HUD Lead Hazard Control GranteesRegarding Their Use of Healthy Homes Supplemental Funding

HH Supplemental Funds Use Questionnaire_16may13 (rev2)

HUD Lead Hazard Control GranteesRegarding Their Use of Healthy Homes Supplemental Funding

OMB: 2539-0023

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HH Supplemental Funds Questionnaire page 23

To: Grantees receiving Healthy Homes supplemental funding

QuanTech has been tasked to obtain information about your experience using Healthy Homes (HH) supplemental funding on your Lead Hazard Control (LHC) grant. Please provide answers to the questions posed below.

This survey is intended to provide HUD with data to help improve its Healthy Homes programs. This is not an audit or evaluation of your performance as a grantee! Your answers will be combined with other grantee responses and provided to HUD as part of an overall summary of findings. Individual grantee responses will be held in strict confidence and will not be released to HUD.

If you have any questions, contact either Gary Dewalt at 610-255-5525 or Eugene Pinzer at 202-402-7685.

Public reporting burden for this collection of information is estimated to be 8 hours per response. This information is designed to provide timely information to HUD regarding the Lead Hazard Control grantees’ use of Healthy Homes Supplemental Funds. This collection does not require the retention of confidential or sensitive material. This agency may not collect this information, and you are not required to complete this form packet, unless it displays a currently valid OMB control number.

1. Please indicate (check one) the category that best describes your organization:

___ a. State health department

___ b. State community development, or economic development department

___ c. State housing authority

___ d. State buildings/housing department

___ e. City/local health department

___ f. City/local community development, or economic development department

___ g. City/local Housing authority

___ h. City/local buildings/housing department

___ i. Other. Please specify: _______________________________________

For the following two questions, we are interested only in your past (not-current) grants.

2. How many previous Lead Hazard Control grants has your organization received? _______

3. How many previous Healthy Homes Demonstration/Production grants has your organization received? _______

For the following questions and the rest of this questionnaire, we are interested only in your use of the Healthy Homes Supplemental funding .

4. Did your program use a standardized assessment tool or tools to identify residential health and safety hazards in assessed units (Y/N)? _____

If No, skip to question 6

5. Please identify the assessment tool(s) used and briefly describe the tool(s).

________________________________________________________________

6. Excluding lead hazards, please indicate (check one) what method was most commonly use to evaluate dwelling units for Healthy Homes (HH) hazards?

___ a. Assessment of HH hazards was combined with the lead hazard control inspection/risk assessment.

___ b. Assessment of HH hazards was conducted separately from the lead hazard control inspection/risk assessment.

___ c. Other. Please specify: _______________________________________

7. Do you provide residents with a summary of the Healthy Homes assessment results (Y/N)? _____ If No, skip to question 9

8. Is the assessment summary provided to property owners in addition to residents (Y/N)? _____

9. For your grants that had supplemental funds for HH interventions:

What was the total number of units that were evaluated (assessed) for lead hazards? ______

What was the total number of dwelling units that were evaluated (assessed) for any HH
1. hazards (exclude units that were assessed for only lead hazards)? ______

What was the total number of dwelling units that received some kind of HH intervention (exclude units that received only lead hazard control)? ______

Were any leveraged (non-HUD) funds used for the HH interventions? (Y/N) ____

If Yes, what was the total leveraged funding expended for HH interventions in the last 12 months? _______

What was the average cost per dwelling unit for HH interventions (direct costs of labor and materials used in assessing, scoping and completing the intervention), including all sources of funding but excluding costs for lead hazard control? ______

What was the cost range (low to high) per dwelling unit for HH interventions, including all sources of funding but excluding costs for lead hazard control? _______ (low$) to ______ (high$)

10. Was HUD's Healthy Homes Rating System (HHRS) used to rate the hazards identified during the assessment of hazards in the home (Y/N)? _____

If Yes, skip to question 13.

11. Excluding lead hazards please identify (check all that apply) the types of HH hazards or conditions for which units were assessed using the supplemental funds:

(1) SAFETY

___ a. Inspect for missing or non-working Fire/smoke detector

___ b. Inspect for missing/expired fire extinguisher

___ c. Inspect for missing/expired carbon monoxide (CO) detector

___ d. Inspect for slip-trip-fall hazards

___ e. Inspect for accessible flames and hot surfaces

___ f. Measure hot water temperature (scalding hazards)

___ g. Inspect\detect presence of fuel gas leaks

(2) INDOOR AIR QUALITY (IAQ)

___ a. Measure carbon monoxide (CO) levels

___ b. Measure volatile organic compounds (VOC) levels

___ c. Inspect gas, oil and solid fuel appliances and associated venting

___ d. HVAC (heating, venting, air conditioning) assessment

___ e. Measure radon levels

(3) BUILDINGS and BUILDING SYSTEMS

___ a. Inspect for mold/moisture/humidity (interior)

___ b. Inspect electrical switches and outlets for shock hazards

___ c. Inspect electrical service supply panel for adequate grounding

___ d. Inspect fuse\breaker panels for proper use and circuit labeling

___ e. Exterior Drainage assessment

___ f. Weatherization/structural energy assessment

___ g. Structure integrity assessment

___ h. Asbestos hazards assessment

Question 11 continued

(4) RESIDENT BEHAVIOR\HEALTH

___ a. Identify smoking in the home

___ b. Identify presence of child\adult with asthma\other respiratory illnesses

___ c. Inspect for adequate cleanliness, lack of clutter, refuse control

___ d. Inspect for unsafe food preparation areas

___ e. Inspect storage and disposal of household wastes

___ f Inspect for unsafe storage of poisonous/hazardous substances

___ g. Inspect for pest infestation

___ h. Identify unsafe use of pesticides

(5) OTHER HAZARD ASSESSMENTS (any category)

___ a. Please specify: _______________________________________________

___ b. Please specify: _______________________________________________

___ c. Please specify: _______________________________________________

___ d. Please specify: _______________________________________________

___ e. Please specify: _______________________________________________

___ f. Please specify: _______________________________________________

12. Please identify (check all that apply) the HH interventions used. For each intervention checked, please enter the approximate fraction of homes (% of dwelling units) that received this intervention under your current program

CATEGORY\Intervention % of Homes

(1) SAFETY

___ a. Install fire/smoke detector ____%

___ b. Install fire extinguisher ____%

___ c. Install carbon monoxide (CO) detector ____%

___ d. Repair\correct slip-trip-fall hazards:

___ d1. Install grab bars\handrails in bathroom ____%

___ d2. Install non-slip stickers in bath tub or shower ____%

___ d3. Install\repair stairway handrails ____%

___ d4. Install\repair stairway components ____%

___ d5. Install\repair floor components ____%

___ d6. Install non-slip mats for rugs ____%

___ d7. Install child safety-gate(s) for stairs ____%

___ d8. Install corner or edge guards ____%

___ d9. Install fall guards or rails for interior fall hazards ____%

___ d10. Install barriers for exterior fall hazards ____%

___ d11. OTHER slip-trip-fall hazard intervention(s):

___ d11a. Please specify: _______________________ ____%

___ d11b. Please specify: _______________________ ____%

___ d11c. Please specify: _______________________ ____%

___ e. Install barrier(s) to reduce incidental contact with flames and hot surfaces ____%

___ f. Reduce hot water temperature ____%

___ g. Repair of fuel gas leaks ____%

___ h OTHER Safety-related interventions:

___ h1. Safety education and/or safety educational materials ____%

___ h2. Please specify: _________________________________ ____%

___ h3. Please specify: _________________________________ ____%

___ h4. Please specify: _________________________________ ____%

Question 12 continued:

(2) INDOOR AIR QUALITY (IAQ)

___ a. Unsafe CO levels:

___ a1. Install\repair\replace CO source venting ____%

___ a2. Repair\replace\remove CO source ____%

___ b Remove\replace sources of VOCs ____%

___ c. Repair\replace combustion gas venting ____%

___ d. Inadequate heating, venting or air conditioning (HVAC):

___ d1. Install\repair of ventilation ductwork ____%

___ d2. Install\repair of windows\screens ____%

___ d3. HVAC filter replacement ____%

___ d4. Repair\replace cooling system ____%

___ d5. Repair\replace heating system ____%

___ e. Install radon mitigation system ____%

___ f OTHER IAQ related interventions:

___ f1. Please specify: _________________________________ ____%

___ f2. Please specify: _________________________________ ____%

___ f3. Please specify: _________________________________ ____%

(3) BUILDINGS and BUILDING SYSTEMS

___ a. Damp and mold growth:

___ a1. Repair\replacement of components causing or damaged by moisture problems ____%

___ a2. Replace moldy components ____%

___ b. Resolve electrical switch and outlet shock hazards:

___ b1. Install\repair electrical switch/receptacle plates ____%

___ b2. Install safety-shock guards on electrical outlets ____%

___ c. Repair electrical service grounding ____%

___ d. Repair\replace fuse\breaker panel deficiencies ____%

___ e. Repair\replace gutters and/or related draining components ____%

___ f. Weatherization\energy efficiency upgrade ____%

___ g. Repair\replace components lacking structural integrity ____%

___ h. Asbestos abatement ____%

___ i OTHER IAQ related interventions:

___ i1. Please specify: ________________________________ ____%

___ i2. Please specify: ________________________________ ____%

___ i3. Please specify: ________________________________ ____%

Question 12 continued:

(4) RESIDENT BEHAVIOR\HEALTH

___ a. Provide education and/or educational materials on smoking ____%

___ b. Presence of child\adult with asthma\other respiratory illnesses:

___ b1. Provide education and/or educational materials ____%

___ b2. Delivery of anti-allergy pillow and/or mattress covers ____%

___ c. Cleanliness, clutter, and\or refuse hazards:

___ c1. Provide education and/or educational materials ____%

___ c2. Install cleanable surfaces (e.g. countertop/linoleum) ____%

___ c3. Provision with cleaning supplies\equipment ____%

___ d. Provide education and/or educational materials on safe food preparation ____%

___ e. Unsafe storage and\or disposal of household wastes:

___ e1. Provide education and/or educational materials ____%

___ e2. Install child-proof door latches ____%

___ f. Unsafe storage of poisonous/hazardous substances:

___ f1. Provide education and/or educational materials ____%

___ f2. Install child-proof door latches ____%

___ g. Pest infestation:

___ g1. Provide education and/or educational materials ____%

___ g2. Implement pest control by referral to pest management professional ____%

___ g3. Implement pest control by grantee staff ____%

___ g4. Provide resident with pest control supplies ____%

___ h. Provide education and/or educational materials on pesticides use ____%

___ i OTHER Behavior\Health related interventions:

___ i1. Please specify: ________________________________ ____%

___ i2. Please specify: ________________________________ ____%

___ i3. Please specify: ________________________________ ____%

___ i4. Please specify: ________________________________ ____%

Question 12 continued:

(5) OTHER HAZARD ASSESSMENTS (any category)

___ a. Please specify: ____________________________________ ____%

___ b. Please specify: ____________________________________ ____%

___ c. Please specify: ____________________________________ ____%

___ d. Please specify: ____________________________________ ____%

___ e. Please specify: ____________________________________ ____%

___ f. Please specify: ____________________________________ ____%

End question 12, skip to question 18 (page 17) if you did not use the HHRS

13. Excluding lead hazards please identify (check all that apply) the types of HH hazards or conditions for which units were assessed using the supplemental funds:

(1) DAMP AND MOLD GROWTH

___ a. Inspect for Mold/moisture/humidity (interior)

___ b. Exterior Drainage assessment

___ c. Repair\replace gutters and/or related draining components

(2) EXCESS COLD and (3) EXCESS HEAT

___ a. HVAC (heating, venting, air conditioning) assessment

___ b. Weatherization\energy assessment

(4) ASBESTOS, SILICA AND OTHER MMF

___ a. Asbestos hazards assessment

___ b. Inspection for identification of fibrous materials

(5) BIOCIDE

___ a. Inspection for identification of components containing treated lumber

___ b. Identify unsafe use of pesticides

(6) CARBON MONOXIDE (CO) AND FUEL COMBUSTION PRODUCTS

___ a. Inspect for missing/expired CO detector

___ b. Measure CO levels

(7) LEAD - not applicable

(8) RADIATION

___ a. Measure radon levels

(9) UNCOMBUSTED FUEL GAS

___ a. Inspect\detect presence of fuel gas leaks

___ b. Inspect gas, oil and solid fuel appliances and associated venting

(10) VOLATILE ORGANIC COMPOUNDS (VOC)

___ a. Measure VOC levels

(11) CROWDING AND SPACE

___ a. Evaluate space utilization

(12) ENTRY BY INTRUDERS

___ a. Evaluate security against unauthorized entry

(13) LIGHTING

___ a. Evaluate habitable spaces for adequate lighting

(14) NOISE

___ a. Evaluate\measure noise levels

Question 13 continued:

(15) DOMESTIC HYGIENE, PESTS AND REFUSE

___ a. Inspect for adequate cleanliness, lack of cutter, refuse control

___ b. Inspect for unsafe storage of poisonous/hazardous substances

___ c. Inspect for pest infestation

___ d. Inspect storage and disposal of household wastes

(16) FOOD SAFETY

___ a. Inspect for unsafe food preparation areas

(17) PERSONAL HYGIENE, SANITATION, AND DRAINAGE

___ a. Identify smoking in the home

___ b. Assess bathrooms for function and hygienic utilization

___ c. Inspect indoor drain systems

(18) WATER SUPPLY

___ a. Inspect water supply installations and fittings

___ b. Measure hot water temperature (scalding hazards)

(19) FALLS ASSOCIATED WITH BATHS, ETC

___ a. Inspect bathroom areas for slip-trip-fall hazards

(20) FALLING ON LEVEL SURFACES, ETC

___ a. Inspect all rooms, areas, paths and passages for slip-trip-fall hazards

(21) FALLING ON STAIRS, ETC

___ a. Inspect stairways for slip-trip-fall hazards

(22) FALLING BETWEEN LEVELS

___ a. Inspect windows, balconies, and landings for fall hazards

___ b. Inspect exterior areas for fall hazards

(23) ELECTRICAL HAZARDS

___ a. Inspect switches and outlets for shock hazards

___ b. Inspect electrical service supply panel for adequate grounding

___ c. Inspect fuse\breaker panels for proper use and circuit labeling

(24) FIRE

___ a. Inspect for missing or non-working fire/smoke detector

___ b. Inspect for missing/expired fire extinguisher

(25) FLAMES, HIT SURFACES, ETC

___ a. Inspect for accessible flames and hot surfaces

Question 13 continued:

(26) COLLISION AND ENTRAPMENT

___ a. Inspect for collision and entrapment areas

(27) EXPLOSIONS

___ a. Inspection of fuel lines and detection of fuel leaks

(28) POSITION AND OPERABILITY OF AMENITIES ETC

___ a. Inspect housing systems for ease of use\access without strain

(29) STRUCTURAL COLLAPSE AND FALLING ELEMENTS

___ a. Structure integrity assessment

(30) OTHER

___ a. Identify presence of child\adult with asthma\other respiratory illnesses

___ b. Please Specify: __________________________________________

___ c. Please Specify: __________________________________________

___ d. Please Specify: __________________________________________

___ e. Please Specify: __________________________________________

___ f. Please Specify: __________________________________________

14. Please identify (check all that apply) the HH interventions used. For each intervention checked, please enter the approximate fraction of homes (% of dwelling units) that received this intervention under your current program

CATEGORY\Intervention % of Homes

(1) DAMP AND MOLD GROWTH

___ a. Repair\replacement of components causing or damaged by moisture problems ____%

___ b. Replace moldy components ____%

___ c. Repair\replace gutters and/or related draining components ____%

(2) EXCESS COLD and (3) EXCESS HEAT

___ a. Inadequate heating, venting or air conditioning (HVAC):

___ a1. Install\repair of ventilation ductwork ____%

___ a2. Install\repair of windows\screens ____%

___ a3. HVAC filter replacement ____%

___ a4. Repair\replace cooling system ____%

___ a5. Repair\replace heating system ____%

___ b. Weatherization\energy efficiency upgrade

(4) ASBESTOS, SILICA AND OTHER MMF

___ a. Asbestos abatement ____%

___ b. Abatement of fibrous materials ____%

(5) BIOCIDE

___ a. Provide education and/or educational materials on treated wood hazards ____%

___ b. Provide education and/or educational materials on pesticides ____%

(6) CARBON MONOXIDE (CO) AND FUEL COMBUSTION PRODUCTS

___ a. Install CO detector ____%

___ b. Unsafe CO levels:

___ b1. Install\repair\replace CO source venting ____%

___ b2. Repair\replace\remove CO source ____%

(8) RADIATION

___ a. Install radon mitigation system ____%

(9) UNCOMBUSTED FUEL GAS

___ a. Repair of fuel gas leakage ____%

___ b. Repair\replace combusted gas venting ____%

Question 14 continued:

(10) VOLATILE ORGANIC COMPOUNDS (VOCs)

___ a. Remove\replace sources of VOCs ____%

(11) CROWDING AND SPACE

___ a. Provide education and/or educational materials ____%

(12) ENTRY BY INTRUDERS

___ a. Install\repair door locking mechanisms ____%

___ b. Install\repair window locking mechanisms\bars ____%

(13) LIGHTING

___ a. Install\repair electrical lighting ____%

___ b. Install\repair windows ____%

(14) NOISE

___ a. Install noise abatement measures ____%

(15) DOMESTIC HYGIENE, PESTS AND REFUSE

___ a. Cleanliness, clutter, and\or refuse hazards:

___ a1. Provide education and/or educational materials ____%

___ a2. Install cleanable surfaces (e.g. countertop/linoleum) ____%

___ a3. Provision with cleaning supplies\equipment ____%

___ b. Unsafe storage of poisonous/hazardous substances:

___ b1. Provide education and/or educational materials ____%

___ b2. Install child-proof door latches ____%

___ c. Pest infestation:

___ c1. Provide education and/or educational materials ____%

___ c2. Implement pest control by referral to pest management professional ____%

___ c3. Implement pest control by grantee ____%

___ c4. Provide resident with pest control supplies ____%

___ d. Unsafe storage and\or disposal of household wastes:

___ d1. Provide education and/or educational materials ____%

___ d2. Install child-proof door latches ____%

(16) FOOD SAFETY

___ a. Provide education and/or educational materials ____%

Question 14 continued:

(17) PERSONAL HYGIENE, SANITATION, AND DRAINAGE

___ a. Provide educational and/or educational materials on smoking ____%

___ b. Unsanitary bathrooms:

___ b1. Provide education and/or educational materials ____%

___ b2. Provision with cleaning supplies\equipment ____%

___ c. Repair inadequate indoor drain systems

(18) WATER SUPPLY

___ a. Repair inadequate water fixture installations and fittings ____%

___ b. Reduce hot water temperature ____%

(19) FALLS ASSOCIATED WITH BATHS, ETC

___ a. Install grab bars\handrails in bathroom ____%

___ b. Install non-slip stickers in bath tub or shower ____%

(20) FALLING ON LEVEL SURFACES, ETC

___ a. Install\repair floor components ____%

___ b. Install non-slip mats for rugs ____%

___ c. Install corner or edge guards ____%

(21) FALLING ON STAIRS, ETC

___ a. Install\repair stairway handrails ____%

___ b. Install\repair stairway components ____%

___ c. Install child safety-gate(s) for stairs ____%

(22) FALLING BETWEEN LEVELS

___ a. Install fall guards or rails for interior fall hazards ____%

___ b. Install barriers for exterior fall hazards ____%

(23) ELECTRICAL HAZARDS

___ a. Resolve electrical switch and outlet shock hazards:

___ a1. Install\repair electrical switch/receptacle plates ____%

___ a2. Install safety-shock guards on electrical outlets ____%

___ b. Repair electrical service grounding ____%

___ c. Repair\replace fuse\breaker panel deficiencies ____%

(24) FIRE

___ a. Install fire/smoke detector

___ b. Install fire extinguisher

(25) FLAMES, HOT SURFACES, ETC

___ a. Install barrier(s) to reduce incidental contact with flames and hot surfaces ____%

Question 14 continued:

(26) COLLISION AND ENTRAPMENT

___ a. Collision and entrapment hazards:

___ a1. Provide education and/or educational materials ____%

___ a2. Install warning signage ____%

___ a3. Repair\remove collision hazards ____%

___ a4. Install\repair door locking mechanisms ____%

(27) EXPLOSIONS

___ a. Repair fuel gas leaks ____%

(28) POSITION AND OPERABILITY OF AMENITIES ETC

___ a. Repair\replace hard to access housing systems (reduce strain) ____%

(29) STRUCTURAL COLLAPSE AND FALLING ELEMENTS

___ a. Repair\replace components lacking structural integrity ____%

(30) OTHER HAZARD INTERVENTIONS (any category)

___ a. Identify presence of child/adult with asthma/other respiratory illnesses

___ a1. Provide education and/or educational materials ____%

___ a2. Delivery of anti-allergy pillow and/or mattress covers ____%

___ b. Please specify: ____________________________________ ____%

___ c. Please specify: ____________________________________ ____%

___ d. Please specify: ____________________________________ ____%

___ e. Please specify: ____________________________________ ____%

___ f. Please specify: ____________________________________ ____%

15. Did users of the HHRS rating system receive formal training on how to use the HHRS? (Y/N) ____

15a. If Yes, please indicate who provided the training:

__________________________________________________________________

16. What is your opinion of the value and effectiveness of the HHRS to your program in rating and prioritizing HH hazards? Enter a value from 1 to 5 using the sliding scale shown

below ______.

17. Please provide any suggestions to improve the HHRS, including training on its use:

_______________________________________________________________

18. Did you conduct any follow-up evaluation of units after completing the HH interventions to assess the longevity or effectiveness of the interventions? (Y/N) ____. If No, SKIP to question 20

19. On average, approximately how long after completing the HH interventions did you conduct the follow-up (check one):

___a. less than 3 months

___b. 3 -11months

___c. One year or longer

20. To what extent were the HH supplement funds useful in allowing your program to provide greater protection to households from HH hazards? Enter a value from 1 to 5 using the sliding scale shown below ______.

21. Briefly describe any “best practices” that you have identified on the use of the HH supplemental funds. This specifically refers to practices that maximize the impact of the funds in protecting residents from health and safety hazards:

__________________________________________________________________

22. Are there specific uses of the HH funds that you have found to be ineffective? (Y/N) ____

22a. If yes, please indicate the uses found to be ineffective:

__________________________________________________________________

23. Was the HH supplemental funding helpful in the possible transition of your Lead Hazard Control Program to a HH model (Y/N)? ____

23a. If Yes, please provide a brief description of how it was or was not helpful:

__________________________________________________________________

24. Is there any other information that you would like to convey to HUD on the HH supplement (Y/N)? ____

24a. If Yes, please provide this information below:

__________________________________________________________________

END. THANK YOU FOR PARTICIPATING.

OMB Approval No. 2539-####

(exp. ##/##/####)

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title	To: Grantees receiving Healthy Homes supplemental funding
File Modified	0000-00-00
File Created	2021-01-29