Third Party Checklist – CPCCWHS2001 and CPCCCM2009

CPCCWHS2001 Apply WHS requirements, policies and procedures in the workplace & CPCCCM2009 Carry out basic demolition

This Third Party Report instructions- this form is designed from a workplace prospective to provide evidence that the participant is working at the standard required by industry over a period of time. The third party report is intended to be completed by a supervisor, a suitably experienced Industry Peer or Safety Officer who can comment on the candidate’s experience and role in carrying out their functions on a Demolition/Construction Site

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Step 1 of 3 – Details

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Company

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Candidate Name*

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Candidate Organisation*

Name of person completing the report*

First Last

Position*

Qualification / Background*

I have known this candidate for:*

Location and description of workplace conditions*

DECLARATION*

This checklist is a true and accurate report of my interactions with, observations and knowledge of, the student’s performance against the listed criteria. I understand that I may be included in internal and external validation audits.

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CPCCWHS2001 Apply WHS requirements, policies and procedures in the construction industry.

IDENTIFY AND ASSESS RISKS. Can the candidate:

Identify, assess and report hazards such as chemicals, slip/trip hazards, assessed and reported to supervisor*

Yes

Reports safety risks to correct person? Supervisor/team leader*

Yes

Contributes to WHS, hazard accidents/incident reports in accordance with workplace procedures and legislation*

Yes

Follow safe work practices, know duty of care responsibilities and instructions for controlling risks- wears correct PPE, housekeeping, participates in training and looks out for own safety and others?*

Yes

Comments

IDENTIFY HAZARDOUS MATERIALS AND OTHER HAZARDS. Can the candidate:

Identifies and if appropriate handle and use hazardous materials*

Yes

Controls Risks and construction hazards promptly*

Yes

Uses signs and symbols to secure hazardous materials*

Yes

Can identify POTENTIAL Asbestos Containing material on a worksite and reports it to appropriate person*

Yes

Comments

PLAN AND PREPARE FOR SAFE WORK PRACTICES. Can the candidate:

Identify, wear and correctly fit, use and store PPE*

Yes

Selects tools, equipment and materials and is able to organise tasks with other personnel on site and in accordance with procedures*

Yes

Determines barricades, signs and erects them at appropriate places*

Yes

Can Apply Safety Data Sheets (SDS) Job Safety Analysis and Safe Work Method Statements relevant to the job being performed*

Yes

Comments

APPLY SAFE WORK PRACTICES. Can the candidate:

Completes task in a safe manner*

Yes

Uses plant and equipment guards correctly*

Yes

Follows procedures and reports hazards and injuries correctly*

Yes

Doesn’t use prohibited tools and equipment in Asbestos areas*

Yes

Identifies and follows safety signs and symbols*

Yes

Keeps work area clean and maintained*

Yes

Comments

FOLLOW EMERGENCY PROCEDURES. Can the candidate:

Can Identify emergency personnel*

Yes

Follow safe workplace procedures for dealing with fire and emergencies*

Yes

Can describe and practise evacuation procedures and emergency response when required- Have they been involved in an emergency evacuation drill or situation before?*

Yes

Can carry out first aid treatment of minor injuries and, as soon as possible report treatment to designated personnel*

Yes

Comments

CPCCCM2009 Carry out basic demolition

PLAN AND PREPARE. Can the candidate:

Read and interpret site demolition plan and plan sequence of work*

Yes

Plan all work to comply with laws and regulations, the National Construction Code (NCC), Australian Standards, work health and safety (WHS) and environmental requirements, workplace requirements, drawings and specifications*

Yes

Select and use personal protective equipment (PPE) for each part of the task*

Yes

Select tools and equipment, check for serviceability and report any faults*

Yes

Comments

Prepare demolition site and erect safety equipment. Can the candidate:

Inspect work site to assess hazards and determine risk controls*

Yes

Confirm with supervisor or regulatory authorities that existing services have been disconnected*

Yes

Install signs and barriers around the demolition site and to identify underground and above-ground services*

Yes

Identify and report hazardous material for separate demolition and handling*

Yes

Comments

Remove building components. Can the candidate:

Remove building components in sequence and in accordance with site demolition plan, demolition method statement, standards and workplace procedures*

Yes

Remove components to storage or disposal area using safe materials handling techniques*

Yes

Comments

Check and store tools and equipment. Can the candidate:

Clean up, meeting all legislative and workplace requirements for safety, waste disposal and materials handling*

Yes

Plant, tools and equipment are cleaned, checked, maintained and stored correctly*

Yes

Comments