Machine Guarding Checklist Template - Get FREE Editable PDF

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Machine guarding checklist template

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Use this template with Lumiform

Customize this template or build your own
Fill out templates via mobile app
Get reports and analyse your data

Prices start from ░░░ per month

Book a demo

Learn more

A machine guarding checklist ensures your workplace complies with critical safety standards for mechanical equipment. This inspection tool helps you systematically evaluate guards that prevent contact with dangerous moving parts, from fixed barriers to interlocked systems.

Based on OSHA data, approximately 18,000 serious injuries occur every year from inadequately guarded machinery, including amputations and crushing injuries. You can use this template to conduct thorough inspections that document guard conditions, verify proper installation, and confirm employee training.

Related categories

Preview of the template

Inspection

Description of work to be performed

List down the name of employees working on machines

Choose the type of guards

PRE-OPERATION CHECKS

MACHINE GUARDS

Are all machine guards in good condition?

Do machine guards prevent workers hands, arms, and other body parts from making contact with dangerous moving parts of machine?

Are all machine guards firmly secured and not easily removed?

REFERENCE: Machine guards that are secured and cannot be easily removed [This is an example of how you can use Lumiform 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?

Do machine guards permit safe, comfortable, and relatively easy operation of the machine?

Are all pulleys and belts on working level properly guarded?

Are all moving chains and gears properly guarded?

Are all fan blades protected with a guard with opening not larger than the standard size?

Can the machine be oiled without removing the machine guards?

Does the machinery automatically shut down when machine guard is removed?

Do machine guards prevent operators to access machinery while in operation?

Do machine guards protect against hazards to the rear and sides of machinery?

Is warning sign placed around the machine?

TRAINING

Are all operators trained on how machine guards work?

Do operators have the necessary education and training in how to use the guards?

Do operators know the procedure when guards are damaged, missing or inadequate?

Are all operators trained on how and under what circumstances guards can be removed?

PEOPLE

Are all employees wearing appropriate PPE?

Do employees follow safe handling instruction using machineries?

Are all employees aware of emergency procedures in case of an accident involving machinery?

Is adequate supervision provided to ensure that employees are following safe machine operating procedures?

POST-OPERATION

Are all machine guards in good condition?

Is lock-out tag placed when removing machine guard?

Are all machine updates were escalated to a supervisor?

Are all incidents reported to a supervisor?

COMPLETION

Observation or recommendations

Overall assessment

Inspector's Name and Signature

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This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.