VERSION 4.4 CY2015

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Annual Monitoring Checklist-Section 5311 Programs

Name of Transit System: ______Date of Completion:

Items in blue are documented in the Annual Management Plan in Black Cat reports and may be completed at any time during the monitoring period.

Annual Management Plan Conferences

Visit Record at end of checklist

Use Date and Comments section to note deficiencies and corrective actions. Provide subrecipient with written documentation of deficiencies, corrective actions and expected date of completion.

Checklist Category / Date and Comments
1.0 / Organizational Structure
1.1 / Type of Governing Board1
__ County Commission
__ City Council
__ Community Action Council
__ Other Non-profit Board
__ Joint Powers Board
__ Tribal Government
1.2 / Public Input Opportunities
__ Public Outreach Plan2
__ Formal Transit Advisory Committee3
__ Other Citizens Input
Frequency of meetings:
1.3 / Third Party Contractor4
__ Driver Services
__ Dispatch
__ Maintenance
__ Vehicle Storage
__ Other:
Contract Term Dates
Start:
End:
Amendments: / N/A
1.4 / Special Transportation Service §174.305
Certificate Number:
Date of Expiration: / N/A
2.0 / ADMINISTRATION
Contract Compliance6
__ Black Cat reporting is timely
__ Monthly reporting is timely7
__ Revenue contract renewal dates are current
__ Expense contract renewal dates are current
__ Other Federal and State compliance:
__ Title VI (Section 13.0)
__ ADA (Section 14.0)
__ Drug and Alcohol Program (Section 15.0)
3.0 / HUMAN RESOURCES AND LABOR RELATIONS
3.1 / Labor Contract
__ Labor relations agreement
Date of expiration: / N/A
3.2 / Job Descriptions8
Last update:
__ Essential duties
__ Physical requirements
__ Licensure requirements*
__ Safety sensitive status
3.3 / Background Checks9
__ Criminal background check completed annually
__ Driving record check completed annually
__ Medical card is up to date
__ Driver qualification files are current
3.4 / Recruitment and Turnover10
__ Number of open positions
__ Recruitment methods
__ Average length of vacancy
3.5 / Work Related Injuries11
__ Number of injuries
__ Cause of injuries
__ Return to work outcome
3.4 / Employee handbook12
Last updated:
4.0 / Risk Management and Safety Training
4.1 / Driver Training13
__ Driver training program conforms to Minnesota Rules Chapter 8840
__ Maximizes uses the RTAP Program
__ Uses other safety training programs
Describe:
__ Accident/incident procedures are reviewed annually / N/A
4.2 / Passenger Safety14
__ Safety belt notices are posted in the buses
__ Passengers are aware of safety policies
__ Incident reporting in timely
4.3 / Maintenance Training15
__ Mechanics are appropriately certified for duties/specialties
__ Maintenance training—Describe activities during last year:
Specialty training:
__ Garage
__ Building
__ Vehicle and Equipment / N/A
5.0 / SERVICE DESIGN
5.1 / Service Plan16
__ Published service hours conform to current Management Plan
__ Published service area conforms to current Management Plan
__ Changes in hours/area in current year
Last updated:
5.2 / Review of Service Trends17
__ Review of ridership statistics
__ Review year to date service analysis
__ Review 3 year trend
6.0 / SERVICE DELIVERY
6.1 / Trip Scheduling18
__ Method of scheduling
Describe:
__ Advanced technologies used
__ Two-way communications method
__ Same day trip requests
__ Advance reservations
__ Answering machine/voice mail available
__ Referrals to other organizations
__ Volunteer program available
__ Service to special groups
__ Denial rate19
6.2 / Service Policies20
__ Cancellation policy
__ No-show policy
__ Billing services
__ Quality indicator review
__ On time performance
__ Pick up window
__ Complaints
7.0 / PERFORMANCE STANDARDS
7.1 / Review Service Analysis – Overall Program21
__ Cost per hour
__ Cost per trip
__ Cost per mile
__ Passengers per hour
__ Revenue/expense ratio
__ Service segment review22 – individual:
__ Cost allocation model completed:
7.2 / Trend Analysis23
__ 5-year spreadsheet showing progress on performance indicators
8.0 / VEHICLES AND VEHICLE MAINTENENCE
9.1 / Vehicle Inventory24
__ Reconcile to Black Cat
__ Reconcile to insurance certificate
__ Disposed vehicles are not part of MnDOT budget
8.2 / Maintenance Plan and Schedule
__ Review vehicle maintenance plans.
__ Review vehicle maintenance schedules25
__ Spot check maintenance records
__ Documented repetitive issues26
__ Spot check daily vehicle inspection reports / Complete specialty checklist.
Vehicle Maintenance On Site Spot Check
8.3 / Insurance
__ Insurance certificate is on file at Office of Transit at N:\TRA\PROGRAMS\Public Transit Participation Program\Insurance Certificates
[Note—This hyperlink is internal only]
8.4 / Inspections27
__ USDOT or STS number
__ Annual vehicle inspections
__ Commercial Vehicle:
__ Department of Public Safety:
__ Special Transportation Services: / N/A
9.0 / FACILITIES
9.1 / Facilities28
__ Facility and related equipment inventory—Last update:
__ Facilities maintenance plan— if new, notify Kent E. Last update:
__ Facility Site Checklist, date: / Complete Facilities Checklist if applicable.
10.0 / PROCUREMENT
10.1 / Local procurement policy29
Last update: ______
10.2 / Federal Requirements30
__ Disadvantaged Business Enterprise process followed with any RFPs.
__ Direct vehicle procurements
__ Buy America
__ Labor Clauses and Federal Certifications are included / Verify proper procedures.
Administrative Procedure 2010-04
Verify proper procedures.
Administrative Procedure 2010-08
11.0 / FINANCIAL MANAGEMENT
11.1 / Cost allocation plans31
__ Payroll Allocation Plan
__ Premium/contract service
__ Space/utility sharing
__ Staff sharing
Most recent cost allocation plan submission:
Date: ______
11.2 / Audits33
__ Most recent independent financial audit
Date:
__ Most recent Mn/DOT field audit
Date:
11.3 / Fare Collection and Reconciliation34
__ Farebox procedures are congruent with the Annual Management Plan
__ Segregation of duties is verified
__ Counts of non-cash media and deposit of cash media are reconciled with trip sheets
12.0 / MARKETING AND COMMUNICATIONS
12.1 / External Publications35
__ Brochure—Last update:
__ Riders Guide—Last update:
__ Website—Last update:
__ Rider survey—Last update:
__ Title VI notifications included in all publications
12.2 / Marketing Plan36
Last update:
__ Media relations policy
__ Crisis communications
__ Advertising policy
__ LEP/LAP Advertising
13.0 / Title vi – civil rights
13.1 / Notice of rights under Title VI37
__ Posted on vehicles
__ Included in brochures/promotional materials
__ Posted on website
13.2 / Complaint form and procedure38
__ Most recent update:
13.3 / List of Investigations/Complaints/
Lawsuits38
__ Most recent update:
13.4 / Racial breakdown of non-elected boards and committees38
__ Most recent update:
13.5 / Public outreach plan38
__ Most recent update:
13.6 / Language assistance plan39
__ Most recent update:
__ Most recent staff training on language assistance measures
14.0 / AMERICANS WITH DISABILITIES
14.1 / Transit rolling stock and facilities
__ Vehicles are accessible
__ Bus stops, where they exist, are accessible40
14.2 / Complaints41
__ Lawsuits alleging discrimination on the basis of disability
14.3 / Communications42
__ Call taking and ride reservation
__ Published materials
14.4 / Service Delivery
__ Loading and unloading passengers43
__ Service animals44
15.0 / DRUG AND ALCOHOL COMPLIANCE / Currently overseen by Federal Programs Officer
16.0 / SAFETY AND SECURITY
16.1 / Safety & Security Plan45
Last update:
16.2 / Impact on federal transit assets46
Review any reports of events where public transit assets were affected. See related Technical Assistance Brief -- Reporting Adverse Transit Impacts / N/A

SITE VISIT RECORD

DATE OF ON-SITE VISIT: / TOPICS ADDRESSED: / PRESENT AT VISIT:

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