LOWER NORTH COAST BRANCH

ASSESSMENT EVIDENCE CHECKLIST

ONLY TO BE USED for Club Run Courses Course: Venue: Date(s) Trainers: Assessors/Facilitators: Content Experts: Candidates:

CONTENTS:

Please return completed paperwork to Forster Mitre 10 or Rocket Tools (Taree)

Club to retain (Club run courses)

Training Enrolment Forms (1 per candidate)

Participants Joining Instructions (Copy)

Participant Attendance Sheet – completed – Multi or single day.

Completed Assessors worksheet (BM and SRC)

Signed copy of Form 14 – 1 X Club copy Forward to branch (Club run courses)

Training Course Report

Signed copy of Form 14 –1 X Assessment copy

Participant Course Evaluation Forms (1 per candidate)

Assessment Portfolio – 1 per candidate – if applicable (Front sign off page) OR

Final Assessment Sign-off page (BM and SRC) – 1 per candidate – if applicable

Participant Exit Questionnaire – if applicable

Assessors to sign following assessment:

I verify that I have sighted all club required paperwork (listed above) and that it is complete.

Assessor/s name & signature:

Lead Assessor Declaration: (MUST BE EXTERNAL to HOST CLUB) I verify that all candidates have been trained in all elements of this course

Lead Assessor name & signature:

Please note that paperwork cannot be processed until it is completed correctly. It will be returned for completion.

Date Received: Processed: Signed:

6

LNC Branch Training/Assessment Procedure Guide – Club

Courses

Tick box to indicate task completed.

1. Advertise course and display Participant Joining Instruction Poster with details of

course – include information such as date/s, venue, start time, duration, any special requirements

2. Induction/introduction – Ensure participants are financial members, collect completed

and signed Training Enrolment Forms.

Start Training Course Report, attendance sheet

3. Enter New Assessment Request into SurfGuard, with approximate date of

assessment (this can be changed, if necessary). Include ALL participants’ names and trainers,

content experts, etc.

4. Conduct training – Continue completing Training Course Report – include details such

as early exits, special needs, reasonable adjustment, content experts (and what they delivered). If

BM or SRC – conduct and record timed pool swim. Complete and submit (with course paperwork)

‘Aquatic Activity Risk Assessment and Management Form’ for each water based training session.

[SLSA Water Safety Policy 1.1]. See example Training Course Report, highlight good/bad, negative

outcomes experienced.

5. CTO send out email to request assessors Confirm Date of Assessment with DOE at

least one week prior to assessment – ‘submit’ assessment. Include information in ‘comments’ box,

such as probationary trainers, content experts, early exits.

6. Complete training.

7. Assessment day –

Club – set up. Ensure all paperwork is present and completed – hand to assessors prior to

commencement of assessment.

Assessors – record evidence on checklists. Complete Training Course Report and sign, Assessment

sign-off sheets, Complete and sign Form 14s. Provide feedback to candidates and trainers.

Candidates – complete Participant Course Evaluation Forms and hand in.

8. Club enters information into assessment request. At ‘Process Results’ Enter

assessors, and pool swim times, run swim run times if BM or SRC.

9. Submit paperwork to DOE within 14 days. Use course checklist to verify all

paperwork is enclosed.

10. DOE completes processing of course paperwork, summarizes and prepares report

and actions outcomes as necessary.

Multi-Day Attendance Record

Unit of Competency/Course Name:______________________ Venue: _____________________________________________ Trainer/s:___________________________________________ ___________________________________________ Content experts: _____________________________________ Club Surname Given Name

Dates/Times of Sessions

Sessions delivered (see reverse for session numbers to use.)

Venue checked (Trainer to tick each session to indicate venue check completed)

Training Course Report completed and attached YES Signature: Date:

Multi-Day Attendance Record

Suggestion: Use the listed numbers to identify the sessions:

SRC and/or BM/Cert II

1. Induction

2. Safety and Wellbeing

3. Surf Awareness

4. Rescue Board Paddling

5. The Human Body

6. Resuscitation

7. Defibrillation Awareness

8. Oxygen Therapy / Mouth-to-mouth Rescue Breathing with Oxygen

9. First Aid

10. Radio Communications

11. Communications

12. Signals

13. Rescue Techniques

14. Rescues without equipment

15. Tube Rescues

16. Board Rescues

17. Rescue Bodyboards

18. Mass Rescues

19. Carries and Supports

a. 2 person

b. Spinal

c. Stretcher

20. Patrols

a. Starting and finishing patrols

b. Patrolling the beach

c. Closing of beaches

d. Emergency Services

Advanced Resuscitation Techniques (ARTC)

1. Induction and introduction

2. First Aid and Resuscitation Review

3. Advanced Resuscitation and Oxygen Administration

4. Oropharyngeal Airways

5. Suction

6. Defibrillation

IRB Crew Certificate

1. Course Introduction and induction

2. Roles and responsibilities for IRB Crew

3. Launching Operating and Recovering the IRB

4. Basic Crewing of an IRB ib various conditions

5. Crew IRB to transport equipment and participate in rescues

6. Post Operational Procedures

Silver Medallion IRB Driver

1. SM IRB Driver pre-course work (Marine Licence)

2. Course Introduction and Induction

3. Role and responsibilities of IRB Driver

4. Prepare and drive the IRB

5. Drive IRB to participate in rescues and perform emergency drills

6. Post-operational procedures and maintenance

Dear

We are pleased to confirm your attendance at the following course. The details for the course are:

Course Name:

Venue:

Date:

Time:

Additional Requirements: (e.g. specific clothing)

Prior to the commencement of the course, please ensure that you make yourself familiar with thefollowing documents as they contain reference to policies that relate to you as a courseparticipant. These documents are available from the Surf Life Saving NSW websitewww.surflifesaving.com.au.

SLSNSW Academy Handbook SLSNSW RPL Guide for Applicants Participant Code of Conduct policy (TA3.2)

To access these documents, select Training & Education, then Member Training, then ParticipantResources.

You should also print a copy of the Training Enrolment Form, and bring this completed andsigned form with you to the course. To access this form select Training & Education; MemberTraining; Participant Resources, then SLSNSW Training Enrolment Form.

It is our aim to cater for the special needs of all our participants. If you feel you have additionallearning needs or may require extra assistance, please speak with your trainer before the first dayof your course or at your induction session.

Should you have any enquiries regarding the course, or have difficulty accessing the resourcesfrom the internet, please contact your Club or Branch Education Officer.

I trust that we have anticipated your enquiries, however please feel free to contact theundersigned should you require further clarification.

Regards

Appendix - Candidate tracking sheet

Venue: ………………………………………………………. Date:…………………………………………………………….. Assessor Name: ……………………………………………………………………

36

Candidate name

AT 1 Sign-als

AT 2 Radios

AT 3 First Aid

AT 4 Resuscitation

AT 5 RSR

AT 6 Rescues/ Carries

AT 7 Patrol

Comments/ Questions

10 c

orre

ct

Equi

pmen

t use

Com

ms (

PPPP

)

Term

inol

ogy

Patie

nt c

are

Haza

rd m

anag

emen

t

Corr

ect a

sses

smen

t

Trea

tmen

t

DRAB

CD

CPR

Defib

Aw

aren

ess

Oxy

gen

Ther

apy

Run-

swim

-run

Ti

me

Tube

/Boa

rd/ U

naid

ed

(2 re

scue

s)

Spin

al (w

ater

/land

)

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

Form TA301 Participant Exit Questionnaire – July 2008 Page 1 of 2

Participant Exit Questionnaire

Surf Life Saving NSW (Training Division) values your comments on how we can improvethe delivery of our courses and the quality of support services for our students. Pleasecomplete the following questions and return this questionnaire to our office in theenvelope provided.

Date: Student Name:

Course Details:

Facilitators Name:

Please circle the most appropriate response to indicate your reasons for leaving the course:

1 None 2 Small influence 3 Moderate Influence 4 Major Influence 5 Only Reason

Please indicate the main reasons influencing your decision to leave the course:1 2 3 4 5 1 2 3 4 5

Difficulty - the course contentwas too hard.

Relevant - the course wasnot what I expected.

Difficulty - the course was notchallenging.

Facilities – the standard offacilities used for the deliveryof the course.

Interest - the course was notinteresting.

Location - the location of thecourse was not suitable.

Instructors - the standard ofinstructors used to present thecourse.

Student Support - The typeand level of student supportprovided.

Assessment – the type ofassessment used. RPL – recognition was not

given for your prior skills andknowledge.

Flexibility in delivery – thecourse delivery times wereunsuitable.

Personal reasons.

Commenced employment. Other:

Form TA301 Participant Exit Questionnaire – July 2008 Page 2 of 2

Participant Exit Questionnaire

Could we have done anything to prevent you leaving the course?

Is there anything we can do to assist to complete the course now or in the future?

General Comments:

OFFICE USE ONLY

Actions:

Signed: _______________________________ Date: _____________

Training Course Report – July 2011 Page 1 of 2

Training Course Report

This report is to be completed by the Facilitator or Trainer and Assessor at the completion of the course andforwarded to the Branch Education Officer. Attach all course evaluation forms completed by the participantsto this form. Please also attach the Single Day or Multi-Day Attendance Record.

Course Details

Course SurfGuard ID#

Facilitator OR Trainerand Assessor

Course Date

Course Location

Course Summary

Participant Satisfaction

Overall, did the participants find the course beneficial? Yes No

Why?

Participant Exit Questionnaires Yes No(Did any participant leave the course early? Please attach Participant Exit Questionnaires)

Venue

Venue Check Completed Yes No

Further action required regarding venue? Yes No(E.g. improvements to disabled access & facilities, lighting, seating, emergency exits well indicated, environment meets learning needs,industry standards & OH&S requirements)

Comments:

Resources – difficulties / success experienced:

Course material – Comments, suggestions and improvements:

Other comments:

Training Course Report – July 2011 Page 2 of 2

Training Course Report

Details of endorsed members who assisted with this course and/or members who assisted as part oftheir assessment as a probationary Trainer, Assessor or Facilitator in this discipline

Endorsed Probationary

Details of content experts who assisted with this course

Content Expert Name Topic Expert Assisted with

Comments/Recommendations

Signature _________________________________________________________ Date ______________Facilitator OR Trainer and Assessor

Branch Education Officer to read attached evaluation forms and record below a general overview of the feedback. Ifaction required, please discuss at the Branch Education Meeting, complete an Improvement Request and forward toSLSNSW Manager Education, for required action.

Analysis of Course Evaluation Forms

Are there any issues that need to be followed up? Yes No

Action:

Report reviewed by Branch Education Committee Date ______________

Signature _________________________________________ Date ______________

Form HR200 Venue Checklist – July2008 Page 1 of 1

Venue Checklist

VENUE ADDRESS

Are the following available on site? Yes No

Resources in accordance with the requirementsof the SLSNSW (Training Division) SOPS

Resources in adequate supply for the numberof trainees (as per course standards)

Resources are consistent with industry standardsEnvironment is conducive to learning and meetsall statutory requirements (as per the SOPS)

Meets health & safety requirements

Has disabled access & facilities

Adequate lighting

Emergency exits well indicated

Comfortable seating available

The following is available on site (please tick):

Whiteboard OHPFlip Chart TVVideo/DVD Computer/s number ___________Data Projector Meal facilitiesCoffee/Tea facilities Adequate Parking facilitiesVenue meets requirements in terms of safety and comfort to maximise learning

Comments

Checked By ____________________________ Date ________________(Signature)