IQA Form – Appointed Person

Type of IQA

Formative

Summative

Date of IQA

Candidate First Name

Candidate Last Name

Start Date

End Date

Candidate 2 First Name

Candidate 2 Last Name

Candidate 2 – Start Date

End Date

Candidate 3 First Name

Candidate 3 Last Name

Candidate 3 – Start Date

End Date

Assessor First Name

Assessor Last Name

IQA First Name

IQA Last Name

Qualification

Mandatory Units

Registration Form Checks

	Yes	No
Does the candidate picture match with the supplied ID?
Is the form Signed?
Does the signature on the ID closely match the signature on the form?
Was English ability confirmed by the assessor/inductor?
Can you confirm No reasonable adjustment requirements were identified?

Candidate Careers and Qualifications

	Yes	No
Was the form signed?

Evidence – is all the below evidence present and VASCR?

	Yes	No
Operational Progression
Notice Board (Photographs)
Lift Plans x 3
Risk assessment(s) x3
Method Statement(s) x 3
Pre-start checks
Induction Records x 2
Machine LOLER certs x 2
Lifting Accessories LOLER Certs x 4
Toolbox Talks x 2
Permit
Job records / Time sheets
Lifting Team Qualifications
PPE Issue Log
First Aid Checklist
Emergency Procedure from Health and Safety Plan
Welfare Facilities
Equipment storage areas
Site Security
Accident Book
Fire extinguisher inspection date label
Order from client
Duty Chart
Traffic Management Plan

Witness Testimony

	Yes	No
Has the witness completed their details?
Has the witness signed the statement?

Candidate Feedback

	Yes	No
Is the feedback positive?

Overall Feedback

Actions

Development Points

Are certification claims valid?

Yes

IQA Signature

Sign Here

	Yes	No
Was the assessor clearly identified?
Was the candidate clearly identified?
Was the qualification clearly identified?
Was the date clearly identified?