DRS Ladder Evaluation

• Ladder Evaluation for technician

• Tech position

  Training

  OJT

  Technician

• Customer Name

• Customers account number

• Conducted on

  Date

• Manager Name

• Position

  FSM

  H&S

  RE-TRAIN
• Location
  Address

• Activity at Arrival

• Office

  Select Orlando Ocala PSL Jacksonville Gainesville Tallahassee Tampa Ft. Myers Lake Whales

  • Orlando
  • Ocala
  • PSL
  • Jacksonville
  • Gainesville
  • Tallahassee
  • Tampa
  • Ft. Myers
  • Lake Whales

Multi Ladder

• Multi-Ladder found in good working condition

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Multi-Ladder properly stored in the van

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Extended ladder for use on a wall or side of building

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Ladder properly set up (4 to 1 ratio) and secured (if necessary)

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Properly used ladder as a step ladder (stable)

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Worked from multi-Ladder from correct height

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Technician hooked their heels when climbing the ladder

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Technician kept 3-points of contact at all times on ladder

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Properly carried ladder to avoid obstacles, overhangs, steps

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Tech used proper PPE (Hardhat, Safety glasses, Boots)

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

28' or 40' Ladder

• Does the tech have a 28' or 40' ladder

  Yes

  No

• Proper ladder in use

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Ladder found in good working condition

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Ladder safely raised/lowered to work position

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Ladder properly set up (4 to 1 ratio) and secured (if necessary)

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Setup ladder to the correct height (2-rungs/3-rungs)

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• worked from the ladder from the correct position

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Technician hooked their heels when climbing the ladder

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Technician kept 3-points of contact at all times on ladder

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Properly carried ladder to avoid obstacles, overhangs, steps

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Did not overreach while on the ladder (belt buckle rule)

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Ladder properly stored on van (secured)

  Competent

  Non Competent

  Not Observed

• Add media

  Media

• 40' ladder carried/raised/lowered by two

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

• Roof work being performed safely (safety Monitor present)

  Competent

  Non Competent

  Not Observed

• Explain why the technician is Non Competent

• Add media

  Media

Action to be taken

• Technician requires additional ladder training (if more then two non-competent are checked)

• Technician re-training done on site (if only two non-competent or less are checked)

• What action was taken on site and what is the plan for following up with this issue with the technician

• Tech Signature

  Sign

• Manager signature

  Sign