Template OCRI ini membantu tim menilai penerapan perlindungan mesin secara sistematis sebelum operasi. Daftar cek mencakup identifikasi persyaratan hukum, analisis terdokumentasi untuk menentukan mesin dan area yang perlu dijaga, program perlindungan yang dikelola, ketersediaan dan pengelolaan alat pelindung, kontrol saat operasi dengan pengaman dilepas, ketersediaan tombol berhenti darurat, penandaan bahaya yang jelas, inspeksi berkala bulanan, serta pelatihan bagi operator, perawatan, dan personel terdampak. Setiap butir dapat diberi skor, ditambahkan rekomendasi dan evaluasi, serta ditutup dengan tanda tangan.
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