Title Page
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Site conducted
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Name of person being assessed:
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Client / Site
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Conducted on
Person being Assessed
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Name:
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Department:
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Position:
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Is person 16 years or older?
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Holder of a current drivers licence?
Details of Buggy
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Model or Type
MAJOR RISKS
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- Colliding with a student or staff member causing serious injury
- Colliding with another vehicle causing serious injury to self
- Colliding with property or equipment causing serious damage and potential injury to self
COMPETENCY ASSESSMENT
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PRE OPERATION CHECKS: <br><br>Rate the person's ability to conduct the following pre-operation safety checks:<br><br>- Check tyres<br>- Check vehicle for any damage<br>- Check cargo is secure<br>
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OPERATING:<br><br>Rate the person's ability to operate the equipment/machinery safely with no risk of injury to self or others by observing the following rules:<br><br>- Do not drive through the school at more than WALKING speed<br>- Avoid driving through the school during breaks or other busy periods<br>- Always look behind when reversing<br>- Keep arms and legs inside the vehicle at all times<br>- No person allowed in cargo area<br>- Cargo that extends outside cargo area should have warning attached<br>- Remove keys when not in use<br>
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POST OPERATION CHECKS: <br><br>Rate the person's ability to conduct the following post-operation safety checks.<br><br>- Park in designated area<br>- Brakes applied<br>- Keys removed
APPROVAL
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Do you give approval for the person to operate the equipment or machinery with NO direct supervision?
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Name of Assessor
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Position:
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Select date
