Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Photo of delegate

  • Name of delegate?

  • Name of delegate

  • Delegates date of birth?

  • Person performing assessment?

2.0 - “Pre-start checks” (Primary visual inspection)

  • Pre-start Checks.

  • Is the delegate wearing the correct PPE?

  • Did the delegate check the tyres for any cuts and/or bulges etc?

  • Did the delegate check that the forks are fit for purpose with no bends or damage?

  • Did the delegate check the engine bay for fluid levels, deadman, etc?

  • Did the delegate check the cab is clear of anything that could obscure their vision ?

  • Did the delegate check all instrumentation is working as it should? Lights, indicators, horn, beacons, etc?

  • Before starting the Tele-handler did the delegate put a seatbelt on?

  • Is the delegate aware of the “lifting range” and capabilities of the tele-handler?

  • Add signature

  • Is the delegate ready for the main assessment?

3.0 - Main Practical assessment

  • Practical assessment

  • Add media

  • The delegate has been instructed to transport three loads of increasing sizes within a area set by the assessor, the delegate will place the loads as directed by the assessor to three different locations at increasing heights. Has the delegate travelled to the set area at the correct speed, maintaining good all round observation?

  • Has the delegate stopped the tele-handler at the correct distance from the first load and is their positioning correct?

  • The delegate is then asked to “pick up” the first load with the tele-handler, the assessor acts as the banksman.<br>Did the delegate “pick up” the first load correctly?

  • Once loaded the delegate is told to discharge the first load at ground level in an area set by the assessor. Did the delegate maintain good all round observation whilst traveling to the set area and discharge the load correctly?

  • Once loaded the delegate is told to discharge the second load at a increased height level in an area set by the assessor. Did the delegate maintain good all round observation whilst traveling to the set area and discharge the load correctly?

  • Once loaded the delegate is told to discharge the third and final load atop a container at around 2 meters high level in an area set by the assessor. Did the delegate maintain good all round observation whilst traveling to the set area and discharge the load correctly?

  • The delegate is then told to travel up an incline whilst loaded, did the delegate do this correctly?

  • The assessor signals the delegate to stop and hold position, did the delegate stop and hold position until told to continue with the exercise ?

  • Did the delegate shutdown the tele-handler correctly and disembark correctly ?

  • Has the delegate showed they are capable of operating the tele-handler in a safe controlled manner?

4.0 - Maintenance

  • Delegate showing knowledge of maintenance process

  • Has the delegate shown the checked all fluid levels correctly?

  • Has the delegate shown all greasing points along with knowledge of how to maintain these points?

  • The assessor has asked the delegate “when should the tele-handler be topped up with fuel?” Did the delegate have the correct answer and did they know why it should be done at the end of every shift?

6.0 - Summary

  • Is the delegate ready for their official practical test?

  • Message for delegate.

Sign Off

  • Delegate’s signature

  • Assessor’s signature

  • Comments

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.