Children’s Health Express Mobile

Medical Unit

Ava Wood, BSN, RN, NE,BCDirector, Ambulatory Care

Lisa Butterworth, BSN, RNClinical Program Manager

Children’s Health Express

Primary Care

• DATE: _________________• DAILY PRE-TRIP INSPECTION ITEMS AREA COMPONENTINSPECTION HEADLIGHTS Check operation TURN SIGNAL LIGHTS Check operation BRAKE LIGHTS Check operation PARK BRAKE Check operation REAR AXLE Check for leaks SERVICE BRAKES Check operation AIR TANKS W/AUTOMATIC EJECTORS Check operation AIR DRYER OPERATION Check for operation AIR CLEANER AIRFLOW RESTRICTION GUAGE Restriction indicator reading MECHANICAL FAN DRIVE GEAR BOX Check for leaks FUEL/WATER SEPARATOR Drain checking for presence of water HYDRAULIC STEERING SYSTEM Check for leaks STEERING WHEEL Check for excessive play BODY DAMAGE INSPECTION Inspect body damage and note below• Notes:• Driver Signature:_____________________________

• DATE: _________________• WEEKLY MOBILE VEHICLE INSPECTION ITEMS AREA COMPONENT INSPECTION FRONT AXLE WHEEL BEARINGS Check oil level BATTERIES/BATTERY CABLES Check for corrosion, loose connections VISUAL INSPECTION OF FUSE PANELS Check for corrosion, blown fuses ENGINE COOLING FAN Check for nicks, cracks, loose pieces ENGINE OIL Check fluid level ENGINE COOLANT LEVEL Check coolant level ENGINE DRIVE AND ACCESSORY BELTS Check for wear RADIATOR AND CHARGE AIR COOLER Presence of debris/damage COOLANT HOSES, PIPES, AND CLAMPS Check for leaks, loose clamps, chafing CHECK EXHAUST PIPING & MUFFLER Check that all components are secure HYDRAULIC RESERVOIR Check fluid level FRONT AIR SPRINGS Check wear and/or leaks REAR AIR SPRINGS Check wear and/or leaks FRONT SHOCKS Inspect for leaks REAR SHOCKS Inspect for leaks RIDE HEIGHT Check level TRANSMISSION FLUID Check fluid level TIRES Check and adjust air pressure, check for wear, damage WHEELS Check wheel nuts• Notes:• Driver Signature:_____________________________