Forklift Operator Evaluation

Has the operator completed the safety training module?

*NOTICE*

The Evaluation and Certification of a forklift operator must be completed by a company designated evaluator who has successfully completed this course.

The evaluator is required to complete the following competency verification by observing the forklift trainee successfully completing all the tasks listed in this checklist.

The trainee must score in the Fair or Good range of all aspects of the Evaluation in order to pass the observation and become certified.

Date of Evaluation

Date

Evaluator Name

First NameLast Name

Evaluator Email

example@example.com

Trainee Name

First NameLast Name

Pre-use Inspection

Rows	GOOD	FAIR	POOR	N/A
1. Complete equipment inspection.
2. Look for Damage.
3. Documented all findings on the inspection form.

Traveling

Rows	GOOD	FAIR	POOR	N/A
1. Fastened seatbelt.
2. Do not raise or lower the load and forks while traveling.
3. Maintain a safe speed.
4. Observe all traffic rules, warning signs, floor load limits and overhead clearances.
5. Keep arms and legs inside the forklift.
6. Follow other vehicles at safe distance.
7. Slow down when cornering.
8. Use the horn to alert others.
9. Travel with the load facing uphill while on a ramp or incline.
10. Stop smoothly.

Putting Down a Load

Rows	GOOD	FAIR	POOR	N/A
1. Make sure there is sufficient clearance for the load.
2. Clear personnel from the area near the load.
3. Square up to the location and then ease into the drop spot.
4. Raise the load to placement level.
5. Move slowly forward.
6. If the load is on a pallet, lower it into position and lower the forks further.
7. Look over both shoulders before backing out.
8. Back straight out until the forks have cleared.
Adjust the forks as necessary to exit the forks smoothly.
9. Lower the forks to traveling position.

Parking

Rows	GOOD	FAIR	POOR	N/A
1. Fully lower the forks.
2. Neutralize the controls.
3. Set the brakes.
4. Turn off the power.
5. If parked on an incline, block the wheels.
6. Park only in authorized areas.

Fueling and Battery Charging

Rows	GOOD	FAIR	POOR	N/A
1. Engine off.
2. Fire extinguisher nearby.
3. Proper personal protective equipment worn.
4. Safe fueling and battery recharging procedures followed.
5. Spills cleaned up immediately.

Based on my evaluation of this operator:

Printed Name of Evaluator

Forklift Operator Evaluation Program

Forklift Operator Evaluation and Certification

Operator Behaviors