Title Page
-
Site conducted
-
Date and Time
-
Prepared by
-
Location
-
Please use the Note and Photo options to provide as much detail as possible to your responses.
Corrective actions are required as a result of 'Not Compliant' response. Please use the Action option under each question and assign to the relevant stakeholder along with a due-date.
Critical Controls
-
1. Are seatbelts installed and worn by all vehicle occupants?
- Fully Compliant
- Minor Gaps - But safe to continue
- Not Compliant - Resource constraints
- Not Compliant - Worker failed to implement
- Not Applicable
-
2. Are the rented vehicles 5 Star ANCAP rated and at least a medium size SUV?
- Fully Compliant
- Minor Gaps - But safe to continue
- Not Compliant - Resource constraints
- Not Compliant - Worker failed to implement
- Not Applicable
-
3. Have drivers connected their phones to hands free kits and using them instead of touching their phone?
- Fully Compliant
- Minor Gaps - But safe to continue
- Not Compliant - Resource constraints
- Not Compliant - Worker failed to implement
- Not Applicable
-
4. Where a driver has to undertake a FCF defined high risk trip has a journey management plan been developed and relevant check-in times agreed? Have they been met?
- Fully Compliant
- Minor Gaps - But safe to continue
- Not Compliant - Resource constraints
- Not Compliant - Worker failed to implement
- Not Applicable
Other Controls
-
5. Can worker demonstrate they hold the relevant Drivers License for the vehicle they are operating?
- Fully Compliant
- Minor Gaps - But safe to continue
- Not Compliant - Resource constraints
- Not Compliant - Workers failed to implement
- Not Applicable
-
6. Is the operator of the vehicle complying with site and road rules when operating vehicles?
- Fully Compliant
- Minor Gaps - But safe to continue
- Not Compliant - Resource constraints
- Not Compliant - Workers failed to implement
- Not Applicable
-
7. Are the operators free of the signs of fatigue and effects of drug and alcohol? Can the operator explain what they would do if they started to feel fatigued or not fit for work?
- Fully Compliant
- Minor Gaps - But safe to continue
- Not Compliant - Resource constraints
- Not Compliant - Workers failed to implement
- Not Applicable
-
8. can the operator demonstrate that the vehicle is currently in service? Has the vehicle been inspected and approved prior to being operated on site?
- Fully Compliant
- Minor Gaps - But safe to continue
- Not Compliant - Resource constraints
- Not Compliant - Workers failed to implement
- Not Applicable
-
9. Can the worker demonstrate that the vehicle has been prestarted at the start of shift? Were there any faults and if so were they reported to the Supervisor?
- Fully Compliant
- Minor Gaps - But safe to continue
- Not Compliant - Resource constraints
- Not Compliant - Workers failed to implement
- Not Applicable
-
10. Does the vehicle contain all the minimum required emergency equipment including fire extinguisher, first aid kit, emergency triangles, wheel chocks, spare tyre and jack.
- Fully Compliant
- Minor Gaps - But safe to continue
- Not Compliant - Resource constraints
- Not Compliant - Workers failed to implement
- Not Applicable
-
11. Can the operator demonstrate knowledge of how to manage an incident if travelling off site (i.e. Rental Company details)?
- Fully Compliant
- Minor Gaps - But safe to continue
- Not Compliant - Resource constraints
- Not Compliant - Workers failed to implement
- Not Applicable
Inspection Team
Inspection Team
-
Tap on '+' button below to add sign offs as needed
Inspector
-
Name and Signature