ASSESSOR RECORD TEMPLATES
TABLE OF CONTENTS
Pre-Assessment Discussion Checklist
Evidence/Assessment Plan
Evidence Checklist
Record Sheet
Assessor Checklist for Assessment Process
Assessment Review
Assessment Appeal Form
Learner Evaluation
Learner Registration Details
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Pre-Assessment Discussion Checklist
Date
Learner
signature
Evidence
Facilitator/
Assessor
signature
1. Learner has been registered before (date:……………).
2. Previous assessment was conducted
(date:…………..).
3. The purpose of the pre-assessment discussion was
explained.
4. Special needs (for example disability, language etc) or
requirements for the learner in respect of the
assessment were considered.
5. The key elements and background of the NQF was
explained to the learner.
6. The purpose and process of the assessment was
explained.
7. The learner’s roles, responsibilities and the Evidence
Facilitator/Assessors roles and responsibilities were
discussed.
8. The content of the unit standard and the assessment
guide were discussed and handed to the learner.
9. The evidence that is required as proof of competence
in terms of the assessment guide was discussed and
explained (VACS).
10. Prior learning or previous assessments were taken
into account, which may be used as part of the
Portfolio of Evidence.
11. The learner understands the re-assessment and
appeals policy and procedure.
12. The following policies were discussed: The Evidence
Facilitator, Assessor and Moderation Policy.
13. The evidence/assessment plan was discussed,
completed and signed off.
14. Agreement was reached when feedback and results of
the assessment would be given as per the plan.
15. The learner understands the confidentiality of the
assessment process, records and results.
16. An opportunity was given to the learner to take part in
the pre-assessment meeting.
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Additional comments for Evidence Facilitator/Assessor:
I …………………………………….. hereby declare that the above was communicated
to me and that I do understand the contents of everything discussed with me.
Learner Signature: ______________________________ Date: _________________
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Evidence/Assessment Plan
Date:
Unit standard Number:
Unit standard Title:
Specific
Outcome
____________
____________
___________________________________________________________________
Assessment Activities (Optional)
Ob – Observation
Learner Name:
Or – Oral (questioning)
Assessment
methods
Ob E
Or
Venue
_________________________________
Evidence Facilitator/Assessor Signature: _________________________________
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Feedback date
E – Evaluation (written)
_____________________________________ Learner Signature:
Evidence Facilitator/Assessor Name:
Assessment
Date and
Time
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_____________________
Evidence Checklist
Unit standard Number:
Unit standard Title:
____________
___________________________________________________________________
Evidence Facilitator/Assessor
Name and Surname
Registration number – Assessor
Employee number
Learner
Name and Surname
Registration number
Employee number
Place of assessment(s)
Date of assessment(s)
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Specific
outcome
Assessment Criteria
Assessment
Methods
Results of assessment
C
NYC
NA
Date
E = Evaluation (Written)
Ob = Observation
Or = Oral (Questioning)
C = Competent
NYC = Not yet competent NA = Not assessed
We, the undersigned, declare that this assessment activity has been conducted in a fair, valid and reliable manner.
Learner Signature: _____________________
Evidence Facilitator/Assessor Name:
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Comments
Record Sheet
Evidence
Name and Surname:
Registration number:
Employee number:
Name and Surname
Registration number
Employee number:
Facilitator/Assessor:
Learner:
Specific Outcomes and Assessment Criteria:
Competence
demonstrated:

Specific Outcome 1:
1
Assessment Criteria
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Assessment Method
used:
Date
Specific Outcomes and Assessment Criteria:
Competence
demonstrated:

Assessment Method used:
Date
Competence
demonstrated:

Assessment Method used:
Date
Specific Outcome 2
2
Assessment Criteria
2.1
2.2
2.3
2.4
2.5
2.6
2.7
Specific Outcomes and Assessment Criteria:
Specific Outcome 3
3
Assessment Criteria
3.1
3.2
3.3
3.4
3.5
3.6
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Specific Outcomes and Assessment Criteria:
Competence
demonstrated:

Assessment Method used:
Date
Specific Outcome 6
6
Assessment Criteria
6.1
6.2
6.3
We, the undersigned, declare that:


The learner has demonstrated competence against the unit standard _________________________
This record is authentic and that the assessment has been done in a fair, valid and reliable manner.
Learner
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Evidence Facilitator/Assessor
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Assessor Checklist for Assessment Process
Step 1
Step 2
Plan for Assessment
Obtain a unit standard applicable to the job that needs to be
assessed.
Ensure you are clear on the contents of the unit standard before
entering into a discussion.
Produce an Agenda with the topics to be discussed with the
learner.
Obtain copies of the roles of the Assessor and the learner.
Obtain copies of the Assessment Policy.
Obtain copies of the letter of agreement to be signed by relevant
parties to be assessed.
Obtain copies of the Appeals procedure to be discussed.
Obtain the documentation of the assessment plan.
Obtain an Assessment Guide with Assessor Guidelines.
Prepare learner for Assessment
Explain the assessment details to the learner covering the
following:
 Enter into the pre-assessment meeting with the learner by
welcoming the learner and put the learner at ease before the
discussion commences.
 Distribute the prepared agenda and only cover the topics
briefly listed so the learner will have an idea on the process
that will follow.
 Discuss the purpose of the assessment process and cover
the key elements and implications of outcomes-based
assessment.
Discuss purpose of the assessment:
 It will be a transparent process as it is a requirement laid
down by SAQA.
 Explain to the learner what is expected of him/her on the
purpose of the unit standard itself.
 Explain that their job is linked to a job profile/description
therefore a unit standard will be utilised linked to the job
profile/description.
 Explain the purpose of the assessment is to determine
competent or not yet competent.
Key elements to mention of the assessment process:
 The learner must be self-determined.
 The learner must feel capable to be assessed.
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Step 2
Prepare learner for Assessment, continue

The learner must continually strive to acquire and use tools
they possess in order to learn.
 It is a strategic process, in that the learner must know the
tasks they perform.
Learners should also know:
 That the assessment is performance driven.
 That good assessment practices indicate to the learner the
assistance, experiences and forms of practice they need to
require for full competence.
 The assessment builds upon the strengths of the learner.
 That the assessment process offers advice that can be acted
upon by the learner as well as the facilitator in some
instances.
 That the assessment must integrate rather than separate
cognitive (acquiring knowledge), affective (emotional) and
conative (effort of will) factors.
Explain the implications of outcomes-based assessment:
 It places greater pressure on everyone in the assessment
process.
 More time is required to prepare all the parties, so it is a more
time consuming process.
 The learners can determine if they are ready as it is also a
self-assessment process that will prepare them for the
assessment.
 Although the learner is involved in the assessment just
remember to be clear about certain issues, e.g., which
aspects are open to input and which ones are not e.g., the
assessment methods are not negotiable.
 Learners must know that it is a costly process, therefore they
must not waste the time of assessors, as well as other
resources involved in the process.
 Explain who the parties will be in the process as well as the
responsibilities of each party.
 Distribute and discuss the unit standard highlighting the
following:
 The specific outcomes a learner must achieve.
 The essential knowledge, embedded in the outcomes, that
the learner must know.
 The critical outcomes the learner must develop during the
learning process.
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Step 2
Step 3
Prepare learner for Assessment, continue
 The assessment criteria against which the outcomes
and the knowledge must be assessed.
 On being successfully assessed against a unit standard,
the learner is declared competent in that skill.
 Allow the learner to ask questions on the unit standard.
 Explain the co.’s appeals process.
 Discuss the assessment plan and allow interaction from the
learner’s side and modify the plan where applicable.
 Obtain signatures of acknowledgement that the discussion
did take place before the assessment is conducted.
 Conduct regular checks to ensure readiness of the learner
before the assessment takes place, by asking open-ended
questions, observation, prompt the learner to uncover
competence, check quality of evidence gathered so far,
check to see if evidence is in line with the outcome.
Conduct the assessment and document evidence
Check out the environment to ensure it is conducive to
assessment practices. Issues to look out for:
 work-site safety,
 environmental safety,
 legislation issues applicable to the environment.
Carry out all logistical issues before the assessment. Issues to
cover is:
 time availability,
 resources available,
 cost involved (on-site, off-site).
Conduct the assessment as per the assessment plan either
through:
 observation,
 oral (questioning),
 written (evaluation).
Ensure that you make allowances for contingencies beyond the
learners control e.g.
 unforeseen events,
 breakdowns,
 changed circumstances.
Ensure questioning techniques are appropriate and does not
lead the learner i.e. open-ended questions, avoid ambiguous
questions, no leading questions, use follow-up questions, etc.
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Step 3
Step 4
Step 5
Step 6
Conduct the assessment and document evidence, continue
Gather sufficient evidence as per the assessment plan to
ensure the rules of evidence can be applied (VACS) to be able
to make judgements on what was gathered during the
assessment process.
Evaluate the evidence and make judgements
Evaluate the evidence in terms of:
 the outcomes,
 the assessment criteria.
Evaluate the evidence in terms of the methods and
instruments/tools used.
Use the VACS analyses in the evaluation process.
Keep in mind the quality and sufficiency of the evidence.
Provide feedback to relevant parties
Provide feedback keeping in mind:
 confidentiality,
 sequence of activities,
 agreed time frames.
Ensure the feedback is according to the feedback principles of
being constructive, culturally sensitive and specific and provide
sufficient information to the learner. This will also include:
 awarding the credits,
 re-directing for learning or re-assessment.
Apply the sandwich approach (positive – negative – positive).
Other important issues to remember:
 give direct feedback,
 follow-up,
 use the participative approach.
Obtain feedback from the learner on the process by:
 providing clarification
 providing explanations
Deal with appeals as per the Appeals policy.
Review assessment
Review the good and bad practices in the assessment and
design, so that it can be modified where applicable.
Use feedback obtained from the learner and other assessors to
modify the design and process.
Identify the weaknesses that could have compromised the
fairness of the assessment process.
Identify weaknesses that were caused due to the poor quality of
the unit standard and bring to the attention of moderators.
Note: Use the Assessment Review document provided to
conduct the SWOT analysis.
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Assessment Review
Strengths
1.

The unit standard was fit for purpose.
The unit standard addressed the following:
 Specific outcomes
 Assessment criteria
 The job/function being assessed.
2.
The assessment guide covered all the aspects to achieve the purpose of
the assessment.
3.
The right assessment methods were used.
4.
The right assessment instruments/tools were used.
5.
The unit standard was written in a language understood by all parties (clear
and concise).
6.
The unit standard was aimed at the correct level.
7.
The unit standard allowed for the rules of evidence (VACS) to be applied.
Specify any other strengths:
8.
List good practices that were identified during the assessment process:
Weaknesses
1.
The unit standard was not fit for purpose. Explain why:
2.
The unit standard did not address the following:

The correct outcomes for the job being assessed. Explain:
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Weaknesses, continue

The correct assessment criteria/all the relevant criteria for the job being
assessed. Explain:
3.
Gaps were identified in the assessment guide. Clarify:
4.
The correct assessment methods were not used in some or all of the
outcomes being assessed. Explain:
5.
The correct assessment instruments/tools were not used in some or all of
the criteria being assessed. Explain:
6.
Language and terminology were too complex or not very clear in some
cases. Explain:
7.
The unit standard was not aimed at the correct level of learner being
assessed. Explain:
8.
The unit standard did not allow for the rules of evidence (VACS) to be
applied in all situations. Explain:
9.
Special needs were not addressed in all or some of the aspects covered
during the assessment. Explain:
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Weaknesses, continue
10. List bad practices that were identified during the assessment process.
Opportunities
List any opportunities or improvements that can assist to make the assessment
process ran smoother, save time, cut cost or add value for all parties that forms
part of the process.
Threats
Rand
value
Look at the cost of the assessment.
Down time of the learner per hour (average salary per hour).
Down time of the assessor per hour (average salary per hour).
Cost of the venue if applicable.
Cost of the equipment if applicable.
Down time of any other parties that formed part of the assessment (average
salary per hour).
Any other cost that formed part of the assessment.
Total Cost of the assessment
Note: All the aspect must be discussed and put forward for re-design purposes of the
assessment to the SDF and Moderation Committee.
Evidence Facilitator/Assessor name: ____________________________________
Signature:________________________________________ Date:______________
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Assessment Appeal Form
Role Players
Name & Surname
Employee number
Learner:
Evidence Facilitator:
Assessor:
Internal Moderator:
External Moderator:
A. Background Information on the Unit Standard(s) or Qualification appealing against
Unit Standard(s) Title
Unit Standard(s) no.
Qualification
Date of Appeal (Within
___ days of outcome)
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Registration number if applicable
B. Choose the relevant block
Learner appeals against Evidence Facilitator
decision
Evidence Facilitator appeals against Assessor decision
Learner appeals against Assessor decision
Assessor appeals against Moderator decision
Internal Moderator appeals against External
Moderator’s decision
C. State the reason(s) for the Appeal i.e. unfair, special conditions not considered, etc
D. Responsible person receiving the Appeal
Date
Assessor Name:
Assessor Signature:
Internal Moderator Name:
Internal Moderator Signature:
External Moderator Name:
External Moderator Signature:
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E. Status of Appeal Application
Grant appeal
Do not grant appeal
Reason(s) for not granting the appeal:
F. Appeal granted
Stage 1 – Assessor’s response (within ______ days; company specific)
Party accepts/do not accept Assessor’s outcome
Signature:
Date:
Stage 2 – Internal Moderator’s response (within ______ days; company specific)
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Party accepts/do not accept Internal Moderator’s outcome
Signature:
Date:
Stage 3 – External Moderator’s response (within ______ days; company specific)
Party accepts/do not accept External Moderator’s outcome
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Signature:
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Date:
Learner Evaluation
Please answer the questions below:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Question
How was your assessor’s manner
encouraging and designed to put you at
ease?
How was the assessment procedure
explained and agreed with you?
Was the assessment procedure clear
and understandable?
How were you encouraged to
participate and be involved?
Did your assessor ensure that all
specific outcomes and criteria were
covered?
Did your Evidence Facilitator/Assessor
stick to the Evidence/Assessment plan?
How were you given clear, evaluative
feedback against each specific
outcome?
How were all pieces of evidence
considered?
In what manner were assessment
decisions communicated to you?
Did you agree with the decisions?
If you do not agree with the decision,
are you going to appeal and on what
grounds?
Were the feedback conducted in
confidentiality and only thereafter
discussed with relevant parties?
Was all appropriate documentation
completed, signed and copies given to
you for records?
Comments
Learner Name:___________________ Learner Signature:______________________
Evidence Facilitator/Assessor Name:____________________________________
Evidence Facilitator/Assessor Signature: _________________________________
Note: Return to Moderator _____________________________(name)
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Learner registration form
Name of employer organisation: …………………………………………………….
Name of business unit if relevant: …………………………………………………..
Fieldname
Title
First Name
Middle Name
Surname
Initials
ID No
Alternate ID No
Alternate ID Type ID
Date Of Birth
Gender
Equity
Nationality
Home Language
Citizen Resident Status
Disability Status
Geographical Area
Phone No Business
Fax No
Email
Communication Method
Assessor record templates
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Options
(Mr, Ms, Miss, Dr)
Type
(National ID)
(Passport, Drivers
License)
(dd/mm/yyyy)
(Male, Female)
(Black African, Black
Coloured, Black Indian,
White)
(South Africa, Other)
(English, Pedi, Zulu,
Xhosa, Afrikaans, Sotho)
South African, NonResidential
Sight Impaired,
Physically Impaired,
Speech Impaired,
Hearing Impaired
Eastern Cape, Free
State, Gauteng, Kwazulu
Natal, Mpumalanga,
Northern Cape, Northern
Province, North-West
Province, Western Cape
Work Phone, Post, Home
Phone, Email
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Address Type
Address Line1
Address Line2
Address City
Address Postal Code
List of banking unit standards and/or qualifications or the related field(s) or sub-field(s)
achieved:
No.
Level
Credits
Assessor record templates
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Title
Assessor
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Date
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