HUD 52580-A Inspection Form

Housing Choice Voucher Program

52580-a

Housing Choice Voucher Program

OMB: 2577-0169

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 2577-0169 can be found here:

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OMB Approval No. 2577-0169
(exp. 9/30/2010)

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

Inspection Form

Housing Choice Voucher Program

Public reporting burden for this collection of information is estimated to average 0.25 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.
PHA

Tenant ID Number

Date of Request (mm/dd/yyyy)

Inspector

Date Last Inspection (mm/dd/yyyy)

Date of Inspection (mm/dd/yyyy)

Neighborhood/Census Tract

Type of Inspection

Initial

Project Number

Special

A. General Information

Housing Type (check as appropriate)
Single Family Detached

Street Address of Inspected Unit
City

Reinspection

County

State

Name of Family

Duplex or Two Family

Zip

Row House or Town House

Current Telephone of Family

Low Rise: 3,4 Stories, Including
Garden Apartment
High Rise; 5 or More Stories

Current Street Address of Family
City

County

State

Manufactured Home

Zip

Congregate
Cooperative

Number of Children in Family Under 6

Independent Group Residence
Name of Owner or Agent Authorized to Lease Unit Inspected

Telephone of Owner or Agent

Single Room Occupancy
Shared Housing

Address of Owner or Agent

Other:(Specify)

B. Summary Decision on the Unit
(to be completed after the form has been filled in)

C. How to Fill Out This Checklist
Complete the checklist on the unit to be occupied (or currently occupied) by the
tenant. Proceeed through the inspection as follows:

Housing Quality Standard Pass or Fail
1. Fail If there are any checks under the column headed “Fail” the unit
fails the minimum housing quality standards. Discuss with the owner the
repairs noted that would be necessary to bring the unit up to the standard.
2. Inconclusive If there are no checks under the column headed “Fail”
and there are checks under the column headed “Inconclusive,” obtain additional information necessary for a decision (question owner or tenant as
indicated in the item instructions given in this checklist). Once additional
information is obtained, change the rating for the item and record the date of
verification at the far right of the form.
3. Pass If neither (1) nor (2) above is checked, the unit passes the
minimum housing quality standards. Any additional conditions described in the
right hand column of the form should serve to (a) establish the precondition
of the unit, (b) indicate possible additional areas to negotiate with the owner,
(c) aid in assessing the reasonableness of the rent of the unit, and (d) aid the
tenant in deciding among possible units to be rented. The tenant is responsible
for deciding whether he or she finds these conditions acceptable.
Unit Size: Count the number of bedrooms for purposes of the FMR
or Payment Standard. Record in the box provided.
Year Constructed: Enter from Line 5 of the Request
for Tenancy Approval form. Record in the box provided.
Number of Sleeping Rooms: Count the number of rooms which
could be used for sleeping, as identified on the checklist. Record in the box
provided.
Previous editions are obsolete

Area
room by room

Checklist Category
1. Living Room
2. Kitchen
3. Bathroom
4. All Other Rooms Used for Living

basement or utility room

5. All Secondary Rooms Not Used for Living
6. Heating & Plumbing

outside

7. Building Exterior

overall

8. General Health & Safety

Each part of the checklist will be accompanied by an explanation of the item
to be inspected.
Important: For each item numbered on the checklist, check one box only
(e.g., check one box only for item 1.4 "Security,”in the Living Room.)
In the space to the right of the description of the item, if the decision on the item
is: “Fail” write what repairs are necessary; If “Inconclusive” write in details.
Also, if ”Pass” but there are some conditions present that need to be brought
to the attention of the owner or the tenant, write these in the space to the right.
If it is an annual inspection, record to the right of the form any repairs made
since the last inspection. If possible, record reason for repair (e.g., ordinary
maintenance, tenant damage).
If it is a complaint inspection, fill out only those checklist items for which
complaint is lodged. Determine, if possible, tenant or owner cause.
Once the checklist has been completed, return to Part B (Summary Decision
on the Unit).

Page 1 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Living Room

1.1

Living Room Present

1.6

Note: If the unit is an efficiency apartment, consider the living room
present.
1.2

Electricity

In order to qualify, the outlets must be present and properly installed
in the baseboard, wall or floor of the room. Do not count a single
duplex receptacle as two outlets, i.e., there must be two of these in
the room, or one of these plus a permanently installed ceiling or
wall light fixture.
Both the outlets and/or the light must be working. Usually, a room will
have sufficient lights or electrical appliances plugged into outlets to
determine workability. Be sure light fixture does not fail just because
the bulb is burned out.
Do not count any of the following items or fixtures as outlets/fixtures:
Table or floor lamps (these are not permanent light fixtures); ceiling
lamps plugged into socket; extension cords.
If the electric service to the unit has been temporarily turned off
check ‘’Inconclusive.’’ Contact owner or manager after inspection to
verify that electricity functions properly when service is turned on.
Record this information on the checklist.
1.3

Electrical Hazards

Examples of what this means: broken wiring; noninsulated wiring;
frayed wiring; improper types of wiring, connections or insulation;
wires lying in or located near standing water or other unsafe places;
light fixture hanging from electric wiring without other firm support or
fixture; missing cover plates on switches or outlets; badly cracked
outlets; exposed fuse box connections; overloaded circuits evidenced by frequently ‘’blown’’ fuses (ask the tenant).
Check “Inconclusive’’ if you are uncertain about severity of the
problem and seek expert advice.

Ceiling Condition

“Unsound or hazardous” means the presence of such serious defects that either a potential exists for structural collapse or that large
cracks or holes allow significant drafts to enter the unit. The condition
includes: severe bulging or buckling; large holes; missing parts;
falling or in danger of falling loose surface materials (other than
paper or paint).
Pass ceilings that are basically sound but have some nonhazardous
defects, including: small holes or cracks; missing or broken ceiling
tiles; water stains; soiled surfaces; unpainted surfaces; peeling paint
(for peeling paint see item 1.9).
1.7

Wall Condition

“Unsound or hazardous” includes: serious defects such that the
structural safety of the building is threatened, such as severe
buckling, bulging or leaning; damaged or loose structural members;
large holes; air infiltration.
Pass walls that are basically sound but have some nonhazardous
defects, including: small or shallow holes; cracks; loose or missing
parts; unpainted surfaces; peeling paint (for peeling paint see item 1.9).
1.8

Floor Condition

“Unsound or hazardous” means the presence of such serious defects that a potential exists for structural collapse or other threats to
safety (e.g., tripping) or large cracks or holes allow substantial drafts
from below the floor. The condition includes: severe buckling or
major movements under walking stress; damaged or missing parts.
Pass floors that are basically sound but have some nonhazardous
defects, including: heavily worn or damaged floor surface (for example, scratches or gouges in surface, missing portions of tile or
linoleum, previous water damage). If there is a floor covering, also
note the condition, especially if badly worn or soiled. If there is a floor
covering, including paint or sealant, also note the conditions, specially if badly worn, soiled or peeling (for peeling paint, see 1.9).

1. 4 Security

1.9

“Accessible to outside” means: doors open to the outside or to a
common public hall; windows accessible from the outside (e.g.
basement and first floor); windows or doors leading onto a fire
escape, porch or other outside place that can be reached from the
ground.

Housing Choice Voucher Units If the unit was built January 1,
1978, or after, no child under age six will occupy or currently
occupies it, is a 0-BR, elderly or handicapped unit with no children
under age six on the lease or expected, has been certified leadbased paint free by a certified lead-based paint inspector (no
lead-based paint present or no lead-based paint present after
removal of lead-based paint.), check NA and do not inspect
painted surfaces.

“Lockable” means: the window or door has a properly working lock,
or is nailed shut, or the window is not designed to be opened. A storm
window lock that is working properly is acceptable. Windows that are
nailed shut are acceptable only if these windows are not needed for
ventilation or as an alternate exit in case of fire.
1.5

Window Condition

Rate the windows in the room (including windows in doors).
“Severe deterioration” means that the window no longer has the
capacity to keep out the wind and the rain or is a cutting hazard.
Examples are: missing or broken-out panes; dangerously loose
cracked panes; windows that will not close; windows that, when
closed, do not form a reasonably tight seal.
If more than one window in the room is in this condition, give details
in the space provided on the right of the form.
If there is only “moderate deterioration” of the windows the item
should "Pass." "Moderate deterioration” means windows which are
reasonably weather-tight, but show evidence of some aging, abuse,
or lack of repair. Signs of deterioration are: minor crack in window
pane; splintered sill; signs of some minor rotting in the window frame
or the window itself; window panes loose because of missing window
putty. Also for deteriorated and peeling paint see 1.9. If more than
one window is in this condition, give details in the space provided on
the right of the form.
Previous editions are obsolete

Lead-Based Paint

This requirement applies to all painted surfaces (building components) within the unit. (Do not include tenant belongings).
Surfaces to receive a visual assessment for deteriorated paint
include walls, floors, ceilings, built in cabinets (sink bases),
baseboards, doors, door frames, windows systems including
mullions, sills, or frames and any other painted building component within the unit. Deteriorated paint includes any painted
surface that is peeling, chipping, chalking, cracking, damaged or
otherwise separated from the substrate.
All deteriorated paint surfaces more than 2 sq. ft. in any one
interior room or space, or more than 10% of the total surface
area of an interior type of component with a small surface
area (i.e., window sills, baseboards, and trim) must be stabilized (corrected) in accordance with all safe work practice
requirements and clearance is required. If the deteriorated
painted surface is less than 2 sq. ft. or less than 10% of the
component, only stabilization is required. Clearance testing
is not required. Stabilization means removal of deteriorated
paint, repair of the substrate, and application of a new protective
coating or paint. Lead-Based Paint Owner Certification is
required following stabilization activities, except for de minimis
level repairs.

Page 2 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

For each numbered item, check one box only.
Inconclusive

Decision

Description

No, Fail

Item
No.

Living Room

Yes, Pass

If Fail, what repairs are necessary?
If Inconclusive, give details.
If Pass with comments, give details.

If Fail or
Inconclusive,
date (mm/dd/yyyy)
of final approval

1.1 Living Room Present
Is there a living room?
1.2 Electricity
Are there at least two working outlets or one working
outlet and one working light fixture?
1.3 Electrical Hazards
Is the room free from electrical hazards?
1.4 Security
Are all windows and doors that are accessible from
the outside lockable?
1.5 Window Condition
Is there at least one window, and are all windows
free of signs of severe deterioration or missing or
broken out panes?
1.6 Ceiling Condition
Is the ceiling sound and free from hazardous defects?
1.7 Wall Condition
Are the walls sound and free from hazardous defects?
1.8 Floor Condition
Is the floor sound and free from hazardous defects?
1.9 Lead-Based Paint
Are all painted surfaces free of deteriorated paint?
If no, does deteriorated surfaces exceed two square
feet and/or more than 10% of a component?

Not Applicable

Additional Comments: (Give Item Number)

Comments continued on a separate page
Previous editions are obsolete

Yes

No
Page 3 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Kitchen

2.11 Refrigerator

2.1

Kitchen Area Present

If no refrigerator is present, use the same criteria for marking either
“Fail” or “Inconclusive” as were used for the oven and stove or range.

Note: A kitchen is an area used for preparation of meals. It may be
either a separate room or an area of a larger room (for example, a
kitchen area in an efficiency apartment).
2.2 - 2.9 Explanation for these items is the same as that provided for “Living Room’’ with the following modifications:
2.2 Electricity
Note: The requirement is that at least one outlet and one
permanent light fixture are present and working.
2.5 Window Condition
Note: The absence of a window does not fail this item in the
kitchen. If there is no window, check “Pass.”
2.10 Stove or Range with Oven
Both an oven and a stove (or range) with top burners must be present
and working. If either Is missing and you know that the owner is
responsible for supplying these appliances, check “Fail.’’ Put check
in ‘’Inconclusive’’ column if the tenant is responsible for supplying the
appliances and he or she has not yet moved in. Contact tenant or
prospective tenant to gain verification that facility will be supplied and
is in working condition. Hot plates are not acceptable substitutes for
these facilities.
An oven is not working if it will not heat up. To be working a stove or
range must have all burners working and knobs to turn them off and
on. Under “working condition,” also look for hazardous gas hook-ups
evidenced by strong gas smells; these should fail. (Be sure that this
condition is not confused with an unlit pilot light -a condition that
should be noted, but does not fail.)
If both an oven and a stove or range are present, but the gas or
electricity are turned off, check “Inconclusive.” Contact owner or
manager to get verification that facility works when gas is turned on.
If both an oven and a stove or range are present and working, but
defects exist, check "Pass" and note these to the right of the form.
Possible defects are marked, dented, or scratched surfaces;
cracked burner ring; limited size relative to family needs.

A refrigerator is not working if it will not maintain a temperature low
enough to keep food from spoiling over a reasonable period of time.
If the electricity is turned off, mark ‘’Inconclusive.’’ Contact owner (or
tenant if unit is occupied) to get verification of working condition.
If the refrigerator is present and working but defects exist, note these
to the right of the form. Possible minor defects include: broken or
missing interior shelving; dented or scratched interior or exterior
surfaces; minor deterioration of door seal; loose door handle.
2.12 Sink
If a permanently attached kitchen sink is not present in the kitchen or
kitchen area, mark ‘’Fail.’’ A sink in a bathroom or a portable basin will
not satisfy this requirement. A sink is not working unless it has
running hot and cold water from the faucets and a properly connected and properly working drain (with a “gas trap”). In a vacant
apartment, the hot water may have been turned off and there will be
no hot water. Mark this “Inconclusive.” Check with owner or manager
to verify that hot water is available when service is turned on.
If a working sink has defects, note this to the right of the item.
Possible minor defects include: dripping faucet; marked, dented, or
scratched surface; slow drain; missing or broken drain stopper.
2.13 Space for Storage, Preparation, and Serving of Food
Some space must be available for the storage, preparation, and
serving of food. If there is no built-in space for food storage and
preparation, a table used for food preparation and a portable storage
cabinet will satisfy the requirement. If there is no built-in space, and
no room for a table and portable cabinet, check “Inconclusive” and
discuss with the tenant. The tenant makes the final determination as
to whether or not this space is acceptable.
If there are some minor defects, check "Pass" and make notes to the
right. Possible defects include: marked, dented, or scratched surfaces; broken shelving or cabinet doors; broken drawers or cabinet
hardware; limited size relative to family needs.

A microwave oven may be substituted for a tenant-supplied oven and
stove (or range).
A microwave oven may be substituted for an owner-supplied oven
and stove (or range) if the tenant agrees and microwave ovens are
furnished instead of ovens and stoves (or ranges) to both subsidized
and unsubsidized tenants in the building or premises.

Previous editions are obsolete

Page 4 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Kitchen

For each numbered item, check one box only.
Inconclusive

Yes, Pass

Description

No, Fail

Decision
Item
No.

If Fail, what repairs are necessary?
If Inconclusive, give details.
If Pass with comments, give details.

If Fail or
Inconclusive,
date (mm/dd/yyyy)
of final approval

2.1 Kitchen Area Present
Is there a kitchen?
2.2 Electricity
Are there at least one working outlet and one working, permanently installed light fixture?
2.3 Electrical Hazards
Is the kitchen free from electrical hazards?
2.4 Security
Are all windows and doors that are accessible from
the outside lockable?
2.5 Window Condition
Are all windows free of signs of deterioration or
missing or broken out panes?
2.6 Ceiling Condition
Is the ceiling sound and free from hazardous defects?
2.7 Wall Condition
Are the walls sound and free from hazardous defects?
2.8 Floor Condition
Is the floor sound and free from hazardous defects?
2.9 Lead-Based Paint
Are all painted surfaces free of deteriorated paint?
If no, does deteriorated surfaces exceed two square
feet and/or less than 10% of a component?

Not Applicable

2.10 Stove or Range with Oven
Is there a working oven, and a stove (or range) with
top burners that work?
If no oven and stove (or range) are present, is there
a microwave oven and, if microwave is owner-supplied, do other tenants have microwaves instead of
an oven and stove (or range)?
2.11 Refrigerator
Is there a refrigerator that works and maintains a
temperature low enough so that food does not spoil
over a reasonable period of time?
2.12 Sink
Is there a kitchen sink that works with hot and cold
running water?
2.13 Space for Storage, Preparation, and Serving
of Food
Is there space to store, prepare, and serve food?
Additional Comments: (Give Item Number)(Use an additional page if necessary)

Comments continued on a separate page
Previous editions are obsolete

Yes

No
Page 5 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Bathroom

3.1

Bathroom Present

3.11 Fixed Wash Basin or Lavatory in Unit

Most units have easily identifiable bathrooms (i.e., a separate room
with toilet, washbasin and tub or shower). In some cases, however,
you will encounter units with scattered bathroom facilities (i.e., toilet.
washbasin and tub or shower located in separate parts of the unit).
At a minimum, there must be an enclosure around the toilet. In this
case, count the enclosure around the toilet as the bathroom and
proceed with 3.2-3.9 below, with respect to this enclosure. If there is
more than one bathroom that is normally used, rate the one that is in
best condition for Part 3. If there is a second bathroom that is also
used, complete Part 4 of the checklist for this room. (See Inspection
Manual for additional notes on rating the second bathroom.)
3.2 - 3.9 Explanation for these items is the same as that provided for “Living Room’’ with the following modifications:
3.2 Electricity
Note: The requirement is that at least one permanent light
fixture is present and working
3.3 Electrical Hazards
Note: In addition to the previously mentioned hazards, outlets
that are located where water might splash or collect are
considered an electrical hazard.
3.5 Window Condition
Note: The absence of a window does not fail this item in the
bathroom (see item 3.13, Ventilation, for relevance of window
with respect to ventilation). If there is no window, but a working
vent system is present, check “Pass.”
3.7 Wall Condition
Note: Include under nonhazardous defects (that would
pass, but should be noted) the following: broken or loose tile;
deteriorated grouting at tub/wall and tub/floor joints, or tiled
surfaces; water stains.
3.8 Floor Condition
Note: Include under nonhazardous defects (that would pass, but
should be noted) the following: missing floor tiles; water stains.

The wash basin must be permanently installed (i.e., a portable wash
basin does not satisfy the requirement). Also, a kitchen sink used to
pass the requirements under Part 2 of the checklist (kitchen facilities)
cannot also serve as the bathroom wash basin. The wash basin may
be located separate from the other bathroom facilities (e.g., in a
hallway).
Not working means: the wash basin is not connected to a system that
will deliver hot and cold running water; it is not connected to a
properly operating drain; the connectors (or vents or traps) are faulty
to the extent that severe leakage of water or escape of sewer gases
occurs. If the water to the unit or the hot water unit has been turned
off, check "Inconclusive." Obtain verification from owner or manager
that the system is in working condition.
Comment to the right of the form if the wash basin is “present and
working,” but has the following types of minor defects: insufficient
water pressure; dripping faucets; minor leaks; cracked or chipped
porcelain; slow drain (see discussion above under 3.10).
3.12 Tub or Shower in Unit
Not present means that neither a tub nor shower is present in the unit.
Again, these facilities need not be in the same room with the rest of
the bathroom facilities. They must, however, be private.
Not working covers the same requirements detailed above for wash
basin (3.11).
Comment to the right of the form if the tub or shower is present and
working, but has the following types of defects: dripping faucet; minor
leaks; cracked porcelain; slow drain (see discussion under 3.10);
absent or broken support rod for shower curtain.
3.13 Ventilation
Working vent systems include: ventilation shafts (non-mechanical
vents) and electric fans. Electric vent fans must function when switch
is turned on. (Make sure that any malfunctions are not due to the fan
not being plugged in.) If electric current to the unit has not been
turned on (and there is no openable window), check “Inconclusive.”
Obtain verification from owner or manager that system works. Note:
exhaust vents must be vented to the outside, attic, or crawlspace.

3.10 Flush Toilet in Enclosed Room in Unit
The toilet must be contained within the unit, be in proper operating
condition, and be available for the exclusive use of the occupants of
the unit (i.e., outhouses or facilities shared by occupants of other
units are not acceptable). It must allow for privacy.
Not working means: the toilet is not connected to a water supply; it
is not connected to a sewer drain; it is clogged; it does not have a trap;
the connections, vents or traps are faulty to the extent that severe
leakage of water or escape of gases occurs; the flushing mechanism
does not function properly. If the water to the unit has been turned
off, check "Inconclusive.’’ Obtain verification from owner or manager
that facility works properly when water is turned on.
Comment to the right of the form if the toilet is “present, exclusive,
and working,” but has the following types of defects: constant
running; chipped or broken porcelain; slow draining.
If drain blockage is more serious and occurs further in the sewer line,
causing backup, check item 7.6, “Fail,” under the plumbing and
heating part of the checklist. A sign of serious sewer blockage is the
presence of numerous backed-up drains.

Previous editions are obsolete

Page 6 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Bathroom

For each numbered item, check one box only.
Inconclusive

Yes, Pass

Description

No, Fail

Decision
Item
No.

If Fail, what repairs are necessary?
If Inconclusive, give details.
If Pass with comments, give details.

If Fail or
Inconclusive,
date (mm/dd/yyyy)
of final approval

3.1 Bathroom Present (See description)
Is there a bathroom?
3.2 Electricity
Is there at least one permanently installed light fixture?
3.3 Electrical Hazards
Is the bathroom free from electrical hazards?
3.4 Security
Are all windows and doors that are accessible from
the outside lockable?
3.5 Window Condition
Are all windows free of signs of deterioration or
missing or broken out panes?
3.6 Ceiling Condition
Is the ceiling sound and free from hazardous defects?
3.7 Wall Condition
Are the walls sound and free from hazardous defects?
3.8 Floor Condition
Is the floor sound and free from hazardous defects?
3.9 Lead-Based Paint
Are all painted surfaces free of deteriorated paint?
If no, does deteriorated surfaces exceed two square
feet and/or more than 10% of a component?

Not Applicable

3.10 Flush Toilet in Enclosed Room in Unit
Is there a working toilet in the unit for the exclusive
private use of the tenant?
3.11 Fixed Wash Basin or Lavatory in Unit
Is there a working, permanently installed wash basin
with hot and cold running water in the unit?
3.12 Tub or Shower
Is there a working tub or shower with hot and cold
running water in the unit?
3.13 Ventilation
Are there openable windows or a working vent system?
Additional Comments: (Give Item Number)(Use an additional page if necessary)

Comments continued on a separate page

Previous editions are obsolete

Yes

Page 7 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Other Room Used for Living and Halls

Complete an “Other Room” checklist for as many “other rooms
used for living” as are present in the unit and not already noted in
Parts l, 2, and 3 of the checklist. See the discussion below for
definition of ‘’used for living.’’ Also complete an ‘’Other Room”
checklist for all entrance halls, corridors, and staircases that are
located within the unit and are part of the area used for living. If a
hall, entry and/or stairway are contiguous, rate them as a whole
(i.e., as part of one space).

4.2 - 4.9 Explanations of these items are the same as those
provided for ‘’Living Room’’ with the following modifications:
4.2 Electricity/Illumination
If the room code is not a "1," the room must have a means of
natural or artificial illumination such as a permanent light
fixture, wall outlet present, or light from a window in the room
or near the room. If any required item is missing, check “Fail."
If the electricity is turned off, check “Inconclusive."

Additional forms for rating “Other Rooms” are provided in the checklist.

4.5 Window Condition

Definition of “used for living." Rooms "used for living” are areas of the
unit that are walked through or lived in on a regular basis. Do not
include rooms or other areas that have been permanently, or near
permanently, closed off or areas that are infrequently entered. For
example, do not include a utility room, attached shed, attached
cIosed-in porch, basement, or garage if they are closed off from the
main living area or are infrequently entered. Do include any of these
areas if they are frequently used (e.g., a finished basement/playroom, a closed-in porch that is used as a bedroom during summer
months). Occasional use of a washer or dryer in an otherwise unused
room does not constitute regular use.

Any room used for sleeping must have at least one window. If
the windows in sleeping rooms are designed to be opened, at
least one window must be openable. The minimum standards
do not require a window in “other rooms.” Therefore, if there
is no window in another room not used for sleeping, check
“Pass,” and note “no window” in the area for comments.
4.6 Smoke Detectors
At least one battery-operated or hard-wired smoke detector
must be present and working on each level of the unit, including the basement, but not the crawl spaces and unfinished
attic.

If the unit is vacant and you do not know the eventual use of a
particular room, complete an ‘’Other Room’’ checklist if there is any
chance that the room will be used on a regular basis. If there is no
chance that the room will be used on a regular basis, do not include
it (e.g., an unfinished basement) since it will be checked under Part
5, All Secondary Rooms (Rooms not used for living).
4.1

Smoke detectors must be installed in accordance with and
meet the requirements of the National Fire Protection Association Standard (NFPA) 74 (or its successor standards).
If the dwelling unit is occupied by any hearing-impaired person, smoke detectors must have an alarm system designed for
hearing-impaired persons as specified in NFPA 74 (or successor standards).

Room Code and Room Location

Enter the appropriate room code given below:

If the unit was under HAP contract prior to April 24, 1993,
owners who installed battery-operated or hard-wired smoke
detectors in compliance with HUD’s smoke detector requirements, including the regulations published on July 30, 1992
(57 FR 33846), will not be required subsequently to comply
with any additional requirements mandated by NFPA 74 (i.e.
the owner would not be required to install a smoke detector in
a basement not used for living purposes, nor would the owner
be required to change the location of the smoke detectors that
have already been installed on the other floors of the unit). In
this case, check “Pass” and note under comments.

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 (also check presence of sink trap and
clogged toilet)
6 = Other
Room Location: Write on the line provided the location of the room
with respect to the unit’s width, length and floor level as if you were
standing outside the unit facing the entrance to the unit:
right/left/center: record whether the room is situated to the right, left,
or center of the unit.
front/rear/center: record whether the room is situated to the back,
front or center of the unit.

Additional Notes
For staircases, the adequacy of light and condition of the stair rails
and railings is covered under Part 8 of the checklist (General Health
and Safety)

floor level: identify the floor level on which the room is located.
If the unit is vacant, you may have some difficulty predicting the
eventual use of a room. Before giving any room a code of 1
(bedroom), the room must meet all of the requirements for a ‘’room
used for sleeping’’ (see items 4. 2 and 4.5).

Previous editions are obsolete

Page 8 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Other Rooms Used for Living and Halls

4.1

Room Location

For each numbered item, check one box only.

Room Code

______ right/left/center: the room is situated to the right, left,
or center of the unit.
______ front/rear/center: the room is situated to the back, front
or center of the unit.
______ floor level:
the floor level on which the room is
located.

4.2

Inconclusive

No, Fail

Decision

Description

Yes, Pass

Item
No.

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 (also check presence of sink trap and
clogged toilet)
6 = Other:

If Fail, what repairs are necessary?
If Inconclusive, give details.
If Pass with comments, give details.

If Fail or
Inconclusive,
date (mm/dd/yyyy)
of final approval

Electricity/Illumination

If Room Code is a 1, are there at least two working
outlets or one working outlet and one working, permanently installed light fixture?
If Room Code is not a 1, is there a means of illumination?

4.3 Electrical Hazards
Is the room free from electrical hazards?
4.4 Security
Are all windows and doors that are accessible from
the outside lockable?
4.5 Window Condition
If Room Code is a 1, is there at least one window?
And, regardless of Room Code, are all windows free
of signs of severe deterioration or missing or brokenout panes?
4.6 Ceiling Condition
Is the ceiling sound and free from hazardous defects?
4.7 Wall Condition
Are the walls sound and free from hazardous defects?
4.8 Floor Condition
Is the floor sound and free from hazardous defects?
4.9 Lead-Based Paint
Are all painted surfaces free of deteriorated paint?
If no, does deteriorated surfaces exceed two square
feet and/or more than 10% of a component?

Not Applicable

4.10 Smoke Detectors
Is there a working smoke detector on each level?
Do the smoke detectors meet the requirements of
NFPA 74?
In units occupied by the hearing impaired, is there an
alarm system connected to the smoke detector?

Additional Comments: (Give Item Number)(Use an additional page if necessary)

Comments continued on a separate page
Previous editions are obsolete

Yes

No
Page 9 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Supplemental for Other Rooms Used for Living and Halls

4.1

Room Location

Room Code

4.2

Inconclusive

No, Fail

Decision

Description

Yes, Pass

Item
No.

For each numbered item, check one box only.

If Fail or
Inconclusive,
date of final
approval

Electricity/Illumination

If Room Code is a 1, are there at least two working
outlets or one working outlet and one working, permanently installed light fixture?
If Room Code is not a 1, is there a means of illumination?

Not Applicable

Additional Comments: (Give Item Number)(Use an additional page if necessary)

Comments continued on a separate page

Previous editions are obsolete

Yes

Page 10 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Supplemental for Other Rooms Used for Living and Halls

4.1

Room Location

For each numbered item, check one box only.

Room Code

4.2

Inconclusive

Yes, Pass

Description

No, Fail

Decision
Item
No.

If Fail, what repairs are necessary?
If Inconclusive, give details.
If Pass with comments, give details.

If Fail or
Inconclusive,
date (mm/dd/yyyy)
of final approval

Electricity/Illumination

If Room Code is a 1, are there at least two working
outlets or one working outlet and one working, permanently installed light fixture?
If Room Code is not a 1, is there a means of illumination?

Not Applicable

Additional Comments: (Give Item Number)(Use an additional page if necessary)

Comments continued on a separate page
Previous editions are obsolete

Yes

No
Page 11 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Supplemental for Other Rooms Used for Living and Halls

4.1

Room Location

Room Code

4.2

Inconclusive

No, Fail

Decision

Description

Yes, Pass

Item
No.

For each numbered item, check one box only.

If Fail, what repairs are necessary?
If Inconclusive, give details.
If Pass with comments, give details.

If Fail or
Inconclusive,
date (mm/dd/yyyy)
of final approval

Electricity/Illumination

If Room Code is a 1, are there at least two working
outlets or one working outlet and one working, permanently installed light fixture?
If Room Code is not a 1, is there a means of illumination?

Not Applicable

Additional Comments: (Give Item Number)(Use an additional page if necessary)

Comments continued on a separate page
Previous editions are obsolete

Yes

No
Page 12 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

All Secondary Rooms (Rooms not used for living)

Secondary Rooms (Rooms not used for living)

6.4

If any room in the unit did not meet the requirements for “other room
used for living" in Part 4, it is to be considered a “secondary room (not
used for living),” Rate all of these rooms together (i.e., a single Part
5 checklist for all secondary rooms in the unit).
Inspection is required of the following two items since hazardous
defects under these items could jeopardize the rest of the unit, even
if present in rooms not used for living: 5.2 Security, 5.3 Electrical
Hazards. Also, be observant of any other potentially hazardous
features in these rooms and record under 5.4
5.1

None

If there are no “Secondary Rooms (rooms not used for living),” check
"None" and go on to Part 6.
5.2 - 5.4 Explanations of these items is the same as those
provided for ‘’Living Room’’
Additional Note
In recording “other potentially hazardous features,” note (in the
space provided) the means of access to the room with the hazard and
check the box under ‘’Inconclusive.” Discuss the hazard with the HA
inspection supervisor to determine ‘’Pass’’ or ‘’Fail.’’ Include defects
like: large holes in floor, walls or ceilings; evidence of structural
collapse; windows in condition of severe deterioration; and deteriorated paint surfaces.

Building Exterior

6.1

Condition of Foundation

‘’Unsound or hazardous’’ means foundations with severe structural
defects indicating the potential for structural collapse; or foundations
that allow significant entry of ground water (for example, evidenced
by flooding of basement).
6.2

Condition of Stairs, Rails, and Porches

"Unsound or hazardous" means: stairs, porches, balconies, or
decks with severe structural defects; broken, rotting, or missing
steps; absence of a handrail when there are extended lengths of
steps (generally four or more consecutive steps); absence of or
insecure railings around a porch or balcony which is approximately
30 inches or more above the ground.
6.3

Condition of Exterior Surfaces

See definition above for roof, item 6.3.
6.5

Condition of Chimney

The chimney should not be seriously leaning or showing evidence of
significant disintegration (i.e., many missing bricks).
6.6

Lead-Based Paint: Exterior Surfaces

Housing Choice Voucher Units If the unit was built January 1,
1978 or after, no child under age six will occupy or currently
occupies, is a 0-BR, elderly or handicapped unit with no children
under age six on the lease or expected, has been certified leadbased paint free by a certified lead-based paint inspector (no
lead-based paint present or no lead-based paint present after
removal of lead), check NA and do not inspect painted surfaces .
Visual assessment for deteriorated paint applies to all exterior
painted surfaces (building components) associated with the
assisted unit including windows, window sills, exterior walls,
floors, porches, railings, doors, decks, stairs, play areas, garages,
fences or other areas if frequented by children under age six.
All deteriorated paint surfaces more than 20 sq. ft. on exterior
surfaces must be stabilized (corrected) in accordance with all
safe work practice requirements. If the painted surface is less
than 20 sq. ft., only stabilization is required. Clearance
testing is not required. Stabilization means removal of deteriorated paint, repair of the substrate, and application of a new
protective coating or paint. Lead-Based Paint Owner Certification is required following stabilization activities except for de
minimis level repairs.
6.7

Manufactured Homes: Tie Downs

Manufactured homes must be placed on a site in a stable manner
and be free from hazards such as sliding and wind damage. Manufactured homes must be securely anchored by a tiedown device
which distributes and transfers the loads imposed by the unit to
appropriate ground anchors so as to resist wind overturning and
sliding, unless a variation has been approved by the HUD Field
Office.

Condition of Roof and Gutters

“Unsound and hazardous” means: The roof has serious defects such
as serious buckling or sagging, indicating the potential of structural
collapse; large holes or other defects that would result in significant
air or water infiltration (in most cases severe exterior defects will be
reflected in equally serious surface defects within the unit, e.g.,
buckling, water damage). The gutters, downspouts and soffits (area
under the eaves) show serious decay and have allowed the entry of
significant air or water into the interior of the structure. Gutters and
downspouts are, however, not required to pass. If the roof is not
observable and there is no sign of interior water damage, check
“Pass.”

Previous editions are obsolete

Page 13 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

All Secondary Rooms (Rooms not used for living)

For each numbered item, check one box only.

5.1

None

Inconclusive

Yes, Pass

Description

No, Fail

Decision
Item
No.

If Fail, what repairs are necessary?
If Inconclusive, give details.
If Pass with comments, give details.

If Fail or
Inconclusive,
date (mm/dd/yyyy)
of final approval

Go to Part 6

5.2 Security
Are all windows and doors that are accessible from
the outside lockable?
5.3 Electrical Hazards
Are all these rooms free from electrical hazards?
5.4 Other Potentially Hazardous Features
Are all of these rooms free of any other potentially
hazardous features? For each room with an "other
potentially hazardous feature," explain the hazard
and the means of control of interior access to the room.

6.0 Building Exterior
6.1 Condition of Foundation
Is the foundation sound and free from hazards?
6.2 Condition of Stairs, Rails, and Porches
Are all the exterior stairs, rails, and porches sound
and free from hazards?
6.3 Condition of Roof and Gutters
Are the roof, gutters, and downspouts sound and
free from hazards?
6.4 Condition of Exterior Surfaces
Are exterior surfaces sound and free from hazards?
6.5 Condition of Chimney
Is the chimney sound and free from hazards?
6.6 Lead-Based Paint: Exterior Surfaces
Are all painted surfaces free of deteriorated paint?
If no, does deteriorated surfaces exceed 20 sq. ft. of
total exterior surface area?
6.7

Not Applicable

Manufactured Homes: Tie Downs

If the unit is a manufactured home, is it properly placed
and tied down? If not a manufactured home, check
"Not Applicable."

Not Applicable

Additional Comments: (Give Item Number)(Use an additional page if necessary)

Comments continued on a separate page
Previous editions are obsolete

Yes

No
Page 14 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Heating and Plumbing

7.1 Adequacy of Heating Equipment
“Adequate heat” means that the heating system is capable of
delivering enough heat to assure a healthy environment in the unit
(appropriate to the climate). The HA is responsible for defining
what constitutes a healthy living environment in the area of the
country in which it operates. Local codes (city or state codes)
should be instructive in arriving at a reasonable local definition.
For example, for heat adequacy, local codes often require that the
unit’s heating facility be capable of maintaining a given temperature level during a designated time period. Portable electric room
heaters or kitchen stoves or ranges with a built-in heat unit are not
acceptable as a primary source of heat for units located in areas
where climate conditions require regular heating.
“Directly or indirectly to all rooms used for living” means:
“directly” means that each room used for living has a heat
source (e.g., working radiator; working hot air register;
baseboard heat)
‘’indirectly’’ means that, if there is no heat source present in
the room, heat can enter the room easily from a heated
adjacent room (e.g a dining room may not have a radiator,
but would receive heat from the heated living room through
a large open archway).
If the heating system in the unit works, but there is some question
whether a room without a heat source would receive adequate
indirect heat, check “Inconclusive” and verify adequacy from
tenant or owner (e.g., unheated bedroom at the end of a long
hallway).
How to determine the capability of the heating system: If the unit
is occupied, usually the quickest way to determine the capability
of the heating system over time is to question the tenant. If the unit
is not occupied, or the tenant has not lived in the unit during the
months when heat would be needed, check “Inclusive.” It will be
necessary to question the owner on this point after the inspection
has been completed and, if possible, to question other tenants (if
it is a muIti-unit structure) about the adequacy of heat provided.
Under some circumstances, the adequacy of heat can be determined by a simple comparison of the size of the heating system to
the area to be heated. For example, a small permanently installed
space heater in a living room is probably inadequate for heating
anything larger than a relatively small apartment.
7.2 Safety of Heating Equipment
Examples of “unvented fuel burning space heaters” are: portable
kerosene units; unvented open flame portable units.
‘’Other unsafe conditions’’ include: breakage or damage to heating system such that there is a potential for fire or other threats to
safety; improper connection of flues allowing exhaust gases to
enter the living area; improper installation of equipment (e.g.,
proximity of fuel tank to heat source, absence of safety devices);
indications of improper use of equipment (e.g., evidence of heavy
build-up of soot, creosote, or other substance in the chimney);
disintegrating equipment; combustible materials near heat source
or flue. SeeInspection Manual for a more detailed discussion of the
inspection of safety aspects of the heating systems.
If you are unable to gain access to the primary heating system in
the unit check ‘’Inconclusive." Contact the owner or manager for
verification of safety of the system. If the system has passed a
recent local inspection, check ‘’Pass.” This applies especially to
units in which heat is provided by a large scale, complex central
heating system that serves multiple units (e.g., a boiler in the
basement of a large apartment building). In most cases, a large
scale heating system for a multi-unit building will be subject to
periodic safety inspections by a local public agency. Check with
the owner or manager to determine the date and outcome of the
last such inspection, or look for an inspection certificate posted on
the heating system.

Previous editions are obsolete

7.3 Ventilation and Adequacy of Cooling
If the tenant is present and has occupied the unit during the summer
months, inquire about the adequacy of air flow. If the tenant is not
present or has not occupied the unit during the summer months, test
a sample of windows to see that they open (see Inspection Manual
for instruction).
“Working cooling equipment’’ includes: central (fan) ventilation system;
evaporative cooling system; room or central air conditioning.
Check “Inconclusive” if there are no openable windows and it is
impossible, or inappropriate, to test whether a cooling system works.
Check with other tenants in the building (in a muIti-unit structure) and
with the owner or manager for verification of the adequacy of
ventilation and cooling.
7.4 Water Heater
"Location presents hazard’’ means that the gas or oil water heater is
located in living areas or closets where safety hazards may exist
(e.g., water heater located in very cluttered closet with cloth and
paper items stacked against it). Gas water heaters in bedrooms or
other living areas must have safety dividers or shields.
Water heaters must have a temperature-pressure relief valve and
discharge line (directed toward the floor or outside of the living area)
as a safeguard against build up of steam if the water heater
malfunctions. If not, they are not properly equipped and shall fail.
To pass, gas or oil fired water heaters must be vented into a properly
installed chimney or flue leading outside. Electric water heaters do
not require venting.
If it is impossible to view the water heater, check “Inconclusive.”
Obtain verification of safety of system from owner or manager.
Check "Pass" if the water heater has passed a local inspection. This
applies primarily to hot water that is supplied by a large scale
complex water heating system that serves multiple units (e.g., water
heating system in large apartment building). Check in the same
manner described for heating system safety, item 7.2, above.
7.5 Water Supply
If the structure is connected to a city or town water system, check
‘’Pass.” If the structure has a private water supply (usually in rural
areas) inquire into the nature of the supply (probably from the owner)
and whether it is approvable by an appropriate public agency.
General note: If items 7.5, 7.6, or 7,7 are checked “Inconclusive,”
check with owner or manager for verification of adequacy.
7.6 Plumbing
“Major leaks” means that main water drain and feed pipes (often
located in the basement) are seriously leaking. (Leaks present at
specific facilities have already been evaluated under the checklist
items for “Bathroom” and “Kitchen.”)
“Corrosion” (causing serious and persistent levels of rust or contamination in the drinking water) can be determined by observing the
color of the drinking water at several taps. Badly corroded pipes will
produce noticeably brownish water. If the tenant is currently occupying the unit, he or she should be able to provide information about the
persistence of this condition. (Make sure that the “rusty water” is not
a temporary condition caused by city or town maintenance of main
water lines.) See general note under 7.5.
7.7 Sewer Connection
If the structure is connected to the city or town sewer system, check
“Pass.” If the structure has its own private disposal system (e.g.,
septic field), inquire into the nature of the system and determine
whether this type of system can meet appropriate health and safety
regulations.
The following conditions constitute “evidence of sewer back up”:
strong sewer gas smell in the basement or outside of unit; numerous
clogged or very slow drains; marshy areas outside of unit above
septic field. See general note under 7.5.

Page 15 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Heating and Plumbing

For each numbered item, check one box only.
Inconclusive

Yes, Pass

Description

No, Fail

Decision
Item
No.

If Fail, what repairs are necessary?
If Inconclusive, give details.
If Pass with comments, give details.

If Fail or
Inconclusive,
date (mm/dd/yyyy)
of final approval

7.1 Adequacy of Heating Equipment
Is the heating equipment capable of providing adequate heat (either directly or indirectly) to all rooms
used for living?
7.2

Safety of Heating Equipment

Is the unit free from unvented fuel burning space heaters or any other types of unsafe heating conditions?

7.3

Ventilation and Adequacy of Cooling

Does the unit have adequate ventilation and cooling by
means of openable windows or a working cooling system?

7.4 Water Heater
Is the water heater located, equipped, and installed
in a safe manner?
7.5 Water Supply
Is the unit served by an approvable public or private
sanitary water supply?
7.6 Plumbing
Is plumbing free from major leaks or corrosion that
causes serious and persistent levels of rust or contamination of the drinking water?
7.7 Sewer Connection
Is plumbing connected to an approvable public or
private disposal system, and is it free from sewer
back-up?
Additional Comments: (Give Item Number)

Comments continued on a separate page
Previous editions are obsolete

Yes

No
Page 16 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

General Health and Safety

8.1

Access to Unit

“Through another unit” means that access to the unit Is only possible
by means of passage through another dwelling unit.
8.2 Exits
“Acceptable fire exit” means that the building must have an alternative means of exit that meets local or State regulations in case of fire;
this could include:
An openable window if the unit is on the first floor or second floor
or easily accessible to the ground.
A back door opening on to a porch with a stairway leading to the
ground.
Fire escape, fire ladder, or fire stairs.
“Blocked” means that the exit is not useable due to conditions such
as debris, storage, door or window nailed shut, broken lock.
Important note: The HA has the final responsibility for deciding
whether the type of emergency exit Is acceptable, although the
tenant should assist in making the decision.
8.3 Evidence of Infestation
“Presence of rats, or severe infestation by mice or vermin” (such as
roaches) is evidenced by: rat holes; droppings; rat runs; numerous
settings of rat poison. If the unit is occupied, ask the tenant,
8.4 Garbage and Debris
“Heavy accumulation” means large piles of trash and garbage,
discarded furniture, and other debris (not temporarily stored awaiting
removal) that might harbor rodents, This may occur inside the unit,
in common areas, or outside. It usually means a level of accumulation beyond the capacity of an individual to pick up within an hour or
two.
8.5 Refuse Disposal
“Adequate covered facilities" includes: trash cans with covers, garbage chutes, “dumpsters” (i.e., large scale refuse boxes with lids);
trash bags (if approvable by local public agency). “ApprovabIe by
local public agency” means that the local Health and Sanitation
Department (city, town or county) approves the type of facility in use.
Note: During the period when the HA is setting up its inspection
program, it will check with the local health and sanitation department to
determine which types of facilities are acceptable and include this in the
inspection requirements.
If the unit is vacant and there are no adequate covered facilities
present, check “Inconclusive.” Contact the owner or manager for
verification of facilities provided when the unit is occupied.
8.6 Interior Stairs and Common Halls
‘’Loose, broken, or missing steps’’ should fail if they present a serious
risk of tripping or falling.
A handrail is required on extended sections of stairs (generally four
or more consecutive steps). A railing is required on unprotected
heights such as around stairwells.
“Other hazards” would be conditions such as bare electrical wires
and tripping hazards.
Housing Choice Voucher Units If the unit was built January 1,
1978, or after, no child under six will occupy or currently occupies
it, is a 0-BR, elderly or handicapped unit with no children under
six on the lease or expected, has been certified lead-based paint
free by a certified lead-based paint inspector (no lead-based paint
present or no lead-based paint present after removal of leadbased paint.), check NA and do not inspect painted surfaces.
This requirement applies to all painted surfaces (building components) within the unit. (Do not include tenant belongings).
Surfaces to receive a visual assessment for deteriorated paint
include walls, floors, ceilings, built in cabinets (sink bases),
baseboards, doors, door frames, windows systems including
Previous editions are obsolete

mullions, sills, or frames and any other painted building component within the unit. Deteriorated paint includes any painted
surface that is peeling, chipping, chalking, cracking, damaged or
otherwise separated from the substrate.
All deteriorated paint surfaces more than 2 sq. ft. in any one
interior room or space, or more than 10% of the total surface
area of an interior type of component with a small surface
area (i.e., window sills, baseboards, and trim) must be stabilized (corrected) in accordance with all safe work practice
requirements and clearance is required. If the deteriorated
painted surface is less than 2 sq. ft. or less than 10% of the
component, only stabilization is required. Clearance testing
is not required. Stabilization means removal of deteriorated
paint, repair of the substrate, and application of a new protective
coating or paint. Lead-Based Paint Owner Certification is
required following stabilization activities, except for de minimis
level repairs.
8.7

Other Interior Hazards

Examples of other hazards might be: a broken bathroom fixture with
a sharp edge in a location where it represents a hazard; a protruding
nail in a doorway.
8.8 Elevators
Note: At the time the HA is setting up its inspection program, it will
determine local licensing practices for elevators. lnspectors should
then be aware of these practices in evaluating this item (e.g., check
inspection date). If no elevator check “Not Applicable.”
8.9 Interior Air Quality
If the inspector has any questions about whether an existing poor air
quality condition should be considered dangerous, he or she should
check with the local Health and Safety Department (city, town or
county).
8.10 Site and Neighborhood Conditions
Examples of conditions that would “seriously and continuously
endanger the health or safety of the residents” are:
other buildings on, or near the property, that pose serious
hazards (e.g., dilapidated shed or garage with potential for
structural collapse),
evidence of flooding or major drainage problems,
evidence of mud slides or large land settlement or collapse,
proximity to open sewage,
unprotected heights (cliffs, quarries, mines, sandpits),
fire hazards,
abnormal air pollution or smoke which continues throughout
the year and is determined to seriously endanger health, and
continuous or excessive vibration of vehicular traffic (if the unit
is occupied, ask the tenant).
8.11 Lead-Based Paint: Owner Certification
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.

Page 17 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

For each numbered item, check one box only.
Inconclusive

Decision

Description

No, Fail

Item
No.

General Health and Safety

Yes, Pass

If Fail, what repairs are necessary?
If Inconclusive, give details.
If Pass with comments, give details.

If Fail or
Inconclusive,
date (mm/dd/yyyy)
of final approval

8.1 Access to Unit
Can the unit be entered without having to go through
another unit?
8.2 Exits
Is there an acceptable fire exit from this building that
is not blocked?
8.3 Evidence of Infestation
Is the unit free from rats or severe infestation by mice
or vermin?
8.4 Garbage and Debris
Is the unit free from heavy accumulation of garbage
or debris inside and outside?
8.5 Refuse Disposal
Are there adequate covered facilities for temporary
storage and disposal of food wastes, and are they
approvable by a local agency?
8.6 Interior Stairs and Common Halls
Are interior stairs and common halls free from hazards to the occupant because of loose, broken, or
missing steps on stairways; absent or insecure railings; inadequate lighting; or other hazards?
8.7 Other Interior Hazards
Is the interior of the unit free from any other hazard
not specifically identified previously?
8.8 Elevators
Where local practice requires, do all elevators have
a current inspection certificate? If local practice
does not require this, are they working and safe?

Not Applicable

8.9 Interior Air Quality
Is the unit free from abnormally high levels of air
pollution from vehicular exhaust, sewer gas, fuel
gas, dust, or other pollutants?
8.10 Site and Neighborhood Conditions
Are the site and immediate neighborhood free from
conditions which would seriously and continuously
endanger the health or safety of the residents?
8.11 Lead-Based Paint: Owner Certification
If the owner of the unit is required to correct any
deteriorated paint or lead-based paint hazards at
the property, has the Lead-Based Paint Owner’s
Certification been completed, and received by the
PHA? If the owner was not required to correct
any deteriorated paint or lead-based paint hazards, check NA.

Not Applicable

Additional Comments: (Give Item Number)

Comments continued on a separate page
Previous editions are obsolete

Yes

No
Page 18 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

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

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

5. Overall Characteristics

Eating counter/breakfast nook

Storm windows and doors

Pantry or abundant shelving or cabinets

Other forms of weatherization (e.g., insulation, weather stripping)

Double oven/self cleaning oven, microwave

Screen doors or windows

Double sink

Good upkeep of grounds (i.e., site cleanliness, landscaping,
condition of lawn)

High quality cabinets
Abundant counter-top space

Garage or parking facilities

Modern appliance(s)

Driveway

Exceptional size relative to needs of family

Large yard

Other: (Specify)

Good maintenance of building exterior
Other: (Specify)

3. Other Rooms Used for Living
High quality floors or wall coverings
Working fireplace or stove
6. Disabled Accessibility

Balcony, patio, deck, porch

Unit is accessible to a particular disability.

Special windows or doors

Yes

Disability _______________________________

Exceptional size relative to needs of family
Other: (Specify)

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

Yes

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) ________________________________________________________________________________
Previous editions are obsolete

Page 19 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

Inspection Summary (Optional)
Provide a summary description of each item which resulted in a rating of Fail or Pass with Comments.
Tenant ID No.

Type of Inspection

Inspector

Initial

Item Number

Date of Inspection

Special

Reinspection

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

Comments continued on a separate page
Previous editions are obsolete

Address of Inspected Unit

Yes

No
Page 20 of 20

ref Handbook 7420.8 form HUD-52580-A (9/00)

File Type	application/pdf
File Title	52580-A
Subject	52580-A
Author	ELK
File Modified	2007-12-26
File Created	2000-11-21