Wheelchair Loading & Securement

Wheelchair Loading & Securement

(Maximum Points – 50)

Contestant Number ______

Sensitivity & Awareness (order not critical)

·  Greets and introduces self to passenger in a positive manner (2 pt) ______

·  Asks passenger if they need assistance in boarding (2 pt) ______

·  Asks passenger if they have all their belongings (2 pt) ______

·  Checks hand grips on wheelchair (2 pt) ______

·  Asks passenger to place hands in lap (4 pt) ______

Possible Points = 12 TOTAL ______

Loading onto Platform

·  Checks rear safety plate (2 pt) ______

·  Back passenger onto platform (2 pt) ______

·  Secures wheelchair brakes (2 pt) ______

·  Secures lift safety strap (2 pt) ______

Possible Points = 8 TOTAL ______

Raising Lift

·  Raises lift and checks front safety plate after it clears surface (2 pt) ______

·  Holds wheelchair with one hand while raising lift (2 pt) ______

·  Secures lift control onto door (2 pt) ______

·  Back wheelchair into vehicle and secures at least one brake (2 pt) ______

Possible Points = 8 TOTAL ______

Wheelchair & Passenger Securement

·  Releases brakes (2 pt) ______

·  Positions wheelchair into secured location and secures brakes (2 pt) ______

·  Attaches rear straps to wheelchair frame and floor (2 pt) ______

·  Attaches front straps to wheelchair frame and floor (2 pt) ______

·  Releases brakes, tightens straps and secures brakes (2 pt) ______

·  Secures lap belt and shoulder belt (2 pt) ______

·  Judge checks wheelchair to determine any movement (10 pt) ______

Possible Points = 22 TOTAL ______

The exercise is completed at this point. The releasing of the securement system and passenger unloading will not be scored as a part of this exercise. Time will be used as second tiebreaker.

TOTAL TIME ______POINTS EARNED ______

There is a 7-minute time limit, after 7 minutes the exercise will be stopped and the contestant will be scored based on their performance to this point.

JUDGE’S SIGNATURE ______

ASSISTANT’S SIGNATURE ______