Housing Choice Voucher Program Inspection Form Page 15
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195.
All Secondary Rooms
(Rooms not used for living)
For each numbered item, check one box only.
Decision
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
5.1
None
Go to Part 6
5.2
Security
Are all windows and doors that are accessible from
the outside lockable?
5.3
Electrical Hazards
Are all these rooms free from electrical hazards?
5.4
Other Potentially Hazardous Features
Are all of these rooms free of any other potentially
hazardous features? For each room with an "other
potentially hazardous feature," explain the hazard
and the means of control of interior access to the room.
6.0 Building Exterior
6.1
Condition of Foundation
Is the foundation sound and free from hazards?
6.2
Condition of Stairs, Rails, and Porches
Are all the exterior stairs, rails, and porches sound
and free from hazards?
6.3
Condition of Roof and Gutters
Are the roof, gutters, and downspouts sound and
free from hazards?
6.4
Condition of Exterior Surfaces
Are exterior surfaces sound and free from hazards?
6.5
Condition of Chimney
Is the chimney sound and free from hazards?
6.6
Lead-Based Paint: Exterior Surfaces
Are all painted surfaces free of deteriorated paint?
If no, does deteriorated surfaces exceed 20 sq. ft. of
Not Applicable
total exterior surface area?
6.7
Manufactured Homes: Tie Downs
If the unit is a manufactured home, is it properly placed
and tied down? If not a manufactured home, check
"Not Applicable."
Not Applicable
Additional Comments: (Give Item Number)(Use an additional page if necessary)
Comments continued on a separate page
Yes
No
Previous editions are obsolete
Page 15 of 19
ref Handbook 7420.8 form HUD-52580-A (9/00)
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