INSTITUTIONAL

ASSESSMENT
TOOLS
 Table of Specification
 Evidence Plan
 Attendance Sheet
 Self-Assessment Guide
 Written Test
 Answer Key (Written Test)
 Performance Test (Specific Instructions)
 Rating Sheet for Demonstration
 Questions about the Demonstration
 Questioning Tool to Probe the Underpinning Knowledge
 Institutional Assessment Result Summary

Prepared by:

(FULL NAME)
 TABLE OF SPECIFICATION

PROVIDE # of
HOUSEKEEPING Knowledge Comprehension Application items/
SERVICES TO GUEST % of test

Handle
housekeeping 5%(2) 5%(2) 10%(4) 20%(8)
requests

Advise guests on
room and 5%(2) 5%(2) 10%(4) 20%(8)
housekeeping
equipment

TOTAL (100%) 20% 20% 60%(24) 100%(40)

 LOLOMBOY NATIONAL HIGH SCHOOL
Bunducan, Bocaue, Bulacan
Tel. No.: (044) 248-3256

ATTENDANCE SHEET

HOUSEKEEPING NC II
(Title of Qualification)

Name of Competency HOUSEKEEPING NC II

Training Center LOLOMBOY NATIONAL HIGH SCHOOL
Date of Assessment Recent Date
No. TRAINEE’S NAME SIGNATURE ASSESSMENT
RESULTS
1. CAMILLE JHONA A. CINCO With signatures COMPETENT
2. ROSALYN R. PANGAN COMPETENT
3. JUDY ANN ERA G. CANUELO COMPETENT
4. ARJAN I. AÑONUEVO COMPETENT
5. AZHEN R. RAFOLS COMPETENT
6. MAR CONRAD D. CAMACHO COMPETENT
7. ANDREA L. RAMOS COMPETENT
8. ALENA M. MOLIT COMPETENT
9. LANCE I. AMOYO COMPETENT
10. JOEL A. MARZAN COMPETENT
Trainer: Training Manager:

(YOUR NAME) With signature and printed name MARK B. DELA CRUZ

Signature Over Printed Name Signature Over Printed Name

 EVIDENCE PLAN

QUALIFICATION HOUSEKEEPING NC II
Unit of competency: PROVIDE HOUSEKEEPING SERVICES TO GUEST
Ways in which evidence will be collected:
[tick the column]

Demonstration with

Third Party Report

Oral Questioning
Oral questioning

Written Test
Portfolio
The evidence must show that the trainee…
1) Requests are handled in a polite and friendly manner
in accordance with the establishment’s customer   
service standards and security procedures.*
2) Guest is acknowledged by use of name wherever   
possible.*
3) Details of requests made are confirmed and noted in   
accordance with enterprise procedures.*
4) Appropriate apologies are made where a request has   
arisen from breakdown in room service.*
5) Timelines for meeting requests are agreed upon with   
guests.*
6) Requested items are promptly located and delivered   
within agreed timeframes.*
7) Items for pick-up are collected within agreed   
timeframes.*
8) Guests are courteously advised on correct usage of   
equipment.*
9) Malfunctions are promptly reported in accordance
with enterprise procedures, and where possible,   
alternative arrangements are made to meet guest
needs.*
10) A collection time for requested equipment is agreed   
upon where appropriate.*
NOTE: *Critical aspects of competency
 SELF-ASSESSMENT GUIDE
Qualification: HOUSEKEEPING NC II
Unit Competency: PROVIDE HOUSEKEEPING SERVICES TO GUEST
Can I? Yes No
1. Requests are handing in a polite and friendly manner in accordance 
with the establishment’s customer service standards and security
procedures.*
2. Guest is acknowledged by using of name wherever possible.* 
3. Requesting details made are confirmed and noted in accordance 
with enterprise procedures.*
4. Apologizing are made appropriate where a request has arisen from 
breakdown in room service.*
5. Requesting timelines for meeting are agreed upon with guests.* 
6. Requesting items are promptly located and delivered within agreed 
timeframes.*
7. Collecting items for pick-up within agreed timeframes.* 
8. Courteously advising guests on correct usage of equipment.* 
9. Reporting malfunctions are promptly in accordance with enterprise 
procedures, and where possible, alternative arrangements are made
to meet guest needs.*
10. Requesting collection time for equipment is agreed upon where 
appropriate.*
Date
___________________________
Trainee’s Name and Signature
NOTE: *Critical aspects of competency
 RATING SHEET FOR DEMONSTRATION

Trainee’s Name: JOEL A. MARZAN

Trainer’s Name:
Qualification HOUSEKEEPING NC II
Unit of Competency PROVIDE HOUSEKEEPING SERVICES TO GUEST
Date of Assessment
Time of Assessment 8AM--5PM
Instructions for Demonstration
Given the necessary materials, tools and equipment, the trainee must be able to Provide
Housekeeping Services to Guest in 3 hours
Materials and Equipment
Facilities, equipment, supplies and materials relevant to the unit of competency
Observation To show if evidence
is demonstrated
During the demonstration of skills, did the candidate
Yes No N/A
Requests are handing in a polite and friendly manner in accordance 
with the establishment’s customer service standards and security
procedures.*
Guest is acknowledged by using of name wherever possible.* 
Requesting details made are confirmed and noted in accordance 
with enterprise procedures.*
Apologizing are made appropriate where a request has arisen from 
breakdown in room service.*
Requesting timelines for meeting are agreed upon with guests.* 
Requesting items are promptly located and delivered within agreed 
timeframes.*
Collecting items for pick-up within agreed timeframes.* 
Courteously advising guests on correct usage of equipment.* 
Reporting malfunctions are promptly in accordance with 
enterprise procedures, and where possible, alternative
arrangements are made to meet guest needs.*
Requesting collection time for equipment is agreed upon where 
appropriate.*
The trainee’s demonstration was:

Satisfactory Not Satisfactory

Date
JOEL A. MARZAN
 Trainee’s Name and Signature
Date
___________________________
Trainer’s Name and Signature
NOTE: *Critical aspects of competency
 PERFORMANCE TEST

Specific Instruction for the Candidate

HOUSEKEEPING NC II
Qualification
PROVIDE HOUSEKEEPING SERVICES TO GUEST
Unit of Competency

General Instruction:

Given the necessary tools, materials and equipment, you are required to Provide
Housekeeping Services to Guest in accordance with accepted institutional/industry
standard for 3 hours

Specific Instruction:

1. The assessment shall be based on the unit of competency in the Training

Regulation and the evidence plan and shall focus on the following evidence
gathering methods:
- Demonstration with Oral Questioning
1) Requests are handled in a polite and friendly manner in accordance with
the establishment’s customer service standards and security procedures.
2) Guest is acknowledged by use of name wherever possible.
3) Details of requests made are confirmed and noted in accordance with
enterprise procedures.
4) Appropriate apologies are made where a request has arisen from
breakdown in room service.
5) Timelines for meeting requests are agreed upon with guests.
6) Requested items are promptly located and delivered within agreed
timeframes
7) Items for pick-up are collected within agreed timeframes.
8) Guests are courteously advised on correct usage of equipment.
9) Malfunctions are promptly reported in accordance with enterprise
procedures, and where possible, alternative arrangements are made to
meet guest needs.
10) A collection time for requested equipment is agreed upon where
appropriate.

2. You shall be given 30 minutes to prepare the needed materials, tools and
equipment for the performance of tasks.

3. You shall be required to perform the following tasks for 3 hours:

LO1: Handle housekeeping requests
LO2: Advise guests on room and housekeeping equipment
4. Present your finished product/work to your assessor
5. After the performance of tasks, answer the questions about your
demonstration to be asked by the assessor.

6. You have to answer other questions to probe the underpinning knowledge

about the unit of competency

7. After the oral questioning portion, answer carefully the written test about the
unit of competency. Please write your answer on a separate sheet of paper to
be provided by the Trainer.

8. After the assessment, the assessor shall provide you feedback on the
assessment result. The feedback shall indicate whether you are:
- COMPETENT
- NOT YET COMPETENT
 QUESTIONS ABOUT THE TRAINEE’S DEMONSTRATION OF TASKS
Name: JOEL A. MARZAN
Qualification: HOUSEKEEPING NC II
Unit of Competency: PROVIDE HOUSEKEEPING SERVICES TO GUEST
QUESTIONS Satisfactory Responses
Tick Yes or No
The trainee should answer the following questions: Yes No
1. What is the role/aim of housekeeping?  

Answer:
The role of housekeeping is to ensure comfort and safety
of guests during there stay at a hospital organization.

The aim of housekeeping is enable to strive guests and

access items as easily as in their own home.
2. Enumerate the areas of Operation within Housekeeping  
Departments?

Answer:
Hotels, motels and clubs
Resorts, chalets and hostels
Passenger ships and trains
Serviced apartments
3. What is the responsibility of Housekeeping Department?  

Answer:
Housekeeping department is responsible for the
cleanliness, maintenance and aesthetic up keep of the hotel.
4. How do you improve service management plan?  

Answer:
Knowledge, Skills and Attitudes
5. What will a housekeeper do when the equipment, tools  
and materials are malfunction?
Answer:
All such equipment must be immediately tagged as “Out of
Order” and, where possible and safe to do so, the item
should be removed from the guest’s room and logged at
the housekeeping department as being in need of repair.
The Trainee’s underpinning knowledge about the demonstration of tasks was:

Satisfactory Not Satisfactory

Feedback to the Trainee:

Overall Performance:

Satisfactory Not Satisfactory

Date
JOEL A. MARZAN
Trainee’s Name and Signature
Date
___________________________
Trainer’s Name and Signature

QUESTIONING TOOL
 Satisfactory
Questions to probe the candidate’s underpinning knowledge
response
Extension/Reflection Questions – additional questions Yes No

1. What would you do to preserve the secrecy of the customers

accommodation in the hotel? How will you ensure that there will be no
access to others?

Answer:
It is therefore important that housekeeping staff maintain a
professional level of integrity, especially staff who clean rooms.  
Housekeeping staff must have high levels of integrity, honesty and
discretion as a guest needs to feel that what takes place or what is left
in their room must be safe and remain confidential. Understandably an
accommodation room is considerably smaller in size than the
customer's normal residence and therefore items that they may need
might not be in immediate access.
2. What if you were using request from the guest generally applicable
standards of courtesy?

Answer:
 Avoid using first names –only use last names  
 Never use nicknames
 Get the pronunciation right –if you are not sure you can do this, use
“Sir” or “Madam”.
 If you don’t know the guest’s name or have forgotten it address the
guest by “Sir” or “Madam”.
3. What would you do if the customers demanded more the hotel cannot
provide all necessary needs? Why?

Answer:
It is vital that housekeeping are able to get a requested item to a room in
the shortest possible time.
 
These are the number of reasons:
The room size is too small
It would become cramped for space
Not all customers need all items
The capital outlay for a business would be considerable
It reduces the chance of damage and theft
Safety Questions---to prevent accidents Yes No
4. What precautions must you take when handling complaints from the  
guest?

Answer:
Ensuring guest comfort may relate not just to issues that can be
handled quickly by housekeeping (such as rectification cleaning, a
replacement jug for one that‟ s not working or extra tea and coffee
supplies) but also handle or direct guest requests relating to:

 Noisy people in the room next doors

 Poor views from the balcony
 Noisy pigeons outside the room which stop guests getting to sleep
 Noisy elevators near the room
 Lack of facilities in the room
 Quality of facilities that is below guest expectations
 Advertising that has created expectations that are not being met
5. What safety equipment and clothing should you use for staff requests?  

Answer:
Types of Staff Requests
1. Cleaning
 Cleaning duties -of items such as furniture, carpets, equipment,
windows, floors and bench surfaces
 Cleaning of in-house facilities –including public areas, change
rooms and offices
 Emergency cleaning –unexpected cleaning requests
 Cleaning and servicing of staff changing rooms

2. Staff Uniforms
 Order and supply of staff uniforms
 Providing laundry service –many properties operate their own
on-premise laundry whilst other venues will use the services of
an outside commercial laundry. Most staff uniforms will be
cleaned through the housekeeping department.

3. Provision of Supplies
 Cleaning products, rags & equipment
 Chemicals
 Clean linen for F&B departments
 Towels for gymnasiums

4. Security
 Check rooms and floors for safety concerns
 Ensure guest room and emergency doors are shut
 Close storerooms
 Participate in emergency and evacuation procedures

5. Other tasks
 Move room service trays from rooms or corridor to
appropriate store area
 Check mini bars for departing guests
 Check actual status of a room– whether a guest has actually
left the room or if it is occupied
6. What should you not do when setting up portable beds and cots as a  
task in housekeeping hate?

Answer:
 Be careful – they bite: watch your fingers.
 Practice before having to do it front of a guest – it’s embarrassing
to have problems with people looking on.
 Follow the instructions.
 Don’t rush.
 Have an experienced person with you when you do your first one.
You never know when you‟ ll need help even though you‟ ve done
loads of practice.
7. (danger) What would you do if you notice an item that looks unusual or  
suspicious, or see an occurrence that is suspicious?

Answer:
The action may be to:
 Advise the floor supervisor, the Floor Housekeeper or the Executive
Housekeeper
 Contact venue security

Always adhere to workplace policies and procedures when dealing

with such matters, as they are potentially dangerous and serious.
Contingency Questions Yes No
8. What would you do in the event of dangerous or suspicious  
circumstances?
Answer:
The role of housekeeping is this regard is only to “report” – it is not to
intervene, take action or put themselves in harm’s way.
9. (Equipment) What would you do if equipment were malfunctioned?  

Answer:
All such equipment must be immediately tagged as “Out of Order” and,
where possible and safe to do so, the item should be removed from the
guest’s room and logged at the housekeeping department as being in
need of repair.
10. (complaint) What would you do in order to develop a good relationship  
with guest and ensure the comfort and well-being of guests,
housekeeping must develop?

Answer:
 Good personal presentation –as determined by house requirements
that apply to uniforms and personal hygiene.
 Greeting guests by name when known.
 Providing excellent service at all times.
 Not giving the guests the impression that serving their needs is a
chore/imposition.
 Not rushing service delivery as and when it is required.
 Enquiring “Is there anything else I can do for you?”.
 Finishing service delivery with appositive statement: “It‟ s been a
pleasure”.
 Providing information to guests (about the property, the local area,
tourist attractions, transport, local customs, currency etc) –and not
just providing service in terms of specific housekeeping duties.
 Assisting guests in public areas (such as the corridors of their floors
or in lifts) or in-room when they see them struggling with their
luggage. The assistance may simply involve offering to call a porter
to assist.
 Smiling
 Handling complaints in a professional manner.
 Providing a safe and secure environment for the guests while they
are staying in the establishment.
 Respecting the guest‟ s need for confidentiality and privacy
 Having excellent product knowledge about the appliances, items,
features in guest rooms.
11. How do you avoid if you see or hear anything that is suspicious,  
unusual or appears illegal ?

Answer:
you should:
 Not say anything to the persons involved
 Try not to alert them to the fact you have noticed something
suspicious, unusual etc.
 Try to remember as much detail as possible – write down notes when
safe to do so
 Alert the relevant person as soon as possible in such a way that
others (those involved and other guests) cannot hear what is being
said
 It is rare for you to have the authority to call police so you should
refrain from doing this in all but the most extreme cases of actual or
imminent danger
Job/ Role Environment Questions Yes No
12. How will you enhance service delivery standards and equipment  
purchase by the housekeeping department?

Answer:
1. Improving staff knowledge, skills and attitudes
This training may come in the form of:
 Workshops
 Training sessions
 Qualifications and courses
 Buddy system
 Mentoring programs

2. Range of services
 New products associated with the service
 New equipment associated with the service
 Staff training to develop required knowledge, skills and
attitudes
13. How will you handle guest complaint?  

Answer:
 Remain pleasant at all times, but do not smile when the guest is
complaining.
 Listen without interruption.
 Know the correct procedure and the establishment policy on dealing
with customer complaints.
 Ask the guest how they would like you to resolve the problem.
 Focus on the issue and don‟ t take the complaint personal.
 Apologize to the guest for any inconvenience.
 Advise your supervisor and get their feedback as to how they feel you
handled the situation.
Rules and Regulations=SOP Yes No
14. What are the regulations with respect to handling guest request?  

Answer:
1) Listen to get the facts.
2) Probe into the needs of guest by asking questions to clarify his
request.
3) Explain what you can do or offer alternative.
4) Confirm with the guest that this is satisfactory.
5) Use positive words like:
 Certainly, I will be happy/glad to…
6) Take personal responsibility to do it. Do not give guest a run around
or passing on request to other departments.
7) Follow up.
8) Give information to the guest.
 Provide directions to the guest when asked.
 Be sure that you are given the correct information.
15. What are the procedures in confirming and noting details of the request?  

Answer:
1. Confirming what is needed
2. Noting details of what is needed
When a guest makes a request simply write down:
 Guest name
 Room number
 Specifics of the request–type of item or service required, number
involved (where appropriate –”6 wine glasses”)
 Time for delivery to the room that was agreed to
16. What are the requirements of the manufacturer/supplier purchases  
used to perform task by housekeeping?

Answer:
Housekeeping needs to purchase the following:
 Equipment – housekeeping cleaning equipment including vacuum
cleaners, waxing machines, trolleys
 Clothing – uniforms and protective clothing
 Chemicals – including all cleaning products and items used to clean
including cloths, rags, mops
17. What are the rules necessary to the following are guidelines to assist in  
dealing with a customer complaint?

Answer:
 Remain pleasant at all times, but do not smile when the guest is
complaining.
 Listen without interruption.
 Know the correct procedure and the establishment policy on dealing
with customer complaints.
 Ask the guest how they would like you to resolve the problem.
 Focus on the issue and don‟ t take the complaint personal.
 Apologize to the guest for any inconvenience.
 Advise your supervisor and get their feedback as to how they feel you
handled the situation.
The candidate’s underpinning knowledge was:  Satisfactory  Not Satisfactory
Date
___________________________
Trainee’s Name and Signature
Date
___________________________
Trainer’s Name and Signature
 WRITTEN TEST

I. IDENTIFICATION. Read carefully and answer all the questions below the given number.

_____________________1.The role is to ensure the comfort and safety of guests whilst

they are staying at a hospital organization.
_____________________2. He or She must at all times exercise the qualities of integrity,
honesty and discretion. The aim of housekeeping is to strive
to enable guests to access items as easily as in their own
home.
_____________________3. Need for item sent to the room when they have needs during
their stay that are not accommodated by the normal in-room
items.
_____________________4. Another common request for long-term guests where guests
with long hair often ask for extra shampoo and conditioner
_____________________5. Guests may request an improvement in the room service.
They require housekeeping staff to provide remedial service
to the room when the original room service is deemed by the
guest to be sub-standard.
_____________________6. Guests may also contact housekeeping when making an
enquiry. They may have found an item in a room they have
just been roomed in or they may contact housekeeping after
they have departed to enquire about something they have
lost.
_____________________7. Ensuring guest comfort may relate not just to issues that can
be handled quickly by housekeeping (such as rectification
cleaning, a replacement jug for one that‟ s not working or
extra tea and coffee supplies) but also handle or direct guest
requests.
_____________________8. Given that housekeeping staff are usually very busy trying to
achieve the tasks set for them by the Executive Housekeeper
on a daily basis (which are essentially the servicing of
departing and staying guest rooms), they must still ensure
they handle any requests from in-room guests in addition to
their allocated workload and do so in a polite and friendly
manner, in accordance with all relevant house policies and
procedures
_____________________9. When dealing with a guest’s request, the room attendant
should acknowledge the guest by addressing them , if
appropriate and possible.
____________________10. In order to ensure the comfort and well-being of guests,
housekeeping must develop a good relationship with guests.
I. MATCHING TYPE. Match Column A to Column B
COLUMN A COLUMN B
_____1. These are sometimes hired by companies for A. housekeeping
business purposes to hold a small meeting make
presentations or display goods and in such
instances it may be your responsibility to move
furniture around, set up tables and chairs before
the meeting commences.
_____2. They can often have problems with B. Passing on requests
technologically-based items in their rooms. Don’t
make them feel stupid for asking, take time to make
sure they have understood what you have told
them and check to see they are able to operate it
properly on their own before you leave.
_____3.Setting up this thing is a task that many in C. Keys in Collecting Items
housekeeping hate.They are often cumbersome to
move, and difficult to set up. Lots of injuries have
resulted from moving and setting up these items.
Where possible, it is advisable to place them into
rooms and get them set up prior to the guests
arriving – so no-one can hear or see what goes on.
_____4. It is important for you to be well-versed on the D. Types of Items for
different types of equipment that need to be set up Collection
and the steps to take to actually set up the
equipment in a safe, secure and fully operational
manner.
_____5.There may be times when the guest will only E. Log books
require an additional piece of equipment for a
certain time span – a short-term loan. When this
item is placed in the room, it may be a good idea for
you to reach an agreement with the guest about
the collection time for that item.
_____6.Some establishments will have to record F. Where appropriate,
information about when and where extra items agree on suitable time
were delivered and when they need to be collected. to collect equipment
_____7.To service a guest request effectively, you may G. Know the house rules
need to pick up items from the guest room such
as room features including furniture, appliances
or amenities not being used, housekeeping items
and equipment that have been left behind and
towels, face washers and bath mats that are now
dirty and need replacing.
 _____8.It is vital to understand that if you have made a H. Portable beds and cots
promise to pick something up at an appointed time,
the guest is expecting you to arrive at that time.
_____9.In other cases , where the request falls outside you I. Elderly people
ability to fulfil it, the appropriate person must be
notified and the request passed on important
points when doing.
____10.To make a room appealing to a guest is the task of J. Guest rooms
which has to ensure the basic human needs of
comfort and security. Thus the personal effort the
housekeeping department makes in giving a guest
a desirable room has a direct bearing on the guests
experience in a hotel.

III. ENUMERATION/FILL IN THE BLANKS. Enumerate the given items.

(1-5) Forms of training
(6-8) Things to Improve the service provided, management must plan form of
improvement each staff member’s
(9-11) Housekeeping needs to purchase
 ANSWER SHEET

Name: _________________________ Score: ___________________

I. IDENTIFICATION II. MATCHING TYPE III. ENUMERATION

1. 1. 1.

2. 2. 2.

3. 3. 3.

4. 4. 4.

5. 5. 5.

6. 6. 6.

7. 7. 7.

8. 8. 8.

9. 9. 9.

10. 10. 10.

11.
 ANSWER KEY

I. IDENTIFICATION II. MATCHING III. ENUMERATION

TYPE
1. HOUSEKEEPING 1. J 1. Workshops
2. Training sessions
3. Qualifications and courses
2. HOUSEKEEPER 2. I 4. Buddy system
5. Mentoring programs

3. Additional equipment in their 3. H

room
6. Knowledge
4. G
4. Extra bathroom guest supplies 7. Skills
8. Attitudes
5. F
5. Servicing of room

6. E
6. Lost and Found

7. Handling Complaints
8.Handling Guest Requests
Promptly
9. Use Guest Name Where
Possible
10. The Basis for Providing
Excellent Levels of
Customer Service in
Housekeeping
7. D 9. Equipment – housekeeping
cleaning equipment
including vacuum cleaners,
8. C waxing machines, trolleys
10. Clothing – uniforms and
protective clothing
9. B
11. Chemicals – including all
cleaning products and
10. A items used to clean
including cloths, rags,
mops
 INSTITUTIONAL ASSESSMENT RESULTS SUMMARY
Trainee’s Name: JOEL A. MARZAN
Trainer’s Name:
Title of Qualification / Cluster of PROVIDE HOUSEKEEPING SERVICES TO GUEST
Units of Competency

Training Center:
LOLOMBOY NATIONAL HIGH SCHOOL Date:

The performance of the candidate in the following unit(s) of competency and corresponding
methods
Satisfactory Not Satisfactory
Unit of Competency Assessment Methods

A. Demonstration/Observation with Oral

PROVIDE HOUSEKEEPING Questioning
SERVICES TO GUEST B. Written Test
C. Oral Questioning

Note: Satisfactory Performance shall only be given to candidate who demonstrated successfully all the competencies identified in the
above-named Qualification/Cluster of Units of Competency

Recommendation:  For issuance of NC/COC

(Indicate title of COC, if full
 For submission of
additional documents
 For re-assessment (pls. specify)

Qualification is not met) Specify: _______________

______________________
Did the candidate overall performance meet the required evidences/standards?
 YES  NO
OVERALL EVALUATION
 Competent  Not Yet Competent

Trainee’s signature Date:

Trainer’s signature Date:

Training Center Manager Signature Date:

TRAINEE’S COPY (Please present this form when you claim your IC/COC)

INSTITUTIONAL ASSESSMENT RESULTS SUMMARY

Name of Trainee JOEL A. MARZAN Date:

Name of Training Center

LOLOMBOY NATIONAL HIGH SCHOOL Date:

Assessment Results
 Competent  Not Yet Competent

Recommendation:  For issuance of NC/COC

(Indicate title of COC, if full
 For submission of
additional documents
 For re-assessment (pls. specify)

Qualification is not met) Specify:

Trained by: __________________________________ Attested by: ___________________________________

Name and Signature Name and Signature

Date: Date: