Form & Instructions

Dampness and Mold Assessment Tool

General Buildings
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may be freely copied or reprinted.

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Suggested Citation

NIOSH [2018]. Dampness and Mold Assessment Tool for General Buildings - Form & Instructions. CoxGanser J, Martin M, Park JH, Game S. Morgantown WV: U.S. Department of Health and Human 

Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and 

Health, DHHS (NIOSH) Publication No. 2019-115, https://doi.org/10.26616/NIOSHPUB2019115.
Instructions Dampness and Mold Assessment Tool

3

About the Form

Background................................................................................................................................................................................4

Dampness and Mold Assessment Form .........................................................................................................................5

Assessment Cycle.....................................................................................................................................................................6

Notice to Users .........................................................................................................................................................................7

Using the Form

General Building Information..............................................................................................................................................8

Room/Area Type ......................................................................................................................................................................8

Mold Odor..................................................................................................................................................................................9

Room Components.................................................................................................................................................................9

Nothing Found .........................................................................................................................................................................10

Assessing Damage and Scoring.........................................................................................................................................10

Component & Assessment Notes.....................................................................................................................................12

Appendix

Scoring Example 1...................................................................................................................................................................13

Scoring Example 2...................................................................................................................................................................14

Scoring Example 3...................................................................................................................................................................15

Special Notes.............................................................................................................................................................................16

 Contents
Instructions Dampness and Mold Assessment Tool

4

 About the Form

Background

The health of those who live, attend school, or work in damp buildings has been a growing concern 

through the years due to a broad range of reported building-related symptoms and illnesses. Research 

has found that people who spend time in damp buildings are more likely to report health problems such 

as these:

• Respiratory symptoms (such as in nose, throat, lungs)

• Development or worsening of asthma 

• Hypersensitivity pneumonitis (a rare lung disease caused by an immune system response to 

 repeated inhalation of sensitizing substances such as bacteria, fungi, organic dusts, and chemicals) 

• Respiratory infections

• Allergic rhinitis (often called “hay fever”) 

• Bronchitis

• Eczema

Exposures in damp buildings are complex. They vary from building to building, and in different places 

within a building. Moisture allows indoor mold to multiply more easily on building materials or other 

surfaces, and people inside buildings may be exposed to microbes and their structural components, such 

as spores and fungal fragments. Mold may also produce substances that can cause or worsen health 

problems, and these substances vary depending on the mold species and on conditions related to the 

indoor environment. Moisture can also attract cockroaches, rodents, and dust mites. Moisture-damaged 

building materials can release volatile organic compounds that can cause health problems. 

Researchers have not found exactly how much exposure to dampness-related substances it takes to 

cause health problems. Research studies report that finding and correcting sources of dampness is a 

more effective way to prevent health problems than counting indoor microbes. Therefore, NIOSH 

developed a tool to help assess areas of dampness in buildings and to help prioritize remediation of 

problems areas.

NOTE: NIOSH uses the term “mold” to refer to fungi in the 

indoor environment, which can include multicellular fungi 

that produce hyphae, unicellular yeasts, and in some 

excessively damp environments, mushroom producing 

basidiomycetes.

Photo by NIOSH
Dampness and Mold Assessment Tool Gen

Use 

General Information Room/Area Type: Describe below the type of 

Date:

Observer:

Building:

Floor:

Room/Area Identification:

See scoring below 

for . 

Check if 

nothing 

found

Damage 

or Stains

Check 

if near 

exterior 

wall* 

Visible 

Mold

Check 

if near 

exterior 

wall* 

Wet or 

Damp

Check 

if near 

exterior 

wall* 

Component Notes 

 Check if component is in the room/area.  See scoring 

below  See scoring below  See scoring below  Fill in the bubbles for the

type of material that is affected.

 Ceiling    Ceiling tile Plaster Concrete

Sheet rock Metal Wood

 Walls    Sheet rock Plaster Concrete

Block Brick Tile Wood

 Floor    Wood Carpet Vinyl

Ceramic Concrete

Windows    Exterior Interior Skylight 

Furnishings    Furniture Mechanical Sink

Toilet Copier

HVAC systems    Radiator Forced-air Fan

Unit ventilator Windowunit

Supplies & Materials    Books Boxes Equipment 

Pipes    Plumbing Gas 

General Notes

* Within 3 feet of exterior wall.

Scoring: = none < or = the size of a sheet of paper > than a sheet of paper to the size of a standard door > than the size 



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:orod dlo mfe ocruoe sbircesD gnorSt  etaredoM  ildM  enNo 
Instructions Dampness and Mold Assessment Tool

*Mold Remediation in School and Commercial Buildings—Environmental Protection Agency (EPA)

www.epa.gov/mold/mold-remediation-schools-and-commercial-buildings-guide

6

1. Assess

Use the 

Dampness and Mold Assessment Tool 

in all rooms and areas of your 

building(s).

Determine the source(s) of 

dampness or mold identified in 

STEP 1 by further investigating 

where the moisture is 

coming from. 

Facilities staff or trained

professionals should repair all 

identified sources of dampness and 

mold and remediate damaged areas 

following proper guidelines.*

2. Identify

3. Repair & 

Remediate

Schedule regular building 

assessments to prevent new or 

worsening problems and 

repeat STEP 1.

4. REPEAT

 About the Form

Assessment Cycle
Instructions Dampness and Mold Assessment Tool

NOTICE TO USERS

Building assessments using the Dampness and Mold Assessment Tool will likely be done in areas 

that may pose health problems for some people. Use caution if you have asthma, allergies, or are 

having current respiratory health symptoms.

7

 About the Form
Instructions Dampness and Mold Assessment Tool

8

1) General Information

Complete the top of the form by entering the following information.

Date: Month, day, and year of the assessment.

Observer: Name of the person that is performing the assessment.

Building: Unique reference of the building (such as main, annex, portable).

Floor: Floor number or level.

Room/Area Identification: Room number or title.

Example:

2) Room/Area Type

Describe the room or area you are assessing. 

NOTE: It is important to keep room/area titles standardized. For example, rooms with more than one 

title (e.g., bathroom, washroom, men's & women's facilities) should be referred to as the same title 

each time an assessment is conducted. This will help with data consistency. 

Example: 

 Using the Form

General Information

Date: 8/20/2017

Observer: Jon Snow

Building: Whitehall Administration

Floor: 2

Room/Area Identification: 2027

 

Room/Area Type: Describe below the type of room/area you are assessing.

Room 2027 is the office directly across from the staff kitchen on the

second floor.
Instructions Dampness and Mold Assessment Tool

3) Mold Odor

If you detect a mold odor, assess it. Be sure to smell for mold odor when you first walk into each room. 

Determine subjectively whether a smell is mild, moderate, or strong, and identify the odor's source. 

Example:

None Mild Moderate Strong Describe source of mold odor: Source Unknown

If you cannot determine the source, fill in the Source Unknown bubble. 

 flooring

4) Room Components

Place a check () in the first (blue) column for all of the room components found in the room you 

are assessing. Because all areas must have a ceiling, walls, and a floor, those components are 

automatically checked. Assess components systematically in the order given from top to bottom.

Example:

• Windows includes internal, external, and skylights.

• Furnishings includes furniture, sinks, toilets, printers and 

copiers.

• HVAC systems includes all systems used to heat/cool the 

room or area including unit ventilators, radiators, forcedair systems, window units, and fans.

• Supplies & Materials includes books, paper, boxes, gym 

equipment, kitchen supplies.

• Pipes includes any exposed pipes in the room.

Automatically 

checked

 Check if component 

is in the room/area.

 Ceiling

 Walls

 Floor

Windows

Furnishings

HVAC systems

Supplies & Materials

Pipes







9

 Using the Form
Instructions Dampness and Mold Assessment Tool

5) Nothing Found

Look closely at all components identified in the room for any damage, mold, or wetness. Place a 

check () in the third (gray) column for all of the room components where no issues are identified. 

Example:

 Check if component 

is in the room/area. 

 Ceiling

 Walls

 Floor

Windows

Furnishings

HVAC systems

Supplies & Materials

Pipes









 

10

6) Assessing Damage and Scoring

Assessing Damage

Use the three different columns of damage types for the assessment.

1) Damage or Stains

This refers to any water-related damage or stains identified per component. 

• Damage could include peeling paint, efflorescence, rust, warping, 

 and deteriorated or crumbling building materials. 

Damage to wall caused by 

flooding.

 Using the Form

In this example, no damage, mold, or wetness 

was found on the floor, the furnishings, or 

supplies & materials.

Check if 

nothing 

found
Instructions Dampness and Mold Assessment Tool

11

Scoring

Scoring is based on the size of all affected areas combined. Individual sizes of each affected area are 

added together to obtain a combined size. Scoring examples are provided in the Appendix (pages 

11–13). 

= No problem areas identified.

= The combined area of damage is the size of a standard sheet of paper

 (81⁄2 inches X 11 inches) or smaller. 

= The combined area of damage is greater than the size of a standard sheet of 

 paper (8 1/2” x 11”) and less than the size of a standard interior door (32” x 80”).

= The combined area of damage is greater than the size of a standard interior door 

 (32” x 80”).

Interior door

• Stains could include discoloration caused by possible water leaks, flooding 

or condensation.

2) Visible Mold

Note if you see visible mold growth or suspect mold growth.

• Mold can include patches or spots that are colored differently than the 

 underlying material (typically gray, brown, or black). Mold can appear 

 fuzzy and can have a musty or earthy odor.

3) Wet or Damp

Note any areas of wetness or dampness that are visible.

• Wet or damp conditions could include visible signs of moisture, such

 as water beads or condensation, humidity, water leaks, or flooding.

Water stained ceiling panels.

Mold on a wall.

Wet area on floor and side 

of wall.

 Using the Form
Instructions Dampness and Mold Assessment Tool

Component Notes Assessment Notes

Fill in the bubbles for the 

type of material that is affected.

Fill in the bubbles for additional detail.

Describe if “Other”

Ceiling tile Plaster Concrete

Sheet rock Metal Wood

Peeling paint Rust 

Other: 

Sheet rock Plaster Concrete

Block Brick Tile Wood

Peeling paint Efflorescence 

Other:

12

Damage

or Stains

Check 

if near 

exterior 

wall*

Visible 

Mold

Check 

if near 

exterior 

wall*

Wet or 

Damp

Check 

if near 

exterior 

wall*

See scoring 

below  See scoring below  See scoring below 

   

Score each component by filling in the appropriate assessment score in the Damage or Stains, Visible 

Mold, or Wet and Damp columns. If the affected area is within 3 feet of an exterior wall, place a check () 

in the yellow column after each scoring column.

Example:

7) Component & Assessment Notes

This section collects more information that you observe for each of the room components: 

• "Component Notes" includes information on the material or location affected.

• "Assessment Notes" includes information on common indicators of dampness. 

Fill in the bubble(s) that most accurately apply to your observational assessment.

Example: 



rt corner crumbling

 

 Using the Form

These evaluations are subjective, so you should try to be consistent in the way you observe the 

conditions and then score each assessment.

A score of 3 for Damage or Stains, Visible Mold, or Wet or Damp should trigger immediate attention to 

identify problem sources and to remediate. Likewise, a score of 3 for Mold Odor should trigger 

attention to identify areas of hidden mold. Scores should also be used for comparison of rooms/areas 

over time to see if remediation works or if problems get worse.
Instructions Dampness and Mold Assessment Tool

13

Scoring Example 1

In this assessment, these two stains are the only problem areas identified on this room's ceiling. 

Therefore, combine the size of both stained areas to determine a score. 

Combine both stained 

areas to get one score.

Damage or Stains

The stains on these ceiling tiles are 

very visible. A score for this would be 

a 2 because both stains combined 

are bigger than the size of a standard

sheet of paper but smaller than an 

interior door. 

Both stains are not within 3 feet of an 

exterior wall.

Visible Mold

There does not appear to be any 

mold growth on these two stains 

at this point. The visible mold score 

would be 0. 

Both stains are not within 3 feet of an 

exterior wall.

Wet or Damp

Both areas were formed after a 

recent rain and appear wet. 

Together, they are larger than the 

size of a standard sheet of paper but 

smaller that the size of an interior 

door. This example would have a score 

of 2.

Both stains are not within 3 feet of an 

exterior wall.

 Appendix

 Ceiling   

Damage

or Stains

Visible 

Mold

Wet or 

Damp

Check 

if near 

exterior 

wall*

Check 

if near 

exterior 

wall*

Check 

if near 

exterior 

wall*
Instructions Dampness and Mold Assessment Tool

14

Damage or Stains

The damage to this wall is extensive, 

and the area is larger than the size of 

an interior door. Therefore, the score 

should be a 3. 

This area is within 3 feet of an 

exterior wall.

Visible Mold

The visible mold on this damaged 

wall area is larger than the size of an 

interior door, so the score should be 

a 3.

This area is within 3 feet of an 

exterior wall.

Wet or Damp

The damage to this wall is very 

discolored and likely wet.The size of 

the dampness is larger than an 

interior door, so the score should be 

a 3.

This area is within 3 feet of an 

exterior wall.

Scoring Example 2

Damage in this area is severe and includes two wall sections that meet at the corner. Determine scores 

based on the combined size of this entire area. 

Note this damage in the "General Notes" section of the form for immediate attention.

 Appendix

 Walls     

Damage

or Stains

Visible 

Mold

Wet or 

Damp

Check 

if near 

exterior 

wall*

Check 

if near 

exterior 

wall*

Check 

if near 

exterior 

wall*
Instructions Dampness and Mold Assessment Tool

15

Scoring Example 3

Damage or Stains

This entryway appears extremely 

wet. The size of the sides combined 

are larger than a sheet of paper, but 

smaller than an interior door, so the 

score would be a 2.

This area is within 3 feet of an 

exterior wall.

Visible Mold

The carpet does not seem to have 

any visible mold. The score would be 

a 0.

This area is within 3 feet of an 

exterior wall.

Wet or Damp

As with the Damage and Stains 

score, this extremely wet carpet is 

larger than a sheet of paper, but 

smaller than an interior door, so the 

score would be a 2.

This area is within 3 feet of an 

exterior wall.

This entryway carpet is visibly saturated along the edges. Therefore, combine the size of the wet edges 

for scoring.

 Appendix

 Floor      

Damage

or Stains

Visible 

Mold

Wet or 

Damp

Check 

if near 

exterior 

wall*

Check 

if near 

exterior 

wall*

Check 

if near 

exterior 

wall*
Instructions Dampness and Mold Assessment Tool

Is it a stain or is it mold?

Many times this is difficult to determine. If you are not certain what you see is mold:

1) Score as 0 in the Visible Mold column.

2) Write a note in the General Notes section of the form for further evaluation.

Not sure if mold or something else?

16

Photographs can be useful for documenting conditions. You may consider 

taking a photograph of an area that seems severe and referring to the 

photograph in the General Notes section of the form.

 Special Notes

Pipes   

General Notes

 

 
Questions? Contact NIOSHBreathe@cdc.gov.