IQA Form – Site Supervisor (Highways)

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?

Evidence – is all the below evidence present and VASCR?

	Yes	No	N/A
Health and Safety Plan
Site Health and Safety (Photographs)
Risk assessments
Toolbox talks
Strutural Drawings
Training Course Research
Training Matrix for Team
Training Certificates
Method statements
Site diary
Site Meetings
Progress Meeting
Site Layout
Site programme of works
Site induction
Request for materials
Material received information
Site instructions /Daily Briefs
Plant requisition sheets
List of equipment on site
Plant return sheets
Health and Safety Checks
Accident reporting
Organisational plan
Contractors remedial sheets
Material testing
Records of waste management
Work Remial order + Variation order
Pre-use Checks
Traffic Management plan
Work Permits
Handover
Harness/Lanyard check or other ppe check
Winter Maintenance plans and schedules
contractors remedial sheets

Observation Report

	Yes	No
Is the candidate and course clearly identified?
Has the location of the observation been identified?
Did the assessor cover all the required areas?
Is Picture evidence included?
Are descriptions with the pictures?
Has the Assessor signed the report?

Professional Discussion

	Yes	No
Is the assessor clearly identified?
Is the candidate clearly identified?
Is qualification clearly identified?
Is the date clearly identified?
Are all questions and any rework marked and satisfactory?
Has the candidate signed?
Has the assessor signed?

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