Physical Intervention Observation Assessment Record

Please indicate the physical skills are exercises you practiced today *

Yes

Demonstrate non-aggressive stance and positioning skills.

Demonstrate the use of a method for physically prompting a person.

Demonstrate the use of a non-restrictive method of escorting a person.

Demonstrate the use of a one-person low level restrictive standing hold that can be used to escort.

Demonstrate the use of a two-person low level restrictive standing hold that can be used to escort.

Demonstrate how to de-escalate and disengage during physical intervention ensuring safety for all parties.

Communicate professionally with the subject of physical intervention, while using prompting, holding and escorting techniques.

Demonstrate how to escort an individual on stairways.

Demonstrate non-aggressive skills used to evade and protect against blow.

Demonstrate non-aggressive methods of disengagement from grabs and holds.

Demonstrate non-aggressive methods to stop one person assaulting another.

Demonstrate non-aggressive team methods to separate persons fighting.

Communicate professionally with the subject of physical intervention while protecting yourself and others.

Demonstrate continuous communication to de-escalate a situation.

Demonstrate how to protect against risk immediately following disengagement.

Post Skills Injury Check *

No Injury Injury
Any injury sustained during the course MUST be immediately reported to the course tutor(s) and an ‘injury report form’ MUST be completed.
Candidate Declaration

I confirm that I fully participated in the training, and accurately and safely demonstrated the required skills. I confirm that I have been informed that I will be issued with materials which will illustrate the physical skills that I have undertaken during this course.
Your full name (as displayed on your 'Group A' identification document) *
Signature *

Clear
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Physical Intervention Skills Observation and Assessment Record