Housing Choice Voucher Program Inspection Checklist (Omb Approval No. 2577-0169) Page 3
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74. Other Rooms Used For Living and Halls
Item
Yes
No
In-
Final Approval
No.
Pass
Fail
Conc.
Comment
Date (mm/dd/yyyy)
4.1
Room Code* and
(Circle One)
(Circle One)
Room Location
Right/Center/Left
Front/Center/Rear
____Floor Level
4.2
Electricity/Illumination
4.3
Electrical Hazards
4.4
Security
4.5
Window Condition
4.6
Ceiling Condition
4.7
Wall Condition
4.8
Floor Condition
Not Applicable
4.9
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?
4.10 Smoke Detectors
4.1
Room Code* and
(Circle One)
(Circle One)
Room Location
Right/Center/Left
Front/Center/Rear
____Floor Level
4.2
Electricity/Illumination
4.3
Electrical Hazards
4.4
Security
4.5
Window Condition
4.6
Ceiling Condition
4.7
Wall Condition
4.8
Floor Condition
4.9
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?
4.10 Smoke Detectors
4.1
Room Code* and
(Circle One)
(Circle One)
Room Location
Right/Center/Left
Front/Center/Rear
____Floor Level
4.2
Electricity/Illumination
4.3
Electrical Hazards
4.4
Security
4.5
Window Condition
4.6
Ceiling Condition
4.7
Wall Condition
4.8
Floor Condition
4.9
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?
4.10 Smoke Detectors
form HUD-52580 (3/2001)
Previous editions are obsolete
Page 3 of 7
ref Handbook 7420.8
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