Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Date and Time audit began

VEHICLE DESCRIPTION

  • Photograph of Vehicle Being Inspected

  • Type

  • License Number

  • Odometer Reading at Inspection

EXTERIOR LIGHTING

  • High and Low Beams Operational

  • Left and Right Tail Lights Operational

  • Left and Right Front Turn Signals Operational

  • Left and Right Rear Turn Signals Operational

  • Left and Right Break Lights Operational

  • Audible Back-up Alarm Operational

EXTERIOR BODY AND GLASS (Take Photos of any noted damage)

  • Windshield Free of Cracks and Chips

  • Front Hood, Grill and Bumper free of Damage

  • Left Mirrors adjustable and Free of Damage

  • Left Fender Free of Damage

  • Left Door Free of Damage

  • Left Side Free of Damage

  • Left Side Windows Free of Cracks and Chips

  • Rear WIndow Free of Cracks and Chips

  • Rear of Vehicle and Bumper Free of Damage (Tailgate if included)

  • Right Side Free of Damage

  • License Plate / Tag is current and not expired / Note expiration date and verify to registration

  • Right Wheel Chair Lift Door Free of Damage

  • Right Side Windows Free of Cracks and Chips

  • Right Door Free of Damage

  • Right Front Fender Free of Damage

  • Right Mirror Adjustable and Free of Damage

  • Vehicle is Clean and Free of Road Grime and Dirt

TIRES

  • Front Driver Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  • Rear Driver Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  • Rear Driver (INSIDE) Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall (If Dual Tire Vehicle)

  • Rear Passenger Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  • Rear Passenger (INSIDE) Driver Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall (If Dual Tire Vehicle)

  • Front Passenger Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  • Adequate Spare Tire is Available if Necessary in Good Repair with No Visible Signs of Wear or Cracking in Sidewall

  • Front Driver and Passenger Wheel/Tire Trim Rings in Place

  • Rear Driver and Passenger Wheel/Tire Trim Rings in Place

INTERIOR

  • Driver Seat in Good Repair

  • Driver Seat Belt Operational with Shoulder Harness

  • Windshield Wipers Functioning Appropriately

  • Windshield Washer Fluid Functioning and Appropriately Wetting Windshield to Clean

  • Heater and Defroster Operational

  • Air Conditioning Operational

  • Dashboard Lights Operational

  • All Gauges are Operating and Show within Appropriate Ranges

  • Interior Compartment Lights Operational

  • Bus Door Operational

  • Entry Grab Bar/Rail Secure

  • Interior is Clean and Free of Loose Objects

  • Television and DVD Operational

  • Passenger Seat Belts Operational

  • Passenger Seats in Good Repair

WHEELCHAIR RESTRAINT and LIFT

  • Adequate Wheelchair Restraint Tie Downs Available for all Wheelchair Positions in Vehicle

  • Wheelchair Safety Straps are Free of Frays, Nicks and Cuts

  • Seat Belt Web Cutter for Emergency Use Available

  • Lift Manufacturer

  • Lift Model Number

  • Lift Serial Number

  • Lift Manufactured Date

  • Vehicle movement is prevented unless the lift door is closed, ensuring the lift is stowed

  • Lift operation is prevented unless the vehicle is stopped and vehicle movement is prevented

  • Platform will not fold/stow if occupied

  • Date of Last Lift Safety Inspection by Manufacturer Authorized Service Center

  • List the Name, Address and Telephone Number of Authorized Service Center Performing Lift Inspection

SAFETY EQUIPMENT

  • Vehicle is Equipped with Two Way Radio System or Driver Has Cell Phone when Vehicle is in Operation

  • Securely mounted First Aid Kit (Ensure Completely Stocked)

  • Fire Extinguisher Charged and Inspected Monthly?

REQUIRED DOCUMENTATION

  • Valid Vehicle Registration is located in Vehicle (Note where kept)

  • Valid Vehicle Insurance Certificate is Located in Vehicle (Note where kept)

  • Is Vehicle Serviced According to the Manufacturers Schedule?

  • Date of Last Service (List Details of Last Service, i.e. New Tires, Oil Change, ect...)

  • Are Adequate Preventative Maintenance and Service Repair Records Kept

SIGNATURES

  • Signature of Auditor

  • Signature of Community Representative

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.