Sysco Cleveland Transportation Observation

• Driver Name

• Observation Type

  Select 30 Day 60 Day 90 Day Post Incident Quarterly

  • 30 Day
  • 60 Day
  • 90 Day
  • Post Incident
  • Quarterly

• Conducted on

  Date

• Prepared by

• Location
  Address

• Route Number, Tractor Number & Trailer Number

Starting Your Route

• Driver arrives to work on time

  Yes

  No

  N/A

• Proceeds directly to hand truck area & puts equipment on trailer in a secure manner

  Yes

  No

  N/A

• Check load condition and verify route

  Yes

  No

  N/A

• Couples and completes a thorough pre-trip inspection

  Yes

  No

  N/A

• Leaves yard in a timely manner

  Yes

  No

  N/A

Driving

• Driver uses seatbelt continuously throughout the trip

  Yes

  No

  N/A

• Driver displays safe driving habits throughout the route

  Yes

  No

  N/A

• Follows all city, state and fedreral laws govering commercial driving

  Yes

  No

  N/A

Smith System "The five keys to safe driving"

• Aim high in steering

  Yes

  No

  N/A

• Get the big picture

  Yes

  No

  N/A

• Keep your eyes moving

  Yes

  No

  N/A

• Leave yourself an out

  Yes

  No

  N/A

• Make sure they see you

  Yes

  No

  N/A

• Employee able to recite the 5 Smith Keys

  Yes

  No

  N/A

Backing

• Avoids backing when possible

  Yes

  No

  N/A

• G.O.A.L. Get Out And Look

  Yes

  No

  N/A

• Aware of surroundings while backing

  Yes

  No

  N/A

• No more than one mph while backing

  Yes

  No

  N/A

• Employee knows the meaning of G.O.A.L.

  Yes

  No

  N/A

• If applicable, did driver utilize their safety cone while backing?

  Yes

  No

  N/A

Arriving and Leaving

• Drives with extreme caution while entering, on and exiting the customer's property

  Yes

  No

  N/A

• Checks all clearances above, below, behind, in front and sides of vehicle

  Yes

  No

  N/A

• Uses four way flashers

  Yes

  No

  N/A

• Secure load, ramp, side steps and doors

  Yes

  No

  N/A

• Check front, back and both side of vehicle prior to entering vehicle when leaving stop

  Yes

  No

  N/A

Delivery

• Driver uses a 3 point stance when entering and exiting the tractor and trailer

  Yes

  No

  N/A

• Driver performs warm up procedures

  Yes

  No

  N/A

• Driver turns off ignition and removes key while not in vehicle

  Yes

  No

  N/A

• Driver safely extends ramp and attaches it to rear of trailer (uses both hands, etc.)

  Yes

  No

  N/A

• Trailer is clean and free of debris

  Yes

  No

  N/A

• Driver organizes and down stacks load throughout the day

  Yes

  No

  N/A

• Driver demonstrates proper lifting procedures

  Yes

  No

  N/A

• Is the driver safe or at risk for injuries associated with improper lifting?

  Safe

  At Risk

  N/A

• Aware of postion in trailer - Maintains a safe distance from the rear and side door

  Yes

  No

  N/A

• Driver has two-wheeler properly loaded

  Yes

  No

  N/A

• Driver proceeds down ramp forward (never backwards) and in a safe manner - Realease two-wheeler if control is lost

  Yes

  No

  N/A

• Observe delivery path, steps, ramp and delivery door for adverse conditions before and while delivering - Remove or report hazards

  Yes

  No

  N/A

• Driver goes up and down steps in a safe manner (uses legs not back)

  Yes

  No

  N/A

• Stack empty pallets flat or secure to the side of trailer

  Yes

  No

  N/A

• Driver is wearing appropriate PPE (gloves, shoes, etc.)

  Yes

  No

  N/A

• Driver safely replaces ramp in carriage (uses both hands, lifts with legs not back, etc.)

  Yes

  No

  N/A

General Assessment

• Driver is properly uniformed for work and is clean and neat

  Yes

  No

  N/A

• Driver proceeds to customer, runs route as scheduled

  Yes

  No

  N/A

• During the observation, driver exhibited a positive and safe attidue

  Yes

  No

  N/A

• Drive is aware of his surroundings at all times

  Yes

  No

  N/A

• Was the delivery free from any equipment problems, barriers or significant delays?

  Yes

  No

  N/A

• Pictures

  Media

Load

• Zoning and Label Placement

  Select Good Bad

  • Good
  • Bad

• Damaged Product

  Yes

  No

  N/A

• Blankets on Cooler Pallets

  Yes

  No

  N/A

• Load Straps

  Yes

  No

  N/A

• Pallet Jack

  Yes

  No

  N/A

DOT/Safety Checklist

• Valid Medical Card

  Yes

  No

  N/A

• Valid CDL

  Yes

  No

  N/A

• Valid Vehicle Registration

  Yes

  No

  N/A

• 2016 Accident Kit

  Yes

  No

  N/A

• Valid Insurance Card

  Yes

  No

  N/A

• Telogis Law Enforcement Card

  Yes

  No

  N/A

• FMCSR Book - Must be dated February 2016 or later

  Yes

  No

  N/A

• 2012 ERG Book

  Yes

  No

  N/A

• Spill Kit

  Yes

  No

  N/A

• Reflective Triangles

  Yes

  No

  N/A

• Fire Extinguisher

  Yes

  No

  N/A

• DVCR Book

  Yes

  No

  N/A

• Log Book

  Yes

  No

  N/A

• Cab Clean

  Yes

  No

  N/A

• Valid Tractor Annual Inspection

  Yes

  No

  N/A

• Valid Trailer Annual Inspection

  Yes

  No

  N/A

Comments & Signature

• Comments

• Employee Signature

  Sign

• Supervisor Signature

  Sign