Workplace supervisor ACM20117

Workplace Supervisor and Facility Checklist

ACM20121 Certificate II in Animal Care

To successfully complete the practical component of this course students need to undertake weekly work placement. This is a minimum of 140 hours work placement in an appropriate workplace under the supervision of qualified and experienced supervisor.

This form provides TAFE specific information about the resources, facilities and supervisor at the proposed workplace. We may seek further clarification from you before approving the work placement and the student's enrolment.

Some units in the course require students to demonstrate skills with several different types of animals. If the workplace only has one species or does not cover all the tasks in the unit, the student may be required to do further work placement at another facility. They will need to take video of themselves in the workplace completing a range of animal care tasks for their practical assessments.

You can download the Host workplace and supervisor guide here which will give you more information about hosting a student.

SECTION A: Student and Workplace Details

Student Firstname

Student Lastname

Student Email

Workplace Name

Workplace address

Brief description of the workplace

If the student is currently employed at this workplace:

How long has the student been employed? Years / Months

What is the student's current position title?

How many hours does the student work each week?

SECTION B: Supervisor Details

Supervisor Firstname:

Supervisor Lastname:

Position Title:

How long have you been in this position?

Phone Number:

Email:

Best days/time to contact:

Supervisor and Facility Requirements

Qualifications - You should hold a Certificate II in Animal Studies or higher, or have at least 5 years experience in the industry at a supervisor level.

Provide details of your qualification(s), year and where it was gained:

Experience - Minimum of two years' experience in the animal care industry with a qualification or at least 5 years at supervisor level without a qualification.

Provide details of your work experience:

Desirable: Experience as a workplace supervisor.

Have you been a workplace supervisor before?

Animal Welfare: TAFE NSW is governed by specific legislation and regulations regarding use of animals in learning. Does your facility adhere to current Animal Welfare and Ethics legislation and acts including, but not limited to below;

Animal Research Act 1985 (NSW)

Australian code for the care and use of animals for scientific purposes

Companion Animals Act 1998 (NSW)

Prevention of Cruelty to Animals Act 1979

Yes this facility complies with all animal welfare and ethics requirements
No

SECTION C: Workplace Resources Checklist

This section outlines the specific facility, equipment and resource requirements the student needs access to in the workplace to successfully complete their practical assessment tasks.

Will the student have access to the following resources in the workplace?

**SECTION C: Workplace Resources Checklist**
This section outlines the specific facility, equipment and resource requirements the student needs access to in the workplace to successfully complete their practical assessment tasks.
Will the student have access to the following resources in the workplace?
Office/Reception
	Yes	No
Receptions office equipment and resources	Yes	No
Instructions for use of equipment and manufacturer’s instructions	Yes	No
Stock control system	Yes	No
Record keeping systems for clients and animals including payments	Yes	No
	Yes	No
Policies and procedures
Waste management and environmental sustainability procedures	Yes	No
Workplace health and safety guidelines including: Manual handling, Infection control procedures, Security procedures, Emergency response and fire safety procedures, Safety Data Sheets, Incident reporting procedure	Yes	No
Duty statements and/or job descriptions & reporting structure	Yes	No
Standard Operating Procedures (SOPs) or written instructions	Yes	No
	Yes	No
Documents specific to the work context including: Organisational policies and procedures concerning care and handling of animals, Animal welfare policy for the facility, Policies and procedures relating to animals which are sick or injured, Acces to Veterinary Practitioners Act (if applicable), Wildlife regulations (if applicable),	Yes	No
Other resources
Personal protective equipment	Yes	No
A range of animal species	Yes	No
Cages and other animal housing for a range of species	Yes	No
	Yes	No
Equipment and resources for providing environmental enrichment, cleaning and disinfecting cages and kennels, care of animals including feeding, weighing and grooming, capture and restraint of animals, providing health care for animals, suspected Infectious Disease Control,	Yes	No
Feedstuffs appropriate for the species including supplements	Yes	No
Sources of information relevant to animal care needs	Yes	No

SECTION D: Permission to collect documentation, film videos and/or record audio and/or take photos in the workplace

As part of the assessment evidence for the Certificate II in Animal Care, the student is required to collect documentation, and/or film videos, and/or record audio, and/or take photos during work placement. These materials are required for the assessments. The student is also required to complete a Work placement logbook.
These materials could involve the student, staff members of the workplace, clients, clients’ animals, and other relevant people involved in the activities of the workplace.

Evidence gathered will include:

written documentation
photographs
videos
audio recordings
work samples including policies/procedures, forms, checklists etc used within the workplace.

In some cases a TAFE NSW assessor may be available to come to the workplace and directly observe the student's practical skills.
Please note:
These materials will only be used for the purposes of assessment in the Certificate II in Animal Care at TAFE NSW.
The student is required to maintain confidentiality of the workplace and client details as provided in Student Code of Conduct. The student will retain these materials for study purposes only.
TAFE NSW will retain these materials for audit purposes only.

I give permission for the student named on this form to gather workplace evidence for the purpose of assessment
Please contact me to discuss this requirement

SECTION E: WHS risk assessment

**SECTION E: WHS risk assessment**
Work health and safety management
	Yes	No
Does your workplace have a work health and safety management processes in place to satisfy its duty to ensure the health and safety of workers and other persons at your workplace?	Yes	No
Is an emergency plan in place and are staff advised of what to do in an emergency such as evacuation?	Yes	No
Induction and training
Will the student be given a WHS induction on commencement in the workplace? The induction should include: Emergency Response Plan First Aid procedures for the workplace Identified Hazards and controls Universal Precautions: Psychological, e.g. violent or abusive clients, challenging behaviour, security, personal safety Welfare, e.g. amenities, toilets, wash areas Manual Handling EEO & Anti-Discrimination	Yes	No

Please list risks to the student:

Please list risks to the student:
	Risk level			How will these be controlled?


	Low	Medium	High	if Medium or High
Manual handling
Exposure to sun
Chemical exposure
Use of particular tools or equipment
Other:
Other:

Please list any tasks/activities the student is not to undertake, such as no-go areas, machinery or equipment that is too dangerous for new or young workers to operate:

WHS risks have been assessed and managed in conformity with the Work Health and Safety Act 2011 (NSW)

I confirm that the activities the student will undertake are suitable for the student

I confirm that the information provided on this form is correct.

Date: 20 May 2025

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