Housing Choice Voucher Program Inspection Checklist (Omb Approval No. 2577-0169) Page 2
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Room Codes: 1 = Bedroom or Any Other Room Used for 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 = Additional Bathroom; 6 = Other
Item
Yes
No
In-
Final Approval
1. L ivin g Room (Continued)
No.
Pas
Fail
Conc.
Comment
Date (mm/dd/yyyy)
1.9
Not Applicable
Lead-Based Paint
Are all painted surfaces free of deteriorated
paint?
If not, do deteriorated surfaces exceed two
square feet per room and/or is more than
10% of a component?
2. K i t c h e n
2.1
Kitchen Area Present
2.2
Electricity
2.3
Electrical Hazards
2.4
Security
2.5
Window Condition
2.6
Ceiling Condition
2.7
Wall Condition
2.8
Floor Condition
Not Applicable
2.9
Lead-Based Paint
Are all painted surfaces free of deteriorated
paint?
If not, do deteriorated surfaces exceed two
square feet per room and/or is more than
10% of a component?
2.10 Stove or Range with Oven
2.11 Refrigerator
2.12 Sink
2.13 Space for Storage, Preparation, and Serving
of Food
3. Bathroom
3.1
Bathroom Present
3.2
Electricity
3.3
Electrical Hazards
3.4
Security
3.5
Window Condition
3.6
Ceiling Condition
3.7
Wall Condition
3.8
Floor Condition
Not Applicable
Lead-Based Paint
3.9
Are all painted surfaces free of deteriorated
paint?
If not, do deteriorated surfaces exceed two
square feet per room and/or is more than
10% of a component?
3.10
Flush Toilet in Enclosed Room in Unit
3.11 Fixed Wash Basin or Lavatory in Unit
3.12 Tub or Shower in Unit
3.13 Ventilation
Page 2 of 8
Previous editions are obsolete
form HUD-52580 (3/2001)
ref Handbook 7420.8
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