Unit of Competency: BSBWHS401 Implement and monitor WHS policies, procedures and programs to meet legislative requirements
Topic: Topic 1 – Australian Workplace Culture
Assessment Task: Task 1.3 - WHS Hazard & Risk Identification Report
Assessment Due Date: Week 4 Duration: 3 hours
Assessment Criteria:
BSBWHS401:
• applying organisational WHS management systems and procedures in the work team area
• applying procedures for assessing and controlling risks to health and safety associated with those hazards, according to the hierarchy of control and as specified in commonwealth and state or territory WHS Acts, regulations and codes of practice
• providing specific, clear and accurate information and advice on workplace hazards to work team
knowledge of legal responsibilities of managers, supervisors, PCBUs or their officers and workers in the workplace.
Assessment Instructions to Student:
• Write your name as it appears on your enrolment form in the appropriate area on this form
• Attempt all questions in the assessment.
• All answers to be typed using Microsoft Word
• Use complete sentences, check grammar, punctuation and spelling
• This assessment cover sheet must be handed in with your answers.
Resources permitted during assessment:
• Dictionaries: Standard, Bilingual, Digital
• Electronic devices: Laptops, Computers, Internet
Additional Assessment Instructions to Assessor:
Reasonable adjustment: Trainers may make reasonable allowances for learners in accordance with the C&I Learner Support Policy contained in the Participant and Trainer Handbooks. This may relate to the timeframe for undertaking this assessment task in class or relate to an extension to the due date. Consult with the Curriculum & Learning Manager prior to administering this assessment to ensure Learner Support needs are met.

The following activities contain questions regarding Work Health & Safety. The WHS Reporting Documents (including Hazard Checklist, Incident & Injury Report, Risk assessment and Control and Monitoring forms are all provided below) and can be completed during class following the criteria below: Please refer to relevant legislation when outlining your recommended actions.
1. Complete a Hazard Checklist using the classroom facility/building as a simulated workplace environment.
2. Based on the completed Hazard Checklist, choose one hazard and create a hypothetic incident based on this hazard. From this incident, complete an Incident/Injury Report.
3. Based on the Hazard checklist and Incident report you have now completed, complete a Risk Assessment based on the hazard & incident you choose.
4. Based on the Hazard checklist, Incident Report and Risk Assessment, complete the Control & Monitoring Form.
Hazard Checklist
Participant Name:
Date:
Element: Yes No N/A Action required
1. LAYOUT
Area is tidy and well kept
Floor is free of obstructions
Aisles are free from obstructions
Floor coverings are in good condition
2. ENVIRONMENT
Temperature is comfortable
Lighting is adequate
Area is free from odours
Noise level is acceptable
Ventilation is adequate
3. ELECTRICAL SAFETY
Portable equipment has current test tags
Power leads in good condition
Power leads are off the floor or placed away from walkways
Power boards used (not double adaptors)
Faulty equipment is tagged out
4. EMERGENCY PROCEDURES
Written procedures posted
Fire extinguisher easily accessible
Tag on extinguisher has been checked in the last 6 months
Alarm can be heard in the area
Escape routes are clear
Emergency and hazard signage is clearly visible
5. FIRST AID FACILITIES
Kits accessible within 5 minutes
Kits are stocked and contents are in date
Name and contacts of first aiders displayed
6. OTHER
Incident/Injury Report
Outcome of incident:
Near Miss • Injury • Property Damage •
1. Details of person involved
Name:
Gender: Male • Female • Date of Birth:
Address:
Email:
Mob Phone: Home Phone:
Position: Employee • Contractor • Visitor • Volunteer •
Employment Status: Full Time • Part Time • Casual •
Job Role: Experience in the job:
2. Details of incident
Date: Time:
Location:
Describe what happened and how it occurred:
3. Details of injury
Nature of injury (eg burn, cut, sprain):
Cause of injury (eg fall, grabbed by person ):
Location on body (eg back, left forearm):
Agency (eg lounge chair, another person, hot water):
4. Treatment administered
First Aid Given Yes • No •
First Aider Name:
Treatment:
Referred to:
5. Did the injured person stop work?
Yes • No •
If yes, state lost time (days):
Outcome:
Treated by:Doctor Hospitalised Workers compensation claim Returned to normal work Alternative duties Rehabilitation
• • • • • •
6. Details of witness
Were there any witnesses? Yes • No •
If Yes, complete the information below:
Witness Name:
Mobile Phone Home Phone:
Email:
Address:
7. Incident investigation
Comments to include causal factors, add extra sheets if needed:

Risk Assessment Form
1. Hazard identification
Describe the hazard Identify the potential risk
2. Assess the risk
Impact Potential risk
Rare Unlikely Possible Likely Almost certain
Catastrophic M M H C C
Major L M M H C
Moderate L M M M H
Minor L L M M M
Insignificant VL VL L L M
IMPACT: How severely could someone be hurt
Catastrophic Death or permanent disability to one or more persons
Major Hospital admission required
Moderate Medical treatment required
Minor First aid required
Insignificant Injuries not requiring first aid
LIKELIHOOD: How likely are those consequences?
Almost certain Expected to occur in most circumstances
Likely Will probably occur in most circumstances
Possible Could occur at some time
Unlikely Is not likely to occur in normal circumstances
Rare May occur only in exceptional circumstances
Risk level Required action
Critical (C) Act immediately:
The proposed task or process activity must not proceed. Steps must be taken to lower the risk level to as low as reasonably practicable using the hierarchy of risk controls.
High (H) Act today:
The proposed activity can only proceed, provided that:
(i) the risk level has been reduced to as low as reasonably practicable using the hierarchy of risk controls;
(ii) the risk controls must include those identified in legislation, Standards, Codes of Practice etc.
(iii) the risk assessment has been reviewed and approved by the Supervisor and
(iv) The supervisor must review and document the effectiveness of the implemented risk controls.
Medium (M) Act this week:
The proposed task or process can proceed, provided that:
(i) the risk level has been reduced to as low as reasonably practicable using the hierarchy of risk controls;
(ii) the risk assessment has been reviewed and approved by the Supervisor.
Low (L) Act this month:
Managed by local documented routine procedures which must include application of the hierarchy of controls.
Very Low (VL) Keep a watching brief:
Although the risk level is low the situation should be monitored periodically to determine if the situation changes.
Control & Monitoring Form
1. Action to prevent recurrence
Level of control Short term controls Who/when Long-term controls Who/when
Eliminate the hazard – remove it completely from your workplace
Substitute the hazard – with a safer alternative
Isolate the hazard – as much as possible away from workers
Use engineering controls- adapt tools or equipment to reduce the risk
Use administrative controls – change work practices and organization
Use personal protective equipment (PPE) – this should be the last option after considering all other options
2. Monitor and review
Potential Hazard(s) to Monitor & Review Review date Person to Reviewed
(Name)
Any Further Comments/Information to report: