Title Page
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Client / Site
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Date and Time of Inspection
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Machine Name
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Machine Number
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Inspected by
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Location
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Description of work to be performed
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List down the name of employees working on machines
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Choose the type of guards
PRE-OPERATION CHECKS
MACHINE GUARDS
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Are all machine guards in good condition?
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Do machine guards prevent workers hands, arms, and other body parts from making contact with dangerous moving parts of machine?
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Are all machine guards firmly secured and not easily removed?
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REFERENCE: Machine guards that are secured and cannot be easily removed
[This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections] -
Do machine guards ensure that no objects fall into the moving parts?
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Do machine guards permit safe, comfortable, and relatively easy operation of the machine?
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Are all pulleys and belts on working level properly guarded?
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Are all moving chains and gears properly guarded?
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Are all fan blades protected with a guard with opening not larger than the standard size?
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Can the machine be oiled without removing the machine guards?
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Does the machinery automatically shut down when machine guard is removed?
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Do machine guards prevent operators to access machinery while in operation?
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Do machine guards protect against hazards to the rear and sides of machinery?
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Is warning sign placed around the machine?
TRAINING
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Are all operators trained on how machine guards work?
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Do operators have the necessary education and training in how to use the guards?
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Do operators know the procedure when guards are damaged, missing or inadequate?
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Are all operators trained on how and under what circumstances guards can be removed?
PEOPLE
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Are all employees wearing appropriate PPE?
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Do employees follow safe handling instruction using machineries?
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Are all employees aware of emergency procedures in case of an accident involving machinery?
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Is adequate supervision provided to ensure that employees are following safe machine operating procedures?
POST-OPERATION
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Are all machine guards in good condition?
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Is lock-out tag placed when removing machine guard?
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Are all machine updates were escalated to a supervisor?
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Are all incidents reported to a supervisor?
COMPLETION
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Observation or recommendations
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Overall assessment
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Inspector's Name and Signature