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Audit template in the LeanSuite app

Last reviewed

Lockout/tagout audit checklist

A lockout tagout audit is made while a real lockout is happening: the auditor watches an authorized employee isolate a machine and compares each step with the written procedure for that machine. This one has 19 questions in five sections, from the procedure at the machine through the try-out, shift change and lock removal. OSHA 29 CFR 1910.147(c)(6) asks for a periodic inspection of each energy control procedure at least once a year; a monthly audit like this one builds the record well before that review.

A supervisor, EHS lead or a second authorized employee usually does the audit, picking a different machine each month so every procedure gets seen in use. A failed audit on the floor looks like a lock on the panel but not on the air supply, a try-out skipped because the start button is out of reach, or one lock left on a group hasp for a person who went home hours ago.

What it is for, as built: Watch a lockout in progress and check each step against your written procedure. Use it monthly per machine or crew.

Use this template in LeanSuite

The full question list

The 19 questions in the audit

Every question is answered Yes, No or N/A. Each No is flagged and asks for a photo and a comment, so the finding arrives with its evidence.

Procedure

  1. 1A written, machine-specific lockout procedure is available at the machine
  2. 2The procedure lists the energy sources and isolation points for this equipment
  3. 3The authorized employee can explain the steps without reading them
  4. 4Affected employees are told before the lockout starts

Isolation

  1. 5All energy sources are identified (electrical, pneumatic, hydraulic, gravity, stored)
  2. 6The machine is stopped with its normal controls before it is isolated
  3. 7Energy isolating devices are locked or tagged in the safe (off) position
  4. 8Each authorized employee applies a personal lock
  5. 9Locks and tags are standard, show the owner's name and are used for lockout only

Stored energy and verification

  1. 10Stored or residual energy is released, restrained or blocked
  2. 11A try-out (attempt to start) confirms zero energy after isolation
  3. 12Controls are returned to off after the try-out

Work and removal

  1. 13Group lockout, if used, follows the written group procedure
  2. 14Shift changes follow the handover rule and locks are transferred properly
  3. 15The area is checked clear of tools and people before locks are removed
  4. 16Only the person who applied a lock removes it, or the written exception is followed
  5. 17Affected employees are told before the machine is restarted

Records

  1. 18The procedure was reviewed in the last 12 months
  2. 19Lockout training records are current for the people observed

Worked example, illustrative

A filled-in example

One section as it might be filled in on the floor, with every other section of the audit answered Yes. The place and finding are made up to show how the audit reads and scores.

Result: pass, 94.7% against a pass mark of 80

  • 19 questions, all of them count.
  • 1 answered No, so 18 of 19 are Yes: 18 ÷ 19 = 94.7%.
  • 94.7% is at or above 80, so the audit passes. The No still needs its fix.

What happened next: Supervisor stopped the job, try-out done with a second person at the HMI, procedure updated to a two-person try-out that week.

Scored here as one point per question with N/A left out. In the app each answer carries the points set on the template, so change them after you clone it if your plant weighs some checks more.

Lockout/Tagout Audit

Audit, monthly

Machine or equipment
Palletizer, Line 2
Authorized employee observed
Maintenance technician, day shift

Stored energy and verification

  1. Stored or residual energy is released, restrained or blockedYes
  2. A try-out (attempt to start) confirms zero energy after isolationNo

    Comment: Electrical and air isolated and locked, but no start attempt made. Technician said the HMI was too far from the panel to reach.

    Photo attached to the No

  3. Controls are returned to off after the try-outYes
Drawn from this template's own questions, not a screenshot of the app. Illustrative answers.

When to use it

  • Once a month.
  • An auditor or leader answers each question from what they see, hear and read in the area.
  • Each record starts with: Machine or equipment, Authorized employee observed.

How it is scored

The template is built with points per answer and a pass mark of 80. In this library every audit is set to pass at 80 and every inspection at 90. Each submitted audit shows its score and pass or fail, and every No is flagged with its photo and comment.

Change the points or the pass mark after you clone it. How rules and scoring work.

Read and print

More in safety inspections and audits

All safety inspections and audits templates

FAQ

Lockout/tagout audit checklist: common questions

  1. Monthly, on a different machine each time, so every written procedure is watched in use over the year. Add one when a procedure is rewritten, when a machine is modified or gets a new energy source, after a near miss or an unexpected start-up, and when a newly authorized employee does their first few lockouts alone.

  2. A supervisor, the EHS lead or a second authorized employee who did not write the procedure being audited. They need to know every energy source on that machine, what a proper try-out looks like, and the group lockout and shift handover rules. A failed audit goes to the EHS lead and the area manager, because the fix is usually training or a procedure change, not one person.

  3. A fail means someone could have been hurt during that lockout: an energy source missed, a try-out skipped, a lock that was not personal. Stop the work until the machine is isolated properly and verified. Then correct the procedure or retrain the person before the next lockout on that machine, with the EHS lead owning the action. In this template every No is flagged and asks for a photo and a comment, and an audit that scores under its pass mark of 80 is a fail.

  4. Keep the machine, the procedure revision, the authorized employee observed, the date and auditor, each step that was missed and what was done about it, and the retraining or procedure change that closed it. These records are what you show at the yearly periodic inspection, and the trend tells you which machines or shifts need the most attention. In LeanSuite each submitted audit is stored with its score, its pass or fail, and the photo and comment on every No.

  5. 19 questions in 5 sections: procedure, isolation, stored energy and verification, work and removal, and records. Every question is answered Yes, No or N/A.

Use this template in LeanSuite

It is ready in the Template Marketplace inside Lean Creator as “Lockout/Tagout Audit”. Clone it into your plant, change any question, then schedule it to a person, role or asset with reminders. Auditors complete it on a phone or tablet, with photo evidence where required.

Not on LeanSuite yet? On a 90-day pilot our team sets up your account and digitizes the forms and checklists you use today, this one included.

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