AUI AED Monthly Check

• Audit Title

• AED location

• Conducted on

  Date

• Prepared by

• Is the AED unit located in its designated area?

  Safe

  At Risk

  N/A

• Is the AED unit clean, undamaged and if applicable in its carry case or cabinet?

  Safe

  At Risk

  N/A

• Does the AED rescue kit include: gloves, prep razor, scissors, towel, moist towelettes, CPR mask?

  Safe

  At Risk

  N/A

• Are all electrode packages sealed and within the expiration date?

  Safe

  At Risk

  N/A

• Is the Status Indicator showing a green check mark or the word 'OK'?

  Safe

  At Risk

  N/A

• Examine the accessory cables for cracks and damages

  Safe

  At Risk

  N/A

• Are the electrodes attached to the unit?

  Safe

  At Risk

  N/A

• Are the batteries within the expiration date?

  Safe

  At Risk

  N/A

Additional Photos

• Serial number photo

  Media

• Photo of unit as left on the wall.

  Media
Follow up Item

• Description of follow up

• To be completed by:

  Date

• Assigned to:

Signature

• Signature of inspector.

  Sign