Bus Inspection Form

 

Circle One: District / Charter School / Contractor Entity’s Name: ___________________________________

 

Status Code

√

= Item OK

Bus # __________________ Mileage ________________________ Date _________________________

X = Needs Repair

O =

(or as noted)

Chassis/Body _______________/_______________ Capacity ____________ Model Year _____________

O = Out of Service

N/A = Not Applicable

Shop Location

________________________________

Circle One: Daily / Spare / Activity

 

 

Status

Code

INSPECTION ITEMS

PICK TEN AREAS

COMMENTS

(Note Specific Deficiencies)

Tech

Init.

 

A. INSIDE BUS

(REQUIRED)

 

  

  

1.

Emergency Equipment -

Fire Ext. (press., tag, mount), First Aid Kit,

Body Fluid Cleanup Kit, and Reflectors

 

  

2.

Registration and Insurance Card

 

  

  

3.

Neutral Safety Switch and Shifter

 

  

  

4.

Engine Controls

- Key Switch, Choke, Accelerator, and Engine Shutdown

  

  

5.

Gauges, Indicators & Dash Lights, Engine Warning

     

Lights, and Buzzers, and ABS Warning Light

 

 

  

6.

Air Brake System-

Gauge(s), Build-Up, Governor, Park Brake,

Adjustment, Air Leaks, Low Air Warning, PP-1 Pop-Off, and Pedal

 

  

7.

Hydraulic Brake System -

Warning Light, Gauge, Pedal, Travel &

Fade, Power Assist, and Park Brake

 

  

8.

Windshield Wipers & Washers -

Operation, Park, and Blades

  

  

9.

Heaters, Defrosters, and External Dash Fan(s)

 

  

  

10.

Dome and Step Well Lights

 

  

  

11.

Service Door -

Operation, Control, and Overhead Pad

  

  

12.

Horn(s)

 

  

  

13.

Mirror Adjustment, Condition -

Rearview, Convex, and Interior

  

  

14.

Operator’s Seat and Seat Belt

 

  

  

15.

Passenger Seats -

Frames, Mounting, Pads, Cuts, Bottoms, Modesty

Panels, Stanchions, Passenger Securement Devices, and Webbing Cutter

 

  

16.

Emergency Door(s)/Windows/Hatch(es)

Operation, Buzzers, Labeling

and Overhead Pad(s)

 

  

17.

Windshield, Side & Rear Windows

Cracks, Fogging, Latches, and Visor

  

  

18.

Wheelchair Lift, Door, and Securement System -

(if equipped)

  

  

19.

2 Way Radio Operation -

(if equipped)

  

  

20.

Interior Wiring, Cab Hoses, and Fire Wall Seals

 

  

  

21.

General Condition, Bus Interior -

Floor, Step well, Grab Rail(s),

Paneling, Broom Mounting, Loose Objects Secured, and Engine Cover

 

  

 

B. OUTSIDE BUS (REQUIRED

)

  

  

1.

Headlights, Turn Signals, Hazard, Side Marker, Brake, Tail, Backup

Lights, Backup Alarm & Dash Sticker (if equipped), and Park Lights

 

 

  

2.

Clearance & ID Lights, Reflectors, and Strobe Light

(if equipped)

  

  

3.

Pupil Warning Lights -

(see eight light warning system chart)

  

  

4.

Stop Arm(s), and Student Crossing Arm -

Wiring, Air or Vacuum Leak,

and Decal

 

  

5.

General Condition, Bus Exterior

Mirrors, Bumpers, Body Damage, Paint

Reflective Marking, Lettering, Emergency Door, Engine Hood, & Cleanliness

 

  

 

C. ENGINE COMPARTMENT (REQUIRED)

  

  

1.

Steering -

Play, Column, Steering Gear Box Mounting, Pitman Arm,

Drag Link, Steering Arm, Tie Rod & Ends, and Idler Arm

 

  

2.

Batteries -

Hold Down, Terminals, Cables, Cleanliness, Slide Tray, & Load

Test

 

  

3.

Fluid Levels and Condition

 

-

Brake, Power Steering, Oil, Transmission,

Windshield Washer, Coolant, and (Antifreeze ______________°F)

 

  

4.

Belts & Hoses -

Tightness, Condition, Routing, and Belt Alignment

  

  

5.

Accessory Mounting & Condition -

Air Cleaner (Restriction ____”H20),

P.S., Pump, Air Compressor & Filter, Water Pump, Fan and Alternator

 

  

6.

Wiring -

Routing and Condition

  

  

---

 

  

 

Status

Code

INSPECTION ITEMS

COMMENTS

(Note Specific Deficiencies)

Tech

Init.

7.

Fuel System and Lines

 

  

  

8.

Radiator -

Mounting, Cap, Reservoir, and Fan Shroud

  

  

 

D. UNDERNEATH BUS

(REQUIRED)

  

  

1.

Front Suspension -

Wheel Bearings, I-Beam (King Pins, Shackles, Spring

Mounts, Pins & Bushings), A-Frames and Bushings (Ball Joints), U-Bolts,

Shocks, Springs, and Seals

 

  

2.

Front Brakes -

Hoses, Lines, Chambers, Slack Adjusters, Pushrods, Linings,

Drums, Rotors, Wheel Cylinders or Calipers. Check Brake Adjustment (on all

buses) and adjust as necessary.

 

  

3.

Engine/Transmission Mounts, Starter Mounting

 

  

  

4.

Transmission -

Bolts, Linkage, Lines, Filter and Cooler, & Clutch (if equipped)

  

  

5.

Fluid Leaks -

Oil, Coolant, Transmission, P.S., etc.

  

  

6.

Fuel Tank -

Leaks, Mounting, Hoses, and Wiring

  

  

7.

Brake Equipment -

Lines, Valves, Reservoir Mounting, and Bleed Reservoirs

  

  

 

8. Driveline -

Shafts, U-Joints, Yokes, Hanger Bearings, Guards, and Driveshaft

Park brake

 

  

9.

Rear Suspension -

Axle Housing, Vent, Differential, Springs, U-Bolts, Shocks,

     

Spring Shackles, Pins and Bushings, Hangers, Seals, and Wheel Bearings

 

  

10.

Rear Brakes -

Hoses, Lines, Chambers, Slack Adjusters, Pushrods, Linings,

Drums, Rotors, Wheel Cylinders or Calipers. Check Brake Adjustment (on all

buses) and adjust as necessary.

 

  

11.

Body Securement & Structure -

Hold Downs, Floor, Outriggers, Braces,

Skirts, and Chassis Frame Rails

 

  

12.

Exhaust Systems -

Leaks, Mounting, Muffler and Tailpipe

  

  

13.

Wheels and Tires -

Tread Depth, Pressure, Damage, Matching, Alignment,

and Wheel Hardware

 

  

 

E. LUBRICATION & MAINTENANCE (OPTIONAL)

 

  

  

1.

Change Oil and Replace Oil Filter(s) qts. _______________

 

  

  

 

2.

Replace Fuel Filter(s) Primary/Secondary and Drain Separator.

 

  

  

 

3.

Replace Transmission Filter(s) qts. _______________

 

  

  

 

4.

Replace Air Compressor Filter (if applicable)

 

  

  

 

5.

Replace P/S Filter pts. ______________

 

  

  

 

6.

Replace Engine Air Cleaner Filter

 

  

  

 

7.

Replace Water Filter (if applicable)

 

  

  

 

8.

Test Starting and Charging System Amps ________) Volts __________)

 

  

  

 

9.

Lubricate Chassis and Body Lbs. ______________

 

  

  

10.

Air Conditioning

Perform A/C system preventive maintenance (if equipped)

according to district procedure.

 

  

 

F. ROAD TEST

(REQUIRED)

  

  

1.

Brake Performance -

Park Brake, Stopping Distance and Equalization

  

  

2.

Engine, Transmission, Driveline -

Engine Performance, Governor, & Shifting

  

  

3.

Steering & Handling -

Free Play, Power Assist, Column, and Tracking

  

  

 

Comments: _______________________________________________

Depth / Pressure

Depth

 

/ Pressure

 

_________________________________________________________

RF ______/_______ RRO ______/_______

 

_________________________________________________________ RRI

_______/_______

 

_________________________________________________________

LRI ______/_______

 

_________________________________________________________

LF ______/________ LRO ______/_______

 

 

NOTE: If bus is equipped with optional equipment not noted on this form, follow the manufacturer’s inspection and maintenance procedures.

 

Inspector’s Signature: _____________________________

Inspector’s Certification #: _________-__________

 

Service Manager’s or Delegate’s Initials: _____________ Bus Returned To Service Date: _______/______/_______

 

 

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Bus Safety Inspections

Performance Determination Worksheet

 

 

Performance Determination

 

a. _____ Number of buses in sample

b. _____ Number of areas on the inspection forms inspected per bus. Ten areas are required.

District may inspect more areas at its discretion.

c. _____ = Total Possible Inspection Items (a x b = c)

d _____ Number of Items Marked Out of Service

e. _____% Performance Level = 100 - [(d. ÷ c.) X 100]

f. _____ Highest number of buses with identical safety related out-of-service item

g. _____% Percentage of buses with identical safety related out-of-service items = (f. ÷ a.) x 100

 

 

If “e” above is less than 90 percent, or if “g” is more than 50 percent, the district must include a written finding

below. The written finding (if applicable) must summarize the specific problems with the transportation

inspection and maintenance program.

 

Written Finding:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A Corrective Action Plan as outlined in the enclosed

COMPLIANCE STATEMENT

must be submitted when

noncompliance exists. The Corrective Action Plan must include measures the district will take to prevent future

occurrences. If any bus has out-of-service items, the district shall withdraw the bus from service until repairs

are made and documented.

 

Signature: __________________________________ Date: _________________

 

---

 

  

 

 

SAFETY INSPECTIONS EXAMPLE:

 

Total sample size of 27 buses. District chose to inspect the minimum of ten (10) areas on

the inspection form. Buses had 11 out-of-service items and seven buses had identical out-

of-service items:

 

 

Performance Determination

 

a.

__27_ Number of Buses in Sample

b.

__27 x 10 (Number of Areas Inspected per Bus)

c.

__270_ = Total Possible Inspection Items (a x 10 = c.)

 

  

27 x 10 = 270

d

__11__ Number of items marked “Out-of-Service”

11 out-of-service items were found

e.

_96_% Performance Level = 100 - [(d ÷ c) x 100]

11 ÷ 270 = .04 then .04 x 100 = 4 then 100 – 4 = 96

f.

__7__ Highest number of buses with identical safety related out-of-service item

Item “X” was out-of-service on seven buses

g.

_26_% Percentage of buses with identical safety related out-of-service items = (f ÷ a) x 100

 

 

  

7 ÷ 27 = .26 then .26 x 100 = 26

 

 

NOTE

: This is an example only. Pick your sample size according to the previous instructions.

 

 

NOTE

: The example above of 96 percent is in compliance. Anything less than 90 percent is noncompliant;

however,

 

if 50 percent or more of the buses in the sample have the same out-of-service item (“g”), the district is

automatically noncompliant.

 

---

 

  

 

Compliance Statement

School Bus Safety Inspections

 

 

Check one as applicable:

 

 

[ ] The ____________________________ School District (including charter schools and contracted student

transportation providers if applicable)

has

completed and complied with all requirements of this criterion.

 

 

[ ] The ____________________________ School District (including charter schools, and contracted student

transportation providers if applicable)

has not

completed and complied with all requirements of this criterion,

i.e., the performance level was less than 90 percent or more than 50 percent of the deficiencies were identical.

 

Note: A Corrective Action Plan as outlined below must be submitted when the district is found to be

noncompliant.

 

 

Signed:______________________________________________ __________________________

District Transportation Director Date

 

Signed:______________________________________________ __________________________

Superintendent of Schools (or designee) Date

 

 

This page and the completed forms must be submitted by OCTOBER 27, 2006, to:

 

 

Bud Fletcher, Monitoring Coordinator

School Transportation Management Section

325 W. Gaines Street, # 1134

Tallahassee, FL 32399-0400

 

Corrective Action:

 

 

 

 

 

 

 

 

 

 

 

 

 

Person Responsible:

 

 

Anticipated Completion Date:

 

---

 

  

Special Needs Transportation

 

Criterion:

 

Documentation was sufficient to confirm that all operators and attendants transporting

students with disabilities were provided the appropriate training to meet the students’

needs based on the students’ individual educational plans (IEPs), and the transportation

services for each student were in compliance with his/her IEP. Observation and

inspection confirmed that the school bus equipment used to meet each student’s IEP was

in compliance with the Florida School Bus Specifications, and that the equipment was

being used properly by the operators and/or attendants (Individuals with Disabilities

Education Act; 34 CFR Parts 300.323(c)(2) and 300.323(d)(1)-(2); Family Education

Rights and Privacy Act, 34 CFR Parts 99.31 and 99.33; Head Start Transportation

Regulations, 45 CFR Part 1310; Section 1003.57, F.S.; National Highway Traffic Safety

Administration Guidelines for the Safe Transportation of Preschool Age Students on

School Buses; and the National School Transportation Specifications and Procedures).

 

 

Procedures for Completing the Self-Evaluation:

 

School buses, school bus operators, and attendants must be prepared to meet the needs of the students with

disabilities that they transport. The buses must be equipped with the proper equipment, the bus operators and

attendants must have appropriate training, and the transportation requirements for each student’s IEP must be

implemented. This criterion should be evaluated based on the training records for school bus operators and

attendants, the IEPs of the students on the specific buses, and an on-site review of bus equipment and student

securement on an official bus route. The district shall evaluate its bus operator and attendant training records,

the students’ IEPs for transportation compliance, and its special bus equipment on routes serving students with

disabilities using the enclosed

Bus Operator and Attendant Training Records Review, Student(s) IEP

Compliance Review, and Bus Equipment Review

worksheets.

 

NOTE:

Ensure that the top portion of each worksheet is completed to identify the entity (i.e., the district,

charter school, or contractor).

 

The completed records worksheets and Special Needs Transportation Review Report must be filed at a single

location within the school district and copies shall be included in the self-evaluation packet submitted to DOE.

 

The superintendent or designee shall verify that the district, charter schools, and contractors have completed

these procedures and that the

Special Needs Transportation Review Report

and associated forms are

submitted to DOE by October 27, 2006.

 

 

Bus Operator and Attendant Training:

 

The bus operator and attendant must be trained to properly handle students with disabilities and their special

needs. For each area listed on the

Bus Operator and Attendant Training Records Review

worksheets, please

identify the date the training was held; if the training was not applicable, please indicate “N/A.” If a student

requires specialized training, please note the type of training and the date the training was held.

NOTE

:

Confidentiality and evacuation planning training must be held for all personnel who ride buses that transport

students with disabilities.

---

 

  

 

Sample Size:

 

NOTE

: The following sample size shall apply to each individual entity, i.e., district operators and attendants,

charter school operators and attendants, and contractor operators and attendants.

 

The minimum sample size shall be ten percent of the bus operators and attendants, with no fewer than five

operators and attendants (when there are at least five) and no more than 25 operators and attendants for the

larger districts.

 

 

IEP Compliance:

 

Please provide with the self-evaluation packet submitted to DOE the procedure used to obtain information from

each student’s IEP for the applicable students for which the district, charter school, or contractor provides

transportation. Using the enclosed Student(s) IEP Compliance Review Worksheet, please indicate whether or

not the IEP transportation requirements were met for each student in the self-evaluation review.

 

 

Sample Size:

 

NOTE

: The following sample size shall apply to each individual entity, i.e., district schools, charter schools,

and contractors.

 

The minimum sample size shall be ten percent of the students with disabilities that receive weighted funding,

i.e., fall under one of the five categories:

(1)

 

Medical equipment required. Medical equipment is defined as wheelchair, crutches, walker, cane,

tracheotomy equipment, positioning or unique seating devices.

(2)

 

Medical condition that requires a special transportation environment as per physician’s prescription (for

instance, tinted windows, dust-controlled atmosphere, temperature control).

(3)

 

Aide or monitor required due to disability and specific need of student.

(4)

 

Shortened day required due to disability and specific need of student.

(5)

 

School assigned is located in an out-of-district school system.

 

No fewer than five student records/IEPs shall be reviewed (when there are at least five) and no more than 25

records are required to be reviewed in the larger districts.

 

 

Bus Equipment:

 

For each bus that transports students with disabilities, fill out the information on the enclosed

Bus Equipment

Review

worksheet while the bus is “en route,” i.e., while the students are riding the bus.

 

For each wheelchair (W/C) position:

o

 

ensure that there is a complete, matching wheelchair tiedown and occupant restraint (WTOR) system;

ensure that the straps have no cuts or frays and that the buckles and retractors work properly

o

 

ensure that the wheelchair is secured properly

o

 

ensure that the occupant is secured appropriately

---

 

  

 

For each child safety restraint system (CSRS):

o

 

circle the type – car seat, safety vest, or integrated seat

o

 

ensure that the equipment (car seat/safety vest) is installed correctly

o

 

ensure that the occupant is secured correctly

For oxygen:

o

 

the tank must be secured to withstand at least five times its weight

For other equipment:

o

 

please note type of equipment and ensure that it is secured appropriately

 

 

Sample Size:

 

NOTE: The following sample size shall apply to each individual entity, i.e., district buses, charter school buses,

and contractor buses.

 

The minimum sample size shall be one bus for rural districts (up to 199 buses in fleet); two buses for urban

districts (200 - 399 buses in fleet); and three buses for mega districts (400 or more buses in fleet).

 

 

 

 

Special Needs Transportation Review Report:

 

The school district shall provide a report based on the review of the requirements of this section, noting any

deficiencies that are found. If there are deficiencies noted, please provide information on how the district plans

to correct the deficiencies along with a time line for implementation.

---

 

  

Bus Operator Training Records Review Worksheet

 

 

Circle One: District / Charter School / Contractor Entity’s name: ____________________________

 

Name

  

  

  

  

  

*Confidentiality

Training

      

*Evacuation

Planning

Training

      

Wheelchair/Occupant

Securement

Training

      

Child Safety Restraint System (CSRS) Training

  

  

  

  

  

Student Specific Training: provide date and type

 

 

  

  

  

  

Student Specific Training: provide date and type

 

 

  

  

  

  

Student Specific Training: provide date and type

 

 

  

  

  

  

Name

  

  

  

  

  

*Confidentiality

Training

      

*Evacuation

Planning

Training

      

Wheelchair/Occupant

Securement

Training

      

Child Safety Restraint System (CSRS) Training

  

  

  

  

  

Student Specific Training: provide date and type

 

 

  

  

  

  

Student Specific Training: provide date and type

 

 

  

  

  

  

Student Specific Training: provide date and type

 

 

  

  

  

  

Name

  

  

  

  

  

*Confidentiality

Training

      

*Evacuation

Planning

Training

      

Wheelchair/Occupant

Securement

Training

      

Child Safety Restraint System (CSRS) Training

  

  

  

  

  

Student Specific Training: provide date and type

 

 

  

  

  

  

Student Specific Training: provide date and type

 

 

  

  

  

  

Student Specific Training: provide date and type

 

 

  

  

  

  

Name

  

  

  

  

  

*Confidentiality

Training

      

*Evacuation

Planning

Training

      

Wheelchair/Occupant

Securement

Training

      

Child Safety Restraint System (CSRS) Training

  

  

  

  

  

Student Specific Training: provide date and type

 

 

  

  

  

  

Student Specific Training: provide date and type

 

 

  

  

  

  

Student Specific Training: provide date and type

 

 

  

  

  

  

Name

  

  

  

  

  

*Confidentiality

Training

      

*Evacuation

Planning

Training

      

Wheelchair/Occupant

Securement

Training

      

Child Safety Restraint System (CSRS) Training

  

  

  

  

  

Student Specific Training: provide date and type

  

  

  

  

  

 

  

  

  

  

  

Student Specific Training: provide date and type

  

  

  

  

  

 

  

  

  

  

  

Student Specific Training: provide date and type

  

  

  

  

  

 

  

  

  

  

  

* Required

---

 

  

Bus Attendant Training Records Review Worksheet

 

 

Circle One: District / Charter School / Contractor Entity’s name: ____________________________

 

Name

  

  

  

  

  

*Confidentiality

Training

  

   

   

*Evacuation Planning Training

  

  

  

  

  

Wheelchair/Occupant Securement Training

  

  

  

  

  

Child Safety Restraint System (CSRS) Training

  

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Name

  

  

  

  

  

*Confidentiality

Training

  

   

   

*Evacuation Planning Training

  

  

  

  

  

Wheelchair/Occupant Securement Training

  

  

  

  

  

Child Safety Restraint System (CSRS) Training

  

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Name

  

  

  

  

  

*Confidentiality

Training

  

   

   

*Evacuation Planning Training

  

  

  

  

  

Wheelchair/Occupant Securement Training

  

  

  

  

  

Child Safety Restraint System (CSRS) Training

  

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Name

  

  

  

  

  

*Confidentiality

Training

  

   

   

*Evacuation Planning Training

  

  

  

  

  

Wheelchair/Occupant Securement Training

  

  

  

  

  

Child Safety Restraint System (CSRS) Training

  

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Name

  

  

  

  

  

*Confidentiality

Training

  

   

   

*Evacuation Planning Training

  

  

  

  

  

Wheelchair/Occupant Securement Training

  

  

  

  

  

Child Safety Restraint System (CSRS) Training

  

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

Student Specific Training: provide details

 

 

  

  

  

  

*Required

 

---

 

  

Student(s) IEP Compliance Review Worksheet

 

 

Circle One: District / Charter School / Contractor Entity’s name: ____________________________

 

Name of Student

  

  

  

  

  

Copy of IEP and/or applicable

transportation form is on file

 

  

  

  

  

Medical

equipment

provided

  

     

Medical

provision

provided

  

     

Required

attendant

provided

  

     

Other: provide details

 

 

 

  

  

  

  

 

  

  

  

  

  

Name of Student

  

  

  

  

  

Copy of IEP and/or applicable

transportation form is on file

 

  

  

  

  

Medical

equipment

provided

  

     

Medical

provision

provided

  

     

Required

attendant

provided

  

     

Other: provide details

 

 

 

  

  

  

  

 

  

  

  

  

  

Name of Student

  

  

  

  

  

Copy of IEP and/or applicable

transportation form is on file

 

  

  

  

  

Medical

equipment

provided

  

     

Medical

provision

made

  

     

Required

attendant

provided

  

     

Other: provide details

 

 

 

  

  

  

  

 

  

  

  

  

  

Name of Student

  

  

  

  

  

Copy of IEP and/or applicable

transportation form is on file

 

  

  

  

  

Medical

equipment

provided

  

     

Medical provision made

  

  

  

  

  

Required

attendant

provided

  

     

Other: provide details

 

 

 

  

  

  

  

 

  

  

  

  

  

Name of Student

  

  

  

  

  

Copy of IEP and/or applicable

transportation form is on file

 

  

  

  

  

Medical

equipment

provided

  

     

Medical

provision

made

  

     

Required

attendant

provided

  

     

Other: provide details

 

 

 

  

  

  

  

---

 

  

Bus Equipment Review Worksheet

 

Circle One: District / Charter School / Contractor Entity’s name: ____________________________

 

√

 

 

= Met Standard

 

X = Standard Not Met

 

  

N/A = Not Applicable

 

Status Code

√

  

X N/A

 

Bus #: ___________

Status Code

√

  

X N/A

 

 

 

W/C #1: complete WTOR system

  

CSRS: car seat / safety vest / integrated seat

 

Correct wheelchair installation

  

Correct equipment/occupant securement

 

Correct occupant securement

  

CSRS: car seat / safety vest / integrated seat

 

W/C #2: complete WTOR system

  

Correct equipment/occupant securement

 

Correct wheelchair installation

  

CSRS: car seat / safety vest / integrated seat

 

Correct occupant securement

  

Correct equipment/occupant securement

 

W/C #3: complete WTOR system

  

CSRS: car seat / safety vest / integrated seat

 

Correct wheelchair installation

  

Correct equipment/occupant securement

 

Correct occupant securement

  

CSRS: car seat / safety vest / integrated seat

 

W/C #4: complete WTOR system

  

Correct equipment/occupant securement

 

Correct wheelchair installation

  

CSRS: car seat / safety vest / integrated seat

 

Correct occupant securement

  

Correct equipment/occupant securement

 

CSRS: car seat / safety vest / integrated seat

  

Oxygen: proper securement

 

Correct equipment installation/occupant securement

  

Other equipment: provide details below

 

CSRS: car seat / safety vest / integrated seat

  

  

 

Correct equipment installation/occupant securement

  

  

 

Bus #: __________

  

  

 

W/C #1: complete WTOR system

  

CSRS: car seat / safety vest / integrated seat

 

Correct wheelchair installation

  

Correct equipment/occupant securement

 

Correct occupant securement

  

CSRS: car seat / safety vest / integrated seat

 

W/C #2: complete WTOR system

  

Correct equipment/occupant securement

 

Correct wheelchair installation

  

CSRS: car seat / safety vest / integrated seat

 

Correct occupant securement

  

Correct equipment/occupant securement

 

W/C #3: complete WTOR system

  

CSRS: car seat / safety vest / integrated seat

 

Correct wheelchair installation

  

Correct equipment/occupant securement

 

Correct occupant securement

  

CSRS: car seat / safety vest / integrated seat

 

W/C #4: complete WTOR system

  

Correct equipment/occupant securement

 

Correct wheelchair installation

  

CSRS: car seat / safety vest / integrated seat

 

Correct occupant securement

  

Correct equipment/occupant securement

 

CSRS: car seat / safety vest / integrated seat

  

Oxygen: proper securement

 

Correct equipment installation/occupant securement

  

Other equipment: provide details below

 

CSRS: car seat / safety vest / integrated seat

  

  

 

Correct equipment installation/occupant securement

  

  

 

Bus #: _________

  

  

 

W/C #1: complete WTOR system

  

CSRS: car seat / safety vest / integrated seat

 

Correct wheelchair installation

  

Correct equipment/occupant securement

 

Correct occupant securement

  

CSRS: car seat / safety vest / integrated seat

 

W/C #2: complete WTOR system

  

Correct equipment/occupant securement

 

Correct wheelchair installation

  

CSRS: car seat / safety vest / integrated seat

 

Correct occupant securement

  

Correct equipment/occupant securement

 

W/C #3: complete WTOR system

  

CSRS: car seat / safety vest / integrated seat

 

Correct wheelchair installation

  

Correct equipment/occupant securement

 

Correct occupant securement

  

CSRS: car seat / safety vest / integrated seat

 

W/C #4: complete WTOR securement system

  

Correct equipment/occupant securement

 

Correct wheelchair installation

  

CSRS: car seat / safety vest / integrated seat

 

Correct occupant securement

  

Correct equipment/occupant securement

 

CSRS: car seat / safety vest / integrated seat

  

Oxygen: proper securement

 

Correct equipment installation/occupant securement

  

Other equipment: provide details below

 

CSRS: car seat / safety vest / integrated seat

  

  

 

Correct equipment installation/occupant securement

  

  

 

---

 

  

  

Special Needs Transportation Review Report

 

Please list any deficiencies found during the bus operator and attendant training records review:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

 

Please list any deficiencies found during the student IEP compliance review:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

 

Please list any deficiencies found during the school bus equipment review:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Please provide information on how your district plans to address these deficiencies:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

 

 

Signed: __________________________________ _____________________________

Transportation Director/Designee Date

 

This page and the completed forms must be submitted by October 27, 2006, to:

 

 

Bud Fletcher, Monitoring Coordinator

School Transportation Management Section

325 W. Gaines Street, # 1134

Tallahassee, FL 32399-0400