Vehicle Inspection Form

Program Tool

WWW.VIRTUALLABSCHOOL.ORG

ACTIVITY ID: 19396

Name

Certifier

Date

Items for School Pick Up/ Trip
Week/Date(s):	Please use this LEGEND to complete this form:
Vehicle #:	Y = Yes N= No N/A = For Contracted Vehicles
Odometer Reading: (Recorded on Monday)	M	T	W	R	F	S
Cell phone or two way radios
Children’s Emergency Information
Children’s Pick Up Lists (if applicable)
Gas Card (if applicable)
Statement of Insurance
Outside Walk Around Inspection
Tires (check for proper inflation and wear)
Mirrors Adjusted Properly
Exterior Lights (turn signals, brake lights, headlights, hazard lights)
Outside Body of Vehicle (check for damage)
Doors (check to ensure all open and close)
Before Starting Engine
Seats/ Seatbelts (ripped, frayed, broken)
Complete First Aid Kit (checklist in the kit)
Emergency Equipment (flares, reflective triangles, cones, etc.)
Emergency Procedures in Vehicle
Vehicle Log Book (if applicable)
Fire Extinguisher Charged
After Starting Engine
Interior Lights- Exit Signs
Gas Levels
Heating and Air Conditioning
Horn Works
Windshield Wipers (work, blades not worn, fluid full)
Trip Destination
Vehicle is Clean and Free of Trash
Complete Walk Through Vehicle Before Securing
Driver’s Initials Every Day
Explanation of problems noted during pre-inspection and/or travel: (Please report problems to supervisor)

Adapted from Navy Child and Youth Programs: Pre-Trip Vehicle Inspection Daily Form