• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel


  • Name

  • Title

  • Phone Number

  • E-Mail

Identification of Machine

  • Make / Model / Identification evidence of machine

  • Photo

  • Use


  • What type of machine guarding is being utilized (eg PLC, Laser detection, automated guards, motion detectors)?

  • Is there currently guarding in place on machinery?

  • Is guarding sufficient to prevent access to the moving parts?

  • Are the gaps small enough to prevent accidental access to dangerous moving parts?

  • Are there any unguarded nip points?

  • Is a tool required to remove exiting guarding?

  • Is the tool stored away from machinery?

  • Are all electrical fixtures covered?

  • Is there a need for integrated guarding (eg two handed operation due to exposed dangerous components while in use)?

  • Are guard rails used to prevent access to dangerous parts?

  • Is there suitable access for servicing ( eg removable section to service, maintenance, removable panels to allow access to adjust bolts etc)?

  • Are guards secured ( eg mounting bolts tightened, grills secured)?

  • Are safety lock out devices fitted, operational?

Additional Information and comments



The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.