Site Visit Safety Review - US

• Client / Site (will be displayed in cover page header)

• Location Name and Number

  Select

• Type of Review

  Monthly

  Bimonthly

  Quarterly

  Annual

• Date of Last Review

• Personnel Participating in Review

• Completed By

Driver Staffing Status (Not scored)

• Is the location fully staffed? (All routes covered plus 10% spares)

  Yes

  No

  N/A

• Give an overview of the current shortage, including the total number of drivers needed to be fully staffed.

• What recruiting efforts are currently in place?

• What is the current status of recruiting and training, (ie. # applications, # in BTW, # in class, # pre training background checks)?

Drive 360 Review

• In Drive360, select 5 random driver files, select the "DOT Required" tab for each driver and review the DOT documents. Flag documents not compliant. Enter the total number of documents flagged. (20 pts)

  Select 0 1 2 3 4 5 6 7 8 9 10 or more

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10 or more

• Have all documents for Trainees and CDL Drivers hired since the last review been approved at a level above the terminal (Employee Approval Process)? (5 pts)

  Yes

  No

  N/A

• Are drivers that are active in Drive 360, but out on LOA or terminated, properly documented in the “Notes” section under the driver’s “Position Details” tab? (5 pts)

  Yes

  No

  N/A

• Are employees who transport passengers properly classified as CDL drivers? (5 pts)

  Yes

  No

  N/A

• Have ADP Employees been reclassified? (5 pts)

  Yes

  No

  N/A

Vehicle Accidents, since last review

• Is there a clear, documented process for responding to accidents (including dispatch, notification process, and response)? (5 pts)

  Yes

  No

  N/A

• Are all accidents entered into Webrisk, including all required attachments? (5 pts)

  Yes

  No

  N/A

• Accidents reviewed and documents missing from the file.

Accident

• Driver Name

• Accident Date

• Required documents missing in Webrisk (click "Select")

  Select Accident Scene Photo(s) Accident Video Complete Accident Report (Supv Rep, Pax Card, etc.) Estimate of Repairs Final Repair Bill Police Report Vehicle Damage Photo(s)

  • Accident Scene Photo(s)
  • Accident Video
  • Complete Accident Report (Supv Rep, Pax Card, etc.)
  • Estimate of Repairs
  • Final Repair Bill
  • Police Report
  • Vehicle Damage Photo(s)

• Are all accidents properly investigated and documented appropriately? (5 pts)

  Yes

  No

  N/A

• Is the accident reporting lag for the period being reviewed equal to or lower than 2.0 days? (found in Power-Bi) (5 pts)

  Yes

  No

  N/A

Work Injuries, since last review

• Are all injuries, regardless of severity, called in to MedCor? (5 pts)

  Yes

  No

  N/A

• Are all injuries listed in Webrisk populated with the required information including Lost Time days? (5 pts)

  Yes

  No

  N/A

• Are all injuries properly investigated and documented appropriately? (5 pts)

  Yes

  No

  N/A

• Injuries reviewed and documents missing from the file.

Work Injury

• Employee Name

• Injury Date

• Required documents missing in Webrisk (click "Select")

  Select Investigation Report Supervisor's Report of Employee Injury State Required Report

  • Investigation Report
  • Supervisor's Report of Employee Injury
  • State Required Report

• Are OSHA (301, 300, 300A) logs maintained and posted during appropriate time frames? (5 pts)

  Yes

  No

  N/A

• Does the location have on file, completed OSHA 301, 300 and 300A documents for the prior 5 years (or years since contract inception if less than 5 years)? (5 pts)

  Yes

  No

  N/A

Safety In-Service Meetings, since last review

• Are Safety In-service Meetings held each month? (5 pts)

  Yes

  No

  N/A

• Is there a calendar of scheduled in-service meeting topics for the year posted? (3 pts)

  Yes

  No

  N/A

• Is one hour dedicated to a relevant safety topic? (3 pts)

  Yes

  No

  N/A

• Is attendance required and documented? (3 pts)

  Yes

  No

  N/A

• Is there an agenda that includes date, start and end time, topic and presenter? (3 pts)

  Yes

  No

  N/A

• Is Operations Manager attendance documented? (3 pts)

  Yes

  No

  N/A

Safety Committee Meetings, since last review

• Are Safety Committee Meetings held each month? (5 pts)

  Yes

  No

  N/A

• Does documentation include an agenda and minutes? (3 pts)

  Yes

  No

  N/A

• Is the committee made up of management and at least 50% employee members representing applicable work groups, ie. drivers, mechanics, etc.? (3 pts)

  Yes

  No

  N/A

• Are accidents and injuries reviewed, recommendations made and action taken? (3 pts)

  Yes

  No

  N/A

• Are safety concerns reviewed, recommendations made and action taken? (3 pts)

  Yes

  No

  N/A

• Are quarterly facility inspections completed and concerns action taken? (3 pts)

  Yes

  No

  N/A

Driver Evaluations - review up to 5 recent driver evaluations.

• Are all evaluations completed by a certified trainer? (3 pts)

  Yes

  No

  N/A

• Are all evaluations completed on the company" Operator Evaluation" form? (3 pts)

  Yes

  No

  N/A

• Are all evaluations comprehensive, covering all relevant skills? (3 pts)

  Yes

  No

  N/A

• Are opportunities to improve skills noted on all evaluations? (3 pts)

  Yes

  No

  N/A

• Is there documentation of corrective action for all areas needing improvement? (3 pts)

  Yes

  No

  N/A

Regulatory Safety and Company Programs

• Reasonable Suspicion Training - Is there evidence of completion on file for all managers, supervisors and anyone handing out keys? (5 pts)

  Yes

  No

  N/A

• Safety Leadership Program - Is there evidence of completion on file for all managers, supervisors, trainers and staff? (5 pts)

  Yes

  No

  N/A

• Trainer Certification Program - Is there evidence of completion on file for all active Instructors and Trainers? (5 pts)

  Yes

  No

  N/A

• OSHA Training Modules - Is there evidence OSHA training is current for all shop personnel? (5 pts)

  Yes

  No

  N/A

• Hours of Service - Is the location in compliance with HOS regulations? (5 pts)

  Yes

  No

  N/A

• Double Check Plan - Is there an approved written plan? (5 pts)

  Yes

  No

  N/A

• Double Check Log - Is there a log confirming compliance with the written plan (select NA if logs are not required)? (5 pts)

  Yes

  No

  N/A

• Emergency Action Plan - Is there a completed plan that is updated annually? (5 pts)

  Yes

  No

  N/A

• Is this a California location?

  Yes

  No

• Is there a written CalOSHA Injury and Illness Prevention Plan (IIPP) in place and implemented?

  Yes

  No

  N/A

Are the following postings visible in the facility?

• Top Ten Safety Poster?

  Yes

  No

  N/A

• Mission, Values and Vision Poster?

  Yes

  No

  N/A

• Double check poster?

  Yes

  No

  N/A

• DVIR Chart?

  Yes

  No

  N/A

• Electronic Accident Board (working and current)?

  Yes

  No

  N/A

• OSHA required postings?

  Yes

  No

  N/A

• Facility Evacuation Plans?

  Yes

  No

  N/A

• Eye protection sign (shop entrance)?

  Yes

  No

  N/A

• Child Check Banner (all lot entrances)?

  Yes

  No

  N/A

• No Unsafe Behaviors (all lot exits)?

  Yes

  No

  N/A

Office Areas

• Walking Surfaces

• Clear from debris, clutter and liquids

  Yes

  No

  N/A

• Stairs

• Free from objects and clutter

  Yes

  No

  N/A

• Railings available and secure

  Yes

  No

  N/A

• Treads well maintained

  Yes

  No

  N/A

• Aisles/Passageways

• Free of objects and clutter

  Yes

  No

  N/A

• Lighting

• Appropriate lighting in all areas

  Yes

  No

  N/A

• Wash Rooms (entire property)

• Clean and sanitary

  Yes

  No

  N/A

• Floors dry and free of debris (caution signs used)

  Yes

  No

  N/A

• Safety

• Fire extinguisher easily accessible, inspected

  Yes

  No

  N/A

• First-Aid kit clearly marked, maintained

  Yes

  No

  N/A

• Electrical outlets are free of clutter

  Yes

  No

  N/A

• Appropriate door mats and carpeting

  Yes

  No

  N/A

• Exits clearly marked

  Yes

  No

  N/A

• Additional hazards, comments and corrective actions:

Parking Areas

• Walking Surfaces

• Environmental causes (e.g. ice, snow, mud)

  Yes

  No

  N/A

• Uneven surfaces (potholes, change in elevation)

  Yes

  No

  N/A

• Lighting

• Adequate lighting during early morning and evening hours

  Yes

  No

  N/A

• Fuel Pump Area

• Fuel hose and nozzle in good repair

  Yes

  No

  N/A

• Fire extinguisher easily accessible and inspected

  Yes

  No

  N/A

• Proper signage (Emergency Shut Off Valve, No Smoking)

  Yes

  No

  N/A

• Spill kit maintained with directions clearly marked

  Yes

  No

  N/A

• Additional hazards, comments and corrective actions:

Maintenance Shop

• Walking Surfaces

• General housekeeping (debris, fluids, materials and tools, etc.)

  Yes

  No

  N/A

• Walking hazards are clearly communicated

  Yes

  No

  N/A

• Stairs

• Free from objects and clutter

  Yes

  No

  N/A

• Railings available and secure

  Yes

  No

  N/A

• Treads well maintained

  Yes

  No

  N/A

• Aisles/Passageways

• Free from objects and clutter

  Yes

  No

  N/A

• Pits

• Open pits protected

  Yes

  No

  N/A

• Lighting

• Appropriate lighting in all areas

  Yes

  No

  N/A

• Ladders

• In good condition

  Yes

  No

  N/A

• Appropriate weight rating

  Yes

  No

  N/A

• Utilization of proper ladder type

  Yes

  No

  N/A

• Personal Protective Equipment

• Proper eyewear protection worn

  Yes

  No

  N/A

• Hearing protection when needed

  Yes

  No

  N/A

• Gloves worn when handling sharp objects

  Yes

  No

  N/A

• Proper footwear worn

  Yes

  No

  N/A

• Protective clothing when handling hazardous materials

  Yes

  No

  N/A

• Hazard Communications

• All Chemicals labeled and stored properly

  Yes

  No

  N/A

• SDS sheets are readily available for all chemicals

  Yes

  No

  N/A

• Fire Safety

• Fire extinguishers mounted, inspected and unobstructed

  Yes

  No

  N/A

• Flammable liquids are in approved safety containers

  Yes

  No

  N/A

• Shop rags are being properly disposed

  Yes

  No

  N/A

• General Hazard Awareness

• Machine guarding in place

  Yes

  No

  N/A

• Equipment well maintained (e.g. electrical cords, power tools, jacks, lifts, etc.)

  Yes

  No

  N/A

• Eyewash station is maintained and unobstructed

  Yes

  No

  N/A

• Employees observed working safely (e.g. proper ergonomics, use of proper tools such as wheel chocks & tire)

  Yes

  No

  N/A

• Appropriately locking/tagging out equipment before servicing

  Yes

  No

  N/A

• Proper signage (Emergency Shut Off Valve, No Smoking, Exit signs, fire extinguisher)

  Yes

  No

  N/A

• Electrical

• Electrical Switches and outlets have plate covers

  Yes

  No

  N/A

• Access to electrical panels unobstructed

  Yes

  No

  N/A

• Ventilation

• Proper ventilation in garage for smoke, dust and fumes

  Yes

  No

  N/A

• Additional hazards, comments and corrective actions:

Vehicle Safety

• Inspect 5 random vehicles

Vehicle

• Bus Number

• Driver Compartment - Clean, orderly, free from unsecured items and no unauthorized postings

  Safe

  At Risk

  N/A

• Camera - Is the on-board camera indicator light working properly (select NA if no camera installed)?

  Safe

  At Risk

  N/A

• Emergency Equipment - Secure and meets standards

  Safe

  At Risk

  N/A

• Lighting Systems – All lights working properly

  Safe

  At Risk

  N/A

• Emergency Exits – Exits are in working order, are labeled properly and alarm work properly

  Safe

  At Risk

  N/A

• Seat Condition and Securement – Seats are secure and in good condition

  Safe

  At Risk

  N/A

• Child Check System – System is working properly to horn

  Safe

  At Risk

  N/A

• Crossing Gate – Working properly

  Safe

  At Risk

  N/A

• Tires and Wheels – Meet all standards

  Safe

  At Risk

  N/A

• Brake System – Complete a brake check for leaks or other malfunction

  Safe

  At Risk

  N/A

• DVIR – Completed properly, defects fixed and properly signed off

  Safe

  At Risk

  N/A

• Other – Any other defects noted

  Safe

  At Risk

  N/A