Housing Choice Voucher Program Inspection Checklist (Omb Approval No. 2577-0169) Page 2
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7Item
Yes
No
In-
Final Approval
1. Living Room (Continued)
No.
Pass Fail
Conc.
Comment
Date (mm/dd/yyyy)
1.9
Lead-Based Paint
Not Applicable
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. Kitchen
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
2.9
Lead-Based Paint
Not Applicable
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
3.9
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?
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
form HUD-52580 (3/2001)
Previous editions are obsolete
Page 2 of 7
ref Handbook 7420.8
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