• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Assessor Competancy

  • The assessor must be a competent person according to OSHA guidelines. This requires the training and knowledge of the task being assessed.

  • Does the assessor meet the requirements in regards to OSHA guidelines for competent trainer?

MCC Equipment

  • Type of powered industrial truck being used for the assessment

Operator Details

  • If an operator has no proof of training held on record, they must not operate a forklift truck until proof of training Competancy has been proven?

  • Has the operator a valid certificate of training that has been passed or refreshed within the last three years?

  • Date of test or refresher course?

Daily Safety Inspection

  • The operator completes the safety Pre-shift safety inspection correctly

  • The operator fully understands the capacity information plate?

  • The operator understands the correct defect reporting procedures?

  • If a defect has been found, the lift truck must be parked up in a safe place and the key removed. The forklift shall be labeled "OUT OF SERVICE" until repairs are made by authorized personnel.

Operator Safety & Observation

  • The operator mounts / dismounts correctly?

  • Uses the seatbelt correctly? If applicable.

  • Keeps body parts within the confines of the vehicle?

  • Operator looks in the direction of travel?

  • Correct use of the horn when appropriate?

  • Follows the correct procedures for an "unattended" vehicle?

  • Operator had good all round safety observation?

Steering & Operating Controls

  • Starts and stops smoothly?

  • Releases the parking brake prior to operating forklift?

  • Does not operate the hydraulic controls when the lift truck is in motion?

  • Operates and understands the controls?

Competency In Load Capacity

  • Operator matches load with the trucks capacity?

  • Operator checks the load for stability?

Maneuvering & Transportation

  • Has the forks at proper height when traveling?

  • Operating in reverse, looking in the direction of travel?

  • Operates at a speed consistent with the type of load and working conditions?

  • Does the operator perform safe maneuvering with the lift truck and load?

Stacking & de-stacking

  • Correct set down on vertical face?

  • Operator applies neutral when operating the hydraulics?

  • Fork arms central under the load?

  • Fork arms not rubbing (entry / withdrawal)?

  • Is the load level?

  • Load correctly stacked?

  • It is some times necessary to undercut a load due to the nature of where it is to be located. It must remain within the limits of the capacity plate.


  • The operator correctly applies the parking brake?

  • The operator sets the direction lever to the neutral position?

  • The operator correctly applies forward tilt?

  • The operator correctly lowers the fork arms?

  • The maneuvering wheels are in the straight position?

  • The operator switches off and removes the key?

Assessment Recommendations & Evaluations

  • Assessors evaluation of operator safety?

  • Comments


  • Date and time of assessment

  • Operator signature

  • Assessor signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.