Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Assessor Competancy

  • Is the assessor trained and does he/she have a full understanding of the vehicles that they are to assess?

Vehicle Type

  • Type of forklift equipment?

  • Add media

Operator Details

  • Has operator completed classroom portion of training?

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

  • Date classroom portion of training completed?

Daily Safety Inspection

  • The operator completed the safety pre-shift safety inspection correctly?

  • The operator understands the correct fault reporting procedures?

  • The operator fully understands the capacity information plate?

Operator Safety & Observation

  • The operator mounts / dismounts correctly?

  • Uses the seatbelt correctly?

  • Keeps body parts within the confines of the vehicle?

  • Operator looks in the direction of travel?

  • Operator slowed down at intersections?

  • Operator sounded horn at intersections?

  • Operator yielded to pedestrians?

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

  • Operator demonstrates proper operation on ramps and other sloped surfaces that would affect stability?

  • Operator has good all around safety awareness?

Steering & Operating Controls

  • Starts and stops smoothly?

  • Gave proper signals when turning?

  • Turned corner correctly (aware of rear end swing)?

  • Releases the parking brake prior to moving?

  • Rough use of hydraulic controls?

  • Shows familiarity with truck controls?

Competency In Load Capacity

  • Operator matches load with the truck's capacity?

  • Operator checks the load for stability?

Maneuvering & Transportation

  • Forks at correct height when traveling empty?

  • Traveled with load at proper height?

  • Forks at correct height when parked?

  • When operating in reverse, looking in the direction of travel?

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

  • Operator performs safe maneuvering with the lift truck and load?

Stacking & de-stacking

  • Raised/lowered load smoothly?

  • Operator applies the park brake when operating the hydraulics?

  • Operator applies neutral when operating the hydraulics?

  • Fork arms centered under the load?

  • Fork arms not rubbing (entry / withdrawal)?

  • Fork tips enter center of pallet opening?

  • Forks / load level?

  • Load correctly stacked?

  • Fork arms fully inserted?

Parking

  • The operator correctly applies the park brake?

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

  • The operator correctly applies forward tilt?

  • The operator correctly lowers the forks?

  • The steering wheels are in the straight position?

  • The operator switches off and removes the key?

Assessment Recommendations & Evaluations

  • Assessor's evaluation of operator safety?

  • Comments

  • Operator passed evaluation?

Signatures

  • 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.