Housing Choice Voucher Program Inspection Checklist (Omb Approval No. 2577-0169) Page 6
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7C. Special Amenities (Optional)
This Section is for optional use of the HA. It is designed to collect additional information about other positive features of
the unit that may be present. Although
the features listed below are not included in the Housing Quality Standards, the tenant and HA may wish to take them into consi deration in decisions about
renting the unit and the reasonableness of the rent.
Check/list any positive features found in relation to the unit.
1. Living Room
4. Bath
High quality floors or wall coverings
Special feature shower head
Working fireplace or stove
Built-in heat lamp
Balcony, patio, deck, porch
Large mirrors
Special windows or doors
Glass door on shower/tub
Exceptional size relative to needs of family
Separate dressing room
Other: (Specify)
Double sink or special lavatory
Exceptional size relative to needs of family
Other: (Specify)
2. Kitchen
Dishwasher
Separate freezer
Garbage disposal
Eating counter/breakfast nook
Pantry or abundant shelving or cabinets
5. Overall Characteristics
Double oven/self cleaning oven, microwave
Storm windows and doors
Double sink
Other forms of weatherization (e.g., insulation, weather stripping)
High quality cabinets
Screen doors or windows
Abundant counter-top space
Good upkeep of grounds (i.e., site cleanliness, landscaping,
Modern appliance(s)
condition of lawn)
Exceptional size relative to needs of family
Garage or parking facilities
Other: (Specify)
Driveway
Large yard
Good maintenance of building exterior
Other: (Specify)
3. Other Rooms Used for Living
High quality floors or wall coverings
Working fireplace or stove
Balcony, patio, deck, porch
6. Disabled Accessibility
Special windows or doors
Unit is accessible to a particular disability.
Yes
No
Exceptional size relative to needs of family
Disability ___________________________
Other: (Specify)
D. Questions to ask the Tenant (Optional)
1.
Does the owner make repairs when asked?
Yes
No
2.
How many people live there? ___________
3.
How much money do you pay to the owner/agent for rent? $ _________________
4.
Do you pay for anything else? (specify) ___________________________________________________________________________
5.
Who owns the range and refrigerator? (insert O = Owner or T = Tenant) Range ______
Refrigerator _____
Microwave _____ _
6.
Is there anything else you want to tell us? (specify) Yes
No
form HUD-52580 (3/2001)
Previous editions are obsolete
Page 6 of 7
ref Handbook 7420.8
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