Checklist template

Medical equipment maintenance and calibration for clinics

A ready-to-use checklist with 118 items in 6 sections, covering Inventory, Calibration, Preventive maintenance, Defects, Electrical safety, Records. Use it as-is in InspectLoop, or adapt it to your own standards in minutes.

  • 6 Sections
  • 118 Items
  • 99 Yes / No checks
  • 6 Scored ratings
  • 129 Points

Use this template How audits work

1. Inventory 18 items

  1. The clinic keeps a written inventory of its medical devices, listed by room Yes / No 1 pt
  2. Each device on the inventory has a unique asset number Yes / No 1 pt
  3. The inventory records the manufacturer, model and serial number of each device Yes / No 1 pt
  4. Asset tags were attached and readable on 10 devices sampled Yes / No 1 pt
  5. 5 devices picked in the exam rooms were all found on the inventory Yes / No 1 pt
  6. 5 devices picked from the inventory were all found in the room listed Yes / No 1 pt
  7. The inventory identifies emergency devices (AED, suction unit, oxygen regulator) as highest maintenance priority Yes / No 1 pt
  8. Leased, loaned and demonstration devices are on the inventory with the owner's name Yes / No 1 pt
  9. Devices personally owned by providers and used on patients are included in the maintenance program Yes / No 1 pt
  10. The most recently purchased device was inspected and tagged before its first use on a patient Yes / No 1 pt
  11. Retired devices have been removed from patient-care rooms Yes / No 1 pt
  12. Devices awaiting disposal are tagged "do not use" Yes / No 1 pt
  13. The operator manual is available, on paper or electronically, for each of 3 devices sampled Yes / No 1 pt
  14. The inventory was reconciled with the devices on site in the last 12 months Yes / No 1 pt
  15. Date of the last inventory reconciliation Date
  16. Devices on the inventory Number
  17. Devices found without an asset tag during the visit Number
  18. Accuracy of the equipment inventory Rating
    • Every sampled device matched 5 pts
    • One or two mismatches 3 pts
    • Inventory missing or largely out of date 1 pt

2. Calibration 21 items

  1. Each device that requires calibration carries a sticker showing the date done and the next due date Yes / No 1 pt
  2. Aneroid blood pressure gauges were checked against a reference device within the interval set by company policy Yes / No 1 pt
  3. The needle of each aneroid gauge sampled rests at zero when the cuff is deflated Yes / No 1 pt
  4. Patient scales were verified with certified test weights within the interval set by company policy Yes / No 1 pt
  5. The infant scale returns to zero when empty Yes / No 1 pt
  6. Ear and forehead thermometers were verified following the manufacturer's method, at the interval set by company policy Yes / No 1 pt
  7. The data logger or thermometer of the vaccine refrigerator has a current calibration certificate Yes / No 1 pt
  8. Pulse oximeters were checked with a tester or by the manufacturer's method, at the interval set by company policy Yes / No 1 pt
  9. The audiometer has a calibration certificate dated within the last 12 months Yes / No 1 pt
  10. The spirometer is checked with a 3-liter calibration syringe on each day of use, with the result logged Yes / No 1 pt
  11. Control solutions are run on glucose meters at the frequency stated by the manufacturer Yes / No 1 pt
  12. The sterilizer's temperature and pressure readings were verified at its last service Yes / No 1 pt
  13. The ECG machine's calibration signal was verified at its last service Yes / No 1 pt
  14. The defibrillator's energy output was tested by a technician within the interval set by company policy Yes / No 1 pt
  15. The centrifuge's speed and timer were verified within the interval set by company policy Yes / No 1 pt
  16. Each calibration record names the technician or trained employee who did the work Yes / No 1 pt
  17. The vendor's service reports list the test instruments used and their own calibration dates Yes / No 1 pt
  18. The last device that failed calibration was removed from use until adjusted or replaced Yes / No 1 pt
  19. Devices found past their calibration due date Number
  20. Date of the calibration vendor's most recent visit Date
  21. Calibration status of the devices sampled Rating
    • All within date 5 pts
    • One or two overdue, none critical 3 pts
    • Several overdue or a critical device overdue 1 pt

3. Preventive maintenance 22 items

  1. A written schedule lists each device with its maintenance tasks and frequency Yes / No 1 pt
  2. Frequencies on the schedule match the manufacturer's manual for 3 devices sampled Yes / No 1 pt
  3. Devices sampled carry a maintenance sticker with the next due date Yes / No 1 pt
  4. The height adjustment of 3 exam tables tested moves smoothly through its full range Yes / No 1 pt
  5. The sterilizer door gasket is cleaned or replaced at the interval stated by the manufacturer Yes / No 1 pt
  6. The sterilizer chamber is cleaned at the interval stated by the manufacturer Yes / No 1 pt
  7. AED electrode pads are within their expiry date Yes / No 1 pt
  8. The AED battery is within its replace-by date Yes / No 1 pt
  9. The monthly AED check is logged for each of the last 3 months Yes / No 1 pt
  10. The defibrillator self-test is recorded on each day the clinic is open Yes / No 1 pt
  11. The suction unit's filter was changed at the interval stated by the manufacturer Yes / No 1 pt
  12. Oxygen regulators and flowmeters were inspected within the interval set by company policy Yes / No 1 pt
  13. Wall-mounted otoscopes and ophthalmoscopes light at full brightness when lifted from their handles Yes / No 1 pt
  14. Rechargeable batteries in portable devices were replaced by the dates on the maintenance schedule Yes / No 1 pt
  15. Nebulizer compressor filters are changed at the interval stated by the manufacturer Yes / No 1 pt
  16. The vaccine refrigerator's door seals were inspected within the interval set by company policy Yes / No 1 pt
  17. Exam light arms hold the position they are set to Yes / No 1 pt
  18. Wheelchair and stretcher brakes hold when applied Yes / No 1 pt
  19. X-ray equipment has been surveyed at the frequency required by local regulation Yes / No 1 pt
  20. Service contracts for vendor-maintained devices are in force Yes / No 1 pt
  21. Devices overdue for preventive maintenance Number
  22. Completion of preventive maintenance Rating
    • Everything on schedule 5 pts
    • A few non-critical devices overdue 3 pts
    • Emergency devices overdue or no schedule 1 pt

4. Defects 19 items

  1. A written procedure tells employees how to report a faulty device Yes / No 1 pt
  2. A clinical employee asked could describe how to report a fault Yes / No 1 pt
  3. Defective devices are tagged "out of service" with the date and the fault Yes / No 1 pt
  4. Tagged devices are moved out of patient rooms to a designated holding area Yes / No 1 pt
  5. No device in use shows visible damage such as a cracked casing, a torn cuff or split tubing Yes / No 1 pt
  6. No device sampled has been repaired with tape or other improvised means Yes / No 1 pt
  7. The defect log shows, for each fault, the date reported and the action taken Yes / No 1 pt
  8. Repair requests in the log were sent to the vendor within the time set by company policy Yes / No 1 pt
  9. Repaired devices are tested and signed off before they return to use Yes / No 1 pt
  10. A working spare is available for each critical device (blood pressure monitor, pulse oximeter, thermometer) Yes / No 1 pt
  11. A named person receives manufacturer recalls and safety notices Yes / No 1 pt
  12. The recall log records the action taken for each notice of the last 12 months Yes / No 1 pt
  13. No device subject to an open recall was found in use Yes / No 1 pt
  14. Device-related patient incidents are reported per company policy and as required by local regulation Yes / No 1 pt
  15. A device involved in an incident is set aside unaltered, with its accessories Yes / No 1 pt
  16. Faults traced to user error led to documented retraining Yes / No 1 pt
  17. Devices out of service at the time of the visit Number
  18. Days the oldest open defect has been waiting for repair Number
  19. Handling of defective devices Rating
    • Tagged, removed and repaired promptly 5 pts
    • Tagged but slow to repair 3 pts
    • Faulty devices left in use 1 pt

5. Electrical safety 20 items

  1. Mains-powered medical devices carry an electrical safety test sticker within the interval set by company policy Yes / No 1 pt
  2. New devices are electrically tested before first use Yes / No 1 pt
  3. Power cords of devices sampled show no cuts or exposed wire Yes / No 1 pt
  4. Strain reliefs are intact where cords enter the devices sampled Yes / No 1 pt
  5. Plugs of devices sampled have their ground pin intact Yes / No 1 pt
  6. No medical device is plugged into an extension cord Yes / No 1 pt
  7. Power strips in patient-care rooms are the type approved by company policy Yes / No 1 pt
  8. Wall outlets in exam rooms have intact cover plates Yes / No 1 pt
  9. Wall outlets in exam rooms hold a plug firmly Yes / No 1 pt
  10. Ground-fault outlets near sinks trip and reset when tested Yes / No 1 pt
  11. Cords do not cross walkways in patient-care rooms Yes / No 1 pt
  12. No liquids are placed on top of electrical devices Yes / No 1 pt
  13. Battery-backed devices are kept plugged in so they stay charged Yes / No 1 pt
  14. Chargers and charging stations are uncovered and clear of paper and linen Yes / No 1 pt
  15. Ventilation openings of devices are not blocked Yes / No 1 pt
  16. The backup power supply of the vaccine refrigerator was tested within the interval set by company policy Yes / No 1 pt
  17. Electrical safety test records show the leakage current measured for each device tested Yes / No 1 pt
  18. No personal appliances (space heaters, kettles) are plugged in within patient-care rooms Yes / No 1 pt
  19. Devices found with a damaged cord or plug Number
  20. Electrical condition of equipment and outlets Rating
    • No defects 5 pts
    • Minor defects, none on a device in use 3 pts
    • Defects on devices in use 1 pt

6. Records 18 items

  1. Each device sampled has a service history file Yes / No 1 pt
  2. Vendor service reports are signed by a clinic employee Yes / No 1 pt
  3. Service reports state the findings, the parts replaced and a pass or fail result Yes / No 1 pt
  4. Service reports are filed within the time set by company policy Yes / No 1 pt
  5. Maintenance records are kept for the retention period set by company policy Yes / No 1 pt
  6. Service contracts are on file with their expiry dates Yes / No 1 pt
  7. Earliest expiry date among the service contracts Date
  8. A named employee is responsible for the equipment program Yes / No 1 pt
  9. A backup is named for the equipment program Yes / No 1 pt
  10. Training records show that operators were trained on the sterilizer, the ECG machine and the AED Yes / No 1 pt
  11. New-hire orientation covers the devices the employee will operate Yes / No 1 pt
  12. A replacement plan lists the devices past their expected service life Yes / No 1 pt
  13. The clinic manager reviewed and signed the maintenance records in the last 3 months Yes / No 1 pt
  14. Corrective actions from the previous review have been completed Yes / No 1 pt
  15. Name of the biomedical service vendor Short text
  16. Name of the person responsible for the equipment program Short text
  17. Overall control of equipment maintenance and calibration Rating
    • Devices inventoried, in date and documented 5 pts
    • Program in place, with overdue devices or missing records 3 pts
    • No working program or unsafe devices in use 1 pt
  18. Corrective actions required Comments

About this template

This checklist is part of the InspectLoop template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In InspectLoop you can add photos, assign corrective actions, require sign-off and compare results across sites.

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