Title Page

  • Site conducted

  • Employees Name

  • Assessors Name

  • Identify the task being reviewed

  • Procedure Reference if applicable

  • Date

  • Location
  • Outline below details of the specific activities demonstrated during the competence assessment. Include details relating to the individual questions to support justification for maintaining or raising competence level.

1) HEALTH AND SAFETY

  • Did the operator understand and have they signed any relevant Task Specific Risk Assessment related to the assessment?

  • Is the operator aware of the correct PPE to be used and did they use it correctly (including carrying out any pre-checks on PPE if applicable)?

  • Is the operator aware of any risks associated with chemicals, reactions etc. relating to the test and how to handle safely?

2) GENERAL UNDERSTANDING, SAMPLING AND SAMPLE CHECKS

  • Does the operator understand the relevant normative standards appropriate to the Competency Level being assessed?

  • Does the operator understand the sampling procedure (s)?

  • Can the operator carry out the sample preparation correctly and/or quality assess the samples (including those samples that had been prepared previously) for suitability, prior to starting testing?

  • Prior to testing or measurement, were the sample(s) supplied or stored in a manner that would have prevented contamination or damage?

  • Did the operator ensure that the test samples were suitably identified and traceable back to the client’s requests?

  • Is the operator aware of all relevant worksheets and documents required and did they have them available?

3) EQUIPMENT

  • Did the operator check the calibration status of all relevant equipment prior to use?

  • Did the operator know which equipment should be calibrated and perform appropriate checks on the calibration status?

  • Was the operator aware of any equipment “pre-test” checks that are required

  • Were any other “pre-test” checks performed and done correctly in accordance with documented procedure(s)?

  • Was the operator fully conversant with the controls & operation of the relevant equipment?

4) UNDERTAKING THE TEST/MEASUREMENT OF THE SPECIMEN

  • Was the sample visually assessed for its integrity and deemed as suitable for measurement?

  • Did the operator correctly position the test sample into the measurement devices

  • Did the operator correctly assess the test specimen after completion of the test?

  • If the procedure is part of long-term tests that requires any checks on a regular basis, on completion of the set-up did the member of staff provide appropriate and accurate documentation for monitoring purposes?

  • Was the operator aware of who to notify of any deviations in samples, procedure or equipment that could occur?

  • Was the operator aware of any possible variations to the test, including conditions, alternative equipment, set-up methodologies etc?

5) RECORDING OF DATA AND SAMPLE IDENTIFICATION

  • Did the operator complete all relevant test records accurately and were they legible and complete?

  • Were any changes or modifications to hand written documents or records carried out in accordance with recognised procedures (ie initialled and dated)?

  • Upon completion of the test did the operator ensure that the test specimens were still suitably identified and traceable back to the client request?

  • Following the measurement process, did the operator ensure that any remaining specimens were stored in a manner that maintained their identification and prevented damage?

  • Was the equipment left in a suitable state and the area tidied after completion of the work?

  • Did the operator file documents relating to the test in the appropriate location and in such a way that an auditable trail could be established?

6) ADDITIONAL QUESTIONS

  • For use by the assessor, to include any additional questions not included above but relevant to the assessment

  • Question
  • Type in your question

  • Outcome

GENERAL COMMENTS AND ADDITIONAL INFORMATION

  • undefined

Sign Off

  • Checklist completed by Name and Signature

  • Assessor Name and Signature

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.