Sample_Driver_Evaluation _1_

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					TRUCKING SAFETY
COUNCIL OF BC                                     www.safetydriven.ca




                                         Driver Evaluation Form
   Name:                                                                                    Date of Hire:

   Street Address:                                  City:                             Province:     Postal Code:

   DL #:                        Class:              Endorsement/Restrictions:         Province:     Expiry Date:



   EQUIPMENT USED FOR TEST (PROVIDE UNIT #’S)

   Truck:                        Tractor:                       Trailer:                       Test Date:

   Mileage End:                              Mileage Start:                          Total Mileage:



   REASON FOR EVALUATION
   INITIAL EVALUATION                       RETURN TO WORK AFTER ________________WEEKS
   RETRAINING                               NEW EQUIPMENT TYPE (SPECIFY)
   ANNUAL EVALUATION                        OTHER REASON (SPECIFY
   POST ACCIDENT




   DEMONSTRATED COMPETENCIES/BEHAVIOURS
   PART 1 –
   PRE-TRIP INSPECTION AND EMERGENCY EQUIPMENT

   Checks general condition approaching unit including leakage of coolants, fuel, and lubricants.
   Checks under hood – Oil levels, fluid levels, coolant, belts, steering, and general condition of
     compartment.
   Circle checks unit – Tires, lights, signals, trailer hookup, brake/light lines, body, doors, horn, and
     windshield wipers.
   Full air system check (Static and dynamic air loss, build time etc), brake action, tractor protection valve,
     parking brake, rolling test.
   Knows use of jacks, tools, emergency warning devices, tire chains, fire extinguisher, spare fuses, 4 way
     flashers, flares.
   Checks instruments and sets mirrors.
   Cleans windshield




            MODIFIED FROM TSCBC TEMPLATE ON NOVEMBER 12, 2012                                                      PAGE 1 OF 6
TRUCKING SAFETY
COUNCIL OF BC                                   www.safetydriven.ca




   PART 2 –
   PLACING VEHICLE IN MOTION AND USE OF CONTROLS
   A    MOTOR
        Starts motor without difficulty
        Allows proper warm-up
        Understands gauges on instrument panel
        Maintains proper engine speed
        Basic knowledge of motors – Gas / Diesel
        Abuse of motor
   B CLUTCH AND TRANSMISSION
        Starts loaded unit smoothly
        Uses clutch properly
        Times shifting properly and shifts smoothly
        Uses proper gear sequence
   C BRAKES
        Knows operating principals of air brakes
        Proper use of tractor protection valve
        Understands low air warning
        Tests brakes before starting trip
   D STEERING
        Fights steering wheel
        Allows truck to wander
        Poor driving posture or grip on wheel
   E LIGHTS
        Knows lighting regulations
        Uses proper headlight beam
        Dims lights when following or meeting traffic
        Adjusts speed to range of headlights
        Proper use of auxiliary lights
   PART 3 –
   COUPLING AND UNCOUPLING
   Lines up units
   Hooks brake and electric lines properly
   Secures trailer against movement
   Backs under slowly
   Tests hookup with power and visually
   Handles landing gear properly
   Proper hookup of full trailer
   Secures power unit against movement




         MODIFIED FROM TSCBC TEMPLATE ON NOVEMBER 12, 2012            PAGE 2 OF 6
TRUCKING SAFETY
COUNCIL OF BC                                    www.safetydriven.ca




   PART 4 –
   BACKING AND PARKING
   A BACKING
        Gets out and checks before backing
        Looks back as well as checks mirrors
        Gets out to re-check on long back (over 1 truck length)
        Avoids backing from blind side
        Sounds horn when backing – before moving and every half truck length
        Controls speed and direction when backing
   B PARKING (CITY)
        Takes too many pull-ups
        Hits nearby vehicles/stationary objects
        Hits curb
        Parks too far from curb
        Fails to secure unit – set park brake, put in gear, block wheels, shut off motor
        Fails to shoulder check traffic conditions and/or signal when pulling out of parked position
        Parks in illegal or unsafe location
   C PARKING (ROAD)
        Parks off pavement
        Avoids parking on soft shoulder
        Uses emergency signals when needed
        Secures unit properly
   PART 5 –
   SLOWING AND STOPPING
   Uses gears properly (ascending)
   Gears down properly (descending)
   Stops and re-starts without rolling backwards (no rollbacks)
   Tests brakes at top of hills
   Uses brakes properly on hills
   Uses mirrors to monitor traffic at rear
   Signals following traffic
   Avoids sudden stops
   Stops smoothly without excessive fanning
   Stops before crosswalk when coming out of driveway or alley
   Stops clear of pedestrian crosswalks




          MODIFIED FROM TSCBC TEMPLATE ON NOVEMBER 12, 2012                                            PAGE 3 OF 6
TRUCKING SAFETY
COUNCIL OF BC                                    www.safetydriven.ca



   PART 6 –
   TRAFFIC OPERATIONS – PASSING AND TURNING
   A TURNING
       Selects correct lane well in advance
       Signals well in advance
       Monitors traffic conditions and turns only when safe to proceed
       Does not swing wide or cut short
       Completes turn in correct lane
   B TRAFFIC SIGNS AND SIGNALS
       Approaches signal prepared to stop if needed (aware of stale green lights)
       Violates traffic signal
       Runs yellow lights
       Starts up too fast or too slow on green signal
       Fails to notice or heed traffic signs
       Runs STOP signs (crosses stop line without stopping first)
   C INTERSECTIONS
       Adjusts speed to permit stopping if required
       Checks for cross traffic regardless of signals or signs
       Yields right-of-way for safety
   D GRADE CROSSINGS
       Adjusts speed to conditions
       Makes safe stop if required
       Selects proper gear
   E PASSING
       Passes with insufficient clear space ahead
       Passes in unsafe location: Hill, curve, intersection, etc.
       Fails to signal lane change or changes lanes too quickly (wait at least 4 signal flashes before moving)
       Fails to warn driver being passed (sound horn, flash lights)
       Tailgates waiting chance to pass
       Blocks traffic with slow pass
       Cuts in too short returning to right lane
   F   SPEED
       Speed consistent with basic ability
       Adjusts speed according to road, weather, traffic conditions or legal limits
       Slows down for rough roads or crossings
       Slows down in advance of curves, intersections, hazards, etc.
       Maintains consistent speed
   G COURTESY AND SAFETY
       Depends on others for safety
       Crowds other drivers or forces way through (aggressive driving)
       Fails to allow faster traffic to pass
       Fails to keep right and in own lane



          MODIFIED FROM TSCBC TEMPLATE ON NOVEMBER 12, 2012                                                      PAGE 4 OF 6
TRUCKING SAFETY
COUNCIL OF BC                                     www.safetydriven.ca

       Unnecessary use of horn
       Other discourtesy or improper conduct
   PART 7 –
   MISCELLANEOUS
   A GENERAL DRIVING HABITS AND ABILITY
       Uses seatbelt
       Consistently alert and attentive, aware of changing traffic conditions
       Reacts to changing conditions
       Performs routine functions without taking eyes off road
       Checks instruments regularly
       Distracted by phone, radio, GPS
       Willing to take instructions and suggestions
       Adequate self-confidence in driving
       Nervous, apprehensive
       Easily angered
       Complains too much
       Professional personal appearance, manner
       Good physical stamina
   B HANDLING OF FREIGHT
       Checks freight properly
       Handles and loads freight properly
       Handles bills properly
       Breaks down load as required
   C RULES AND REGULATIONS
       Knowledge of company rules
       Knowledge of regulations: Federal, Provincial, local
       Knowledge of special truck routes
   D USE OF SPECIAL EQUIPMENT (Detail below)




   REMARKS:




   GENERAL PERFORMANCE:
                                  Satisfactory                       Unsatisfactory
                                Needs Training
   QUALIFIED FOR:
                                         Truck                 Tractor/Semi-trailer
                                Other (specify)
   EXAMINERS SIGNATURE                                                          DATE:




          MODIFIED FROM TSCBC TEMPLATE ON NOVEMBER 12, 2012                             PAGE 5 OF 6
TRUCKING SAFETY
COUNCIL OF BC                                www.safetydriven.ca

   PLEASE ATTACH ADDITIONAL PAGES IF YOU REQUIRE MORE ROOM




         MODIFIED FROM TSCBC TEMPLATE ON NOVEMBER 12, 2012         PAGE 6 OF 6

				
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Description: trucker safety