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Summary

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Description

Examiner Assessment Report

Instructor/Certified Examiner name DTS license #

Date

School

Type (check one) Instructor Certified Examiner Assessment purpose (check one) Certification Recertification

Master Examiner Practice

Audit

Examiner/Instructor Scoring Maneuvers

Danger pot.

Lack skill

Master Examiner/Auditor Scoring Cong. pot

Danger pot.

Lack skill

Cong. pot.

Backing Parallel parking Park & start on hill Starting Lane travel Traffic control devices Stop signs Traffic signal lights Mechanical operation Left turns Right turns Uncontrolled intersect. Following Passing Right-of-way Gen. driving performance Discrepancies

X ME/Auditor signature DTS-661-030 (R/11/14)WAE Page 1 of 2

X Date

Examiner/Instructor signature

Date

(continued on next page)

Skills or certification checklist Place a “+” in the line next to each objective the Examiner accomplishes. Place a “–” in the line next to each objective the Examiner did not successfully accomplish. Pre-test

Delivery of instructions

Introduced self to customer

Maintained sufficient eye contact

Asked customer for ID

Spoke clearly

Verified valid insurance

Spoke so customer could hear them

Checked for valid IP/DL or issued DLE-074

Gave instructions far enough in advance for customer to react properly

Conducted hand and arm signal test Vehicle inspection

Skills test scoring

Checked parking brake

Circled correct abbreviations

Checked brake lights and turn signals

Used hash marks for 2nd errors

Checked for valid license plate

Scored in appropriate area

Checked for obvious defects

Covered all scorable items

Checked seat belts Conducted brake reaction test Instructions (verbatim per Examiner Guide)

Conclusion Waited until car turned off before unbuckling seatbelt Unbuckled seatbelt before advising customer of results

Brake reaction test

Advised customer of results prior to explaining errors

Backing maneuver

Explained each error recorded on the score sheet

Park and start on hill

Provided clear test results

Parallel parking

Provided brief explanation of errors

Starting

Advised customer of the next steps

Turns Lane change

Overall evaluation Examiner observed the customer during all critical points of the drive test Examiner observed for other traffic and pedestrians during all critical points of the drive test

Results Pass:

Yes

No

Notes

DTS-661-030 (R/11/14)WAE Page 2 of 2

Skills test completed within time limit...