Translink. PTS workplace based assessment

• Candidate Name:

• Candidate Contact No:

• Line Manager Name:

• Line Manager No:

• Approved for assessment?

  Yes

  No

  N/A
• Location of assessment:
  Address

• Date of assessment:

  Date

• Start time

  Date

• Assessor Name:

• Assessor contact No:

• Worksite Location/Mileage

• Appropriate PPE worn?

  Yes

  No

  N/A

• Nature of work:

• Choose Yes, No or N/A as an answer for the task. Where further mentoring is required also select FMR and add comments below. Should the candidate have any questions, select the Q column for the relevant subject and add comments below. Multiple slections can be made. For example: Yes & Q; or No & FMR.

Observations & Questions

• Has the candidate the correct PPE on?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Can the candidate identify where the POS is?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the candidate demonstrate 1.5m from a given point

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the candidate demonstrate 2 m from a given point

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Does the candidate know the distance on or near the line?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Does the candidate know what the trackside is?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the candidate look both ways when crossing the track?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the candidate cross at a right angle?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the candidate avoid the sleepers?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the candidate stand in a POS after crossing the track?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Does the candidate know the UP & Dn directions?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the candidate correctly acknowledge all train driver warnings?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Whilst walking, did the PTS candidate look up every 5 seconds?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the candidate show reasonable track safety awareness when walking back to the access location?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Assessor's comments:

• Choose Yes, No or N/A as an answer for the task. Where further mentoring is required also select FMR and add comments below. Should the candidate have any questions, select the Q column for the relevant subject and add comments below. Multiple slections can be made. For example: Yes & Q; or No & FMR.

Observations and Questions

• Did the candidate show reasonable track safety awareness when walking to the site?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the candidate acknowledge the lookout after hearing the warning?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the candidate move to a POS after hearing the Horn/whistle?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Was the candidate focused on the train and not distracted whilst in the POS?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the PTS candidate correctly acknowledge all train driver warnings whilst standing in a position of safety?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Whilst working, did the PTS candidate stay within the worksite limits?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• If tools are being used, were they moved into the correct POS?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Is the PTS candidate continually aware of their own safety and following the TSC’s instructions when working On or Near the Line?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the candidate wait until the TSC gave permission to leave the POS?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Did the candidate show reasonable track safety awareness when walking back to the access location?

  Select YES No Q FMR N/A

  • YES
  • No
  • Q
  • FMR
  • N/A

• Assessor's comments:

• Select Pass, Fail or N/A as required.

Knowledge of TSC briefing.

• Access Location

  Pass

  Fail

  N/A

• Direction of Travel

  Pass

  Fail

  N/A

• Line Speed

  Pass

  Fail

  N/A

• Location of Work

  Pass

  Fail

  N/A

• Working From / TO

  Pass

  Fail

  N/A

• Type Of Work Zone

  Pass

  Fail

  N/A

• Number of Lookouts

  Pass

  Fail

  N/A

• Method of warning

  Pass

  Fail

  N/A

• Position Of Safety

  Pass

  Fail

  N/A

• First Aider

  Pass

  Fail

  N/A

• Means of Contacting emergency services

  Pass

  Fail

  N/A

• Hazards

  Pass

  Fail

  N/A

• Assessor's comments:

• Select Pass, fail or N/A as required.

PTS Knowledge

• If caught between adjacent lines, where should you lie down?

  Pass

  Fail

  N/A

• Where is the five-foot?

  Pass

  Fail

  N/A

• Where is the six-foot?

  Pass

  Fail

  N/A

• What does a limit clearance sign look like?

  Pass

  Fail

  N/A

• What distance is your POS

  Pass

  Fail

  N/A

• What must you do if you’re taking prescribed or non-prescribed medication?

  Pass

  Fail

  N/A

• What distance is defined as on or near the line?

  Pass

  Fail

  N/A

• If you’re working in a separated green zone, what minimum distance must you keep from any line open to train movements?

  Pass

  Fail

  N/A

• What is the minimum distance tools should be placed when moved into POS

  Pass

  Fail

  N/A

• Can you use your mobile phone when “on or near the line”?

  Pass

  Fail

  N/A

• What must you do if warned of an approaching train in a red zone?

  Pass

  Fail

  N/A

• If working in a red zone, who must you never distract?

  Pass

  Fail

  N/A

• What are you permitted to do on your own when ‘on or near the line’?

  Pass

  Fail

  N/A

• Using the phonetic alphabet, ask then for the corresponding names for the following: A,D,E,G,H,I,K,L,Z,9,0

  Pass

  Fail

  N/A

• How many units of alcohol can you drink during working hrs?

  Pass

  Fail

  N/A

• What is the minimum PPE you should be wearing when on or near the line? A Safety gloves.<br>B Dust mask.<br>C Approved High Visibility clothing.<br>D Eye Protection.<br>E Safety helmet.<br>F Ear defenders.<br>G Approved safety footwear.<br>H Earplugs.

  Pass

  Fail

  N/A

• List the procedure for making an emergency call: A. State, “This is an emergency call.”<br>Check you are speaking to the correct person, i.e., Signaller at the correct location<br><br>B. Give your Name, Grade and Location<br><br>C. Say What has happened.<br><br>D. Say exactly where it has happened and what services are required<br><br>C. Use signal numbers or mileposts if possible.<br>

  Pass

  Fail

  N/A

undefined

• Assessor's comments:

Assessors's decision.

• PTS qualification

  Competent

  Not Competent

• Assessor's Signature

  Sign

Candidates declaration

• I have read and confirmed the Assessor's feedback

• Candidate's signature

  Sign

• Date & Time

  Date

• Candidate's comments on assessment.