HUD-52580-52646 Inspection Checklist

U.S. Department of Housing
and Urban Development
Office of Public and Indian Housing

Inspection Checklist
Housing Choice Voucher Program

OMB Approval No. 2577-0169
(Exp. 05/31/2004)

Public reporting burden for this collection of information is estimated to average 0.50 hours per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency
may not conduct or sponsor, and a person is not required to respond to, a collection of information unless that collection displays a valid OMB control number.
This collection of information is authorized under Section 8 of the U.S. Housing Act of l937 (42 U.S.C. 1437f). The information is used to determine if
a unit meets the housing quality standards of the section 8 rental assistance program.
Name of Family

Tenant ID Number

Date of Request (mm/dd/yyyy)

Inspector

Neighborhood/Census Tract

Date of Inspection (mm/dd/yyyy)

Type of Inspection

Initial

Date of Last Inspection (mm/dd/yyyy)

Special

PHA

Reinspection

A. General Information
Inspected Unit

Housing Type (check as appropriate)

Year Constructed (yyyy)

Full Address (including Street, City, County, State, Zip)

Single Family Detached
Duplex or Two Family
Row House or Town House
Low Rise: 3, 4 Stories,
IncludingGarden Apartment

Number of Children in Family Under 6

High Rise; 5 or More Stories
Manufactured Home
Congregate
Cooperative
Independent Group Residence

Owner
Name of Owner or Agent Authorized to Lease Unit Inspected

Phone Number

Single Room Occupancy
Shared Housing
Other

Address of Owner or Agent

B. Summary Decision On Unit (To be completed after form has been filled out)
Number of Bedrooms for Purposes Number of Sleeping Rooms
Pass
of the FMR or Payment Standard

Fail
Inconclusive

Inspection Checklist
Item
No.

1. Living Room

1.1

Living Room Present

1.2

Electricity

1.3

Electrical Hazards

1.4

Security

1.5

Window Condition

1.6

Ceiling Condition

1.7

Wall Condition

1.8

Floor Condition

Yes
Pass

No
Fail

InConc.

Comment

Final Approval
Date (mm/dd/yyyy)

Clear All Form Fields
* 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;
Previous editions are obsolete

Page 1 of 7

6 = Other

form HUD-52580 (3/2001)
ref Handbook 7420.8

Item
No.

1.9

1. Living Room (Continued)
Lead-Based Paint

Yes
No
Pass Fail

InConc.

Comment

Final Approval
Date (mm/dd/yyyy)

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

3.9

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?
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

Previous editions are obsolete

Page 2 of 7

form HUD-52580 (3/2001)
ref Handbook 7420.8

Item
No.

4.1

4. Other Rooms Used For Living and Halls
Room Code* and
Room Location

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

Yes
Pass

No
Fail

InConc.

Comment

(Circle One)
Right/Center/Left

(Circle One)
Front/Center/Rear

Final Approval
Date (mm/dd/yyyy)

____Floor Level

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
Room Location

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

(Circle One)
Right/Center/Left

(Circle One)
Front/Center/Rear

____Floor Level

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
Room Location

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

(Circle One)
Right/Center/Left

(Circle One)
Front/Center/Rear

____Floor Level

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

Previous editions are obsolete

Page 3 of 7

form HUD-52580 (3/2001)
ref Handbook 7420.8

Item
No.

4.1

4. Other Rooms Used For Living and Halls Yes

InConc.

Comment

(Circle One)
Right/Center/Left

(Circle One)
Front/Center/Rear

Pass

Room Code* and
Room Location

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

No
Fail

Final Approval
Date (mm/dd/yyyy)

____Floor Level

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
Room Location

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

(Circle One)
Right/Center/Left

(Circle One)
Front/Center/Rear

____Floor Level

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
5. All Secondary Rooms
(Rooms not used for living)

5.1 None

Go to Part 6

5.2 Security
5.3 Electrical Hazards
5.4 Other Potentially Hazardous Features
in these Rooms

Previous editions are obsolete

Page 4 of 7

form HUD-52580 (3/2001)
ref Handbook 7420.8

Item
No.

6. Building Exterior

Yes
Pass

No
Fail

InConc.

Comment

Final Approval
Date (mm/dd/yyyy)

6.1 Condition of Foundation
6.2 Condition of Stairs, Rails, and Porches
6.3

Condition of Roof/Gutters

6.4 Condition of Exterior Surfaces
6.5

Condition of Chimney

6.6

Lead Paint: Exterior Surfaces
Are all painted surfaces free of deteriorated
paint?

Not Applicable

If not, do deteriorated surfaces exceed 20
square feet of total exterior surface area?
6.7 Manufactured Home: Tie Downs
7. Heating and Plumbing
7.1 Adequacy of Heating Equipment
7.2 Safety of Heating Equipment
7.3 Ventilation/Cooling
7.4 Water Heater
7.5 Approvable Water Supply
7.6 Plumbing
7.7 Sewer Connection
8. General Health and Safety
8.1

Access to Unit

8.2

Fire Exits

8.3

Evidence of Infestation

8.4

Garbage and Debris

8.5

Refuse Disposal

8.6

Interior Stairs and Commom Halls

8.7

Other Interior Hazards

8.8

Elevators

8.9

Interior Air Quality

8.10 Site and Neighborhood Conditions
8.11

Lead-Based Paint: Owner's Certification

Not Applicable

If the owner is required to correct any lead-based paint hazards at the property including deteriorated paint or other hazards identified by a
visual assessor, a certified lead-based paint risk assessor, or certified lead-based paint inspector, the PHA must obtain certification that
the work has been done in accordance with all applicable requirements of 24 CFR Part 35. The Lead-Based Paint Owner Certification
must be received by the PHA before the execution of the HAP contract or within the time period stated by the PHA in the owner HQS
violation notice. Receipt of the completed and signed Lead-Based Paint Owner Certification signifies that all HQS lead-based paint
requirements have been met and no re-inspection by the HQS inspector is required.
Previous editions are obsolete

Page 5 of 7

form HUD-52580 (3/2001)
ref Handbook 7420.8

C. 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 consideration 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
Working fireplace or stove
Balcony, patio, deck, porch
Special windows or doors
Exceptional size relative to needs of family
Other: (Specify)

Special feature shower head
Built-in heat lamp
Large mirrors
Glass door on shower/tub
Separate dressing room
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
Double oven/self cleaning oven, microwave
Double sink
High quality cabinets
Abundant counter-top space
Modern appliance(s)
Exceptional size relative to needs of family
Other: (Specify)

5. Overall Characteristics
Storm windows and doors
Other forms of weatherization (e.g., insulation, weather stripping)
Screen doors or windows
Good upkeep of grounds (i.e., site cleanliness, landscaping,
condition of lawn)
Garage or parking facilities
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
Special windows or doors
Exceptional size relative to needs of family
Other: (Specify)

D. Questions to ask the Tenant (Optional)
1. Does the owner make repairs when asked?

6. Disabled Accessibility
Unit is accessible to a particular disability.

Yes

No

Disability ___________________________

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 ______

6.

Is there anything else you want to tell us? (specify) Yes

Previous editions are obsolete

Refrigerator _____

Microwave ______

No

Page 6 of 7

form HUD-52580 (3/2001)
ref Handbook 7420.8

E. Inspection Summary/Comments (Optional)
Provide a summary description of each item which resulted in a rating of "Fail" or "Pass with Comments."
Tenant ID Number

Type of Inspection

Inspector

Initial

Date of Inspection (mm/dd/yyyy) Address of Inspected Unit

Special

Item Number

Continued on additional page
Previous editions are obsolete

Reinspection
Reason for "Fail" or "Pass with Comments" Rating

Yes

No
Page 7 of 7

form HUD-52580 (3/2001)
ref Handbook 7420.8