New Jersey Department of Health

Hands-on Assessment

Lead INSPECTOR / RISK ASSESSOR

Student Name

Date

For the hands-on assessment of the training course, instructors shall rate student performance on a scale of 1-5 (5 being the best). During the hands-on assessment, students shall be required to demonstrate competency in the following areas. Items/procedures must be developed to test each activity. These items/procedures must be submitted to the Department for approval prior to implementation.
Item	Activity	Rating

(Check one number for each)
1	2	3	4	5
1.	Lead-based paint inspection methods	Inspection strategy
Suspect locations
Painting history
2.	Lead-based paint testing procedures	Sampling and inspection guidelines
Testing methodologies
Random testing procedures
3.	Preparation of final inspection report of test results	Interpreting test results
Components of reports
Recommendations
4	Dust and soil clearance sampling methodologies	Dust sampling methodologies
Soil sampling methodologies
5.	Visual inspection	Categorization of condition
Risk assessment of hazard
6.	Preparation of risk assessment and final inspection report	Components of report
Recommendations
Implementation schedule for report
Total Each Column:
Total Score (add total from each column):
Multiply total score by this number (round to nearest whole number):	X 1.25
Score:
Indicate pass or fail (must have at least 70% to pass):	Pass Fail

Rater (print)

Agency Number

Rater Signature	Date

EHS-42

SEP 14

EHS-42 Hands On Assessment, Lead Inspector, Risk Assessor

ewhite

2014-08-26

NJDOH