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© Canberra Institute of Technology Page 1 of 9 Date created: 16/06/2022
CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022
Observation/Practical Assessment
Student Name: CIT Number:
Name of Subject:
Apply WHS requirements, policies, and procedures in the
construction industry
NAT ID:
CPCCWHS2001
CRN:
Assessment Name Apply WHS requirements while Work Safely at Heights
Assessment Date
Student Statement
This assignment is my own work, except where I have acknowledged the use of the works of other
people. I understand that by submitting this assessment electronically, I agree to this statement.
Student Signature: Date:
Privacy Disclaimer
CIT is collecting your personal information for assessment purposes. The information will only be used in
accordance with the CIT Privacy Policy.
Assessor Feedback
Attempt 1 ☐ Satisfactory ☐ Not Yet Satisfactory Date:
Attempt 2 ☐ Satisfactory ☐ Not Yet Satisfactory Date:
Assessor Signature: Date:
Note from Assessor (including any reasonable adjustment):
Student Information
Review the important information below in relation to this assessment task.
Instructions
© Canberra Institute of Technology Page 2 of 9 Date created: 16/06/2022
CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022
Assessment Task:
To demonstrate competencyinthisunit,acandidatemustmeetthe elementsandperformancecriteriabyworking
safelyatheightsabove 2monthree (3) occasions,usingdifferentfallprotectionequipment/devicesoneach
occasion.
One occasionmustinclude arestrainttechnique(anchorpoint)systemwithaminimumof three anchorpoints.
The candidate mustaccessthe workarea,traverse betweenanchorpoints,andexitfromthe workarea.
The learner is required to demonstrate:
 Knowledgeof WHSrequirements,policies, andprocedures
 Planningtoworksafelyatheights
 Identificationandreportingof faultsandhazards
 Understandingof equipmentuse andlimitations
 Safe workmethodsforaccess,traversingandexitingworkareaswhenworkingatheights
Task Instructions
1. Plan and prepare for the job
Contribute topreparingworkplansandsafetydocumentationandidentifylocationsof workandplantand
equipmenttobe used,including
 Jobinstructions,
 SWMS,
 toolbox talk,JSA includingweatherconditions
 rescue plan
 identifylocationof anchorpointsandplantand equipment
Photograph these documents and upload into Ready Skills
2. Assessand access the work area
 Selectanderectsignage andbarricade equipment
 Identifyunstable,fragile,orbrittle worksurfaces
 SelectandInspectharnesses,lanyards,andotherPPE – report if faulty
 Complete andphotographBeltandharnesschecklist
 Fitharnesses,lanyards,andotherPPE - confirmcorrect fittingwithassessor/supervisor
 Ensure requiredfall protection,scaffoldandbarriershave beenadequatelyinstalledandwhere necessary
certified
 Accessthe work area(tower) safely,minimisingthe riskof fallingobjects
3. Ascendthe Tower via the ladder as per SWMS
Connectto fall protectionequipment,includingtemporary anchorpoints
Confirmcorrectattachmentand adjustments.
 3 pointsof contact
 Connectiontostaticline communicated toothers
 Toolsand equipmentsecured
 Inspectsafetynet
 Prepare slingandshackle forchainblock
© Canberra Institute of Technology Page 3 of 9 Date created: 16/06/2022
CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022
 Connectiontostaticline is continuousandadjustedif necessary
4. Descendthe tower
 Prepare sling&shackle fordescent
 Descendaccordingto safetyrequirementsandcurrentconditions
 Communicate topersonabove.
5. Traverse across the roof usinganchor pointsand static lines
 Accessthe roof safely
 Connectiontostaticline iscontinuousandadjustedif necessary
 Traverse to all 4 anchorpointsand return
 Descendfromthe roof
6. Followemergencyprocedures
 Duringthisexercise there will be ascenariorequiringyoutorespondtoan accident
7. Pack up
 Exitthe area as per site instructions
 Check,cleanandpack away all tools,equipment,PPEandreportanyfaultsor damage
 Remove safetybarricadesandsignage if required
 Cleanupany rubbishandrecycle appropriately
 Photographanduploadcopyof Beltand harnesschecklistto ReadySkills
 Photographanduploadcopyof rescue planto ReadySkills
 Accessphototakenwhile completingthe tasktouploadinto ReadySkills
Inspection of Belts and Harnesses Checklist
Student Name Date
Item of safety belts and harnesses shall be inspected and the condition of faults to be
checked
Component Condition of fault to be checked Checked
Webbing
 Cuts or tears
 Abrasion damage especially where there is contact with
hardware
 Excessive stretching
 Damage due to contact with heat, corrosives, or solvents
 Deterioration due to rotting, mildew or ultraviolet
exposure
Yes

No

© Canberra Institute of Technology Page 4 of 9 Date created: 16/06/2022
CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022
Snap Hooks
and
Carabiners
 Distortion of hook or latch
 Cracks or forging folds
 Wear at swivels and latch pivot pin
 Open rollers
 Free movement of the latch over its full travel
 Broken, weak or misplaced latch springs (compare, if
possible, with new snap hook)
 Free from dirt or other obstructions
Yes

No

D-Rings
 Excessive ‘vertical’ movement of the straight portion of
the D-ring at its attachment point on to the belt, so that
the corners between the straight and curved sections of
the D become completely exposed.
Note: Excessive vertical movement of the ring in its mounting
cart allow the nose of larger snap hooks to become lodged
behind the straight portion of the D, in which position the
snap hook can often accidently ‘roll out’ of the D under load.
 Cracks, especially at the intersection of the straight and
curved portions.
 Distortion or other physical damage of the D ring
 Excessive loss of cross section due to wear
Yes

No

Buckles and
Adjusters
 Distortion of other physical damage
 Cracks and forging laps where applicable
 Bent tongues
 Open rollers
Yes

No

Ropes
 Broken, cut, or worn threads
 Damage or weakening of threads due to contact with
heat, corrosives, solvents, or mildew
 Cuts
 Abrasion or fraying
 Stretching
 Damage due to contact with heat, corrosives, solvents
etc.
 Deterioration due to ultraviolet light or mildew
Yes

No

Chains
 Physical damage
 Security of attachments to snap hooks, rings, and similar
components
Yes

No

Photograph this page to upload to Ready Skills
© Canberra Institute of Technology Page 5 of 9 Date created: 16/06/2022
CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022
Work Safe at Heights – Rescue Plan
Date Job Description Work Safe at heights - Practical
Class / CRN Location P Block
Key Personnel Details
Rescue Equipment
Ensure equipment is suitable for use in
rescue
Select Yes or No
Competent person
Ladder
Yes

No

Scaffold
Yes

No

People to assist
Crane
Yes

No

EWP
Yes

No

Emergency contact
Rescue Rope
Yes

No

Rescue Pole
Yes

No

Phone
Alternative
Yes

No

Control Descent
Device
First Aid Kit Present
© Canberra Institute of Technology Page 6 of 9 Date created: 16/06/2022
CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022
Has a High-Risk Safe Work Method Statement been developed and
signed by all personnel? (Do not proceed without a SWMS being
completed)
Yes

No

Response Procedure Person / People Responsible
Time Allowed
1 hour
Assessment Conditions
This assessment will take place in the High Risk simulated area at CIT’s Bruce campus. You are required
to wear the correct PPE throughout the assessment. If you are being unsafe at anytime throughout the
assessment your assessment will be stopped, and this will count as your first attempt. No mobile phones
are to be used while undertaking this assessment. If the weather is poor on the day of this assessment
alternative day/ time will be arranged.
Materials Provided by CIT
All materials, tools and equipment required to undertake this assessment will be provided, including
lanyards and safety harnesses.
Materials You Need
PPE, mobile devise for uploads
Attempts
You may have at least two (2) attempts for this assessment.
Photograph this page to upload to Ready Skills
© Canberra Institute of Technology Page 7 of 9 Date created: 16/06/2022
CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022
 If your first attempt is not successful, your teacher will discuss your results with you and will arrange
a second attempt.
 If your second attempt is not successful, you may be required to re-enrol in this unit.
Please refer to the CIT Assessment Policy if you have any questions.
Observation/Practical Checklist
You must successfully complete the following skills in the Observation/Practical checklist.
(Please Note: Students only need to complete grey boxes. Your teacher will provide you with feedback and
advise whether your work is Satisfactory or Not Yet Satisfactory).
Student Name: CIT Number:
During the task the following skills were demonstrated
satisfactorily:
Attempt 1 Attempt 2
Date
(Optional)
Date
(Optional)
Observation/Practical Checklist Items S* NYS* S* NYS*
1. Completed a work site Inspection, and review of job
requirements, safety documentation and plant and
equipment checks have been conducted and report
any issues to supervisor
☐ ☐ ☐ ☐
2. Implement SWMS safety controls, including safety
signs and barricades ☐ ☐ ☐ ☐
3. Select and inspect PPE, tools, and equipment
☐ ☐ ☐ ☐
4. Fit harnesses, lanyards, and other PPE
☐ ☐ ☐ ☐
5. Work area is safely accessed, tools, equipment and
materials are positioned and used in accordance to
manufactures instructions
☐ ☐ ☐ ☐
6. Work task scenarios ascend the tower, inspection of
safety net, and prepare sling and shackle for chain
block are completed safely and correctly
☐ ☐ ☐ ☐
© Canberra Institute of Technology Page 8 of 9 Date created: 16/06/2022
CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022
7. Roof traverses are carried out safely ☐ ☐ ☐ ☐
8. Respond to an emergency procedure was completed
safely and correctly
☐ ☐ ☐ ☐
9. Controls are regularly monitored as per instructions
and Australian Standards
☐ ☐ ☐ ☐
10. Tools, equipment, and materials are safely removed,
and work area is exited
☐ ☐ ☐ ☐
11. Clean, check, maintain and store tools and equipment
in accordance with manufacturer specifications ☐ ☐ ☐ ☐
12. Complete damage / fault reporting requirements ☐ ☐ ☐ ☐
*S –Satisfactory, NYS – Not Yet Satisfactory
Observation Questions/Conversation
Attempt 1 Attempt 2
The student has correctly answered the following: S* NYS* S NYS
Q1. What did you identify at the site inspection that you didn’t know about before
Student Response
Attempt 1:
☐ ☐
Student Response
Attempt 2:
☐ ☐
Q2. What did you do with the unsuitable harness?
Student Response
Attempt 1:
☐ ☐
Student Response
Attempt 2:
☐ ☐
© Canberra Institute of Technology Page 9 of 9 Date created: 16/06/2022
CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022
Q3. Signed SWMS – any comments
Student Response
Attempt 1:
☐ ☐
Student Response
Attempt 2:
☐ ☐
Q4. Given (a scenario – i.e., wind, rain, delivery, other workers) What controls would you monitor and
how would you report any problems
Student Response
Attempt 1:
☐ ☐
Student Response
Attempt 2:
☐ ☐
Q5. Environmental question re waste – what could be recycled / how can damaged webbing be disposed
of?
Student Response
Attempt 1:
☐ ☐
Student Response
Attempt 2:
☐ ☐
*S –Satisfactory, NYS – Not Yet Satisfactory

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WHS_Practical Assessment.docx

  • 1. © Canberra Institute of Technology Page 1 of 9 Date created: 16/06/2022 CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022 Observation/Practical Assessment Student Name: CIT Number: Name of Subject: Apply WHS requirements, policies, and procedures in the construction industry NAT ID: CPCCWHS2001 CRN: Assessment Name Apply WHS requirements while Work Safely at Heights Assessment Date Student Statement This assignment is my own work, except where I have acknowledged the use of the works of other people. I understand that by submitting this assessment electronically, I agree to this statement. Student Signature: Date: Privacy Disclaimer CIT is collecting your personal information for assessment purposes. The information will only be used in accordance with the CIT Privacy Policy. Assessor Feedback Attempt 1 ☐ Satisfactory ☐ Not Yet Satisfactory Date: Attempt 2 ☐ Satisfactory ☐ Not Yet Satisfactory Date: Assessor Signature: Date: Note from Assessor (including any reasonable adjustment): Student Information Review the important information below in relation to this assessment task. Instructions
  • 2. © Canberra Institute of Technology Page 2 of 9 Date created: 16/06/2022 CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022 Assessment Task: To demonstrate competencyinthisunit,acandidatemustmeetthe elementsandperformancecriteriabyworking safelyatheightsabove 2monthree (3) occasions,usingdifferentfallprotectionequipment/devicesoneach occasion. One occasionmustinclude arestrainttechnique(anchorpoint)systemwithaminimumof three anchorpoints. The candidate mustaccessthe workarea,traverse betweenanchorpoints,andexitfromthe workarea. The learner is required to demonstrate:  Knowledgeof WHSrequirements,policies, andprocedures  Planningtoworksafelyatheights  Identificationandreportingof faultsandhazards  Understandingof equipmentuse andlimitations  Safe workmethodsforaccess,traversingandexitingworkareaswhenworkingatheights Task Instructions 1. Plan and prepare for the job Contribute topreparingworkplansandsafetydocumentationandidentifylocationsof workandplantand equipmenttobe used,including  Jobinstructions,  SWMS,  toolbox talk,JSA includingweatherconditions  rescue plan  identifylocationof anchorpointsandplantand equipment Photograph these documents and upload into Ready Skills 2. Assessand access the work area  Selectanderectsignage andbarricade equipment  Identifyunstable,fragile,orbrittle worksurfaces  SelectandInspectharnesses,lanyards,andotherPPE – report if faulty  Complete andphotographBeltandharnesschecklist  Fitharnesses,lanyards,andotherPPE - confirmcorrect fittingwithassessor/supervisor  Ensure requiredfall protection,scaffoldandbarriershave beenadequatelyinstalledandwhere necessary certified  Accessthe work area(tower) safely,minimisingthe riskof fallingobjects 3. Ascendthe Tower via the ladder as per SWMS Connectto fall protectionequipment,includingtemporary anchorpoints Confirmcorrectattachmentand adjustments.  3 pointsof contact  Connectiontostaticline communicated toothers  Toolsand equipmentsecured  Inspectsafetynet  Prepare slingandshackle forchainblock
  • 3. © Canberra Institute of Technology Page 3 of 9 Date created: 16/06/2022 CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022  Connectiontostaticline is continuousandadjustedif necessary 4. Descendthe tower  Prepare sling&shackle fordescent  Descendaccordingto safetyrequirementsandcurrentconditions  Communicate topersonabove. 5. Traverse across the roof usinganchor pointsand static lines  Accessthe roof safely  Connectiontostaticline iscontinuousandadjustedif necessary  Traverse to all 4 anchorpointsand return  Descendfromthe roof 6. Followemergencyprocedures  Duringthisexercise there will be ascenariorequiringyoutorespondtoan accident 7. Pack up  Exitthe area as per site instructions  Check,cleanandpack away all tools,equipment,PPEandreportanyfaultsor damage  Remove safetybarricadesandsignage if required  Cleanupany rubbishandrecycle appropriately  Photographanduploadcopyof Beltand harnesschecklistto ReadySkills  Photographanduploadcopyof rescue planto ReadySkills  Accessphototakenwhile completingthe tasktouploadinto ReadySkills Inspection of Belts and Harnesses Checklist Student Name Date Item of safety belts and harnesses shall be inspected and the condition of faults to be checked Component Condition of fault to be checked Checked Webbing  Cuts or tears  Abrasion damage especially where there is contact with hardware  Excessive stretching  Damage due to contact with heat, corrosives, or solvents  Deterioration due to rotting, mildew or ultraviolet exposure Yes  No 
  • 4. © Canberra Institute of Technology Page 4 of 9 Date created: 16/06/2022 CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022 Snap Hooks and Carabiners  Distortion of hook or latch  Cracks or forging folds  Wear at swivels and latch pivot pin  Open rollers  Free movement of the latch over its full travel  Broken, weak or misplaced latch springs (compare, if possible, with new snap hook)  Free from dirt or other obstructions Yes  No  D-Rings  Excessive ‘vertical’ movement of the straight portion of the D-ring at its attachment point on to the belt, so that the corners between the straight and curved sections of the D become completely exposed. Note: Excessive vertical movement of the ring in its mounting cart allow the nose of larger snap hooks to become lodged behind the straight portion of the D, in which position the snap hook can often accidently ‘roll out’ of the D under load.  Cracks, especially at the intersection of the straight and curved portions.  Distortion or other physical damage of the D ring  Excessive loss of cross section due to wear Yes  No  Buckles and Adjusters  Distortion of other physical damage  Cracks and forging laps where applicable  Bent tongues  Open rollers Yes  No  Ropes  Broken, cut, or worn threads  Damage or weakening of threads due to contact with heat, corrosives, solvents, or mildew  Cuts  Abrasion or fraying  Stretching  Damage due to contact with heat, corrosives, solvents etc.  Deterioration due to ultraviolet light or mildew Yes  No  Chains  Physical damage  Security of attachments to snap hooks, rings, and similar components Yes  No  Photograph this page to upload to Ready Skills
  • 5. © Canberra Institute of Technology Page 5 of 9 Date created: 16/06/2022 CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022 Work Safe at Heights – Rescue Plan Date Job Description Work Safe at heights - Practical Class / CRN Location P Block Key Personnel Details Rescue Equipment Ensure equipment is suitable for use in rescue Select Yes or No Competent person Ladder Yes  No  Scaffold Yes  No  People to assist Crane Yes  No  EWP Yes  No  Emergency contact Rescue Rope Yes  No  Rescue Pole Yes  No  Phone Alternative Yes  No  Control Descent Device First Aid Kit Present
  • 6. © Canberra Institute of Technology Page 6 of 9 Date created: 16/06/2022 CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022 Has a High-Risk Safe Work Method Statement been developed and signed by all personnel? (Do not proceed without a SWMS being completed) Yes  No  Response Procedure Person / People Responsible Time Allowed 1 hour Assessment Conditions This assessment will take place in the High Risk simulated area at CIT’s Bruce campus. You are required to wear the correct PPE throughout the assessment. If you are being unsafe at anytime throughout the assessment your assessment will be stopped, and this will count as your first attempt. No mobile phones are to be used while undertaking this assessment. If the weather is poor on the day of this assessment alternative day/ time will be arranged. Materials Provided by CIT All materials, tools and equipment required to undertake this assessment will be provided, including lanyards and safety harnesses. Materials You Need PPE, mobile devise for uploads Attempts You may have at least two (2) attempts for this assessment. Photograph this page to upload to Ready Skills
  • 7. © Canberra Institute of Technology Page 7 of 9 Date created: 16/06/2022 CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022  If your first attempt is not successful, your teacher will discuss your results with you and will arrange a second attempt.  If your second attempt is not successful, you may be required to re-enrol in this unit. Please refer to the CIT Assessment Policy if you have any questions. Observation/Practical Checklist You must successfully complete the following skills in the Observation/Practical checklist. (Please Note: Students only need to complete grey boxes. Your teacher will provide you with feedback and advise whether your work is Satisfactory or Not Yet Satisfactory). Student Name: CIT Number: During the task the following skills were demonstrated satisfactorily: Attempt 1 Attempt 2 Date (Optional) Date (Optional) Observation/Practical Checklist Items S* NYS* S* NYS* 1. Completed a work site Inspection, and review of job requirements, safety documentation and plant and equipment checks have been conducted and report any issues to supervisor ☐ ☐ ☐ ☐ 2. Implement SWMS safety controls, including safety signs and barricades ☐ ☐ ☐ ☐ 3. Select and inspect PPE, tools, and equipment ☐ ☐ ☐ ☐ 4. Fit harnesses, lanyards, and other PPE ☐ ☐ ☐ ☐ 5. Work area is safely accessed, tools, equipment and materials are positioned and used in accordance to manufactures instructions ☐ ☐ ☐ ☐ 6. Work task scenarios ascend the tower, inspection of safety net, and prepare sling and shackle for chain block are completed safely and correctly ☐ ☐ ☐ ☐
  • 8. © Canberra Institute of Technology Page 8 of 9 Date created: 16/06/2022 CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022 7. Roof traverses are carried out safely ☐ ☐ ☐ ☐ 8. Respond to an emergency procedure was completed safely and correctly ☐ ☐ ☐ ☐ 9. Controls are regularly monitored as per instructions and Australian Standards ☐ ☐ ☐ ☐ 10. Tools, equipment, and materials are safely removed, and work area is exited ☐ ☐ ☐ ☐ 11. Clean, check, maintain and store tools and equipment in accordance with manufacturer specifications ☐ ☐ ☐ ☐ 12. Complete damage / fault reporting requirements ☐ ☐ ☐ ☐ *S –Satisfactory, NYS – Not Yet Satisfactory Observation Questions/Conversation Attempt 1 Attempt 2 The student has correctly answered the following: S* NYS* S NYS Q1. What did you identify at the site inspection that you didn’t know about before Student Response Attempt 1: ☐ ☐ Student Response Attempt 2: ☐ ☐ Q2. What did you do with the unsuitable harness? Student Response Attempt 1: ☐ ☐ Student Response Attempt 2: ☐ ☐
  • 9. © Canberra Institute of Technology Page 9 of 9 Date created: 16/06/2022 CRICOS No. 00001K | RTO Code 0101 Date updated: 21/07/2022 Q3. Signed SWMS – any comments Student Response Attempt 1: ☐ ☐ Student Response Attempt 2: ☐ ☐ Q4. Given (a scenario – i.e., wind, rain, delivery, other workers) What controls would you monitor and how would you report any problems Student Response Attempt 1: ☐ ☐ Student Response Attempt 2: ☐ ☐ Q5. Environmental question re waste – what could be recycled / how can damaged webbing be disposed of? Student Response Attempt 1: ☐ ☐ Student Response Attempt 2: ☐ ☐ *S –Satisfactory, NYS – Not Yet Satisfactory