Driver Trainee Evaluation

Date*

Trainee Name*

First Last

FTO Name*

First Last

Shift*

Number of Calls?*

Number of GREEN driving Calls?*

Number of RED driving Calls?*

Preparatory Section

Please select Yes, No, or Not Applicable Evaluate the following statements:

Prompt Arrival?*

Yes
No

In Uniform?*

Yes
No

Rig Check Performed?*

Yes
No

Wears Safety Restraints at all times?*

Yes
No

Completion of duties? (wash rig, restock, etc)*

Yes
No

Base Knowledge (MDT, Phones, Radios, Loan Closet)*

Yes
No

If no to any of the above, please elaborate.

Calls

Call # for the day*

Priority of call?*

Type of Call?

Proper policies and procedure utilization*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Radio Communications and Operations*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Emergency Console and Light operation*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Drives proper speed GREEN*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Drives proper speed RED (No more than 10 over posted speed limit)*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Drives with due regard*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Anticipates road hazards*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Proper and Safe Backing, with backer.*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Good communication and interaction with crew*

Positive acceptance of feedback*

Does not use their cellular device while driving*

Assistant Skills*

Equipment location and use*

Patient lifting and moving*

Geography Knowledge*

Comments on this call?

Was there another call? (2)*

Yes
No

Call number for the day*

Priority of call?*

Type of Call?

Proper policies and procedure utilization*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Radio Communications and Operations*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Emergency Console and Light operation*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Drives proper speed GREEN*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Drives proper speed RED (No more than 10 over posted speed limit)*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Drives with due regard*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Anticipates road hazards*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Proper and Safe Backing, with backer.*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Good communication and interaction with crew*

Positive acceptance of feedback*

Does not use their cellular device while driving*

Assistant Skills*

Equipment location and use*

Patient lifting and moving*

Geography Knowledge*

Comments?

Was there another call? (3)*

Yes
No

Call number for the day*

Priority of call?*

Type of Call?

Proper policies and procedure utilization*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Radio Communications and Operations*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Emergency Console and Light operation*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Drives proper speed GREEN*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Drives proper speed RED (No more than 10 over posted speed limit)*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Drives with due regard*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Anticipates road hazards*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Proper and Safe Backing, with backer.*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Good communication and interaction with crew*

Positive acceptance of feedback*

Does not use their cellular device while driving*

Assistant Skills*

Equipment location and use*

Patient lifting and moving*

Geography Knowledge*

Comments

Was there another call? (4)*

Yes
No

Call number for the day*

Priority of call?*

Type of Call?

Proper policies and procedure utilization*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Radio Communications and Operations*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Emergency Console and Light operation*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Drives proper speed GREEN*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Drives proper speed RED (No more than 10 over posted speed limit)*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Drives with due regard*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Anticipates road hazards*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Proper and Safe Backing, with backer.*

Performs Independently
Needs Guidance
Needs Remediation
Observed
N/A

Good communication and interaction with crew*

Positive acceptance of feedback*

Does not use their cellular device while driving*

Assistant Skills*

Equipment location and use*

Patient lifting and moving*

Geography Knowledge*

Comments

Closing

Overall, was your trainee professional in their appearance and demeanor?*

Yes
No
Sort of. Please explain below.

Any issues the Training Department needs to be aware of throughout the shift?*

Yes
No

What were the issues?

Comments to the Training Department*

Comments to the Trainee*

Are you giving this driver trainee a clearance signature?

Name

This field is for validation purposes and should be left unchanged.