Training Record For Work Placement Handbook: CHC43015 Certificate IV in Ageing Support

CHC43015
Certificate IV in Ageing Support
Training Record for Work Placement

HANDBOOK
Version 1.5 May 2018
Guidelines for
Facilities and Students
Student Name:
Integrated Training Solutions (Aust) Pty Ltd

T/A Intercare Training
1 Fairborne Way
Keysborough Vic 3173
Phone: 1300 10 2273
www.integratedtrainingsolutions.com.au
info@integratedtrainingsolutions.com.au
CHC43015 Cert IV Ageing Support_WPB_Final_May 2018 V1.5 Page 2 of 206
TABLE OF CONTENTS
DETAILS
SECTION 1 GENERAL INFORMATION FOR STUDENTS AND AGENCIES
1.1 Contact Details PG 4
1.2 Student checklist PG 5
1.3 Important information regarding Training Placement with Intercare Training PG 6
1.4 Facility Assessment and Training Placement Dates PG 8
1.5 Recognition of Prior Learning (RPL)/Current Competence (RCC) PG 8
1.6 Student Supervision PG 8
1.7 Course Overview PG 8
1.8 Competency Based Training (CBT) PG 8
1.9 Grievance Procedure PG 9
1.10 Occupational Health & Safety/ Workplace Health & Safety PG 9
1.11 Practical Placement Agreement PG 9
1.12 Work Cover PG 10
SECTION 2 INFORMATION FOR THE WORKPLACE SUPERVISOR
2.1 Workplace Supervisor Responsibilities Overview PG 11
2.2 Workplace Supervisor Responsibilities, Communication and Verification PG 11
SECTION 3 INFORMATION FOR STUDENTS
3.1 Aims of Facility based training ( Placement)) PG 12
3.2 Roles and Responsibilities of the Student PG 12
3.3 Student Responsibilities, Communication and Verification PG 12
SECTION 4 INFORMATION FOR THE ASSESSOR
4.1 Roles and Responsibilities of the Assessor PG 16
4.2 Timing PG 16
SECTION 5 ASSESSMENT
5.1 Assessment Overview PG 14
5.2 General Assessment Information PG 14
5.3Assessment Instructions for Assessors PG 19
WORK PLACEMENTBOOK INSTRUCTIONS FOR COMPLETION BY STUDENTS AND
SECTION 6 PG 22
SUPERVISORS
Acknowledgement PG 23
Appendices
Appendix 1 Workplace Supervisor Performance Checklist PG 24
Appendix 2 Attendance Record PG 26
Appendix 3 Record of placement visits by Trainer / Assessor PG 29
Appendix 4 Counselling Record – Student PG 30
Appendix 5 Units of Competency within this Work Placement Book PG 31
Appendix 6a Pre - Placement goals PG 32
Appendix 6b Post Placement Debrief PG 193
Section 1: General Information for Student’s and Agencies
1.1 Contact details (Student to complete)
Intercare Training Trainer/Assessor:
Telephone: Mobile:
Email:
Head Office: Integrated Training Solutions, 1 Fairborne Way
Telephone: 1300 102 273
Keysborough Vic 3173
www.integratedtrainingsolutions.com.au
Facsimile: 1300 139 783
info@integratedtrainingsolutions.com.au
Office Contact Person:
Telephone: Mobile:
Email:
Once the Facility training has started the RTO contact person will be the Trainer/Assessor. The contact details will be
outlined in the practical placement agreement
Facility
Telephone: Mobile:
Email:
Head Office:
Facsimile:
Office Contact Person:
Telephone: Mobile:
Email:
If the Workplace Supervisor is not involved in day to day supervision of the student please indicate below the relevant
staff member/s that will be supervising the student in their work placement on a regular basis.
Name: Telephone:
Name: Telephone:
Name: Telephone:
The Trainer/Assessor will need to have access to the above named staff member in order to assess student
competence.

1.2 Student Checklist
This checklist has been devised for the pre-placement meeting and aims to act as a guide to student and Workplace
supervisor in regard to areas that should be considered and discussed prior to, or soon after the commencement of
facility training.
Student has an understanding of the Facility and the role they are required to undertake during
On-the-Job Assessment and Training □
The Work Cover information contained in this Manual has been discussed with the student and
Workplace Supervisor □
The Practical Placement Agreement has been signed by the Student and the Workplace Supervisor
and Assessor. □
The Grievance Procedure has been discussed □
Competency Based Training has been discussed □
The daily routine of the Facility and the\student’s role in this setting has been explained by the
Workplace Supervisor □
Facility expectations relating to dress, hours of work and breaks have been discussed and agreed
upon □
Student assessment and supervision requirements have been discussed □
Time has been allocated to student for completion of Assessment Items □
Identification of the day to day support person (if not the Workplace Supervisor) □
Facility specific Workplace Health and Safety requirements have been identified and outlined □
Hours of attendance have been negotiated and agreed upon □
All Criminal records checks have been obtained by the student □

1.3 Important information regarding Training Placement with Intercare Training
General placement information for Intercare Training students:
 Placement will be conducted after the theory component of the course and must be a minimum of 120
hours. All placement is unpaid work.
 During the period of placement, you will be required to participate in a full time capacity and the days will be
from Monday to Friday. No weekend or Public Holiday placements are permitted
 All Intercare Training facilities will require you to perform day or afternoon shifts for your placement. Day
shifts are generally the busiest shifts where you will learn the most whilst on placement.
o The hours for day shift are from 7am-3pm.
o Afternoon shifts are from 3.00pm-10.00pm
 All facilities that Intercare Training utilises for placement will differ in the number of residents that they
have. Most commonly facilities will have high care residents and/or low care residents and dementia specific
residents.
 Cultural diversity is also a very large part of any aged care facility and you may get more exposure to this in
some facilities than others.
The main thing to remember is that there is so much to learn no matter where you are placed and you will not get
any different training from one facility to another. All facilities have access to the same learning equipment the only
thing that will differ is the way that your learning will be delivered.
Buddying:
 During placement, all facilities will pair you up with a buddy/qualified PCA to work alongside each shift. This
maybe the same person or a different person on each shift. Please remember that you are a student and not
a staff member, so please ask your buddy questions all the time during this learning period
Employment offers:
 All facilities that we utilise for placement may offer job opportunities to students who have performed well
during their placement.
 Please remember it is your approach that will gain you a position. If you are offered a position, you generally
will start off as casual staff. Please take note that NO job is ever guaranteed on completion of this course
 Please take note of your attitude, attendance and enthusiasm whilst on placement, as you will be constantly
monitored during this period and any feedback from your buddy will be reported to the manager.

Volunteering:
 If you are interested in expanding your employment opportunities, volunteering at a facility may assist with
this. All volunteer work is the responsibility of the student and a police check is also required for any
volunteer work
 Any Volunteering activities must not be used as evidence for this training program.
 Any Volunteering arrangements are outside of the Memorandum of Understanding (MoU) between the
facility and the student.
 InterCare Training will not be responsible for any adverse events due to a student’s acts or omissions whilst a
undertaking Volunteering arrangements
Compulsory placement aspects for Intercare Training students:
 Placement allocations will be organised by Intercare Training. We will always endeavour to allocate you an
Aged Care facility for you to complete your placement which will be no more than 45 minutes’ drive from
the course location.
 Your allocated placement facility is non-negotiable and as part of the course contract and requirements, it is
expected that you will complete your placement at this facility
 If you are absent due to illness or a public holiday, you will be required to make up these hours, in order for
you to complete your minimum of 120 hours. In some cases of illness or injury a medical clearance/
certificate may be required to produce to the facility manger in order for you to return back to the
workplace
 A police check is required to complete your placement and this must be produced on your first day. You are
not able to start placement without a police check that is clear and current (within 1 year of issue). Please
Note: All students must have their police check in week 7 in order to complete work placement. If you do not
have your police check by then you will not be permitted to complete placement until the next group of
placement occurs in that region. There will be no exceptions permitted.
 Full uniform is required at all times and must be neat and tidy. Black Polo required, black pants and black
enclosed shoes with your name badge. Minimal jewellery is allowed (please ask the facility when you start if
you are unsure), hair is to be tied back and nails trimmed short
Please note that our course is based on a combination of classroom & practical learning. As Intercare Training
arranges this practical learning component on behalf of the student we acknowledge that each practical
component may be slightly different in its total hours & shift times. Regardless, successful completion of this
qualification is based on the successful completion of your individually allocated placement event. Intercare
Training will have final & absolute discretion to decide if you require more than 120 hours of placement in order
for you to have completed and satisfy the Assessment requirements.

1.4 Facility Assessment and Training Placement Dates
Placement will commence as detailed in the Student Placement Agreement. It is preferable that the placements fits in
with the course time table however it is understood that some placements may be conducted out of normal hours
due to the nature of the work or the seasonal work increase of some agencies. The on the job component is a minimum
of 120 Hours
Starting dates are built into the time table but can be negotiated on an individual basis with the student and agency.
Part time placements must meet the required hours of the weekly student time table. There is some flexibility for
students and agencies to negotiate dates extending beyond the timeframe of the time table, to suit individual needs.
1.5 Recognition of Prior Learning (RPL)
Some students may be able to complete a reduced number of hours because they have been granted RPL for past
experience, education or training. However as this course CHC43015 does not have any equivalent units of
competency. The student, will still need to complete the minimum 120 hours of placements as per the critical Aspect
of assessment.
1.6 Student Supervision
Each student will have a:
Workplace Supervisor (Facility) who will observe and provide written and oral feedback about the student under
his/her supervision in the facility or workplace.
Assessor (RTO) who will observe, monitor and assess the student’s progress and consult with the Workplace
Supervisor and the student to ensure that all requirements are met. The Assessor is responsible for assessing the
student and providing them with their assessment outcome, i.e. Competent or Not Yet Competent.
The Assessor must be approved by the RTO to ensure they hold the appropriate training qualifications, have the
required industry experience and currency.
1.7 Course Overview
The CHC43015 Certificate IV in Ageing Support course was developed from industry consultation to meet the changed
needs of the community services sector. On-the-job training is necessary in the course.
The Facility based Assessment and Training component of the course provides students with the opportunity to apply
skills and knowledge within the work environment and be assessed to industry standards. Therefore we encourage
facilities to regard them in a similar light to new workers but with a little more support and supervision.
1.8 Competency Based Training (CBT)
Students undertaking the CHC43015 Certificate IV in Ageing Support are following a nationally accredited training
program. This program has been written as a competency based training document to reflect the competencies
required in the Community Services sector. Competency standards determine the requirements for effective
workplace performance and act as a benchmark for training program development and assessment. Only the
competencies that need to be met during the On-the-Job Assessment and Training have been included in this
handbook.
CBT focuses on the ability of an employee or student to apply the relevant skills, knowledge and attitudes to the
standard determined by the industry and covers all aspects of work performance including the ability to:
 Undertake and manage the task

 Manage a number of different tasks
 Implement contingency plans
 Transfer tasks to different environments
 Work within industry/workplace standards
Students will be marked as C (Competent) or as NYC (Not Yet Competent).
1.9 Grievance Procedure
1) Facility Intercare Training

o Grievance procedure as per MOU
2) Facility Student
o The Workplace Supervisor and the student will attempt to resolve any issues.
o If this fails to resolve the issues, the Assessor must be contacted.
o A meeting between the student, Workplace Supervisor and Assessor will then be convened to
develop strategies for resolution of the issues.
o If no remedy can be found to the issues, the student may be withdrawn from the agency, in
consultation with Placement Coordinators.
o Alternative On-the-Job Assessment and Training arrangements may be negotiated dependent on the
circumstances of the withdrawal.
o Students consistently failing to meet agency requirements may be withdrawn and not provided with
an alternative On-the-Job Assessment and Training program.
3) Intercare Training Student

o The student and Intercare Training representative will attempt to resolve the issue.
o Should the matter remain unresolved the student is encouraged to submit a written complaint to
the complaints officer.
o The complaint will be registered and the matter referred the appropriate Manager.
o The student will be contacted by the Manager within two working days with the aim of seeking
mutually agreeable outcome.
o The manager will advise all involved parties as to the progress of the dispute resolution.
o The Manager will record the outcome and refer to the Complaints officer for finalisation.
1.10 Occupational Health & Safety/ Workplace Health & Safety
Students:
 Have a right to the minimal Occupational Health & Safety conditions being met in the Agency or workplace;
 Have a right to feel safe in their workplace
 Should not administer first aid under any condition;
 Should not be in the agency alone or where inadequate security mechanisms exist
1.11 Practical Placement Agreement
Part 7 of the Vocational Education and Training Act 1990 (VET Act) provides the framework for On-the-Job Assessment
and Training practical placements. If placements are not arranged in accordance with the VET Act, students will not be
protected by the Department of Education and Training’s insurance policy and will not be entitled to compensation
through this insurance. The written On-the-Job Assessment and Training Practical Placement Agreement is one of

the fundamental requirements to ensure government insurance is activated. In the absence of the agreement, an
injured student may still be entitled to Work Cover compensation through the host employer’s insurance coverage.
However, the training organisation and/ or host employer may also be held liable and could be sued.
Other legislation governing the obligations of employers and employees also applies to On-the-Job Assessment and
Training practical placements. This includes:
 Workplace Health and Safety Act 2004

 Equal Opportunity Act 1994
 Privacy Act 1988.
1.12 Work Cover
Further information about student Personal Accident Voluntary Work Cover is available from Intercare Training. The
Insurer is Dual Australia (0)3 8611 3500
Please Note:
i. Work Cover does not cover any employee, including On-the-Job Assessment and Training practical placement
students, travelling to or from work.
ii. The VET Act does not specifically refer to students undertaking practical placement in another State or
Territory.
iii. Victorian Students:
As per the Amended Guidelines for Registered Training Organisations and Employers in relation to students of
technical and further education undertaking Practical Placement (the amended Practical Placement
Guidelines), the term ‘practical placement’ refers to work experience or training undertaken by a post-
secondary student with an employer under an arrangement entered into between the employer and a RTO
pursuant to section 5.4.14 of the Education and Training Reform Act (2006). Students who are injured while
undertaking a practical placement are eligible to make a claim under Department of Education and Early
Childhood Development (DEECD) WorkSafe insurance policy.
Please note that there is no requirement for a practical placement student to be paid.
All Victorian students under this agreement are covered by the Departments policy and the following
conditions are applicable in the event that a claim is made:
o The RTO must be registered through the Australian Skills Quality Authority (ASQA)
o Upon receipt of a valid claim there must be a completed and signed practical placement form

Section 2: Information for the Workplace Supervisor
2.1 Workplace Supervisor Responsibilities Overview
To explain the expectations of the facility regarding performance of tasks, agency standards, hours of work, Workplace
Health and Safety requirements and any other relevant details, prior to commencement of the on-the-job training.
 To ensure that the student is adequately briefed on agency policy and procedures.
 To inform clients and facility staff as to the role of the student while undertaking on-the-job training.
 To support the student's work on a day to day basis.
 To notify the Trainer/Assessor if it is felt that the student is not complying with the general rules of the
facility, or not making satisfactory progress. (After the Workplace Supervisor and student have attempted to
address the issues)
 To submit student time sheets at the end of each week to the Trainer/Assessor
 This is imperative for student Attendance records
2.2 Workplace Supervisor Responsibilities, Communication and Verification
To participate in an initial meeting to set up the placement with the student. □

To participate in at least two evaluation meetings with the student and the
Trainer/Assessor. □
To provide relevant feedback to Trainer/Assessor □
To complete the Student Evaluation form □
To sign the attendance record contained in this handbook □
To sign the On-the-job Training Contract with the student □
To complete the Workplace Supervisor Performance Checklist (Appendix 1) □

Section 3: Information for Students
3.1 Aims of Facility based Assessment and Training (Placement)
3.1.1 For students to apply theory to practice

3.1.2 For students to demonstrate an ability to communicate and work pro-actively with
both staff and clients
3.1.3 For students to demonstrate they can work as a co-operative team member
demonstrating appropriate attitudes that are consistent with current philosophies and
practices, and the course and module objectives
3.1.4 For students to satisfactorily complete the On-the-Job Assessment and Training
requirements of the course as outlined in this Manual.
3.2 Roles and Responsibilities of Students
 To demonstrate sensitivity and discretion toward the clients of the service.

 To work within the Facility structure, meet facility standards, policies and procedures.
 To conform to Facility hours and arrangements.
 To be aware of and adhere to ethical standards.
 To inform the Facility and Trainer/Assessor if they are absent if the reason is due to ill health or other
reason.
 A doctor’s certificate will be required by the Facility.
 It will be necessary for the student to make up time owing.
 To actively participate in the professional learning process.
 To be aware and adhere to confidentiality. Breaches of confidentiality are regarded as serious violations of
professional ethics and will be dealt with as such.
 To be aware they are under the direction of the nominated Workplace supervisor, in so far as the direction is
compatible with their level of skill and knowledge.
 To be aware that they are a student and not an extra staff member.
 To notify Facility and/or Trainer/Assessor if there are difficulties with the on-the-job training.
 Be identified as competent in regard to performance criteria for on-the-job training.
3.3 Student Responsibilities, Communication and Verification
To successfully complete the Facility based training component of the CHC43015 Certificate IV in Ageing Support,
students must:
Attend a pre placement meeting with Workplace Supervisor
Attend the allocated work site for the specified hours
Complete the required on-the-job assessment tasks competently and Activity Record sheets
Attend at least 2 supervision meetings with both the Trainer/Assessor and the Workplace Supervisor.
Obtain a Working with Children Check (if required) and a National Police Check

Section 4: Information for the Assessor
4.1 Roles and Responsibilities of the Assessor
Each student completing the On-the-Job Assessment and Training component of the CHC43015 Certificate IV in Ageing
Support is allocated an Assessor who is responsible for the following:
 Ensuring that the student and the Facility or workplaces are aware of Work cover responsibilities.
 Completing the Practical Placement Agreement and returning the original to the Coordinator of Work
Placement and Field Work.
 Providing the student and the Workplace Supervisor with a copy of the completed Practical Placement
Agreement. This must be completed for all students including those undertaking On-the-Job Assessment and
Training in their own workplace otherwise a Work Cover liability may fall on the college if a student is
injured.
 Explaining the Grievance Procedure to the student and Workplace Supervisor
 Ensuring that all relevant sections of the On-the-Job Assessment and Training handbook are understood by
all parties.
 Providing support to the student and the Workplace Supervisor during On-the-Job Assessment and Training
and responding to any concerns.
 Monitoring the completion of student assessment tasks during the during On-the-Job Assessment and
Training period.
 Participating in an initial meeting with the student and Workplace Supervisor where the Training Agreement
outlining goals and tasks is discussed & signed.
 Negotiating a mutually agreeable date and time for a further evaluation and assessment meeting/s with the
student and Workplace Supervisor.
 Observing and assessing the student against the required assessment task/s detailed in this Work Placement
Book and recording assessment outcomes as appropriate. Ensure all required fields are completed in Work
Placement Book.
 Ensuring that the work place supervisor holds at least the equivalent qualification to the level being
undertaken by the student(s) he/she is supervising.
 Abide by the memorandum of understanding between the host employer/agency providing the placement
and the college/RTO that the host employer/agency providing the placement indicates/agrees to host
students of the RTO/college as students on field placement/work experience as per the conditions and
requirements set out in this booklet.
4.2 Timing
It is anticipated that the Assessor upon checking the students attendance records (Appendix 2) to ensure that the
students is keeping in line with recommended timing of key learning events (as listed in Appendix 2). This will allow
the student and the Assessor to identify any difficulties the student may be having in completing the Mode 2
assessment with in the recommended timeframes and where applicable commence extension of placement hours as
needed.
4.2.1 Key Learning Events
Learning Focus Commencement Halfway Prompt Focus Completion
 Part One (Orientation) Shift 1 Shift 3
 Part Two Shift 4 Shift 10 Shift 15

Section 5: Assessment
5.1 Assessment Overview
In line with the requirements for the CHC43015 Certificate IV in Ageing Support, students are assessed:
 off-the-job in the class room

 on-the-job in the workplace (practical/field placement).
The RTO Trainer/Assessor is responsible for determining the student’s competence in relation to the assessment
criteria.
Assessment of competence takes place through a range of mechanisms, including:
Mode One:
 Assessment Workbook -
Once the student has completed the theory component (in the classroom) for a unit of competency they are
required to complete an Assessment Workbook demonstrating their knowledge and understanding. Students
are assessed by question/answer, case studies, etc. The Assessor with notify students of their assessment due
dates.
Mode Two:
 Practical demonstration
Assessment occurs on-the-job through practical demonstration by the student which is observed and assessed
by the Assessor. Assessment is in the form of holistic activities, documented in the Work Placement Book.
The student is required to satisfactorily complete these activities over a period of time in order to meet the
relevant assessment criteria.
There is, in addition, a Workplace Supervisor Performance Checklist included in this handbook (refer to
Appendix 1). This checklist provides a framework for observation of student’s practice by the workplace
supervisor.
 Reflective Journal
The student is required to complete a case study at the completion of their work placement (week 3). This
case study is documented in the Work Placement Book.
 Competency Conversation
Some units require a competency conversation to be had between the student and trainer/assessor.
Questions have been supplied so both the student and trainer/assessor will be guided as to the required
performance criteria to be addressed.
5.2 General Assessment Information
Development of the Assessment Tools

A Training and Assessment Strategy (TAS) has been developed for the program. This TAS outlines our delivery and
assessment methodology to ensure consistency with our scope and requirements under NVR regulations and
legislations. Furthermore all assessments are written in line with the assessment guidelines of the relevant training
package.
A professional approach is applied to ensure that these assessment resources are current, valid, fair and flexible
assessment tools that accurately relate to the elements and performance criteria to meet competency standards.
Assessment Tools have been reviewed to ensure they meet the unit of competency evidence requirements.
All resources comply with the appropriate training packages, released on www.training.gov.au.
To ensure they are kept current and fair they undergo several types of formal validation processes. These include:
 Industry validation of our programs via Intercare Training Industry Consultation committee
 Industry validation of our assessment tools via Intercare Training Industry Consultation committee
 Trainer/ Assessor validations as scheduled in our programs register
Feedback from our clients and students is also encouraged to maintain currency and reflect any changes within the
industry.
Program Duration/Timeframes
The timeframe for assessment is outlined in each Training Program Outline that is issued and discussed at enrolment;
and each student must complete the ‘Student Declaration’ to verify both their understanding of the unit assessment
requirements and their readiness to proceed with the assessment process.
Formative/Summative definitions
There is a combination of formative and summative approaches to assessment designed for a learning environment
that enables simulation in workplace environments or employment seeking activities when required.
 Formative Assessment -
Provides feedback to both trainer and student about progress both of the course program and the individual.
It does not necessarily contribute to formal outcomes, e.g. certification.
 Summative Assessment -
Summative assessment is by contrast a high value function that evaluates against a standard; it does
contribute to formal outcomes.
Resources needed for the assessment:

The assessment modes are designed for general classroom delivery with access to:
 A relevant simulated environment for the purposes of practical demonstration

 Business technology and organisational processes where required - a computer with access to the internet,
an email function and a word processing application will generally be provided for the completion of all
assessments as required.
Assessment process
When you have completed all Assessment Modes, and you have (if required) made a copy of your completed
Assessment Modes; it is time to submit the completed Assessment Workbook to your Assessor. Your Assessor will
provide you with feedback, whether this is verbal or written responses, and a judgment of competency will be made.
Reasonable Adjustment
Assessors must apply special consideration and make reasonable adjustment to assessment, as appropriate.
Information regarding reasonable adjustment can be found in both the relevant program Training and Assessment
Strategy (TAS) and Student/Employer Handbook.

Reassessment
Incomplete Assessment Modes will result in the Assessment Workbook being handed back to the student and marking
of the respective Assessment Mode will not commence until the Assessment Mode is completed. If there is a Not
Satisfactory assessment outcome, the Assessor will discuss and provide feedback to the student on the area/s for
improvement and confirm further requirements. At this time a mutually agreed future date for re-assessment will be
set.
Reassessment Process
 Each student is entitled to 3 assessment attempts at no additional cost

 Each re-assessment attempt must be completed within a 48-96 hour maximum timeframe from the previous
attempt.
 Trainer/Assessor will provide direction to the student on the further learning required for next assessment
attempt.
 Assessor may apply reasonable adjustment to the subsequent assessment attempts if required
 These 3 assessment attempts should be across a maximum period of 2 weeks
 At the end of the third unsuccessful assessment attempt, a formal student/trainer counselling session will
occur, to discuss the student’s suitability to the learning program and available options
 Post this process, a student may re-enrol and the learning and assessment process commences again from
the beginning
 Further fees after re-assessment attempts can be found on the Intercare Training website
How you will be assessed / able to demonstrate competency?

Assessment needs to include the full expression of competency which includes assessment of knowledge,
understanding, and application and performance reliability.
To demonstrate competence you must satisfactorily meet the requirements of Assessment Mode One (Assessment
Workbook) and Assessment Mode Two (Practical Demonstration and Case Study).
Each Assessment Mode is reviewed by an Assessor and an outcome determined for each completed Assessment Mode
submission.
INDIVIDUAL ASSESSMENT MODES can include:
MODE ONE (Formative/Summative)

1. Question / Answer : - Written or verbal
This Assessment Mode is designed to capture written or verbal responses and can include different question
types such as short answers, multiple choice and True/False.
Written questions: Questions will be provided within this Assessment Mode; space is provided for you to write
your answers.
Verbal questions: Your Assessor may ask you a range of questions and record your answers in the appropriate
mode/s as required for assessment.

2. Project/Activities: - these will require gathering and interpreting information, research with analysis and
presentation of findings
The Assessment Mode will provide you with a scenario or a real life situation for analysis and you will need to
provide a response in the form of written content. This may be in the form of a Project and/or Activities. Some
research or practical application of skills will be required by you the student. Some of these Project and/or
Activities will require you to complete and provide further or specific documents for additional evidence. You
will need to attach the documents that you create and any that you have gathered from research, or from the
simulated workplace, as part of the completed Projects and/or Activities.
Conditions of Assessment for Mode One
 Assessment Mode One can be completed within class time or during periods of self-study.
 Assessment Mode One can be completed with the direct access and or use of any course issued resource or
students own research source
 It is expected that Assessment Mode One will be completed in line with the students Training Plan dates
allocated at course commencement.
 It is expected to take 8 hours to complete this Assessment Mode.
 Reasonable adjustment can be applied in line with the Intercare Training reasonable adjustment policy
MODE TWO (Summative)

Assessor Observation (Work Placement Log Book): - Demonstration / Role play
This Assessment Mode requires you to participate in a work placement program. You will be given a Work Placement
Log Book for this qualification containing instructions and requirements for this Assessment Mode. Your Assessor will
observe you during your work placement demonstrating the required skills and assess your competence accordingly.
Where required a relevant simulated environment for the purposes of practical demonstration will be provided.
Case Study (Work Placement Log Book):

This Assessment Mode requires you to also complete a case study to consolidate your learning and focus on sharpening
your skill sets. This aims to demonstrate your holistic understanding of the program.
Competency Conversation
Some units require a competency conversation to be had between the student and trainer/assessor. Questions have
been supplied so both the student and trainer/assessor will be guided as to the required performance criteria to be
addressed.
Conditions of Assessment for Mode Two
 Assessment Mode Two should be completed within structured work placement periods within an approved
Community Service Provider that is relevant to the course enrolled in such as a Residential Aged Care Facility
(RACF), Home and Community Care Service Provider, Disability Service Provider.
 Assessment Mode Two can be completed with the direct access and or use of any workplace Standard
Operating Procedures/Policies and or equipment required to satisfy the demonstration of knowledge/skills
 It is expected that Assessment Mode Two will be completed in line with the students Training Plan dates
allocated at course commencement.
 It is required that a student will consistently apply the required skills and knowledge competently over a
minimum 120 hour period to complete this Assessment Mode.
 Assessment Mode Two can only be completed via practical demonstration, simulated environment or as the
Training Package rules allow
 Reasonable adjustment can be applied in line with the Intercare Training reasonable adjustment policy
Rules for Completing Assessment Modes

Intercare strongly recommends that students should continue on with best practice according to their chosen industry
and complete their Work Placement Logbook using Black or Blue ink, as per industry standards; this also includes not
using correction fluid or tape (whiteout).
If you need to amend written information cross it out and rewrite the correct information and initial. Additional sheets
maybe attached if required.
Assessment Mode Length
Where space/lines have been provided for responding to an Assessment Mode, you should not see the size of the
space provided as a guide to the length of your answer.
If you require extra room for a response, attach a separate page to this Assessment Workbook with the following
points included – your name, date the response/s were made, the unit code and Assessment Mode clearly indicated.
How are the Outcomes for Assessment Modes Assessed?
Each Assessment Mode within this Assessment Workbook will be given an outcome of either Satisfactory or Not
satisfactory.
 Satisfactory Outcome:
The Assessor has reviewed the Assessment Workbook against the requirements of the Assessment Mode and
is satisfied that all requirements have been met.
 Not Satisfactory Outcome:

is not satisfied that all requirements have been met.
If you receive a Not Satisfactory outcome you will be given an opportunity to discuss and review with your Assessor
the area/s for improvement and resubmit the individual Assessment Mode as per Assessor’s instructions.
If you receive a Satisfactory outcome for the individual Assessment Mode, then this outcome forms one part of the
requirement used to form a final judgement of competency for this unit.
How is Competency Judgement Made?

Competency judgement is made up of a combination of (2) two satisfactorily completed Assessment Modes within
this Assessment Workbook. The Assessor, understanding the rules of evidence, is also able to make a determination
of competency for you the individual student factoring the need for reasonable adjustment as required.
Student Please Note:
 Your suitability for this program has been determined at your Pre Training Review and again at Enrolment.
If at any point you feel that this program is not suitable you are able to withdraw at any time. If this is the
case please notify your trainer.
 A zero tolerance to cheating and plagiarism is taken with Intercare Training.
If you the student are found to have cheated on any forms of assessment, including plagiarism of another’s
work, you will be required to re-sit an alternative assessment under the supervision of an assessor to
confirm competence in this unit.
 You must satisfy the requirements for competency within this Assessment Workbook to achieve a
competency outcome.

It is highly recommend that you keep a copy of all assessment work that you submit.
Evidence provided by you is retained for our records and not returned to you.
5.3 Assessment Instructions for Assessors
Evidence Gathering/Collection required

Assessment of a Unit of Competency is based on the review of the required Assessment Modes. The Assessment
Modes have been mapped to cover the specifics of the Unit of Competency as per the contents of the Training
Package and includes:
 Performance Criteria  Critical /aspects of evidence

 Required Skills/Knowledge  Evidence requirements for assessment
It is also essential that assessment is conducted with the rules of evidence as a primary focus:
 Authentic  Current
 Valid  Sufficient
Guidelines for Acceptable Responses to Assessment Tasks/Modes

Assessors must always refer back to the individual Unit of Competency and in particular the specific Essential Skills and
Essential Knowledge listed within, to assist them in determining sufficiency of response in line with the rules of
evidence.
The RTO supplied model answers satisfy demonstration of Essential Skills and Essential Knowledge for the Assessment
Task. These model answers are provided as a guide and any combination, inclusive of these model answers can be
used by the Assessor to determine a satisfactory outcome of the assessment mode.
It is the responsibility of the Assessor to review and assess each submitted Assessment Task response on its individual
content and in line with the individual Unit of Competency requirements and Intercare Training Assessment Policy.
How to make an assessment outcome using the Assessment Modes

Each individual Assessment Mode within this Assessment Workbook will be given an outcome of either Satisfactory or
Not Satisfactory
 Satisfactory Outcome:
is satisfied that all requirements have been met.
 Not Satisfactory Outcome:

is not satisfied that all requirements have been met.
If you make a Not Satisfactory assessment outcome you will give the student a chance to review and discuss the area/s
for improvement and elect a time the student must resubmit the Assessment Workbook as per your instructions.
If you make a Satisfactory outcome for the individual Assessment Mode, then this outcome will contribute to final
judgement of competency for this unit.

How to make a judgement of competency using the Assessment Modes
Competency judgement is made up of a combination of (2) two satisfactorily completed Assessment Modes within
this Assessment Workbook. The Assessor, understanding the rules of evidence, is also able to make a determination
of competency for an individual student factoring the need for reasonable adjustment as required.
 Please note: that the formative Appendices 6a and 6b do not affect the assessment if this left blank by the
student. The purpose of these appendices enable the student to plan for their placement to cover any areas
of personal interest and/or to strategize debriefing if applicable with the assessor at any time during their
practicum.
Rules for Assessing Completed Assessment Modes

Each Assessment Mode must be reviewed to assess competency. As you review each question / page it is preferable
that you use an easily identified colour ink pen to indicate each question and/or page has been reviewed.
Feedback given should be initialled by the Assessor and the student. The Verbal Feedback section in the Assessment
Mode must be signed by both Assessor and Student with the date of the discussion.
At the end of each Assessment Mode section there is a table that must be completed in Black or Blue pen, see example
below.
ASSESSMENT MODE ONE RECORD

QUESTION / ANSWER ASSESSMENT OUTCOME
Date Satisfactory Not Satisfactory Trainer / Assessor Initial
23 / 04 / 2013   Assessor
Reassessment Date
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
Confirmation of verbal responses if required

I declare that the student and I have verbally answered, clarified
Assessor Declaration
and provided the responses as listed above.
Date 23 / 04 / 2013
Assessor Signature Assessor

Student Signature John Citizen
If verbal assessment is required you must write responses in RED pen where relevant.
DO NOT amend dates if possible. If you write in the wrong section you need to cross it out and rewrite the correct
information mark as error and initial.
White out must not be used.

Assessor Please Note:
 A student’s suitability for this program has been determined at their Pre Training Review and again at
Enrolment. If at any point you feel that this program is not suitable for the student please discuss this with
the student.
 A zero tolerance to cheating and plagiarism is taken with Intercare Training.
If a student is found to have cheated on any forms of assessment, including plagiarism of another’s work,
they will be required to re-sit an alternative assessment under the supervision of an assessor to confirm
competence in this unit.
 A Student must satisfy the requirements for competency within this Assessment Workbook to achieve a
competency outcome.
 A Completed Assessment Workbook and any additional evidence provided by the student is retained for
our RTO records and is not returned to the student.
It is important that all areas of this Assessment Workbook are completed prior to submission to the
administration department for final outcome recording.

Section 6: Work Placement Book Instructions for Completion by Students
and Supervisors
6.1 Purpose
The purpose of this Work Placement Book is to demonstrate a student’s competence in the workplace for
the units of competency relevant to the National Qualification CHC43015 Certificate IV in Ageing Support;
and to ensure authenticity, reliability and validity. Assessment of competence in this course will be
determined and recorded by an approved Assessor.
Students
The records showing the name of the facility, Area/Unit, Date, Start and Finishing times and total hours
worked by the student must not include unpaid breaks. For example if a student works 0700 to 1500 the
TOTAL hours will be 7.5 to include 30 minute lunch break, if there is no lunch break there must be a MANAGER
signature stating why no break was taken.
Supervisors
The supervisor is responsible for authorising the hours recorded by the student whilst doing their practical
placement.
In addition, the supervisor is responsible for providing the student with a buddy to assist and supervise them
during their practical placement component and to provide other guidance and support as needed.
IMPORTANT Participant Information:

All Students participating in Practical Placement in a Residential Aged Care Facility must be considered as
supernumerary.
Students must not be allocated a full workload.
Students must be supervised at all times.
If a student finds that either or both of the above is not adhered to, they are to inform Intercare Training
immediately.
IMPORTANT Host Information:

Students are aware that they must adhere to the Host Organisational Policies and Procedures.
If a Student Breaches Policies and Procedures the Host may immediately suspend the student’s placement
and must notify Intercare Training of the breach.
If the Host organisation suspends placement due to breach, it will then be the student’s responsibility to
secure another host organisation to recommence the TOTAL hours of Placement.
If the host organisation deems the student requires additional hours due to unsatisfactorily performance it
may at its discretion allow or disallow the student to complete the required hours at the facility, if the
student is not allowed to finish at the host facility it will fall upon the student to find an alternative
arrangement

Explanation of colour codes in workbook:
When you see these colours;
Student to complete and sign all areas
Trainer/Assessor to sign and complete all areas
Workplace supervisor to sign and complete all areas
Acknowledgement
We, the undersigned, state we have read and understood the obligations of the Code of Conduct for the duration of
the Students Placements.
All practical placements require students to have a police check prior to placement and Working with Children’s
Check if appropriate.
Student Signature: Date: / /
Facility manager: Date: / /
Trainer/Assessor Signature: Date: / /
Instruction to the Supervisor:

Observe the student performing a task/s in their workplace in accordance with the Workplace Supervisor
Performance Checklist (Appendix 1). Place a tick in the relevant column indicating whether the student currently
and consistently performs the related tasks during the placement. Document examples and/or comments where
applicable. As the supervisor, I declare that the entries recorded in the reflective journal can be validated.
Instruction to the Student:

Observation of tasks/activities relevant to your course/industry will take place at your workplace. Ensure that you
read each observation task prior to your observation assessment at your workplace so that you can prepare for each
setting as listed in the tool. As the student, I declare that all reflective journal entries can be validated and is a true
reflection of my experiences during the work placement component.
Difficulties please inform the Intercare Training Trainer/Assessor

If you require clarification of any of the tasks/activities listed, consult your Trainer/Assessor.
If you are unable to demonstrate competency in any listed tasks at the time of your Trainers/Assessors visit, you will
be provided with further opportunities to do so at a later date.

Appendix 1
Competency Conversation with Host Organisation Representatives

Elements Observation Examples and Comments
Organisational & Statutory Requirements
The student adheres to confidentiality requirements

within the agency and is aware of Facility protocols
The student performs his/her work in line with

organisational policies and procedures
The student seeks clarification regarding specific tasks

and work roles and adheres to role boundaries
The student provides requested information within

designated timelines and to a an acceptable standard
The student maintains all workplace documentation in

accordance with agency standards
The student is able to communicate effectively with

colleagues and makes positive contributions to the
team environment

Client Services
The student’s written communication is consistent with

organisational standards
The student’s oral communication is of a professional

standard and demonstrates respect for colleagues and
clients
The student is aware of case management policies and

procedures and respective worker roles within these.
The student can identify other agencies used by or of

relevance to clients and to the facility.
During supervision sessions, the student demonstrates

self-awareness and the ability to reflect upon
professional practice constructively.
Workplace representative signature: Date:
Student signature: Date:

Appendix 2
ATTENDANCE RECORD
Student Name:
Facility:
Shift number
Date Start time Finish time Hours completed Total Hours to date Supervisor signature
and Focus
1) Part one
commence
2) Part one
3) Part one
complete
4) Part two
commence
5) Part two
6) Part two
7) Part two
8) Part two
9) Part two
10) Part two

ATTENDANCE RECORD
Shift Number
Date Start time Finish time Hours completed Total Hours to date Supervisor signature
and focus
11) Part two
12) Part two
13) Part two
14) Part two
15) Part 2
completed
16) If needed
17) If needed
18) If needed
19) If needed
20) If needed
This form needs to be signed by the student and the workplace supervisor to confirm student records
Workplace Supervisor Signature: Date:
Student Signature: Date:

Appendix 3
RECORD OF PLACEMENT VISITS BY TRAINER/ASSESSOR
Student Name:
Facility Name:
Occurrence
Date of Visit Persons Present Signatures
/Visit No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
This form needs to be signed by the student and the trainer/assessor to confirm student records
Trainer/Assessor Signature: Date

Date
Student Signature:

Appendix 4
Counselling Record – Student
Student Position
Division Trainer/Assessor
Date Conducted Time Conducted
Details of performance/behavioural issue discussed with student:
Specific incidents that may have led to this issue:
Student response to allegations:
The student acknowledges the issue: YES/NO
The student agrees to try to improve performance/behaviour: YES/NO
Agreed actions to resolve the issue: (Detail specific actions, responsibilities and timeframes)
Manager Signature: Date
Student Signature: Date

Appendix 5
This Work Placement Book comprises of the following units of competency from the CHC43015 Certificate IV in
Ageing Support qualification.
UNIT CODE UNIT NAME
CHCDIV001 Work with diverse people
CHCLEG003 Manage Legal and ethical compliance
HLTAAP001 Recognise healthy body systems
CHCCOM002 Use communication to build relationships
CHCPRP001 Develop and maintain networks and collaborative partnerships
CHCCCS025 Support relationships with carers and families
CHCADV001 Facilitate the interests and rights of clients
HLTWHS002 Follow safe work practices for direct client care
CHCCCS011 Meet personal support needs
CHCAGE004 Implement interventions with older people at risk
CHCAGE002 Implement falls prevention strategies
CHCAGE003 Coordinate services for older people
CHCCCS006 Facilitate individual service planning and delivery
CHCAGE005 Provide support to people living with dementia
CHCAGE001 Facilitate the empowerment of older people
CHCCCS023 Support independence and wellbeing
CHCPAL001 Deliver care services using a palliative approach

Appendix 6a - Pre - Placement goals
CHC43015 Certificate IV in Ageing Support
In order to prepare for the following placement, tell us what your 5 (five) top goals or achievements that you
want to complete during your placement event.
Goal 1
Goal 2
Goal 3
Goal 4
Goal 5
This is formative and may be left blank – refer to note on page 22

Integrate into the workplace, practice the skills and apply the knowledge you have
learned so far.
It is expected that over Shifts 1 to 3 of your placement, you complete the checklists in
Part One that are outlined on the following pages.
The intent for Part One is to shadow and begin to orientate yourself to the host facility’s
work flow and systems of work.
If you are having difficulties in completing the Part One tasks by the recommended
timelines please contact your assessor.
If you feel uncomfortable or need further direction at any time, please STOP & talk with
your buddy or Director of Nursing to ensure you are confident to complete the tasks
that are being asked of you.

MODE TWO
Assessor Observation 1
Assessment Mode Instructions:
Carefully read the instructions detailed below and complete task as detailed.
Please ask your Assessor to clarify if needed.
Upon completion of this Assessment Mode’s requirements, both the Student and the Assessor must complete and
sign the Assessment Mode Record at the end of this section.
Assessment activity type: Scenario (Demonstration)  Observation 
Days 1-3; Induction Period
Your RTO Trainer/Assessor will assess your performance using the Assessment
Observation Checklist over the next page.
Before you start the assessment, read the checklist and discuss any concerns you
may have with your Trainer/Assessor.
This assessment should not be new to you as the learning guide and activities you
have completed were designed to give you practice in the assessment
requirements.
This assessment can be completed in small groups, observed by the RTO

Trainer/Assessor.
Activity description:
Assessor to enter Observation – To complete this assessment you must be present within a Facility
description of the and undertaking a structured work placement program that allows you access to
assessment activity residents and their workplace equipment/environment.
You need to demonstrate to your RTO Assessor your ability to competently operate
within the work environment and complete the following activities for each of the
identified skill areas.
IMPORTANT NOTE:
 There is a series of ‘Star Questions’ throughout the checklist that have been
clearly identified with the symbol to the top left of this paragraph. To meet the
assessment requirements for Mode One and Mode Two you must demonstrate
your competence in all of these Star Questions. In the event a Star Question is not
met, you will be deemed Not Competent in the relevant unit of competency.
Environment conditions: Workplace Observation Only 

Whilst undertaking the facility induction/orientation program, the Student ASSESSOR ONLY
following skills and knowledge were addressed by the student: Self Check Yes No
Complete the facility induction program~   
Complete the facility orientation program~   
 The student has been introduced to their buddy, shift/Team leader
Clinical Care Staff
  
 Student has been given an employee/student handbook of the
facility provide them with general information including but not
limited to:
 employees code of conduct   
 privacy and confidentiality
 reporting guidelines
 no/minimal lifting policy
 Students have been taken on a tour of the facility and can locate the
following:
 Facility Layout
 Staff Toilets/Room/Lockers   
 Emergency Egress and Muster points
 Dining Room/Pan Rooms
 Smoking areas/ break times
 The student has been granted access to applicable
documents/records essential to their roles, including but not limited
to:
 Past Medical History
 Progress Notes
  
 Handover sheets
 Daily reporting charts
 Vital/Weight charts
 Client Care Plans’ for:
 Mobility/Transfers
 Nutrition and Hydration
 Elimination
 Personal Hygiene
  
 Social interactions
 Cultural care kits
 Cultural and/or spiritual
Workplace Health & Safety:
Building safe systems   
Disaster Plan Manual (DISPLAN-emergency response)   
Manual Handling equipment   
Chemical storage   
Waste segregation   
Infection Control i/c PPE – hand washing   
Identified state/territory WHS authorities   

During the induction phase, has the student demonstrated Student ASSESSOR ONLY
participation in the following sets of skills: Self Check Yes No
Policies & Procedures: Scope of responsibility
Host Organisation’s Mission Statement & Values   
Student Scope of practice   
Rights and responsibilities of employers and workers, including duty of
care
  
Privacy and Confidentiality   
Cultural Care Kit   
Observation Only
Daily Routine: Client Care needs
Attend Handover   
Review Care Plan/Communication Book   
Identifies applicable reporting lines to Senior Staff   
Respectful communication
Knock before entering   
Self-introduction & greeting   
Ask the client for the preference   
Explain to client/significant other what’s happening   
What would you like to wear   
Prepare for task   
Verbally reports back to ‘Shift Buddy’ post task   
Has the Student participated in the following types of Transfers:
Independent   
Requires assistance   
Independent with aid (wheelchair/frame etc.)   
Requires prompting   
Requires assistance   
Fully dependant (note requires 2 staff with machine)   
Has the Student participated in the following types of Toileting:
Toileting ensuring privacy and dignity   
3 levels of assisting – prompt; partial assist; full assist   
Toileting types – be/slipper pan / commode / urinal   

Adjusting and readjusting clothes   
Replace and ensure continence aids in situ   
Ensure skin integrity   
Infection control protocols pre & post toileting   
Has the Student participated in the following types of Personal Hygiene:
Showering 3 levels of assistance; full; partial; prompt   
Bed Bathing   
Perineal care   
Has the Student participated in the following types of Grooming:
Dressing and undressing 3 levels of assistance full; partial; prompt   
Hair care i/c removal/shaving ; brushing;   
Appropriate for the day events and weather   
Has the Student participated in the following types of Bed Making:
Unoccupied bed   
Occupied bed   
Bed requiring specialised equipment e.g. Pressure reliving devices   
Incontinence aids e.g. kylie/bluey/draw sheet & mackintosh   
Has the Student participated in the following types of Skin Integrity:
Post personal hygiene   
PAC   
Identifies different skin conditions; e.g. dry, fragile, oedema   
Has the Student participated in the following types of Oral Hygiene:
Oral health and reporting   
Cleaning Teeth including own/ partial full denture   
Identifies oral hygiene barriers and reports   
Has the Student participated in the following types of Pain Management:
Identifying pain   
Reporting on Pain   
Following up on effectiveness of Pain management   
Has the Student participated in the following types of Assist with meals:
Assisting with meals 3 levels of Assist; full; partial; prompt   
ensure correct diet   

Reporting on intake levels   
Has the Student participated in the following types of Social Interaction:
Informing client on the activities of the day   
Encouraging participation   
Reporting on clients feedback   
Has the Student participated in the following types of Reporting and documentation:
Attends Care/team/Handover meeting as directed   
Reports to buddy   
Where required reported to senior staff   
Locates applicable: forms; notes; recording sheets; reports   
 I, the Assessor, have observed the student undertaking the above activities and they have been satisfactorily completed.
ASSESSMENT MODE TWO - RECORD OF RESULT

ASSESSOR OBSERVATION 1 (ORIENTATION) ASSESSMENT OUTCOME
____ / ____ / ____  
Reassessment Date(s):
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
Assessment Guide
Satisfactory The Assessor has reviewed the Assessment Workbook against the requirements of the
Outcome Assessment Mode and is satisfied that all requirements have been met
Not Satisfactory The Assessor has reviewed the Assessment Workbook against the requirements of the
Outcome Assessment Mode and is not satisfied that all requirements have been met.

CLIENT/RESIDENT INFORMATION SHEET
This document has been designed to support you with the completion of your Work Placement Book.
During your placement event you may work closely with specific clients/residents that you may choose to list in the
below sections to help prompt and validate your placement journey.
InterCare has developed this form so you can enter the relevant information about your clients/residents and
discuss these with your trainer as well as demonstrate some of the key skill areas listed in your book.
We anticipate that your trainer will refer back to this template when assessing you on placement so please select
your clients/residents in week one for you to experience the best learning journey possible.
Please refer to the “Student Directions” section for more information
Student Directions
Please fill out the details in the Client/Resident Profile sections below to represent the clients/residents that you
have worked with. You may enter up to five (5) different individuals and complete this activity for a minimum of
three (3) different individuals.
For Example: You may perform Personal Care for Client/Resident – Number ONE and may then choose to record an
entry in your book and in star questions within the reflective journal section under the unit CHCCCS011 – Meet
Personal Support Needs that directly relates to the activities you have completed with Client/Resident – Number
ONE.
It is recommended that you select different clients/residents in order to broaden your overall experience whilst
completing your placement event.
InterCare Training ask that you select a minimum of three (3) clients/residents with dementia and a falls
prevention strategy plan as this will support you with making observations to record within your book as well as
across the star questions within the reflective Journal – This is marked with a below as a reminder.
Note: You may use one resident to cover off on both of these areas if appropriate.
It is also important to add when completing star questions in the reflective journal or within the notes section of this
form under each Client/Resident profile how you have monitored and evaluated strategies surrounding dementia
care and falls prevention in a collaborative, positive and respectful manner. –
For Example: You may note, I supported Jenny with managing her transfer from her bed to the toileting seat today
by using positive reinforcement as Jenny was nervous given that she had suffered from a fall before. I made sure that
I covered Jenny with a towel after I removed her pants and underwear so Jenny felt respected and her dignity was
maintained.
Work directly with your trainer/assessor when placement visits are scheduled to support you with this if you feel
that you need some more direction and support.

Client / Resident Information – (Number ONE)
Note: In order to protect the Privacy & Confidentiality of the client/resident within the facility you have been placed, please only
supply a first name.
First Name: ____________________________________________________________________
Location: ____________________________________________________________________
(For example: North Wing, West Wing, Dementia Unit)
Client / Resident Care Plan
Note: If a client/resident does not have a care plan available for you to source this information, please refer to the Registered
Nurse (RN) or your assigned buddy to support you with this information.
From the options listed below, please select the relevant care plan detail for this client;
FRIENDLY REMINDER: Please make sure you select a minimum of three (3) clients who have dementia and a falls
prevention plan – You can identify this tick box by looking for a  next to it in the table below.
 Dementia Assists with Meals (Required) Mobility
Speech Impediment Insulin Dependent Diabetic
Incontinence Prescribed Medications  Falls Prevention

Other: ____________________ Disability Allergies
Trainer/Assessor Section:
I confirm that I have observed the student working with this client/resident and reviewed their entries within all star
questions in the reflective journal section.
Trainer/Assessor Name:
Trainer/Assessor Signature:
Notes/Feedback:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

Client / Resident Information – (Number TWO)
First Name: ____________________________________________________________________
Location: ____________________________________________________________________

Notes/Feedback:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

Client / Resident Information – (Number THREE)
First Name: ____________________________________________________________________
Location: ____________________________________________________________________

Notes/Feedback:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

Client / Resident Information – (Number FOUR)
First Name: ____________________________________________________________________
Location: ____________________________________________________________________

Notes/Feedback:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

Client / Resident Information – (Number FIVE)
First Name: ____________________________________________________________________
Location: ____________________________________________________________________

Notes/Feedback:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

Cement your learning and begin to finalise your assessments.
It is expected that on Shift 2 onwards you will commence working towards completing
the assigned Assessment Tasks.
The intent for Part Two (Week1-3) is to demonstrate your ability to operate as a PCA by
applying the skills and knowledge from the Mode 1 Assessment into practice.

It is expected that by the end of your first few shifts you have been proactive in providing a person
centred approach to a wide range of clients to meet their individual care needs.
The following section requires you to reflect on how you have adopted the skills you have learnt and
adapted them to meet the individual needs of the clients.
When writing your reflective statements for the following criteria, we suggest you follow the 'SAO'
approach:
Situation – what was happening; what were you doing at the time?
Action - what actions did you take and how did you do it?
Outcome - what was the result of your actions?
If you have any difficulties in competing this section, please speak to your Assessor.
Be factual and positive, without exaggerating or minimising your capabilities and experience.
Example taken from HLTAAP001:
1. How have you worked effectively with information regarding a client’s health status in order for you
to perform routine tasks for the client taking into consideration the client diagnosis? Please give 3
(three) different examples.
S – Through my placement I attended a pre-shift handover, this was important as I was able to get
the latest information regarding the client. I was allocated Client A, who was undergoing a Care Plan
Review. Client A, had a past medical history of postural Hypotension – which I didn’t understand what
it meant.
A – I was asked to assist client A, with their ADL’s, I asked the Nurse on our wing what is postural
hypotension and he informed me that if the client went from lying or sitting down to standing up to
quickly they may get dizzy and have a fall.
O – When I was assisting with this client I sat on the side of the bed for a little while before leaving
them to go through their wardrobe to provide choices of what they would like to wear today. Once
this was done I then proceeded to assist them with their personal hygiene.
 There is a series of ‘Star Questions’ throughout the checklist that have been clearly identified with the symbol
to the top left of this paragraph. To meet the assessment requirements for Mode One and Mode Two you must
demonstrate your competence in all of these Star Questions. In the event a Star Question is not met, you will be
deemed Not Competent in the relevant unit of competency.

Assessment 1; CHCDIV001: Work with diverse people
These assessments link to unit of competency CHCDIV001 – Work with diverse people.
Application:
This unit describes the skills and knowledge required to work respectfully with people from diverse social and cultural groups and
situations, including Aboriginal and/or Torres Strait Islander people.
This unit applies to all workers.
The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand
standards and industry codes of practice.
Performance Evidence:
The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit
manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:
1. undertaken a structured process to reflect on own perspectives on diversity
2. recognised and respected the needs of people from diverse social and cultural backgrounds in at least 3 different situations:
3. selected and used appropriate verbal and non-verbal communication
4. recognised situations where misunderstandings may arise from diversity and formed appropriate responses
Assessment Conditions:
Skills must have been demonstrated in the workplace or in a simulated environment that reflects workplace conditions. Where
simulation is used, it must reflect real working conditions by modelling industry operating conditions and contingencies, as well
as, using suitable facilities, equipment and resources.
Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency
requirements for assessors.
This is what you will need:
- Workplace environment
This is who you will need (if applicable):
- Team mates, colleagues, supervisors
- Residents or persons to provide care services for
These are the Performance Evidence Assessment Tasks you will need to complete:
1. Undertake reflective process
2. Recognise needs of people in three different situations AND selected and used appropriate verbal and non-verbal
communication AND recognised situations where misunderstandings may arise from diversity and formed
appropriate responses

Assessment Task One
Before you begin (Please Circle):
Do you have access to the equipment? Yes N/A
Do you have access to the people? Yes N/A
List the people present when you completed the task (if applicable):
Supervisor C/R #3
□ □
Team Member (Buddy) C/R #4
□ □
C/R #1 C/R #5
□ □
C/R #2 Other: (Please list)
□
Before starting this course, you may have had preconceived thoughts, ideas and feelings about
interacting with people who have a different culture from your own. Describe the changes you have
noticed within yourself and include the following perspectives:
 What limitations within yourself have you become aware of in relation to self and social
awareness? (There is no right or wrong answer, this is just about checking in with yourself)
 What do you think you can do to improve on these limitations?
 What have you found that you really appreciated about being exposed to the cultural diversity of
your clients? 
S.A.O Activity 1
Situation 1
Action 1

Outcome 1
Assessment Task Two
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 Give an example on how you have identified and responded to the needs of people from diverse social and
cultural backgrounds. Provide 3 (three) different situations.
S.A.O Activity 1
Situation 1

Action 1
Outcome 1
S.A.O Activity 2
Situation 2
Action 2

Outcome 2
S.A.O Activity 3
Situation 3
Action 3
Outcome 3

Assessor will ask you to identify or explain your understanding, approach or S NS
procedures you used
What changes in own responses or behaviours have you noticed after interactions with
different cultures?
Did you have any difficult communications that required the assistance of either a
supervisor or interpreter? If so, please explain situation
What verbal and/or non-verbal communication strategies did you use when there was
a barrier to communication?
Competency Conversation – Student’s Answers / Assessor Comments
Assessor signature: Date:
Assessor to complete
In completing the observation criteria below, the Assessor takes into account evidence collected through the
participant’s reflective journal responses and completed work practice.
Observation Criteria S NS
Correctly identified the needs of people from diverse social and cultural
backgrounds on three separate occasions
Responded appropriately to the needs of people from diverse social and cultural
backgrounds on three separate occasions

ASSESSESMENT OUTCOME
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 2; CHCLEG003: Manage Legal and Ethical Compliance
These assessments link to unit of competency CHCLEG003 – Manage Legal and Ethical Compliance.
Application:
This unit describes the skills and knowledge required to research information about compliance and ethical practice
responsibilities, and then develop and monitor policies and procedures to meet those responsibilities.
This unit applies to people working in roles with managerial responsibility for legal and ethical compliance in small to medium
sized organisations. There may or may not be a team of workers involved.
The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New
Zealand standards and industry codes of practice.
The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit,
1. determined the scope of legal and ethical compliance requirements and responsibilities, and developed policies and
procedures for at least 1 workplace or business
2. developed a strategic response to at least 3 different situations where legal or ethical requirements have been breached
Skills must have been demonstrated in the workplace or in a simulated environment that reflects workplace conditions. The
following conditions must be met for this unit:
 use of suitable facilities, equipment and resources, including:
 current legislation and regulations
 workplace policies and procedures
 modelling of industry operating conditions, including:
 use of real or simulated organisation for which the candidate develops policies and procedures
 integration of problem solving activities
- Access to organisational/workplace Policies & Procedures
- Access to Team Meetings Schedules
- Access to people to conduct workplace meeting with
1. Develop a Policy & Procedure
2. Develop Strategic Responses to Breaches

Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□

Develop a policy and procedure that could be used for the business in the area of legal and ethical compliance.
 Email completed policy and procedure to your trainer by the date provided to you by your trainer.
Here is a template below to guide you with this task:
Format to follow Examples of what this may look like
Document Header: information about the policy including title, effective, approver’s
signature.
Policy statement: The aims of the policy.
Application: Who does this apply to?
Procedures: step-by-step instructions for routine tasks and operations.
Reporting what employees need to report.

Requirements:
Aged Care Residential policy relates to these standards.

Accreditation
Standards:
Risks, penalties and Accreditation Standards not met

consequences of non-
compliance Risk to facility accreditation
Nominate the staff Roles: All staff

roles/ responsibilities
for monitoring this Responsibility: Adhere to policy
policy
Policy Revision Date: Policy revision scheduled annually by Axillary Supervisor
Date: Name & Signature:

Write your Policy and Procedure using the template provided to you below to support this scenario.
Email completed policy and procedure to your trainer by the date provided to you by your trainer.
Document
Header:
Policy
statement:
Application:
Procedures:

Reporting
Requirements:
Aged Care
Residential
Accreditation
Standards:
Risks,
penalties and
consequences
of non-
compliance
Nominate the
staff roles/
responsibilities
for monitoring
this policy
Policy Revision
Date:

Explain how you would distribute this Policy and Procedure to staff
Develop strategic responses where legal or ethical requirements have been breached
Consider the following scenarios and outline how you would strategically respond to these. Ensure you reference legislative
and/or ethical issues/notifications you have based your determinations on.
A) A Residents Care Plan has been destroyed
B) A Resident has fallen and the carer has failed to report the fall
C) A Residents Medical Records have been incorrectly shared with another residents family

In light of the above breaches, what responsibilities to workers, clients and the broader community does the age care
system have and you yourself as a care worker?
In completing the observation criteria below, the Assessor takes into account evidence collected through the participant’s
reflective journal responses and completed work practice.
Student legally and ethically completed work tasks on at least three separate occasions
Student documented examples that meet legal and ethical guidelines
Student responded correctly to legal and/or ethical dilemmas in the workplace
Student correctly identified workplace improvements related to legal and ethical
practices
Student correctly responded to three breaches of legal and ethical procedures, noting the
legislative basis
Student followed distribution of policies, procedures and legal information instructions

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 3; HLTWHS002 – Follow Safe work practices for
direct client care
These assessments link to unit of competency HLTWHS002 – Follow safe work practices for direct client care.
Application:
This unit describes the skills and knowledge required for a worker to participate in safe work practices to ensure
their own health and safety, and that of others in work environments that involve caring directly for clients. It
has a focus on maintaining safety of the worker, the people being supported and other community members.
This unit applies to all workers who require knowledge of workplace health and safety (WHS) to carry out their
own work, in both centre-based and home-based service provision.
The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation,
Australian/New Zealand standards and industry codes of practice.
The candidate must show evidence of the ability to complete tasks outlined in elements and performance
criteria of this unit, manage tasks and manage contingencies in the context of the job role.
There must be demonstrated evidence that the candidate has completed the following tasks at least once in
line with state/territory WHS regulations, relevant codes of practice and workplace procedures:
1. contributed to a workplace WHS meeting or inspection
 conducted a workplace risk assessment and recorded the results
 consistently applied workplace safety procedures in the day-to-day work activities required by the job
role, including:
o infection control
o hazardous manual tasks
o use of personal protective equipment
2. reporting incidents
3. followed workplace procedures for at least one simulated emergency situation.
Skills must be demonstrated:
in the workplace
OR
in an environment that provides realistic in-depth industry validated scenarios and simulations to assess
candidates’ skills and knowledge.
In addition, assessment must ensure use of:
current workplace policies and procedures for WHS
PPE relevant to the workplace and job role of the worker

1. Contribute to Workplace WHS Meeting or Inspection
2. Conducted Workplace Risk Assessment
3. Consistently Applied Workplace Procedures
4. Simulated Emergency Response
Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
Please complete the following record:

Record of staff toolbox meeting
Meeting details
Business name:
Meeting held at: Date:
Meeting conducted by: Signed:
WHS representative: Signed:
Persons attending
Issues covered
Action required
Action Responsible Timeframe

Assessment Task Two
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
Using the Risk Scale below, please complete the record on the following page,
ensure that one of the hazards address manual handling risks:

What is the Hazard Who do you Risk How is the Risk Reduced? What Controls New Risk Control Action Plans
report it to Rating are in place Rating
In this column, place your hazard What is the What controls can be put into place to reduce What is the How will you monitor the controls
current Risk the risk or the severity of the hazard? e.g. use New to ensure they remain effective?
rating standing machine Controlled
Risk rating
Hazard 1
Hazard 2

Assessment Task Three
Before you begin (Please Circle): Yes N/A
Do you have access to the equipment?

Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
The student must have completed the facility’s Induction/Orientation prior to undertaking these
tasks, as per Part One of this Workplace Log Book.
The simulated incident is an oil fire in the kitchen which quickly spreads across the stove and up into
the exhaust vent into the ceiling space.
The Trainer is to inform the student that there is a Code Red in the Kitchen and the student will need
to follow the Standard Operating Procudres. NB – do not use actual Alarms / evacuate clients
during this excerise.
The student will walk and talk their way through their actions following the RACE method. The
student must be able to:
 Identify applicable alarms and facility alert mechanmisms.
 Identify appropriate 1st stage of evacuation areas
 Identify mobility characteristics and order of priority
 Identify applicable egress and muster points.

Code Red (HLTWHS002)
Student ASSESSOR ONLY
Simulated Emergency Response Self
Yes No
Check
Student is able to locate and identify DISPLAN manuals   
Student is able to identify egress routes   
Workplace Health & Safety:
Student is able to identify the following Emergency Codes:
Code Red   
Code Orange   
Code Blue   
Code Purple   
Code Black   
Code Yellow   
Other Code* if Applicable   
Policies & Procedures:
Student responded to the Alarm/Alert in the Kitchen by:
 Checking the immediate area
 Checks for immediate Danger to self and others

 Describe risk assessment process
 Removing people from the immediate area according to

mobility status
 Checks immediate area including
toilets/rooms/wardrobes/linen storage if unlocked
 Raises the Alarm or Alerts applicable personnel
 Discusses the type of communication devices to facilitate

  
raising the alarm including how to contact emergency
services
 Contains Smoke or Fire by closing windows/doors
 Where applicable locates and describes master

switches/valves
 Escorts clients in the following order ambulant semi

ambulant non ambulant
 Reports to senior staff for further instructions

 Obtains and explains the incident report processes
 Gives verbal handover to Trainer

Assessor will ask you to identify or explain your understanding, S NS
approach or procedures you used
Correctly identify and explain (5) five safety symbols and their meanings.
You can either show your trainer from within the facility, or you trainer will
have some on hand, these must include:
o poisons
o emergency equipment
o personal protective equipment (PPE)
o specific hazards such as sharps, radiation
Noting the risk rating scale you completed in Assessment Task 2, advise
your trainer of the correct procedure to follow if you had to lodge it with
the facility.
Identify and explain an occasion when PPE is required to be used. When
would additional infection control procedures be required?
Identify and explain a behaviour of concern. Who would you report it to
and what is the procedure to record the concern?
How are your own levels of stress and fatigue going? According to
workplaces procedures, who will you report to if you require support with
this?

In completing the observation criteria below, the Assessor takes into account evidence collected
through the participant’s reflective journal responses and completed work practice.
Contributed to a workplace WHS meeting
Contributed to a workplace WHS inspection
Contributed to a workplace risk assessment

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 4; CHCAGE003 – Coordinate services for older
people
These assessments link to unit of competency CHCAGE003 – Coordinate services for older people.
Application:
This unit describes the skills and knowledge to provide services to an older person. It involves following and
contributing to an established individual plan.
This unit applies to workers in a residential or community context, or those in personal care or support services
that work with older people. Work performed requires some discretion and judgement and is carried out under
regular direct or indirect supervision.
criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be
evidence that the candidate has:
1. coordinated the service needs for at least 3 older people requiring varying levels or types of support
Skills must have been demonstrated in an ageing support workplace with the addition of simulations and
scenarios where the full range of contexts and situations have not been provided in the workplace. These are
situations relating to emergency or unplanned procedures where assessment in these circumstances would be
unsafe, impractical or threatens the dignity of the older person. The following conditions must be met for this
unit:
use of suitable facilities, equipment and resources, including:
individualised plans and any relevant equipment outlined in the plan
organisation guidelines for abuse or neglect
Overall, assessment must involve workplace interactions with older people, colleagues, families/carers and
working with the older person’s individualised plan.
Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory
competency requirements for assessors.
- Individualised Plans or Care Plans of residents
- Workplace policy and procedures

1. Coordinated the service needs for at least 3 older people requiring varying levels or types of
support
Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
Explain how you have coordinated services to meet the varying needs of 3 (three) different
clients. Consultation with the older persons and colleagues must be had to reinforce and
clarify service providers’ roles and responsibilities.
In your explanation include details for the following:
• Report on the role and function of the health professionals involved with each of these
clients
 What outside community and support services are utilised for each of these clients?”
 What principles and practices of case management have you applied with each client?
 Ask the client/advocate how they feel about the service accessed and report this to your
supervisor/trainer if you don’t have access to the particular health professional.
S.A.O Activity 1
Situation 1

Action 1
Outcome 1
S.A.O Activity 2
Situation 2
Action 2

Outcome 2
S.A.O Activity 3
Situation 3
Action 3
Outcome 3

Assessor will ask you to identify or explain your understanding, approach S NS
or procedures you used
Correctly identify and explain what financial, physical or emotional
abuse/neglect of the older person looks like. Then explain:
o what your response needs to be in line with organization guidelines
o the emotional impact of abuse
o the appropriate management of issues surrounding abuse
Effectively coordinated services to meet the needs of three separate
clients
Student identified and prioritised the needs, goals and preferences of
the older person outlined in their individualised plans

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 5; CHCAGE005 – Provide support to people living
with dementia
These assessments link to unit of competency CHCAGE005 – Provide support to people living with dementia.
Application:
This unit describes the skills and knowledge required to provide person-centred care and support to people
living with dementia. It involves following and contributing to an established individual plan.
This unit applies to workers in a residential or community context, including family homes. Work performed
requires some discretion and judgement and may be carried out under regular direct or indirect supervision.
1. provided support to 2 different people living with dementia:
 using a person-centred approach to support
 using appropriate communication strategies
 assisting in implementing a range of suitable activities that meet the person’s needs
unsafe, impractical or threatens the dignity of the older person.
The following conditions must be met for this unit:
use of suitable facilities, equipment and resources, including individualised plans and any relevant equipment
outlined in the plan modelling of industry operating conditions, including scenarios that reflect a range of
dementia support services involving a range of dementia symptoms and behaviours of concern
Overall, assessment must involve some real interactions with people with dementia, colleagues and
families/carers.

1. provided support to 2 different people living with dementia:

 using a person-centred approach to support
 using appropriate communication strategies
 assisting in implementing a range of suitable activities that meet the person’s needs
Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 Reflect on how you have supported 2 (two) people living with dementia.
In your reflections address the following specifics:
 How you used a person-centred approach to care for each of the people
 How you adjusted your verbal and non-verbal communication for each person you
supported
 How you assisted with appropriate activities to meet each of the person’s needs,
likes/dislikes and cultural sensitivities
 How you gained cooperation and provided reassurance as appropriate by using
reality orientation
 How you used a range of validation strategies to relieve distress and agitation in
the person (if applicable) and who did/would you report this to?
 How you accessed information about the person’s reminiscences and routines with
family and carers

S.A.O Activity 1
Situation 1
Action 1
Outcome 1
S.A.O Activity 2
Situation 2

Action 2
Outcome 2
Reflect on the conversations you have had with the primary carers (including other workers) of
people living with dementia and comment on the effects it has on them caring for a person
living with dementia. 
Situation
Action

Outcome
Did you notice any behaviours of concern and potential triggers in your
clients? If so, what were they and what was the procedure for reporting it?
If not, identify a behaviour of concern, its potential trigger and what is the
procedure for reporting it.
Now explain what action you would need to take to minimise the
likelihood of and reduce the impact of the noted behaviour on themselves
and others
During a team discussion regarding the evaluation of implemented
strategies to minimise a behaviour of concern in the person, what was the
outcome?
Have you noticed increased stress during you time working with people
with dementia?
Did you need to use any self-care strategies and/or seek support?
(There is no right or wrong answer, this question aids in accessing self-
awareness and can also be used as a debrief with your trainer)


Student effectively supported two separate clients living with dementia
utilising their individualised plans
Student correctly and effectively used a person centred approach for
both clients
Student used and adjusted appropriate verbal and non-verbal
communication techniques with clients
Student assisted clients with activities to meet their needs ensuring
cultural likes and dislikes were considered and safety was balanced with
risk taking
Student effectively communicated with the primary carers of dementia
patients
Student discussed any effects caring for a dementia patient has had on
the primary carer
Student assisted in providing support and guidance to family, carers
and/or significant others where appropriate
Student was involved in team discussions on support planning and
review
Student was involved in completing, maintaining and storing of
documentation according to organisation policy and protocols

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 6; HLTAAP001 – Recognise healthy body systems
These assessments link to unit of competency HLTAAP001 – Recognise healthy body systems
Application:
This unit describes the skills and knowledge required to work with basic information about the human body and
to recognise and promote ways to maintain healthy functioning of the body.
This unit applies to any worker who needs to use and interpret information that includes references to client
anatomy and physiology.
1. worked effectively with information about the human body and its healthy functioning in at least 3
different situations
Skills must have been demonstrated in the workplace or in a simulated environment that reflects workplace
conditions. The following conditions must be met for this unit:
use of suitable facilities, equipment and resources, including client health information
modelling of industry operating conditions, including integration of problem solving activities
competency requirements for assessors
1. Worked effectively with information about the human body and its healthy functioning in at least
3 different situations

.
Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
How has the information regarding the health status of a client affected the way you have
provided care for the client to meet their individual care needs, and if necessary what
changes to their care was necessary?
Provide 3 examples of clients with anatomical or physiological health issues.
 Explain what their health issue is, e.g. diabetes, high blood pressure, cancer etc.
 Explain which body system is involved and how it is impacted
 Explain the client’s plan to manage it, e.g. medication, exercise, chemo
 Explain the effects of this health issue you have observed in the client
 Explain how you have supported your client to manage the condition, e.g. encouraged
the client with diabetes to have a little walk for their circulation
S.A.O Activity 1
Situation 1

Action 1
Outcome 1
S.A.O Activity 2
Situation 2
Action 2

Outcome 2
S.A.O Activity 3
Situation 3
Action 3
Outcome 3

Correctly interpreted information regarding health status of client on
three separate occasions
Correctly adjusted care provided to client as a result of health status
information on three separate occasions

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 7; CHCCOM002 – Use communication to build
relationships
These assessments link to unit of competency CHCCOM002 – Use communication to build relationships
Application:
This unit describes the skills and knowledge to apply specific communication techniques to establish, build and
maintain relationships with clients, colleagues and other stakeholders based on respect and trust.
This unit applies to work across a range of workplace contexts where workers at all levels may communicate
with individuals and/or groups both in person and in writing.
demonstrated evidence that the candidate has:
1. obtained feedback from 3 clients or colleagues on effectiveness of communication and responded
appropriately
2. prepared 3 types of written correspondence in accordance with organisation communication protocols
3. facilitated resolution of 1 difficult situation with a client, colleague or service provider
4. facilitated 1 meeting around a workplace issue
use of suitable facilities, equipment and resources, including use of real workplace policies and procedures
modelling typical workplace conditions, including:
interactions with clients and co-workers from a range of diverse backgrounds
facilitation of groups of at least 3 people
typical workplace reporting processes
interpreter and translation services where required
use of digital media

1. Obtained feedback from 3 clients or colleagues on effectiveness of communication and responded

appropriately
2. Prepared 3 types of written correspondence in accordance with organisation communication
protocols
3. Facilitated resolution of 1 difficult situation with a client, colleague or service provider
4. Facilitated 1 meeting around a workplace issue
Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
How have you responded to 3 (three) pieces of client feedback to improve client interaction?
It is recommended to include in your answer the following:
 strategies you used when responding to the feedback
 what non-verbal communication did you notice in the client?
 with every communication, list a minimum of (2) two ideal outcomes that you strived to
achieve with your client
S.A.O Activity 1
Situation 1

Action 1
Outcome 1
S.A.O Activity 2
Situation 2
Action 2

Outcome 2
S.A.O Activity 3
Situation 3
Action 3
Outcome 3

List below all of the internal and or external individuals or groups you have obtained feedback
from during your placement event. You must list a minimum of (3) three.
Item # Individual or Reason for Service Delivery Frequency of

Group Feedback Feedback Area Feedback
Received from
during placement
Advise on client’s
Weekly – post
Example E.g. Physio needs post Resident Care
treatment
treatment
1

Assessment Task Two
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
For each S.A.O below, list (3) three types of written correspondence you prepared and explain
what the communication protocols were that you had to follow when creating and distributing
them.
S.A.O Activity 1
Situation 1
Action 1
Outcome 1

S.A.O Activity 2
Situation 2
Action 2
Outcome 2
S.A.O Activity 3
Situation 3

Action 3
Outcome 3

List below all of the written correspondence you have created during your placement event (including any created using digital media such as internal
computer/record systems, electronic tablet such as iPads etc.)
 Your trainer must be able to verify these documents
 You must list a minimum of (3) three.
Written correspondence Type of Frequency of

Item # created during Record Reason for Correspondence Service Delivery Area Correspondence
placement
Paper Record, Daily – post any

Example E.g. Care Plan Updates Advise on client’s status Resident Care
Digital activity

Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
List (1) one difficult situation you have experienced with a client, colleague or service provider
during your placement event.
Outline the Situation
Why was this situation difficult, and include what the communication barriers were.
How did you resolve this situation, e.g. what communication strategies did you use to resolve the
issue?

Assessment Task Four
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
Facilitate a meeting - Already done this – tell us where here:
Reference information:
OR, Complete the task below:
 How have you facilitated a workplace meeting about a workplace issue? Include the following
information:
 Provide a copy of the agenda you assisted in developing
 Provide a copy of the minutes/record of the meeting
 What procedure did you follow to communicate details of the meeting to the participants
and other stakeholders?
 How did you contribute to and follow the objectives and agenda for the meeting?
 How did you assist in providing opportunities to fully explore the relevant issues and provide
relevant information
 Evaluate the meeting process and identify lessons learned or opportunities for improvement.
(There is no right or wrong answer here, this is your evaluation from your perspective).
S.A.O Activity 2
Situation 2

Action 2
Outcome 2
Student used three different acceptable forms of communication during
placement
Student communicated in a manner that demonstrated respect, acceptance
of individual differences and upheld the person’s rights
Student professionally and respectfully navigated three situations where
communication barriers were present
Student accurately completed two workplace documents that met
organisational standards
Student effectively responded to and resolved a difficult situation involving a
client or colleague
Student effectively facilitated a workplace meeting about a workplace issue

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  


It is expected that by the end of your first 10 shifts you have been proactive in providing a person
approach:
it meant.

Assessment 8; CHCPRP001 – Develop and maintain networks and
collaborative partnerships
These assessments link to unit of competency CHCPRP001 – Develop and maintain networks and collaborative
partnerships
Application:
This unit describes the skills and knowledge required to identify networking and collaboration needs and
develop formal and informal partnerships to enhance service delivery and improve professional practice.
This unit applies to work in all industry sectors, and to individuals who take pro-active responsibility for
improving collaboration between workers and organisations.
Australian/New Zealand standards and industry codes of practice
1. developed strategies for networking and collaboration for at least 1 organisation
2. worked collaboratively with external individuals or groups in at least 3 different service delivery situations
use of suitable facilities, equipment and resources, including information relating to peak bodies, network
groups and web based network services
modelling of industry operating conditions, including presence of situations that allow interactions with
individuals and organisations
1. Developed strategies for networking and collaboration for at least 1 organisation

2. Worked collaboratively with external individuals or groups in at least 3 different service delivery
situations

Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
What strategies have you identified to improve networking opportunities for the service
provider?
 Explain your strategy to promote a positive image of your organisation
S.A.O Activity 1
Situation 1
Action 1

Outcome 1
S.A.O Activity 2
Situation 2
Action 2
Outcome 2

Considering your current or future role in industry, develop a strategy that could be used for the
business to network and collaborate.
Identify individuals or groups that a community services provider would benefit from
networking with?

Explain the reason why these individuals or groups would add value to network with
Explain how you could engage these individuals or groups to create a network or collaborate
Explain how you could maintain these connections with these networks

Assessment Task Two
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 How have you worked with and collaborated with 3 (three) external individuals or groups to
improve services? Include the following details:
 What were the benefits of the networking and collaboration for the client, the organisation
and yourself as the worker
 What is yours (or your organisation’s) strategy to monitor the benefits to you the worker,
the organisation and client group?
 Evaluate the strengths and weaknesses of the collaborations and briefly explain (1)) one
recommended action
S.A.O Activity 1
Situation 1
Action 1

Outcome 1
S.A.O Activity 2
Situation 2
Action 2
Outcome 2

S.A.O Activity 3
Situation 3
Action 3
Outcome 3

List below all of the internal and or external individuals or groups you have networked with during
your placement event. You must list a minimum of (3) three.
Individual or Group Reason for Service Delivery Area Frequency

Item # Networked with collaboration of contact
during placement
Support residents
Example E.g. Physio Resident Care Weekly
physical care
Effectively worked/collaborated with external individuals/group to improve
services on three separate occasions
Identified strategies to improve networking opportunities for the service provider
Referred strategies to appropriate personnel
Student adhered to privacy, confidentiality and disclosure requirements

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 9; CHCAGE001 – Facilitate the empowerment of
older people
These assessments link to unit of competency CHCAGE001 – Facilitate the empowerment of older people.
Application:
This unit describes the skills and knowledge required to respond to the goals and aspirations of older people
and provide support services in a manner that focuses on improving health outcomes and quality of life, using a
person-centred approach.
This unit applies to support workers in residential or community contexts.
1. responded to the goals and aspirations of at least 2 older people, 1 in a simulated environment and 1 in
the workplace:
 employing flexible, adaptable and person-centred approaches to empower the individual
 recognising and responding appropriately to situations of risk or potential risk
2. used oral communication skills to maintain positive and respectful relationships
All aspects of the performance evidence must have been demonstrated using simulation prior to being
demonstrated in the workplace. The following conditions must be met for this unit:
relevant organisation policies and procedures
relevant aids to assist with independent living

1. Responded to the goals and aspirations of at least 1 older person in the workplace:
o employing flexible, adaptable and person-centred approaches to empower the
individual
o recognising and responding appropriately to situations of risk or potential risk
2. Used oral communication skills to maintain positive and respectful relationships
Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 Reflect on how you have adopted and changed the following statements to provide care and
support for at least 1 (one) person:
 Used a person-centred approach to care for each of their clients to empower them
(SOA 1)
 Adjusted communication for each person you supported; include in your answer the
following perspectives (SOA 2)
o the cultural, spiritual and social makeup of the older person and how they differed to
you and to your other clients.
 Assisted with appropriate activities to meet each of the person’s needs. Ensure you explain
how you encouraged them to actively engage e.g. what information did you provide them
etc. (SOA 3)
S.A.O Activity 1
Situation
1

Action 1
Outcome
1
S.A.O Activity 2
Situation
2
Action 2

Outcome
2
S.A.O Activity 3
Situation
3
Action 3
Outcome
3

Assessment Task Two
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 It can be a difficult concept to learn to balance the following three aspects, but so
important in relation to empowering and supporting the older person in a dignified yet safe
manner.
Provide an example of how you applied balancing dignity of risk along with duty of care
from within your own work role boundaries, responsibilities and limitations. 
Situation
Action

Outcome
How did you recognise and respond to situations of risk or potential risks to clients or others?
Situation
Action
Outcome

Explain the relevant organisation policies and procedures you used to
correctly support your clients
Explain what the various indicators of abuse and/or neglect would look like
and what the reporting requirements are
through the participant’s reflective journal responses and completed work practice and if
necessary, confirmation with their supervisor/work buddy.
Student correctly and effectively used a person centred approach for
clients whilst assisting them with activities that met their needs
Student used and adjusted appropriate communication techniques with
their client where required
Student correctly identified and responded to situations of risk/potential
risk to clients or others
Student maintained appropriate confidentiality and privacy of the
person within organisation policy and protocols

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 10; CHCADV001 – Facilitate the interests and rights
of clients
These assessments link to unit of competency CHCADV001 – Facilitate the interests and rights of clients
Application:
This unit describes the skills and knowledge required to assist clients to identify their rights, voice their needs
and concerns and realise their interests, rights and needs.
This unit applies to workers of all levels in a range of health or community services settings who provide
services using a human rights based approach and have direct interaction with clients.
1. Worked in collaboration with 1 client to identify their interests, needs and rights
2. Advocated on behalf of 1 client to achieve a specific outcome
3. Supported 1 client throughout an organisational or legal complaints process
conditions. Where simulation is used, it must reflect real working conditions by modelling industry operating
conditions and contingencies, as well as, using suitable facilities, equipment and resources.
1. Worked in collaboration with 1 client to identify their interests, needs and rights
2. Advocated on behalf of 1 client to achieve a specific outcome AND Supported 1 client throughout
an organisational or legal complaints process

Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 How have you worked with a client to identify their interests and rights?
S.A.O Activity 1
Situation
Action

Outcome
Assessment Task Two

Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 Reflect on your interactions with a client and explain how you addressed the following
aspects of supporting their interests and rights:
 Advocated on behalf of a client to achieve a specific outcome – (SOA 1)
o What rights were infringed or not being met?
o Explain any potential barriers as well as resources you used to facilitate your clients
wishes.
o What procedures did you follow to ensure information was kept in confidence – unless
otherwise advised to release it?
 Supported a client throughout an organisation, or, legal complaints process – (SOA 2)
o What strategies did you use to empower your client?
o What negotiation, advocacy and/or mediation techniques did you utilise?
o Explain how you provided the client with information on available options for
meeting their rights and needs and how did you assist them to identify their
preferred option
o Explain how you supported and encouraged your client to exercise their rights and
personal preferences without compromising their safety and that of others
o Who did you consult with?


S.A.O Activity 1 – Advocated on behalf of a client to achieve a specific outcome
Situation 1
Action 1
Outcome 1
S.A.O Activity 2 – Supported a client throughout an organisation, or, legal complaints process
Situation 2

Action 2
Outcome 2
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 Go back to the two clients you reported on in AT2 and obtain their feedback on how you
performed. Ask them to identify the positives and negatives of your performance. Use this
exercise to identify what you’re getting right and what you may need to improvement.



S.A.O Activity 1 – Advocated on behalf of a client to achieve a specific outcome
Feedback
Improvements required
and how to achieve them
S.A.O Activity 2 – Supported a client throughout an organisation, or, legal complaints

process
Feedback
Improvements required
and how to achieve them

Student effectively worked with a client and correctly identified their
interests and rights, needs, choices and responsibilities
Student correctly and effectively advocated on behalf of a client
Student correctly and effectively supported a client throughout an
organisation or legal complaint process that included providing ongoing
support and information to client

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 11; CHCPAL001 – Deliver care services using a
palliative approach
These assessments link to unit of competency CHCPAL001 – Deliver care using a palliative approach.
Application:
This unit describes the skills and knowledge required to care for people with life-threatening or life-limiting
illness and/or normal ageing process within a palliative approach.
This unit applies to workers in a residential or community context. Work performed requires some discretion
and judgement and is carried out under regular direct or indirect supervision.
1. supported, reported and documented issues and needs of 3 people in palliative care
Skills must be demonstrated in the workplace or in a simulated environment that reflects workplace conditions.
modelling typical workplace conditions, including:
typical workplace documentation and reporting processes
scenarios and simulations in provision of care using a palliative approach in a range of contexts
palliative care plans and equipment and/or resources outlined in plan

1. Supported, reported and documented issues and needs of 3 people in palliative care
Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 Reflect on how you have supported 3 (three) client’s receiving palliative care.
 Explain the differences between the 3 clients in relation to their cultural, religious and
spiritual beliefs/preferences to death and dying. Refer to advanced care directive and end
of life plan.
 Did you notice any bias or judgement within yourself in relation to how they were choosing
to die? There is no right or wrong answer here, it is important to understand how you may
respond to future clients and how to cope with that.
 Were you able to observe the emotional impact of their diagnosis? If so, what did you
observe?
 Explain how you applied communication strategies to show empathy, support and
empowered all to cope and share their changing needs.
S.A.O Activity 1
Situation 1

Action 1
Outcome 1
S.A.O Activity 2
Situation 2
Action 2

Outcome 2
S.A.O Activity 3
Situation 3
Action 3
Outcome 3

According to your organisation’s approach to and provision of palliative care; what
changes/issues did you report and/or document for each of these clients?
Please note the name of the policy/procedure document you needed to follow.
S.A.O Activity 1
Situation 1
Action 1
Outcome 1
S.A.O Activity 2
Situation 2

Action 2
Outcome 2
S.A.O Activity 3
Situation 3
Action 3

Outcome 3

Assessor will ask you to identify or explain your understanding, approach or S NS
procedures you used
It is recommended to use this conversation as a debriefing session as well
What responsibility do you have to yourself and your colleagues when work
with palliative care clients
What needs and issues were outside the scope of your role and how did you
handle it?
Did you become aware of any emotional, ethical issues related to death and
dying? If so, what were they and who did you report these to?
What self-care strategies do you have access to in your work environment?

Student effectively supported three clients receiving palliative care
Student correctly documented and reported issues that arise
Student showed appropriate respect and empathetic support for the
family and carers communicating the information and support needed
Student implemented/supported strategies to manage pain and
promote comfort in line with care plan and the scope of their role

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 12; CHCCCS011 – Meet personal support needs
These assessments link to unit of competency CHCCCS011 – Meet personal support needs.
Application:
This unit describes the skills and knowledge required to determine and respond to an individual’s physical
personal support needs and to support activities of daily living.
This unit applies to workers who provide support to people according to an established individualised plan in
any community services context. Work performed requires some discretion and judgement and may be carried
out under regular direct or indirect supervision.
1. safely supported at least 2 individuals by performing the activities outlined in the performance criteria of
this unit. This includes following support requirements of an established individualised plan and supporting
each of the following activities:
bed bathing
dressing, undressing and grooming
eating and drinking using appropriate feeding techniques
oral hygiene
shaving
showering
toileting and the use of continence aids
using aids and equipment including devices used by the person
2. performed the following hazardous manual handling scenarios at least once:
transferring a person between bed and chair
transferring a person in and out of car
falls recovering
Skills must have been demonstrated in a relevant workplace that provides personal support services to people,
with the addition of simulations and scenarios where the full range of contexts and situations have not been
provided in the workplace. These are situations relating to emergency or unplanned procedures where
assessment in these circumstances would be unsafe, impractical or threatens the dignity of the person. The
following conditions must be met for the unit:
use of suitable facilities and resources including:
individualised plans specifying different personal support needs
equipment outlined in individualised plans
modelling of industry operating conditions including involvement of real people when simulating the provision
of service and equipment use
Overall, assessment must involve some real interactions with people who require personal support.

1. Safely supported at least 2 individuals by performing the activities outlined in the performance
criteria of this unit. This includes following support requirements of an established individualised
plan and supporting each of the following activities:
bed bathing
dressing, undressing and grooming
eating and drinking using appropriate feeding techniques
oral hygiene
shaving
showering
toileting and the use of continence aids
using aids and equipment including devices used by the person
2. Performed the following hazardous manual handling scenarios at least once:
 transferring a person between bed and chair
 transferring a person in and out of car
 falls recovering
Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□

Unit Title: Meet personal support needs
* further supporting evidence can be located within the placement logbook ‘Orientation’ section
Reflect on your first experience in assisting a client with Activities of Daily Living. Reference two
clients experiences below ensuring you address the following factors as well:
 Explain any routine difficulties you responded to during support routines. For more complex
problems who would or did you report these to?
 If a change to processes and/or equipment was required, what did you do to facilitate this?
S.A.O Activity 1 – Client 1
Situation 1
Action 1
Outcome 1
S.A.O Activity 2 – Client 2
Situation 2

Unit Title: Meet personal support needs
* further supporting evidence can be located within the placement logbook ‘Orientation’ section
Action 2
Outcome 2

Assessment Task Two
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
The student must have completed the facility’s Induction/Orientation prior to undertaking these
tasks, as per Part One of this Workplace Log Book.
The simulated incident is a client who has an unwitnessed fall.
They are to follow the facilities SOP on Responding to a code Blue (medical emergency) & DRSABCD.
NB – do not use actual Alarms during this excerise.

Simulated Code Blue (CHCCCS011 – hazardous manual handling fall
recovery)
Student ASSESSOR
Falls recovery Self ONLY
Check Yes No
Student is able to locate Falls recovery Policy and Procedures
 Student is able to explain the fall recovery process
 Student is able to locate and explain the relevant

  
documentation relating to fall
Student responded:
 By checking for immediate Danger to self and others
 Describe risk assessment process
 Checking for a Response
 Checks for verbal response
 Checks Airway
 Raises the Alarm or Alerts applicable personnel
 Uses call bells to raise an alarm/uses phone   

obtaining outside line to contact emergency
services
 Keeps the client calm and still until Assessed by senior staff
 Gives verbal handover to senior staff
 Follows directions from senior staff
 Correctly rings emergency services including obtaining an

outside line if applicable and gives correct address.
Transferring a person in and out of a car - (CHCCCS011)

Student is able to locate and explain the mobility status of the client   
Prompts/reminds the client that they are going out   
Student ensures that the client is ready to be transported
 Checks with senior staff if the client requires anything extra
e.g. documentation; money etc.   
 Checks with client if they are ready e.g. toileting, food etc.
Student ensures that the client is signed out in the Resident leave
register
  
Student conducts an Environmental Risk Assessment   
Student ensures that the mobility aids are suitable for the
environment
  

Student ensures that the car is parked and ignition is turned off   
Student ensures that the seat in the car is in an optimal position for
the client
  
Student positions the mobility aid as to allow optimal access in and
out of the car
  
Student ensures that the mobility aid is locked/secure to ensure
stability
  
The student ensures that the car door will not inadvertently close on
the client
  
The student ensures the client does not hit their head on the doorjamb   
Student follows the no lift policy and does not take excess weight of
the client as they are lowering/rising out of the car
  
The student moves the mobility aid out of the way to assist/allow the
client to lift their legs up and into the car
  
I, the Assessor, have observed the student undertaking the above activities and they have been
 satisfactorily completed.
Assessor will ask you to identify or explain your understanding, S NS
approach or procedures you used
How did you confirm the person’s own assistance preferences during
the transfer in/out of vehicle
What risk was associated with toileting your client and how did you
minimise that risk?
Describe an occasion when you identified changes in the person’s health
or personal support requirements and reported it to your supervisor
What – if anything – came up that was outside of the scope of your own
role and how did you handle it?

Student correctly reviewed and determined the clients personal
support requirements on two separate occasions
Student correctly supported client through their daily routines on two
separate occasions
Student using a positive manner the student encouraged the client
to independently complete task where appropriate
Student safely used and adjusted equipment and aids in provision
of personal support where required

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

It is expected that by the end of your first 10 shifts you have been proactive in providing a person
approach:
it meant.

Assessment 13; CHCCCS006 – Facilitate individual service
planning and delivery
These assessments link to unit of competency CHCCCS006 – Facilitate individual service planning and delivery.
Application:
This unit describes the skills and knowledge required to contribute to the development, implementation and
review of individualised support.
This unit applies to workers in a range of community services and service delivery contexts. Work will involve
collaborating with the person requiring support and other people involved in the support network. Service
needs may be complex or multiple.
1. worked within established guidelines to contribute to the planning and reviewing of services which meet
the needs of at least 3 people
2. contributed to the planning processes by communicating effectively with the person and other
stakeholders using active listening and questioning
planning and service delivery policies and procedures
planning templates and tools

1. Work within established guidelines to contribute to the planning and reviewing of services which
meet the needs of at least 3 people AND Contribute to the planning processes by communicating
effectively with the person and other stakeholders using active listening and questioning
Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 You have contributed to the planning and reviewing of services that meet the needs of at
least 3 (three) people. In your report ensure you address the following aspects:
o Who was the assessor you liaised with prior to planning?
o Describe what you said to discuss different service options with the person and how you
helped them choose the most appropriate one for them
o Explain how you and the person determined their readiness for development of an
individualised plan
o Explain who needed to be included in the planning processes and how you organised it
o You had to collate, prepare and distribute the information, who were the relevant
stakeholders?
S.A.O Activity 1
Situation 1

Action 1
Outcome 1
S.A.O Activity 2
Situation 2
Action 2

Outcome 2
S.A.O Activity 3
Situation 3
Action 3
Outcome 3

Assessment Task 2
 Interview the three clients you supported and ask them the following questions:
How did you find the quality of the service/activity?
Client 1
Client 2
Client 3
Did you enjoy and/or find the service/activity beneficial? Please explain.
Client 1
Client 2
Client 3

If you were to adjust/improve anything about the service/activity, what would it be?
Client 1
Client 2
Client 3
Now briefly explain the procedure to report the above feedback and possible need for changes
to an individualised plan
Client 1
Client 2
Client 3

Explain how to maintain currency of the documentation
Explain how the organisation incorporates review findings into continuous

improvement processes

Student effectively contributed to the planning of services to meet the
need of three separate clients
Student effectively reviewed the services to ensure they meet the needs
of three separate clients
Student identified and confirmed key aspects of individualized service
delivery by working collaboratively with the person and other
stakeholders to establish goals
Student considered interrelated needs of the person and planned an
integrated approach to service delivery
Student clearly recorded planning activities and decisions made
Student prepared reports and other documentation according to
organisation requirements

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 14; CHCCCS025 - Support relationships with carers
and families
These assessments link to unit of competency CHCCS025 – Support relationships
Application:
This unit describes the skills and knowledge required to work positively with the carers and families of people
using the service based on an understanding of their support needs.
This unit applies to workers across a range of community services contexts.
1. assessed and responded to the needs of at least 3 different people and their carers or family members
2. used strengths-based solutions to respond to both routine and unpredictable problems related to care
relationships
conditions. The following conditions must have been met for this unit:
use of suitable facilities, equipment and resources, including organisation policy, protocols and procedures
relevant to carers and families
modelling of industry operating conditions and contingencies, including people, carers or family members with
whom the candidate can interact

1. Assess and respond to the needs of at least 3 different people and their carers or family members
2. Use strengths-based solutions to respond to both routine and unpredictable problems related to
care relationships
Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 Reflect on how you have assessed and responded to the different needs of 3 (three)
different people and their carers and/or family members and in your response for S.O.A
please address the following aspects of holistically caring for all people involved:
 Explain what you did to show the carer/family member/s that you respect their
knowledge of your client’s needs and support their relationship.
 Explain what you (and your work buddy) did to involve the carers/families in the design
and delivery of the person’s support services
Change and transitioning from one strategy/situation/stage can be very difficult for all
involved.
 Explain what you did to support the person and carer/family to work out the best
strategies to use in order to maximise the positive aspects of any change/transition.
S.A.O Activity 1
Situation 1

Action 1
Outcome 1
S.A.O Activity 2
Situation 2
Action 2

Outcome 2
S.A.O Activity 3
Situation 3
Action 3
Outcome 3

Assessment Task Two
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 Referring to the above; what strength based solutions could you use to respond to
unpredictable or routine problems that could affect the care relationship for each of the 3
(three) different people and their carers and/or family members? Also include in your
response the following:
 Explain 1 (one) different problem for each of your client’s and their carer/family member
 Explain how you responded to the carer/family member regarding their need for services
to support their care relationship with the person. If this wasn’t a requirement from you,
what could you have done if given the opportunity?
 What, if any, information did you provide to the carers/families about support services for
themselves? If you weren’t required to do this, what information could you give them?
S.A.O Activity 1
Situation 1
Action 1

Outcome 1
S.A.O Activity 2
Situation 2
Action 2
Outcome 2
S.A.O Activity 3
Situation 3

Action 3
Outcome 3

What potential ‘risks of change to the care relationship’ could happen as
your clients situation/health changes/deteriorates? Include in your answer
any potential physical and/or psychological harm to carers and the person.
In each of the (3) three cases, were there any aspects of the person’s care
you were required to keep confidential/private?
If so, what was it?
If not, what information are you required to keep confidential/private?
Explain (1) one example.
Did you need to identify and respond to any issues that impacted on the
physical and/or emotional health and wellbeing of the carer?
If so, give (1) one example of what happened and how you responded.
If not, provide an example of what could happen and how you could
respond.

Correctly determined the needs of people and their carers on three
separate occasions
Correctly responded to the needs of people and their carers on three
separate occasions
Correctly identified three solutions for unpredictable or routine
problems between a client and their carer/family member

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 15; CHCCCS023 – Support independence and well-
being
These assessments link to unit of competency CHCCCS023 – Support independence and well-being
Application:
This unit describes the skills and knowledge required to provide individualised services in ways that support
independence, as well as, physical and emotional wellbeing.
This unit applies to workers in a range of community services contexts who provide frontline support services
within the context of an established individualised plan.
1. safely supported at least 3 people to enhance independence and wellbeing
2. performed the activities outlined in the performance criteria of this unit during a period of at least 120
hours of direct support work in at least one aged care, home and community, disability or community
service organisation
Skills must have been demonstrated in a relevant workplace with the addition of simulations and scenarios
where the full range of contexts and situations have not been provided in the workplace. Where simulation is
used it must reflect real working conditions and contingencies by modelling industry operating conditions and
contingencies, as well as using suitable facilities, equipment and resources, including:
modelling of industry operating conditions including real interactions with the person and their carers
Overall, assessment must involve some real interactions with the person and their families/carers.

1. Safely support at least 3 people to enhance independence and wellbeing
2. Complete the log book validating completion of 120hours of work placement
Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 Think back on 3 (three) different occasions of how a client’s care plan influenced your
actions to safely support and enhance the client’s independence and wellbeing.
S.A.O Activity 1
Situation 1
Action 1

Outcome 1
S.A.O Activity 2
Situation 2
Action 2
Outcome 2
S.A.O Activity 3
Situation 3

Action 3
Outcome 3
Assessment Task Two
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
Complete the log book on Page 29 of this booklet

Student correctly implemented a client’s care plan to ensure actions safely
support the clients independence and wellbeing on three separate occasions
Student correctly implemented a client’s care plan to ensure actions enhance
the clients independence and wellbeing on (3) three separate occasions

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 16; CHCAGE004 – Implement interventions with
older people at risk
These assessments link to unit of competency CHCAGE004 – Implement interventions with older people at risk.
Application:
This unit describes the skills and knowledge required to work in partnership with older people and their carers
to implement interventions in the context of an individualised plan to reduce risk.
This unit applies to support workers in a residential or community context. Work performed requires a range of
well developed skills where some discretion and judgement is required. Workers will take responsibility for their
own outputs under direct or indirect supervision.
1. assisted with the assessment of risk and the implementation and evaluation of risk minimisation strategies
for at least 2 older people, 1 in a simulated environment and 1 in the workplace, in a manner that is
respectful of the older person’s dignity and privacy.
unsafe, impractical or threatens the dignity of the older person.
use of suitable facilities, equipment and resources, including relevant assessment tools
Overall, assessment must involve some real interactions with older people, colleagues, families/carers and the
use of individualised plans.

1. Assist with the assessment of risk and the implementation and evaluation of risk minimisation
strategies for 1 older person in the workplace, in a manner that is respectful of the older person’s
dignity and privacy
Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 How have you assisted with a risk assessment and implemented risk minimisation strategies
for (2) two clients? Ensure one assessment is a falls assessment (one can be in a simulated
environment) Have a look at the Observation Criteria checklist and the Competency
Conversation to understand the factors involved in assisting with risk assessments. Then
explain how you achieved the tasks of risk assessment and implementation of the risk
minimisation strategies. Also address the following:
 Explain how you worked with the older person and carer to identify risk minimisation
strategies that were consistent with their safety needs, priorities and specific requirements
– and what these?
 How did you ensure that the person’s discomfort was minimal?
S.A.O Activity 1
Situation 1

Action 1
Outcome 1
S.A.O Activity 2
Situation 2
Action 2

Outcome 2
Assessment Task Two

Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 Monitor the effects of the strategies on your (2) two clients by having a feedback session
with them. First write down what risk minimisation strategy/s have been put in place. Then
interview them and ask the following questions and write down their answers:
1. What have been the positives and/or negatives of the implemented strategies? Any
negatives will be a possible indicator of increased risk so this will need to be reported.
2. Even if there are no negatives, what does the person feel would work better for them?
Take this information back to your supervisor and/or relevant health professional to
facilitate further action, then answer the following question:
3. What was the outcome of the discussions for each of the client’s?

S.A.O Activity 1
Feedback Client
1
Outcome 1
S.A.O Activity 2
Feedback Client 2
Outcome 2

When you worked with the supervisor/health professional, what risk
factors did you determine based on your clients medical history,
measurements and findings?
What needs, issues and concerns presented themselves that were outside
of your scope of practice? How did you handle this?
Correctly completed risk assessments on two separate clients
Student used organisational tools and methodologies within the scope
of their role
Student confirmed assessment requirements with supervisor or relevant
health professional
Student provided encouragement and information in a way that showed
respect of the person/carer’s rights, level of understanding and cultural
background
Student sought older person’s permission and cooperation in the
assessment process

Student safely and effectively implemented risk minimisation strategies
for two separate clients
Student completed, maintained and stored all relevant documentation
and reports according to organisation policy and protocols in a timely
manner
Student performed their duties in the appropriate legal and ethical
manner

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  

Assessment 17; CHCAGE002 – Implement falls prevention
strategies
These assessments link to unit of competency CHCAGE002 – Implement falls prevention strategies.
Application:
This unit describes the skills and knowledge required to work in partnership with older people and their carer/s to implement
strategies to minimise the risk of falls.
This unit applies to support workers in a residential or community context. Work performed requires some discretion and
judgement and may be carried out under regular direct or indirect supervision.
The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand
standards and industry codes of practice.
The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit,
1. implemented falls prevention strategies for at least 2 older people and monitored and evaluated those strategies in a
collaborative, positive and respectful manner
Skills must have been demonstrated in an ageing support workplace with the addition of simulations and scenarios where the full
range of contexts and situations have not been provided in the workplace. These are situations relating to emergency or
unplanned procedures where assessment in these circumstances would be unsafe, impractical or threatens the dignity of the
older person. The following conditions must be met for this units:
relevant risk assessment tools
relevant organisation policies and procedures
Overall, assessment must involve workplace interactions with older people, colleagues and families/carers.
1. Implement falls prevention strategies for at least 2 older people and monitored and evaluated those strategies in
a collaborative, positive and respectful manner

Assessment Task One
Supervisor C/R #3
□ □
□ □
C/R #1 C/R #5
□ □
□
 How have you assisted with the implementation of a falls risk minimisation strategies for 2 (two) clients? If
your one or two clients in the previous unit CHCAGE004 were both falls risk minimisations and
implementations, please use that information here.
 Explain the process you followed to share and celebrate positive results with the older person, carers,
supervisor or health professional
S.A.O Activity 1
Situation 1
Action 1

Outcome 1
S.A.O Activity 2
Situation 2
Action 2
Outcome 2

In completing the observation criteria below, the Assessor takes into account evidence collected through the
participant’s reflective journal responses and completed work practice.
Correctly implemented strategies for minimising risk of falls for two separate clients

____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
____ / ____ / ____  
Assessment Guide
The Assessor has reviewed the Assessment Workbook against the requirements of
Satisfactory Outcome
the Assessment Mode and is satisfied that all requirements have been met
The Assessor has reviewed the Assessment Workbook against the requirements of
Not Satisfactory Outcome
the Assessment Mode and is not satisfied that all requirements have been met.

Appendix 6b – Post Placement Debrief
You have completed you placement event, did you achieve your 5 (Five) goals mentioned in Appendix 6a?
Please tell us your top 5 (five) memorable moments that you witnessed during your placement.
Goal 1
Goal 2
Goal 3
Goal 4
Goal 5
This is formative and may be left blank – refer to note on page 22

c

Competency Summary Declaration
c
Mode One Assessment Mode Two Assessment
Unit of Final Assessment Outcome
Outcome Outcome Date of
Competency Unit of Competency Title
Not Yet Not Yet Not Yet Assessment
Code Competent Competent Competent
Competent Competent Competent
CHCDIV001 Work with diverse people ☐ ☐ ☐ ☐ ☐ ☐
CHCLEG003 Manage legal and ethical compliance ☐ ☐ ☐ ☐ ☐ ☐
HLTAAP001 Recognise healthy body systems ☐ ☐ ☐ ☐ ☐ ☐
CHCCOM002 Use communication to build relationships ☐ ☐ ☐ ☐ ☐ ☐
CHCPRP001 Develop and maintain networks and
collaborative partnerships
☐ ☐ ☐ ☐ ☐ ☐
CHCCCS025 Support relationships with carers and
families
☐ ☐ ☐ ☐ ☐ ☐
CHCADV001 Facilitate the interests and rights of clients ☐ ☐ ☐ ☐ ☐ ☐
HLTWHS002 Follow safe work practices for direct client
care
☐ ☐ ☐ ☐ ☐ ☐
CHCCCS011 Meet personal support needs ☐ ☐ ☐ ☐ ☐ ☐
CHCAGE004 Implement interventions with older people
at risk
☐ ☐ ☐ ☐ ☐ ☐
CHCAGE002 Implement falls prevention strategies ☐ ☐ ☐ ☐ ☐ ☐
CHCAGE003 Coordinate services for older people ☐ ☐ ☐ ☐ ☐ ☐
CHCCCS006 Facilitate individual service planning delivery ☐ ☐ ☐ ☐ ☐ ☐
CHCAGE005 Provide support to people living with
dementia
☐ ☐ ☐ ☐ ☐ ☐
CHCAGE001 Facilitate the empowerment of older people ☐ ☐ ☐ ☐ ☐ ☐
CHCCCS023 Support independence and wellbeing ☐ ☐ ☐ ☐ ☐ ☐

Mode One Assessment Mode Two Assessment
Unit of Final Assessment Outcome
Outcome Outcome Date of
Competency Unit of Competency Title
Not Yet Not Yet Not Yet Assessment
Code Competent Competent Competent
Competent Competent Competent
CHCPAL001 Deliver care services using a palliative
approach
☐ ☐ ☐ ☐ ☐ ☐
BSBLDR402 Lead effective workplace relationships This UOC Assessment Result - As Per Mode One Assessment Date/Training Plan
☐ All required assessment criteria has been satisfied for the qualification.
Assessor Name: Provided feedback to student:
Assessor Signature: Date: ____ / ____ / ____ ☐ Verbally ☐ Written
Student Declaration
☐ I agree with the Assessor’s final assessment outcome. ☐ I have received feedback on my completed assessment from the Assessor.
Student Signature: Date: ____ / ____ / ____

Assessor Student Feedback
Instructions:
In relation to the completed assessment, please document any comments and/or student feedback you have in the space provided below.

Reasonable Adjustment Information
Reasonable Adjustment details applied to this student
What reasonable adjustment was made:
Why this adjustment was made:
Assessor Declaration
Assessor Name
Assessor Signature
Date
Student Declaration
I agree with the reasonable adjustment made as listed above and I was consulted in the adjustments made to suit
 my individual needs.
Student Signature
Date

Re-Assessment Competency Summary Declaration
Final Assessment Outcome

Unit of Competency Code Unit of Competency Title
Competent Not Yet Competent
CHCDIV001 Work with diverse people ☐ ☐
CHCLEG003 Manage legal and ethical compliance ☐ ☐
HLTAAP001 Recognise healthy body systems ☐ ☐
CHCCOM002 Use communication to build relationships ☐ ☐
CHCPRP001 Develop and maintain networks and collaborative partnerships ☐ ☐
CHCCCS025 Support relationships with carers and families ☐ ☐
CHCADV001 Facilitate the interests and rights of clients ☐ ☐
HLTWHS002 Follow safe work practices for direct client care ☐ ☐
CHCCCS011 Meet personal support needs ☐ ☐
CHCAGE004 Implement interventions with older people at risk ☐ ☐
CHCAGE002 Implement falls prevention strategies ☐ ☐
CHCAGE003 Coordinate services for older people ☐ ☐
CHCCCS006 Facilitate individual service planning delivery ☐ ☐
CHCAGE005 Provide support to people living with dementia ☐ ☐
CHCAGE001 Facilitate the empowerment of older people ☐ ☐
CHCCCS023 Support independence and wellbeing ☐ ☐
CHCPAL001 Deliver care services using a palliative approach ☐ ☐

 All required assessment criteria has been satisfied for the qualification.
Assessor Name: Provided feedback to student:
Assessor Signature: Date: ____ / ____ / ____  Verbally  Written
Student Declaration
 I agree with the Assessor’s final assessment outcome.  I have received feedback on my completed assessment from the Assessor.
Student Signature: Date: ____ / ____ / ____

Feedback on the Assessments
Feedback Form Instructions:
In an effort to continuously improve our Assessments, please feel free to document any feedback or
suggestions you may have. Once completed, please remove this page and submit it to your Assessor at any
time during your assessment process. This form will then be forwarded to our Program Manager for
further review and consideration.
Feedback:
Student Name
Date


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CHC43015

Certificate IV in Ageing Support

Training Record for Work Placement

Integrated Training Solutions (Aust) Pty Ltd

Intercare Training Trainer/Assessor:

Office Contact Person:

CHC43015 Cert IV Ageing Support_WPB_Final_May 2018 V1.5 Page 4 of 206

CHC43015 Cert IV Ageing Support_WPB_Final_May 2018 V1.5 Page 5 of 206

General placement information for Intercare Training students:

CHC43015 Cert IV Ageing Support_WPB_Final_May 2018 V1.5 Page 6 of 206

Compulsory placement aspects for Intercare Training students:

CHC43015 Cert IV Ageing Support_WPB_Final_May 2018 V1.5 Page 7 of 206

1.5 Recognition of Prior Learning (RPL)

1.6 Student Supervision

Each student will have a:

1.7 Course Overview

1.8 Competency Based Training (CBT)

 Undertake and manage the task

Students will be marked as C (Competent) or as NYC (Not Yet Competent).

1.9 Grievance Procedure

1) Facility Intercare Training

3) Intercare Training Student

1.10 Occupational Health & Safety/ Workplace Health & Safety

1.11 Practical Placement Agreement

CHC43015 Cert IV Ageing Support_WPB_Final_May 2018 V1.5 Page 9 of 206

 Workplace Health and Safety Act 2004

1.12 Work Cover

CHC43015 Cert IV Ageing Support_WPB_Final_May 2018 V1.5 Page 10 of 206

2.2 Workplace Supervisor Responsibilities, Communication and Verification

To participate in an initial meeting to set up the placement with the student. □

CHC43015 Cert IV Ageing Support_WPB_Final_May 2018 V1.5 Page 11 of 206

3.1.1 For students to apply theory to practice

3.2 Roles and Responsibilities of Students

 To demonstrate sensitivity and discretion toward the clients of the service.

3.3 Student Responsibilities, Communication and Verification

Attend a pre placement meeting with Workplace Supervisor

Attend the allocated work site for the specified hours

CHC43015 Cert IV Ageing Support_WPB_Final_May 2018 V1.5 Page 12 of 206

CHC43015 Cert IV Ageing Support_WPB_Final_May 2018 V1.5 Page 13 of 206

 off-the-job in the class room

Assessment of competence takes place through a range of mechanisms, including:

5.2 General Assessment Information

Development of the Assessment Tools

Resources needed for the assessment:

 A relevant simulated environment for the purposes of practical demonstration

CHC43015 Cert IV Ageing Support_WPB_Final_May 2018 V1.5 Page 15 of 206

 Each student is entitled to 3 assessment attempts at no additional cost

How you will be assessed / able to demonstrate competency?

INDIVIDUAL ASSESSMENT MODES can include:

MODE ONE (Formative/Summative)

CHC43015 Cert IV Ageing Support_WPB_Final_May 2018 V1.5 Page 16 of 206

Conditions of Assessment for Mode One

MODE TWO (Summative)

Case Study (Work Placement Log Book):

Rules for Completing Assessment Modes

 Not Satisfactory Outcome:

How is Competency Judgement Made?

Student Please Note: