Modality Equipment Inspection and Calibration Log

Scheduled inspection and calibration log for physical therapy modality equipment, including ultrasound, e-stim, and traction units, to verify safe operation, functional performance, and readiness before patient use.

Inspection Details

• Inspection date and time recorded
• Inspector name and role documented
• Equipment asset ID / serial number documented
• Equipment type identified
• Inspection interval is current per facility schedule
  Confirm the inspection is being completed at the required scheduled interval, such as annual or facility-defined preventive maintenance frequency.

Visual Condition and Labeling

• Power cord, plug, and strain relief free of cuts, fraying, or exposed conductors
• Housing, controls, display, and connectors intact with no cracks or missing parts
• Safety labels, warnings, and operating instructions legible and present
• Accessory cables, applicators, transducers, and pads are clean and undamaged
• Device is clean, dry, and free of visible contamination
• No visible signs of overheating, liquid intrusion, or burn damage

Calibration and Functional Performance

• Calibration status current and within required interval
  Confirm calibration has been completed according to manufacturer guidance and facility policy. Annual calibration is commonly required for modality equipment.
• Ultrasound output verified within acceptable range
  Record measured output or calibration result for ultrasound units using the facility-approved test method.
• E-stim output verified within acceptable range
  Record measured output or calibration result for electrical stimulation units using the facility-approved test method.
• Traction force verified within acceptable range
  Record measured traction force or calibration result using the facility-approved test method. If the unit uses a different scale, enter the measured value in the unit specified by the manufacturer.
• Timer, intensity, mode, and output controls respond correctly
• Emergency stop, pause, or output shutoff functions operate correctly

Patient Safety Controls and Environment

• Grounding, isolation, and electrical safety checks completed per policy
• Cables and leads routed to prevent trip hazards and accidental disconnection
• Treatment area clear of obstructions and safe for patient use
• Emergency call device or staff access available during treatment setup
• PPE and infection control supplies available as required by facility policy
• Equipment removed from service if any unsafe condition is identified
  If a deficiency is found, the device must be tagged out and not used until repaired and rechecked.

Deficiencies, Corrective Actions, and Closeout

• Deficiencies or non-conformances documented
  List each deficiency, affected component, and observed condition.
• Corrective action assigned with responsible person and due date
• Equipment tagged out or returned to service status documented
• Inspector signature completed