Title Page
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Date
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Driver Name
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Driver Title
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Terminal Location
- 5123-Annapolis
- 5127-Bel Air
- 5107-Catonsville
- 3348-Central Ave
- 5086-Dundalk
- 4376-Elkridge
- 5247-Falls Rd
- 5170-Timonium
- 5060-Westminster
- 3357-White Marsh
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Vehicle Assigned
Pre-Assessment
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Is all required training and onboarding complete for this driver?
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What is the Driver's risk rating?
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What was the date of the most recent risk change? (Within 12-month period)
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Did the Driver receive documented coaching at the risk change?
Pre-Assessement
Pre-Trip Inspection
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Pictures of vehicle (All four sides, VIN, odometer, Fire Extinguisher tag)
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Does the driver have their DL and Med Card with them?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Is the current ERG on the drivers side door?
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Are the following documents in the glove box?
- Emissions Certificate
- Registration (in)
- Registration (not in)
- Annual DOT Inspection (in)
- Annual DOT Inspection (not in)
- Insurance Card (in)
- Insurance Card (not in)
- Hazmat Certificate (in)
- Hazmat Certificate (not in)
- Driver MEC
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Is the driver in uniform? (safety boots, hi-vis shirt/vest, pants/shorts)
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Are there any critical items that were not reported on the eDVIR?
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Are there any non-critical items not reported on the eDVIR?
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Are any vehicle supplies missing, need replacing, low on stock?
- Gloves (In)
- Gloves (not in)
- Absorbent (in)
- Absorbent (not in)
- Trash Bags (in)
- Trash Bags (not in)
- Rags (in)
- Rags (not in)
- Absorbent Boom (in)
- Absorbent Boom (not in)
- Safety Glasses (in)
- Safety Glasses (not in)
- Emergency Triangles (in)
- Emergency Triangles (not in)
- Spray Cleaner (Spray Nine/Simple Green). (in)
- Spray Cleaner (Spray Nine/Simple Green) (not in)
- First Aid Kit (in)
- First Aid Kit (not in)
- Ratchet Straps (8' Red, 12' Yellow, 16' Grey, 20' Blue). (in)
- Ratchet Straps (8' Red, 12' Yellow, 16' Grey, 20' Blue) (not in)
- Safety Knife (in)
- Safety Knife ( not in)
- Hard Hat (in)
- Hard Hat (not in)
- Scoop (in)
- Scoop (not in)
- Hand Trucks (in)
- Hand Truck (not in)
- Hi-Visibility Vest (in)
- Hi-Visibility Vest (not in)
- Fire Extinguisher (in)
- Fire Extinguisher (not in)
- 2020 ERG (in)
- 2020 ERG (not in)
- Completely Stocked
Assessment
Personal Safety
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Is the driver using three points of contact when entering and exiting the vehicle?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Is the driver using proper PPE when onsite?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Is the driver using correct lifting techniques?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Is the driver using manual material handling equipment to reduce injury?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
MobileLink Proficiency
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Is the driver using the handheld device correctly to status stops? (Enroute, Arrive, Load/Unload, Complete)
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Is the driver using the map function for every stop?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Is the driver reviewing time windows so deliveries are not late?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Is the driver taking a mininum of three pictures for unattended deliveries?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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If there were "Missed Stops" during ride along, did the driver call the originating store?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
Federal Motor Carrier Safety Administration Compliance
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Are BOL's accessible and on top the driver’s clipboard?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Is the driver properly securing cargo?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Do BOL's with Hazmats have an orange label attached on right side?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Is the driver signing their BOL’s
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
Driving Behaviors
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Is the driver using the GOAL principle when needed?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Adjusts driving to meet changing conditions?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Slows down in advance for curves, intersections, etc?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Yields right of way for safety?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Signals for lane changes and turns?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Consistently alert and attentive?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Maintains good lane control?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
Vehicle Security/Idling
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When the vehicle is unattended, is the Driver turning off the engine and removing keys and mobile device?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
Post-Trip Inspection
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Are there any critical items that were not reported on the eDVIR?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Are there any non-critical items not reported on the eDVIR?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
End of Day
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Did the Driver file their signed BOL's in the store?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
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Did the driver plug in their device in the store?
- Yes
- No
- Qualified
- Needs Improvement
- Unqualified
- N/A
Driver Trainer Results
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I have reviewed the above infomation with the driver and have coached him/her in any areas of deficientcy
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Instructor comments
Driver Field
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I have reviewed the above information and understand any areas where improvement is needed.
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Driver comments