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C4 Risk Management Group Ltd
MANAGE
PERSONALFITNESSUnit Standard 505
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PRE-ASSESSMENT AGREEMENT
Trainee Name
Trainee NSN [NZQA] Number
[Please ensure trainee has this number]
Assessor Name
Assessor Contact Details
[Phone or email to contact you for support]
Assessment Date Time Evidence
Re-assessment Date Time Evidence
Pre-assessment statement Assessor to initial
Health and safety considerations have been met
Any special needs of the trainee have been accommodated
The requirements of the special notes in the unit standard have been met
Trainee Signature
Date this Pre-Assessment
Agreement was discussed and
signed
Assessor Signature Assessor number
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PURPOSE OF THIS UNIT STANDARD
This unit standard is intended for people who wish to be physically active and manage their own general
fitness levels with guidance, if required. This may be for healthy living, or to meet job related or other
physical activity requirements. People credited with this unit standard are able to, with guidance:
assess personal levels of physical fitness using reliable techniques; develop and
produce a personal exercise plan based on results of personal fitness assessment;
implement the personal exercise plan
measure progress in relation to goals.
Special notes
It is recommended that all candidates complete a basic health screen or questionnaire, such as the Physical
Activity Readiness Questionnaire (PAR-Q), prior to beginning training for assessment against this unit
standard. If the screening results indicate the need, candidates should obtain a written medical clearance
before beginning any physical activity.
Candidates may be provided with guidance and/or assistance when conducting fitness tests, and developing
and implementing a personal exercise plan, from qualified people such as physical education teachers,
sports coaches, gym instructors and/or fitness trainers.
DEFINITIONS
Aerobic capacity or cardiovascular endurance refers to the ability of an individual to keep performing physical
movements involving the whole body for extended periods of time, where the primary source of energy
production is aerobic respiration.
Flexibilityrefers to the range of motion around a joint.
Muscular strength refers to the maximum force an individual is able to exert on or against a given resistance.
Muscular endurance refers to the ability of the muscles, or a group of muscles, to keep working against a
resistance.
Using reliable techniques involves correctly following standard fitness testing protocols to ensure the fitness
tests can be reproduced in exactly the same way and under the exactly the same conditions.
The general principles of training are specificity, progression, frequency, intensity, duration, regularity,
reversibility, individuality, warm up and cool down.
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YOU MUST PROVE YOU KNOW AND ARE ABLE TO:
1. Conduct a personal assessment of your current levels of fitness, with help from a fitness
professional, using reliable methods.
2. You will need to complete a questionnaire asking questions about your general health.
3. You have to develop and produce a personal exercise plan, with help from a fitness professional,
based on your results of your personal fitness assessment
4. Implement your personal assessment plan, with the help from a fitness professional, and measure
your results over a four week period
Complete all sections of this Trainee Assessment Workbook using the accompanying Trainee Information
Workbook.
Once you have completed this entire assessment workbook, you should arrange with your workplace
assessor to go through your answers.
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EVIDENCE YOU WILL NEED TO COMPLETE AND COLLECT
This evidence will be given to your assessor before, or on the day of your assessment.
With training and guidance you will develop the skills and knowledge to help you finish these five tasks.
Task 1 Workplace documents
Complete the Physical Activity Readiness Questionnaire [PAR-Q].
Once you have completed this questionnaire, make sure it is attached to this workbook for evidence.
If you require a medical clearance, or have indicated No to any of the questions, make sure you develop a
plan with the help of a medical professional. They should also see a copy of the questionnaire as well
Task 2 Personal fitness assessment
You have to complete a series of personal fitness tests to see what your level of fitness is and the results
recorded.
Complete the tests in this workbook that covers cardiovascular, flexibility, strength and aerobic exercises.
[Refer to your Trainee Learning Resource to find out how to do these tests].
NOTE:
It may be possible that you show no improvement against the selected fitness tests after completing this
fitness unit standard. Therefore you cannot be found Not Yet Competent if this is the case.
It is completing the processes required in this unit standard that you achieve competency, not the changesin your own physical fitness.
Task 3 Training plan
Based on the results of your fitness assessment, create a training plan using the templates at the
back of this workbook, to improve or maintain your cardiovascular condition, your flexibility, your strength and
your aerobic endurance. You will need to follow this training plan for the next four weeks.
Task 4 Fitness re-tests
After you have followed your training plan for four weeks it is time to repeat all the fitness tests you
completed in Task 2. Try to make the re-test exactly the same as the first time you did it [i.e. same time of
day, exactly the same activity]. Record your results in the re-test date and result section of the table in Task
2.
Task 5 Questions
You need to answer 3 questions that relate to your physical fitness
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TASK 1 WORKPLACE DOCUMENTS
Name:
Health History
1. Do you smoke? Yes No If so, how many per day?
2. Has your doctor ever said your Blood Pressure
was too high or too low?
Yes No
4. Do you have any known cardiovascular
problems [abnormal ECG, previous heart
attack, atherosclerosis, etc]?
Yes No If so, what?
6. Has your doctor ever told you your cholesterol
level was too high?
Yes No If so, how much?
8. Are you taking any prescribed medication or
dietary supplements?
Yes No If so, what?
10. Do you have any medical problems not
previously mentioned?
Yes No If so, what are they?
12. Are you currently involved in a regular exercise
programme?
Yes No If so, please describe
11. What are your goals for this programme?
Consent Statement [select one by ticking box]
I acknowledge, to the best of my ability, that I am in good health and have no known medical problems that would restrict myability to participate in this programme.
OR
I have been assessed by my Doctor and agree to attach [optional] their consent to undertake this exercise programme.Trainee Signature:_________________________________________________Date: _____________________
Managers Signature_______________________________________________Date:______________________
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TASK 2 PERSONAL FITNESS ASSESSMENT
[Refer to your Trainee Learning Resource to see how to do these tests. Record your results]
DO ANY ONE FROM THIS LIST
Cardiovascular AssessmentTest Date Result Re-Test Date Result
Cycle Test
Treadmill Test
Step Test
Flexibility Assessment
Test Date Result Re-Test Date Result
Sit & Reach Test
DO THE FIRST THREE FROM THIS LIST
Strength Assessment
Test Date Result Re-Test Date Result
1 Rep Max Test
Abdominal Curl Test
Press Up Test
DO ANY ONE FROM THIS LIST
Aerobic Assessment
Test Date Result Re-Test Date Result
Run test
Walk test
I verify that I completed the above exercises and results recorded are true!
Trainee Signature:_______________________________________________Date: _____________________
I verify that I witnessed the trainee completing these exercises and the results recorded are accurate.
Witness Signature_______________________________________________Date:______________________
Witness contact details____________________________________________________________________
_______________________________________________________________________________________
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TASK 3 TRAINING PLAN
Based on the results of your first fitness assessment, create a training plan using the templates at the back
of this workbook to improve or maintain your cardiovascular condition, your flexibility, your strength and your
aerobic endurance. You will need to follow this training plan for the next four weeks.
Your plan must clearly state the exercises and records your activities over a four week period.
The plan must have the following contents:
Goals indicating improvement areas are realistic and are able to be achieved
Timeframes, equipment required and the location of where the exercises were carried out
Activities that were related to your goals
Includes how the trainee will cope with injuries, boredom etc
Measure progress over the 4 weeks
Any changes are shown
TASK 4 FITNESS RE-TESTS
After you have followed your training plan for four weeks it is time to repeat all the fitness tests you
completed in Task 2. Try to make the re-test exactly the same as the first time you did it [i.e. same time of
day, exactly the same activity]. Record your results in the re-test date and result section of the table in Task
2.
Compare these results against your records that you completed 4 weeks before and identify any goals that
you achieved. Make a comment on this in your training plan.
I verify that I completed the above exercises and results recorded are true!
Trainee Signature:_______________________________________________Date: _____________________
I verify that I witnessed the trainee completing these exercises and the results recorded are accurate.
Witness Signature_______________________________________________Date:______________________
Witness contact details____________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
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TASK 5 QUESTIONS
Look at your results for your re-test and answer these 3 questions [PC 3.1 3.4]
1. What improvements did you make after your four weeks of exercise for each of the following?
a. Cardiovascular
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b. Aerobic endurance
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c. Strength
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d. Flexibility
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2. What barriers [things that stopped you from doing the activities e.g. family, weather, etc] did you
come up against and how did you deal with these?
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3. What changes will you make [if any] to your training plan to ensure you keep going with yourpersonal physical fitness?
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TRAINEE ASSESSMENT PROGRESS RECORD
Trainee Name: NZQA No:
Task Assessor Name Assessment decision Date of
assessment
Re-
assessment
date
1 [PC 1.1] Competent / Not Yet Competent
2 [PC 1.3] Competent / Not Yet Competent
3 [PC 2.1 2.7] Competent / Not Yet Competent
4 [PC 3.3] Competent / Not Yet Competent
5 [PC 3.1 3.4] Competent / Not Yet Competent
Trainee to complete:
Post-assessment statement Signature
The assessment occurred as we had planned
I was treated fairly during the assessment
I understand the assessment outcome
The feedback I received met my needs
I verify that this workbook represents all my own work.
Assessor to complete:
The trainee has completed this workbook competently. The work is their own and shows a level of
understanding that is appropriate for the unit standard.
Assessor name_________________________________________ Number __________________________
Date_______________________________________________ Signature_________________________
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Written feedback to trainee:
Assessment Decision
Assessor to complete once the trainee has met all the
requirements of this workbook.
Competent