Automated External Defibrillator (AED) Equipment Inspection Report

AED Equipment must be checked at least once per day (and/or during opening and closing facility checks) to ensure functionality (according to manufacturer specifications), equipment components, and accessories, as well as ensuring the immediate readiness of all equipment in the event of an emergency. EAP operating criteria call for AED Equipment be available to a guest in distress within two minutes of extrication from the water.

Organization

Facility

Location of AED Equipment

Report Start Date

Report End Date

AED Electrode Pads (Adult and Pediatric) must be packaged, in good condition, and have not expired.

CHECK THE BOXES IN EACH CATAGORY TO INDICATE AVAILABLITY AND GOOD CONDITION.

All emergency equipment must be in good, fully functional condition or immediately corrected / replaced.

EXPIRATION
DATES OF PADS
ADULT PADS
PEDIATRIC PADS*
Date Time AED Self Test Successful? Back up Battery Available? Clothing Scissors Available? Hair Razor Available? ADULT Pads Available? PEDIATRIC* Pads (or Key) Available? Back up Pads Available? Alcohol Wipes Available? Towel Available? Staff Initials
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Periodic Supervisor Equipment Check

Date AED in proper
location?
Equipment Properly
Organized?
All Equipment in
Good Condition?
Supervisor Initials
Yes
Yes
Yes
Yes
Yes
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Yes
Yes

Pediatric pads are highly recommend, but not required.

AED PAD Replacement

Date of
Replacement
What was
Replaced?
Pads Returned to
proper location?
Supervisor Initials
Yes