Fleet Driver Assessment

• Company Name:

• Drivers Name:

• Driving Licence Number:

• Job Title

• Department

• Assessment Date / Time

  Date

• Assessor

• Location
  Address

• Weather Conditions

Vehicle Details

• Is this a company vehicle ?

  Yes

  No

• Vehicle Manufacturer

• Vehicle Model

• Vehicle Registration

• Vehicle Mileage

• Road Tax Expiry Date

  Date

Vehicle Checks - FLOWERY

• Fuel Level

  Empty

  1/4 Full

  1/2 Full

  3/4 Full

  Full

• Parking Lights

  Yes

  No

• Dipped Beam

  Yes

  No

• Full Beam

  Yes

  No

• Tail Lights

  Yes

  No

• Brake Lights

  Yes

  No

• Front Fog Lights

  Yes

  No

  N/A

• Rear Fog Lights

  Yes

  No

• Oil Level

  Full

  Midway

  Low

• Water Levels - Engine Coolant

  Yes

  No

• Water Levels - Windscreen Washers - Front & Rear

  Yes

  No

• Tyres - Tread, Pressure & Safe Condition

  Yes

  No

• Electrical System - Wipers, Demisters, Instrument Panel, Heaters Etc Etc

  Yes

  No

• Any Current Medical Requirements or Medication

Cockpit Check

• Licence checked, valid & current

  Yes

  No

  N/A

• Eyesight Checked

  Yes

  No

  N/A

• Handbrake Checked

  Yes

  No

  N/A

• Seating Position

  Yes

  No

  N/A

• Locate seatbelt, Secure & Release

  Yes

  No

  N/A

• Mirrors - Interior & Side Mirrors, Set Up & Clean

  Yes

  No

• Vehicle Glass -Free From Chips & Cracks

  Yes

  No

Vehicle operations

• Accelerator

  Yes

  No

  N/A

• Gears

  Yes

  No

  N/A

• Clutch

  Yes

  No

  N/A

• Steering

  Yes

  No

  N/A

• Braking

  Yes

  No

  N/A

• Road position

  Yes

  No

  N/A

Hazard Awareness

• Observations & Forward Planning<br>

  Yes

  No

  N/A

• Shoulder checks

  Yes

  No

  N/A

• Mirrors

  Yes

  No

  N/A

• Signalling

  Yes

  No

  N/A

• Traffic hazard

  Yes

  No

  N/A

• Judgment

  Yes

  No

  N/A

• Safety margins

  Yes

  No

  N/A

• Progress

  Yes

  No

  N/A

• Road Signs, Road Markings

  Yes

  No

  N/A

• Traffic Controllers

  Yes

  No

  N/A

Speed

• Minor Speeding - up to 3mph variance

  Yes

  No

  N/A

• Major speeding -over 3mph variance

  Yes

  No

  N/A

Maneuvers

• Hill start

  Yes

  No

  N/A

• Reverse exercise

  Yes

  No

  N/A

• Uncouple- Recouple Exercise - Towing Only

  Yes

  No

  N/A

• Traffic Lights

  Yes

  No

  N/A

• Roundabouts

  Yes

  No

  N/A

Final comments

• Drive Adequate ?

  Yes

  No

  N/A

• Assessor Comments & Recommendations

• Student Signature: By signing this from you declare that you have completed your lesson and have received useful feedback from the assessor on the outcome

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• Trainers Signature: By signing this form you are certifying that the vehicle is road worthy to the limits of the inspection, and all checks were carried out as per the inspection checklist.

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