**CQC ACCESSIBILITY INSPECTION REPORT**

CONTRACT NO.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ REPORT
NO. \_\_\_\_\_\_\_\_\_\_\_\_\_ SHEET \_\_\_\_\_ OF \_\_\_\_\_\_\_\_\_

Note: This report covers only the most common accessibility
requirements. This form can be expanded as needed for elements not
shown. Inspect for compliance with all requirements of the ABAAS.

+--------------------------------------------+-------------------------+
| CQC Inspector:                             | Date:                   |
+--------------------------------------------+-------------------------+
| 1.  Parking and Passenger Loading Zones:   |                         |
|     Attach grading plan with running and   |                         |
|     cross slope readings noted.            |                         |
|                                            |                         |
| #### Yes  No  Accessible                   |                         |
| parking spaces and access aisles running s |                         |
| lope and cross slope is 1:48 (2%) or less. |                         |
|                                            |                         |
| #### Yes  No  Car spaces are at leas       |                         |
| t 96 inches wide and van spaces 132 inches |                         |
|  wide, and have an adjacent access aisle.  |                         |
|                                            |                         |
| #### Yes  No  Access aisles are 60 inches  |                         |
| wide min. and adjoin an accessible route.  |                         |
|                                            |                         |
| #### Yes  No  Curb ramps meet              |                         |
| slope requirements for ramps and have 36 i |                         |
| nch minimum landing length at top of ramp. |                         |
|                                            |                         |
| #### Yes  No  Curb ramp                    |                         |
| flared side slopes are 1:10 (10%) or less. |                         |
|                                            |                         |
| Inspection Results:                        |                         |
|                                            |                         |
| Corrective Actions Needed/Taken:           |                         |
|                                            |                         |
| ![](medi                                   |                         |
| a/image1.png){width="3.1166666666666667in" |                         |
| height="2.8152777777777778in"}             |                         |
| ![](medi                                   |                         |
| a/image2.png){width="3.4569444444444444in" |                         |
| height="2.828472222222222in"}              |                         |
| ![](media/image3.png){width="2.93125in"    |                         |
| height="2.05in"}                           |                         |
+--------------------------------------------+-------------------------+

SHEET \_\_\_\_\_ OF \_\_\_\_\_\_\_\_\_

+-----------------------------------------------------------------------+
| 2.  Walking surfaces and Accessible Route: The accessible route is    |
|     defined as the pedestrian route from the accessible parking and   |
|     passenger loading zones to all accessible facilities and          |
|     features. Attach grading plan with accessible route highlighted   |
|     and running and cross slope readings noted.                       |
|                                                                       |
| #### Yes  No  Floor and ground surfaces are s                         |
| table, firm, and slip resistant as defined by ADAABAAG Advisory 302.1 |
|                                                                       |
| #### Yes  No  Running slope o                                         |
| f all walking surfaces on the accessible route is 1:20 (5%) or less.  |
|                                                                       |
| #### Yes  No  Cross slope of walking surfaces is 1:48 (2%) or less.   |
|                                                                       |
| #### Yes  No  Clear widths of walking surfaces are 36 inches minimum. |
|                                                                       |
| #### Yes  No  Elong                                                   |
| ated openings in floor or ground surfaces are 1/2 inch wide or less.  |
|                                                                       |
| #### Y                                                                |
| es  No  Elongated openings are perpendicular to direction of travel.  |
|                                                                       |
| #### Yes  No  Accessible route surface                                |
|  changes are 1/2 inch or less with 1/4 inch maximum vertical change.  |
|                                                                       |
| #### Yes  No  Flo                                                     |
| or drains and grates on accessible route meet all above requirements  |
|                                                                       |
| Inspection Results:                                                   |
|                                                                       |
| Corrective Actions Needed/Taken:                                      |
|                                                                       |
| ![](media/image4.png){width="3.6145833333333335in"                    |
| height="1                                                             |
| .742361111111111in"}![](media/image5.png){width="2.838888888888889in" |
| height="1.5375in"}                                                    |
+-----------------------------------------------------------------------+
| 3.  Ramps: Ramps are defined as walking surfaces on the accessible    |
|     route that are steeper than 1:20 (5%) but less than 1:12 (8.33%). |
|     Attach grading plan with running and cross slope readings noted.  |
|                                                                       |
| #### Yes  No                                                          |
|  Running slope is 1:12 (8.33%) or less. Measured at 2-foot intervals. |
|                                                                       |
| #### Yes                                                              |
|   No  Cross slope is 1:48 (2%) or less. Measured at 2-foot intervals. |
|                                                                       |
| #### Yes  No  Clear width is 3                                        |
| 6 inches minimum, clear width between handrails is 36 inches minimum. |
|                                                                       |
| #### Yes  No  Rise for any ramp run is 30 inches maximum.             |
|                                                                       |
| #### Yes                                                              |
|  No  Ramps have landings at the top and the bottom of each ramp run.  |
|                                                                       |
| #### Yes  No  Landing clear length is 60 inches mi                    |
| nimum, running slope and cross slope of landing is 1:48 (2%) or less. |
|                                                                       |
| #### Yes  No  Ramps with a rise greater than 6 inches have handrails. |
|                                                                       |
| #### Yes  No  Ramps and landings have edge protec                     |
| tion on both sides that prevents passage of a 4 inch diameter sphere. |
|                                                                       |
| Inspection Results:                                                   |
|                                                                       |
| Corrective Actions Needed/Taken:                                      |
|                                                                       |
| ![](media/image6.png){width="4.782638888888889in"                     |
| height="2                                                             |
| .045138888888889in"}![](media/image7.png){width="2.042361111111111in" |
| height="1.66875in"}                                                   |
+-----------------------------------------------------------------------+

SHEET \_\_\_\_\_ OF \_\_\_\_\_\_\_\_\_

+-----------------------------------------------------------------------+
| 4\. Handrails:                                                        |
|                                                                       |
| #### Yes  No  Top of handrail is 34 inc                               |
| hes minimum and 38 inches maximum vertically above walking surfaces.  |
|                                                                       |
| #### Yes  No  Handr                                                   |
| ails extend 12 inches minimum beyond the top and bottom of ramp runs. |
|                                                                       |
| #### Yes  N                                                           |
| o  Handrails extend horizontally 12 inches minimum at top of stairs.  |
|                                                                       |
| #### Yes  No  Handrails extend at slope of the stair f                |
| light at bottom of stairs minimum one tread depth beyond last riser.  |
|                                                                       |
| #### Yes  No  Handrail clearance is                                   |
|  1 ½ inches clear minimum to walls and above horizontal attachments.  |
|                                                                       |
| Inspection Results:                                                   |
|                                                                       |
| Corrective Actions Needed/Taken:                                      |
|                                                                       |
| ![](media/image8.png){width="3.38125in"                               |
| height="2.                                                            |
| 098611111111111in"}![](media/image9.png){width="1.5465277777777777in" |
| height="2.2                                                           |
| 83333333333333in"}![](media/image10.png){width="2.2319444444444443in" |
| height="2.1                                                           |
| 805555555555554in"}![](media/image11.png){width="2.548611111111111in" |
| height="1.4027777777777777in"}                                        |
+-----------------------------------------------------------------------+
| ![](media/image12.png){width="2.075in" height="2.8875in"}5. Drinking  |
| fountains (Two spout heights required for each drinking fountain):    |
|                                                                       |
| #### Yes  No  Spout outlet is 36 inches maxi                          |
| mum above the finish floor or ground for wheelchair accessible spout. |
|                                                                       |
| #### Yes  No  Spout outlet for standing perso                         |
| ns is 38 inches minimum and 43 inches maximum above the finish floor. |
|                                                                       |
| #### Yes  No  Drinking fountain is rece                               |
| ssed or has 27 inches maximum space from floor to bottom of fountain. |
|                                                                       |
| Inspection Results:                                                   |
|                                                                       |
| Corrective Actions Needed/Taken:                                      |
+-----------------------------------------------------------------------+

SHEET \_\_\_\_\_ OF \_\_\_\_\_\_\_\_\_

+-----------------------------------------------------------------------+
| 6\. Toilet Compartments: Attach floor plan with as-constructed        |
| dimensions noted.                                                     |
|                                                                       |
| #### Yes  No  Wheelchair access                                       |
| ible compartment is 60 inches wide min., and 59 inches deep minimum.  |
|                                                                       |
| #### Yes  No  Ambulatory stall is 60 inches deep min. wi              |
| dth of 35 inches min. and 37 inches max, toilet is centered in stall. |
|                                                                       |
| #### Yes  No                                                          |
|  Accessible compartment has 32 inch wide door opening minimum with do |
| or opening outward, or adequate clear space for door opening inward.  |
|                                                                       |
| #### Yes  No  Seat height is 17                                       |
| inches minimum and 19 inches maximum measured to the top of the seat. |
|                                                                       |
| #### Yes  No  Urinal rim is 17                                        |
| inches maximum above the finish floor and 13 1/2 inches deep minimum. |
|                                                                       |
| #### Yes  No  Urinal                                                  |
|  has a clear floor space of 30 inches wide by 48 inches long minimum. |
|                                                                       |
| #### Yes  No  Side wall grab bar is                                   |
| 42 inches long minimum, located 12 inches maximum from the rear wall. |
|                                                                       |
| #### Yes  No  Rear wall grab bar is 36" long min. e                   |
| xtends from toilet centerline 12" min. one side, 24" min. other side. |
|                                                                       |
| ####                                                                  |
| Yes  No  Grab bar height is 33 inches minimum and 36 inches maximum.  |
|                                                                       |
| #### Yes  No  Toilet paper dispensers are 7 inches min. and           |
| 9 inches max. in front of the toilet to centerline of the dispenser.  |
|                                                                       |
| #### Yes  No  Toilet paper dispenser outl                             |
| et is 15 inches minimum and 48 inches maximum above the finish floor. |
|                                                                       |
| #### Yes  No  Centerline of the wheelchair                            |
|  stall toilet is 16 inches min. to 18 inches max. from the side wall. |
|                                                                       |
| #### Yes  No  S                                                       |
| inks and counters are 34 inches max. above the finish floor with 27 i |
| nches min. knee space. Sink drain pipes are insulated, or concealed.  |
|                                                                       |
| Inspection Results:                                                   |
|                                                                       |
| Corrective Actions Needed/Taken:                                      |
|                                                                       |
| ![](media/image13.png){width="7.1194444444444445in"                   |
| height="4.438888888888889in"}                                         |
+-----------------------------------------------------------------------+
| 7\. Service Counters, Dining and Work Surfaces: (Service counters are |
| parallel or forward approach)                                         |
|                                                                       |
| #### Yes  No  Paral                                                   |
| lel Approach. Counter is 36 inches long min. and 36 inches high max.  |
|                                                                       |
| #### Yes  No  Forward Approach. Counter surface is 3                  |
| 0 inches long min. and 36 inches high max, knee space under counter.  |
|                                                                       |
| #### Yes  No  Tops of dining and work surfaces                        |
|  are 28 inches minimum and 34 inches maximum above the finish floor.  |
|                                                                       |
| Inspection Results:                                                   |
|                                                                       |
| Corrective Actions Needed/Taken:                                      |
+-----------------------------------------------------------------------+

SHEET \_\_\_\_\_ OF \_\_\_\_\_\_\_\_\_

+--------------------------------------+-------------------------------+
| 8\. Doors:                           |                               |
|                                      |                               |
| #### Yes  No  Door op                |                               |
| enings on accessible routes provide  |                               |
| a clear width of 32 inches minimum.  |                               |
|                                      |                               |
| #### Yes                             |                               |
|   No  Door closers move door from op |                               |
| en position of 90 degrees to 12 degr |                               |
| ees from the latch is 5 seconds min. |                               |
|                                      |                               |
| #### Y                               |                               |
| es  No  Spring hinge doors close fro |                               |
| m open position of 70 degrees to clo |                               |
| sed position in 1.5 seconds minimum. |                               |
|                                      |                               |
| ###                                  |                               |
| # Yes  No  Fire doors have the minim |                               |
| um opening force allowable by the ap |                               |
| propriate administrative authority.  |                               |
|                                      |                               |
| #### Y                               |                               |
| es  No  Interior hinged doors have a |                               |
| n opening force of 5 pounds maximum. |                               |
|                                      |                               |
| Inspection Results:                  |                               |
|                                      |                               |
| Corrective Actions Needed/Taken:     |                               |
|                                      |                               |
| ![](media/imag                       |                               |
| e14.png){width="4.979166666666667in" |                               |
| height="1.66875in"}                  |                               |
+--------------------------------------+-------------------------------+
| 9\. Signs:                           |                               |
|                                      |                               |
| #### Yes  No                         |                               |
|   Parking space signs are 60 inches  |                               |
| minimum above finish ground surface  |                               |
| measured to the bottom of the sign.  |                               |
|                                      |                               |
| #### Yes                             |                               |
| No  Van parking space sign includes  |                               |
| the designation \"van accessible\".  |                               |
|                                      |                               |
| #                                    |                               |
| ### Yes  No  Tactile characters on s |                               |
| igns are 48 inches minimum and 60 in |                               |
| ches maximum above the finish floor. |                               |
|                                      |                               |
| #### Yes  No  Sign is located al     |                               |
| ongside the door at the latch side.  |                               |
|                                      |                               |
| #### Yes  No  Sign                   |                               |
|  is located with a clear floor space |                               |
|  of 18 inches by 18 inches minimum.  |                               |
|                                      |                               |
| Inspection Results:                  |                               |
|                                      |                               |
| Corrective Actions Needed/Taken:     |                               |
|                                      |                               |
| ![](                                 |                               |
| media/image15.png){width="3.85625in" |                               |
| height="2                            |                               |
| .4569444444444444in"}![](media/image |                               |
| 16.png){width="2.7736111111111112in" |                               |
| height="1.7201388888888889in"}       |                               |
+--------------------------------------+-------------------------------+
| CERTIFICATION:                       |                               |
|                                      |                               |
| I certify that the above inspection  |                               |
| report is complete and correct and   |                               |
| that this inspection is in           |                               |
| compliance with the contract         |                               |
| documents.                           |                               |
+--------------------------------------+-------------------------------+
|                                      | Signature of Inspector        |
+--------------------------------------+-------------------------------+