07 - Apply accident/emergency procedures ASSESSMENT - TLIF607C

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Conducted on

  Date

• Personnel

WRITTEN QUESTIONS

• What information are you legally required to exchange in the event of an accident?

  Yes

  No

  N/A

• What are your workplace requirements in relation to accidents/injuries?

  Yes

  No

  N/A

• What information would the emergency services require?

  Yes

  No

  N/A

• What assistance would you provide to an injured person?

  Yes

  No

  N/A

ASSESSMENT TASK

• For this assessment you will be required to write down or tell your supervisor at least 3 emergency/accident situations. When you have done this you will then have to write or describe solutions to these problems or how to avoid them happening.

  Yes

  No

  N/A

ASSESSMENT MODE B - Skills observational checklist

• Response to the incident or accident in accordance with workplace emergency procedures and relevant regulatory requirements.

  Yes

  No

  N/A

• Details of the cause and effects of the incident are identified and reported.

  Yes

  No

  N/A

• Assistance requirements for accidents and emergencies are clarified and reported immediately to the appropriate parties.

  Yes

  No

  N/A

• Requests for assistance are made to relevant personnel and emergency services.

  Yes

  No

  N/A

• Site is controlled and protected until the arrival of authorized personnel.

  Yes

  No

  N/A

• Assistance is provided to injured persons, within the limitations of duty of care and workplace procedures.

  Yes

  No

  N/A

• Relevant authorities at the site are cooperated with and assisted within workplace policies.

  Yes

  No

  N/A

• Relevant information is exchanged in accordance with state/territory law and workplace procedures.

  Yes

  No

  N/A

• Documentation and reports are completed and processed in accordance with workplace and relevant regulatory requirements.

  Yes

  No

  N/A

• Instructor signature

  Sign

• Select date

  Date

• Student signature

  Sign

• Select date

  Date

FINAL SIGN-OFF Apply accident/emergency procedures

• STUDENT NAME

  Yes

  No

  N/A

• HOURS

  Yes

  No

  N/A

• Element 1. Respond to the incident. 1.1, 1.2, 1.3, 1.4

  Yes

  No

  N/A

• Element 2. Control and assist at accident or emergency site. 2.1, 2.2, 2.3

  Yes

  No

  N/A

• Finalize accident - emergency process and complete records. 3.1, 3.2

  Yes

  No

  N/A

• FINAL INSTRUCTOR SIGNATURE

  Sign

• Select date

  Date