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Forklift operator evaluation form

OSHA 29 CFR 1910.178(l) splits operator training into formal instruction, practical training, and an evaluation of the operator in the workplace. An online course is the formal instruction. This is the form for the evaluation, which only the employer can do, on their own trucks. Print it, observe the operator, sign it, keep it on file.

Go to the form

What the rule actually requires

Under 1910.178(l)(6) the employer certifies that each operator has been trained and evaluated, and the record must name the operator, the date of the training, the date of the evaluation, and who performed the evaluation. Under 1910.178(l)(4) that evaluation is repeated at least once every three years, and sooner after an accident, a near miss, an unsafe-operation observation, a change of equipment or a change in workplace conditions. OSHA does not approve or accredit training providers or their forms, ours included; this is a working document, not an endorsement.

Powered Industrial Truck Operator Evaluation
Employer certification under 29 CFR 1910.178(l)(6)
Retain with the operator's training file
Operator name
Employee / ID number
Employer / site
Truck type and class evaluated
Date of formal instruction
Date of this evaluation
Observed behaviour
Meets
Retrain
N/A
Before the truck moves
Completes the pre-use inspection and records defects
Removes a truck from service when a defect affects safe operation
Checks the data plate, capacity and attachment rating for the load at hand
Adjusts seat, mirrors and restraint, and wears the seatbelt where fitted
Operating the truck
Starts, stops and steers smoothly, without abrupt braking
Travels at a speed suited to the surface, load and pedestrian traffic
Sounds the horn at blind corners, doorways and aisle intersections
Travels in reverse when the load restricts forward visibility
Keeps forks low while travelling and tilted back as appropriate
Negotiates ramps and grades with the load upgrade
Handling loads
Judges load weight and centre of gravity against the capacity plate
Approaches, engages and lifts the load squarely and fully
Stacks and unstacks without damaging the load or the rack
Recognises when a load is unstable, damaged or overwidth and stops
The workplace itself
Works safely around pedestrians and maintains separation
Recognises surface conditions, floor loading and overhead clearance
Operates safely in narrow aisles, at docks and on trailers or railcars
Follows site rules for chocking, dock locks and trailer stability
Fuelling, charging and parking
Refuels or changes and charges batteries following site procedure
Parks with forks down, controls neutralised, brake set and key removed
Reports damage, near misses and unsafe conditions
Notes, retraining required, or conditions observed
Evaluator name and job title
Evaluator signature and date
Operator signature and date
Authorised to operate (truck types)

By signing, the employer certifies this operator has received the training required by 29 CFR 1910.178(l) and has been evaluated operating the truck types listed. Re-evaluate at least once every three years, and sooner where 1910.178(l)(4) requires it.

The classroom portion is our Forklift Operator Certification course, and you can watch a full module free before buying. Employers who would rather certify their own evaluators in house take Forklift Train the Trainer.