Forklift Competency assessment

• Forklift Operator Evaluation Form

• Conducted on

  Date

• Operator Name

• Evaluator Name

• Equipment Operated

• Location
  Address

Safety inspections

• Completes pre-operational forklift safety inspection and sight checklist

  Yes

  No

  N/A

• Knows how to report faults or unsafe equipment

  Good

  Fair

  Poor

  N/A

Pick up load

• Wears seatbelt (if applicable)

  Good

  Fair

  Poor

  N/A

• Checks pallet/load for safety (i.e damage, loose boards or cartons etc)

  Good

  Fair

  Poor

  N/A

• Confirms weight of load prior to lifting & confirms safe work load with capacity plate of forklift

  Yes

  No

  N/A

• Aligns fork square with load & drives forwards slowly, tines level with clearance

  Yes

  No

  N/A

• Load rests on backrest, forklift stopped prior to lifting

  Good

  Fair

  Poor

  N/A

• Lifts load smoothly to safe travel height, tilts mast to stabilise load prior to driving off

  Good

  Fair

  Poor

  N/A

• Checks over the shoulder and mirror (if applicable) prior to reversing or moving off

  Yes

  No

  N/A

Travel

• Travels at safe speed (no abrupt braking or turning)

  Good

  Fair

  Poor

  N/A

• Observes safety rules (uses horn at intersections and blind spots)<br>

  Good

  Fair

  Poor

  N/A

• Travels with load facing correct direction (I.e uphill on incline)

  Good

  Fair

  Poor

  N/A

• Maintains exclusion zone around forklift during operation (3m + height of tines)

  Good

  Fair

  Poor

  N/A

Place load

• Manoeuvres forklift safely into position square to racking with clearance to enter or stop (uses park break if applicable)

  Good

  Fair

  Poor

  N/A

• Allows sufficient clearance between load and unload areas to successfully lift load

  Good

  Fair

  Poor

  N/A

• Slowly lifts load to required height to allow safe clearence of load to racking

  Good

  Fair

  Poor

  N/A

• Safely drives into racking without contact with sides of racking

  Good

  Fair

  Poor

  N/A

• Reverses straight back slowly/safely without contact with objects and stops with clearence to objects to lower tines safely

  Good

  Fair

  Poor

  N/A

• Safely lowers tines to just above ground level while completely stopped (no moving with raised tines)

  Good

  Fair

  Poor

  N/A

Parking

• Fully lower the forks.<br>

  Good

  Fair

  Poor

  N/A

• Neutralize the controls.<br>

  Good

  Fair

  Poor

  N/A

• Set the brakes.<br>

  Good

  Fair

  Poor

  N/A

• Turn off the power. <br>

  Good

  Fair

  Poor

  N/A

Assessors recommendation

• Forklift operator assessed as competent

  Off

  On

• Assessor signature

  Sign

• Operator signature

  Sign