Survey of Residents 063022.xlsx

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Overview

Instructions
Questions

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Sheet 1: Instructions

RVI Survey of Residents

RVI Survey of Residents

Public reporting burden for the collection of information is estimated to average 0.08 hours, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions to reduce this burden, to the Reports Management Officer, Paperwork Reduction Project, to the Office of Information Technology, US. Department of Housing and Urban Development, Washington, DC 20410-3600. When providing comments, please refer to OMB Approval No. 2577-0298. HUD may not conduct and sponsor, and a person is not required to respond to, a collection of information unless the collection displays a valid control number.
Due to the COVID-19 outbreak, The U.S. Department of Housing and Urban Development would like to hear from you about your willingness to participate in its Remote Video Inspection (RVI) through this pre-inspection survey.
An RVI is a flexible way to conduct physical property inspections and is a form of visual inspection which uses a computer or smart device to allow an inspector or team of inspectors to assess the health and safety of your residence from a distance. RVIs are often used because the items at a property are inaccessible or are in dangerous environments, or whereby circumstances prevent an in-person inspection. HUD may routinely conduct RVIs in the future.
If applicable to you and your residence, you may be asked to assist with conducting a physical property inspection. This involves having the ability to: smell mold or a gas leak; open a window; climb stairs; reach above your head for some time; and, operate a smart device with a front and rear camera.
The responses from this pre-inspection survey will help HUD identify properties with residents, who meet to criteria for assisting with an RVI to assess the quality of public housing and the services provided to residents. This survey is voluntary. HUD will comply with the requirements of the Privacy Act and this information will not be linked directly to the respondent. This survey presents no direct risk or benefit to you other than the opportunity to participate in efforts to improve the quality of HUD public housing programs overall.

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Sheet 2: Questions

Remote Video Inspection (RVI)
Survey of Residents
	Inspection ID	Property ID	Please select your unit number.	Head of Household Certification: This survey is intended for the Head of Household participating in HUD-assisted housing. I certify I am the head of household for the unit indicated on this form.	Participating in a Remote Video Inspection (RVI): If applicable to your residence, an RVI involves having the ability to hear, smell mold or a gas leak, open a window and climb stairs, reach over your head, and operate a smart device with a front and rear	Do you have a smart device?	Are you willing to use your data from your internet plan for a RVI?