Work Health and Safety Assignment

Work Health and Safety Assignment
BSB51319 – Diploma of Work Health and Safety

Workbook 2 – Practical Tasks

Units of Competency
BSBWHS522 Manage WHS consultation and participation processes
BSBWHS513 Lead WHS risk management
BSBWHS515 Lead initial response to and investigate WHS incidents
BSBWHS516 Contribute to developing, implementing and maintaining an organisation’s WHS management system
BSBWHS519 Lead the development and use of WHS risk management tools
BSBWHS514 Manage WHS compliance of contractors
BSBWHS518 Manage WHS hazards associated with maintenance and use of plant
BSBWHS520 Manage implementation of emergency procedures
BSBWHS504 Manage WHS risks
BSBMGT516 Facilitate continuous improvement

Assessment Cover Sheet

Assessments submitted via the HBA Learning Centres Student Portal do not require an accompanying cover sheet. Candidates will be required to complete an electronic authenticity statement when submitting work.

Complete the cover sheet below and provide a physical signature ONLY when submitting evidence by means other than the Student Portal.
Name:
USI:
Candidate Declaration
– I declare that I have personally completed all activities included in this submission.
– I understand that competency will not be granted if I do not meet the assessment evidence and activity requirements or if it is discovered that I have not undertaken all required tasks.
– I understand that HBA reserves the right to immediately withdraw a qualification if it is found that I have provided false or misleading evidence, this includes any declaration, resource or tool I have submitted as being authored by me.
– I further note this includes any statement, whether written or spoken, by any witness or other third party I have used to provide testimony, or any other evidence which serves to allow HBA assessors to make an assessment decision.
– I understand that HBA may, at its own discretion and without notice, contact any third party I have used to provide testimony or other evidence to HBA assessors. If HBA forms a reasonable doubt as to the authenticity of such evidence, then HBA shall withdraw any issued qualification without notice.
– I have been advised of the assessment requirements; I have been made aware of my rights and responsibilities as a candidate for assessment and choose to be assessed at this time.
Candidate signature
Date

Contents

Workbook 2 – Overview & Instructions 5
Workbook Structure 5
Completion Requirements 6
Self-Paced Delivery 6
Face-to-Face Workshops 6
Important Notes 6
Resources & Support 7
Undertaking Assessment Activities 7
Assessment Activities 7
Case Study 1 – Trident Electrical Pty Ltd. 9
Section 1 Management Commitment and Policy 10
1.1 Develop a WHS Policy 10
1.2 Communication Strategy for WHS Policy 11
Section 2 Planning 13
2.1 Legal and Other Requirements 13
2.2 Objectives, Targets and Performance Indicators 15
2.3 WHS Management Plan Matrix 17
Section 3 Implementation and Operation 19
3.1 Roles and Responsibilities 19
3.1.1 Organisational Chart 19
3.1.2 WHS Roles and Responsibilities Register 20
3.2 Competency and Training 21
3.2.1 Conduct Training Needs Analysis 21
3.2.2 Training Register 22
3.2.3 Contractor Training Resource 22
3.3 Consultation and Participation Processes 23
3.3.1 Consultation and Participation Policy 23
3.3.2 Team Consultation Statement 24
3.4 Document Control and Managing WHS Records 24
3.4.1 Managing WHS Records 25
3.4.2 Document Control 25
3.5 Hazards and Risks 26
3.5.1 Risk Management Procedure 27
3.5.2 Hazard Management Tools 28
3.5.3 WHS Risk Register 28
3.5.4 Hazards Associated with Plant 29
3.6 Internal and External Reporting 30
3.7 Emergency Planning 31
3.7.1 Emergency Risk Register 31
3.7.2 Emergency Response Plan 32
3.7.3 Emergency Contact List 32
3.8 Incident Response 33
3.8.1 Incident Notification Report 33
3.8.2 Incident Investigation Flow Chart 36
3.8.3 Incident Investigation Plan 37
3.8.4 Incident Investigation Report 39
Section 4 Measurement and Evaluation 42
4.1 WHSMS Audit 42
4.1.1 Audit Plan 42
4.1.2 WHS Management System Audit 43
4.1.3 Assessment and Rating Table – Summary of Audit Findings 56
Section 5 Management Review 58
5.1 WHSMS Targeted Review 58
5.2 WHS Action Plan 58
5.3 WHSMS Review Report 61
Activity 5.4 – Contractor Review 61
Activity 5.4.1 – Current Contractors and Services 67
Activity 5.4.2 – Contractor Review 67
Section 6 Finalisation 69
6.1 Self-Reflection 69
6.2 Skills Confirmation Checklist 70
6.3 Third Party Declaration 71
Finalising and Submitting Work 71

Evidence to Submit
Completed Workbook 2 (this document) ☐
3.1.1 – Organisational Chart ☐
3.2.1 – Training Needs Analysis ☐
3.2.3 – Contractor Training Resource ☐
3.5.2 – Hazard Management Tool ☐
3.5.3 – WHS Risk Register Template ☐
3.5.4 – Plant Risk Register ☐
☐
☐
Other Documents (List Below)

Workbook 2 – Overview & Instructions

The assessment tasks in this document form part of the evidence requirements to demonstrate competency in the BSB51319 Diploma of Work Health and Safety. Candidates are also required to satisfactorily complete all of the assessment tasks in Workbook 1 to achieve the full BSB51319 qualification. This workbook is clustered into sections. Each of the Units of Competency will be assessed holistically throughout each section of this Workbook. All sections in this workbook must be completed prior to submitting for assessment.

To achieve this, you will assume the role of a WHS Manager for the duration of the training as part of the steering committee. In order to meet the objectives of the Units of Competency and in line with Industry best practice, you will be utilising a number of resources to assist you in developing components of a Work Health and Safety Management System (WHSMS).

To allow for flexibility in this course HBA has provided participants with three (3) options for completing Workbook 2.

Option 1 – Own workplace (preferred option)
Use your own workplace to complete the activities in this workbook. HBA will ensure the privacy and confidentiality of all workplace documents. If you are submitting workplace documents, you must:
o Ensure all documents submitted directly address the evidence requirements and are clearly labelled;
o Indicate clearly which activity you are submitting the document for; and
o Provide third party confirmation that the workplace documentation submitted is that of your own work.

Option 2 – Simulated organisation
You may choose to base your work on a simulated organisation or as a consultant to an organisation that you are familiar with. This option will require you to create your own scenario and information to support the activities.

Option 3 – Case Study, Trident Electrical
HBA has provided a brief case study to assist you in completing this Workbook. Relevant components of the case study will be addressed in the later sections of this Workbook. You will be required to simulate some information not covered in the scenario.

Workbook Structure

This Workbook is divided into six (6) sections. There are five (5) key sections replicating the requirements of a Work Health and Safety Management System (WHSMS) as outlined in the AS/NZ 4801: 2001 Occupational Health and Safety Management Systems – specification with guidance for use. Section six (6) relates to the finalisation and submission of your assessment evidence.

The five (5) sections follow five (5) key elements of developing an effective Work Health and Safety Management System (WHSMS). Each section flows into the next as a continuous cycle. Throughout the life of the project, you will return to various stages to carry out or review actions and or activities from the five (5) key elements.

Completion Requirements

Self-Paced Delivery
It is recommended that learners undertaking BSB51319 Diploma of Work Health and Safety through the Self-Paced delivery method complete Workbook 1 satisfactorily before commencing the activities in Workbook 2. HBA only recommends this, it is not an essential requirement. If you decide to take the recommendation made by HBA, please keep in mind HBA’s assessment turnaround timeframe.

Face-to-Face Workshops
We recommend that learners attending any of our Blended / Intensive Face-to-Face courses commence Workbook 1 prior to commencement of the course. Workbook 1 will not be completed during the Face-to-Face course and will be completed in the learner’s own time.

Workbook 2 activities will be commenced during the Face-to-Face course, with homework requirements and potential post Face-to-Face assessment work conducted as required by the individual progress of the learner.

Important Notes
o Assessment submissions should be made electronically via the HBA Learning Centres Student Portal.
o Assessments submitted by means other than the Student Portal require a completed cover sheet.

o Label any file attachments clearly with your name, document title and version, list the filenames on the cover sheet. Any attachments not clearly labelled or listed will not be assessed.
o A maximum of three (3) attempts of each assessment task is allowable. Candidates exceeding three (3) attempts may be required to undertake further training and additional assessment charges may apply.

Resources & Support
 WHS Learner Guide
 HBA Learner Resources
 Additional external research will also be required
 Direct support channels – E-mail, online forums and telephone (1300 721 503)
 Examples are provided in some instances. These are to be used as a guide only. The submission of any parts of the completed HBA examples as your own work is not acceptable.

For further information regarding learner support, appeals, reasonable adjustments, special needs, Recognition of Prior Learning (RPL) or Credit Transfer please refer to the HBA Learning Centres Learner Handbook, contact us via email to assess@hba.edu.au or by phone on 1300 721 503.

Undertaking Assessment Activities
The HBA learner resources are available via your “Student Portal” access. You are also required to conduct some external research when completing the learner activities. Research, analysis, reporting, and planning are critical aspects of BSB51319 – Diploma of Work Health and Safety.

Assessment Activities
The following activities relate to skills and knowledge required for specific Units of Competency. You will need to provide your answer by completing tables and answering questions.

The Learner Guide has been designed to provide you with ample amount of background information to assist you with understanding each Unit of Competency. Use the Learner Guide and conduct some additional research to formulate your answers. It is essential that your answer addresses all components of the question adequately, simply copying and pasting content that more or less answers the question is not appropriate. You can copy and paste content from other sources, but you must modify/paraphrase it to meet the question requirements and demonstrate your understanding of key concepts, ideas and models.

Course Completion Date: You are given 12 months from the date of enrolment to complete this course. An extension may be granted in exceptional circumstances on receipt and approval of a written request.

Tips:
• Answer the questions using your own words, copy and paste is not acceptable unless stated in the activity, except where referencing legislation.
• Read the questions to ensure you are providing what has been asked for.
• Answers do not need to be overly expansive, but they do need to have sufficient information to clearly answer the question and demonstrate your understanding.
• Once you answer the question, re-read the question to make sure you have covered off on all of the requirements.
• It is not appropriate to use the example provided for you in your answer.
• Provide legislative references where required

Case Study 1 – Trident Electrical Pty Ltd.

You are the recently employed WHS Manager for a medium sized Electrical Contracting company, Trident Electrical.

The company currently employees 52 workers including the Director, 3 Department Managers covering the Operations, WHS and the Human Resource Departments and 4 Area Supervisors. The Supervisors have a 2IC (Second in Charge) appointed to them to assist with the day to day operations of the business.

The previous WHS Manager was dismissed due to failing to meet the companies WHS objectives. Trident Electrical does not have a Work Health and Safety Management System (WHSMS) in place and is grossly lacking in relation to having industry best practice and legislative compliance documents such as policies, processes and procedures included as part of the overall Work Health and Safety Information System (WHSIS). Historical, Trident Electrical has not adopted a systematic approach to the management of the business.

It is now your role to develop in consultation with relevant stakeholders, implement, and monitor and review the WHSMS and associated documents.

You can assume that you are working through the limited historical data on file. As you move through the ad hoc and incomplete document filing system you happen across an incident register. You can see there are 5 incidents recorded in the register. One incident in particular raises alarm bells for you.

You are sifting through the documents on hand in order to locate more information regarding this incident and are able to locate 3 incident reports, including the incident in relation to a worker’s back injury. You can see by the data recorded the worker is an apprentice named John Agave. He was working on a temporary power switch board installation. The job details described in the report outlined the worker was to connect the mains power cables to the temporary switch board. The incident details state the worker was preparing to terminate the cables. When he exposed the copper wiring on the cable, he suffered an electric shock and was thrown backwards, landing with force onto his lower back.

There is a statement completed by the Electrical Supervisor Robert Wong, attached to the incident report. The Supervisor of the area has recorded that he found the apprentice sometime later (there were no witnesses to the incident, so the exact time is unknown) on his back and not moving. The Supervisor shook the Injured Person (IP) and called out his name. A few seconds later, the IP came to. The Supervisor asked if the IP was alright and the IP responded he had received an electric shock and now has a sore back. The Supervisor took him to the First Aid Hut for a check-up.

A short time later, after obtaining the all clear from one of the onsite First Aiders Karen Victor, John returned to complete the power installation to the switch board.

There is no evidence of an Incident Investigation taking place on file.

The standard practice for new inductees and apprentice’s is they are required to attend an induction on the first day of shift, prior to the commencement of duties. As stated in the induction, there is a mentoring program in place and all inductees are to be paired up with a ‘Buddy’ for the first 2 weeks of employment and all trainees and apprentice’s must not work unsupervised.

You continue to make your way through the current files for the remainder of the week in order to establish an action plan and the priority order in which to address the matters at hand.
Section 1 Management Commitment and Policy

This Section of the Workbook requires you to develop a Work Health and Safety (WHS) Policy which states in broad terms how Management aims to provide a safe workplace, including allocation of resources and responsibilities for implementation and communication of information.

Senior leaders and management within organisations need to clearly define their commitment to WHS and communicate this regularly to all Workers.

Contributing to the development and implementation of a WHS Policy clearly demonstrates a commitment to WHS and ensures that everyone understands their health and safety responsibilities in the workplace.

1.1 Develop a WHS Policy

In this activity you are required to contribute to the development and implementation of WHS Policy and the commitment to the Work Health and Safety Management System (WHSMS).

The WHS Policy developed must be appropriate to the nature and scale of the organisation’s hazards and risks and will need to include the following:

o A commitment of Senior Managers to providing a safe workplace;
o Consultation with workers (including volunteers and contractors where applicable)
o The organisation’s overall health and safety objectives;
o The organisation’s commitment to establishing measurable objectives and targets in relation to health and safety;
o Commitment to identifying, assessing and controlling hazards and risks in the workplace;
o A commitment to comply with relevant legislation and any other health and safety requirements (Commonwealth, State and/or Territory);
o Return to work and injury management;
o Review dates

The WHS Policy must contain an appropriate document title and format using appropriate naming conventions as per organisational policies and procedures.

In developing the WHS Policy you will also need to consider integration with other functional areas of management which may include:

o Engineering and maintenance;
o Environmental management;
o Finance and auditing;
o Human resources, industrial relations and payroll;
o Information, data and records management;
o Logistics;
o Purchasing, procurement and contracting;
o Quality management; and
o Strategic planning

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

1.1 Work Health and Safety Policy
Organisation:
SCOPE & PURPOSE

AIMS & OBJECTIVES

STRATEGIES

Issue Date: Review Date:
DEVELOPED BY:
Name: Position:
Signature: Date:
AUTHORISED BY (PCBU):
Name: Position:
Signature: Date:

1.2 Communication Strategy for WHS Policy

In this activity you are required to develop a communication strategy to document how you will communicate all of the relevant WHS information, including the WHS Policy to the PCBU, officers, workers (including contractors) and others.

Consider strategies such as:

o Introducing new workers to the WHSMS and the WHS Policy during induction processes;
o Conducting regular refresher training for all workers;
o Displaying the WHS Policy on your notice board;
o Saving the WHS Policy to the Work Health and Safety Management System (WHSMS) you have created;
o Including the WHS Policy in worker, volunteer and contractor handbooks;
o Displaying the WHS Policy on the organisation’s website.

The communication strategy must be detailed and reflective of a document suitable for presentation to Senior Management for approval. It will also need to include the monitoring, review and continuous improvement details of the strategy.

Once developed, you will need to seek approval and endorsement for the Communication Strategy from the relevant Stakeholder within the organisation.

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

1.2 WHS Communication Strategy
Target Audience Key Messages
(Duties, Rights, Obligations) Communication Methods Responsible Staff Member/s Due Date Completion Date
PCBU
Officers
Workers – Staff
Workers – Contractors
Others in the workplace

DEVELOPED BY:
Name: Position:
Signature: Date:
AUTHORISED BY (PCBU):
Name: Position:
Signature: Date:
(Insert additional rows for any stakeholders not listed.)

End of Section 1

Section 2 Planning

This section of the Workbook will involve contributing to the development of an overall WHS Management Plan and deciding how you will meet the commitments you have made in the WHS Policy.
For Example: What will you do to ensure appropriate resources are allocated? How will you set objectives and targets for the improvement of WHS and how you will measure and record your progress?

In developing the WHSMS, you will also need to consider integration with other functional areas of management, which may include:

2.1 Legal and Other Requirements

In developing a WHS Policy where you have stated the organisation’s commitment to complying with relevant WHS legislation.

In order to meet this commitment, you will need to establish how the organisation plans to:

o Identify and monitor the content of WHS Legislation, Standards, Codes of practice, agreements and guidelines relevant to your activities, products and services;
o Advise Workers of the legislation, Standards and Codes as they apply to their own roles; and
o Keep abreast of any changes.
o The scope of the organisation’s requirements are likely to include:
o The relevant State and or Territory WHS legislation;
o WHS Regulations and Codes of practice relevant to the organisation’s activities i.e. Management and control of asbestos, manual handling, etc.;
o Other local, state and federal laws which may apply to the organisation;
o Industry and Employer association guidelines; and
o Contracts or agreements with suppliers.

Consider the case study you are working with in order to complete this activity.

Complete the template below, or complete and submit as a separate attachment (ensure ALL current, relevant legislative and compliance requirements documents in this register, not just the WHS legislation e.g. the relevant Fair Work legislation or bullying and harassment legislation). Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

Legislative & Other Legal Requirements Source / Website Link
Relevant Legislation
Example: The Workers Compensation Act 1987 http://www.workcover.nsw.gov.au/

Relevant Codes of practice (Compliance Codes – Victoria)
Example: Construction work http://www.safeworkaustralia.gov.au/sites/SWA

Standards or Guidance
Example: AS/NZS 3745:2010 Planning for emergencies in facilities http://www.standards.org.au/
2.2 Objectives, Targets and Performance Indicators

Setting measurable objectives and targets gives you the means to evaluate the organisations WHS performance. Objectives and targets can apply broadly across the organisation or be more narrow or relevant to specific activities or circumstances and should relate to the overall objectives set out in the WHS Policy developed in 1.1. Develop a WHS Policy. Consider the case study you are working with in order to complete the task

Targets define performance levels and timeframes. They need to be clear, measurable and realistic. To measure whether objectives and targets have been met, you will need to establish Performance Indicators. Performance Indicators also provide evidence of due diligence and its implementation, which is invaluable.

Example of Relationship between Policy and Indicators
WHS Policy Objective Endeavour to prevent injury and illness in the workplace
Site Specific Objective To eliminate injuries associated with operating a forklift
Target To achieve zero harm in the next 12-month period
Performance Indicator (Lag) The percentage of injuries associated with operating a forklift
Performance Indicator (Lead) Number of workers who participated in safe forklift ops training

You are required to:

o Develop specific objectives, targets and performance indicators in consultation with Workers; and
o Establish a system for recording objectives and targets and measuring your performance.

IMPORTANT: These objectives, targets and performance indicators will be recorded in 2.3 WHS Management Plan Matrix.

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

2.2 Objectives, Targets and Performance Indicators
WHS Policy Objective Specific Objective Target Performance Indicator Lead or Lag Indicator?
Example: Providing workers and visitors with a healthy and safe work environment. Housekeeping to reduce the risk of Slips, Trips and Falls. Reduce incident and injury rates by 20% within 6 months in relation to Slips, Trips and Falls. Example: Providing workers and visitors with a healthy and safe work environment. Housekeeping to reduce the risk of Slips, Trips and Falls.

2.3 WHS Management Plan Matrix

For the purpose of training, the WHS Management Plans key elements will be recorded in a matrix format. This matrix serves as a guide in the development of the WHS Management Plan. Consider the case study you are working with in order to complete this activity.

The WHS Management Plan Matrix will document how the organisation plans to:
o Comply with relevant legal requirements;
o Document and achieve the organisations WHS objectives and targets and within a specified timeframe;
o Assign responsibility for the achievement of goals and targets
o Manage specific WHS risks in the workplace;
o Monitor and record progress;
o Establish a review schedule and criteria for special review; and
o Allocate resources.

The WHS Management Plan Matrix needs to be reviewed by relevant management personnel on a regular basis to ensure that:
o Targets are realistic;
o Risks are current and managed;
o Priorities are in line with the WHS Policy; and
o The allocation of resources remains appropriate.

A review should also occur when there are changes to activities, products, services or legislation.
Specifically, the WHS Management Plan as a minimum will need to include the following items:
o Responsibilities and Accountabilities;
o Hazard Management Tools;
o Training and Competency;
o Emergency Plans;
o Legal and Regulatory Compliance;
o Monitoring and Reviews;
o Risk Management;
o Injury Management.

Using the outcomes of 2.1 and 2.2 and additional research for further information, complete the WHS Management Plan Matrix.

There is a wealth of information that can be accessed and researched to assist in developing the WHS Management Plan, for example:

o AS/NZS 4804:2001 Occupational Health and Safety Management Systems – General guidelines on principles, systems and supporting techniques
o AS/NZS 4801:2001 Occupational Health and Safety Management Systems – Specification with guidance for use
o OHSAS 18001:2007 Occupational health and safety management systems – Requirements
o WHS Plan Templates, for example: Work health and safety (WHS) management plan templates

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.
2.3 Work Health and Safety Management Plan Matrix
Issue Date: Review Date: Authorised By:
Item
Legal Requirements Objectives Target Performance Indicator Activity Responsibility Resources Allocated Related Policies, Procedures and Other Documents Expected Completion Date Location of Record
Example:
Legal and other requirements WHS Act, WHS
Regulations,
Codes of
Practice &
Australian
Standards Comply with legal requirements 100% compliance with legal requirements 100% compliance of currency of legal register Annual audit of register WHS Advisor Audit team WHS policy,
Training policy
Training Register/Matrix 17/05/2019 WHSIS Folder/ Personnel File

Review Schedule and Criteria for Review
Example: WHSMS Policies and Procedures to be reviewed every 2 years

End of Section 2
Section 3 Implementation and Operation

This section of the Workbook requires you to develop the capabilities and tools necessary to achieve your objectives and targets and implement the planned activities. This includes: establishing which roles have duties under WHS legislation and allocating responsibilities; deciding how and when you will communicate and consult with Workers and how you will report on and document your WHS activities, procedures and processes.

3.1 Roles and Responsibilities

Now that you have developed your WHS Management Plan Matrix it is time to implement it so that the organisations WHSMS is effective. Consider the case study you are working with in order to complete this activity.

The implementation phase includes ensuring that you have the right balance of human, physical and financial resources in place to achieve the organisations WHS goals and targets.

It is important to establish specific roles and responsibilities and clear lines of reporting in relation the WHS in the workplace.

NOTE: You may consult your relevant State or Territory WHS /OHS Legislation and WHS Regulator, to ensure that you are familiar with the appropriate roles and responsibilities that apply to you and your relevant jurisdiction.

In order to implement aspects of the WHS Management Plan Matrix that you have developed in 2.3 WHS Management Plan Matrix you will need to:

o Define, document and communicate key responsibilities for WHS for the PCBU, Officers and Workers and Contractors; and
o Designate the responsibility and authority for the overall implementation of the organisations WHSMS to a specific position(s).

Roles and responsibilities may be documented in:

o The WHS policy (in a broad sense keeping in mind WHS is everyone’s responsibility);
o WHS Manual;
o WHS Management Plan Matrix;
o WHS Procedures;
o Handbooks for Workers and Contractors;
o Contract/tender documents; and
o Position descriptions.

In these activities you are required to:

o Document and communicate these roles and responsibilities;
o Record the consultation method used to gather the information; and
o List the training requirements.

3.1.1 Organisational Chart

In this activity, you are required to finalise the Organisational Chart as it relates to the case study or your workplace.
Complete the template located in the WHS learner resources and submits as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.
3.1.2 WHS Roles and Responsibilities Register

Based on the completed Organisational Chart you are now required to complete the WHS Roles and Responsibilities Register.

NOTE: You may need to refer back to and add to your overall WHS Management Plan Matrix template you commenced in 2.3. WHS Management Plan Matrix

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.1.2 Roles and Responsibilities Register
Principal Contractor / PCBU
Officers
Workers
People with specific WHS Roles and Responsibilities
Name Role Specific Responsibilities

3.2 Competency and Training

Effective implementation of your WHSMS requires that the workers hold the appropriate skills and competencies to carry out their assigned roles and responsibilities.

The employer needs to have a process in place to check that a worker/contractor has the appropriate skills, qualifications and/or certificates to complete the job specifications safely.

Any general WHS Training should cover:
o The WHS policy;
o How to access information about WHS matters;
o Hazard identification, risk assessment and control of risks;
o Safe work practices;
o WHS reporting procedures; and
o Emergency procedures.

Specific training may also be required in areas such as:
o Working at heights;
o Manual handling, or hazardous manual tasks;
o Asbestos;
o Ergonomics;
o Food safety; and
o Electrical safety.

NOTE: You may need to refer back to and add to your overall WHS Management Plan Matrix commenced in 2.3. WHS Management Plan Matrix

In the following activities, you are required to:

o Conduct a Training Needs Analysis (TNA) to assess whether your Workers are able to carry out their roles safely and competently;
o Develop a Training Register.
o Create a training resource suitable for contractors

3.2.1 Conduct Training Needs Analysis

Modify the template provided within the Assessment Folder to conduct and document a Training Needs Analysis to assess whether your workers are able to carry out their roles safely and competently and to identify the need for any required gap training.

For this activity, you must consider at least five (5) training requirements, including those listed below:

o Language, Literacy and Numeracy (LLN);
o WHSIS training requirements;
o Health & Safety Representative (HSR) training
o Contractor Inductions
o Plant

Complete the template located with the WHS learner resources and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.2.2 Training Register

The Training Register contains details of training courses and individual assessments. The register is used to monitor and record that workers are provided and complete all mandatory and organisational training prior to carrying out relevant activities.

Use the information in 3.2.1 Training Needs Analysis, modify the template below for a minimum of two (2) workers. One (1) of the workers listed must be a contractor.

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.2.2 Training Register – Worker #1
Worker Name:
Role / Position:
Start Date:
Provider Training Date Duration Qualification Refresher Due
Example: First Aid St. Johns 7/05/2019 1 Day intensive HLTAID003 – Provide First Aid CPR- Annual First Aid – 3 yrs.

3.2.2 Training Register – Worker #2 (CONTRACTOR)
Worker Name:
Role / Position:
Start Date:
Provider Training Date Duration Qualification Refresher Due
Example: First Aid St. Johns 7/05/2019 1 Day intensive HLTAID003 – Provide First Aid CPR- Annual First Aid – 3 yrs.
3.2.3 Contractor Training Resource

Develop a training resource that would be suitable to use when communicating WHS obligations, rights and responsibilities to contractors. This may include a handout, PowerPoint presentation, poster, or any other appropriate resource. The training resource must include:
o Legislative obligations of all parties
o WHS rights and responsibilities
o Emergency & Incident response and reporting
o Monitoring and review processes
o Consultation & participation processes
o High risk work and licensing where applicable
o PPE obligations
o Strategies to address non-conformance / non-compliance
o Other WHS obligations and/or information relevant to your specific operations.

There is no template for this activity. Complete and submit as a separate attachment. Clearly label all attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.3 Consultation and Participation Processes

Consultation with workers is a requirement of the WHS Legislation and is essential for the management of health and safety. Consideration must also be given to all feedback provided on all matters which may affect their health and safety.

Regardless of the size of the Organisation and work structure all procedures for consultation need to be documented and agreed to by Workers.

In the following activities you are required to document the following:

o Develop a brief policy for consultation and participation;
o Complete the Team WHS Consultation Statement

NOTE: You may need to refer back to and add to your overall WHS Management Plan template commenced in 2.3. WHS Management Plan Matrix

3.3.1 Consultation and Participation Policy

In this activity, you are required to develop a brief policy for consultation and participation. Provide details of each of the following:

o The policy
o Possible procedures
o Possible consultation

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.3.1 Consultation and Participation Policy
Policy and Scope
Procedure
Include key steps for a minimum of three (3) participative arrangements
Consultation
Who have you consulted with in the development of this policy and procedure

3.3.2 Team Consultation Statement

The purpose of the WHS Consultation Statement is to document the methods or mechanisms for staff consultation and participation relevant to all health and safety matters, as agreed by the workers.

Refer to 3.3.1 Consultation and Participation Policy, as a team discuss and agree on the preferred method or mechanism(s) for consultation and communication of WHS information or issues for your work area.

In the following activities, you are required to complete the following:
o Discuss and document how and when you will consult, communicate and encourage worker participation

NOTE: You may need to refer back to and add to your overall WHS Management Plan template commenced in 2.3 WHS Management Plan Matrix.

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.3.2 Team WHS Consultation Statement
Organisation:
Department / Team:
Team Commitment

When employees will be consulted

How employees will be consulted – Include at least four (4) agreed consultation / participation strategies
1
2
3
4
Establishment of Consultation and Participation Arrangements

Review of Consultation and Participation Arrangements

Agreed By:
Name: Signature: Date:
Name: Signature: Date:
Name: Signature: Date:
Name: Signature: Date:
Name: Signature: Date:
Name: Signature: Date:

3.4 Document Control and Managing WHS Records

It is vital to maintain records of the WHSMS. Records show Regulators, Insurers, workers and others that the organisation has taken all reasonable steps required to provide workers and others with a workplace that hazards, and risks are managed as much as reasonably practicable to reduce the probability of injury and harm occurring.

Records also demonstrate the effectiveness of the organisations WHS processes and procedures and can be used to measure whether WHS performance in the workplace has improved over time.

The Work Health and Safety Information System (WHSIS) is an organised system for the collection, organisation, storage and communication of information. The information needs to be organised so that it is easy to use and easy to access for all users.

3.4.1 Managing WHS Records

Records may include:
o Training and formal Qualifications and Certificates;
o Registers (Example: asbestos registers);
o The risk assessment and hazard identification process;
o Incident report forms;
o WHS meeting minutes; and
o Environmental monitoring including noise assessments.

In this activity you are required to determine any regulatory requirements and then develop a process for managing your records.

You will need to provide a minimum of five (5) examples for each section.

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.4.1 WHS Records Management
What records need to be kept? Refer to and record both internal and external requirements. Provide a minimum of five (5) examples.
Internal:
External:
How will records be filed?

How long are records retained for? Include both internal and external requirements
Internal:
External:
When and how will records be disposed of?

Who will be responsible for the records management?

3.4.2 Document Control

You will be required to decide:
o How and when you will consult with workers regarding the development and/or revision of documents;
o Who will be responsible for the development and approval of documents;
o Whether your documents will be available electronically or in hard copy;
o How you will control any external documents i.e. Codes of practice.

In this Activity you will be required to:
o Establish and implement procedures for managing and control of your WHSMS.

Complete the table below to detail how the WHSMS documentation will be managed and controlled as it relates to the case study or your workplace.

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.4.2 Documentation Control
Detail how and when you will consult with workers regarding the development of documents (identify the stakeholders consulted)

Detail who will be responsible for the development and approval of documents.

Explain whether the documents will be available electronically or in hard copy or both.

Describe how workers will access documents.

Detail how you will communicate with workers when new or revised documents are available.

Describe how often documents will be reviewed and by whom
(detail different types of document i.e. SWMS Weekly)

Explain how you will control your documents to ensure that only the current versions are in use.

Detail how you will control the currency of external documents.
EG: Codes of practice

3.5 Hazards and Risks

In developing the WHS Policy, you will have identified and stated how you will meet your commitment to identifying, assessing and controlling hazards and risks in the workplace.

In order to meet this commitment, you will need to:

o Identify potentially hazardous situations in the workplace which may cause injury, illness or harm;
o Assess the likelihood and consequence of the exposure to risk;
o Identify and implement control measures for eliminating or reducing the risk;
o Continuously review these measures to ensure the effectiveness of the controls.

Make sure you refer to your relevant State or Territory WHS Regulator for further information and guidance if required.

In the following activities you are required to contribute to the development of the WHS Management Plan by developing an outline of the following:

o Establish a Risk Management procedure for identifying and assessing risks and assigning controls; and
o Develop the tools for managing and recording hazards, risks and controls including:
 WHS Risk Register;
 Hazard Identification Tools/Checklists.

3.5.1 Risk Management Procedure

The Risk Management Procedure outlines how an organisation will comply with its legal requirement to identify hazards and control risks arising from its activities. This procedure ensures that there is a consistent approach across the organisation.

Complete the template provided for 3.5.1 Risk Management Procedure to outline your overall Risk Management Procedure that will form part of your overall WHS Management Plan. Consider how it relates to the case study or your workplace in order to complete this activity. You may decide to develop an Isolation or High-Risk Activity Supervision procedure for example.

NOTE: This is not a Standard Operating Procedure however; it may form the basis for the development of a Standard Operating Procedure.

The template provided is a guide only. You may elect to develop your own template if preferred.

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.5.1 Risk Management Procedure

Hazards Identification
Consider hazard identification methods/ tools used in the workplace e.g. hazard report form

Risk Assessment
Consider how to conduct a risk assessment using a risk matrix

Identify Controls using the Hierarchy of Controls
Consider general application of the hierarchy of control

Implement Control Measures
Consider documentation and consultation

Monitoring and Review
Consider some common monitor and review practices in the workplace

Issue Date: Review Date:
DEVELOPED BY:
Name: Position:
Signature: Date:
AUTHORISED BY (PCBU):
Name: Position:
Signature: Date:

3.5.2 Hazard Management Tools

In 2.3 WHS Management Plan Matrix you have outlined how you plan to identify, assess and control risks in your workplace, including those you are required to control by legislation.

Now you are required to carry out these tasks in consultation with your Workers. Consider how it relates to the case study or your workplace in order to complete this activity.

Remember, you will be required to review and repeat the process as required on a regular basis to ensure any new information available is considered.

You will also be required to repeat the process:

o After an incident has been reported;
o When you are planning to carry out any new tasks; and
o When you use different equipment or change the way something is done.

Ensure any changes are documented and incorporated into relevant work procedures and that Workers receive the appropriate training required.

In this Activity you will be required to create a Hazard Management tool suitable for your workplace

NOTE: There is no template provided for this activity.

Complete the activity on a separate document and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.5.3 WHS Risk Register

Based on the case study or your own workplace, develop a WHS Risk Register that can be used to record the hazards, risks and controls relevant to the case study or your workplace.

Your risk register must contain fields to capture the following:
o Description and location of hazards
o Associated risk/s
o Inherent risk rating
o Controls implemented
o Residual risk rating
o Owner / responsible person
o Close out and review dates
o
NOTE: There is no template provided for this activity.

3.5.4 Hazards Associated with Plant

Plant includes machinery, equipment, appliances, containers, implements and tools and any components or anything fitted or connected to those things. Plant includes items as diverse as lifts, cranes, computers, machinery, conveyors, forklifts, vehicles, power tools, quad bikes, mobile plant and amusement devices.
The general duty of care under the WHS Act applies to this type of plant. Plant that relies exclusively on manual power for its operation and is designed to be primarily supported by hand, for example a screwdriver, is not covered by the WHS Regulations.
Plant is a major cause of work-related death and injury in Australian workplaces. There are significant risks associated with using plant and severe injuries can result from the unsafe use of plant including:
o Limbs amputated by unguarded moving parts of machines
o Being crushed by mobile plant
o Sustaining fractures from falls while accessing, operating or maintaining plant
o Being crushed by a quad bike rollover
o Electric shock from plant that is not adequately protected or isolated, and
o Burns or scalds due to contact with hot surfaces, or exposure to flames or hot fluids.
Other risks include hearing loss due to noisy plant and musculoskeletal disorders caused by manually handling or operating poorly designed plant.

Identify two (2) items of plant used (or which could be used) in your workplace and complete the following activity.
3.5.4 Hazards Associated with Plant
Question / Activity Item of Plant #1 Item of Plant #1
Plant Description:
Make / Model:
Application / use in the workplace:
Plant Registration Required? (Describe)
Operator licensing and/or certification required?
(Describe)
Strategies for communicating registration, licencing and/or certification requirements:
Stakeholders to be consulted:
(Include specialist consultants where applicable)
Applicable WHS Legislation:
Applicable organisational policies and procedures:
Sources of relevant WHS information about the item of plant (at least three (3)):

Determine the hazards arising from the item of plant. Consider each of the following:
plant use, condition, suitability, location and potential abnormal situations Plant Use Plant Use

Plant Condition Plant Condition

Plant Suitability Plant Suitability

Plant Location Plant Location

Potential Abnormal Situations Potential Abnormal Situations

Use the WHS Risk Register developed in Activity 3.5.3 to record all of the hazards identified for both items of plant. Assess the risks posed by each hazard, apply controls and determine the residual risks. Save as Activity 3.5.4 and submit separately.
Who would you consult with to confirm the risk management strategies and controls defined in the risk register?
Monitoring strategies:
Training needs:
Retention of training records:
How do you ensure that only trained operators use this plant?

3.6 Internal and External Reporting

Workers are often the first ones to become aware of WHS hazards.

Reporting is a useful tool for:
o Identifying trends; and
o Understanding why incidents occur and whether the actions taken to prevent them have been effective or not.

You will be required to establish internal procedures for:
o Reporting hazards;
o Incident reporting and investigating incidents;
o Reporting and resolution of WHS issues; and
o Reporting on WHS performance.

You will also need to establish external reporting procedures for:
o Reporting to the organisations Workers Compensation Insurer;
o Statutory reporting i.e. reporting of notifiable incidents, death, serious injury or illness or a dangerous incident to the appropriate authorities; and
o Stakeholder reporting including annual reports.
Complete the template for internal and external WHS reporting relevant to the case study or your workplace. Ensure specific examples are provided for each i.e. notifiable incident reporting to the Regulator.

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.6 Internal and External Reporting Procedures
Internal Reporting Procedures

External Reporting Procedures

3.7 Emergency Planning

There is still a chance that incidents will occur that are beyond the PCBU’s control i.e. external emergencies, natural disasters, etc.

It is vital to have appropriate emergency plans and procedures in place.

This means you will be required to:

o Identify the types of emergency situations which may arise;
o Determine how you will respond to these emergencies;
o Assign responsibilities (e.g. emergency wardens, first aid officers, etc.);
o Provide appropriate training;
o Communicate emergency arrangements including emergency contact numbers to all Workers;
o Ensure any emergency equipment is regularly inspected, serviced and maintained by a licensed contractor or service provider;
o Comply with essential services maintenance requirements in your State and/or Territory; and
o Practice your emergency procedures regularly.

In this activity you will be required to:

o Develop an Emergency Risk Register
o Develop and implement emergency plans and procedures including incident response.

Refer to the following to assist you with this activity if available: AS/NZS 3745:2010 Planning for emergencies in facilities

3.7.1 Emergency Risk Register

Complete the following table to identify potential emergencies assess the level of risk associated with each potential emergency and provide recommended controls. (Include Fire emergency response)

In developing the risk register and procedures you will need to seek input from key stakeholders and specialist emergency services where required to assist in identifying causes of potential emergencies.

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.7.1 Emergency Risk Register
Nature of emergency Recommended Controls Risk Rating
Example: Bomb threats and suspected devices Procedures
Evacuation Drills
Training M
Fire Emergency

3.7.2 Emergency Response Plan

In this activity you are required to design an emergency response plan for two (2) of the emergency categories identified in 3.7.1 Emergency Risk Register. One must be designed for a Fire emergency response plan for your Organisation. You may choose to develop an emergency plan for any relevant emergency:

In your emergency plan, you will need to include the following elements:

o State the type of emergency you have chosen from the above list;
o Design and prioritise actions to be taken in the initial response phase;
o List the process for checking and accounting for people and;
o Identify the resource requirements e.g. personnel and equipment;
o Design and prioritise actions to be taken in the secondary response phase e.g. post disaster;
o How are you going to monitor and review this procedure?

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

Emergency Plan #1
Emergency type:

Emergency Plan #2
Emergency type:

3.7.3 Emergency Contact List

Based on the case study provided or your own workplace complete an emergency contact list. Where possible, provide genuine contact numbers.

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.7.3 Emergency Contact List
POLICE, FIRE & AMBULANCE – Call 000
(112 from a mobile handset)
Internal Information
Principal contractor:
Contact details:
Site supervisor:
Contact details:
Local Information
Poisons Information Centre:
Phone Carrier:
Local Council:
Electrical Emergency:
Dial before you dig:
Gas Emergency:
Water Emergency:
Regulator:
Insurance Provider:

3.8 Incident Response

Based on the case study provided or your own workplace you are required to complete the Incident Notification Report form. Simulate that you are the first person at the scene, consider your priority of actions, after you have secured the scene and arranged assistance; you are to fill out the incident notification form.

3.8.1 Incident Notification Report

For this activity, develop an incident investigation procedure to depict what workers need to follow.

Consider factors such as:

o Incident classification or severity
o Regulatory requirements
o Chain of command
o Internal and external timeframes
o Documentation
o Confidentiality

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.8.1 Incident Notification Report
All workplace incident must be immediately reported to your Area Manager/Supervisor
Section 1: Details of person completing the report
Report Date:
Last Name: First Name:
Position: Department:
Contact No: Contact Email:
Section 2: Incident Type
☐
Hazard ☐
Near miss ☐
Injury/illness ☐
Property damage or loss ☐
Other: (specify below)

Section 3: Incident Description – What happened
Description of Incident Location Date Time
am/pm
Section 4: Incident Cause(s) – How it happened
*Indicate the most relevant causes of the incident including near misses or hazards.

Injury Details
Did the injury result in (select below) Was the person injured by (select below)
Fatality ☐
Contact with moving parts or materials on a machine ☐
Amputation ☐
Being struck by a moving or falling object ☐
Fracture ☐
Being struck by moving vehicle or plant ☐
Soft tissue damage, strain or compression ☐
Striking against an object not moving ☐
ye injury ☐
Handling, lifting, moving or carrying a load ☐
Loss of consciousness ☐
Slipping, tripping or falling on the same le el ☐
Electric shock ☐
Falling from a height ☐
Electric burns ☐
Being trapped by a collapsing or overturning object ☐
Thermal burns ☐
Drowning or asphyxiation ☐
Chemical burns ☐
Contact with a harmful substance ☐
Stress, trauma or shock ☐
Exposure to harmful substance ☐
First aid treatment only ☐
Exposure to heat or fire ☐
Immediate medical treatment ☐
Exposure to explosion ☐
Hospitalisation for 24 hours or more ☐
Contact with electricity or electrical Discharge ☐
Three or more days absence from work ☐
Occupational violence ☐
Other (specify): ☐
Exposure to an animal or pathogen ☐
Section 5: Details of person involved in incident
*If more than one-person complete separate forms
Last Name: First Name:
Date of Birth: Guardian Name:
(if injured person is under 18 years)
Address:
Contact No: Email:
Employment Status: Employee: ☐
Contractor: ☐
Volunteer: ☐
Student: ☐
Member of Public: ☐
Other: (specify below)

Department: Position:
Section 6: Details of witnesses to the incident
*If not applicable, proceed to Section 7
Witness 1 Last Name: Fist Name:
Contact No:
Witness 2 Last Name: Fist Name:
Contact No:
Section 7: Details of injury / illness
*If not applicable, proceed to Section 8
Nature of Injury Location of Injury (Please specify below)
☐
Laceration / Contusion / Superficial
☐
Sprain / Strain
☐
Fracture / Dislocation
☐
Exposure to hazardous substances
☐
Psychological Injury
☐
Other:
Treatment Provided: Address of treatment – Medical Facility:
☐
None
☐
First Aid
☐
Doctor
☐
Hospital in-patient
☐
Unknown
☐
Other:
Section 8: Details of property damage or loss
*If not applicable, processed to Section 9

Nature of loss / damage Description of property
EG: Vehicle Make / Model / Year Location of loss / damage
(Supply image where possible)
☐
Damage to Motor Vehicle
☐
Lost / stolen physical / tangible property
☐
Lost / stolen intangible property (e.g. confidential information)
☐
Damage to clothing / equipment / machinery
☐
Damage to perishable goods
☐
Structural damage to building
☐
Fines / penalties
☐
Other:
Section 9: Details of action taken after the incident
*If not applicable, processed to Section 10
Action Taken By whom Date Completed

Section 10: Incident report notification
Internal notification Date
☐
Risk / Audit Committee
☐
Executive Group
☐
General Manager
☐
WHS Manager
☐
HSR/HSC
☐
Other:
External notification Date
☐
Insurer
☐
WHS Regulator
☐
Police
☐
Other:
Section 11: Manager/Supervisor Assessment
Does this incident require further investigation?
Assess the need for an investigation against the Organisations Investigation Policy or Procedure. ☐
Yes (complete incident investigation)
☐
No, provide reasons below:

Full name of Manager / Supervisor: Date:
Signature of Manager / Supervisor: Date:
NOTES:

☐
A copy of the report has been securely filed. The pathway is:

3.8.2 Incident Investigation Flow Chart
For this activity, develop an incident investigation procedure to depict what workers need to follow.

Consider factors such as:

o Incident classification or severity
o Regulatory requirements
o Chain of command
o Internal and external timeframes
o Documentation
o Confidentiality

From the incident report completed above you are now required to develop an incident investigation plan. The plan will need to detail the following:

o Who will be involved in the incident investigation team (names and roles);
o Define the scope and purpose of the investigation;
o Detail agreed processes for all phases of the investigation;
o Identify and document the necessary resources to conduct the investigation including expert advice as required;
o Identify agreed timelines, objectives, responsibilities, roles, documentation, action and outcomes required.

Throughout this planning phase you will need to ensure the participation of and consultation with individuals and parties.

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.8.3 Incident Investigation Plan
Incident ID No: Date:
Investigation Team:
Name: Position: Allocated responsibilities:
EG: interview witnesses
Name: Position: Allocated responsibilities:
Name: Position: Allocated responsibilities:
Name: Position: Allocated responsibilities:
Investigation Scope

Detail agreed processes for all phases of the investigation:

Resource Requirements (including document and expert advice):

Investigation Details
Timelines of the investigation:
Objectives:
Documentation:
Immediate actions undertaken:

3.8.4 Incident Investigation Report

Based on the plan you have just developed and the incident/emergency that has taken place, you are now required to conduct an incident investigation.

As a minimum you will need to:

o Identify and access sources of information and data;
o Inspect incident site, equipment and other evidence, and document outcome of inspection;
o Gather information and data in ways that ensure objectivity, confidentiality, validity and accuracy.

You will be required to analyse the information and data gathered during the investigation process and identify immediate and underlying causes including practical prevention measures.

This will require you to:

o Construct timeline of events leading up to the incident;
o Investigate key events, conditions and/or circumstances that together resulted in the incident;
o Develop corrective actions, interventions and practical measures to prevent the re-occurrence of the incident and to address root causes;
o Detail recommended corrective actions, interventions or measures, and plans for the implementation and evaluation.

After conducting the incident investigation, you will need to compile and communicate the investigation report to relevant stakeholders. The report will need to be written using objective language, cite evidence and the basis for conclusions and your recommendations.

Complete the template below, or complete and submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

3.8.4 Incident Investigation Report
Section 1: Details of person completing the report
Report Date: ID No:
Last Name: First Name:
Position: Department:
Contact No: Contact Email:
Section 2: Details of investigation team
Name: Position: Responsibilities:
Name: Position: Responsibilities:
Name: Position: Responsibilities:
Section 3: Details of persons interviewed
Name: Contact no:
Name: Contact no:
Name: Contact no:
Section 4: Incident description (what happened)

Section 5: Timeline of events

Section 6: Key events

Section 7: Contributing factors (List all contributing factors to the incident (People, Environment, Equipment, Process, Organisation) to identify root causes)

Section 8: Risk identification and analysis (If no controls in place or controls not effective complete Section 9)
Identify all risks that are relevant to the incident
Example: Inexperienced workers operating plant Identify any existing controls in place to manage the risks
Example: Supervision and training of staff Are the existing controls effective?
Yes No N/A
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
Section 9: Corrective Action Plan
What actions have been undertaken or will be undertaken to prevent the incident from recurring?
Corrective Action Responsibility Due Date Completed Date

Section 10: Incident investigation notification
Completed report has been provided to:
☐
WHS Advisor ☐
WHS Manager
☐
Executive Group ☐
HSR
☐
General Manager ☐
Other:
Section 11: Supporting Evidence (detail all attachments and file appropriately):

NOTES:

☐
A copy of the report has been securely filed. The pathway is:

End of Section 3

Section 4 Measurement and Evaluation

This section of the Workbook requires you to develop systems and reporting processes to measure, monitor and evaluate WHS performance and determine how and when preventative or corrective actions should be taken.

4.1 WHSMS Audit

In this activity you are conducting an audit of the WHSMS you have developed thus far. You are to confirm whether the system conforms to the Australian Standard, AS/NZ4801:2001 Occupational Health and Safety Management Systems, Specification with guidance for use objectives.

Should there be an element that does not conform; you will need to state the degree of non-compliance. You are to conduct this audit on the WHSMS and data you have developed to date. This will assist to establish in gaps in the system for further action.

You will need to complete these activities on the following pages:
o 4.1.1 Audit plan
o 4.1.2 WHS Management Systems Audit
o 4.1.3 Assessment and Rating Table – Summary of Audit Findings

4.1.1 Audit Plan

4.1.1 Audit Plan
General Information
Organisation Name: Organisation Representative:
Date: Location:
Audit Requirement / Standard
AS/NZS 4801:2001 Occupational Health and Safety Management Systems
Scope & Objectives
Scope:
Objectives:
Audit Team
Name Responsibilities

Privacy & Confidentiality

Distribution of Reports

Contingency Actions
1.
2.
3.
Audit Schedule
Activity Allocated Time Personnel Topic/s Resources / Documents
4.1.2 WHS Management System Audit

WHSMS Audit – Assessment & Rating Methodology
LABEL RESULT PERFORMANCE
YES Conformance An element is deemed to have met conformance when it can be demonstrated that the element requirements have been addressed.
NO – Minor Minor Non-conformance Satisfies minimum requirements of the indicator only. Basic documentation can be produced if specified in the indicator. A minor non-conformance occurs if all requirements have only been partially implemented.
NO – Major Major Non-conformance A major non-conformance is where many of the element requirements have not been met or are in the early stages of development. Areas of high risk that have not been effectively controlled would also constitute a major non-conformance.

AS/NZS 4801:2001 – Audit Checklist
4.2 OHS/WHS Policy
4.2 OHS/WHS Policy Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Is there a written OHS/WHS Policy statement?
Has the Organisation’s OHS/WHS policy been authorised by the Organisations top management?
Does the OHS/WHS policy clearly state the health and safety objectives?
Does the OHS/WHS policy clearly state the commitment to improving health and safety performance?
Is the OHS/WHS policy appropriate to the nature and scale of the Organisation’s OHS/WHS risks?
Does the Organisation’s OHS/WHS policy include the commitment to establish measurable objectives and targets to ensure continued improvement aimed at elimination of work-related injury and illness?
Does the Organisation’s OHS/WHS policy include a commitment to comply with relevant OHS/WHS legislation and with other requirements placed upon the Organisation or to which the Organisation subscribes?
Does the OHS/WHS policy include a commitment to consultation with employees?
Has the Organisation’s OHS/WHS policy been documented, maintained and communicated to all employees as part of the company’s operations and incorporated into duty statements, procedure manuals and job descriptions??
Has the Organisation’s OHS/WHS policy been made available to all interested parties?
Has/Is the Organisation’s OHS/WHS policy been periodically reviewed to ensure it remains relevant and appropriate to the Organisation?
Comments:

4.3 Planning
4.3.1: Planning Identification of hazards, assessment and control of risks
Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Has the Organisation established, implemented and maintained documented procedures to identify the OHS/WHS hazards and assess and control the associated risks of activities, products and services over which an Organisation has control or influence, including the activities, products and services of contractors and suppliers?
Has the Organisation developed a methodology for hazard identification, risk assessment and risk control, based on its operation experience and its commitment to eliminate workplace illness and injury?
Comments:

4.3.2 Legal and other Requirements Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Has the Organisation established implemented and maintained procedures to identify and have access to all legal and other requirements that are directly applicable to the OHS/WHS issues related to its activities, products or services, including relevant relationships with contractors or suppliers?
Has the Organisation communicated relevant legal and other requirements to its Employees?
Comments:

4.3.3 Objectives and Targets
Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
The Organisation has established implemented and maintained documented OHS/WHS objectives and targets, at each relevant function and level within the Organisation.
When establishing and reviewing its objectives, the Organisation has considered its legal and other requirements, its hazards and risks, its technological options, its operational and business requirements.
When reviewing OHS/WHS objectives does the Organisation consider the views and opinions or interested parties?
Are the OHS/WHS objectives consistent with the OHS/WHS policy (including commitment to measuring and improving OHS/WHS performance)?
Comments:

4.3.4 OHS/WHS Management Plans Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Have OHS/WHS management plans been established and maintained that include the following:
Plans for achieving OHS/WHS objectives and targets;
Designation of responsibility for objectives and targets at relevant functions and levels of the Organisation; and
The means and time frame by which objectives and targets are to be achieved.
Do procedures exist to ensure that current plans are reviewed, and if necessary, amended to address such changes at regular and planned intervals, and whenever there are changes to the activities, products, or services of the Organisation or significant changes in operating conditions?
There is a documented process to regularly monitor/review the implementation of the OHS/WHS management plan and update as required.
There is a documented process/procedure (or similar document) that defines the requirement and methodology for reviewing the implementation of the project OHS/WHS plan and a provision for updating if necessary. The process should consider the suitability, adequacy, effectiveness and possible improvement of the OHSWHS plan.
Review periods can be time dependent or based on milestones applicable to the project program.
Evidence of previous versions of the OHS/WHS plan.
Project audits focussed on verifying implementation of the OHS/WHS plan.
Comments:

4.4 Implementation and Operation
4.4.1 Structure and Responsibility
4.4.1.1 Resources Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Have management identified and provided resources to implement, maintain and improve the OHS/WHSMS, as required? Resources include human resources and specialised skills, technology and financial resources.
Does management:
Provide equipment, materials and personal protective equipment as prescribed by legislation?
See that equipment is maintained in good condition?
See that the equipment, materials and personal protective equipment provided are used as prescribed?
Is there a PPE procedure in the workplace?
Is it appropriate and sufficient for the job being done and in good condition?
Has training on the fit, use and maintenance been provided to employees?
Do employees and others wear their PPE?
Comments:

4.4.1.2 Responsibility and Accountability Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
To establish that managers have been delegated specific responsibilities in the area of health and safety as part of their management function. This includes the method and extent of accountability to executive management for the discharge of these responsibilities.
The Organisation is required to provide evidence that:
managers have been delegated specific responsibilities in the area of health and safety as part of their management function;
this delegation is supported by written documentation;
where such delegation has been made, managers concerned have adequate understanding of method and extent of accountability to executive management;
level of understanding and method/extent of accountability to executive management for discharge of these responsibilities is adequate;
whether the demonstration of a manager’s ability to carry out these responsibilities is performance based and integrated with other measures of performance, e.g. production, lost time, damage minimisation;
whether evidence exists of regular reporting, preferable in written form and to a particular format;
whether key performance indicators have been established for health and safety performance in each area of responsibility; and
whether a Workplace Health and Safety Officer has been appointed, trained and resourced as required by legislation.
Does the Organisation define, document and communicate the areas of accountability and responsibility (including those imposed by OHS/WHS legislation) of all personnel involved in the OHS/WHSMS’s operation?
If contractors are involved, does the Organisation clarify areas of accountability and responsibility as applied to those contractors?
Is there a specifically appointed management representative who has defined roles, responsibility, and authority for ensuring that OHS/WHSMS requirements are established, implemented and maintained in accordance with this Standard (AS/NZ4801)?
Is there a specifically appointed management representative who has defined roles, responsibility, and authority for reporting on the performance of the OHS/WHSMS to top management for review and as a basis for improvement of the OHS/WHSMS?
Are health, safety and welfare responsibilities clearly defined, assigned and understood by everyone at the workplace?
Is there a person who is responsible for developing and implementing the health and safety program and for ensuring the program’s compliance with all legislation? Is this a senior position in the Organisation and does this person have authority to take action?
Are Directors and Managers aware of their responsibilities under the legislation? Do they:
Ensure that people under their control work in compliance with the Act and Regulations?
Verify and review health, safety and welfare issues at every board meeting and ensure that the company is in compliance with the relevant legislation. (e.g. are procedures in place)?
Act promptly when they become aware of a problem (e.g. if a notice is issued)? Do they promptly issue instructions in writing to the appropriate company official to ensure that any contraventions are quickly corrected?
Keep documentation on file to demonstrate their involvement in major health and safety issues.
Take appropriate steps after an incident.
Keep up to date on OHS/WHS issues relating to the business and understand the hazards and nature of risks; and
Have knowledge of hazard controls to manage the risks to as low as reasonable.
Do Supervisors:
Advise workers under their control of potential or actual hazards?
Provide workers with written instructions on the measures and procedures that are to be followed?
Ensure that workers under their control work, use, or wear the equipment, personal protective equipment or clothing that the employer require
Ensure that workers work in the manner and with the personal protective equipment, measures and procedures required by the Act and applicable Regulations or that is required by the relevant legislation?
Do Employees:
Use or wear the equipment, PPE or clothing that is required by the employer?
Cooperate with respect to legislative requirements?
Comments:

4.4.2 Training and Competency Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Does the Organisation consult with employees to identify training needs in relation to performing work activities competently, including OHS/WHS training?
Are procedures in place to ensure that OHS/WHS competencies are developed and maintained?
Are personnel assessed as competent based on skills achieved through education, training or experience, to perform assigned tasks taking into account the OHS/WHS obligations, hazards and risks associated with the work activities?
Do procedures exist for OHS/WHS training that take into account the characteristics and composition of the workforce which impact on occupational health and safety management?
Do procedures exist for OHS/WHS training that take into account responsibilities, hazards and risks?
Does the Organisation ensure that all personnel (including contractors and visitors) have undertaken training appropriate to the identified needs?
Is training conducted by persons with appropriate knowledge, skills and experience in OHS/WHS and training?
Does management communicate responsibilities/ accountabilities to line management and others?
Does management have a system which revises the allocation of responsibilities/accountabilities following evaluation?
Has management identified training needs of all persons within this workplace?
Does the Organisation provide information, instruction, training and supervision to employees to protect their health, safety and welfare?
Can recipients understand the training?
Have all training activities been documented (date of training, content, who received the training)? Are these records kept on file?
Have employees been evaluated or tested to ensure that they understand and can apply what they’ve been taught? (Tests can be performance-based, oral, written etc.) Is additional training and testing carried out if a person doesn’t pass any tests given? Are the results kept on file?
Is refresher training provided regularly and updated on a regular basis to ensure that it covers the equipment, materials and processes that are currently being used in the workplace?
Are contractors provided with information, instruction & training on site safety requirements?
Are contractors checked for safety systems & practices, relevant qualifications, licenses and permits prior to the commencement of the contract?
Do contractors provide safe work method statements and job safety analyses for work to be performed
Do contractors follow the safe work method statements they provide?
Are contractors supervised whilst on site?
Is a post contract review conducted to review the performance of the contractor?
Comments:

4.4.3 Consultation, Communication and Reporting
4.4.3.1 Consultation
Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Are there documented procedures, agreed to by the employees, for employee involvement and consultation in OHS/WHS issues?
Are Employee involvement and consultation arrangements documented and made available to interested parties?
Are Employees:
Involved in the development of policies and procedures to manage risks?
Consulted where there are any changes that affect workplace health and safety?
Represented on health and safety matters?
Informed of who their employee OHS/WHS representative(s) is/are aware of whom their OHS/WHS representative and management representatives are?
Comments:

4.4.3.2 Communication
Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Does the Organisation have procedures for ensuring that pertinent OHS/WHS information is communicated to and from employees and other interested parties?
There is a documented process to ensure all workers onsite are advised of, and have ready access to, current Health and Safety Acts, Regulations, Australian Standards, Codes of practice and other documentation relevant to health and safety.
Does management communicate the policy objectives to all employees and others at this workplace?
Does management evaluate the effectiveness of communicating the policy objectives?
Do supervisors regularly communicate to their workers the hazards and potential hazards involved in their tasks and provide training in how to work safely to protect against those hazards?
Are changes to tools, equipment, materials, processes and procedures communicated to employees before they are implemented? Are employees given specific instructions in how to work safely when these workplace changes are made?
Is health and safety regularly discussed at supervisory, managerial and department meetings? For example, are safety rules, practices and procedures regularly reviewed? Are employee questions and concerns about health and safety discussed?
Are safety rules and procedures posted in prominent places to remind workers how to work safely?
Are safety signs used in the workplace? If so, what are they?
Are posters displayed in the workplace as required by State/Territory legislation?
Do you have posted the name of who to contact for First Aid, Bullying & Harassment issues?
Comments:

4.4.3.3 Reporting
Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Does the Organisation have appropriate implemented procedures for relevant and timely reporting of information that ensure the OHS/WHSMS is monitored and performance reviewed?
Do these reporting procedures include OHS/WHS performance reporting including:
Results of OHS/WHS audits and reviews)?
Reporting of incidents and system failures?
Reporting on hazard identifications?
Reporting on risk assessment?
Reporting on preventative and corrective action?
Statutory reporting requirements?
Does management evaluate the effectiveness of the performance of persons with allocated responsibilities?
Does management have a system for investigating and recording accidents/incidents, dangerous occurrences and work-related illnesses?
Is there a company standard for investigating and reporting of accidents/incidents?
Does management implement these requirements for investigating and reporting accidents/incidents at this workplace?
Is there a comprehensive injury/ incident investigation reporting procedure in place and is it monitored on a regular basis to ensure that it is being followed?
Is there an internal procedure that requires management to undertake its own investigation after an incident/accident? Is this investigation thorough and detailed? Are immediate steps taken to correct and implement remedial solutions?
Is the HSC involved in the procedure of investigating critical injuries or fatalities?
Are Incident Report Forms filed with the Regulator e.g. WorkCover (in the case of fatalities, serious personal injury, work-related illnesses and dangerous occurrences) within the required time frame?
In the event of a serious injury or fatality, is the workplace secured and left undisturbed until the appropriate authorities (e.g. police, WorkCover) have completed all investigations?
Is follow-up action taken to ensure that corrective measures have been implemented and are functioning?
Are injury/incident investigation reports reviewed to determine the causes of accidents and the means of preventing similar accidents in the future?
4.4.4 Documentation Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Does the Organisation establish, implement and maintain information to describe the core elements of the management system and their interaction?
Does the Organisation establish, implement and maintain information to provide direction to related documentation?
Does management identify information pertinent to this workplace?
Comments:

4.4.5 Documentation and Data Control Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Has the Organisation established, implemented and maintained procedures for controlling all relevant documents and data required by this standard to ensure that:
they can be readily located;
periodically reviewed;
current versions are accessible at all locations
obsolete documents and data are promptly removed; and
Archival documents and data are retained for legal or knowledge preservation.
Comments:

4.4.6 Hazard Identification, risk assessment and control of risks Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Does the Organisation ensure that hazards are identified, risks assessed, control measures implemented then monitored and reviewed for effectiveness?
Does the Organisation have established, implemented and maintained documented procedures ensuring that:
Hazards are identified?
Risks are assessed?
Risks are controlled?
Evaluation of the above?
Does the employer take corrective action when hazards are reported?
Are managers and directors aware of the nature of the hazards and the risk factors associated with these hazards?
Are all potential and actual hazards identified and communicated to the employees?
Are regular workplace inspections conducted by members of the HSC?
Do supervisors and employees monitor their work areas and equipment on an ongoing basis to identify and correct hazardous situations?
Are written procedures established for different types of inspections (e.g. production, equipment, vehicle)? Do the written procedures have specific checklists for reporting hazards?
Is the supervisor actively involved in all aspects of audits, inspections and other means of hazard identification so that a system is in place to address all actual or potential hazards?
Is there an assessment procedure for hazards that is based on degree of risk, probability of occurrence, number of persons exposed and duration of exposure?
Are high-risk activities (e.g. confined space entry, working with electricity) identified and safe procedures put in place?
Are the assessment criteria taken into account when determining priorities for action?
Are appropriate control mechanisms (such as engineering controls, work practices, hygiene practices and procedures, personal protective equipment, emergency plan, etc.) in place and maintained?
Are standards set for each hazard control element? Do these standards take applicable regulations, standards, codes, manufacturing specifications, etc., into account?
Comments:

4.4.6.2 Hazard Identification Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
When identifying hazards, has the Organisation taken into account;
The situation or events or combination of circumstances that has the potential to give rise to injury or illness;
The nature of potential injury or illness relevant to the hazard;
Past injuries, incidents and illnesses;
Further consideration has been given to:
work Organisation;
work design;
work systems;
the purchase of goods and services;
Hazard associated with contractual arrangements.
The inspection, maintenance, testing repair and replacement of plant and equipment.
Comments:

4.4.6.3 Risk assessment Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Has the Organisations hazards/risks been assessed and have control priorities been assigned, based on the established level of risk.
Comments:

4.4.6.4 Control of risks Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Are all risks identified through the assessment process as requiring control, controlled through a preferred hierarchy of control methods based on reasonable practicability?
Comments:

4.4.6.5 Evaluation Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Does the Organisation conduct a documented evaluation of hazard identification, risk assessment and risk control to ascertain the effectiveness of controls and make modifications as required?
Comments:

4.4.7 Emergency preparedness and response Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Has the Organisation identified potential emergency situations and developed implemented and practiced emergency preparedness and response procedures?
Does the Organisation review and revise, where necessary, its emergency preparedness and response procedures, in particular, after the occurrence of incidents or emergency situations?
Does the Organisation periodically test (or train for) such procedures?
There is a documented process to ensure emergency response arrangements are communicated to all personnel and visitors.
There is a documented process to ensure emergency drills are planned and carried out onsite.
There is a documented process to ensure designated emergency personnel (wardens etc.) receive training and practice in emergency procedures appropriate to their allocated emergency response responsibilities and the degree of risk.
There is a documented process to ensure competent persons have assessed the suitability, location and accessibility of emergency equipment.
Has management implemented emergency procedures?
Have all emergencies which require evacuation of the working area been identified (e.g. fire, bomb threat, flooding)
Have you nominated a person/s to be responsible for managing the evacuation?
Have you identified evacuation communications?
Is there someone responsible for activating the signal?
Is there a designated assembly point after the evacuation?
Have emergency plans been developed for emergencies identified?
Is there a system in place to ensure that everyone is accounted for following evacuation?
Are fire extinguishers in place, clearly marked for the type of fire and serviced within the last 6 months?
Are there illuminated exit signs and direction to exits?
Are exit doors easily opened from inside?
Are exits and fire extinguishers clear of obstructions?
Is the fire alarm system working (if you have one)?
Are staff trained in evacuation procedures?
Are records kept of training conducted?
Are emergency plans or procedure displayed? (Procedure for evacuation, assembly location, nominated person etc.)
Have fire drills been conducted in the previous 12 months?
When was the last fire evacuation drill?
Are any staff trained in the use of fire extinguishers?
Comments:

4.5.1.1 Monitoring and measurement
Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Has the Organisation established, implemented and maintained documented procedures to monitor and measure on a regular basis the activities that may cause injury or illness, using the appropriate equipment for monitoring and measuring that is calibrated, maintained and stored appropriately?
Has equipment for monitoring and measuring health and safety risks been identified, calibrated, maintained and stored as necessary?
Have records of such monitoring and measuring procedures.
With regard to OHS/WHSMS the Organisation has established implemented and maintained procedures for measuring: Performance effectiveness of relevant controls conformance with Organisations targets and objectives; and Compliance with relevant OHS/WHS legislation.
Comments:

4.5.1.2 Health surveillance
Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Has the Organisation identified those situations where employee health surveillance should occur?
Is the health of employees exposed to specific hazards monitored, where required by legislation?
Comments:

4.5.2 Incident investigation, corrective and preventative action Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Has the Organisation implemented and recorded any changes in the OHS/WHSMS procedures resulting from incident investigations and corrective and preventative actions for:
Responding to and taking action to minimise any harm caused from incidents?
Investigation and responding to system failures?
Initiating and completing appropriate corrective and preventative action?
Has the Organisation established a system of implementation and recording changes in OHS/WHSMS procedures resulting from incident investigations, preventative and corrective action?
Comments:

4.5.3 Records and records management Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Do established, implemented and maintained procedures exist for the identification, maintenance and disposition of OHS/WHS records, as well as the results of audits and reviews?
Are OHS/WHS records legible, identifiable and traceable to the activity, product or service involved?
Are OHS/WHS records stored and maintained in such a way that they are readily retrievable and protected against damage, deterioration and loss?
Has the Organisation established and recorded retention times for OHS/WHS records?
Are records maintained as appropriate to the system and to the Organisation, to demonstrate conformance to the requirements of this standard?
Comments:

4.5.4 OHS/WHSMS Audit
Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Has the Organisation established, implemented and maintained an audit program and procedures for periodic OHS/WHSMS Audits – carried out by a competent person.
Determine whether the OHS/WHSMS:
Conforms to planned arrangements for OHS/WHS management including the requirements of this Standard;
Has been properly implemented and maintained; and
Is effective in meeting the Organisation’s policy as well as objectives and targets for continual OHS/WHS improvement; and
Provide information on the results of audits to management, and employees
Comments:

4.6 Management Review Conformance

EG: Yes Reference and Comments
(Activity / Doc Name / No.)
EG 1.1 WHS Policy Sep19
Do the Organisation’s senior management perform management reviews of the OHS/WHSMS, to ensure its suitability, adequacy and effectiveness?
Does the management review process ensure that the necessary information is collected to allow management to carry out the above evaluation?
Does management review the continued relevance of, and change where appropriate, policy, objectives, responsibilities and other elements of the OHSMS, in the light of OHSMS audit results, changing circumstances and the commitment to continual improvement?
Comments:

4.1.3 Assessment and Rating Table – Summary of Audit Findings

Complete the table below using the results of the audit from the previous activity.

Element Documentation
Reviewed
(Yes/No) Conformance
(Yes/No) Non-Conformance
(Major/Minor)

4.2 OHS/WHS Policy
4.3.1 Planning Identification of hazards, assessment & control of risks.
4.3.2 Legal & other Requirements
4.3.3 Objectives & Targets
4.3.4 OHS/WHS/WHS Management Plans
4.4.11 Resources
4.4.1.2 Responsibility & Accountability
4.4.2 Training & Competency
4.4.3.1 Consultation
4.4.3.2 Communication
4.4.3.3 Reporting
4.4.4 Documentation
4.4.5 Document and Data Control
4.4.6 Hazard Identification, Risk Assessment and Control of Risks
4.4.6.2 Hazard Identification
4.4.6.3 Risk Assessment
4.4.6.4 Control of Risks
4.4.6.5 Evaluation
4.4.7 Emergency Preparedness & Response
4.5.1.1 Monitoring and Measurement
4.5.1.2 Health Surveillance
4.5.2 Incident Investigation, Corrective & Preventative Action
4.5.3 Records & Records Management
4.5.4 OHS/WHS/WHS Management System Audit
4.6 Management Review

End of Section 4

Section 5 Management Review

This section of the Workbook requires you to develop a schedule and process for reviewing the WHSMS to ensure that it continues to meet the Organisations needs and achieves the objective of continuous improvement.
5.1 WHSMS Targeted Review

The WHSMS must be reviewed regularly. In this activity you are required to conduct a review of the WHSMS targeting the following:

WHSMS Targeted Review
Legislation
o Have there been any changes to legislation?
o Has the WHSMS accounted for changes to regulatory requirements?
o Are changes to legislation expected during the next review period?

WHS Policy
o Does the policy comply with any changes made to WHS Legislation?
o Does the policy take into consideration any changes in worker activities or the workplace?
o Does the policy adequately express the Organisation’s commitment to WHS?

Objectives
o Have you met WHS objectives?
o Are any further actions required to meet the objectives?
o Do you need to modify the existing objectives or develop new ones?

Audits
o Have issues identified by audits been resolved?
o Are reviews of specific procedures or processes required?
o Is any specific training required?
o Does the audit process need to be reviewed?

WHS Reports
Analyse reports to identify trends and decide which aspects of WHS at the workplace require further action and help with setting new objectives or revising existing objectives. Document your findings below.

Communication
Review findings have been distributed to stakeholders using the following communication methods:

5.2 WHS Action Plan

Based on the review completed in Activity 5.1 you are now required to compile an action plan detailing how you intend to improve WHS performance across the Organisation. Include what is to be established and the steps required.

Complete the template below or submit as a separate attachment. Clearly label all attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.
5.2 WHS Action Plan
Topic / Factor Action/s What is to be established and implemented?
List all required steps Priority
(1=Highest, 5=Lowest) Responsibility Completion Date Review Date
Legislation

WHS Policy

Objectives

Audits

WHS Reports

Contractors

Fixed and Mobile Plant

5.3 WHSMS Review Report

Using the data collected during the evaluation and review process you are required to compile a report to Senior Management detailing how WHS could be improved through the WHSMS. Complete the template below to document improvements to WHS through the WHSMS or submit as a separate attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

5.3 WHSMS Review Report
Scope of Report:
Date:
Report compiled for:
Report compiled by:
Barriers to maintaining WHSMS:
Recommendations for promoting the WHSMS:
Recommendations to encourage consultation & participation:
Recommendations to encourage participation in the evaluation of WHS performance:
Recommended Positive Performance Indicators (PPIs) for improvement of the WHSMS:
Recommendations for training and development:
Recommendations for risk management:
Recommendations to improve contractor compliance:
Recommendations to improve safety relating to fixed and mobile plant.

Activity 5.4 – Contractor Review

Your management has asked you to review two (2) contractor services currently being supplied to your organisation. Review the service agreements below.

SERVICE #1 – Office Cleaner

OFFICE CLEANING SERVICE AGREEMENT

This office cleaning service agreement (the agreement) dated this 2nd day of September 2019
Between:
The Client Contractor
(Your Organisation) Cleanyberg Pty Ltd

OVERVIEW
1. The client is of the opinion that the Contractor has the necessary qualifications, experience and abilities to provide services to the Client.
2. The Contractor is agreeable to providing such services to The Client on the terms and conditions set out in this agreement.
In consideration of the matters described above and of the mutual benefits and obligations set forth in this agreement, the receipt and sufficiency in this agreement, the recept and sufficiency of which consideration is hereby acknowledged, the client and the contractor agree as follows:
SERVICES PROVIDED
1. The client hereby agrees to engage the contractor to provide the client with the following services:
a. Clean each office
b. Clean meeting rooms
c. Attend to, as necessary, the staff toilet amenities including the restocking of consumables such as tissues and soap etc.
d. Tidy kitchen, place dirty dishes and utensils in dishwasher and turn on
e. Empty garbage bins and remove waste
f. Wipe down all furniture, removing all dust and dirt
g. Place all furniture in correct position
2. The service is to be delivered at (Your business address)
3. The service is to be provided nightly, Monday to Friday after hours
4. From time to time there will be additional services required e.g.: glass cleaning. The contractor hereby agrees to provide such services to the client.
TERMS OF AGREEMENT
5. The term of this agreement will begin on the date of this agreement and will remain in full force and effect indefinitely until terminated as provided for in this agreement.
6. In the event that either party wishes to terminate this agreement, that party will be required to provide 30 day’s written notice to the other party.
7. In the event that either party breaches a material provision under this agreement, the non-defaulting party may terminate this agreement immediately and require the defaulting party to indemnify the non-defaulting party against all reasonable damages
8. This agreement may be terminated at any time by mutual agreement of both parties.
9. Except as otherwise provided in this agreement, the obligation of the Contractor will end upon the termination of this agreement.
PERFORMANCE
10. The parties agree to do everything necessary to ensure the terms referred to in this agreement take effect.
CURRENCY
11. Except as otherwise provided in this agreement, all monetary amounts referred to in this agreement are in AUD (Australian Dollars).
PAYMENT
12. The contractor will charge the client for the services at the rate of $33.00 per hour
13. The client will be invoiced on the last working day of each month
14. Invoices submitted for payment are due within 30 days of receipt of same.
15. The contractor is responsible for paying any Superannuation contributions that will be required in relation to the work performed by the contractor or by employees of the contractor under this agreement.
16. The payment as stated in this agreement does not include GST, all invoices submitted for payment by the contractor will have GST added to the total value of the invoice.
17. The contractor will not be reimbursed for any expenses incurred in connection with providing the services of this agreement.
PENALTIES FOR LATE PAYMENT
18. Any late payments will trigger a 5.0% per month interest payment on the amount owing.
CONFIDENTIALITY
19. Confidential information refers to any data or information relating to the business of the client which would reasonably be considered to be proprietary and these include but are not limited to records, processes, procedures and financial information that is not generally in the public arena. In particular, where the release of such information could reasonably be expected to cause harm to the client.
20. The contractor agrees that they will not disclose, divulge, reveal, report or use, for any purpose, any confidential information which the contractor has obtained, except as authorised by the client or as required by Law. The contractor further agrees that they will not disclose, divulge, reveal, report or use, for any purpose, any personal information of the client, without the prior written consent of the client. The obligations of confidentiality will apply during the term and will survive indefinitely upon termination of this agreement.
RETURN OF PROPERTY
21. Upon the expiry or termination of this agreement, the contractor will return to the client any property, documentation, records or confidential information which is the property of the client.
CAPACITY ON INDEPENDENT CONTRACTOR
22. In providing the services under this agreement it is expressly agreed that the contractor is acting as an independent contractor and not as an employee. The contractor and the client acknowledge that this agreement does not create a partnership or joint venture between them, and is exclusively a contract for service.
NOTICE
23. All notices, requests, demands or other communication required or permitted by the terms of this agreement will be given in writing and delivered to the parties at the following addresses:
a. Your Organisation Your Address
b. Cleanyberg Pty Ltd. 118 Charlestone Ave Whoopiberg South Australia 5009
AUSTRALIAN COMPANY NUMBER (ACN)
24. The ACN for the parties to this agreement are:
a. (Your Organisation) 12345678911
b. Cleanyberg Pty Ltd: 11987654321
INDEMNIFICATION
25. Except to the extent paid in settlement from any applicable insurance policies, and to the extent permitted by applicable law, each party agrees to indemnify and hold harmless the other party and its respective directors, shareholders, affiliates, officers, agents, employees, and permitted successors and assigns against any and all claims, losses, damages, liabilities, penalties, punitive damages, expenses, reasonable legal fees and costs of any kind or amount whatsoever, which result from or arise out of any act or omission of the indemnifying party, its respective directors, shareholders, affiliates, officers, agents, employees, and permitted successors and assigns that occurs in connection with this agreement. This indemnification will survive the termination of this agreement.
MODIFICATION OF AGREEMENT
26. Any amendment or modification of this agreement or additional obligation assumed by either party in connection with this agreement will only be binding if evidenced in writing, signed by each party or an authorised representative of each party.
TIME OF THE ESSENCE
27. Time is of the essence in this agreement. No extension or variation of this agreement will operate as a waiver of this provision.
ASSIGNMENT
28. The contractor will not voluntarily, or by operation of law, assign or otherwise transfer its obligations under the agreement without the prior written consent of the client.
ENTIRE AGREEMENT
29. It is agreed that there is no representation, warranty, collateral agreement or condition affecting this agreement except as expressly provided under this agreement.
ENUREMENT
30. This agreement will enure to the benefit of and be binding on the parties and their respective heirs, executors, administrators, and permitted successors and assigns.
TITLES AND HEADINGS
31. Headings are inserted for the convenience of the parties only and are not meant to be considered when interpreting this agreement
GENDER
32. Words in the singular mean and include the plural and vice versa. Words in the masculine mean and include the feminine and vice versa.
GOVERNING LAW
33. This agreement will be governed by and construed in accordance with the laws of the state in which the agreement is executed.
SEVERABILITY
34. In the event that any of the provisions of this agreement are held to be invalid or unenforceable in whole or in part, all other provisions will nevertheless continue to be valid and enforceable with the invalid or unenforceable parts severed from the remainder of this agreement.
WAIVER
35. The waiver by either party of a breach, default, delay or omission of any of the provisions of this agreement by the other party will not be construed as a waiver of any subsequent breach of the same or other provisions.
IN WITNESS WHEREOFF the parties have duly affixed their signatures under hand and seal on this 18th day of September 2019

Your Company Per Your Representative
Cleanyberg Pty Ltd Per Cynthia Cleanit

SERVICE #2, Photocopier Maintenance Contract

GENERAL SERVICE AGREEMENT
THIS GENERAL SERVICE AGREEMENT (the “Agreement”) dated this 19th day of September 2019
BETWEEN:
CLIENT
Your Organisation ABN: 12345678911 Your Address (the “Client”)
CONTRACTOR
Smashed Crab Printing ABN: 123456789123 Copyright St, Plagiarism SA 5000 (the “Contractor”)
BACKGROUND
A. The Client is of the opinion that the Contractor has the necessary qualifications, experience and abilities to provide services to the Client.
B. The Contractor is agreeable to providing such services to the Client on the terms and conditions set out in this Agreement.
IN CONSIDERATION OF the matters described above and of the mutual benefits and obligations set forth in this Agreement, the receipt and sufficiency of which consideration is hereby acknowledged, the Client and the Contractor (individually the “Party” and collectively the “Parties” to this Agreement) agree as follows:
SERVICES PROVIDED
1. The Client hereby agrees to engage the Contractor to provide the Client with the following services (the “Services”):
o Service and maintain XYZ brand photocopier.;
o Provide emergency repair within 4 hours of notification.; and
• Supply Toner.
2. The Services will also include any other tasks which the Parties may agree on. The Contractor hereby agrees to provide such Services to the Client.
TERM OF AGREEMENT
3. The term of this Agreement (the “Term”) will begin on the date of this Agreement and will remain in full force and effect indefinitely until terminated as provided in this Agreement.
4. In the event that either Party wishes to terminate this Agreement, that Party will be required to provide 21 days’ written notice to the other Party.
5. In the event that either Party breaches a material provision under this Agreement, the non-defaulting Party may terminate this Agreement immediately and require the defaulting Party to indemnify the non-defaulting Party against all reasonable damages.
6. This Agreement may be terminated at any time by mutual agreement of the Parties.
7. Except as otherwise provided in this Agreement, the obligations of the Contractor will end upon the termination of this Agreement.
PERFORMANCE
8. The Parties agree to do everything necessary to ensure that the terms of this Agreement take effect.
CURRENCY
9. Except as otherwise provided in this Agreement, all monetary amounts referred to in this Agreement are in AUD (Australian Dollars).
PAYMENT
10. The Contractor will charge the Client for the Services at the rate of $55.00 per hour (the “Payment”).
11. A deposit of $1,000.00 (the “Deposit”) is payable by the Client upon execution of this Agreement.
12. For the remaining amount, the Client will be invoiced every month.
13. Invoices submitted by the Contractor to the Client are due within 30 days of receipt.
14. The Contractor is responsible for paying any Superannuation Guarantee contributions that may be required in relation to the work performed by the Contractor or by employees of the Contractor under this Agreement.
15. The Payment as stated in this Agreement does not include sales tax, or other applicable duties as may be required by law. Any sales tax and duties required by law will be charged to the Client in addition to the Payment.
16. The Contractor will not be reimbursed for any expenses incurred in connection with providing the Services of this Agreement.
PENALTIES FOR LATE PAYMENT
17. Any late payments will trigger a fee of 2.00% per month on the amount still owing.
CONFIDENTIALITY
18. Confidential information (the “Confidential Information”) refers to any data or information relating to the business of the Client which would reasonably be considered to be proprietary to the Client including, but not limited to, accounting records, business processes, and client records and that is not generally known in the industry of the Client and where the release of that Confidential Information could reasonably be expected to cause harm to the Client.
19. The Contractor agrees that they will not disclose, divulge, reveal, report or use, for any purpose, any Confidential Information which the Contractor has obtained, except as authorised by the Client or as required by law. The obligations of confidentiality will apply during the Term and will survive indefinitely upon termination of this Agreement.
20. All written and oral information and material disclosed or provided by the Client to the Contractor under this Agreement is Confidential Information regardless of whether it was provided before or after the date of this Agreement or how it was provided to the Contractor.
OWNERSHIP OF INTELLECTUAL PROPERTY
21. All intellectual property and related material (the “Intellectual Property”) that is developed or produced under this Agreement, will be the property of the Contractor. The Client is granted a non-exclusive limited-use licence of this Intellectual Property.
22. Title, copyright, intellectual property rights and distribution rights of the Intellectual Property remain exclusively with the Contractor.
RETURN OF PROPERTY
23. Upon the expiry or termination of this Agreement, the Contractor will return to the Client any property, documentation, records, or Confidential Information which is the property of the Client.
CAPACITY/INDEPENDENT CONTRACTOR
24. In providing the Services under this Agreement it is expressly agreed that the Contractor is acting as an independent contractor and not as an employee. The Contractor and the Client acknowledge that this Agreement does not create a partnership or joint venture between them and is exclusively a contract for service.
NOTICE
25. All notices, requests, demands or other communications required or permitted by the terms of this Agreement will be given in writing and delivered to the Parties at the following addresses:

a. Your Organisation
b. Smashed Crab Printing
123 Copyright St, Plagiarism SA 5000
or to such other address as either Party may from time to time notify the other.
AUSTRALIAN COMPANY NUMBER (ACN)
26. The Australian Company Numbers (ACN’s) for the Parties to this Agreement are as follows:

1. Your Organisation: ______________________
2. Smashed Crab Printing: ______________________
INDEMNIFICATION
27. Except to the extent paid in settlement from any applicable insurance policies, and to the extent permitted by applicable law, each Party agrees to indemnify and hold harmless the other Party, and its respective directors, shareholders, affiliates, officers, agents, employees, and permitted successors and assigns against any and all claims, losses, damages, liabilities, penalties, punitive damages, expenses, reasonable legal fees and costs of any kind or amount whatsoever, which result from or arise out of any act or omission of the indemnifying party, its respective directors, shareholders, affiliates, officers, agents, employees, and permitted successors and assigns that occurs in connection with this Agreement. This indemnification will survive the termination of this Agreement.
ADDITIONAL CLAUSES
28. Contractor is responsible for supply of PPE to workers as PCBU.
29. Contractors staff must attend WHS induction training prior to commencement.
MODIFICATION OF AGREEMENT
30. Any amendment or modification of this Agreement or additional obligation assumed by either Party in connection with this Agreement will only be binding if evidenced in writing signed by each Party or an authorised representative of each Party.
TIME OF THE ESSENCE
31. Time is of the essence in this Agreement. No extension or variation of this Agreement will operate as a waiver of this provision.
ASSIGNMENT
32. The Contractor will not voluntarily, or by operation of law, assign or otherwise transfer its obligations under this Agreement without the prior written consent of the Client.
ENTIRE AGREEMENT
33. It is agreed that there is no representation, warranty, collateral agreement or condition affecting this Agreement except as expressly provided in this Agreement.
ENUREMENT
34. This Agreement will enure to the benefit of and be binding on the Parties and their respective heirs, executors, administrators and permitted successors and assigns.
TITLES/HEADINGS
35. Headings are inserted for the convenience of the Parties only and are not to be considered when interpreting this Agreement.
GENDER
36. Words in the singular mean and include the plural and vice versa. Words in the masculine mean and include the feminine and vice versa.
GOVERNING LAW
37. This Agreement will be governed by and construed in accordance with the laws of the State of South Australia.
SEVERABILITY
38. In the event that any of the provisions of this Agreement are held to be invalid or unenforceable in whole or in part, all other provisions will nevertheless continue to be valid and enforceable with the invalid or unenforceable parts severed from the remainder of this Agreement.
WAIVER
39. The waiver by either Party of a breach, default, delay or omission of any of the provisions of this Agreement by the other Party will not be construed as a waiver of any subsequent breach of the same or other provisions

IN WITNESS WHEREOF the Parties have duly affixed their signatures under hand and seal on this 19th day of September 2019.
Your Organisation
Per:__Your Representative_________________ (Seal)

Smashed Crab Printing
Per:___Cynthia Cleanit____________ (Seal)

Activity 5.4.1 – Current Contractors and Services

Instructions
Complete the tables below using information located in each of the service contracts above.

SERVICE #1 Office Cleaner
Company / Contractor:
Scope of Services:
Agreed Work Arrangements:
Legislative Obligations:
Organisational Obligations:

SERVICE #2 Photocopier maintenance
Company / Contractor:
Scope of Services:
Agreed Work Arrangements:
Legislative Obligations:
Organisational Obligations:

Activity 5.4.2 – Contractor Review

Instructions
On review of the training registers and contractor management documentation it is apparent that some key WHS obligations have not been addressed. The company KPI is for all contractors to be 100% compliant at all times. In the table below, document the requirements and training obligations for each listed contractor.

SERVICE #1 Office Cleaner
Documentation required from this contractor
Company policies and procedures to be shared with this contractor
Induction training topics to be covered
Site supervisory arrangements
Work inspection schedule
Corrective actions where non-conformances are identified
Other stakeholders
Contractor WHS obligations
Our WHS obligations to this contractor
Consultation processes
Induction Process documentation stored (location)
Establish lead & lag KPI’s to measure WHS performance. (at least one (1) of each) Lead Indicator / KPI (at least one (1))

Lag Indicator / KPI (at least one (1))

SERVICE #2 Photocopier maintenance and repair
Documentation required from this contractor
Company policies and procedures to be shared with this contractor
Induction training topics to be covered
Site supervisory arrangements
Work inspection schedule
Corrective actions where non-conformances are identified
Other stakeholders
Contractor WHS obligations
Our WHS obligations to this contractor
Consultation processes
Induction process documentation stored (location)
Establish lead & lag KPI’s to measure WHS performance. (at least one (1) of each) Lead Indicator / KPI (at least one (1))

Lag Indicator / KPI (at least one (1))

One of the contractor’s staff has attended the site multiple times, however they have not completed an induction. What steps would you take to investigate the cause, rectify the situation and prevent recurrence? Investigating the cause

Rectifying the non-conformance

Preventing recurrence

End of Section 5
Section 6 Finalisation

This section details the checklist and requirements for submitting your workbook activities.

6.1 Self-Reflection

Complete the self-reflection below detailing how you feel you addressed each of the continuous improvement related activities during this assessment process.

Complete the template below or complete separately and submit as an attachment. Clearly label any attachments. List the file names of any attachments in the ‘Evidence to Submit’ table on page 4.

6.1 Self Reflection
Explain how you used communication skills to communicate opportunities for improvement.

Explain how you used learning skills to coach and mentor staff, using a range of methods to cater for different learning styles.

Explain how you used innovation and lateral thinking skills to design better ways for achieving work outcomes.

Explain how you used planning skills to establish and monitor systems and process for continuous improvement.

Explain how you used teamwork and leadership skills to gain the confidence and trust of others.

How effective do you feel you were you in your approach to facilitating continuous improvement? Explain your response.

What would you do differently to further improve your performance in facilitating continuous improvement activities?

Other Comments

6.2 Skills Confirmation Checklist

You will need to complete the checklist below to confirm your participation and contributions to each of the criteria. Your HBA Assessor will use the checklist to confirm your ability to facilitate continuous improvement activities based on your participation and completion and submission of this workbook.

6.2 Skills Confirmation Checklist
Candidate Name: Date:
Assessor Name: Date:
Did the candidate demonstrate the following? (Check where applicable)
Candidate Assessor
Leading continuous improvement systems and processes
Actively encouraged & supported team to participate in decision-making processes ☐
☐
Communicated the organisation’s continuous improvement processes to stakeholders ☐
☐
Assumed responsibility and exercised initiative as appropriate ☐
☐
Ensured that change and improvement processes meet sustainability requirements ☐
☐
Demonstrated effective mentoring and coaching skills ☐
☐
Ensured insights and experiences from business activities were captured and accessible through knowledge management systems ☐
☐
Monitoring and adjusting performance strategies
Monitor operational progress to ensure planning and operations could be improved ☐
☐
Ensure communication strategies to stakeholders reflect organisational protocols ☐
☐
Manage opportunities for further improvement
Informed team members of outcomes of continuous improvement efforts ☐
☐
Performance management of team where necessary ☐
☐
Future planning should include identified areas of professional development ☐
☐
Comments / Notes

Outcome: ☐
Satisfactory ☐
Not Satisfactory
Assessor Feedback:

Assessor Signature: Date:
Candidate Signature: Date:

6.3 Third Party Declaration

Where external documents have been submitted for assessment, third party details must be provided to verify the authenticity of the documents submitted as required. You are not required to submit this section if you have not submitted workplace documents as evidence.

6.3 Third Party Declaration
Candidate Name: Date:
Third Party Details
Third Party Name: Organisation:
Contact Phone: Role / Position:
Contact Email:
Relationship to Candidate:
List of Workplace Documents Submitted DOCUMENT TITLE DOCUMENT DESCRIThird Party Declaration – I declare that:
To the best of my knowledge the documents listed above are the work of the person listed in the ‘Candidate Name’ section at the top of this document. I have provided true, accurate and current contact details above. I am willing to have an HBA assessor contact me as required if they have queries about the evidence portfolio.
Third Party Signature: Date:
Outcome: ☐
Satisfactory ☐
Not Satisfactory
Assessor Feedback:

Assessor Signature: Date:
Candidate Signature: Date:

End of Section 6

Finalising and Submitting Work

Review your responses and submit this document for assessment via the HBA Student Portal.

End of Document

Leave a Reply

Leave a Reply Cancel reply

Writing Services

Papers

Essay Services

Contact Info