Page 61 - Confined Space Training - Student Manual 2021
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Appendix B – Skills Assessment Checklist
PEER REVIEW PERFORMED BY: ____________________________ DATE: _____________
TEAM MEMBERS’ NAMES:
____________________________________________________________
____________________________________________________________
ASSESSOR NOTES: 1 POINT FOR EACH SKILL OBSERVED SAFETY
Skill Block #1: Proper Use of an Entry Permit
☐ ___________ How to Fill Out a Confined Space Entry Permit
☐ ___________ Hazard Assessment
☐ ___________ Atmospheric Monitoring
☐ ___________ Pre-Entry Preparation
☐ ___________ Hot Work
☐ ___________ Lock Out / Tag Out
☐ ___________ Ventilation
☐ ___________ Employee Notifications
☐ ___________ Pre-Entry Work Crew Briefing
SAFE WORK PRACTICE SCORE: ____________
Skill Block #2: Fall Protection/Harness Inspection and Wear
☐ ___________ Initial Harness Inspection
☐ ___________ Donning and Fitting Harness
☐ ___________ Post Entry Harness Inspection
☐ ___________ Fall Arrest Line/Equipment Inspection and Test
SAFE WORK PRACTICE SCORE: ____________
Skill Block #3: Personal Protective Equipment
☐ ___________ Respiratory Protection
☐ ___________ Protective Clothing
☐ ___________ Ear/Eye/Hand Protection
☐ ___________ Head Protection
SAFE WORK PRACTICE SCORE: ____________
Confined Space Training for Entrants, Attendants & Supervisors 61
