DOT Safety Report

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

Management Leadership

• Is senior leadership committed to driver and vehicle safety?

  Yes

  No

  N/A

• Is there a written driving safety policy statement?

  Yes

  No

  N/A

• Does the policy address seat belt use while operating a motor vehicle?

  Yes

  No

  N/A

• Does the policy address use of electronic devices for calling, texting, or watching while operating a motor vehicle?

  Yes

  No

  N/A

• Does the policy address other distractions that can occur while driving, including: eating; drinking; smoking; reading; applying makeup or other grooming activities; reaching for items; focusing on other passengers in the vehicle; and activity other than driving?

  Yes

  No

  N/A

• Does the policy include a driver assessment component, such as using in-vehicle monitoring systems, driver observation, or shadowing experienced drivers in the same types of vehicles?

  Yes

  No

  N/A

• Does the policy include a journey management component that requires employees to plan work-related travel to reduce risk and take the safest route?

  Yes

  No

  N/A

• Does the policy include a pre-hire driving record check?

  Yes

  No

  N/A

• Are driver qualifications evaluated and licenses verified before employees drive for work?

  Yes

  No

  N/A

• Does the policy include a periodic driving record check for all employees who drive motor vehicles at work?

  Yes

  No

  N/A

• Is the insurability of employees who drive assessed before they drive for work?

  Yes

  No

  N/A

• Does the policy address impaired driving, including alcohol, illegal substances, over-the-counter drugs, and prescription drugs?

  Yes

  No

  N/A

• Do driving policies comply with, support, and emphasize state and local laws?

  Yes

  No

  N/A

• Are copies of the policy provided to employees?

  Yes

  No

  N/A

• Are individuals assigned responsibility for the development, implementation, and enforcement of the driving safety plan?

  Yes

  No

  N/A

• Is there a formal driver orientation procedure?

  Yes

  No

  N/A

• Is the driving safety policy and program reviewed at least annually?

  Yes

  No

  N/A

Driver

• Are employees trained that the roadway and vehicle are part of the workplace while they driving, and that applicable safety policies and law must be followed?

  Yes

  No

  N/A

• Are employees who drive assessed through in-vehicle monitoring systems, driver observation, or shadowing with experienced drivers?

  Yes

  No

  N/A

• Are employees trained in the dangers of distracted driving?

  Yes

  No

  N/A

• Are employees trained on the dangers of driving fatigued?

  Yes

  No

  N/A

• Are work shifts planned to avoid employees driving after working long hours?

  Yes

  No

  N/A

• Are drug or alcohol tests performed when employees are involved in motor vehicle incidents if there is reasonable suspicion; or state or federal laws require the tests?

  Yes

  No

  N/A

• Are drivers assessed for being healthy and fit to drive on a daily basis?

  Yes

  No

  N/A

• Are drivers submitting journey management plans to supervisors for approval before travel?

  Yes

  No

  N/A

• Are employees trained in how to perform and document thorough vehicle inspections, and follow up on needed maintenance or repairs?

  Yes

  No

  N/A

Vehicle

• Have employees’ driving skills been assessed for operating the types of vehicle(s) used for work?

  Yes

  No

  N/A

• Are employees trained in proper vehicle maintenance?

  Yes

  No

  N/A

• Are all vehicles inspected using an appropriate checklist before each trip?

  Yes

  No

  N/A

• Are vehicles taken out of service if maintenance issues are identified during inspection?

  Yes

  No

  N/A

• Are vehicles repairs and maintenance documented?

  Yes

  No

  N/A

• Is a process in place to communicate to employees which vehicles can be used and which have been taken out of service?

  Yes

  No

  N/A

• Are loads verified to be properly secured and within the vehicle’s weight limits prior to travel?

  Yes

  No

  N/A

Environment

• Are drivers trained how to check and plan for adverse weather conditions before embarking on a trip?

  Yes

  No

  N/A

• Are drivers trained in extra precautions to take when driving in serve weather?

  Yes

  No

  N/A

• Are employees trained how to drive safely in a work zone?

  Yes

  No

  N/A

• Do employees understand work-zone signage?

  Yes

  No

  N/A

• Are employees trained how to deal with road rage and poor habits of other drivers?

  Yes

  No

  N/A

• Do employees who drive for work receive annual defensive driving training?

  Yes

  No

  N/A

• Are emergency kits available and stocked in all company vehicles?

  Yes

  No

  N/A

Work Zone

• Are employees working in work zones provided and required to wear high-visibility personal protective equipment?

  Yes

  No

  N/A

• Are vehicles used in work-zones marked with safety features such as red chevrons?

  Yes

  No

  N/A

• Are traffic control flaggers trained and certified?

  Yes

  No

  N/A

• Are vehicle used in work-zones equipped with flashing lights?

  Yes

  No

  N/A

Hazardous Materials and Cargo

• Using proper lifting techniques when loading and unloading cargo?

  Yes

  No

  N/A

• Items are properly secure and balance the load to prevent shifting or falling during transport?

  Yes

  No

  N/A

• Ensure proper loading and securing of cargo to prevent shifting or falling during transit?

  Yes

  No

  N/A

• Following all regulations for transporting hazardous materials?

  Yes

  No

  N/A

Accident Reporting

• Is there a formal accident reporting system?

  Yes

  No

  N/A

• Is there a formal accident investigation system?

  Yes

  No

  N/A

• Is there an accident review process?

  Yes

  No

  N/A

• Is there an established emergency road procedures?

  Yes

  No

  N/A

• Are vehicles stored or parked in appropriate areas?

  Yes

  No

  N/A

• Is there a policy for managing vehicle keys?

  Yes

  No

  N/A