Title Page
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Conducted on
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Prepared by
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Location
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Subject or Activity Assessed
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Is the work being undertaken by contractor or employee
- Employee
- Contractor - Inducted Personnel
- Contractor -Not inducted
- other
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Provide details
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Provide details of training subject or process being accessed - if safe system of work, operational procedure etc attach the document with details covered.
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Name of formal training undertaken prior to this assessment - where possible provide evidence of training certificate -if this is not possible include in statement how you have assessed they have attended training.
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Has the person receiving training or being observed demonstrated they can complete the take correctly
- Best Practice
- Compliant
- Some learning
- Poor
- Repeat failure
- N/A
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Is the observed person wearing the correct PPE and able to explain why it is required and how to use and take care of it.
- Best Practice
- Compliant
- Some learning
- Poor
- Repeat failure
- N/A
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Is the observed person able to explain the purpose for equipment, how to correctly use, store it and take care of it.
- Best Practice
- Compliant
- Some learning
- Poor
- Repeat failure
- N/A
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Is the observed person working in a tidy manner and taking steps to avoid slips and trips
- Best Practice
- Compliant
- Some learning
- Poor
- Repeat failure
- N/A
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Is the observed person able to demonstrate good understanding of materials and processes associated with the activity.
- Best Practice
- Compliant
- Some learning
- Poor
- Repeat failure
- N/A
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Activities discussed
- POWRA
- Permits
- Driving / Towing
- Opening chambers
- Working underground
- Working at height
- MEWP Operations
- Pole climbing
- Emergency Response
- Digging activities
- Cutting or drilling
- Use of hazardous substances
- Environmental Controls
- other
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List areas discussed
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Is the observed person deemed to demonstrate competency
- Excellent level demonstrated and ability to mentor or provide practical training on this subject.
- Competent and working to a high standard
- Competent
- Demonstrates understanding and ability but needs monitoring to ensure learning remains.
- Requires further training as not able to demonstrate standard required.
- Repeated failure to take on board training and demonstrate the required quality and safety.
- other
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Identify how this person will be supported to improve or other action required
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Has the individual being observed got any comments about their performance?
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Agreed actions and improvements
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Any concerns or comments made by the observed person
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Observers signature to demonstrate that this is a true record of training/ competency assessment
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Observers signature to demonstrate that this is a true record of training/ competency assessment
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Employee / Contractor signature to confirm this is a true record of training/ competency assessment
