BSBWHS416 Contribute to Workplace Incident Response Assessment Brief 2026

BSBWHS416 Assessment Brief

Section 1 – Theory Questions
Section 2 – Practical Assignment
Summary Sheet

Assessment Requirements

The assessment activities in this Assessment Task Portfolio assess all the elements, performance criteria, skills and knowledge of the unit of competency BSBWHS416 Assist with responding to incidents.

To demonstrate competency in this unit, you must undertake all tasks in this Assessment Task Portfolio and complete them satisfactorily, as well as successfully complete your work placement. If you do not answer some questions or perform some tasks, you will be deemed ‘Not Competent’, and your trainer/assessor may ask you supplementary questions to determine your competence. In addition to completing all tasks satisfactorily, you will also be required to demonstrate satisfactory communication skills during some practical activities. Once you have demonstrated successful completion and consistency in performance, you will be awarded this unit.

Should you still be deemed Not Yet Competent, you will have the opportunity to undertake a supplementary assessment or appeal the result.

As part of the assessment process, all students must abide by any relevant assessment policies as provided during induction.

If you feel you are not yet ready to be assessed or that this assessment is unfair, please contact your assessor to discuss your options.

Certificate IV in Workplace Health and Safety BSB41419
Email: certivwhs@ohsa.com.au or info@ohsa.com.au
Phone: 1300 647 200

Candidate Information

Section 1 – Theory Questions

Instructions to the Student

Please read all the information given to you before you start any assessment task. If you do not understand some or all of the questions, please ask your trainer/assessor for assistance. If you are uncomfortable with any of these questions, please contact your assessor, who will make alternative
arrangements. Attempt to answer ALL questions in your own words on the assessment paper provided.

The questions are designed to assess your understanding of the unit as well as your underpinning
knowledge.

To satisfactorily complete this assessment task, you are required to complete the whole assessment. To do this, you will need to answer all questions correctly and demonstrate you have achieved the required knowledge to industry standards. This assessment is intended to be equitable, fair and flexible. If you feel that we should change any aspect of this assessment to be fair, equitable or flexible, immediately contact your assessor, who will attempt to make alternative arrangements.

1. This assessment may be reassessed. If you need more than two attempts, the RTO may charge a reassessment fee and recommend additional training. 2. Upon notification of your assessment results, your trainer/assessor can provide you with additional information on interpreting the assessment outcomes and guide you on your future options.

Question 1.

Explain, in approx. 10 words, the term ‘Root Cause/s’.

Question 2.

Explain, in 15-20 words, the term ‘Root Cause Analysis’.

Question 3.

Communicate/list the four (4) basic stages of the process of responding to incidents.

Question 4.

Give an example of an incident that may be a category A, B or C incident.

Question 5.

Briefly (in approx. 20 words) explain what the Common-Law Duty of Care is.

Question 6.

What is the legislative provision for a serious injury or illness, and list at least three examples.

Serious Injury or Illness legislative provision:

List three (3) examples:

Question 7.

What is the legislative provision of a Dangerous Incident, and list three (3) examples?

Legislative provision of a dangerous incident:

List three (3) examples of a dangerous incident

Question 8.

When may an incident site be disturbed? List at least four (4) points.

Question 9.

Explain what the ‘Swiss Cheese’ model is in 1-2 paragraphs.

Question 10.

List five (5) issues an Incident Response Policy might include.

Question 11.

What briefing might you need to provide to a WHS Inspector about an incident at your workplace? Your answer should be approximately 20 words in length.

Question 12.

List four (4) processes/topics/etc that would be relevant in incident response planning, actual response and reporting to external authorities.

Question 13.

List three (3) internal workplace persons/groups/duty holders that should be notified of a WHS incident at your workplace, and what initial information should they be provided with? Ensure that your manager is one of the people listed.

Question 14.

List five (5) powers of a WHS Inspector when investigating WHS incidents.

Question 15.

List five (5) investigation techniques that could be applied when establishing what causes an incident.

Question 16.

List three (3) things you should consider when collecting evidence at the scene of a WHS Incident.

Question 17.

What is a timeline of actions and events, and how could it be helpful in a WHS investigation?

Question 18.

When conducting an incident investigation, how would you obtain or request access to the following internal documents/information? An example has been provided.

Question 19.

Why should a WHS investigator be aware of the principles of ethical considerations and investigator bias? Explain in 2-3 paragraphs.

Question 20.

Name three (3) sources of external information that may be relevant in investigations, and how you would obtain them. An example has been provided; please list another three.

Question 21.

What must a WHS advisor consider when forming recommendations from a WHS incident investigation? Your answer should be approximately 20 words in length.

Question 22.

Explain in approximately 20 words why the hierarchy of hazard control is important to consider in incident investigation reports.

Question 23.

How should incident records/reports be stored?

Question 24.

What policy could be used to outline how incident documentation should be stored? (i.e. List a policy that would include this information)

Question 25.

Match the incident response to the most appropriate duty holders: Number the right-hand column to match the number provided on the left column. One has been completed as an example.

Question 26.

What initial treatment may you be required to provide to those involved in a workplace incident? Your response should be 15-25 words in length.

Question 27.

What communication strategy or methods would you use to facilitate the engagement of/communicate with people during an incident response?

Question 28.

When reviewing incident response and looking toward continual improvements, which of the following actions may be beneficial?

A. Updating incident investigation and emergency response policies
B. Updating the training needs analysis documents for job roles
C. Implementing changes to processes
D. All of the above

End of theory

Section 2 – Practical Activity

The requirement for this unit is to contribute to a response for at least two different incidents. The practical component of this unit will involve two different case studies.

This assessment requires you to complete the following activities.

If you are uncomfortable with any aspect of the assigned tasks, please contact your assessor, who will try to make alternative arrangements. This assessment is intended to be equitable, fair and just. If you feel that we should change any aspect of this assessment to be fair, equitable or just, immediately contact your assessor, who will attempt to make alternative arrangements.

Additional context of the Assessment: (As part of this assessment, your assessor will provide you with additional instructions, subject to the available project.)

Assessment requirements will consist of the following tasks.

• Task 1 – Respond to a simulated incident and provide initial assistance to those involved.
• Task 2 – Participate in an investigation response for the Fred’s injured leg case study. (This does relate to the Seedies Furniture business.)
• Task 3 – Prepare a brief request for approval memo to the PCBU to implement changes based on the outcomes of the investigation. This will include an outline of an incident response policy.
• Task 4 – Create a short one-page information sheet reminding workers of responsibilities.
• Task 5 – Participate in an investigation response for the vehicle rollover case study. (This does not relate to the Seedies Furniture Case Study.)

Task 1:

In small groups of two or three, please respond to the following scenario. Rotate to ensure all have a chance to respond.

You have just been called to assist in responding to Fred, who has suffered some type of injury. The patient (Fred) has a suspected broken leg and can’t stand and is looking and sounding confused. Role-play what you would do to assist the patient.

Plan your response below.

Outline a message you would communicate to the parties involved to ensure WHS requirements are met. (E.g. To align with the requirements to preserve the scene)

As you don’t know the exact seriousness of the injury as yet, what external agencies would you need to contact for assistance or to notify of the incident? Role-play how you would contact/notify these agencies.

How would you notify your regulator of this incident? Include your state/territory’s regulator’s name and contact details.

Task 2

You are required to conduct an interview with Fred; see the incident case outline below. Upon completion of the simulated Role Play, you are to complete an Incident Report (see attached herewith)

FRED’S BROKEN LEG

Scenario:

Fred Biggs is a 50-year-old trades assistant at Seedies Furniture and works predominantly in the warehouse.

Fred was discovered outside the crib room (where the weekly Monday morning pre-start was occurring), limping and in a dazed and confused state. After initial treatment, Fred was driven to the local hospital by a worker and is currently in A&E. He was diagnosed with a Greenstick fracture (crack up the bone), which the Doctor seems somewhat confused by as this type of fracture does not really match up with the way he fell and is usually a fracture associated with young children due to their bone flexibility. Dr Holiday has issued a 6-week Not Fit for Work (no work capacity) medical certificate and stated that the injury doesn’t seem consistent with the reported cause, i.e. falling backwards.

Fred is just waiting to get a discharge from A&E so he can go home.

You get approval from the receptionist, nurse and Fred to have a chat with him about the incident. You are now conducting a brief interview with him whilst he awaits his discharge.

You are to interview Fred about the injury/incident. Fred appears to be quite tired and dishevelled.

You have the following answers from Fred.

• Date: Today
• Time: The incident happened at approximately 6:05 am
• What happened: I arrived a little late (I normally start work at 6 am) and slipped on oil, fell backward. It was just near the crib room. Did anyone see it? One of the security guys did, and by memory, there is a security camera nearby, if it is working. How did you get here this morning? On my bike, like I always do Were you drug tested at all? No, tests were done, but I’m a non-drinker and not a drug user What caused you to fall? Oil leak, I reckon. It was there a few days ago, I reported it and barricaded off the area. Maintenance cutbacks mean we never really fix this stuff, just bandaid them. The yellow-painted pathway makes it super slippery, too; they should just have the outlines painted in non-slip yellow. How did you get to the hospital? Some guy from security drove me in a blue ute, just left me here. I waited a bit for a Doctor, but have now seen Dr Holiday. What first aid was given? No specific first aid from what I recall, they just put me in the ute and took me here, but did talk to me a fair bit, asking where I was sore. I didn’t think anyone was first-aid trained. How could this have been prevented? Proper maintenance schedule and no half attempts to fix things. This is my third workplace injury in a few years.

Please note, the Seedies Injury report form was not filled in for this incident.

Incident Notification Form

Please note this has been developed to facilitate the role play, in your professional work, you will need to use the regulator’s approved form.

Based on the incident type above, who would have needed to be contacted? (Consider internal duty holders and external parties, including regulators)

Internal duty holders/ persons: List three

External stakeholders: List one

What other sources of information may be useful to obtain to assist in this investigation?

Injured Workers Name:

Describe Location of the Incident: (E.g., Warehouse, Yard, Office)

Describe the incident: What happened?

Provide a possible timeline for the incident from before, during and after the incident. (Dot point timeline will suffice)

What injuries did the worker sustain?

What immediate first aid was provided after incident?

The below sections can be filled in once the role play has finished and the group has discussed with the trainer any gaps that were not identified.

What are the contributing factors of this incident

What recommendations will be implemented following this incident to ensure it doesn’t reoccur?

Your Name:

Your Signature:

SIGN

Task 3

Based on the findings during the above activities, including contributing factors and recommendations, please provide some overall recommendations to the PCBU. This should also include the development of an incident response policy.

MEMO: Seedies Furniture

To: Seedies Furniture PCBU and Officers
From: Insert Your Name
Date: Insert Date

RE: Incident Response Recommendation

Dear PCBU and Officers of Seedies

As requested, please find a quick summary of recommendations following the incident investigation conducted after Fred’s incident.

There is a lack of understanding regarding the incident response process at Seedies, which needs to be addressed. However, in addition, please see below the recommendations from this case.

It is essential that we have an incident response policy that is implemented across Seedies. Please see the points below that I recommend being included based on legislation.

Please provide some points below as to what should be included, taking into consideration the following headings.

Seedies Furniture Duty holders’ requirements in response to incidents, including notification to external parties.

Legislative provisions for responding to incidents (This must also include notifiable incidents)

Supporting Policies and or procedures concerning incident response planning and reporting. (i.e. What other policies will be needed to be developed to ensure appropriate incident response planning, action, and reporting?)

Required personnel who may form an Emergency Response Team (ERT) and their responsibilities to respond during an incident.

Communication protocols to inform key internal stakeholders (ERT) of an incident.

Proposed training is required for those who respond to incidents.

Kind Regards,

Insert Your Name
WHS Advisor
Seedies Furniture

Task 4

The PCBU has approved the implementation of the above recommendations and additional policy.

Please provide a brief to advise workers of the changes that will be implemented and the new policy that will be implemented.

MEMO: Seedies Furniture

To: Seedies Furniture PCBU and Officers
From: Insert Your Name
Date: Insert Date

RE: New Incident Response Process

Dear All Staff and Contractors

Over the next few weeks, there will be a new direction in regard to the way Seedies responds to incidents. This will impact what you will need to do if you are injured at work, see something unsafe, or how you may be involved in responding to incidents.

Please see the proposed changes below. Please liaise with your workgroup HSR to provide any feedback.

Insert a few dot points of changes that are planned. The requirement to fill in the injury report, etc.

In addition, Seedies is creating an Emergency Response Team that will be required to assist with incidents in future. If you wish to be involved, please liaise with your HSRs, who will also form part of the response team. The HSRs will also be leading the implementation of the above changes.

The implementation of the changes will occur via a number of measures. Please outline a few points on how the change will be implemented. E.g., Training for the ERT, including first aid/ toolbox talks for new injury reports as a requirement for all injuries/reporting unsafe acts, situations, etc.

If you have any questions, please speak to your HSR or me.

Kind Regards,

Insert Your Name
WHS Advisor

Task 5 – This Task Does Not Relate To Seedies Furniture

For this task, you will be interviewing an injured worker played by the trainer. The trainer will have extra information to help them play the character.

The trainer will play the injured worker and allow the investigation questioning to continue as long as they feel necessary.

Once the trainer believes the questioning has taken its course, the role play will finish. The trainer will then provide further information on the incident that can be used to show what other questions could have been asked.

INSTRUCTIONS

Please take 5 minutes to read the following role-play and consider some questions you could ask the worker. Consider the relevant interview techniques discussed during the unit.

You will then act as a team to conduct an investigation, using the incident notification form below to guide you.

Complete the incident notification form and discuss recommendations as a class or in small groups, and determine how you would implement the recommendations.

Role Play: Light Vehicle Accident

Your Character: EASTFIELD RESOURCES Maintenance Manager – Sherlock Holmes!

Rules:

1. You are all the managers responsible for all maintenance contractors at EASTFIELD RESOURCES, 15km out of Blackwater.
2. You are part of the incident investigation team.
3. You need to determine the contributing factors and root causes of the incident and make recommendations.
4. You are conducting an interview with the injured worker, 5 days after he was released from Rockhampton hospital.
5. The injured worker has been deemed fit by his doctor to attend work and be interviewed about the incident and has been driven to work by his fiancé, who is in the foyer waiting.
6. Your team has already conducted a considerable inquiry into the incident; however, you are now meeting with the worker to try to determine the relevant facts/causes so that you can finalise your report and recommendations.
7. Although you would have already gathered much of the information about the facts of the incident prior to this interview, assume for the purposes of this activity that you only have the information detailed below.

Information you know:

Jason McQueen, a contractor, had a light vehicle accident on one of your mine service roads. The ambulance attended and took him to Rockhampton Hospital. He has now been discharged after five (5) days (so it is ten (10) days since the accident). He sustained considerable injuries. The vehicle was badly damaged.

The initial incident report that was completed after the incident is provided below; however, it doesn’t provide much information.

Internal Injury Report Form

Once you (safety advisor) have been notified of this incident, outline a message you would communicate to the parties involved to ensure the WHS notifiable incident requirements are met.

Task 5, Section B: Role Play

Participate in an investigation with the trainer. The trainer will play the injured worker. You may use the following form (Section C below) to identify the type of information you will need to determine. You may use the space below to plan what questions you want to ask the injured worker, keeping in mind just culture and techniques outlined during the course.

Task 5, Section C: Complete The Following Incident Notification Form

After you have participated in a role-play with the trainer, complete the following form.

Please note, this has been developed to facilitate the role play. In your professional work, you will need to use the regulator’s approved form. Whilst this incident occurred on a mine site and would be covered under different legislation, please use the following generic WHS Act 2011 for your responses.

Based on the incident type above, who would have needed to be contacted?

What other sources of information may be useful to obtain to assist in this investigation?

What is the form that the PCBU would need to fill in to report to WHSQ as per a notifiable incident?

Please provide the web address to find this form which will be used by the PCBU to notify the regulator.

www.

Injured Workers Name:

Describe the Location of the Incident: (E.g. Warehouse, Yard, Office)

Describe the incident: What happened?

Provide a possible timeline for the incident from before, during, and after the incident. (Dot point timeline will suffice)

What injuries did the worker sustain?

What immediate first aid was provided after the incident?

The below sections can be filled in once the role-play has finished and the group has discussed with the trainer any gaps that were not identified.

What are the contributing factors of this incident?

What recommendations will be implemented following this incident to ensure it doesn’t reoccur?

Your Name

Your Signature:

SIGN

Task 5, Section D: Implementation Strategy

Develop an implementation strategy for the recommendations. This may be provided in a table or other similar format showing the items to be implemented, the responsible person, resources and timeframe. At least four actions will need to be listed.

You may use the format below or another of your choosing.

Marking Criteria – Part A

Marking Criteria – Part B

Marking Criteria – Part C

Competency Summary Record Sheet