Staffing – Appointment Nominated Supervisor

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Staffing – Appointment Nominated Supervisor

Note you also need to complete ACECQA form NS01

I appoint <INSERT FULL NAME>

 _________________________________________________________________________

 to be a Nominated Supervisor at < INSERT NAME OF SERVICE >

_________________________________________________________________________

and declare that that this person:

  • has the required skills to be a person in day to day charge eg has adequate knowledge and understanding about providing education and care including understanding of child protection obligations
  • can effectively supervise and manage the service
  • is at least 18 years
  • has successfully completed a child protection course approved by the NSW Regulatory Authority (NSW ONLY)
  • is a fit and proper person – they have
    • a current child protection clearance
    • declared they have never been subject to any compliance action or disciplinary proceedings under the National Law or Regulations or State/ Territory early childhood laws (Supervisor to complete ACECQA Compliance History Statement template attached)
    • declared they are not a ‘Prohibited Person’

 _________________________________________________________________________

Signature
 _________________________________________________________________________

Print Full Name

Approved Provider

Date
 _________________________________________________________________________

I accept being Nominated Supervisor and will  always uphold the National Law and Regulations, my obligations as Nominated Supervisor under those laws and regulations, and the policies, procedures, philosophy and Code of Conduct of the service

 _________________________________________________________________________

Signature

 _________________________________________________________________________

Print Full Name

Date

  _________________________________________________________________________

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