Pre-Shift Fitness & Vehicle Readiness Report for Transit Operators

Operator ID Number

Full Legal Name

Operator Role/Position

Shift Start Date and Time

Shift Type/Rotation

Assigned Vehicle/Unit Number

Route/Line Designation

Base Depot/Operating Location

Emergency Contact Number

Primary Language for Operational Communication

Time You Went to Sleep (most recent rest period)

Time You Woke Up (most recent rest period)

Overall Sleep Quality Rating (1=Poor, 5=Excellent)

Did you experience any sleep interruptions?

Did you take any naps in the last 24 hours?

Did you use any sleep aids or medication to assist with sleep?

Do you feel adequately rested and refreshed upon waking?

Did you work any overtime or extra shifts in the last 24 hours?

Sleep Environment Quality (1=Very Poor, 5=Optimal)

Are you experiencing cumulative fatigue or sleep debt from previous shifts?

Are you currently experiencing any illness, infection, or health symptoms?

Are you experiencing symptoms of infectious disease (fever, cough, sore throat, etc.)?

Have you taken any prescription or over-the-counter medication in the last 24 hours?

Have you consumed any alcohol in the last 24 hours?

Have you used any non-prescribed substances that may impair performance?

Is your vision adequate for duty (with or without corrective lenses)?

Is your hearing adequate for duty (with or without hearing aids)?

Are you experiencing any pain, discomfort, or mobility limitations?

Do you have any dental pain or issues affecting your ability to concentrate?

Current Mental Alertness Level (1=Very Drowsy, 5=Fully Alert)

Current Stress Level (1=Very Stressed, 5=Calm/Composed)

Current Emotional State

Can you perform safety-critical tasks without cognitive impairment?

Fatigue Level Self-Assessment

Do you have any scheduled medical appointments or treatments during this shift?

Hydration Status (1=Dehydrated, 5=Well Hydrated)

Hunger/Nutritional Status (1=Very Hungry, 5=Satisfied)

I confirm that all medical and health information provided is accurate and complete to the best of my knowledge.

Have you completed the exterior walk-around visual inspection?

Are all brake systems responding correctly (service, parking, emergency)?

Do all door control systems operate smoothly and safely?

Are all communication systems functional (radio, PA, emergency communication)?

Are all signaling and indicator systems operational?

Is the speedometer accurate and calibrated?

Is all mandatory emergency equipment present and accessible?

Are all primary control systems responsive and functioning?

Is the HVAC system operating correctly (heating, ventilation, air conditioning)?

Are all interior and exterior lights functioning properly?

Is the windshield clear and are wipers/washers operational?

Is the operator seat adjustable and in safe condition?

Are all mirrors and camera systems clean, adjusted, and functional?

Are all onboard computer and diagnostic systems functioning without critical errors?

Is the vehicle clean and sanitized to operational standards?

Did you identify any defects or anomalies during inspection?

I confirm that the vehicle cab inspection has been completed thoroughly and accurately according to standard operating procedures.

Dispatch Supervisor Name

Supervisor ID Number

Have you reviewed all sections (1-4) of this pre-shift report in detail?

Are there any concerns regarding operator fitness, vehicle readiness, or documentation completeness?

Categories of Concern Identified (select all that apply)

Final Fitness for Duty Determination

Is escalation to higher management or medical review required?

Additional Supervisor Comments and Operational Instructions:

Dispatch Supervisor Digital Signature

Supervisor Review Completion Timestamp

I confirm that this pre-shift report has been properly reviewed and the operator has been cleared (or not cleared) for duty according to established safety protocols.