Title Page

  • Date:

  • Full Name:

  • Mobile Number:

  • Any medical condition:

  • If yes, would that limit your ability to work at height or work with electrical settings?

  • Emergency Name:

  • Emergency Contact Number:

  • Induction done:

Competency Assessment

  • 1)Which government regulator is responsible for WHS regulation, implementation and law enforcement in your state? Choose correct answer from options below depending the state(s) you are working:

  • 2)Safety at workplace is responsibility of everyone. Do you agree?

  • 3)Who can assist/guide me regarding compliance matter such as Safety, Electrical, Standards etc.?

  • 4)Which form do I need to use to report an incident/a near miss?

  • 5)Can any worker on site fill out an Incident report/near miss?

  • 6)Do I need SWMS/JSA for each job?

  • 7)What are the consequences if installer doesn’t follow his obligations regarding Safety. Such as not preparing SWMS/JSA, not using edge protection/safety harness where it is practical to do so?

  • 8)How much minimum ‘on the spot fine can be issued by SafeWork Inspector for breach of WHS laws and regulation, if you are working in NSW? (A) Personal (B) Company

  • 9)Out of two, which is the most effective control measure that can be implemented to minimize the risk of fall from height?

  • 10)What ratio you need to maintain while setting up the ladder?

  • 11)How often Safety harness must be checked by a competent person?

  • 12)Do you always do visual inspection of safety equipment before use i .e. Safety Harness, Anchor Points?

  • 13)What is the purpose of setting up ‘Emergency Assembly Point’?

  • 14)Do you need a license to remove or work on Asbestos?

  • 15)What kind of kit do you need to rescue someone from electrocution while working on low voltage?

  • 16)Do you agree that Sunboost Site Safety Compliance Manager can do random site audits?

  • Yes, I agree

  • 17)What are the accreditation/licenses required for Installer or Electrician to install PV System? Choose from the options below.

  • 18)It is installer’s responsibility to check that his crew is competent and trained to complete the task. Such as work at height card and White Card. Is this sentence correct?

  • 19)To comply with CEC’s guidelines and SRES changes made on 1st April 2022, Installer must be able to prove his presence at site. The Installer must take 3 selfies at the 3 stages of installation, on SPV app. Is this correct?

  • 20)None of your crew member can work on electrical circuit if they are not licensed. Is this correct?

  • 21)Installer must not work on live electrical circuit. Is this correct? (Unless if something is specifically mentioned in standard as an exemption)

  • 22)What can be the possible disciplinary actions taken by regulatory bodies if installer found to be non-compliant?

  • 23)Select all correct options from the list below which can be considered correct selfie of a CEC accredited installer?

  • ACKNOWLEDGEMENT

    While at work, a worker must (Section 28 of the WH&S Act 2011):

    a) take reasonable care for his or her own health and safety; and

    b) take reasonable care that his or her acts or omissions do not adversely affect the health and safety of other persons; and

    c) comply, so far as the worker is reasonably able, with any reasonable instruction that is given by the person conducting the business or undertaking to allow the person to comply with this Act; and

    d) co-operate with any reasonable policy or procedure of the person conducting the business or undertaking relating to health or safety at the workplace that has been notified to workers.

    My signature below confirms that I understand the NSEG safety rules and Installer Procedures, outlined above. I am responsible to observe these safety requirements at all times while on site for my own safety and for the safety of others. I confirm that I have been consulted, read, understand and have signed off on the safe work method statement of my employer for the installation work to be conducted when on site, and agree to follow the process to the best of my ability at all times.

    I shall report immediately any unsafe work practices, unacceptable behaviour, injuries or hazards that exist on site and any notifications, infringements, non-compliances issued by the Regulators’( SafeWork, CEC etc).

    I shall stop work if the work is deemed unsafe and not accordance with the required controls in the SWMS. I will resume work when the correct controls have been put in place and the task is safe to complete. I will actively participate in OH&S programs and toolbox talks as required.

  • Contractors'/Installer's Signature

  • Inductor's Name

  • Date:

Attachments

  • Selfie

  • Electrician Licence

  • Electrical Contractor Licence

  • CEC Accreditation

  • Driver's Licence/ Passport

  • White Card

  • Work at height card

  • First Aid Certificate

  • EWP

  • Workers Insurance

  • Public Liability Insurance

  • Work with Asbestos

  • Battery Endorsement

  • VU22744/22515VIC (VIC only)

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.