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🚜 Training & Competence

Forklift Practical Evaluation

Industrial Forklift Operator Competency Assessment

📋 Basic Information

Employee Name *

Evaluator Name *

District / Base *

Evaluation Date *

Forklift ID/Number

⚡ Energy Sources Present

Select all energy sources present during this operation:

🪨Gravity

🏃Motion

⚙️Mechanical

⚡Electrical

💨Pressure

🧪Chemical

🌡️Temperature

🔋Stored

💀 STKY (Stuff That Kills You) Assessment

Does this forklift operation involve Life-Threatening, Life-Altering, or Life-Ending potential? *

🔴 Yes - High Energy/SIF Potential

🟢 No - Low Energy Operation

🔍 Pre-Operation Inspection

⚠️ Conducted visual inspection of forklift? *

✅ Pass

❌ Fail

Checked fluid levels (hydraulic, engine oil, coolant)? *

✅ Pass

❌ Fail

⚠️ Tested horn and backup alarm? *

✅ Pass

❌ Fail

⚠️ Inspected forks for damage or excessive wear? *

✅ Pass

❌ Fail

⚠️ Verified load capacity chart visible and legible? *

✅ Pass

❌ Fail

📦 Load Handling Skills

⚠️ Approaches loads straight-on and centers forks? *

✅ Pass

❌ Fail

⚠️ Tilts mast slightly back after lifting load? *

✅ Pass

❌ Fail

⚠️ Keeps forks low (4-6 inches) during travel? *

✅ Pass

❌ Fail

⚠️ Observes load capacity limits? *

✅ Pass

❌ Fail

🚛 Travel and Maneuvering

⚠️ Maintains safe travel speed? *

✅ Pass

❌ Fail

⚠️ Travels in reverse when load obstructs forward view? *

✅ Pass

❌ Fail

⚠️ Maintains awareness of pedestrians and other equipment? *

✅ Pass

❌ Fail

⚠️ Comes to complete stop before changing direction? *

✅ Pass

❌ Fail

🦺 Safety Protocols

⚠️ Uses proper PPE (hard hat, high-vis, safety boots)? *

✅ Pass

❌ Fail

⚠️ Uses seatbelt when equipped? *

✅ Pass

❌ Fail

⚠️ Never allows passengers on forklift? *

✅ Pass

❌ Fail

⚠️ Never lifts personnel without proper platform/attachment? *

✅ Pass

❌ Fail

🛑 Shutdown and Parking

⚠️ Lowers forks completely to ground? *

✅ Pass

❌ Fail

⚠️ Neutralizes controls and engages parking brake? *

✅ Pass

❌ Fail

⚠️ Parks in designated area away from traffic? *

✅ Pass

❌ Fail

💭 Evaluator Comments & Assessment

Evaluator Comments

Overall Assessment *

Note: Any safety-critical failure results in automatic FAIL.

✅ PASS - Competent for independent operation

❌ FAIL - Requires additional training

Follow-up Action Required

AnthroSafe™ Field Driven Safety

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