Driving Assessment Form

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Driver Assessment Checklist

Doc No: HSE-TEM-G165 Issue No: 01, Rev: 0 Date: 8.1.2020

Name: Location:

License No.: Current & Valid: Yes No

Vehicle Type: Date:

SUB TASKS STEPS: Did the Driver: C/ Initial of


NYC Assessor

1. Complete a  Make sure that a comprehensive Pre-Trip Inspection was completed?


Pre-Trip  Make sure vehicle was fuelled sufficiently for the forthcoming task?
Inspection
2. Prepare for  Fit the seat belt securely?
driving  Adjust the mirrors to suit?
 Start the engine with one hand on the wheel?
 Check all gauges?
3. Maintain At the front?
space  Stop in traffic, one car length behind the vehicle in front?
 Use 1, 2, 3 delay after vehicle ahead starts to move?
 Maintain four to six second following time?
At the rear?
 Use rear view mirrors to understand what was happening behind and before
braking?
 Manage ‘tailgaters’?
To the sides?
 Slow down or speed up to avoid being boxed in?
4. Maintain  Check intersections – check LRL or RLR before entering and until cleared?
visibility  Use five to eight second mirror check – include side mirrors and rear vision
mirror?
 Scan the steering wheels of parked cars – to see if anyone is sitting there
ready to pull out?
 Glance over shoulder – clear blind spot before changing lanes or pulling out
from a curve?
 Establish eye contact with others who may enter your path?
 Check instruments and gauges at appropriate time?
 Use trained eye lead time planning zone – aim high in steering using eyes to
safety lead the vehicle down the road?

5.Considerate  Slow down when encountering rough terrain?


driving  Use appropriate driving style to avoid equipment abuse?

Assessor comments:

Note: GPS Black Key will be issued once passed the practical driving test by HSE Department.

Assessor Name & Signature: ……………………………. Approved By: …………………………….

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