Forklift Skills Audit Coaching New Hire

• Site conducted

  Select

• Conducted on

  Date

• Assessor name

• Operators name
  Address
• PepsiCo GPID (if applicable) or Contractor Company
  Address
• Work Location
  Address

For workers that are new to PepsiCo ANZ and are required to operate a Powered Industrial Truck as part of their job role, operators will be assessed as Competent or Not Yet Competent to the Lift SAFE driving behaviors (regardless of holding a valid license)

• Current valid forklift / Powered Industrial Truck license

  Yes

  No

• Forklift is parked in a designated area with tynes tilted to ground

  Operator Competent

  Operator Not Yet Competent

• Completes pre-operation check and documents

  Operator Competent

  Operator Not Yet Competent

• Can describe process for PIT that does not meet pre-operational checks / fault found / error code

  Operator Competent

  Operator Not Yet Competent

• Wearing correct personal protective equipment (safety footwear, hi visibility uniform

  Operator Competent

  Operator Not Yet Competent

• Operator is able to explain the basic traffic management requirements of the area (speed limits, direction of traffic, special conditions – roller door, trailer access, side loading truck requirements)

  Operator Competent

  Operator Not Yet Competent

• Seatbelt is worn (where fitted)

  Operator Competent

  Operator Not Yet Competent

• Where available, assessor reviews prior 1 month of forklift operation data for operator to identify any behaviours / trends / incidents

  Operator Competent

  Operator Not Yet Competent

• COMMENTS AND OBSERVATIONS

LIFT S.A.F.E.

• One Move at A Time – demonstrates operating the PIT in one plane of movement at a time (for example : 1 – turn to face load, 2 – lift tynes, 3 – Extend tynes into pallet, 4 – engage with load, 5 – lift, 6 – Retract load from racking, 7 – lower load, 8 – turn to direction of travel, 9 – proceed)

  Operator Competent

  Operator Not Yet Competent

• Only begins travel once mast & tynes is in lowest reasonable position

  Operator Competent

  Operator Not Yet Competent

• COMMENTS AND OBSERVATIONS

• To Be Aware – can explain what ‘To be Aware’ means

  Operator Competent

  Operator Not Yet Competent

• Completes head check prior to changing direction / turning

  Operator Competent

  Operator Not Yet Competent

• Maintains maximum visibility of the surrounding area

  Operator Competent

  Operator Not Yet Competent

• Travels in reverse when cannot see over load

  Operator Competent

  Operator Not Yet Competent

• Uses mirrors including mirrors in location e.g. convex mirrors

  Operator Competent

  Operator Not Yet Competent

• Checks visibility on camera for high bay racking (where fitted)

  Operator Competent

  Operator Not Yet Competent

• Operator can identify potential hazards / obstacles in area of operation

  Operator Competent

  Operator Not Yet Competent

• Adjusts speed appropriate to the traffic management requirements or potential hazards in area, shared pedestrian zones

  Operator Competent

  Operator Not Yet Competent

• COMMENTS AND OBSERVATIONS

• Distance of 3 – can explain what ‘Distance of 3’ means

  Operator Competent

  Operator Not Yet Competent

• Maintains 3m clearance between other forklifts or waits to allow other forklifts to finish activity before proceeding

  Operator Competent

  Operator Not Yet Competent

• Operator uses horns, visual cues, eye contact to communicate with others in the area

  Operator Competent

  Operator Not Yet Competent

• Maintains 3 m operating distance from pedestrians e.g. ensures drivers are in Driver Safety Areas before loading

  Operator Competent

  Operator Not Yet Competent

• COMMENTS AND OBSERVATIONS

• S.T.O.P means STOP – operator fully stops forklift, toots horns, observes any other traffic / hazards, ensures it is safe to proceed before travelling

  Operator Competent

  Operator Not Yet Competent

• Applies S.T.O.P when coming to the end of aisles, driveways, doorways, rapid rollers, and intersections where you do not have right of way

  Operator Competent

  Operator Not Yet Competent

• COMMENTS AND OBSERVATIONS

• Safe Work Load – can explain what ‘Safe Work Load’ means

  Operator Competent

  Operator Not Yet Competent

• Can identify load plate and safe work load capacity of forklift in at least 2 different load positions

  Operator Competent

  Operator Not Yet Competent

• Checks load is safely stack and stable prior to moving

  Operator Competent

  Operator Not Yet Competent

• Pallet centre of the forklift (use of side shift as needed

  Operator Competent

  Operator Not Yet Competent

• Forklift square on the load / pallet before the lift

  Operator Competent

  Operator Not Yet Competent

• Travels at appropriate speed for load stability

  Operator Competent

  Operator Not Yet Competent

• Carries load as low as reasonably possible when travelling

  Operator Competent

  Operator Not Yet Competent

• Ensure tynes are retracted when travelling

  Operator Competent

  Operator Not Yet Competent

• Parks forklift in designated area (not blocking access or creating safety issue)

  Operator Competent

  Operator Not Yet Competent

• Removes key (if applicable)

  Operator Competent

  Operator Not Yet Competent

• COMMENTS AND OBSERVATIONS

Assessment Outcome:

• Competent

  Yes

  No

• Not Yet Competent – not allowed to commence PIT operation on PepsiCo site

  Operator Competent

  Operator Not Yet Competent

• Action Plan if not yet competent

• Operator signature

  Sign

• Date

  Date

• Assessors signature

  Sign

• Line manager signature

  Sign

• When assessment has been completed please select yes to submit.

  Yes