Assessment Element Title: Safe Manual Handling

Service. DATE:
Name: Competent Coaching Required
INSTRUCTOR WILL COMPLETE THE FOLLOWING
Skill Assessment:

Proper Lifting Techniques & Stretching

Hip Hinge
Properly done? Yes No

Diagonal Lift
Properly done? Yes No

Power lift
Properly done? Yes No

Deep & Partial Squat Lift

Properly done? Yes No

Straight Leg Lift

Properly done? Yes No

Stretchings
Properly done? Yes No

INSTRUCTOR:
Course Description: Proper Lifting Techniques & Stretching Date:

Name:

Assessment Results:

The nominee described above has or has not demonstrated competence in the element
above.

What gaps in knowledge, skills or application have been identified?

List.

What recommendations does the assessor make to improve outcome?

Follow-up date:
Follow up results:
Was the nominee able to correct problems immediately?
Explain plan.

Does the nominee agree with this assessment?

Signature Nominee:

Signature of Assessor:

Certificate issued:
Assessment Element Title: Date:

Name: Competent Coaching Required

Knowledge Assessment:
Assessment Element Title: Date:

Name: Competent Coaching Required

Knowledge Assessment:
Assessment Element Title: Date:

Name: Competent Coaching Required

Knowledge Assessment:
Assessment Element Title: Date:

Name: Competent Coaching Required

Knowledge Assessment:
Assessment Element Title: Date:

Name: Competent Coaching Required

Skill Assessment:
Assessment Element Description: Date:

Name:

Assessment Results:

The nominee described above has or has not demonstrated competence in the element
above.

What gaps in knowledge, skills or application have been identified?

List.

What recommendations does the assessor make to improve outcome?

Follow-up date:
Follow up results:
Was the nominee able to correct problems immediately?
Explain plan.

Does the nominee agree with this assessment?

Signature Nominee:

Signature of Assessor: