Forklift Operator Evaluation Form
Instructions: Use this checklist during the field session to evaluate operator proficiency. It can also be used for periodic evaluation to ensure that operators are continuing to operate forklifts properly.
Operator Name
First Name
Last Name
Evaluator Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Type of Equipment
Please Select
Stand-up 4250 model
Sit down 4460 model
Swing Reach (Turret) 9600 model
Walkie rider 8410 model
Operator Behaviors
1. Preuse Inspection: Follow the Operator's Daily Checklist.
Good
Fair
Poor
NA
2. Preuse Inspection: Look for damage.
Good
Fair
Poor
NA
3. Preuse Inspection: Document all findings on the checklist.
Good
Fair
Poor
NA
4. Picking Up A Load: Square up on the center of the load.
Good
Fair
Poor
NA
5. Picking Up A Load: Stop with the fork tips about 1 foot from the load.
Good
Fair
Poor
NA
6. Picking Up A Load: Clear personnel from the area near the load.
Good
Fair
Poor
NA
7. Picking Up A Load: Level the forks; then slowly drive forward untilthe load contacts the carriage.
Good
Fair
Poor
NA
8. Picking Up A Load: Lift the load carefully and smoothly until it is clear.
Good
Fair
Poor
NA
9. Picking Up A Load: Tilt the mast back slightly to stabilize the load.
Good
Fair
Poor
NA
10. Picking Up A Load: Look over both shoulders.
Good
Fair
Poor
NA
11. Picking Up A Load: After out and stopped, lower the load to travel height.
Good
Fair
Poor
NA
12. Traveling: Do not raise or lower the load and forks while traveling.
Good
Fair
Poor
NA
13. Picking Up A Load: Observe all traffic rules, warning signs, floor loadlimits and overhead clearances.
Good
Fair
Poor
NA
14. Picking Up A Load: Keep arms and legs inside the forklift.
Good
Fair
Poor
NA
15. Picking Up A Load: Follow other vehicles at a safe distance.
Good
Fair
Poor
NA
16. Picking Up A Load: Slow down when cornering.
Good
Fair
Poor
NA
16. Picking Up A Load: Use the horn to alert others.
Good
Fair
Poor
NA
17. Picking Up A Load: Travel with the load facing uphill while on a rampor incline.
Good
Fair
Poor
NA
18. Picking Up A Load: Stop smoothly.
Good
Fair
Poor
NA
19. Putting Down A Load: Make sure there is sufficient clearance for the load.
Good
Fair
Poor
NA
20. Putting Down A Load: Clear personnel for the area near the load.
Good
Fair
Poor
NA
21. Putting Down A Load: Square up to the location; then stop about 1 foot away.
Good
Fair
Poor
NA
22. Putting Down A Load: Raise the load to placement level.
Good
Fair
Poor
NA
23. Putting Down A Load: Move slowly forward.
Good
Fair
Poor
NA
24. Putting Down A Load: If the load is on a pallet, lower it into position andlower the forks further.
Good
Fair
Poor
NA
25. Putting Down A Load: If the load is on a pallet, lower it into position and lower the forks further.
Good
Fair
Poor
NA
26. Putting Down A Load: Look over both shoulders before backing out.
Good
Fair
Poor
NA
27. Putting Down A Load: Back straight out until the forks have cleared.
Good
Fair
Poor
NA
28. Putting Down A Load: Lower the forks to traveling position.
Good
Fair
Poor
NA
29. Parking: Fully lower the forks.
Good
Fair
Poor
NA
30. Parking: Neutralize the controls.
Good
Fair
Poor
NA
31. Parking: Set the brakes.
Good
Fair
Poor
NA
32. Parking: Turn off the power.
Good
Fair
Poor
NA
33. Parking: If parked on an incline, block the wheels.
Good
Fair
Poor
NA
34. Parking: Park only in authorized areas.
Good
Fair
Poor
NA
35. Fueling And Battery Recharging: Turn the engine off.
Good
Fair
Poor
NA
36. Fueling And Battery Recharging: Keep a fire extinguisher nearby.
Good
Fair
Poor
NA
37. Fueling And Battery Recharging: Use the proper Personal Protective Equipment(PPE).
Good
Fair
Poor
NA
38. Fueling And Battery Recharging: Follow safe fueling and battery rechargingprocedures.
Good
Fair
Poor
NA
39. Fueling And Battery Recharging: Clean up spills immediately.
Good
Fair
Poor
NA
FINAL EVALUATION
Based on my evaluation, the operator has successfully completed the evaluation and is qualified to operate the following equipment.
Based on my evaluation, the operator has not demonstrated competence in operating the followingequipment.
Notes From Evaluator
Evaluator Signature
Operator Signature
Submit
Should be Empty: