| Item | Pass | Fail | N/A | Comments |
|---|---|---|---|---|
| Exterior Condition (no visible damage) | ||||
| Tires (tread, inflation, no damage) | ||||
| Brakes | ||||
| Seat Belts (all functioning) | ||||
| Wheelchair Lift/Ramp Operation | ||||
| Vehicle Lighting & Signals | ||||
| First Aid Kit Onboard | ||||
| Fire Extinguisher Present/Charged | ||||
| Cleanliness (interior and exterior) | ||||
| Other |