Crane Operator Safety Evaluation Checklist Form
Complete this checklist to evaluate crane operator safety, including operator details, equipment inspection, safety checks, observed hazards, and evaluation outcome.
Operator Full Name
*
First Name
Last Name
Date of Evaluation
*
-
Month
-
Day
Year
Date
Crane Type/Model
*
Job Site/Location
*
Pre-Operation Inspection Checklist
*
Checked fluid levels (oil, hydraulic, fuel)
Inspected wire ropes and hooks
Verified controls and safety devices
Checked tires/tracks and outriggers
Inspected for visible damage or leaks
Operational Safety Checklist
*
Operator wearing required PPE
Load chart present and understood
Proper communication signals used
Area clear of personnel and obstructions
Stability and ground conditions checked
Rate Operator's Awareness of Surroundings
*
Low
1
2
3
4
High
5
1 is Low, 5 is High
Observed Hazards (if any)
Evaluator's Comments
Final Evaluation Outcome
*
Pass
Needs Improvement
Fail
Evaluator Name
*
First Name
Last Name
Submit Evaluation
Should be Empty: