MACHINE GUARDING INSPECTION CHECKLIST

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--- GENERAL INFORMATION ---
[ ] Inspection Date
[ ] Inspection Time
[ ] Machine Location (Building/Area/Specific Coordinates)
[ ] Machine Name/Model
[ ] Machine Serial Number
[ ] Inspector Name
[ ] Machine Speed (RPM/FPM)
[ ] Department Responsible (Production, Maintenance, Engineering, Other)
[ ] Brief Description of Machine Function

--- MACHINE IDENTIFICATION & OPERATION ---
[ ] Machine Name/Model
[ ] Machine Serial Number
[ ] Location of Machine (Building/Room)
[ ] Machine Speed (RPM/Cycles per Minute)
[ ] Brief Description of Machine Operation
[ ] Is a Standard Operating Procedure (SOP) available for this machine? (Yes, No, N/A)
[ ] Date of Last Operational Review
[ ] Is the machine operating within its design specifications? (Yes, No, Unsure)

--- GUARD CONDITION & INTEGRITY ---
[ ] Guard Material Condition (Excellent, Good, Fair, Poor, Damaged)
[ ] Guard Attachment Security (Securely Attached, Slightly Loose, Moderately Loose, Significantly Loose, Missing/Absent)
[ ] Guard Thickness (inches/mm)
[ ] Detailed Description of Guard Condition
[ ] Interlock Functionality (Operational, Non-Operational, Missing, Bypassed)
[ ] Photos/Videos of Guard Condition
[ ] Presence of Warning Signage (Present and legible, Present, but faded/damaged, Missing)
[ ] Notes on Guard Modifications

--- POINT OF OPERATION HAZARD ASSESSMENT ---
[ ] Is a physical barrier present at the point of operation? (Yes, No, Partial/Inadequate)
[ ] Describe the type of guarding in place (e.g., fixed barrier, interlocked guard, light curtain).
[ ] Is the guarding adequate to prevent contact with moving parts? (Yes, No, Uncertain)
[ ] Describe any observed hazards at the point of operation (e.g., pinch points, shear points, crush points).
[ ] Distance between operator and moving parts (mm/inches â€“ specify unit)
[ ] Potential Hazards Observed (Select all that apply) (Pinch Point, Shear Point, Crush Point, Wrap Point, Impact Point, Entanglement Point, None Observed)
[ ] Attach photos/videos of the point of operation area (if applicable)

--- INGOING/OUTGOING POINTS HAZARD ASSESSMENT ---
[ ] Are guards present at all ingoing material points? (Yes, No, N/A)
[ ] Are guards present at all outgoing material points? (Yes, No, N/A)
[ ] Describe any observed hazards at ingoing points (e.g., pinch points, crush hazards).
[ ] Describe any observed hazards at outgoing points (e.g., ejected materials, sharp edges).
[ ] Distance from point of operation to nearest accessible surface (inches)
[ ] Are any moving parts exposed during material feed/removal? (Yes, No, N/A)
[ ] If 'Yes' to exposed moving parts, describe the specific parts and potential hazard.
[ ] Upload photos/videos of ingoing/outgoing points (if applicable).

--- EMERGENCY STOP FUNCTIONALITY ---
[ ] Are Emergency Stop Buttons Present? (Yes, No, N/A)
[ ] Are Emergency Stop Buttons Clearly Marked? (Yes, No, N/A)
[ ] Were Emergency Stop Buttons Tested? (Yes, No, N/A)
[ ] Did Emergency Stop Buttons Function Correctly? (Yes, No, N/A)
[ ] Describe any issues found during Emergency Stop testing (if applicable)
[ ] Number of Emergency Stop Buttons Tested
[ ] Date of Last Emergency Stop Test

--- LOCKOUT/TAGOUT (LOTO) COMPLIANCE ---
[ ] Is a written LOTO procedure available for this machine? (Yes, No, N/A)
[ ] Are authorized employees properly trained on LOTO procedures? (Yes, No, N/A)
[ ] Date of last LOTO training for this machine
[ ] Are lockout/tagout devices readily available? (Yes, No, N/A)
[ ] Observed deviations from LOTO procedures (if any)
[ ] Are energy isolating devices properly secured during servicing? (Yes, No, N/A)
[ ] Number of lockout/tagout devices used during last servicing (if applicable)
[ ] Inspector Signature to verify LOTOTO compliance

--- EMPLOYEE TRAINING & AWARENESS ---
[ ] Has the employee received machine-specific guarding training? (Yes, No, N/A - New Employee)
[ ] Date of last machine guarding training
[ ] Does the employee understand the purpose of machine guards? (Yes, No, Unsure)
[ ] Briefly describe employeeâ€™s understanding of machine hazards.
[ ] Which of the following safety procedures are the employees familiar with? (Lockout/Tagout (LOTO), Emergency Stop Procedures, Safe Operating Procedures, Reporting Hazards, Personal Protective Equipment (PPE) Requirements)
[ ] Was a refresher training conducted during the last year? (Yes, No)
[ ] Trainer Name/Signature

--- CORRECTIVE ACTIONS & FOLLOW-UP ---
[ ] Detailed Description of Corrective Action Required
[ ] Priority Level (1-High, 5-Low)
[ ] Target Completion Date
[ ] Assigned To (Department/Individual) (Maintenance, Engineering, Production, Safety, Other)
[ ] Notes/Comments Regarding Corrective Action
[ ] Status of Corrective Action (Not Started, In Progress, Completed, On Hold)
[ ] Actual Completion Date (If Completed)
[ ] Supporting Documentation (Photos, Reports)
[ ] Verification Initials (Person verifying completion)

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