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<br />4. Other Rooms Used for Living and Halls For each numbered item, check one box only. <br /> <br />4.1 Room Location <br />righVlefUcenter: the room is situated to the right, lell, <br />or center of the unit. <br />fronUrear/center: the room is situated to the back, front <br />or center of the unit. <br />floor level: the floor level on which the room is <br />located. <br /> <br />Room Code D <br /> <br />1 = Bedroom or Any Other Room Used for Sleeping (regardless of <br />type of room) <br />2 = Dining Room or Dining Area <br />3 = Second Living Room, Family Room, Den, Playroom, TV Room <br />4 = Entrance Halls, Corridors, Halls, Staircases <br />5 = Additional Bathroom (also check presence of sink trap and <br />clogged toilet) <br />6 = Other: <br /> <br /> Decision <br />Item Description > If Fail or <br /> w .;;; If Fail. what repairs are necessary? Inconclusive. <br />No. w <br /> m ~ <br /> a. '" U If Inconclusive, give details. dale (mm/dd/yyyy) <br /> "- c <br /> u; 0 0 If Pass with comments, give details. of final approval <br /> ~ u <br /> >- Z c <br />4.2 Electricity/III um inatlon <br />If Room Code is a 1. are there at least two working <br />outlets or one working outlet and one working, perma- ODD <br />nently installed light fixture? <br />If Room Code is nota 1 ,is there a means of illumination? DDD <br />4.3 Electrical Hazards <br />Is the room free from electrical hazards? DDD <br />4.4 Security <br />Are all windows and doors that are accessible from <br />the outside lockable? DD <br />4.5 Window Condition <br />If Room Code is a 1, is there at least one window? DD <br />And, regardless of Room Code, are all windows free <br />of signs of severe deterioration or missing or broken- DD <br />out panes? <br />4.6 Ceiling Condition <br />Is the ceiling sound and free from hazardous defects? DD <br />4.7 Wall Condition <br />Are the walls sound and free from hazardous defects? DD <br />4.8 Floor Condition <br />Is the floor sound and free from hazardous defects? DD <br />n. <br />4.9 Lead-Based Paint DD <br />Are all painted surfaces free of deteriorated paint? <br />If no, does deteriorated surfaces exceed two square DD D Not Applicable <br />feet and/or more than 10% of a component? <br />4.10 Smoke Detectors <br />Is there a working smoke detector on each level? DD <br />Do the smoke detectors meet the requirements of DD <br />NFPA 747 <br />In units occupied by the hearing impaired, is there an DD <br />alarm system connected to the smoke detector? <br /> <br />Additional Comments: (Give Item Number)(Use an additional page if necessary) <br /> <br />Comments continued on a separate page Yes 0 <br /> <br />No D <br /> <br />Previous editions are obsolete <br /> <br />Page 9 of 20 <br /> <br />form HUD-52580-A (9//2000) <br />ref Handbook 7420.8 <br />