Public Access AED Maintenance and Inspection Checklist
Client/Site
Please Select
Bridge Water Place / Hertz
Location of AED
*
Floor/Short Description of location (ie second floor breakroom)
AED Model
*
AED Serial Number
*
Inspection Date
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspectors Name
*
Visual Inspection:
*
Easily accessible and unobstructed.
Securely mounted or stored in its designated location.
Case is free of visible damage (no cracks,dents, or loose parts).
Cabinet is clean and undamaged
Battery Inspection
*
Battery is installed and properly seated
Battery indicator shows sufficient charge (indicator status light)
Battery is in good physical condition (no corrosion or leakage)
Battery Expiration Date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Defibrillation Pads
*
Adult electrode pads are present and unopened
Pediatric electrode pads are present and unopened
Spare electrode pads are present and unopened
Primary Pads are installed correctly (if applicable)
Expiration Date: Adult Pads
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Expiration Date: Pediatric Pads
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Expiration Date: Spare Pads
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Accessory Pack:
Scissors
Gloves
Razor
Face Mask
Environmental Check
AED is stored at correct temperature (check mfg recommendations)
AED is protected from moisture, dust, and extreme conditions
Inspectors Signature
*
Notes
Explain any issues/deficiencies identified:
Photo(s) of AED
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Include pictures of AED in assigned location, as well as photos to support any identified problems.
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