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Occupational Therapy Equipment Maintenance Log

Comprehensive Documentation Template for Equipment Care and Safety

Occupational Therapy

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Last updated: Mar 24, 2025

Equipment Information

  • Equipment Name: _______________________
  • Model Number: ________________________
  • Serial Number: ________________________
  • Location: ____________________________
  • Purchase Date: ________________________
  • Warranty Expiration: ___________________

Maintenance Schedule

Daily Checks

  • Visual inspection completed
  • Sanitization performed
  • Safety features tested
  • Equipment storage verified

Weekly Maintenance

  • Deep cleaning performed
  • Moving parts lubricated (if applicable)
  • Calibration verified
  • Safety straps/supports checked

Maintenance Record

Date Maintenance Type Action Taken Performed By Next Due Date

Issues/Repairs Log

Problem Report

  • Date Identified: ________________
  • Issue Description: _____________
  • Reported By: __________________
  • Impact on Patient Care: ________

Resolution

  • Action Taken: _________________
  • Service Provider: ______________
  • Cost: ________________________
  • Date Resolved: ________________

Safety Certification

  • Last Certification Date: ________
  • Next Due Date: _______________
  • Certifying Agency: ____________

Notes

Supervisor Review

  • Reviewed By: __________________
  • Date: ________________________
  • Comments: ____________________

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