Title Page

  • Candidate

  • Assessor

  • IQA

  • Date and Time

  • Scenario

  • Location
  • INSTRUCTIONS 1. " Pass", "Pass at Level 1", " Marginal Fail Level 2", "Significant Fail Level 3" or "Professional Discussion" on the questions provided below. 2. Add Photos in "Image" and Comments in "Note" if needed. 3. Add a Corrective Measure by tapping on "Action", then provide a description, assign to a member, set priority, and due date. 4. Complete the audit by providing a digital signature. 5. Share your report by exporting as PDF, Word, Excel, ensure candidate has seen the report conclusions and had the opportunity to discuss.

Marking Criteria for Assessor please tick to indicate you understand the criteria as the assessor

  • Indicate "Pass" for a competent performance for the criteria

  • Indicate "Pass Level 1" for a pass with prompts for questions needed to confirm understanding

  • Indicate "Review Level 1" for a some issues identified, where a lack of understanding or knowledge is shown on a non safety critical issue or command skill but need further investigation and provision of a development.

  • Indicate "Review Level 2" for a significant issues identified where a lack of understanding or knowledge is shown on a safety critical issue or command skill, this must include a Remedial Action plan as an outcome

Before carrying out Assessment Confirm:

  • Room is safe and fit for purpose and candidate has been fully briefed and is happy for the assessment to begin

  • Has the Video and Audio been checked and is ready to record if applicable?

  • All supporting materials are available in the room for the candidate?

  • All Role players have been briefed and understand the scenario

Performance indicators for this level are Based upon National occupational standard EFSM 2 OR CAP 699 AFSM 1:

Review and determine incident status

  • P1. Collect and confirm information from all available sources on the incident

  • P2. Confirm that current action complies with relevant legislation and protocols

  • P3. Determine the current involvement of other agencies, their current activities and key contacts

  • P4. Determine and resolve discrepancies between information obtained at the incident and information provided pre-incident

  • P5. Confirm roles, responsibilities and communication channels with key personnel

  • P6. Confirm risks and implications for personnel, for the community and for the wider context, if Aviation based considers impact on the aerodrome.

  • P7. Anticipate likely future resource needs including consideration of possible escalation of incident

  • P8.Confirm the priority actions for resolution of incident

  • P9. Ensure that information concerning change in roles and control of the incident reaches those who assist with its resolution

Assume responsibility and implement action to support those involved in the incident

  • P10. Plan a response which takes account of all available information and anticipated risks

  • P11. Implement the plan, and confirm roles, responsibilities, tasks, and communication channels

  • P12. Monitor the progress of activity against your plan

  • P13. Anticipate risks to health, safety and welfare and ensure adequate and timely control measures are implemented

  • P14. Review your incident plan to meet the emerging needs of the incident

  • P15. Obtain technical and professional advice from suitable sources to support decision making

  • P16. Provide information to other agencies to assist with their decision making.

  • P17. Conduct comprehensive briefings with relevant people to obtain progress reports and instigate action

  • P18. Evaluate the implications of the incident on the organisation, the environment, the local community and other agencies roles and responsibilities

  • P19. Ensure that relevant people are updated regarding identified implications

  • P20. Provide accurate information to the media and utilise media resources to inform and protect the community

  • P21. Confirm that objectives within immediate responsibility of the organisation have been met

  • P22. Handover status to relevant agencies before you withdraw support from the incident

Debrief following resolution of incidents

  • P23. Arrange sufficient debriefs of suitable type and frequency to meet the needs of the incident type and scale

  • P24. Gather and review pertinent information from internal and external sources

  • P25. Support a full review of procedures and performance relevant to the incident in order to identify learning outcomes for the organisation and individuals

  • P26. identify possible changes to procedures and resource requirements that would improve future practice and service delivery

  • P27. Recommend improvements, with supporting evidence, to relevant people

  • P28. Identify trends and their implications for future service delivery

  • P29. Provide feedback to personnel and other agencies involved

  • P30. Establish the support needs of personnel involved in the incident and instigate action to deliver this

  • P31. Agree action to be taken following debrief activities including responsibilities and timescales

Feedback to Candidate and conclusions from the Assessment session

  • Are there any questions you need to ask the candidate to complete the assessment or confirm understanding, record any questions asked in the notes

Completion

  • Outcome

  • Candidate Feedback – Assessor record outcome and feedback given here.

  • IQA Feedback to Assessor

  • Candidate Signature

  • Assessor Signature

  • IQA 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.