Machine Safety Assessment Checklist

• Conducted on

  Date
• Location
  Address

• Assessor Name

• Equipment - Name, Type, CL-number

• Area - Department, Cell number

Suitability of Work Equipment

• Is the equipment suitable for its intended purpose?

  Yes

  No

  N/A

• Does the equipment location pose a risk to health and safety of persons?

  Yes

  No

  N/A

Maintenance

• Is the procedure and frequency of maintenance (jobs) entered in the TPM

  Yes

  No

  N/A

• Is the equipment inspected for any deterioration that may result in risks to personnel?

  Yes

  No

  N/A

• Where fitted, are the safety and protection devices periodically tested and recorded?

  Yes

  No

  N/A

• Is the maintenance history available?

  Yes

  No

  N/A

Specific Risks

• If this is "Specific Risk Equipment", are there measures in place to ensure that only authorised/trained personnel use/maintain the equipment?

  Yes

  No

  N/A

Information & Instruction

• Do you consider all relevant health and safety information, and where required written instructions have been made available at the work site?

  Yes

  No

  N/A

Conformity with Community Requirements

• Is the equipment CE marked?

  Yes

  No

  N/A

Dangerous Parts of Machinery

• Are the "Dangerous Parts" of this equipment suitably guarded?

  Yes

  No

  N/A

• Is it possible to bypass any guards or protective devices without the need for a tool?

  Yes

  No

  N/A

• Where guards are not fitted, are suitable risk reduction measures in place to control danger to personnel?

  Yes

  No

  N/A

Protection Against Specific Hazards

• Is there any reasonable probability of any article or substance being ejected, falling, rupturing, breaking, being thrown out, disintegrating, catching fire, overheating or exploding?

  Yes

  No

  N/A

High or Very Low Temperature

• Are there parts of the equipment that could cause a burn, scald or sear protected?

  Yes

  No

  N/A

Controls

• Are the controls for starting, stopping and controlling the equipment clearly identifiable and safe to use?

  Yes

  No

  N/A

• Is it likely the controls could be inadvertently, accidentally or self activated?

  Yes

  No

  N/A

• Are combined stop and start controls designed so that the stop function has priority following release of the control?

  Yes

  No

  N/A

• Is the stop control easy to use and will its activation bring the equipment to a safe condition in a safe manner?

  Yes

  No

  N/A

• Where fitted confirm that the Emergency Stop is readily accessible and NOT combined with the Stop control.

  Yes

  No

  N/A

• Would any failure of a control system result in a "fail safe" condition which would not impede the operation of the Stop or Emergency Stop Controls?

  Yes

  No

  N/A

Isolations

• Is it possible to safely isolate the equipment's energy supplies?

  Yes

  No

  N/A

Stability

• Is the equipment securely mounted and stable?

  Yes

  No

  N/A

Lighting

• Is the local lighting sufficient?

  Yes

  No

  N/A

Maintenance Operations

• Can maintenance be performed without risk to persons (using appropriate measures)?

  Yes

  No

  N/A

• Are there likely to be any hazardous substances generated by the equipment or equipment near by that may cause harm whilst performing maintenance?

  Yes

  No

  N/A

Markings & Warnings

• Is the equipment appropriately marked for reasons of health and safety, and so that the equipment can't be confused with similar equipment?

  Yes

  No

  N/A

• Are any warning signs or warning signals for the reasons of health and safety clearly visible/audible?

  Yes

  No

  N/A

Mobile Work Equipment

• Is the equipment suitable for carrying persons safely?

  Yes

  No

  N/A

• Is the operator protected by roll over protection?

  Yes

  No

  N/A

Lifting Equipment

• Is the equipment used for lifting and subject to independent inspection (LOLER)?

  Yes

  No

  N/A

• Congratulations! You have completed the inspection

• Signature of person completing this report

  Sign