Surfaces can be built of brick, stucco, wood, stone, cement/ concrete block, asbestos, vinyl, or other materials. DEFICIENCy: Not necessarily a deficiency; assessed because type of surface could lead inspector to other issues.(2003 IPMC CROSS-REFERENCES: 304.1 GENERAl; 304.2 PROTECTIVE TREATMENT) DEFICIENCy: There is a split, separation, or gap in the exterior walls. NOTE: If there is any doubt about the severity of the condition, request an inspection by a structural engineer. Healthy Housing Inspection Manual | Page 65 ExTERIOR 54. Damaged Chimney (2003 IPMC CROSS-REFERENCE: 304.11 CHIMNEyS AND TOWERS) DEFICIENCy: The chimney, including the part that extends above the roof line, has separated from the wall or has cracks, spalling, missing pieces, or broken sections. ExTERIOR 55. Wall Surface Deterioration (2003 IPMC CROSS-REFERENCES: 304.1 GENERAl;DEFICIENCy: There is deterioration of the exterior wall surface, including missing pieces, holes, or spalling. This may also be attributed to rotting materials -OR-a concrete, stucco, or masonry wall that is flaking, chipping, or crumbling.If there is any doubt about the severity of the condition, request an inspection by a structural engineer.#
APPENDIx 3: Additional Resources........................................................................................................ The agencies' initiatives related to healthy homes were created to develop a holistic approach to healthy housing based on the following broad objectives:
- Broaden the scope of single-issue public health and safety programs-such as childhood lead poisoning prevention, residential asthma intervention, injury preventionto adopt a holistic approach addressing multiple housing deficiencies that affect health and safety.
- Build competency among environmental public health practitioners, public health nurses, housing specialists, housing owners, housing managers, and others who work in the community so they can incorporate healthy housing activities into their professional activities.
- Develop national healthy homes capacity through crossdisciplinary grants, contracts, and other activities at the federal, state, tribal, and community levels that research and demonstrate low-cost, effective home hazard assessment and intervention methods.
- Develop effective education and outreach materials, with a particular focus on high-risk populations, to increase public awareness of residential hazards and highlight effective actions households can take to reduce the risk for illness and injury.
The Healthy Housing Inspection Manual is a model reference tool that local jurisdictions or others may use as is or modify based on local needs. Use of the manual is expected to improve the effectiveness and efficiency of the public health, housing management, and workforces that identify, prevent, and control health problems associated with housing.
The manual does not introduce any inspection requirements, nor does it modify any existing inspection requirements for housing agencies, residents, HUD, or CDC. The manual is not a substitute for the Federal Housing Administration (FHA) Minimum Property Standards.
Finally, the manual does not propose to establish any regulatory authority for HUD or CDC with regard to residential inspection requirements.
The Healthy Housing Inspection Manual takes environmental health professionals and housing managers, specialists, and inspectors through the elements of a holistic home inspection. It is also a useful reference tool for nurses, outreach workers, and others who are interested in preventing illness and injury due to residential health and safety hazards.
The Healthy Housing Inspection Manual addresses the broad range of housing deficiencies and hazards that can affect residents' health and safety. The purpose of the manual is to
- improve communication and collaboration among public health professionals, housing professionals, property owners and property managers,
- increase the understanding of the relations among exposure to hazardous agents, conditions in the home, and adverse health outcomes, and
- improve the ability of programs to address an array of housing deficiencies in an efficient, effective, and timely manner.
HUD and CDC have also jointly developed and funded other important activities related to healthy homes, including
- a healthy housing curriculum that addresses the training needs of environmental public health practitioners, public health nurses, housing specialists, and others interested in building local capacity to address housing-related health hazards (Healthy Homes Training Center and Network, ).
- the Healthy Housing Reference Manual, which gives public health and housing professionals the tools necessary to ensure that housing stock is safe, decent, and healthy for our citizens, particularly children and the elderly, who are often most vulnerable and spend more time in the home (/ books/housing/housing.htm).

# FORMAT OF THIS MANUAl
HUD and CDC recommend that section 1, the Healthy Housing Model Resident Questionnaire (a voluntary health assessment), be completed first. The questionnaire should be used to collect information that cannot be determined visually. Information from the questionnaire can provide important clues that point to housing deficiencies.
SECTION 2, the Visual Assessment Data Collection Form, should be used to collect information that can be determined without asking questions of a resident. This form includes detailed assessment of exterior housing, kitchen, bathroom, and living area, as well as a general building information.
This manual also contains three supporting appendices:
- a data dictionary that defines housing deficiencies listed in the Visual Assessment Data Collection Form;
- a cross-reference to code provisions in the 2003 International Property Maintenance Code (2003 IPMC); and
- additional resources (links to environmental sampling methods and to more information about substances or issues related to healthy housing).

# Section 1
HEAlTHy HOMES MODEl RESIDENT QUESTIONNAIRE Information from questionnaire responses such as these can provide important clues that point to housing deficiencies. The Healthy Homes Model Resident Questionnaire is a tool that can be adapted by local jurisdictions to meet their specific needs. Be sure to follow local jurisdiction regulations for the collection and safeguarding of personal data.
For example, jurisdictions may want to add questions about - whether the respondent owns or rents the building/unit - the name and contact information of the building/unit owner (rental units)
- whether the building/unit is privately owned or owned by a public housing authority - whether the government pays some of the cost of the building/unit - the name of the person who is responding to the questionnaire.

# INjURIES
During the past 3 months, did you/did you or anyone in your family have an injury where any part of the body was hurt (including burns, electric shock, or falls)? 5
Did you talk to or see a medical professional about any of these injuries?
Please describe the circumstances or events leading to the injury, and any objects, substances, or other people involved. Include what the person was doing at the time.

# POISONINGS
Have you or anyone in your family been poisoned in the house/unit by swallowing or breathing in a harmful substance such as bleach, carbon monoxide, or too many pills or prescription medications? Do not include food poisoning, sun poisoning, or poison ivy. - Select only one answer per question. If more than one answer is possible, record the most severe hazard and note the others in the comments section at the end of each section.
- Complete one set of "site" observations for each building or housing development.
- Complete one set of "exterior and building system" observations for each building.
- Complete one set of "common area" observations for each building. Do not complete the common area section if no common area exists.
- Complete one set of "unit" and "other" observations for each housing unit inspected.
- Document deviations from inspection protocol in the comments section space (e.g., units not available for inspection)
- Specific locations of specific hazards can be recorded in the comments section if desired. -OR-Pavement that sinks or rises because of the failure of sub-base materials. Five percent or more of the walkways must be impacted-50 out of 1,000 square feet, for example. Relief joints are there by design; do not consider them cracks. When observing traffic ability, consider the capacity to support pedestrians, wheelchairs, and people using walkers. Cracks greater than 34 inch, hinging/tilting, or missing section(s) that affect traffic ability over more than 5% of the property's walkways/steps. A comment area for the common areas category is also included in this section.  Common Areas 92. Peeling/Needs Paint q2 square feet: More than 2 square feet of peeling or deteriorated paint in one or more common areas q<2 square feet: Less than 2 square feet of peeling or deteriorated paint in one or more common areas qAll intact: All paint intact Common Areas 93. Water Stains/Water Damage q2 square feet: One or more ceilings(s) has evidence of a leak, water damage, or water staining (such as a darkened area) over a large area (more than 4 square feet) q<2 square feet: One or more ceiling(s) has evidence of a leak, water damage, or water staining (such as a darkened area) over a small area (less than 4 square feet)

# ElEVATORS
qNo water stains/water damage NOTE: This does not include visible mold on ceiling, which is addressed in Common Areas 94.
Common Areas 94. Mold q4 square feet mold observed or musty odor detected: On one or more ceilings(s), mold is seen in a large area (more than 4 square feet) or there is a musty odor q<4 square feet visible mold: On one or more ceiling(s), mold is seen in a small area (less than 4 square feet)
qNo mold or musty odor NOTE: This does not include water stains or damage on ceiling, which is addressed in Common Areas 93. Common Areas 98. Flooring/Tiles q50% missing or damaged: More than 50% of the flooring is affected by small holes and damage.
-OR-The condition causes a safety problem q10%-<50% missing or damaged: An estimated 10%-50% of the flooring has small holes in areas of the floor surface, but there are no safety problems q<10% missing or damaged: For a single floor, there are small holes in areas of the floor surface.
Less than 10% of the floor is affected and there are no safety problems.  basins or ponding on paved areas such as parking lots. Detention/retention basins are covered in Site 24: Storm Drainage. Ponding on paved areas is covered in Site 7: Cracks in Pavement. If there has been measurable precipitation ( 1 /10 inch or more) during the previous 48 hours, consider its impact on the extent of the ponding. Determine that ponding has occurred only when there is clear evidence of a persistent or longstanding problem. An area for parking motorized vehicles begins at the curbside and includes all parking lots, driveways, or roads within the property lines that are under the control of the homeowner or housing provider.
DEFICIENCy: There are visible faults (longitudinal, lateral, alligator, etc.) in the pavement.

# NOTE:
Do not include small cracks on walkways.
Relief joints are there by design; do not consider them cracks. When observing traffic ability, consider the capacity to support people on foot, in wheelchairs, and using walkers-and the potential for problems and hazards. For parking lots only, note a deficiency if there are cracks on more than 5% of the parking spaces. For driveways/roads, note a deficiency if there are cracks on more than 5% of the driveways/roads.

# CHIlDREN'S PlAy AREAS SITE 10. Equipment (2003 IPMC CROSS-REFERENCE: NONE)
An outdoor area set aside for recreation or play, espe cially an area containing equipment such as seesaws and swings. Surfaces around playground equipment should have at least 12 inches of wood chips, mulch, sand, pea gravel, or mats made of safety-tested rubber or rubber-like materials.

# DEFICIENCy: Playground equipment is danger ous or broken. IF ANy EQUIPMENT POSES AN IMMEDIATE THREAT: REPORT TO bUIlDING MANAGEMENT/OWNER IMMEDIATEly AND RECORD SPECIFICS IN THE COMMENTS SECTION
NOTE: Except when safety is still a concern (sharp edges, dangerous leaning, etc.), do not evaluate equip ment that the owner states has been withdrawn from service. For example, if the owner removed the net and hoop from a basketball backboard and the back board poses no safety hazards, it is not a deficiency. The presence of large areas of bare soil in play areas can be a soil lead hazard. This is especially a concern near structures built before 1978 or near areas where older structures were demolished and new ones built on the site. Passages for walking and the structures that allow for changes in vertical orientation. Deficiencies: broken/ missing hand railing for four or more stairs, cracks/ settlement/heaving, or spalling.  All buildings must have acceptable fire exits. This includes both stairway access doors and external exits. These can include external fire escapes, fire towers, operable windows on the lower floors with easy access to the ground, or a back door opening onto a porch with a stairway leading to the ground.
DEFICIENCy: Any part of the fire escape-including ladders-is blocked, limiting or restricting people from exiting-OR-In multifamily buildings, fire exits are not properly marked-OR-A fire exit is cannot be used or the exit is limited because a door or window is nailed shut; a lock is broken; panic hardware is chained; or debris, storage, or other conditions cause the exit to be unusable.

# NOTE:
This includes fire escapes, fire towers, and windows on the ground floor that would be used in an emergency. Portion of the building system that safely provides electrical power throughout the building, including equipment that provides control, protection, metering, and service.

# NOTE:
This does not include transformers or metering that belongs to the providing utility, equip ment that is part of any emergency power generating system, or terminal equipment such as receptacles, switches, or panelboards located in the units or common areas (which are inspected in the Unit or Common Area sections).
This inspectable item can have the following deficien cies: blocked access/improper storage, burnt or melted or missing breakers or improper fusing, evidence of leaks/corrosion, frayed wiring, missing breakers/fuses, or missing covers.
DEFICIENCy: Breakers have carbon on the plastic body or the plastic body is melted or scarred.

# FIRE PROTECTION (bUIlDING)
Building systems designed to minimize the effects of a fire. These systems include fire walls and doors, portable fire extinguishers, and permanent sprinkler systems. Interior collection areas for trash/garbage common pick-up or conveyance.
DEFICIENCIES: Trash on common area floor, containers missing covers or not sealed, or trash chutes damaged or missing components. The receptacle connected to a power supply or method to control the flow of electricity. This includes two-and three-prong outlets, ground fault circuit interrupters, pull cords, two-and three-pole switches, and dimmer switches.

# OUTlETS, SWITCHES, COVER PlATES
This inspectable item can have the following deficien cies: missing/broken wiring or exposed wiring. The visible overhead structure lining the inside of a room or area.
This inspectable item can have the following defi ciencies: bulging/buckling, holes/missing tiles/panels/ cracks, peeling/needs paint, or water stains/water damage/mold/mildew.

# DEFICIENCy:
A ceiling is bowed, deflected, sagging, or is no longer aligned horizontally.

# NOTE:
If there is any doubt about the severity of the condition, request an inspection by a structural engineer. DEFICIENCy: There is a leaking roof or appliance or water pipe in wall or ceiling.

# COMMON AREAS 91. Ceiling Holes

# FlOORS
Floors are defined as the visible horizontal surface system within a room or area underfoot; the horizontal division between two stories of a structure.

# ElECTRICAl
Portion of the unit that safely provides electrical power throughout the building. Includes equipment that provides control, protection, metering, and service. This inspectable item can have the following deficiencies: blocked access to electric panel, burnt breakers, evidence of leaks or corrosion, frayed wir ing, inoperable ground fault circuit interruptor, miss ing breakers/fuses, or missing covers.

# COMMENTS, bUIlDING SySTEMS SECTION COMMENTS, COMMON AREAS SECTION oVerall coMMents on tHis inspection
Add any other comments related to this inspection here.

# APPENDIx 1: DESCRIPTION OF HEAlTH AND SAFETy CONDITIONS IDENTIFIED ON THE VISUAl ASSESSMENT FORM
Adapted from the HUD Public Housing Assessment System (PHAS) and its Physical Assessment Subsystem (PASS) as well as from inspection protocols used by healthy homes grantees. This inspection protocol does not establish legal and/or complete compliance with local, state, federal or other applicable housing, building, health, safety or other applicable policies, codes, regulations, statutes and laws. DEFICIENCy: A fence or gate is rusted, deteriorated, or uprooted and may threaten security, health, or safety.
If the fence has deteriorated paint in an area larger than 20 square feet and the property was built before 1978, record this as damaged but not functional.

# NOTE:
Gates for swimming pool fences are covered in Other Items/Swimming Pool, Spa, or Whirlpool.

# SITE 2. Holes or Openings in Soil Below Fence (2003 IPMC CROSS-REFERENCE: NONE)
DEFICIENCy: There is an opening or penetration in any fence or gate designed to keep intruders out or children in. Look for holes that could allow animals to enter or could threaten the safety of children.
There is an opening/hole in soil beneath the fence.

# NOTE:
If the fence or gate is not designed to keep intruders out or children in (such as a rail fence), do not evaluate it for holes or openings.

# GROUNDS OR PAVEMENT SITE 3. Areas of Erosion (2003 IPMC CROSS-REFERENCE: 302.2 GRADING AND DRAINAGE)
The improved land adjacent to or surrounding the housing and related structures. This does not include land not owned or under the control of the homeowner or housing provider.
DEFICIENCy: Natural processes-weathering, ero sion, or gravity-or human processes have caused any of these conditions: collection or removal of surface material or sunken tracks, ruts, grooves, or depressions.

# NOTES: This does not include detention/retention
ExTERIOR 46. Damaged Soffits/Fascia/Flashing DEFICIENCy: Damage to soffit, fascia, soffit vents, or associated components that may provide oppor tunity for water penetration or other damage from natural elements.

# NOTE:
If there is any doubt about the severity of the condition, an inspection by a roofing specialist is recommended.

# WAllS
The exterior enclosure of the building or structure. Materials for construction include concrete, masonry block, brick, stone, wood, and glass block. Surface fin ish materials include metal, wood, vinyl, and stucco.

# NOTE:
Paint that is lead-based and larger than 2 square feet in area is defined in regulations as a significant lead-based paint hazard. DEFICIENCy: There is evidence of mold or mildew (such as a darkening of the surface) that may have been caused by saturation, surface failure, leaks, or condensation.

# Housing unit (iteMs 103-196)
Items to inspect in the Housing Unit are as follows:

# CEIlING, FlOORS, AND WAllS
The inside envelope inside the housing unit, includ ing the visible overhead structure lining the inside of a room or area (ceiling), the walls, and the floors and associated trim (e.g. There is a leaking roof or appliance or water pipe in wall or ceiling.

# DOORS
Means of access to the interior of a unit, room within the unit, or closet. Doors provide privacy and security, control passage, provide fire and weather resistance. This inspectable item can have the following deficien cies: damaged surface (holes/paint/rusting/glass), dam aged frames/threshold/lintels/trim, damaged hardware/ locks, damaged/missing screen/storm/security door, deteriorated/missing seals (entry only), or missing door.

# HOUSING UNIT 124. Door Surface

# INTERIOR SURFACES)
DEFICIENCy: There is damage to the door surface that may affect either the surface protection or the strength of the door-OR-that may compromise building security. This includes holes, peeling/cracking/ no paint, broken glass, and significant rust. The receptacle connected to a power supply or meth od to control the flow of electricity. Includes two-and three-prong outlets, ground-fault circuit interrupters, pull cords, two-and three-pole switches, and dimmer switches. This inspectable item can have the following deficiencies: missing or missing/broken cover plates.
DEFICIENCy: An outlet, switch, or both are missing.

# NOTE:
This does not apply to empty junction boxes that were not intended to contain an outlet or switch. Environmental sampling for contaminants can sometimes yield additional useful information on housing related health hazards. Each sampling method has its strengths and weaknesses, inherent sampling and analytical error and interferences. Multiple methods exist to sample each contaminant. Sampling must be performed carefully, properly, and in a manner that protects both the person doing the sampling and the occupants. Instruments for certain contaminants may be able to measure the contaminant in real time. For some substances, sampling in the home environment may require a license or certification or training or other requirements in certain jurisdictions.
Consult your local or state government to determine whether such requirements apply before undertaking any environmental sampling in the home environment. If laboratory analysis is required, consult with the analytic laboratory before collecting any sample. If you are uncertain about how to use a particular method or have not been trained, it is recommended that you consult with the local health or environmental department, a professional industrial hygienist or other environmental scientist.
This list of methods and products is not intended to be exhaustive. Additional or other sampling procedures may be recommended in any individual situation. Use of detector tubes and any instrumentation must always be performed according to the manufacturer's instructions. Listing in this document is not intended to be an endorsement of any product or method by the National Center for Healthy Housing or any government agency.

# Agency/orgAnizAtion key