Title Page

  • Unit Completion Date

  • Assessor

  • Student

  • Job 1 Address
  • Job 2 Address
  • Job 3 Address
  • For 5357-23/94 has at least 1 job been done on a non domestic property?

Assessor Checklist

Risk Assessments and Method Statements

  • Has a Risk Assessment been completed for job 1

  • Location of evidence

  • Has a Risk Assessment been completed for job 2

  • Location of evidence

  • Has a Method Statement been completed for job 1

  • Location of evidence

  • Has a Method Statement been completed for job 2

  • Location of evidence

Additional Photographic Evidence Required.

What 2 pieces of access equipment have been evidenced.

  • Ladder

  • Location of evidence

What 2 pieces of access equipment have been evidenced?

  • Ladder

  • Location of evidence

  • Tower scaffold or MEWP

  • Location of evidence

  • Stepladder

  • Location of evidence

  • Platform

  • Location of evidence

Additional Evidence Needed

  • PPE Used Correctly

  • Location of evidence

  • Use of guards, notices, barriers

  • Location of evidence

Assessor Feedback and Forward Planning

  • Assessor Feedback To Learner

  • Forward Planning For Learner

Signatures and Completion

Assessor Signature

  • I agree that the information provided here is an accurate account of what has taken place.

Expert Witness Signature

  • As the expert witness I can confirm that all the work carried out in this unit has been done by the student named above under my supervision to the required standards.

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