Student Assessment Agreement | My Assignment Tutor

Student Assessment Agreement Make sure you read through the assessments in this booklet before you fill out and sign the agreement below. If there is anything that you are unsure of, consult your assessor prior to signing this agreement. Have you read the assessment requirements for this unit?  Yes  No Do you understand the requirements of the assessments for this unit?  Yes  No Do you agree to the way in which you are being assessed?  Yes  No Do you have any specific needs that should be considered?  Yes  No If so, explain these in the space below. Do you understand your rights to re-assessment?  Yes  No Do you understand your right to appeal the decisions made in an assessment?  Yes  No Student nameStudent numberStudent signatureDateQualification Code and TitleCPC30211: Certificate III in CarpentryUnit Code and TitleCPCCCA2003A – Erect and dismantle formwork for footings and slabs on groundAssessor nameAssessor signatureDate Assessment Task Cover Sheet Student Declaration To be filled out and submitted with assessment responses  I declare that this task is all my own work and I have not cheated or plagiarised the work or colluded with any other student(s).  I understand that if I If I am found to have plagiarised, cheated or colluded, action will be taken against me according to the process explained to me.  I have correctly referenced all resources and reference texts throughout these assessment tasks. Student nameStudent ID numberStudent signatureDate Assessor declaration  I hereby certify that this student has been assessed by me and that the assessment has been carried out according to the required assessment procedures. Assessor nameAssessor signatureDateAssessment outcomeSNSDNSResubmission Y N Feedback Student result response  My performance in this assessment task has been discussed and explained to me.  I would like to appeal this assessment decision. Student signatureDate A copy of this page must be supplied to the office and kept in the student’s file with the evidence Document Title: Student final assessment submission evidenceDocument Subtitle: CPCCCA2003A – Erect and dismantle formwork for footings and slabs on ground Disclaimer: This work is under copyright and permission is not given to make copies for hire or resale to third parties to use the document for their own or commercial use.Universal Training Solutions does not give warranty or accept any legal liability in relation to the content of this work.Licenced to: RTO Name: Trinity Institute (Australia) RTO NO: 41310 CRICOS NO: 03556F RTO Address: Level 7 16-18 Wentworth St Parramatta NSW 2150Copyright: Universal Training Solutions Developed by: Universal Training Solutions and validated by Trinity Institute (Australia)Acknowledgement: Thanks to Universal Training Solutions and Trinity Institute (Australia) staff for their consultation and development work.Version: Trinity Institute (Australia) V1 STUDENT DETAILS Please complete this declaration with the studentUnit of competency:Unit CodeUnit TitleTrainer/Assessor Name:Student Name:Student ID:Time AllocationRefer to Training PlanDue date:Refer to you student program guide (training plan). Please insert the due date as confirmed by your assessor below:Due Date: ……………/……………. /……………. Declarations TaskDeclaration:SignatureDateTask 1 Knowledge QuestionnaireI confirm that I have read and understood the instructions, my responsibilities and requirements for this assessmentTask 2 projectI confirm that I have read and understood the instructions, my responsibilities and requirements for this assessmentTask 3 Simulated Practical and/or workplace observationI confirm that I have read and understood the instructions, my responsibilities and requirements for this assessment Assessor declarationThe assessor is to complete this declaration with the student.I have acknowledged the underpinning knowledge and skills may be assessed on or off the job.☐Yes☐NoI confirm that I am a qualified workplace assessor and will be conducting the assessment for this unit and student☐Yes☐NoHave all aspects of the student agreement been explained and understood?☐Yes☐NoDoes the student understand they have three attempts to complete each task satisfactorily? If after the third attempt the student is deemed ‘Not Yet Competent’, they will be required to do further training before reattempting this unit.☐Yes☐NoI have explained the requirements for reasonable adjustment as a result of workplace constraints☐Yes☐NoI confirm that I have explained and confirmed all of the above items with the student.Assessor SignatureDate____/____/____ Student declarationAgreement by the student: Please sign below to demonstrate that you understand what is required of you in relation to this assessment.Do you have any special needs or considerations to be made for this assessment? If yes, what are they?☐Yes☐NoDo you understand your rights to appeal the decisions made in an assessment?☐Yes☐NoI understand I have three attempts to complete each task satisfactorily. If after the third attempt I am deemed ‘Not Yet Competent’, I will be required to do further training before reattempting this unit☐Yes☐NoReasonable adjustment: If you require any adjustments to accommodate a need in order to complete this assessment, please talk to your assessor. Arrangements will be put in place to ensure a fair and flexible approach is undertaken for this assessment. Please note that the range or nature of the adjustment will ensure that the outcomes of the unit are not compromised.☐Yes☐NoI agree to comply with all rules, regulations, policies and procedures provided as part of the simulated environment.☐Yes☐NoI give permission for the RTO to use my assignment at the workplace for assessment moderation / validation purposes.☐Yes☐NoI confirm that I have read and understood my responsibilities and requirements for assessment.Student SignatureDate____/____/____ SUBMISSION EVIDENCE – ASSESSMENT TASK 3 SIMULATED PRACTICAL AND/OR WORKPLACE OBSERVATION Appendix 1 Quality requirements Refer to attachment 1 – 11 to complete this section. When completing this document complete in the right-hand column a description of the requirement type relating to this task: For example: safety, quality, environmental and then describe: Policies and procedures and standards, – Describe the references/documents you refer to when performing this taskManufacturer specifications – Describe how manufacturer’s instructions would impact constructing a wall frameLegislation including federal, state and local authorities administering applicable acts, regulations and codes of practice. – List one form of legislation that may be applicable for this taskAustralian standards® – Describe the Australian standards applicable to construction a wall frameEnvironmental requirements Quality RequirementTypePolicies and proceduresDescribe the regulatory requirementsManufacturer specifications if applicableDescribe the regulatory requirementsLegislationList one form of legislation that may be applicable for this task in relation to the following:Describe the regulatory requirementsAs applicableFederal/ State and local authorities administering applicable acts/ Regulations/ Codes of practice/Australian standards/Environmental requirementSWMS/JSEA/SDSI have sighted and read the applicable SWMS/JSEA/SDSDateSupervisor signatureYour signature Appendix 2 Safety checklist To complete the checklist, you must: Identify the job name, location and datetick YES, NO or NA for each inspection itemcomplete the corrective action section identifying the item, the corrective action and the date completedsign as the “inspected by” and dateyour assessor must sign as indication of hazards or safety issues being reported PROJECT/WORKORDERLOCATIONDate Work description – generalYesNoN/AJSEA/SWMS: inducted into the safe work method statement☐☐☐JSEA: Work has progressed in accordance with the safe work method statement.☐☐☐Signage and barricades: identify and ensure implementation of any signage and barricade requirement☐☐☐Weather conditions: Are monitored for potentially hazardous conditions such as strong winds and / or electrical storms and that a contingency plan can be activated as required☐☐☐Prior to commencement of the task checked plant, tools and equipment for serviceability, and any faults are rectified or reported prior to commencement of build☐☐☐Environmental requirements such as clean up management, waste management, noise and dust and vibration meet the requirements as per the environmental plans in accordance with the statutory and regulatory authority obligations such as federal, state and local authorities administering applicable Acts, regulations and codes of practice.☐☐☐Work description -JSEA – Site planningEach worker must have a: – site induction –white card and appropriate PPE☐☐☐Each worker has been briefed on the procedure and their duties☐☐☐appropriate materials selected such as connectors, metal, nails, reconstituted timber products and piers, screws, timber, flooring materials such as strip, boards and sheets, may be either fitted or platform construction.☐☐☐ Work description -JSEA – Prepare work areaInspected site and clear area of any obstructing material or debris☐☐☐Isolated work zone; erect barricading and signageStabilize/compact ground where required☐☐☐Identify all electrical lines in work area and confirm electrical current is disconnected to those lines☐☐☐Work description -Safe Work Method Statement – End of shiftSecure all plant and equipment☐☐☐Inspect site and clean up area☐☐☐Personal Protective Equipment: Safety glasses, hard hats and work boots are required 100% of the time while working within the designated construction area on any construction or facilities maintenance project. High visibility safety vests are required on most construction sites. Identify the PPE that you will require based on the hazards of the tasks to be performed:Full Face Shields☐☐☐Chemical Splash Goggles☐☐☐Welders Hood and Goggles, Leathers Gloves☐☐☐Steel Toed Boots,☐☐☐Work Gloves☐☐☐Ear plugs Or Earmuffs☐☐☐Hand and Power Tools -if power tools to be used have you completed a safety check and reported any faultsWill the work involve the use of electrically powered tools?☐☐☐Will the work involve the use of pneumatically powered tools?☐☐☐Will the work performed on this project involve the use of powder-actuated tools?☐☐☐Check for suitability Ground & Surface PenetrationsWill the work scope require you to cut into, chip into, drill into, or make any other penetrations into walls, ceilings or floors deeper than 1 5/8”?☐☐☐Will the work scope require you to excavate, trench, dig, or otherwise penetrate into the ground (including use of stakes or poles) deeper then 1 5/8”?☐☐☐Will the work scope require you to penetrate into any concrete surface at any depth?☐☐☐Have building surfaces or structures to be penetrated been evaluated for lead and asbestos?☐☐☐ Check for suitability Excavation and TrenchingWill this work scope involve any excavation up to 5 feet deep?☐☐☐Will this work scope involve sanitary sewer line repair or replacement?☐☐☐Traffic & Pedestrian ControlWill this work scope require ANY traffic or pedestrian disruptions? Blocking or partially blocking any roadway. walkway or driveway…?☐☐☐Fire Protection & PreventionWill work include the use of open flames such as torches, welders, grinders, tar pits or any other tool or process/procedure that could cause sparks or open flames?☐☐☐Will work be performed near combustible storage containers?☐☐☐Will there be on-site refuelling of equipment?☐☐☐Has a Fire Watch been training in the use of fire extinguisher and emergency procedures for the work being performed?☐☐☐Hazardous chemicalsWill the work involve the use of any chemicals, such as paints, solvents, adhesives, epoxy coatings, fuels or other hazardous materials?☐☐☐Are all personnel using these materials trained in safe handling?☐☐☐Will there be an emergency eyewash and shower in the immediate work area at a location that can be reached by a blinded worker in an uncomplicated and unimpeded path within 10 seconds travel time (approximately 50 feet)? If “NO”, a portable eyewash station, capable of providing 15 minutes of continuous water flow, shall be provided (handheld squeeze bottle type is not allowed) that meets the same access requirement listed above?☐☐☐Will employees be potentially exposed to airborne concentrations of hazardous gas, fume, dust or mist?☐☐☐Will MSDS(s) be available to the workers onsite?☐☐☐Will respirators be required?☐☐☐Permit-Required Confined Space EntryWill the scope of your work require you to be working in a confined space where physical or atmospheric hazards (i.e. Flammable or toxic) may be present?☐☐☐AsbestosWill the work require asbestos removal or disturbance?☐☐☐ Silica DustWill work involve jackhammering, roto hammering, drilling, grinding or other disturbance of concrete or use of products that contain crystalline silica that might create silica dust?☐☐☐Will work involve wet slab or wall concrete cutting, drilling, and coring or cutting/sanding drywall or joint compound?☐☐☐Item #Corrective ActionDate Comp.Inspected byDateReported to supervisor namesupervisor signatureDateAssessor nameassessor signatureDate Appendix 3 Tool List & Condition requirement List the tools you are required to use to complete the task (SWMS/JSEA/SDS & procedure Attachment 1, 2, 3, 4, 8, 9, 10). When you have collected the tools, perform a pre-check and identify any faults and maintenance issues. Use the right-hand column to describe their condition. Tool ListCondition Appendix 4 Faults report If you identified any faults with the tools (appendix 3) you will be using for this task you must record the fault information as required in the table below: S = Serviceable U/S = Unserviceable Tool nameSUSDescription of faultManufacturer’s specifications Appendix 5 Material List List the materials you will need to complete the task (you can refer to attachment 6). Referring to the site plan, prepare a materials list. Then calculate the quantity required. Material descriptionSizeQuantity Appendix 6 Formwork checklist Procedural stepsSet string lines to the profile to indicate face of wall and top of slab.Stand a suitable thickness and straight edge board on edge, with its face in line with the string line. The edge board must be below the line i.e. the depth of a brick/block course (depth of the rebate).Butt together and cleat the boards to make up the wall length.Drive in pegs behind the edgeboard to hold it in a vertical position.Nail the edgeboard to the pegs at the required height. Have an offsider hold a big hammer behind the peg as you are nailing the board on.At the corners, let one board run past the other so they can be fixed together. Nail a cleat on the face side of edgeboard 1 to prevent board 2 moving when the concrete is being poured.Brace the edge boards and pegs if necessary.Drive in another peg (secondary peg) about 450mm away from the pegs which you have fixed the edge boards to. These pegs are positioned at right angles (90 degrees) to the face of the edge board.Sit the rebate board temporarily on the edge board and mark the positions of the ends of the outriggers on the back face.Remove the rebate board and nail the outriggers to it.Return rebate board (with outriggers) to required location and nail the outriggers to the pegs with the rebate board in the correct position.Form up block-outs as specified by plansApply release agent with a brush or spray unit InspectionAll formwork components are of the specified type and material grade in accordance with AS 3610Erection conforms with the formwork documentationThe dimensional accuracies, plumb and straightness are within the specified tolerancesThe foundations are adequate; they are not likely to be disturbed and that they and the lower parts of the supporting structure are not liable to damage by interference, accident, traffic, scouring or undermining.Members are correctly positioned and connected.Confirm all required components, pins, bolts, nuts, clips, and similar components are undamaged and are of the correct type and have been correctly inserted and are secure.Formwork is clear of debris APPENDIX 7 – ASSESSOR OBSERVATION CHECKLISTTo be completed by the assessor whist observing the student perform the task as outlined in this documentStudent NameWho was present for the observation task? Please listNamePositionNote to the assessorAssessors note: You must record in detail under the explain below how the student demonstrated their ability to satisfactorily perform this task when participating in observation activity. Record your observations in detail under the section labelled “Explain How”. You need to ensure that you take detailed notes on the performance of the learner in the explanation section providedIs reasonable adjustment required to complete this task. If yes please explain☐Yes ☐ No If yes please explain: ASSESSOR OBSERVATION CHECKLIST – CRITERION 1Before commencing was this observation conducted: ☐ In the workplace as a workplace observation in real time ☐ Via simulation with access to a real workplace ☐ In a simulated classroom environment ☐ Online (mainly used for meetings)When observing the student perform this task, the student was able to demonstrate their ability to plan and prepare. The student can?Criterion (All criterion must be satisfactory to pass)SNS☐obtain, confirm and apply work instructions, including plans, specifications, quality requirements and operational details from relevant informationPlan and prepare to complete the following tasks: form up a slab on ground a minimum of 9 square metres, incorporating an edge rebate and internal corner to specifications form up a step to a foundation excavation to specified masonry units. Refer to Attachment 1 – 11☐☐☐follow safety (WHS) requirements in accordance with safety plans and policies☐☐☐identify and implement signage and barricade requirements☐☐☐select tools and equipment to carry out tasks consistent with job requirements, check for serviceability, and rectify or report any faults prior to commencement☐☐☐calculate material quantity requirements in accordance with plans, specifications and quality requirements☐☐☐identify, obtain, prepare and safely handle and locate ready for use materials appropriate to the work application☐☐☐identify and apply environmental requirements for the project in accordance with environmental plans and statutory and regulatory authority obligations☐☐☐communicate effectively: determine requirements enable clear and direct communication, using questioning to identify and confirm requirements, share information, listen and understand follow instructions read and interpret documentation from a variety of sources and drawings and specifications report faults use language and concepts appropriate to cultural differences use and interpret non-verbal communication, such as hand signals☐☐Observation comments. You (assessor) must detail exactly what was observed including the setting, people involved and how this section was performed and to what level taking into consideration the outcome for each observable item in the checklist. Should the student receive an NS for any of the items then arrangements must be made for reassessment. It should be noted that one or more dates can be utilised. For example, a section of the assessment may require a meeting so therefore that meeting can take place on line and most likely will be on a different day to a role play observationWrite your comment here. OBSERVATION DATE/S (AS REQUIRED) – Insert the dates all observations took place for this section……./……./…….……./……./…….……./……./…….……./……./…….……./……./……. ☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace ASSESSOR OBSERVATION CHECKLIST – CRITERION 2Before commencing was this observation conducted: ☐ In the workplace as a workplace observation in real time ☐ Via simulation with access to a real workplace ☐ In a simulated classroom environment ☐ On line (mainly used for meetings)When observing the student perform this task, the student was able to demonstrate their ability to erect formwork. The student can?Criterion (All criterion must be satisfactory to pass)SNS☐Refer to the job drawings/specifications and identify the design of the footing and/or slab on ground (Attachment 6 Concrete slab drawings and specifications)☐☐☐Check that drawings and specifications are in accordance with legislation, regulations and codes of practice.☐☐☐Set out formwork to requirements of drawings and specifications (Attachment 6) Form up a slab on ground a minimum of 9 square metres, incorporating an edge rebate and internal corner Form up a step to a foundation excavation to specified masonry units.☐☐☐prepare subgrade to specification Clear the area – remove soil, organic materials, rocks or other unwanted items in the area. Be sure to remove enough so that the final area of your concrete will sit slightly above ground. Backfill the area with either sand, gravel or crushed stone to help deliver an even pour and provide strength to concrete Compact the subgrade until it is hard, uniform, and well drained☐☐☐Set out formwork as per drawings and specifications Formwork includes prefabricated or in situ and is to be rigid to withstand the mass of wet concrete and actions imposed during placement Formwork complies with specifications to height and level and includes timber, metal or prefabricated for both footings and slabs on ground.☐☐☐Select fixings and fasteners as per job specifications☐☐☐Construct and erect formwork shutters and/or edge boxing as per drawings and specifications☐☐☐Brace formwork to specifications☐☐☐Install block-outs and cast-in services as per locations in drawings and to specifications☐☐☐Apply form release agent to formwork as required by specification☐☐☐demonstrate the following skills at all times: Effective communication teamwork skills to work with others to action tasks and relate to people from a range of cultural and ethnic backgrounds and with varying physical and mental abilities use a range of mobile technology, such as two-way radio and mobile phones Use voice and hand signals to access and understand site-specific instructions.☐☐Observation comments. You (assessor) must detail exactly what was observed including the setting, people involved and how this section was performed and to what level taking into consideration the outcome for each observable item in the checklist. Should the student receive an NS for any of the items then arrangements must be made for reassessment. It should be noted that one or more dates can be utilised. For example, a section of the assessment may require a meeting so therefore that meeting can take place on line and most likely will be on a different day to a role play observationWrite your comment here. OBSERVATION DATE/S (AS REQUIRED) – Insert the dates all observations took place for this section……./……./…….……./……./…….……./……./…….……./……./…….……./……./……. ☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace ASSESSOR OBSERVATION CHECKLIST – CRITERION 3Before commencing was this observation conducted: ☐ In the workplace as a workplace observation in real time ☐ Via simulation with access to a real workplace ☐ In a simulated classroom environment ☐ On line (mainly used for meetings)When observing the student perform this task, the student was able to demonstrate their ability to strip formwork. The student can?Criterion (All criterion must be satisfactory to pass)SNS☐Return to the site when the concrete has set and strip the formwork without damaging concrete slab: Remove edge boxing and bracing/strutting supports in an orderly, systematic and progressive manner, considering the risks of falls, falling objects and manual task hazards in the now enclosed space. De-nail formwork, clean and check for damage Appropriately discard damaged formwork components Sort and stack timber formwork components for re-use or bundle for transportation Clean and oil steel components Stack and store steel formwork components to prevent distortion and protect from the elements☐☐☐demonstrate the following skills at all times: Effective communication teamwork skills to work with others to action tasks and relate to people from a range of cultural and ethnic backgrounds and with varying physical and mental abilities use a range of mobile technology, such as two-way radio and mobile phones Use voice and hand signals to access and understand site-specific instructions.☐☐ Observation comments. You (assessor) must detail exactly what was observed including the setting, people involved and how this section was performed and to what level taking into consideration the outcome for each observable item in the checklist. Should the student receive an NS for any of the items then arrangements must be made for reassessment. It should be noted that one or more dates can be utilised. For example, a section of the assessment may require a meeting so therefore that meeting can take place on line and most likely will be on a different day to a role play observationWrite your comment here. OBSERVATION DATE/S (AS REQUIRED) – Insert the dates all observations took place for this section……./……./…….……./……./…….……./……./…….……./……./…….……./……./……. ☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace ASSESSOR OBSERVATION CHECKLIST – CRITERION 4Before commencing was this observation conducted: ☐ In the workplace as a workplace observation in real time ☐ Via simulation with access to a real workplace ☐ In a simulated classroom environment ☐ Online (mainly used for meetings)When observing the student perform this task, the student was able to demonstrate their ability to clean up. The student can?Criterion (All criterion must be satisfactory to pass)SNS☐Clear work area and dispose of, reuse or recycle materials in accordance with legislation, regulations, codes of practice and job specification Identify and prepare an area for material waste disposal Provide an effective means to contain wind blown rubbish Correctly identify and provide correct temporary storage for materials to be re-used Identify any hazardous materials from their SDS and take appropriate measures for disposal or recycling Clear work of off cut material Correctly dispose of, or where possible, mark for recycling☐☐☐Clean, check, maintain and store tools and equipment in accordance with manufacturer recommendations and standard work practices Conduct a post-operational check for the tools used Report faults if identified (appendix 4) Conduct maintenance on tools as required Pack away tools Store excess materials☐☐☐demonstrate the following skills at all times: Effective communication teamwork skills to work with others to action tasks and relate to people from a range of cultural and ethnic backgrounds and with varying physical and mental abilities use a range of mobile technology, such as two-way radio and mobile phones Use voice and hand signals to access and understand site-specific instructions.☐☐ Observation comments. You (assessor) must detail exactly what was observed including the setting, people involved and how this section was performed and to what level taking into consideration the outcome for each observable item in the checklist. Should the student receive an NS for any of the items then arrangements must be made for reassessment. It should be noted that one or more dates can be utilised. For example, a section of the assessment may require a meeting so therefore that meeting can take place on line and most likely will be on a different day to a role play observationWrite your comment here. OBSERVATION DATE/S (AS REQUIRED) – Insert the dates all observations took place for this section……./……./…….……./……./…….……./……./…….……./……./…….……./……./……. ☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace ASSESSOR OBSERVATION CHECKLIST – PROCEDURAL CHECKLISTBefore commencing was this observation conducted: ☐ In the workplace as a workplace observation in real time e ☐ Via simulation with access to a real workplace ☐ In a simulated classroom environment ☐ On line (mainly used for meetings)When observing the student perform this task, the student was able to demonstrate their ability to erect and dismantle formwork for footings and slabs on ground. The student can?Criterion (All criterion must be satisfactory to pass)SNS☐Set string lines to the profile to indicate face of wall and top of slab.☐☐☐Stand a suitable thickness and straight edge board on edge, with its face in line with the string line. The edge board must be below the line i.e. the depth of a brick/block course (depth of the rebate).☐☐☐Butt together and cleat the boards to make up the wall length.☐☐☐Drive in pegs behind the edgeboard to hold it in a vertical position.☐☐☐Nail the edgeboard to the pegs at the required height. Have an offsider hold a big hammer behind the peg as you are nailing the board on.☐☐☐At the corners, let one board run past the other so they can be fixed together. Nail a cleat on the face side of edgeboard 1 to prevent board 2 moving when the concrete is being poured.☐☐☐Brace the edge boards and pegs if necessary.☐☐☐Drive in another peg (secondary peg) about 450mm away from the pegs which you have fixed the edge boards to. These pegs are positioned at right angles (90 degrees) to the face of the edge board.☐☐☐Sit the rebate board temporarily on the edge board and mark the positions of the ends of the outriggers on the back face.☐☐☐Remove the rebate board and nail the outriggers to it.☐☐☐Return rebate board (with outriggers) to required location and nail the outriggers to the pegs with the rebate board in the correct position.☐☐☐Form up block-outs as specified by plans☐☐☐Apply release agent with a brush or spray unit☐☐☐For inspection All formwork components are of the specified type and material grade in accordance with AS 3610 Erection conforms with the formwork documentation The dimensional accuracies, plumb and straightness are within the specified tolerances The foundations are adequate; they are not likely to be disturbed and that they and the lower parts of the supporting structure are not liable to damage by interference, accident, traffic, scouring or undermining. Members are correctly positioned and connected. Confirm all required components, pins, bolts, nuts, clips, and similar components are undamaged and are of the correct type and have been correctly inserted and are secure. Formwork is clear of debris☐☐Observation comments. You (assessor) must detail exactly what was observed including the setting, people involved and how this section was performed and to what level taking into consideration the outcome for each observable item in the checklist. Should the student receive an NS for any of the items then arrangements must be made for reassessment. It should be noted that one or more dates can be utilised. For example, a section of the assessment may require a meeting so therefore that meeting can take place on line and most likely will be on a different day to a role play observationWrite your comment here. OBSERVATION DATE/S (AS REQUIRED) – Insert the dates all observations took place for this section……./……./…….……./……./…….……./……./…….……./……./…….……./……./……. ☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace☐Simulated ☐workplace RECORD OF ASSESSMENT TASK 3 SIMULATED PRACTICAL AND/OR WORKPLACE OBSERVATIONTo be completed by the assessorLearner detailsAssessor detailsNameNameUnit CodeCPCCCA2003AUnit TitleErect and dismantle formwork for footings and slabs on ground Record of assessment results (please tick appropriate box). ASSESSORS NOTE: Before making a final judgement on this assessment task, you must determine if the student is able to satisfactorily apply and perform the following criteria. Review the knowledge evidence by clicking on the link https://training.gov.au/Training/Details/CPCCCA2003A. Marking should be in line with the guides to completing the appendixes and/or attachments provided as the performance evidence, performance criterion and foundation skills is underpinned by this assessment task. All assessment tasks or parts for each section must be deemed satisfactory to achieve a satisfactory outcome for this task. If a NS is provided for any section or questions relating to this task then the task outcome should be treated as NS and the reassessment process should be applied. If a NS (not satisfactory) outcome is applied then you must inform the student in detail as to “why” this outcome was provided. Record your reasons in the section labelled “Not satisfactory (NS) outcomes”. See below for recording appropriate information Assessment activity – The learner has completed all the assessments requirements for this unit of competency and has been deemedFinal outcomeDate of final outcomeTask 3 – Simulated practical observation – Part 1: Plan and prepare (Appendix 1, 2, 3, 4, 5, 7)☐Satisfactory ☐ Not satisfactoryTask 3 – Simulated practical observation – Part 2: Erect formwork (Appendix 6, 7)☐Satisfactory ☐ Not satisfactoryTask 3 – Simulated practical observation – Part 3: Strip formwork (Appendix 7)☐Satisfactory ☐ Not satisfactoryTask 3 – Simulated practical observation – Part 4: Clean-up work area (Appendix 7)☐Satisfactory ☐ Not satisfactoryTask 3 – Simulated practical observation – Assessor observation checklist☐Satisfactory ☐ Not satisfactory AttemptsAttempt 1…../……/…….Attempt 2…../……/…….Attempt 3…../.…../…..Not satisfactory (NS) OutcomesPart numberRecord in detail the reason for the NS outcome appliedAppeals – refer to the complaints and appeals policy and procedureIf you receive a Not Satisfactory assessment result you have the right to appeal. You have three assessment attempts. After the third attempt arrangements for payment will be made for reassessment purposes. Refer to your student hand book for more details on the complaints and appeals process.Assessor Feedback to learner: The assessor must write full feedback to the learner that is constructive and not genericReasonable Adjustment (if applicable) explain why reasonable adjustment has been applied and the tasks it was applied toAssessor Intervention (if applicable) – did you need to assist the student in this assessment. If so please explain:Assessor NameAssessor SignatureDate Student declaration – I hereby certify that this assessment is my own work, based on my personal study and/or research. I have acknowledged all material and resources used in the presentation of this assessment whether they are books, articles, reports, internet searched or any other document or personal communication. I also certify that the assessment has not previously been submitted for assessment in any other subject or any other time in the same subject and that I have not copied in part or whole or otherwise plagiarised the work of other learning and/or other persons. I confirm that I understand that I must complete this assessment on my own. I confirm that I will not cheat or plagiarise or copy from another student during the completion of this assessment.Student nameStudent signatureDate CPCCCA2003A – Erect and dismantle formwork for footings and slabs on ground Task 3 – Direct ObservationStudent NameStudent ID NumberUnit Start DateUnit End DateAssessment Due DateDate SubmittedThis cover sheet is to be completed by the student and assessor and used as a record to determine student competency in this assessment taskThe assessment process and tasks were fully explained.Yes / NoI am aware of which evidence will be collected and how.Yes / NoI am aware of my right to appeal an assessment decision.Yes / NoI am aware that I can locate The RTO Complaints and Appeals Policy and Procedureon their website at (https://trinityinstitute.edu.au/wp-content/uploads/2020/09/SC4-I-Complaints-and-Appeals-PP-v2.0.pdf)Yes / NoI have discussed any additional educational support or reasonable adjustments I require in order to undertake this assessment with the Student Support Services Officer and Trainer / Assessor, (if applicable). e.g. Student Handbook and Access and Equity Policy https://trinityinstitute.edu.au/student-handbook-policies/Yes / NoI have access to all required resources via Moodle?Yes / NoCheating & Plagiarism DeclarationStudent Declaration: In accordance with The RTO Plagiarism Policy, I hereby acknowledge by signing this declaration that I have not cheated or plagiarised any work regarding the assessment tasks undertaken in this unit of competency except where the work has been correctly acknowledged. NOTE: Student must sign this prior to submitting their assessments to the assessorSignatureDate:______ / ______ / 20___Assessment ResultsSatisfactoryorNot Yet Satisfactory(Please circle the assessment result for this task)Feedback to Student – Please provide general feedback on the student’s performanceStudent Declaration: – I verify that the work completed is my own and that I was adequately informed of the assessment process prior to commencing this assessment task.Assessor Declaration: – I verify that I have adequately explained and negotiated the assessment tasks with the student prior to commencing assessment.Student Name:Assessor Name:Student SignatureDateAssessor SignatureDateAssessor Guide for Practical AssessmentAssessor InstructionsInstructions to include, but not limited to: Assessors will observe the student completing the tasks. Students may work individually or in pairs depending on class size. Assessment is based on the Assessment Requirements of each unit. At any time, students may refer to manuals and their learning guides or Textbooks for further information if needed. If there is a clear breach of safety, assessors MUST intervene immediately and advise the student of the breach. Students MUST successfully follow environmental and sustainability best practice in a carpentry workplace before competency can be achieved for the practical component. Observable behaviors and answers to oral questions MUST be recorded on this document. If reassessment is required, this must be done after further study and discussion with the student.Task/s to be assessedThe tasks you will be observing is what the student will be undertaking: The student MUST follow best practice in a carpentry workplace for specific applications that safely follows workplace procedures to meet required outcomes.Oral questioningDuring the practical demonstration you will ask the student observation questions that will address the skills and knowledge aspects of the unit of competency. The student will respond orally, and you will record the student’s response.Time allowedOn average, the Assessments should take 2 – 4 hours to complete.LocationAssessment will take place in a simulated workshop environment relevant to the trade stream being studied.Decision making rulesTo achieve a satisfactory outcome, the student MUST follow and complete all tasks before competency can be achieved for the practical component, and answer all questions presented by the Assessor. Expected answers to oral questions are indicative of the correct answer.Performance Observation Criteria for Assessment TaskThe assessment methods MUST be by direct observation of tasks on required skills and knowledge to ensure correct interpretation and application.Assessment conditionsAssessors MUST satisfy NVR/AQTF assessor requirements.  Competency is to be assessed in the workplace or a simulated environment that accurately reflects performance in a real workplace setting.  Assessment MUST include direct observation of tasks.  Where assessment of competency includes third-party evidence, individuals MUST provide evidence that links them to having followed best practice in their carpentry workplace. Assessors MUST verify performance evidence through questioning on skills and knowledge to ensure correct interpretation and application. Resources requiredThe following equipment MUST be made available to students: The students MUST be wearing the correct PPE. This is to include: Safety boots/shoes, Protective clothing, Safety glasses, and Gloves as required The students MUST have the practical assessment sheet and a pen to complete each task.Results/Re-assessmentYou will grade either S – Satisfactory or NS – Not Satisfactory for the assessment. In all cases you will provide the student with feedback. Only when all assessment tasks have been graded as S – Satisfactory the student will be deemed C – Competent in the final result of the unit of competency; if the student dose not satisfactorily complete all the assessment tasks the student will be deemed NYC – Not Yet Competent. If the evidence is graded as NS – Not Satisfactory the student will be required to re-submit the evidence. In this case, the student will be provided with clear and constructive feedback based on the assessment decision so that they can improve your skills / knowledge prior to reassessment. Where a ‘NS – Not Satisfactory’ judgement is made, the student will be given guidance on steps to take to improve your performance and provided the opportunity to resubmit evidence to demonstrate competence. You will determine and discuss the reasons for NS – Not satisfactory on any of the criteria and will assess the student through a different method of assessment e.g. verbal/oral questioning, problem solving exercises.Reasonable AdjustmentYou may adjust assessment conditions (vehicles, tools, analysis required) to suit workplace objectives provided that the integrity of the task is maintained.