Fillable Printable Care Home Inspection Reports Scotland
Fillable Printable Care Home Inspection Reports Scotland
Care Home Inspection Reports Scotland
Inspection Form
U.S. Department of Housing
OMB Approval No. 2577-0169
and Urban Development
(exp. 04/30/2018)
Housing Choice Voucher Program
Office of Public and Indian Housing
Public reporting burden for this collection of information is estimated to average 0. 25 hours per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless that collection displays a valid OMB control number.
Privacy Act Statement. The Department of Housing and Urban Development (HUD) is authorized to collect the information required on this form by Section 8 of
the U.S. Housing Act of 1937 (42 U.S.C. 1437f). Collection of the name and address of both the family and the owner is mandatory. The information is used to
determine if a unit meets the housing quality standards of the section 8 rental assistance program. HUD may disclose this information to Federal, State and local
agencies when relevant to civil, criminal, or regulatory investigations and prosecutions. It will not be otherwise disclosed or released outside of HUD, except as
permitted or required by law. Failure to provide any of the information may result in delay or rejection of family participation.
Assurances of confidentiality are not provided under this collection.
This collection of information is authorized under Section 8 of the U.S. Housing Act of l937 (42 U.S.C. 1437f).
The information is used to determine if
a unit meets the housing quality standards of the section 8 rental assistance program.
PHA
Tenant ID Number
Date of Request (mm/dd/yyyy)
Inspector
Date Last Inspection (mm/dd/yyyy)
Date of Inspection (mm/dd/yyyy)
Type of Inspection
Project Number
Neighborhood/Census Tract
Initial
Special
Reinspection
A. General Information
Street Address of Inspected Unit
City
County
State
Zip
Name of Family
Current Telephone of Family
Current Street Address of Family
City
County
State
Zip
Number of Children in Family Under 6
Name of Owner or Agent Authorized to Lease Unit Inspected
Telephone of Owner or Agent
Address of Owner or Agent
Housing Type (check as appropriate)
Single Family Detached
Duplex or Two Family Row
House or Town House
Low Rise: 3,4 Stories, Including
Garden Apartment
High Rise; 5 or More Stories
Manufactured Home
Congregate
Cooperative
Independent Group Residence
Single Room Occupancy
Shared Housing
Other:(Specify)
Previous editions are obsolete Page 1 of 19 ref Handbook 7420.8 form HUD-52580A(04/15)
B. Summary Decision on the Unit
(to be completed after the form has been filled in)
Housing Quality Standard Pass or Fail
1. Fail If there are any checks under the column headed “Fail” the unit
fails the minimum housing quality standards. Discuss with the owner the
repairs noted that would be necessary to bring the unit up to the standard.
2. Inconclusive If there are no checks under the column headed
“Fail”
and there are checks under the column headed “Inconclusive,” obtain
additional information necessary for a decision (question owner or tenant as
indicated in t he i tem i nstructions gi ven in this c hecklist). O nce additional
information is obtained, change the rating for the item and record the date of
verificat
ion
at the far right of the form.
3. Pass If neither ( 1) nor ( 2) above is checked, the unit passes the
minimum housing quality standards. Any additional conditions described in the
right hand column of the form should serve to (a) establish the precondition of the
unit, (b) indicate possible additional areas to negotiate with the owner,
(c) ai d i n assessing the reasonableness of the rent of the unit, and ( d) ai d
the tenant in deciding among possible units to be rented. The tenant is
responsible for deciding whether he or she finds these conditions
acceptable.
Unit Size: Count the number of bedrooms for purposes of the
FMR or Payment Standard. Record in the box provided.
Year Constructed: Enter from Line 5 of the
Request for Tenancy Approval form. Record in the box provided.
Number of Sleeping Rooms: Count the number of rooms which
could be used for sleeping, as identified on the checklist. Record in the box
provided.
C. How to Fill Out This Checklist
Complete the checklist on the unit to be occupied (or currently occupied) by
the tenant. Proceed through the inspection as follows:
Area Checklist Category
room by room 1. Living Room
2. Kitchen
3. Bathroom
4. All Other Rooms Used for Living
5.
All Secondary Rooms Not Used for Living
basement or utility room 6. Heating & Plumbing
outside 7. Building Exterior
overall 8. General Health & Safety
Each part of the checklist will be accompanied by an explanation of the item
to be inspected.
Important: For each item numbered on the checklist, check one box only
(e.g., check one box only for item 1.4 "Security ”in the Living Room.)
In the space to the right of the description of the item, if the decision on the item
is: “Fail” write what repairs are necessary; If “Inconclusive” write in details.
Also, if ”Pass” but there are some conditions present that need to be brought to
the attention of the owner or the tenant, write these in the space to the right.
If it is an annual inspection, record to the right of the form any repairs made
since the last inspection. If possible, record reason for repair (e.g., ordinary
maintenance, tenant damage).
If it is a complaint inspection, fill out only those checklist items for which
complaint is lodged. Determine, if possible, tenant or owner cause.
Once the checklist has been completed, return to Part B (Summary
Decision on the Unit).
1. Living Room
1.1 Living Room Present
Note: If the unit is an efficiency apartment, consider the living room
present.
1.2 Electricity
In order to qualify, the outlets must be present and properly
installed in the baseboard, wall or floor of the room. Do not count a
single duplex receptacle as two outlets, i.e., there must be two of
these in the room, or one of these plus a permanently installed
ceiling or wall light fixture.
Both the outlets and/or the light must be working. Usually, a room
will have sufficient lights or electrical appliances plugged into
outlets t o determine w orkability. B e s ure light f ixture doe s not f ail
just because the bulb is burned out.
Do not count any of the following items or fixtures as
outlets/fixtures: Table or floor lamps (these are not permanent light
fixtures); ceiling lamps plugged into socket; extension cords.
If t he electric service to t he unit h as been t emporarily turned of f
check ‘’Inconclusive.’’ Contact owner or manager after inspection to
verify that electricity functions properly when service is turned on.
Record this information on the checklist.
1.3 Electrical Hazards
Examples of what this means: broken wiring; non-insulated wiring;
frayed w iring; i mproper t ypes of w iring, c onnections or i nsulation;
wires lying in or located near standing water or other unsafe places;
light fixture hanging from electric wiring without other firm support
or fixture; missing cover plates on switches or outlets; badly
cracked outlets; exposed fuse box connections; overloaded circuits
evidenced by frequently ‘’blown’’ fuses (ask the tenant).
Check “Inconclusive’’ if you are uncertain about severity of the
problem and seek expert advice.
1. 4 Security
“Accessible t o o utside” m eans: d oors o pen t o t he o utside or t o a
common public hall; windows accessible from the outside (e.g.
basement and first floor); windows or doors leading onto a fire
escape, porch or other outside place that can be r eached from the
ground.
“Lockable” means: the window or door has a properly working lock,
or is nailed shut, or t he window i s not designed to be opened. A
storm window lock that is working properly is acceptable. Windows
that are nailed shut are acceptable only if these windows are not
needed for ventilation or as an alternate exit in case of fire.
1.5 Window Condition
Rate the windows in the room (including windows in doors).
“Severe deterioration” means that t he w indow no longer has the
capacity to keep out the wind and the rain or is a cutting hazard.
Examples are: missing or broken-out panes; dangerously loose
cracked panes; windows that will not close; windows that, when
closed, do not form a reasonably tight seal.
If more than one window in the room is in this condition, give details
in the space provided on the right of the form.
If there i s only “ moderate deterioration” of the w indows the item
should "Pass." "Moderate deterioration” means windows which are
reasonably weather-tight, but show evidence of some aging, abuse,
or lack of repair. Signs of deterioration are: minor crack in window
pane; splintered sill; signs of some minor rotting in the window
frame or the window itself; window panes loose because of missing
window putty. Also for deteriorated and peeling paint see 1.9. If
more than one window is in this condition, give details in the space
provided on the right of the form.
Page 2 of 19
Previous editions are obsolete ref Handbook 7420.8 form HUD-52580A (04/15)
1.6 Ceiling Condition
“Unsound or hazardous” means the presence of such serious de-
fects that either a potential exists for structural collapse or that large
cracks or holes allow significant drafts to enter the unit. The
condition includes: severe bulging or buckling; large holes; missing
parts; falling or in da nger of falling loose s urface materials ( other
than paper or paint).
Pass ceilings that are basically sound but haves some
nonhazardous defects, including: small holes or cracks; missing or
broken ceiling tiles; water stains; soiled surfaces; unpainted
surfaces; peeling paint (for peeling paint see item 1.9).
1.7 Wall Condition
“Unsound or hazardous” includes: serious de fects such that t he
structural safety of the building is threatened, such as severe
buckling, bulging or leaning; damaged or loose structural members;
large holes; air infiltration.
Pass walls that are basically sound but have some non hazardous
defects, including: small or shallow holes; cracks; loose or missing
parts; unpainted surfaces; peeling paint (for peeling paint see item 1.9).
1.8 Floor Condition
“Unsound or hazardous” means the presence of such serious defects
that a potential exists for structural collapse or other threats to safety
(e.g., st ripping) or large cracks or hol es al low substantial dr afts f rom
below the floor. The condition includes: severe buckling or major
movements under walking stress; damaged or missi
ng parts.
Pass floors that are basically sound but have some nonhazardous
defects, including: heavily worn or damaged floor surface (for ex-ample,
scratches or gouges in surface, missing portions of tile or linoleum
,
previous w
ater damage). If there is
a floor covering, also note the
c
ondition, es pecially i f badly worn or soiled. If there is a f loor covering,
including paint or sealant, al so note the conditions, specially if badly
worn, soiled or peeling (for peeling paint, see 1.9).
1.9 Lead-Based Paint
Housing Choice Voucher Units If the unit was built January 1,
1978, or after, no child under age six will occupy or currently
occupies it, is a 0-BR, elderly or handicapped unit with no children
under age six on the lease or expected, has been certified lead-
based paint free by a certified lead-based paint inspector (no lead-
based paint present or no lead-based paint present after removal of
lead-based paint.), check NA and do not inspect painted surfaces.
This requirement applies to all painted surfaces (building
components) within the unit. (Do not include tenant belongings).
Surfaces to receive a visual assessment for deteriorated paint
include walls, floors, ceilings, built in cabinets (sink bases),
baseboards, doors, door frames, windows systems including
mullions, sills, or frames and any other painted building
component within the unit. Deteriorated paint includes any painted
surface that is peeling, chipping, chalking, cracking, damaged or
otherwise separated from the substrate.
All deteriorated paint surfaces more than 2 sq. ft. in any one
interior room or space, or more than 10% of the total surface
area of an interior type of component with a small surface
area (i.e., window sills, baseboards, and trim) must be
stabilized (corrected) in accordance with all safe work practice
requirements and clearance is required. If the deteriorated
painted surface is less than 2 sq. ft. or less than 10% of the
component, only stabilization is required. Clearance testing
is not required. Stabilization means removal of deteriorated
paint, repair of the substrate, and application of a new protective
coating or paint. Lead-Based Paint Owner Certification is required
following stabilization activities, except for de minimis level
repairs.
Previous editions are obsolete Page 3 of 19 ref Handbook 7420.8 form HUD-52580A (04/15)
1.
Living Room
For each numbered item, check one box only.
Item
Description
If Fail or
No.
If Fail, what repairs are necessary?
Inconclusive,
If Inconclusive, give details.
date (mm/dd/yyyy)
If Pass with comments, give details.
of final approval
1.1
Living Room Present
Is there a living room?
1.2
Electricity
Are there at least two working outlets or one working
outlet and one working light fixture?
1.3
Electrical Hazards
Is the room free from electrical hazards?
1.4
Security
Are all windows and doors that are accessible from
the outside lockable?
1.5
Window Condition
Is there at least one window, and are all windows
free of signs of severe deterioration or missing or
broken out panes?
1.6
Ceiling Condition
Is the ceiling sound and free from hazardous defects?
1.7
Wall Condition
Are the walls sound and free from hazardous defects?
1.8
Floor Condition
Is the floor sound and free from hazardous defects?
1.9
Lead-Based Paint
Are all painted surfaces free of deteriorated paint?
If no, does deteriorated surfaces exceed two square
Not Applicable
feet and/or more than 10% of a component?
Additional Comments: (Give Item Number)
Comments continued on a separate page Yes
No
Previous editions are obsolete Page 4 of 19 ref Handbook 7420.8 form HUD-52580A (04/15)
Decision
Yes, Pass
No, Fail
Inconclusive
2. Kitchen
2.1 Kitchen Area Present
Note: A kitchen is an area used for preparation of meals. It may be
either a separate room or an area of a larger room (for example, a
kitchen area in an efficiency apartment).
2.2 - 2.9 Explanation for these items is the same as that
provided for "Living Room’’ with the following
modifications:
2.2 Electricity
Note: The requirement is that at least one outlet and one
permanent light fixture are present and working.
2.5 Window Condition
Note: The absence of a window does not fail this item in the
kitchen. If there is no window, check “Pass.”
2.10 Stove or Range with Oven
Both an oven and a stove ( or range) w ith t op burners must be
present and working. If either Is missing and you know that the
owner is responsible for supplying these appliances, check “Fail.’’
Put check in ‘’Inconclusive’’ column if the tenant is responsible f or
supplying the appliances and he or she has not yet moved i n.
Contact tenant or prospective tenant to gain verification that facility
will be supplied and is in working condition. Hot plates are not
acceptable substitutes for these facilities.
An oven is not working if it will not heat up. To be w orking a s tove
or range must have all burners working and knobs to turn them off
and on. Under “ working c ondition,” also look for hazardous gas
hook-ups evidenced by s trong ga s smells; these s hould f ail. ( Be
sure that this condition is not confused with an unlit pilot light -a
condition that should be noted, but does not fail.)
If both an oven and a stove or range are present, but the gas or
electricity are turned off, check “ Inconclusive.” Contact owner or
manager to get v erification t hat f acility w orks w hen gas is t urned
on. If both an oven and a stove or range are present and working,
but d efects exist, check " Pass" and not e t hese to t he right of t he
form. P ossible defects are marked, dented, or scratched surfaces;
cracked burner ring; limited size relative to family needs.
A microwave oven may be substituted for a tenant-supplied oven
and stove (or range).
A microwave oven may be substituted for an owner-supplied oven
and stove (or range) if the tenant agrees and microwave ovens are
furnished instead of ovens and stoves (or ranges) to both
subsidized and unsubsidized tenants in the building or premises.
2.11 Refrigerator
If no refrigerator is present, use the same criteria for marking either
“Fail” or “Inconclusive” as were used for the oven and stove or range.
A refrigerator is not working if it will not maintain a temperature low
enough to keep food from spoiling over a reasonable period of time.
If t he el ectricity i s t urned of f, m ark ‘ ’Inconclusive.’’ C ontact ow ner
(or tenant if unit is occupied) to get verification of working condition.
If the refrigerator is present and working but defects exist, note these to
the right of the form. Possible minor defects include: broken or missing
interior shelving; dented or scratched interior or exterior surfaces; minor
deterioration of door seal; loose door handle.
2.12 Sink
If a permanently attached kitchen sink is not present in the kitchen or
kitchen area, mark ‘’Fail.’’ A sink in a bathroom or a por table basin will
not satisfy this requirement. A sink i
s not work
ing unless it has running
hot and cold water from the faucets and a properly connected and
properly w orki
ng dr ain ( with a “gas t rap”). In a vacant apar
tment, t he
hot w ater may have be en turned off and there w ill be no hot water.
Mark this “Inconclus
ive.” Check with owner or man
ager to verify that hot
water is available when service is turned on.
If a working sink has defects, note this to the right of the item.
Possible minor defects include: dripping faucet; marked, dented, or
scratched surface; slow drain; missing or broken drain stopper.
2.13 Space for Storage, Preparation, and Serving of Food
Some space must be available for the storage, preparation, and
serving of f ood. If t here i s no bui lt-in s pace f or f ood storage and
preparation, a table used for food preparation and a portable
storage cabinet will satisfy t he requirement. If t here is no built-in
space, and no room for a table and portable cabinet, check
“Inconclusive” a nd discuss w ith t he tenant. T he t enant makes t he
final determination as to whether or not this space is acceptable.
If there ar e some minor def ects, c heck "Pass" and make notes to
the right. Possible def ects i nclude: marked, dented, or scratched
surfaces; broken shelving or cabinet doors; broken drawers or
cabinet hardware; limited size relative to family needs.
Previous editions are obsolete Page 5 of 19 ref Handbook 7420.8 form HUD-52580A (04/15)
2.
Kitchen
For each numbered item, check one box only.
Item Description
No.
If Fail, what repairs are necessary?
If Inconclusive, give details.
If Pass with comments, give details.
2.1 Kitchen Area Present
Is there a kitchen?
2.2 Electricity
Are there at least one working outlet and one work-
ing, permanently installed light fixture?
2.3 Electrical Hazards
Is the kitchen free from electrical hazards?
2.4 Security
Are all windows and doors that are accessible from
the outside lockable?
2.5 Window Condition
Are all windows free of signs of deterioration or
missing or broken out panes?
2.6 Ceiling Condition
Is the ceiling sound and free from hazardous defects?
2.7 Wall Condition
Are the walls sound and free from hazardous
defects?
2.8 Floor Condition
Is the floor sound and free from hazardous defects?
2.9 Lead-Based Paint
Are all painted surfaces free of deteriorated paint?
If no, does deteriorated surfaces exceed two square
Not Applicable
feet and/or less than 10% of a component?
2.10 Stove or Range with Oven
Is there a working oven, and a stove (or range) with
top burners that work?
If no oven and stove (or range) are present, is there
a microwave oven and, if microwave is owner-sup-
plied, do other tenants have microwaves instead of
an oven and stove (or range)?
2.11 Refrigerator
Is there a refrigerator that works and maintains
a temperature low enough so that food does not
spoil over a reasonable period of time?
2.12 Sink
Is there a kitchen sink that works with hot and cold
running water?
2.13 Space for Storage, Preparation, and
Serving
Serving of Food
Is there space to store, prepare, and serve food?
Additional Comments: (Give Item Number)(Use an additional page if necessary)
Comments continued on a separate page Yes
No
If Fail or
Inconclusive, date
(mm/dd/yyyy) of
final approval
Previous editions are obsolete Page 6 of 19 ref Handbook 7420.8 form HUD-52580A (04/15)
Decision
Yes, Pass
No, Fail
Inconclusive
3. Bathroom
3.1 Bathroom Present
Most units have easily identifiable bathrooms (i.e., a separate room with
toilet, washbasin and t ub or shower). In some cases, however, you w ill
encounter units with scattered bathroom facilities (i.e., toilet. washbasin
and tub or shower located in separate parts of the unit). At a m inimum,
there m ust be an enclosure ar ound t he t oilet. I n t his c ase, count t he
enclosure around the toilet as the bathroom and proceed with 3.2-3.9
below, with respect to this enclosure. If there is more than one
bathroom that is normally used, rate the one that i
s in best condition for
Part 3.
If there is a second bathroom that is also used, complete Part 4
of the checklist for this room. (See Inspection Manual for additional
notes on rating the second bathroom.)
3.2 - 3.9 Explanation for these items is the same as that
provided for “Living Room’’ with the following
modifications:
3.2 Electricity
Note: The requirement is that at least one permanent light
fixture is present and working
3.3 Electrical Hazards
Note: In addition to the previously mentioned hazards, outlets
that are located where water might splash or collect are
considered an electrical hazard.
3.5 Window Condition
Note: The absence of a w indow does not fail this item in the
bathroom (see item 3.13, Ventilation, for relevance of window
with respect to ventilation). If there is no window, but a
working vent system is present, check “Pass.”
3.7 Wall Condition
Note: Include under nonhazardous defects (that would pass,
but should be noted) the following: broken or loose tile;
deteriorated gr outing at t ub/wall an d t ub/floor joints, or tiled
surfaces; water stains.
3.8 Floor Condition
Note: Include under nonhazardous defects (that would pass, but
should be noted) the following: missing floor tiles; water stains.
3.10 Flush Toilet in Enclosed Room in Unit
The toilet must be contained within the unit, be in proper operating
condition, and be available for the exclusive use of the occupants of
the u nit ( i.e., outhouses or facilities shared by oc cupants o f ot her
units are not acceptable). It must allow for privacy.
Not working means: the toilet is not connected to a water supply; it is
not connected to a sewer drain; it is clogged; it does not have a trap;
the connections, vents or traps ar e faulty to the extent that severe
leakage
of w ater or escape of gases occurs; the flus
hing mechanism
does not function properly. If the water to the unit has been t
urned of
f,
check " Inconclusive.’’ O btain ver ification f rom ow ner or m anager t hat
facility works properly when water is turned on.
Comment to the right of the form if the toilet is “present, exclusive,
and working,” but has the following types of defects: constant
running; chipped or broken porcelain; slow draining.
If dr ain b lockage i s more s erious and occurs f urther in t he s ewer
line, causing backup, check item 7.6, “Fail,” under the plumbing and
heating par t of t he c hecklist. A s ign o f serious s ewer bl ockage is
the presence of numerous backed-up drains.
3.11 Fixed Wash Basin or Lavatory in Unit
The wash basin must be permanently installed ( i.e., a portable
wash basin does not satisfy the requirement). Also, a kitchen sink
used to pass the requirements under Part 2 of the checklist (kitchen
facilities) cannot also serve as the bathroom wash basin. The wash
basin may be located separate from the other bathroom facilities
(e.g., in a hallway).
Not w orking means: t he wash basin is not connected t o a system
that will deliver hot and cold running water; it is not connected to a
properly operating drain; the connectors ( or vents or traps) are
faulty to the extent that severe leakage of water or escape of sewer
gases occurs. If the water to the unit or the hot water unit has been
turned off, check "Inconclusive." Obtain verification from owner or
manager that the system is in working condition.
Comment to the right of the form if the wash basin is “present and
working,” but has the following types of minor defects: insufficient
water pressure; dripping faucets; minor leaks; cracked or chipped
porcelain; slow drain (see discussion above under 3.10).
3.12 Tub or Shower in Unit
Not present means that neither a tub nor shower is present i n the
unit. Again, these facilities need not be in the same room with the
rest of the bathroom facilities. They must, however, be private.
Not working covers the same requirements detailed above for wash
basin (3.11).
Comment to the right of the form if the tub or shower is present and
working, but has the following types of defects: dripping faucet;
minor leaks; cracked porcelain; slow drain (see discussion under
3.10); absent or broken support rod for shower curtain.
3.13 Ventilation
Working vent systems include: ventilation shafts ( non -mechanical
vents) and electric fans. Electric vent fans must function when switch is
turned on. (Make sure that any malfunctions are not due to the fan not
being pl ugged in.) If electric current to the unit has not been t urned on
(and there is no operable window), check “Inconclusive.” Obtain
verification from owner or m anager that system works. Note: exhaust
vents must be vented to the outside, attic, or crawlspace.
Previous editions are obsolete Page 7 of 19 ref Handbook 7420.8 form HUD-52580A (04/15)
3.
Bathroom
For each numbered item, check one box only.
Item
Description
If Fail or
No.
If Fail, what repairs are necessary?
Inconclusive,
If Inconclusive, give details. date (mm/dd/yyyy)
If Pass with comments, give details.
of final approval
3.1
Bathroom Present (See description)
Is there a bathroom?
3.2
Electricity
Is there at least one permanently installed light fixture?
3.3
Electrical Hazards
Is the bathroom free from electrical hazards?
3.4 Security
Are all windows and doors that are accessible from
the outside lockable?
3.5 Window Condition
Are all windows free of signs of deterioration or
missing or broken out panes?
3.6 Ceiling Condition
Is the ceiling sound and free from hazardous defects?
3.7 Wall Condition
Are the walls sound and free from hazardous defects?
3.8
Floor Condition
Is the floor sound and free from hazardous defects?
3.9
Lead-Based Paint
Are all painted surfaces free of deteriorated paint?
If no, does deteriorated surfaces exceed two square
Not Applicable
feet and/or more than 10% of a component?
3.10
Flush Toilet in Enclosed Room in Unit
Is there a working toilet in the unit for the exclusive
private use of the tenant?
3.11
Fixed Wash Basin or Lavatory in Unit
Is there a working, permanently installed wash basin
with hot and cold running water in the unit?
3.12
Tub or Shower
Is there a working tub or shower with hot and cold
running water in the unit?
3.13 Ventilation
Are there operable windows or a working vent sys-
tem?
Additional Comments: (Give Item Number)(Use an additional page if necessary)
Comments continued on a separate page Yes
No
Previous editions are obsolete Page 8 of 19 ref Handbook 7420.8 form HUD-52580A (04/15)
Decision
Yes, Pass
No, Fail
Inconclusive
4. Other Room Used for Living and Halls
Complete an “ Other Room” checklist for as many “ other rooms
used for living” as are present in the unit and not already noted in
Parts l, 2, and 3 of the checklist. See the discussion below f or
definition of ‘’used for living.’’ Also complete an ‘’Other Room”
checklist for al l entrance halls, corridors, and staircases that are
located within the unit and are part of the area used for living. If a
hall, entry and/ or stairway ar e contiguous, rate them as a w hole
(i.e., as part of one space).
Additional forms for rating “Other Rooms” are provided in the
check-list.
Definition of “used f or living." Rooms "used for living” are areas of
the unit that are walked through or lived in on a regular basis. Do
not i nclude rooms or o ther ar eas t hat h ave bee n per manently, or
near permanently, closed off or areas that are infrequently entered.
For example, do not include a utility room, attached shed, attached
closed-in porch, basement, or garage if they are closed off from the
main living area or ar e i nfrequently ent ered. Do include any of
these areas if they are frequently used (e.g., a finished
basement/play-room, a closed-in porch that is used as a bedroom
during summer months). Occasional use of a washer or dryer in an
otherwise unused room does not constitute regular use.
If t he uni t i s v acant and y ou do not know t he eventual use of a
particular room, complete an ‘’Other Room’’ checklist if there is any
chance that the room will be used on a regular basis. If there is no
chance that the room will be used on a regular basis, do not include
it (e.g., an unfinished basement) since it will be checked under Part
5, All Secondary Rooms (Rooms not used for living).
4.1 Room Code and Room Location
Enter the appropriate room code given below:
Room Codes:
1 = B edroom or a ny other r oom us ed f or sleeping ( regardless of
type of room)
2 = Dining Room or Dining Area
3 = Second Living Room, Family Room, Den, Playroom, TV Room
4 = Entrance Halls, Corridors, Halls, Staircases
5 = A dditional Bathroom ( also check presence of sink trap and
clogged toilet)
6 = Other
Room Location: Write on the line provided the location of the room
with respect to the unit’s width, length and floor level as if you were
standing outside the unit facing the entrance to the unit:
right/left/center: record whether the room is situated to the right,
left, or center of the unit.
front/rear/center: record whether the room is situated to the back,
front or center of the unit.
floor level: identify the floor level on which the room is located.
If t he unit is vacant, you may hav e some difficulty pr edicting t he
eventual use of a room. Before giving any room a code of 1
(bedroom), the room must meet all of the requirements for a ‘’room
used for sleeping’’ (see items 4. 2 and 4.5).
4.2 - 4.9 E xplanations o f t hese items are the same a s those
provided for "Living Room" with the following
modifications:
4.2 Electricity/Illumination
If the room code is not a "1," the room must have a means of
natural or ar tificial illumination such as a permanent l ight
fixture, wall outlet present, or light from a window in the room
or near the room. If any required item is missing, check “Fail."
If the electricity is turned off, check “Inconclusive."
4.5 Window Condition
Any room used for sleeping must have at least one window. If
the windows in sleeping rooms are designed to be opened, at
least one window must be operable. The minimum standards
do not require a window in “other rooms.” Therefore, if there
is no w indow i n ano ther r oom not us ed f or s leeping, c heck
“Pass,” and note “no window” in the area for comments.
4.6 Smoke Detectors
At least one battery-operated or hard-wired smoke detector
must be present and working on each level of the unit,
including the basement, but not the crawl spaces and
unfinished attic.
Smoke detectors must be installed in ac cordance with and m eet
the requirements of the National Fire Protection Association
Stand
ard (
NFPA) 74 (or its successor st
andards).
If the dwelling unit is occupied by any hearing-impaired per-
son, smoke detectors must have an alarm s ystem d esigned
for hearing-impaired per sons as specified in NFPA 74 ( or
successor standards).
If t he unit was under H AP contract prior t o April 2 4, 1 993,
owners who i nstalled battery -operated or hard-wired smoke
detectors in compliance with HUD’s smoke detector
requirements, including the regulations published on July 30,
1992 ( 57 F R 33846), will not be required subsequently t o
comply with any additional requirements mandated by NFPA
74 ( i.e. t he ow ner w ould not be required to install a s moke
detector in a basement not used for living purposes, nor
would the ow ner be required t o change the location of the
smoke detectors that have already been installed on the
other floors of the unit). In this case, check “ Pass” and note
under comments.
Additional Notes
For staircases, the adequacy of light and condition of the stair rails
and railings is covered under Part 8 of the checklist (General Health
and Safety)
Previous editions are obsolete Page 9 of 19 ref Handbook 7420.8 form HUD-52580A (04/15)
4. Other Rooms Used for Living and Halls For each numbered item, check one box only.
4.1 Room Location Room Code
______
right/left/center: the room is situated to the right, left,
1 = Bedroom or Any Other Room Used for Sleeping (regardless of
or center of the unit.
type of room)
______
front/rear/center: the room is situated to the back, front
2 = Dining Room or Dining Area
or center of the unit.
3 = Second Living Room, Family Room, Den, Playroom, TV Room
______
floor level: the floor level on which the room is
4 = Entrance Halls, Corridors, Halls, Staircases
located.
5 =
Additional Bathroom (also check presence of sink trap and
clogged toilet)
6 = Other:
Item
Description
If Fail or
No.
If Fail, what repairs are necessary? Inconclusive,
If Inconclusive, give details. date (mm/dd/yyyy)
If Pass with comments, give details. of final approval
4.2 Electricity/Illumination
If Room Code is a 1, are there at least two working
outlets or one working outlet and one working,
permanently ins
tal
led light fixture?
If Room Code is not a 1, is there a means of illumination?
4.3 Electrical Hazards
Is the room free from electrical hazards?
4.4 Security
Are all windows and doors that are accessible from
the outside lockable?
4.5 Window Condition
If Room Code is a 1, is there at least one window?
And, regardless of Room Code, are all windows
free of signs of severe deterioration or m issing or
broken-out panes?
4.6 Ceiling Condition
Is the ceiling sound and free from hazardous defects?
4.7 Wall Condition
Are the walls sound and free from hazardous defects?
4.8
Floor Condition
Is the floor sound and free from hazardous defects?
4.9
Lead-Based Paint
Are all painted surfaces free of deteriorated paint?
If no, does deteriorated surfaces exceed two square
Not Applicable
feet and/or more than 10% of a component?
4.10 Smoke Detectors
Is there a working smoke detector on each level?
Do the smoke detectors meet the requirements of
NFPA 74?
In units occupied by the hearing impaired, is there an
alarm system connected to the smoke detector?
Additional Comments: (Give Item Number)(Use an additional page if necessary)
Comments continued on a separate page
Yes
No
Previous editions are obsolete Page 10 of 19 ref Handbook 7420.8 form HUD-52580A (04/15)
Decision
Yes, Pass
No, Fail
Inconclusive
4. Supplemental for Other Rooms Used for Living and Halls
For each numbered item, check one box only.
4.1 Room Location Room Code
______
right/left/center: the room is situated to the right, left,
1 = Bedroom or Any Other Room Used for Sleeping (regardless of
or center of the unit.
type of room)
______
front/rear/center: the room is situated to the back, front
2 = Dining Room or Dining Area
or center of the unit.
3 = Second Living Room, Family Room, Den, Playroom, TV Room
______
floor level: the floor level on which the room is
4 = Entrance Halls, Corridors, Halls, Staircases
located.
5 =
Additional Bathroom (also check presence of sink trap and
clogged toilet)
6 = Other:
Item
Description
If Fail or
No.
If Fail, what repairs are necessary? Inconclusive,
If Inconclusive, give details. date (mm/dd/yyyy)
If Pass with comments, give details. of final approval
4.2 Electricity/Illumination
If Room Code is a 1, are there at least two working
outlets or one working outlet and one working,
permanently installed light fixt
ure?
If Room Code is not a 1, is there a means of illumination?
4.3 Electrical Hazards
Is the room free from electrical hazards?
4.4 Security
Are all windows and doors that are accessible from
the outside lockable?
4.5 Window Condition
If Room Code is a 1, is there at least one window?
And, regardless of Room Code, are all windows
free of s igns of severe d eterioration or m issing or
broken-out panes?
4.6 Ceiling Condition
Is the ceiling sound and free from hazardous defects?
4.7 Wall Condition
Are the walls sound and free from hazardous defects?
4.8 Floor Condition
Is the floor sound and free from hazardous defects?
4.9 Lead-Based Paint
Are all painted surfaces free of deteriorated paint?
If no, does deteriorated surfaces exceed two square
Not Applicable
feet and/or more than 10% of a component?
4.10 Smoke Detectors
Is there a working smoke detector on each level?
Do the smoke detectors meet the requirements of
NFPA 74?
In units occupied by the hearing impaired, is there an
alarm system connected to the smoke detector?
Additional Comments: (Give Item Number)(Use an additional page if necessary)
Comments continued on a separate page Yes
No
Previous editions are obsolete Page 11 of 19 ref Handbook 7420.8 form HUD-52580A (04/15)
Decision
Yes, Pass
No, Fail
Inconclusive
