Vehicle Pre-Trip Safety Inspection

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Which Vehicle? (Last 4 digits of the VIN or Description Everyone Uses ie "Blue Bus")

• Please check “YES” or “NO” beside each category below and provide details in the comment section as needed. Please note that the vehicle shall not be used to transport passengers when any unsafe issues are noted. Notify the supervisor to report unsafe conditions.

Vehicle #:

• Visual Check – Walk around the vehicle. Is there any damage?

  Yes.

  No.

• Visual Check – Are tires under inflated?

  Yes.

  No.

• Are there fluid leaks under vehicle?

  Yes.

  No.

• Are headlights working? Brights too?

  Yes

  No

• Are the brake lights working?

  Yes

  No

• Are turn signal lights working?

  Yes

  No

• Are hazard lights working?

  Yes

  No

INTERIOR

• Are any seat belts inoperable?

  Yes.

  No.

• First aid kit in vehicle? Stocked properly?

  Yes

  No

• Bodily fluid spill kit in vehicle?

  Yes

  No

• Fire extinguisher in vehicle?

  Yes

  No

STAFF & SUPERVISION

• Will there be a staff member in the vehicle devoted to supervision and behavior management - separate than the person driving?

  Yes

  No

  N/A

• Does the vehicle driver understand that cell phone use while driving is not permitted?

  Yes

  No

FORMS & PAPERWORK

• Is mileage log in vehicle? Up to date?

  Yes

  No

• Are accident report forms in vehicle?

  Yes

  No

• Is emergency contact & roadside assistance information in vehicle?

  Yes

  No

• Signature

  Sign