Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Patrol Number

  • Patrol Team

Presentation

  • Is the Patrol van clean?

  • Where is the issue?

  • Is the Patrol wearing a safety vest at all times?

  • Is the safety vest clean and presentable?

  • What is the concern?

  • Is the safety vest fastened?

  • Is the Patrol wearing a name badge?

  • Is the Patrol wearing presentable work attire?

  • What is the concern?

  • Explain

Van Entry and Exit

  • Did the Patrol exit the service vehicle using 3 points of contact?

  • Did the patrol us the correct lifting techniques?

  • Did the Patrol enter the service vehicle using 3 points of contact?

Duress

  • Is the Patrol wearing the Duress pendant?

  • Where is it?

  • Explain

  • Is the Duress Pendant charged and turned on?

  • What was the issue?

  • During the Duress Test, did the Patrol know how to activate the pendant?

  • What was the issue?

  • Did the Duress test pin the Patrol in the correct location?

Patrol

WZTM Card

  • Does the Patrol have their WZTM card?

  • Why not?

  • Reason

  • is it in date?

Use of Mobile Responder

  • Did the Patrol change status to ER at the commencement of driving?

  • When did they change their status?

  • Comments checked before changing status to ER?

  • Were comments checked prior to driving?

  • Was the Patrol proactive towards using the status delay function?

  • Was this for travel or at scene?

Driving

  • What resource did the Patrol use as a source of navigation?

  • Did the Patrol comply with the CWD SOP?

  • Did the Patrol touch the Phone, Tablet or both?

Positioning of Service Vehicle

  • Did the Patrol use traffic control devices?

  • Did they comply with an RAA approved layout?

  • Did the Patrol position the service vehicle behind the Members vehicle when working in or adjacent to an active lane?

  • Did the Patrol

  • Did the Patrol activate the Service Vehicle safety lights?

Member Interaction

  • Did the Patrol build an appropriate rapport with the Member?

  • Why?

  • Explain

  • Did the Patrol introduce himself by name?

  • Did the Patrol communicate to the Member clearly?

  • What was the issue?

  • Explain

  • Did the Patrol display cultural/social awareness?

  • Explain

Member Safe Zone

  • Did the Patrol ensure the Member was in a safe zone relative to the Event location?

  • Why

RSAR

  • Did the Patrol ask to view the Membership card before commencing on the Event?

  • Did the Patrol establish Membership credentials?

  • Did the Patrol explain the indemnity and ask the Member to tick and sign the ERSAR BEFORE commencing the task?

  • Did the Patrol explain the indemnity BEFORE commencing the task?

  • Did the Patrol ask the Member to tick the indemnity box BEFORE commencing the task?

  • Did the Patrol tick the indemnity box?

  • Did the Patrol ask the Member to sign the ERSAR BEFORE commencing the task?

  • Did the Patrol ask the Member to sign the ERSAR AFTER commencing the task?

  • Did the Patrol verbally explain or point out for the Member to read?

  • Did the Patrol give a clear explanation regarding the Event?

  • Why

  • Explain

  • Did the Patrol check the oil and water levels and record on the RSAR?

Securing the vehicle

  • Did the Patrol secure the vehicle as per the SOP

  • What was the issue?

PPE

  • Was task appropriate PPE worn as per the SOP?

  • What was the issue?

  • Explain

Closing the Event

  • Did the Patrol clearly explain the outcome of the job to the Member?

  • Why?

  • Explain

  • Were Member entitlements clearly explained?

  • Was the site shut down as per the SOP?

  • Was the ERSAR correctly filled out relevant to the event?

  • What was missing?

  • Explain

  • Did the Patrol add comments in the correct area of MR where required?

  • Did the Patrol enter the required information in the comments section where required?

  • What task was it related to?

  • Explain

  • Did the Patrol clear the event ASAP?

Patrol Conditioning

  • Do you carry out any conditioning to maintain fitness and remain injury free?

  • What do you do?

Battery

Boost Start

  • Did the Patrol view the boost start procedure QRG?

  • Was the Boost Start procedure completed correctly?

  • What was the issue?

  • Explain

Battery Replacement Process

  • Did the Patrol check the age and physical condition of the battery and inform the Member?

  • Was the battery replacement posed in a positive manner?

  • What was your concern?

  • Explain

  • Did the Patrol give the member the correct advice in the scenario?

  • What was your concern?

  • Did the Patrol let the Member know of the battery's availability?

  • Did the Patrol check and record radio operation before and after?

  • Did the Patrol check operation at all?

  • Did the Patrol use a memory minder during the battery replacement?

  • Was there a valid reason not to?

  • Did the Patrol use the correct manual handling techniques for battery replacement?

  • What was the concern?

  • Please explain

  • Did the Patrol use the pneumatics to open and close the battery draw as per the SOP?

  • Was the Patrol proactive towards restocking?

Wheel Change

  • Was the jacking plate used?

  • Did the Patrol used the correct jacking point?

  • Did the Patrol use the impact wrench or manual process to loosen the wheel nuts/studs?

  • Did the Patrol use use the knee pad and use the half kneeling position?

  • Did the Patrol use the nylon wheel lifting strap where appropriate?

  • Did the Patrol use the correct manual handling techniques when lifting wheels?

  • When was incorrect technique used?

  • Explain

  • Did the Patrol start the nuts/studs by hand?

  • What method did the Patrol use to tighten the wheel nuts/studs?

  • Did the Patrol use a torque wrench to set stud/nut tension?

  • What method was used to identify the correct wheel torque?

  • Please explain?

  • Did the Patrol use safety stands?

  • Did the Patrol use wheel chocks?

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.