Fillable Printable Commercial Motor Vehicle Driver Performance Evaluation Form

Commercial Motor Vehicle Driver Performance Evaluation Form

Commercial Motor Vehicle Driver

Performance Evaluation Form

DRIVER IDENTIFYING INFORMATION

___________________________________________________________________________

Name of Employer

____________________________________ _________________________________

Driver Name Evaluation Date

____________________________________ _________________________________

Driver License # and State of Issue Expiration Date

Check each item that driver performs in a satisfactory manner.

All un-checked items require additional driver training.

-------------------------------------------------------------------------------------------

PRE-TRIP INSPECTION (Checks by the Driver) CONTROLS AND EQUIPMENT

J Fully evaluates condition of vehicle J Knows proper use of parking brake

J Checks for oil, water, fuel leaks J Knows proper use of hand valve

J Checks fuel, oil, and water levels J Understands “low air” warning

J Checks tires, lights, reflectors J Understands use of 4-way flashers

J Checks air hoses, electrical connections J Uses proper headlight beam

J Checks suspension points, steering linkage J Dims lights when following others

J Checks service and parking brakes; hand valve J Dims lights when meeting others

J Checks wipers, mirrors, horn, and gauges J Adjusts speed to range of lights

J Checks emergency equipment J Knows how to replace fuses

J Cleans windows, mirrors, lights J Knows how to use fire extinguisher

J Uses DVIR J Knows placement of warning devices

J Knows placement position of chocks

PLACING VEHICLE IN MOTION J Knows operation of engine brake (if equipped)

J Checks mirror adjustment

J Puts transmission in neutral OPERATING IN TRAFFIC

J Shifts gears smoothly Intersections and Turning

J Starts motor without difficulty J Enters intersections prepared to stop

J Allows proper warm-up J Checks for cross traffic

J Builds full air pressure before starting J Yields to others

J Checks brakes within 100 ft. of starting J Signals direction changes in advance

J Checks and understands instruments J Gets in proper lane well in advance of turn

J Uses clutch properly J Turns only when way is clear

J Maintains proper engine RPM J Blocks traffic from curb side of turn

J Times gearshift properly Signs and Signals

J Uses proper gear sequence J Starts slowly from stopped position

J Uses seat belt J Looks ahead for signs and signals

J Comes to a complete stop at stop signs

BRAKING AND SLOWING J Approaches signs and signals prepared to stop

J Brakes as soon as need is recognized J Slows vehicle gradually

J Avoids sudden stops R.R. Grade Crossings

J Stops smoothly without rolling back J Adjusts speed to crossing conditions

J Tests brakes at top of hills J If required, comes to a complete stop

J Gears down to descend grades J Stops required distance from crossing

J Uses brake properly on grades J Avoids shifting gears while crossing

J Keeps check on air gauges

Over …

BACKING AND PARKING OPERATING IN TRAFFIC (continued…)

Backing Passing

J Avoids backing from blind side J Allows sufficient space for passing

J Avoids unnecessary backing J Passes only when there is long-term advantage

J Warns others when backing J Passes only in safe location

J Checks area before backing J Signals when changing lanes

J Uses mirrors to advantage J Signals before passing

J If in doubt, gets out and looks J Proceeds in proper lane

J Proper backing maneuvers Speed

J Observes posted speed limit

J Uses timed interval following distance

J Observes speed limit consistent with conditions

J Maintains steady speed on open road

Vehicle Parking J Adjusts speed for curves, other danger zones

J Selects safe area to park General

J Parks to avoid backing when leaving J Grips steering wheel properly

J Parks correct distance from curb or roadway J Good driving posture

J Turns on warning flashers J Centers vehicle in driving lane

J Secures unit: J Reads traffic lights in advance

J Turns wheels J Evaluates traffic patterns early

J Sets brakes J Aware of traffic around unit

J Puts in gear J Frequent use of mirrors

J Shuts off engine J Avoids being boxed in

J Uses chocks J Makes eye contact with others

J Locks unit J Alert to live parking

J Checks traffic when pulling out J Makes good driving decisions

Driver Performance Evaluation Results

Based on this examination, is this driver qualified to operate commercial motor vehicles for this

company? ( ) Yes ( ) No

If “No”, explain additional training planned for this driver:

________________________________________________________________________

Name of examiner: _______________________________________________________

Signature of examiner: ____________________________________________________

Date of examination: __________________