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Geriatric Medical Equipment Maintenance Log

Daily, Weekly, and Monthly Documentation Template

Geriatrics

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Template Content

Last updated: Mar 24, 2025

Equipment Information

  • Equipment Name: ________________
  • Model Number: __________________
  • Serial Number: __________________
  • Location: ______________________

Daily Checks

Date Visual Inspection Calibration Check Sanitization Staff Initials Notes

Weekly Maintenance

Week of: _______________

  • Deep cleaning performed
  • Safety features tested
  • Battery backup check (if applicable)
  • Mobility parts lubricated (wheelchairs, lifts)
  • Pressure settings verified (BP machines, oxygen)

Technician: ________________

Monthly Inspections

Month: ________________

Safety Checks

  • Electrical safety testing
  • Emergency stop function
  • Alarm systems
  • Weight capacity verification

Calibration

  • Pressure gauges
  • Digital displays
  • Temperature sensors
  • Scale accuracy

Maintenance History

Date Service Type Performed By Next Due Date Comments

Equipment-Specific Notes

Emergency Contacts

Service Provider: _____________ Phone: ____________________ Account Number: ____________

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