CDL Form Driver Performance Evaluation - PSATS

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)

J Fully evaluates condition of vehicle

J Checks for oil, water, fuel leaks

J Checks fuel, oil, and water levels

J Checks tires, lights, reflectors

J Checks air hoses, electrical connections

J Checks suspension points, steering linkage

J Checks service and parking brakes; hand valve

J Checks wipers, mirrors, horn, and gauges

J Checks emergency equipment

J Cleans windows, mirrors, lights

J Uses DVIR

PLACING VEHICLE IN MOTION

J Checks mirror adjustment

J Puts transmission in neutral

J Shifts gears smoothly

J Starts motor without difficulty

J Allows proper warm-up

J Builds full air pressure before starting

J Checks brakes within 100 ft. of starting

J Checks and understands instruments

J Uses clutch properly

J Maintains proper engine RPM

J Times gearshift properly

J Uses proper gear sequence

J Uses seat belt

BRAKING AND SLOWING

J Brakes as soon as need is recognized

J Avoids sudden stops

J Stops smoothly without rolling back

J Tests brakes at top of hills

J Gears down to descend grades

J Uses brake properly on grades

J Keeps check on air gauges

CONTROLS AND EQUIPMENT

J Knows proper use of parking brake

J Knows proper use of hand valve

J Understands ¡°low air¡± warning

J Understands use of 4-way flashers

J Uses proper headlight beam

J Dims lights when following others

J Dims lights when meeting others

J Adjusts speed to range of lights

J Knows how to replace fuses

J Knows how to use fire extinguisher

J Knows placement of warning devices

J Knows placement position of chocks

J Knows operation of engine brake (if equipped)

OPERATING IN TRAFFIC

Intersections and Turning

J Enters intersections prepared to stop

J Checks for cross traffic

J Yields to others

J Signals direction changes in advance

J Gets in proper lane well in advance of turn

J Turns only when way is clear

J Blocks traffic from curb side of turn

Signs and Signals

J Starts slowly from stopped position

J Looks ahead for signs and signals

J Comes to a complete stop at stop signs

J Approaches signs and signals prepared to stop

J Slows vehicle gradually

R.R. Grade Crossings

J Adjusts speed to crossing conditions

J If required, comes to a complete stop

J Stops required distance from crossing

J Avoids shifting gears while crossing

Over ¡­

BACKING AND PARKING

Backing

J Avoids backing from blind side

J Avoids unnecessary backing

J Warns others when backing

J Checks area before backing

J Uses mirrors to advantage

J If in doubt, gets out and looks

J Proper backing maneuvers

Vehicle Parking

J Selects safe area to park

J Parks to avoid backing when leaving

J Parks correct distance from curb or roadway

J Turns on warning flashers

J Secures unit:

J Turns wheels

J Sets brakes

J Puts in gear

J Shuts off engine

J Uses chocks

J Locks unit

J Checks traffic when pulling out

OPERATING IN TRAFFIC (continued¡­)

Passing

J Allows sufficient space for passing

J Passes only when there is long-term advantage

J Passes only in safe location

J Signals when changing lanes

J Signals before passing

J Proceeds in proper lane

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

J Adjusts speed for curves, other danger zones

General

J Grips steering wheel properly

J Good driving posture

J Centers vehicle in driving lane

J Reads traffic lights in advance

J Evaluates traffic patterns early

J Aware of traffic around unit

J Frequent use of mirrors

J Avoids being boxed in

J Makes eye contact with others

J Alert to live parking

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: __________________

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