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Occupational Health and Safety Act, 1993 (Act No. 85 of 1993)

Driven Machinery Regulations, 1988

National Code of Practice for the Training Providers of Lifting Machine Operators (2015)

Appendices

Appendix 3 : Example of a practical assessment mark sheet

 

 

ACCREDITED PROVIDER:                                                                                                                                                                                                          

CANDIDATE:                                                                                          

DATE:                                                                              

I.D.  NUMBER:                                                                                        

MACHINE TYPE:                                                          

MACHINE MAKE:                                                                                  

MACHINE CODE:                                                        

COMPANY:                                                                                              

CAPACITY:                                                                    

 

PRE-START CHECKS (Delete items not specific to the test machine or conditions)

 

Personal Protective Equipment for the work environment                                                                                                                                        

{May include hardhats, overalls, thermal suits, goggles, earplugs as applicable}

 

Safety Shoes /Boots


Load Chart & Max Mass Load


Forks /Attachments *


Position of Forks


Load Backrest


Tyre Condition & Pressure


Machine Condition


Wheel Nuts


Battery Terminals


Overhead Guards


Electroylyte Level


Engine & Transmission Leaks


Engine Oil Level *


Hydraulic Oil Leaks


Hydraulic Oil Level


Brake Fluid Leaks


Brake Fluid Level *


Petrol/Diesel Leaks


Radiator Water Level *


Gas Leaks


Radiator Cap


Water Leaks


Water Pump


Drivers Compartment


Fan Belts


Mast & Chains *


Fan Blades


Hydraulic Cylinders


Drive Belts


Hoses Condition


Fuel Level




 

PRE-OPERATIONAL TESTS

 

Enter & Adjust Seat


Gauges (before and after)*


Control levers/pedals


Ignition Key


Raise & lower


Foot Brake*


Tilt Front & Back


Hand /Park Brake*


Forward & Reverse


Steering Operation*


Horn


Attachment controls


Lights /Indicators




Total Items Unchecked                            




* Omission to check anyone of these items would constitute the learner/operator not being yet competent of the Pre-start checks and Pre-operational test.

THEORY TEST QUESTIONS (group)




1                                                                                            


4                                                                                          


2                                                                                          


5                                                                                          


3                                                                                          




 

Penalties

 

Total items unchecked from Pre-start and Operational Assessment:                                               : x 2 =                                                     *      

 

* Maximum 20 penalties

 

 

1        TOTAL PRE-START AND PRE-OPERATIONAL PENALTIES


 

 

PRACTICAL OPERATING ASSESSMENT

(Delete items not specific to the test machine)

 

Penalties

Forks Bind on Entry/Withdrawal


=


: x 5 =


Forks not central under Load


=


: x 5 =


Load not at Heel of Forks


=


: x 5 =


Stack/De-stack with Mast Tilted


=


: x 5 =


Fails to Stack/De-stack Correctly


=


: x 5 =


Fails to Apply Park/Handbrake


=


: x 5 =


Fails to Place in Neutral


=


: x 5 =


Fails to Position Mast for Travel


=


: x 5 =


Fails to Position Forks for Travel


=


: x 5 =


Places Body Outside Cabin


=


: x 5 =


Bump Side of Course


=


: x 10 =


Fails to Look in Direction of Travel


=


: x 5 =


Selects Wrong Control/Direction


=


: x 10 =


Shunts to Stack/Un-stack


=


: x 1 =


Shunts to negotiate Chicane


=


: x 1 =


Fails to Release Park/Handbrake


=


: x 5 =


Fails to hold steering wheel during travel


=


: x 10 =


Accelerates erratically


=


: x 1 =


Brakes erratically


=


: x 3 =


Uses Controls roughly


=


: x 5 =


Hands on Controls


=


: x 5 =


 

CLOSE DOWN CHECKS (PARK)






Fails to Place in Neutral


=


: x 2 =


Fails to Set Park Brake


=


: x 2 =


Fails to Set Mast and Forks


=


: x 2 =


Fails to Shut off Gas


=


: x 2 =


Fails to Operate Diesel Cut Out


=


: x 2 =


Fails to Switch Off


=


: x 2 =


Fails to Remove Key


=


: x 2 =


 

2        TOTAL OPERATING AND CLOSE DOWN PENALITES


 

 

TIME PENALTIES

 

The assessor is to complete the course to establish a fair time (minimum 15 minutes) and then add 50% to establish the maximum time to complete the operational and close down (park) assessment.

 

Maximum time permitted


Minutes


Seconds

Duration of operating assessment


Minutes


Seconds

 

 

 

3        TIME PENALTIES (6 penalties for every 60 seconds above the maximum)


Summary of Penalties


1  PRE-START AND PRE-OPERATIONAL


2  OPERATING AND CLOSE DOWN


3 TIME


 

TOTAL  PENALTIES


 

 

Note

 

A maximum of 50% of the total scored penalty points calculated by 6 penalty points per 1 minute of operational assessment time (driving time).

 

RESULT:








COMPETENT


NOT YET COMPETENT


 

Assessor:


Registration No:


Signature:


Date:


 

I, the undersigned, acknowledge that the process and results were explained to me and I accept the outcome of the assessment.

Signature/Mark of Learner