Evaluation of Performance2

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Name:

• Type of Equipment

  Select Forklift Skid Steer Scissor Lift Aerial Lift Front End Loader Excavator

  • Forklift
  • Skid Steer
  • Scissor Lift
  • Aerial Lift
  • Front End Loader
  • Excavator

• Follows Inspection Checklist

  Yes

  No

  N/A

Proper Use of Controls

• Tilt

  Yes

  No

  N/A

• Lift

  Yes

  No

  N/A

• Attatchments

  Yes

  No

  N/A

• Steering Mechanism

  Yes

  No

  N/A

• Swing

  Yes

  No

  N/A

Competency in maneuvering skills

• Uses Horn when appropriate

  Yes

  No

  N/A

• Starts and stops smoothly

  Satisfactory

  Good

  Excellent

  Needs Improvement

• Maintains proper speed

  Satisfactory

  Good

  Excellent

  Needs Improvement

• Scans Effectively

  Satisfactory

  Good

  Excellent

  Needs Improvement

Competency in Load Capacity

• Matches load with truck's capacity

  Yes

  No

  N/A

• Checks load for stability

  Yes

  No

  N/A

Demonstrates competency in driving

• Steering and Maneuvering

  Satisfactory

  Good

  Excellent

  Needs Improvement

• Keeps an adequate distance from obstacles

  Satisfactory

  Good

  Excellent

  Needs Improvement

• Drives in Reverse

  Satisfactory

  Good

  Excellent

  Needs Improvement

• Successfully completes obstacle course

  Satisfactory

  Good

  Excellent

  Needs Improvement

Demonstrates competency in operating equipment

• Operates and understands controls

  Satisfactory

  Good

  Excellent

  Needs Improvement

• Uses Seatbelt (if no, retrain operator on importance of seatbelt usage)

  Yes

  No

  N/A

• Fall Protection

  Yes

  No

  N/A

• Performs safe maneuvers with equipment task

  Satisfactory

  Good

  Excellent

  Needs Improvement

Demonstrates Competency in work environment conditions

• Surface Condition

  Satisfactory

  Good

  Excellent

  Needs Improvement

• Traffic and pedestrians

  Satisfactory

  Good

  Excellent

  Needs Improvement