.
➢ The principal thoroughly checks each aspect of the proposal form before signing.
➢ You must gain Principal approval and sign off before sending out permission slips.

School: Derby District High School

Excursion to: Windjana Gorge

Class/Year groups: Year 11/12 General Outdoor Education & AIS

Tuesday 24th of May 2022 No. of Approx. 20
students
Departure date and time: 7:30am attending

Tuesday 24th of May 2022 Is any activity

2:30pm in the Yes/No
Return date and time: excursion
water-based? Yes - Complete Appendix 3

Excursion leader: Hayden Harris

Documents attached: Names, addresses (home and away) and contact details
of students, supervisors and emergency contact
Up-to-date student health care plans and information

Parent/Carer/Guardian consent forms

Detailed itinerary and accommodation details

Copy of insurance certificate(s)

- Shire Derby West Kimberley page 21.
Additional documents (please list)

DERBY DHS EXPECTATIONS ☐

 Term planner has been checked and there are no clashes.
Arrangements for relief: (Spelling Mastery, PRIME, DOTT teachers notified - Yes) NA
 Arrangements for duty cover: Duty - NA Replaced by: NA
Arrangements have been made for students not participating, and communicated to staff.
☐ • Students not attending will be placed in ____________ Teacher notified – Y / N
• Program of work for students not attending will be provided to alternate class teacher – Y / N
☐ Students are in Good Standing and eligible to attend.
APPROVALS
All approvals as required, and from principals of any other schools attended by participating students,
have been obtained. (Forms attached)
☐
Details:

Line Manager _________________ Principal _________________

Date ______________ Date ______________

☐ Excursion Planning Form A / B completed and submitted to SLT.

☐ Approval for excursion signed, returned, and approved.

1
 EDUCATIONAL PURPOSE OF EXCURSION
The proposed excursion has a clear educational purpose in the context of the syllabuses of the K-10
Western Australian Curriculum and/or senior secondary WACE courses / programs.
☐
Details:
Outdoor Education:
To assess students’ practical and performance skills for outdoor adventure activities when bushwalking in an
outdoor setting. These excursions are linked to assessment Task 3 (7.5%) and Task 5 (5%) of the Year 11 and
12 General Outdoor Education courses. This excursion is linked to Outcomes 1,2,3 & 4 of the Year 11 and 12
General Outdoor Education courses.

AIS:
Year 11 - Students will be studying the ways Indigenous People have and continue to express their connection
to Country. They are also studying how this connection has been used by the tourism industry.
Assessment 5: Test 10%
Year 12 - Students have been studying traditional and contemporary land management strategies, as well as
the way land use has changed. They will also investigate how land has been used for Tourism and the
contribution of this to the WA Tourism Industry.

EDUCATIONAL BENEFIT OF EXCURSION

The excursion will significantly enhance student outcomes and achievement in a manner that cannot
be done in the classroom/school environment.
☐
Details:
Student will gain experience and an understanding of the relevant bushwalking skills in a realistic setting to
better themselves and to work towards assessment tasks. Student will also develop reflective skills when
completing a journal of the day’s events.

VENUE/SITE FOR THE EXCURSION

Outline how the venue or site for the excursion is suitable for the student group. Attach Emergency
Evacuation Plan for venue and include map of location, details of directions to destination and GPS ☐
coordinates if applicable.
Details:
Map of location attached page: 11
Emergency evacuation plan attached page: 12
Details of directions attached page: 13-14

Venue Name: Windjana Gorge

Address: Fairfield-Leopold Downs Rd, Wunaamin Miliwundi Ranges WA 6728 (17°24'43.3"S 124°56'31.9"E)
Windjana Gorge Campground contact: 91955500
RISK ASSESSMENT (Appendix 1)
The risk management plan covers proposed alternative arrangements in circumstances where part of
the excursion or any activities scheduled for the excursion are unable to proceed.
☐
Details:

Risk management plan attached pages: 7-9

The risk assessment considers and documents:

❑ the number of students, their age range, and the students’ experience, capacity and behaviour;
❑ the excursion venue/site and any potential hazards and risks associated with the proposed activities at that
venue;
❑ the method of transport to the excursion venue and all activities;
❑ issues that might arise due to the length of time of the excursion and/or possible weather events;
❑ additional risks and supervisory requirements associated outdoor education and recreation activities and
strategies for student safety in accordance with Outdoor Education and Recreation Activities for Public Schools
Policy (2019);
❑ additional risks and supervisory requirements associated with land-based recreational activities;
❑ any medical or behavioural conditions that need to be managed; and
❑ any special clothing or required items that should be taken on the excursion by students and supervisors.

2
 STUDENTS’ CAPACITY
Participating students have the capacity to undertake the excursion as evidenced by the student health
care plans and information and as attested to by the principal of any other participating school.
☐
Details:
All students have been taught the basics of bushwalking and will have the capacity to walk the distance. Students that have
low fitness levels will walk a shorter distance with an allocated teacher. All students that attend will all have good behaviour
records. All assessments and work must be up to date to attend this excursion.
Students Attending
Year Sex Name Consent Year Sex Name Consent
11 M Lincoln Albert 12 M Cornelius Lennard
11 M Ernie (Busta) Clancy 12 F Tayana Nandoo
11 M William Donnelly 12 M Jalen Sampi
11 M Vainepoto Ejai 12 F Nikoda Thomas
11 F Bella Fernandez 12 M Clay Merriman
11 M Lennox Gordon 12 F Summer Armstrong
11 F Jorja Hammond 12 M Liam Gordon
11 F D’Shinay Hudson 12 M Jerold Johnstone
11 M Harry Hunter 12 M Keil-Jamarl Taylor
11 M Vinne Lacanare 12 M Tyzeal Williams-Wilson
11 M Jack Macale
11 M Joash McMahon
11 F Makayla Prouse
11 M Aaron Shadforth
11 M Frederick Shovellor
11 F Chelsea Van Vugt
11 M Tristan Weaver
11 M Zimmarley Williams-Wilson
11 M Marcellus Clinch
11 M Rumbah Delvin
11 M Jack McAlister Gugeri
11 F Kassandra Dolby
11 F Phillipa Nulgit
11 M Noel Peters
11 F Elayna Sampi
11 F Tia Shaw
11 F Geneva Skeen
Students Requiring Medications during the Excursion
Please itemise all medication requirements during the camp / excursion in the table below
Student Medication Name & Dosage Time Taken Staff Responsible
NA
Supervision / Plans for Individuals and Small Groups Requiring Extra Support
Student/s Staff Supervising Plan/Strategies (Once Approved)
Jalen Sampi Hayden Harris Behaviour: Constant supervision by all staff. Clear expectation
Marcellus Clinch provided before excursion.
Jack Macale
Keil-Jamarl Taylor
Mikayla Prouse Shooting Stars & Female staff to provide extra assistance to Makayla.
Hayden Harris
Bella Fernandez Shooting Stars & Will constantly monitor her anxiety levels and if she is feeling
Hayden Harris anxious, I will check in and not push her too far.
Students Highlighted Allocated staff Unknown or low fitness levels – Allocated teacher or staff to
Above member & Hayden walk with or wait at the back of the hiking group.

3
 Student Allergies / Health Conditions / Dietary Requirements
Please outline any conditions applicable
Student Details of condition Action Plan
Jalen Sampi Asthma When experiencing symptoms like wheezing, coughing or
Lennox Gordon shortness of breath:
D’Shinay Hudson •Use Ventolin – 6 puffs via spacer
Joash McMahon
Summer Armstrong Asthma emergency (severe breathing problems, symptoms
get worse very quickly, reliever has little or no effect):
•Call an ambulance immediately
•Say that this is an asthma emergency
•Keep taking reliever as often as needed
Tayana Nandoo Allergy (other) Allergic to penicillin (lumps appear). No action plan outlined
Kassandra Dolby on SIS. Avoid penicillin.
William Donnelly Allergy - Prawns Provide antihistamine. Avoid prawns. Squid or mullet will used as
bait.
Students Not Attending:
The student that arrives at school but are not attending the excursion will be required to complete any of the assessment
tasks they have not finished. If these are all finished, they will complete questions out of the workbook (chapter 1 and 2).

SUPERVISORY TEAM
An appropriately qualified supervisor, a suitable supervisory team, supervision strategies and a
system for identifying excursion participants, have been established.
Supervision strategies have been established with the supervisory team.
☐
Systems for identifying excursion participants have been established.
Details:
Students will all be required to wear school uniform to allow for easy identification.
Students will each have a number and be required to do frequent number offs as a way of checking everyone
is present.
Student will be allocated to groups of maximum 5 and one of the supervising staff will be responsible for
working with this group. Female staff member will be with Makayla’s group. Female students will be in this
group.

Excursion Leader: Hayden Harris – 0478980590

Responsible for the planning and supervision of all curriculum tasks while on excursion. Will do the roll prior,
during and after the excursion. Responsible for the number off. Carries a list of names of participating
students, contact details and up to date medical information (at the end of this package). Appropriate first aid
bag carried. In-charge of staff and student briefing prior to excursion and during excursion.

Female Support: Kaitlyn Tovey - 0479 057 257 & Johanna Kitching – 0437 317 237
Will assist with supervision of other female students. Kaitlyn to teach and provide learnings to her class.
Johanna to driving females in SS vehicle.

Male Support: Gerrick Weedon 0456 573 356

Will assist with supervision of all students. Gerrick can assist culturally and use his local experience to assist
when out on excursion. Required to drive a vehicle to transport students. To drive Clontarf vehicle (12 seats)
and provide extra supervision to the boy’s groups.

COMMUNICATION STRATGEY
An appropriate communication strategy has been established and communicated to all those attending
the excursion.
☐
Details:
Signal for gaining attention: Whistle (2 blows and hand up) followed by a number off.
Emergency signal: Whistle (3 short blows)
Main communication method: Mobile Phone
Alternative communication method: SAT Phone

4
 BRIEFING STUDENTS AND SUPERVISORS
All relevant information about respective responsibilities and obligations has been communicated to
students and supervisors. The excursion leader has confirmed, in writing, during the consent seeking
process, that parents/carers/guardians are fully aware of all supervisory arrangements throughout the
☐
excursion.
Details:
Staff roles:
Staff responsibilities stated in supervisoy team section above.
Staff & Student Briefing / Meeting
Please give details of the planned briefing / meeting held at least 1 week prior to the camp or excursion below
Staff Briefing Date: 23/05/2022 Student Briefing Date: 23rd May 2022
Staff Briefing Time: 2:15pm Student Briefing Time: 8:00am
Staff Briefing Location: Staff room Student Briefing Location: TC1
Additional Information: CrocWise Talks, Safety Briefing, Local Area Discussion, Behaviour Expectations

TRANSPORT ARRANGEMENTS
Arrangements have been made for the safe transport of excursion participants. ☐
All travel arrangements have been made in adherence to the Official Travel Policy.
Details:
Hayden Harris to drive School Pajero (6 seats)
Johanna Kitching to drive Shooting Stars Vehicle (4 seats)
Gerrick Weedon to drive Clontarf Vehicle (12 seats).
EMERGENCY RESPONSE PLANNING (Appendix 4)
An emergency response plan (including full contact details for supervising staff) has been developed, provided to
and retained by the principal of the school.
☐
Details:
Attached is the emergency response plan (page: 12-14)
There are clear procedures to be followed in the event a student’s participation in the excursion is
☐ terminated.
WORKING WITH CHILDREN CHECK
There is a valid WWCC for each supervisor/adult travelling on the excursion, where required. ☐
DETAILED COST OF EXCURSION
The excursion has been properly costed, with details of staff costs including expenses and
teacher relief.
The excursion has been properly costed.
Parents/carers/guardians have been informed of all fundraising provisions.
☐
Parents/carers/guardians have been informed that any fundraising monies will remain with the school in case of
cancellation.
Pricing Worksheet Instructions to Pricing Worksheet

Anticipated cost of staff participation

Expenses: __________________________

Teacher relief: _______________________

WAIVERS
No waivers have been or will be signed, that absolve venues/external providers from liability for negligent acts or
omissions.
☐
EXTERNAL PROVIDERS
Where external providers are engaged, they have proper and current insurance cover and staff responsibilities
have been established. ☐
All documents have been sighted and certificates attached.
Details:

☐ All documents have been retained and appropriately stored.

5
Information to parents/carers/guardians for their consent to participate (Appendix 2)
Parents/carers/guardians have been provided with full details of the excursion and have provided
☐ signed, and informed consent to participate, including movie and photo permissions.
Students who are over 18 years of age have been provided with full details of the excursion and have
☐ signed an Excursions Participation Agreement, (if applicable).
I confirm that all sections of the Proposal for Local Area Excursions with Overnight Stay Including Camps have been
completed in accordance with the Excursions in Public School Procedures and Local Area Excursions with Overnight
Stay Including Camps Planning and Risk mitigation document.

Authorised Excursion Leader _______________________ Date ______________

Principal _______________________________ Date ______________

6
Appendix 1
Risk Management Plan
Excursion Title: Bushwalk Windjana Gorge

Name of school: Derby District High School Name of excursion coordinator: Hayden Harris - 0478980590
Name of principal: Eliot Money Accompanying staff, parents, caregivers, volunteers:
Description and location of excursion: Bushwalking – Windjana Gorge Kaitlyn Tovey - 0479 057 257
Date of excursion: 24th May 2022 Johanna Kitching – 0437 317 237
Group/class: Year 11/12 AIS & Outdoor Education
Gerrick Weedon 0456 573 356
Number in group/class: Approx. 20

Identified Assess
Task/Activity Hazards/Risks Risk Elimination or Control Measures Who When

Travel to and from Vehicle Accident L (3) • Utilise Qualified drivers to provide transport. Hayden, Travel
Cuttings from • Staff have driven the track several times in the past. Gerrick,
school Johanna
Vehicle Break Down L (3) • Regularly serviced. Hayden, Travel
• Spare wheel. Gerrick,
• Call school if a serious break down. Johanna
• Keep students in a safe area.
Vehicle becomes L (3) • Stay on designated tracks. Hayden, Travel
bogged Gerrick,
Johanna
Pre-existing medical M (6) • Permission form to include section on existing conditions, whether Hayden At all
conditions and student has had any medication in the last 2 weeks/is on any times.
allergies. currently/allergies/food requirements.
• SIS medical forms printed out and will be taken on excursion for
reference.
Become lost / M (6) • Brief students prior to excursion on schedule, meeting points and Hayden & At all
separated from staff. what is required from them. Support times.
• Explicitly state rules. Staff
• Regular head counts. 1 staff member per 3 students.

7
Appendix 1
Environmental – Sun, M (8) • All students to wear sunscreen, hats and encouraged to bring long Hayden At all
wind etc sleeved shirt. times.
• Provide and make sure students drink plenty of water to avoid
dehydration.
Members of public. L (2) • Will stay well away from members of the public when possible. Hayden At all
times.
Thunder / Lightning L (3) • Monitor weather and check forecast prior to excursion. Hayden Prior to
• If this occurs during excursion, will pack up immediately and go and
back to school. during
excursion
Rain L (3) • Monitor weather and check forecast prior to excursion. Hayden Prior to
• If this occurs during excursion, will pack up immediately and go and
back to school. during
excursion
Bushwalking at Croc Attack L (3) • Students and staff to stay a minimum of 5 metres from the water’s All staff Bushwalk
Windjana edge.
• Do not annoy or aggravate freshies.
Drowning L (3) • Students and staff to stay a minimum of 5 metres from the water’s Hayden Bushwalk
edge.
• No swimming permitted.
Snake bite M (6) 1. Follow DRSABCD Hayden Bushwalk
2. Lay the casualty down and provide reassurance
3. Apply a pressure immobilisation bandage:
Wrap a broad pressure bandage around the bite as soon as possible
Apply a firm heavy elasticised roller bandage just above the fingers or
toes and work your way upwards on the limb. Wrap the bandage
past the snakebite and as far up the limb as possible
Ensure the bandage is applied firmly without hindering blood circulation
4. Splint the bandaged limb
5. Ensure the patient remains still
6. Call triple zero (000) for medical assistance
7. Record the time the bite occurred and when the bandage was
applied
8. Wait with the casualty, monitor, and record any changes in their
condition.

8
Appendix 1
Minor Injury M (6) • Rules and expectations explicitly explained prior to excursion. Hayden At all
- Rolled ankle • Any messing about students to sit out. times
- Sunburn • First aid if required.
- Heatstroke • Report incident.
• Advise parents and admin.
Serious injury. L (3) • Rules and expectations explicitly explained prior to excursion. Hayden At all
• Any messing about students to sit out. times
• Call 000 or Derby Hospital (Loch St - 9193 3333).
• Keep student calm.
• Apply first aid, inform parents and Eliot.
Student Participation is Terminated

Behaviour / Under the L (3) • Monitor students prior to leaving for excursion. All staff Duration
influence of drug or If you become aware of anything whilst on excursion do the following: of
alcohol / unsafe / - Call Mohamed 0409130976 or Eliot 0427429334. excursion
mental health risk - Keep student in a safe place away from the water (utilise Jason).
- Contact parents.
- Contact police or ambulance if necessary.
- Monitor students until admin arrive.
Contact phone numbers:
Derby Police Station 9115 2500 Derby DHS 08 9193 3000
Derby Hospital 9193 3333 Principal – Eliot Money 0427429334
Emergency Responders 000 Line Manager – Mohamed Youssef 0409130976
Poison info 13 11 26 Line Manager – Fiona Hunter 0431 975 569

Plan prepared by: Hayden Harris Position: Teacher in Charge Date: 13/5/2022
Prepared in consultation with: Mohamed Youssef, Kaitlyn Tovey
Communicated to: Mohamed Youssef and Eliot Money
Monitor and Review – Monitor the effectiveness of controls and change if necessary. Review the risk assessment if an incident or significant change occurs.
Contact Principal and advise of changes as necessary.

9
Appendix 1
Risk Assessment Matrix

10
Appendix 1
Map of location: Windjana Gorge

Hiking Route:

Lunch and
Vehicle parking

11
Appendix 1
Emergency Response Plan – Windjana Gorge

Evacuation Assembly Points:

Evacuate to the car, count

student numbers, and leave if
safe. If not safe, move to an
open sand flat near the water,
identified in the map.

2.

3.

Evacuation
Assembly
Points

1.

12
Appendix 1
Route to Windjana Gorge: 147km, 2 hours – Via Gibb River Road

13
Appendix 1
Route to Hospital and Police Station from Derby HWY:

14
 Appendix 2
Derby DHS Excursion Advice

Dear Parent/Carer/Guardian,
I am pleased to provide you with the following details regarding our excursion.

Excursion to: Windjana Gorge

Class/Year groups attending: Year 11/12 General Outdoor Education & AIS
th
Departure venue, date and time: DDHS, Tuesday 24 May 2022, 7:30am
Return venue, date and time: DDHS, Tuesday 24th May 2022, 2:30pm

Excursion leader: Hayden Harris

School Pajero
Travel details:
Clontarf and Shooting Stars Vehicles
Excursion cost: NA

Supervisory team: Hayden Harris (Teacher in Charge)

(Include details of staff member Kaitlyn Tovey
with first aid responsibility)
Johanna Kitching
Gerrick Weedon

Contact arrangements during School Number: 9193 3000

excursion:
Educational purpose of excursion
This excursion has been planned to supplement the following work being completed in your child’s
classroom and/or is part of their education program.
Details:
This excursion is linked to assessment Task 3 (7.5%) and Task 5 (5%) of the Year 11 and 12 General Outdoor
Education courses, as well as 10% towards the AIS test.
Activities
Your child will be participating in the following activities.
Details:
- Bushwalking through Windjana gorge.
- Journal writing
- Learning ways Indigenous People have and continue to express their connection to Country. They are also
studying how this connection has been used by the tourism industry.
Special clothing or other items required
Details:
- School uniform (sport shorts preferred).

- Wide brim hat.

- Sunglasses.

- Minimum 2 litres of water

- Lunch / snacks

Excursion Leader signature:

Principal signature:

15
Appendix 2
Itinerary – Bushwalking Windjana Gorge

7:00am – Arrive at Phys Ed office, assist in preparation for the day.

7:30am – Depart school on route to Windjana Gorge.

9:30am – Arrive at the gorge. Have recess.

9:30am - 12:00pm – Hike through Windjana Gorge

12:00pm – Eat lunch at the entrance of the gorge.

12:15pm – Depart Windjana on route to school.

2:30pm – Arrive at DDHS. Help pack up / clean vehicles.

2:45pm – Home time

16
 Appendix 2

Derby DHS Excursion Consent

Please complete, sign and return the section below to the school by (20/05/2022).
Child’s name:
Class / Year: Year 11/12 General Outdoor Education & AIS
Excursion to: Windjana Gorge
Student health considerations

If your child’s medical condition has changed or your child has special needs, please provide full details
and include any relevant medical details on the attached Student Health Care Summary.

Special considerations
If the proposed excursion poses additional health risks in addition to those identified in the Student Health Care
Summary, please outline additional health risks below:
e.g. if your child suffers from anaphylaxis there may be risks associated with the provision of meals and
storage of an adrenaline auto injector at the appropriate temperature.
Details:

Parent/carer/guardian consent
I give permission for my child to receive medical treatment in case of emergency.

I am aware that the school and its employees are not responsible for personal injuries or property damage
that may occur on an excursion, unless the school or its employees are proven to be negligent.

Emergency Contact

Name Name

Mobile Mobile

Relationship Relationship

I consent to (Your child’s name)

participating in an excursion to Windjana Gorge

on (Date) Tuesday 24th May 2022

Signed

Date

17
Appendix 2
STUDENT HEALTH FORM

Student’s name: _____________________ Medicare Number: ____________________/____

Medical details
Is your child subject to asthma, allergies, seizures, fainting, epilepsy, diabetes or any other condition that may affect his or her
safety during the camp and aquatic activities? (Staff cannot take responsibility for medical conditions of which they are unaware.)
Yes No
If “yes”, give details:

Medication
Parents/Guardians are requested to make arrangements with the teacher-in-charge for the safekeeping and handling of prescribed
medications prior to the excursion.
Is your child presently taking tablets and/or other forms of prescribed medication?
Yes No

Does your child self-administer the medication?

Yes No

If “yes”, state name of medication, dosage and frequency of use:

Does your child have a current Health Care Authorisation Plan at school?
Yes No

Other information
Does your child have any other trait that may affect his or her general health? E.g. bed wetting, sleep walking, phobias.
Yes No
If “yes”, give details.

Does your child have any food or other allergies?

Yes No
If “yes”, give details.

Swimming Ability
Weak OK Strong I am unsure. Please assess my child.

Please provide any other information about your child which will enable the organisers of the excursion to provide better care for
your child.
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
18
Appendix 4
Derby DHS Emergency Response Plan

In the case of an emergency staff will:

1. Call the relevant Emergency Provider;

2. Administer appropriate first aid, where possible;
3. Contact the relevant Deputy;
4. Notify Parents/Caregivers and update as information changes;
5. Have an appropriate staff member remain with the student (if applicable); and

6. Ensure remaining staff stay with rest of group and return to school (if applicable).

Telephone numbers and addresses of nearest facilities:

Derby Police Station 9115 2500 Address 123 Loch Street, Derby
Derby Hospital 9193 3333 Address 80 Clarendon Street, Derby
Emergency 000 (Principal) 0427429334 - Eliot
Poison info 13 11 26 (Line Mgr) 0409130976 - Mohamed

Note: 131444 will connect to the nearest Police Station.

Emergency assembly points in case of evacuation or separation have been identified. Please
see attached map(s).

Student(s) Absconding

In the event that student(s) abscond from the excursion activity:

1. The Teacher in Charge (TIC) must be notified immediately;

2. The TIC is to ensure appropriate staff member is shadowing or actively trying to locate
missing student(s);
3. If the student(s) cannot be located and successfully returned to the group within 30
minutes or there is concern for student safety/welfare, school administration are to be
informed immediately;
4. TIC to inform parents/caregivers and seek advice on possible whereabouts;
5. All available staff to search immediate area, possible locations, and interview peers for
information; and finally
6. If the student cannot be located by school staff with in 1 hour → notify local Police.

19
Appendix 4
COVID RESPONSE PLANNING
COVID Response Plan:
In Case of a government required lockdown being called, the Teacher in Charge:
Contact Mr Money and seek advice on returning to school.
A return to school plan will be formed ensuring drivers are receiving appropriate breaks.
Parents will be individually contacted by the school and advised of the estimated arrival time.
Masks will be provided to students and staff if their use becomes mandatory.
Student will be returned to school.
Rest breaks will occur on the journey using strategies that maintain social distances with the general
public.

Staff or student becoming unwell with symptoms

Staff Member Role

Level 3 Admin ✓ Level 3 staff member to take direct responsibility of the patient.
or ✓ Level 3 staff to call Principal and advise of situation.
Teacher in ✓ Level 3 to ask Principal to advise parent or partner of the situation.
✓ Provide mask to unwell person and self until advised by medical staff it is safe to
charge (TIC)
remove them.
or ✓ Seek medical advice at the health campus.
Identified Staff ✓ If COVID 19 test is required ask if it can be completed at a COVID clinic.
Member ✓ Once medical assistance has been provided, call parents and update of the
situation
✓ Follow medical advice which may be to isolate after having a COVID 19 test.
✓ Isolate in the closest COVID clinic.
✓ If COVID clinic is unavailable, isolate in independent accommodation until test
results are received.

Positive result ✓ Patient to isolate until they are testing negative.

✓ Level 3 to remain in the vicinity of the patient and support them with their
Level 3 personal needs.
✓ School excursion continues under management of the TIC and returns to school
as scheduled.
✓ Patient to remain in isolation until they are returning negative tests and released
under medical advice.
✓ Level 3 to support patient in their needs while in isolation.
✓ Transport for patient and Level 3 to be arranged upon release from medical care
by Principal.
✓ Maintain regular communication with Principal giving updates when the situation
changes.

Negative result If patient tests negative, they can return to camp school and return to activities on
Level 3 medical advice.
TIC

20
Appendix 4

21
Appendix 4

22