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safety

Defibrillator Monthly Functional Check Log

Monthly log for checking each defibrillator/AED’s self-test, pads, battery, readiness indicators, and any corrective action. Use it to document device readiness and create a clear audit trail.

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Overview

This template is a monthly functional check log for a defibrillator or AED. It captures the basic readiness items a workplace needs to confirm: the check date, device ID, location, who inspected it, self-test result, readiness indicator, pad condition, battery status, accessories present, any issues found, the corrective action taken, and whether follow-up is required.

Use it when you need a repeatable record that each AED was checked and left in a known state. It is especially useful across multiple locations, shifts, or shared facilities where responsibility can otherwise get lost. The form gives you a consistent audit trail and makes it easier to spot recurring problems such as expired pads, low batteries, missing accessories, or a unit that is not ready.

Do not use this as a replacement for manufacturer service procedures, emergency response training, or a full maintenance record if your program requires one. It is also not the right template if you need a one-time incident report after an AED deployment. Keep the scope narrow: one device, one monthly check, one clear outcome. If a problem is found, the log should show what happened next, who owns the follow-up, and whether the device was taken out of service.

What's inside this template

Check Details

This section establishes which device was inspected, where it is located, and who completed the check.

  • Check Date (required)

    Date the monthly functional check was completed.

  • AED / Defibrillator ID (required)

    Asset tag, room number, or other internal identifier for the device.

  • Location (required)

    Where the device is installed or stored.

  • Inspected By (required)

    Name or role of the person completing the check.

Functional Check

This section records the actual readiness checks that determine whether the AED can be used.

  • Self-Test Result (required)

    Select the result shown by the device self-test or readiness indicator.

  • Readiness Indicator Status (required)

    Confirm the status light or readiness indicator is normal.

  • Pad Condition (required)

    Confirm electrode pads are present, sealed, and not expired or damaged.

  • Battery Status (required)

    Confirm the battery is installed and shows acceptable status.

  • Required Accessories Present (required)

    Confirm any required accessories for this unit are present and usable, such as spare pads or rescue kit items.

Issues and Corrective Action

This section captures any defect or missing item and documents what was done next.

  • Were any issues found? (required)
  • Issue Details

    Describe the issue, including the specific field that failed and any visible damage or missing items.

  • Device Status After Check

    Indicate whether the device remains in service or has been taken out of service.

  • Corrective Action Taken

    Record replacement, escalation, maintenance request, or other action taken.

Sign-Off

This section confirms ownership of the inspection and whether additional follow-up is still needed.

  • Follow-Up Required (required)

    Select whether maintenance, replacement, or supervisor review is needed.

  • Follow-Up Notes

    Add any handoff details, work order numbers, or escalation notes.

  • Inspector Signature (required)

    Signature confirming the monthly functional check was completed.

How to use this template

  1. 1. Create one record for each AED and prefill the device ID, location, and the person responsible for the monthly check.
  2. 2. Inspect the unit in place and record the check_date, self_test_result, readiness_indicator, pads_condition, battery_status, and accessories_present using the correct field type for each item.
  3. 3. If anything is missing, expired, damaged, or not ready, complete issues_found, issue_details, device_status, and corrective_action before closing the form.
  4. 4. Use follow_up_required and follow_up_notes to assign the next action when the device needs service, replacement parts, or re-checking.
  5. 5. Submit the log with the inspector’s signature so the organization has a clear audit trail for the monthly inspection.

Best practices

  • Check the AED in the same physical location every month so location drift does not hide a missing or moved device.
  • Record the result immediately during the inspection instead of reconstructing it later from memory.
  • Treat a failed self-test or missing readiness indicator as an out-of-service condition until the issue is resolved.
  • Use conditional logic to show corrective-action fields only when an issue is found, so the form stays fast to complete.
  • Verify pad expiration and battery status separately, because one can be acceptable while the other is not.
  • Keep the device_id consistent across all logs so you can trace the maintenance history of a single unit.
  • Document any accessory gaps, such as missing scissors, gloves, or spare pads, when your site standard includes them.

What this template typically catches

Issues teams running this template most often surface in practice:

Expired or near-expiry pads that were not replaced on time.
Low battery warnings or failed self-tests that were missed during routine checks.
Readiness indicators showing a fault while the device was still marked ready.
Missing accessories that would slow response during an emergency.
Device location changes that were not updated in the log.
Corrective actions that were noted informally but not tied to a follow-up owner or status.
Incomplete sign-off fields that weaken the audit trail.

Common use cases

Facilities Manager for a Corporate Office
Use this log to track one AED per floor and confirm each unit is ready before the next monthly safety review. It helps facilities teams keep device status visible across multiple buildings.
School Nurse or Campus Safety Lead
Use the template to document AED checks across classrooms, gyms, and common areas. The location field and follow-up notes make it easier to coordinate replacements or service calls.
Warehouse Safety Coordinator
Use this form to verify emergency equipment in high-traffic areas where response time matters. The structured fields help confirm the unit is present, powered, and fully stocked.
Hotel or Venue Operations Manager
Use the log to keep AED readiness documented across guest areas, back-of-house spaces, and event floors. It supports shift-based handoffs and a clear record of any device taken out of service.

Frequently asked questions

What is this template used for?

This template records the monthly functional check for a defibrillator or AED at a specific location. It captures the device ID, self-test result, readiness indicators, pad condition, battery status, and any corrective action taken. The goal is to confirm the unit is ready for use and to keep a simple audit trail.

How often should this log be completed?

It is designed for monthly checks, which is the typical cadence for AED readiness reviews. If your site policy, manufacturer instructions, or local safety program requires more frequent checks, you can adjust the check_date and workflow accordingly. The template works well as a recurring inspection form.

Who should fill out the monthly check?

Usually a trained facilities, safety, security, or designated workplace responder completes it. The inspected_by field makes ownership explicit, and the submitter_signature provides accountability. If your organization uses delegated coverage across shifts or sites, the template can be assigned to the responsible role rather than a single person.

Does this template support compliance documentation?

Yes, it supports documentation for workplace safety programs by showing that the AED was checked, what condition it was in, and what action was taken if something was wrong. It is not a substitute for manufacturer maintenance instructions or local regulatory requirements, but it helps maintain a consistent record. Keep the log aligned with your internal inspection policy and retention rules.

What are the most common mistakes when using this form?

Common issues include skipping the battery or pad check, marking the device ready without verifying the readiness indicator, and leaving corrective_action blank when a problem is found. Another frequent mistake is using free text where a clear field value would be better, which makes review harder later. The form works best when each field is completed at the time of inspection.

Can we customize the fields for our AED model or site?

Yes. You can add model-specific checks, cabinet alarm status, tamper seal status, or site-specific location details if your program needs them. Keep the form focused on what you actually inspect, and use conditional logic so extra fields only appear when relevant.

How does this compare with an ad-hoc checklist or spreadsheet?

A structured template is easier to assign, review, and audit than a loose checklist or freeform spreadsheet. It standardizes the same fields every month, which reduces missed checks and makes follow-up easier when a device is out of service. It also helps teams see trends across locations instead of hunting through scattered notes.

Can this be integrated into a broader safety workflow?

Yes. It can sit alongside incident reporting, equipment maintenance, or facilities inspection workflows. If a device is marked out of service, you can route the issue to maintenance, safety, or procurement and use the follow_up_required field to trigger the next step.

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