CPCSIL3001 – Assessment Task 2 – Assessor Checklist – Observational Report Step 1 of 8 12% ASSESSMENT TASK 2 - ASSESSOR OBSERVATIONAL REPORT (RELEASE 1 - CPCSIL3001)REMINDER This form must be completed by the course assessor. 📃Subject: Employer/Manager/Supervisor Support for CPCSIL3001 AssessmentIMPORTANT NOTE: We kindly request your support by completing the attached checklist and providing any comments based on your observations. Your input will play a crucial role in verifying the student’s competence and application of fatigue management strategies in a workplace setting. Please ensure your feedback: Is honest and reflects your professional opinion. It relates only to tasks and behaviours you have observed. If you have any questions regarding the submission process, please contact our support team for assistance. We greatly appreciate your time in supporting this student’s learning journey. 🖋️ COURSE ASSESSOR TO COMPLETE THIS SECTIONThis observational checklist/report has been designed to guide the course assessor in collecting the student evidence required by the CPCSIL3001 unit of competence to demonstrate competency. This checklist must be completed for each student.Recording your Observations Observations are to be recorded on the observational checklist below by placing a mark (🞇) in the appropriate box (example: 🞇 YES or 🞇 NO) Feedback/Comments are to be used when a student is deemed NO or NS to explain why. Where possible, you are to take photographic, or video recorded evidence of the student performing each of the three tasks. As the student is expected to wear the required PPE when performing their tasks, we understand it may not always be possible to identify the student in the picture or video. If this is the case, we request that you take photographic, or video recorded evidence of the student conducting their RPE fit tests as these images will generally show more of the student face. Example: Assessment Duration: When conducting on-site assessments at a client's workplace, the nature of their duties may not always provide opportunities to complete three distinct work activities (e.g., cutting, drilling, or grinding) within the designated assessment timeframe. In such cases, you may choose to observe the student’s performance over multiple occasions or document their compliance with the assessment criteria based on prior performances you have directly witnessed. Please ensure that you inform the employee (our student) about the observational methods you intend to use in advance.PLEASE PROVIDE US WITH YOUR DETAILS HEREAssessor Full Name(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Mobile NumberContact Email Address PLEASE PROVIDE US WITH THE STUDENT'S DETAILS HEREStudent's Name(Required) First Last Please enter the name of the person requesting that you complete this form.Student's Email Address SUBJECT: CPCSIL3001 Work with products and materials containing crystalline silica Part 1The student must identify and select appropriate PPE/RPE for the work activities. The student must demonstrate fit-checking procedures of disposable and re-usable devices in accordance with manufacturer instructions: IMPORTANT NOTE: If the student is unable to successfully demonstrate the requirements listed below in Part A, they are not to proceed with Part B or C! Please state whether you have observed the student perform the following to an acceptable level or standard within your organisation: Did the student consistently:Select the correct RPE for the work activity being performed.(Required) YES NO NOTE: Students must select the appropriate RPE for the specific hazards present in the workplace. Things to watch out for: The student ensures that the RPE is the correct size and fits their face shape. The student selects the appropriate RPE (disposable or re-useable) for the work activity. Perform a fit check of the RPE. (Photographic evidence required)(Required) YES NO Steps: Students should start by inspecting the equipment for any visible signs of damage or wear. This may include checking the straps, face seals, and filters for any tears or deformities. Students should put on the RPE according to the manufacturer's instructions, ensuring that the straps are correctly positioned and tightened to provide a secure fit. Students should perform a fit check to confirm that the equipment is properly sealed. This will involve performing positive and negative pressure checks. If any air leakage is detected during the fit check, the student should readjust the position of the RPE on their face and repeat the process until a proper seal is achieved. Example of the photo's required: RPE Fit Test Photos Drop files here or Select files Max. file size: 64 MB. Report any damage that may be detected.(Required) YES NO N/A Employer/Manager/Supervisor's Notes & Observations Part 2Pre-Work Activity Checks IMPORTANT NOTE: Unless specified, the observational performance criteria listed here need to be demonstrated consistently across all three work tasks. If the student cannot successfully demonstrate the requirements for one work task, a NO should be recorded for all three tasks!List the three work activities you have observed this student complete. Remember: You will need to provide PHOTO evidence of ONE work activity.Work Activity #1(Required)Cutting – Using saws or grinders to cut materials such as concrete, stone, bricks, or tiles.Drilling – Drilling into concrete, stone, or masonry surfaces.Grinding – Smoothing or shaping materials containing silica using grinders or sanders.Sawing – Operating power saws or hand saws to cut through silica-containing materials.Polishing – Polishing stone surfaces such as granite or engineered stone countertops.Mixing – Combining silica-containing materials such as cement, grout, or mortar.Jackhammering – Breaking up concrete or masonry using jackhammers.Sanding – Smoothing silica-based surfaces using sanding tools.Demolition – Removing or dismantling structures made from concrete, bricks, or other silica-containing materials.Chiseling – Manually or mechanically chiseling stone, concrete, or masonry products.Tuckpointing – Removing and replacing mortar in brickwork.Shot Blasting – Cleaning or preparing surfaces by blasting silica-containing materials.Abrasive Blasting – Sandblasting materials to remove coatings or surface contaminants.Handling Raw Materials – Transporting, pouring, or handling silica-containing products such as sand, cement, or engineered stone slabs.Installing Countertops – Working with stone or engineered stone during fabrication or installation.Sweeping and Cleaning – Dry sweeping or using compressed air to clean up dust and debris containing silica.Casting and Molding – Pouring concrete or silica-based mixtures into molds.Bricklaying – Cutting and laying bricks or concrete blocks.Plastering – Applying or smoothing plaster and cement-based coatings.Tile Cutting and Installation – Cutting and setting tiles made from silica-based materials.OtherWork Activity #2(Required)Cutting – Using saws or grinders to cut materials such as concrete, stone, bricks, or tiles.Drilling – Drilling into concrete, stone, or masonry surfaces.Grinding – Smoothing or shaping materials containing silica using grinders or sanders.Sawing – Operating power saws or hand saws to cut through silica-containing materials.Polishing – Polishing stone surfaces such as granite or engineered stone countertops.Mixing – Combining silica-containing materials such as cement, grout, or mortar.Jackhammering – Breaking up concrete or masonry using jackhammers.Sanding – Smoothing silica-based surfaces using sanding tools.Demolition – Removing or dismantling structures made from concrete, bricks, or other silica-containing materials.Chiseling – Manually or mechanically chiseling stone, concrete, or masonry products.Tuckpointing – Removing and replacing mortar in brickwork.Shot Blasting – Cleaning or preparing surfaces by blasting silica-containing materials.Abrasive Blasting – Sandblasting materials to remove coatings or surface contaminants.Handling Raw Materials – Transporting, pouring, or handling silica-containing products such as sand, cement, or engineered stone slabs.Installing Countertops – Working with stone or engineered stone during fabrication or installation.Sweeping and Cleaning – Dry sweeping or using compressed air to clean up dust and debris containing silica.Casting and Molding – Pouring concrete or silica-based mixtures into molds.Bricklaying – Cutting and laying bricks or concrete blocks.Plastering – Applying or smoothing plaster and cement-based coatings.Tile Cutting and Installation – Cutting and setting tiles made from silica-based materials.OtherWork Activity #3(Required)Cutting – Using saws or grinders to cut materials such as concrete, stone, bricks, or tiles.Drilling – Drilling into concrete, stone, or masonry surfaces.Grinding – Smoothing or shaping materials containing silica using grinders or sanders.Sawing – Operating power saws or hand saws to cut through silica-containing materials.Polishing – Polishing stone surfaces such as granite or engineered stone countertops.Mixing – Combining silica-containing materials such as cement, grout, or mortar.Jackhammering – Breaking up concrete or masonry using jackhammers.Sanding – Smoothing silica-based surfaces using sanding tools.Demolition – Removing or dismantling structures made from concrete, bricks, or other silica-containing materials.Chiseling – Manually or mechanically chiseling stone, concrete, or masonry products.Tuckpointing – Removing and replacing mortar in brickwork.Shot Blasting – Cleaning or preparing surfaces by blasting silica-containing materials.Abrasive Blasting – Sandblasting materials to remove coatings or surface contaminants.Handling Raw Materials – Transporting, pouring, or handling silica-containing products such as sand, cement, or engineered stone slabs.Installing Countertops – Working with stone or engineered stone during fabrication or installation.Sweeping and Cleaning – Dry sweeping or using compressed air to clean up dust and debris containing silica.Casting and Molding – Pouring concrete or silica-based mixtures into molds.Bricklaying – Cutting and laying bricks or concrete blocks.Plastering – Applying or smoothing plaster and cement-based coatings.Tile Cutting and Installation – Cutting and setting tiles made from silica-based materials.OtherPart 2.1Preparing to handle products and materials containing crystalline silica. Did the student consistently:Review and interpret the work requirements and instructions required to handle products containing CS.(Required) YES NO Example: This can be achieved by holding a conversation about the SDS. Read and interpret the technical specifications for the products or materials containing crystalline silica to identify the nature of the product and the risk level, risk controls, and personal exposure reduction requirements.(Required) YES NO Example: This can be achieved by holding a conversation about the SDS, SWMS, or equivalent safety briefing. Participate in consultations on matters affecting health and safety with respect to exposure to RCS.(Required) YES NO Example: This can be achieved by holding a conversation about the SDS. Classify the level of exposure risk to airborne RCS for identified products and materials, including likely duration of exposure.(Required) YES NO Example: This can be achieved by holding a conversation about the SDS. Seek feedback from a supervisor when the CS content of a product or material is unknown or unclear.(Required) YES NO NOTE: If this criterion cannot be observed, the following question must be asked. Question: What would you do if you were unable to find the level of silica content of a product? Select plant, tools, equipment, PPE and RPE required to perform specified tasks in accordance with the hierarchy of controls and regulatory requirements. Did they check to ensure they have an extraction system in place, and that they have all the correct tools?(Required) YES NO Review the relevant safety documentation for planned work activity and work environment and contribute where required.(Required) YES NO Example: You should be able to observe this criterion through the SWMS & SDS. Check operation and serviceability of relevant plant, tools, equipment, PPE, and RPE to perform the work activity in accordance with WHS procedures and manufacturer instructions.(Required) YES NO Report any faults and damage to relevant plant, tools, equipment, PPE, and RPE in accordance with WHS procedures.(Required) YES NO Third-Party Observer's Notes & Observations Part 2.2 - Performing work activities (Photographic Evidence Required)Course Requirement: The student must demonstrate three different work activities (for example: cutting, drilling, grinding) using products or materials containing crystalline silica while applying all relevant work health and safety (WHS) considerations. This may include dust capture and suppression measures. The student must also demonstrate the safe use of their PPE and RPE in accordance with manufacturer instructions. Reminder: You may observe the student’s performance over multiple occasions OR document their compliance with the assessment criteria based on prior performances you have witnessed. This will serve as a professional declaration of compliance and contribute as evidence toward the student’s competence requirements. IMPORTANT NOTE: Unless specified, the observational performance criteria listed here need to be demonstrated consistently across all three work tasks. If the student is unable to successfully demonstrate the requirements for one work task, a NO should be recorded for all three tasks! Did the student consistently:Inspect worksite, locate services, assess hazards, and apply risk controls, including required signage and barricades.(Required) YES NO Perform fit checking of RPE in accordance with manufacturer instructions and WHS procedures.(Required) YES NO Confirm risk control measures for planned work are in place, in accordance with WHS procedures and manufacturer instructions.(Required) YES NO Use plant, tools, equipment, PPE and RPE required to perform specified tasks in accordance with WHS procedures and manufacturer instructions.(Required) YES NO Perform work activities and continual monitoring of risk control measures in accordance with WHS procedures.(Required) YES NO (Photographic or Video Evidence is required of at least one work task being completed by the student. The images must show that the student is wearing the correct RPE and PPE and is using the appropriate equipment for the task.) Photo Required of the student performing ONE of the work activities you listed above. Drop files here or Select files Max. file size: 64 MB. Third-Party Observer's Notes & Observations Part 3 - MaintenanceThe student must demonstrate how they performed maintenance activities, and cleaned the work area, including disposing of contaminated products and waste materials in the work area in accordance with OHS/WHS procedures. IMPORTANT NOTE: Unless specified, the observational performance criteria listed here need to be demonstrated consistently across all three work tasks. If the student is unable to successfully demonstrate the requirements for one work task, a NO should be recorded for all three tasks! Please state whether you have observed the student perform the following to an acceptable level or standard within your organisation. Does this student consistently:Identify or demonstrate knowledge of the PPE and RPE maintenance requirements, the correct storage methods, and on the correct waste disposal requirements for the contaminated materials, in accordance with manufacturer instructions and WHS procedures.(Required) YES NO Example: You should observe the student cleaning their equipment, by wiping down or vacuuming up dust. Clean up and dispose of dust and slurry from the work area.(Required) YES NO Clean, inspect, and determine serviceability of PPE, RPE, tools and equipment.(Required) YES NO Example: Student should be observed wiping down equipment. Apply maintenance requirements and record and report findings of serviceability inspections in accordance with WHS procedures and manufacturer instructions.(Required) YES NO Example: Student should be observed appropriately checking/swapping/adding/removing mask filters. Store and secure relevant tools and equipment.(Required) YES NO Third-Party Observer's Notes & Observations IF THE STUDENT (WORKER) IS WITH YOU, PLEASE ASK THE STUDENT TO SIGN THIS SECTION. IF NOT, PLEASE MOVE TO THE LAST SECTION.STUDENT Declaration I agree to the following statements.I declare that the information contained in this Assessment Task is accurate and is a true reflection of my thoughts, opinions, and responses.STUDENT Signature COURSE ASSESSOR TO SIGN THIS SECTION!Assessor Declaration(Required) I agree to the following statements.I (the person who completed this report), hereby declare that: I have observed the above-named student perform the tasks and activities outlined in this report as part of their assessment for the unit CPCSIL3001 - Work with products and materials containing crystalline silica. I am in a position within my organisation to accurately evaluate and confirm this student’s application of skills and knowledge related to working safely with products and materials containing crystalline silica based on my direct observations and professional judgment. To the best of my knowledge, the student has demonstrated the required competence in a workplace setting, and my feedback is an honest and truthful account of their performance. I understand that this observational report will be used as evidence to support the student’s assessment for the above-mentioned unit, and I have completed this declaration accordingly. Assessor Signature(Required)
