Forklift Truck Operator Assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• 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?

  Yes

  No

  N/A

MCC Equipment

• Type of powered industrial truck being used for the assessment

  Select Counterbalance forklift Reach forklift Pedestrian forklift MEWP (with boom) MEWP (scissor lift)

  • Counterbalance forklift
  • Reach forklift
  • Pedestrian forklift
  • MEWP (with boom)
  • MEWP (scissor lift)

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?

  Yes

  No

  N/A

• Date of test or refresher course?

  Date

Daily Safety Inspection

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

  Yes

  No

  N/A

• The operator fully understands the capacity information plate?

  Yes

  No

  N/A

• The operator understands the correct defect reporting procedures?

  Yes

  No

  N/A

• 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?

  Yes

  No

  N/A

• Uses the seatbelt correctly? If applicable.

  Yes

  No

  N/A

• Keeps body parts within the confines of the vehicle?

  Yes

  No

  N/A

• Operator looks in the direction of travel?

  Yes

  No

  N/A

• Correct use of the horn when appropriate?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Operator had good all round safety observation?

  Yes

  No

  N/A

Steering & Operating Controls

• Starts and stops smoothly?

  Yes

  No

  N/A

• Releases the parking brake prior to operating forklift?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Operates and understands the controls?

  Yes

  No

  N/A

Competency In Load Capacity

• Operator matches load with the trucks capacity?

  Yes

  No

  N/A

• Operator checks the load for stability?

  Yes

  No

  N/A

Maneuvering & Transportation

• Has the forks at proper height when traveling?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

Stacking & de-stacking

• Correct set down on vertical face?

  Yes

  No

  N/A

• Operator applies neutral when operating the hydraulics?

  Yes

  No

  N/A

• Fork arms central under the load?

  Yes

  No

  N/A

• Fork arms not rubbing (entry / withdrawal)?

  Yes

  No

  N/A

• Is the load level?

  Yes

  No

  N/A

• Load correctly stacked?

  Yes

  No

  N/A

• 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.

Parking

• The operator correctly applies the parking brake?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• The operator correctly applies forward tilt?

  Yes

  No

  N/A

• The operator correctly lowers the fork arms?

  Yes

  No

  N/A

• The maneuvering wheels are in the straight position?

  Yes

  No

  N/A

• The operator switches off and removes the key?

  Yes

  No

  N/A

Assessment Recommendations & Evaluations

• Assessors evaluation of operator safety?

  Excellent

  Good

  Satisfactory

  Re-training is advised

• Comments

Signatures

• Date and time of assessment

  Date

• Operator signature

  Sign

• Assessor signature

  Sign