Header
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Date of Inspection
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Department
- DDS
- DMH
- DPH/EIP
- DMA/MH
- MCB
- MRC
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Program/Inspection Site
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Program Code
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Transportation Provider
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MART Inspector Signature
Driver-Monitor-Vehicle Information
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Driver Name
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Monitor Name
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Vehicle Registration #
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Vehicle Year
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Vehicle Type
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Seating Capacity
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Vehicle on time (program/home/site)
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Vehicle operated in safe manor
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Exterior clean & free of damage
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Company name/lettering clearly visible (pass side & rear, w/min 2" letters)
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Windows, glass, lights and wipers intact
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Vehicle seating capacity not exceeded
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Valid (passed) MA vehicle inspection sticker
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Safe tires (for all seasons)
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Valid Mass. drivers license in hand or contiguous state license
- MA
- NH
- RI
- CT
- NY
- VT
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Valid MA vehicle registration on board
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Vehicle no older than 5 years (7 for W/C) mfg. date (program based only)
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Driver First Aid & CPR certifications (DPH only)
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Working Communication Device
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First Aid kit (complete)
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Seatbelt extension & cutter
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Fire extinguisher (fully charged) and other safety equipment (chock blocks, triangles, etc.)
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All equipment properly secured
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Interior clean & free of damage
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AC and heater cool/heat entire vehicle (seasonal)
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Vehicle is smoke free
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All passengers "fact sheets" data available
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Daily vehicle inspection documented
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All scheduled consumers transported
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Only authorized riders in vehicle
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Driver & monitor assist consumers when entering and exiting the vehicle
Other
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Consumer/Route Information (list any consumer involved)
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Remarks (explain briefly any negative findings)
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Photo/video report
