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Occupational Health and Safety

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Occupational Health and Safety
FINAL EVALUATION AND ASSESSMENT RECORD OFUNIT STANDARD ID 116520SUPERVISOR SHE TRAININGASSESSMENT:SPECIFIC OUTCOME TWO AND THREE | Facilitator name: FRED WAGNERFacilitator number: ____________________ | | Learner No:(Office use ONLY) | | | | Training Centre: DEKRA NORISKOTown: PRETORIA (Centurion) | | Date of course: from 12/10/2010 to: 14/10/2010(Total hours: ________________) | FINAL EVALUATION AND ASSESSMENT RECORD | Surname: CronjèFirst names: AnnérieI.D. Number: 610910 0062 085Company: South African National Defence ForceDepartment/Division: SA Army Training FormationStreet address: Dequar Road, PretoriaPostal address: Private Bag X 172, Pretoria, 0001Phone: Cell: 071 679 6503 or (012) 355-1665 Fax: 086 211 7661Email: amecronje@gmail.com | The following questions relate to critical points covered in the material, content scope of practical activities covered by this Unit Standard:Unit Standard: “Apply safety, health and environmental principles and procedures in a workplace.” | |

INSTRUCTIONS TO LEARNERS:

1. Complete all the course details and your personal details in the space provided above (page 2 of this document). 2. Enter your name and ID no. in the block at the top of each page. 3. Read the questions carefully. 4. Record your answers to all the questions in the space provided. 5. The practical assessments for Specific Outcome 2 and 3 should be completed once you have returned to your workplace and should be submitted to the facilitator/assessor within 30 days of completion of the course. 6. On completion, sign and date the forms before handing it to the facilitator.

NOTE:
Please remember that this form is for assessment purposes only and may not, and will not be used for any other purpose by Assurance International. All completed assessment documents are treated as confidential and no information contained in these documents will be accessible to anybody besides Assurance International

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