Equipment Competency Assessment Form
Evaluate and document an individual's competency to operate or use specific equipment. Complete all sections for a thorough assessment.
Assessor Name
*
First Name
Last Name
Operator (Assessee) Name
*
First Name
Last Name
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Equipment Name or Type
*
Equipment/Asset ID or Identifier
*
Competency Areas Assessment
*
Rows
Not Competent
Needs Improvement
Competent
Exceeds Expectations
Pre-operational Checks
1
2
3
4
Equipment Setup
5
6
7
8
Operation/Use of Equipment
9
10
11
12
Shutdown Procedures
13
14
15
16
Safety and Inspection Knowledge
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Assessment of Practical Skills/Operating Procedures
*
1
2
3
4
5
Overall Competency Result
*
Competent
Requires Further Training
Not Competent
Assessor Comments or Next Steps
Submit Assessment
Should be Empty: