TESTER’S CHECKLIST
Entrance to Unit
If Clear Opening Width of Doorway < 32”: ____________
Door Opening Hardware: ____________
Kitchen
U-Shaped? ____ Yes ___ No // If yes, stove or sink at bottom of U? ___ Yes ____ No
Appliance to counter: ____________
Counter to counter: ____________
If Midline of Stove to nearest obstruction < 24”: ____________
If Midline of Sink to nearest obstruction < 24”: ____________
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Cabinet under Sink |
Yes |
No |
? |
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Flooring continues under sink? |
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Wall paint continues under sink? |
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Water pipes covered? |
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Living/Dining Room
If Height of highest control button on wall thermostat > 48”: ____________
If Height of midline of lowest electrical outlet < 15”: ____________
Number of electrical outlets measured: ____________
Bathroom(s)
Number of Bathrooms: ____
Bathroom 1:
Type: __ (A or B)
If Clear Opening Width of Doorway < 31 5/8”: ____________
If Midline of Sink to nearest obstruction < 24”: ____________
|
Cabinet under Sink |
Yes |
No |
? |
|
Flooring continues under sink? |
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Wall paint continues under sink? |
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Water pipes covered? |
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If Midline of toilet to left nearest obstruction < 18”: ____________
If Midline of toilet to right nearest obstruction < 18”: ____________
Does swing of door overlap 30” x 48” cloth? ___ Yes ___ No
Bathroom 2:
Type: __ (A or B)
If Clear Opening Width of Doorway < 31 5/8”: ____________
If Midline of Sink to nearest obstruction < 24”: ____________
|
Cabinet under Sink |
Yes |
No |
? |
|
Flooring continues under sink? |
|
|
|
|
Wall paint continues under sink? |
|
|
|
|
Water pipes covered? |
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If Midline of toilet to left nearest obstruction < 18”: ____________
If Midline of toilet to right nearest obstruction < 18”: ____________
Does swing of door overlap 30” x 48” cloth? ___ Yes ___ No
Patio/Balcony
If Clear Opening Width of Doorway < 31 5/8”: ____________
If Interior Threshold Drop > ¼”: ____________
Exterior Threshold Drop: ____________
Surface of patio/balcony? __ Impervious (e.g., Concrete) __ Pervious (e.g., Wood)
Bedroom
Height of midline of lowest electrical outlet: ____________
Number of electrical outlets measured: ____________
Mailboxes
Are there steps, curbs, or any obstruction on route to mailboxes? ___ Yes ___ No
Height of keyhole on top row of mailboxes: ____________
Playground
Are there steps, curbs, or any obstruction on route to playground? ___ Yes ___ No
Fitness Center
Are there steps, curbs, or any obstruction on route to fitness center? ___ Yes ___ No
If Clear Opening Width of Doorway < 31 5/8”: ____________
Parking Outside Building Containing Tested Unit
Total # Parking Spaces: ____
Blue-Sign (Accessible) Parking Space
Total # Accessible Parking Spaces: ____
If Width of Accessible Parking Space < 96”: ____________
If Width of Access Aisle < 60”: ____________
Curb Cutout
Curb Cut at Access Aisle? ___ Yes ___ No
Entrance to Building
Are there steps, or any obstruction on route to building entrance? ___ Yes ___ No
Inside building, are there steps or any obstruction on route to Unit Tested? ___ Yes ___ No
Other Observations or Measurements:
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Date/Time this TESTER’S CHECKLIST was completed: _____________________
Signature of Tester: ______________________________
Date Signed: ___________