Healthy Home Checkup Assessment€¦ · Recommend Repairs: 7006. Repair roofing and flashing as...

Project ID #:

Contact:

Street Address:

Date of Site Visit:

Assessor Report Date

Healthy Home Checkup Assessment

089/2016-0180

Woman, Lucky

secret location

5/7/2016

Memmer, Vickie 5/7/2016

Jackson, Wyoming 83001

Page: 1 of 42Healthy Home Checkup Assessment

What is a Healthy Home?

A “healthy home” supports and protects the health and safety of its occupants, based on the Seven Principles of Healthy Homes:

· Keep It DRY · Keep It SAFE · Keep It CLEAN · Keep It CONTAMINANT-FREE· Keep It PEST-FREE · Keep It MAINTAINED· Keep It VENTILATED

Scientists now understand how our homes can harm our health. Millions of American homes pose health and safety risks, including moisture and ventilation problems; asthma triggers; toxic exposures; and fire, electrical and tripping hazards.

Sometimes poor construction is at fault. More often, inadequate maintenance leads to hazards. Also, some homes pose challenges to occupants’ mobility, safety and independence as they age.

Fortunately, these hazards can be identified, their causes can be determined, and steps can be taken to protect occupants’ health and safety.

Healthy Home Checkup

The Healthy Home Checkup is the most cost-effective way to check for critical health and safety risks that are common in American homes. The Checkup takes an integrated approach that encompasses the structure itself, all of its major systems, and its occupants.

This Report presents the results of your Healthy Home Checkup. In most cases, photographs will highlight the identified problems. The results and recommendations are ranked in five tiers:

X - Extreme Repair Items (RED): hazard/deficiency is extremely dangerous and could immediately result in loss of life. 1 - Critical Repair Items (ORANGE): hazard/deficiency poses serious threat to health and/or safety. 2 - Recommended Repair Items (YELLOW): intended to eliminate or reduce imminent or likely hazard/deficiency, which could impact health and/or safety. 3 - Additional Opportunities to Reduce Risk (BLUE): addressing hazard/deficiency can contribute to increased health and/or safety. 4 - No Visible Hazard/Deficiency Observed (GREEN): no readily observed or detected hazard/deficiency.

Disclaimer

The Healthy Home Checkup has been developed by Healthy Housing Solutions, Inc. to provide the most cost-effective way to check a home for common problems that pose health and safety risks. The Checkup does not constitute a comprehensive health, safety and/or environmental inspection or assessment of your home. The Checkup is based on conditions observed and reported on the date of the assessment and does not predict conditions that may develop in the future. The Checkup identifies deficiencies and hazards that can be observed in readily accessible areas of your home. While this Report lists deficiencies and hazards that may result in health and/or safety risks to occupants, there is no assurance, guarantee, or express or implied warranty that all potential deficiencies and hazards have and/or could have been detected and identified during the assessment. The repair recommendations to address deficiencies and hazards identified in this Report represent general guidance based on generally accepted practices and do not provide detailed work specifications.

The assessor makes no representations regarding latent or concealed defects that may exist in your home and no warranty or guarantee is expressed or implied regarding the health status of current or future occupants. Furthermore, the assessor shall not be liable for any special, direct, indirect, or consequential damages arising out of the Checkup.

Some residential health and safety hazards can be characterized more accurately through a variety of environmental sampling and testing. If the Report identifies potential hazards of concern, you may consider hiring a qualified professional and arranging for a more detailed evaluation of your home. In every case, you should ensure the person conducting that evaluation and interpreting the results is fully qualified.

Low-Cost Repair, typically less than $100

Ongoing maintenance or behavior change

Special benefits to reduce asthma and respiratory problems

A - ApplianceC - CarpentryD - Drywall/PaintingE - ElectricalF - FlooringH - Handyman

M - MasonryP - PlumbingR - Roofing/SidingS - Other SpecialistV - Ventilation/Heating/Cooling (HVAC)N/A - Not Applicable

For each hazard identified, the Report recommends one or more corrective actions. Some recommendations are one-time repairs, while others call for ongoing changes in maintenance practices or occupant behaviors. These icons will help you set priorities to make your home healthier and safer:

The report provides an associated Trade designation for some but not all Recommended Repairs. The following is a listing of the abbreviations used:


Date of Site Visit:089/2016-0180Project ID #: 5/7/2016

Site/Property and General Building Characteristics

Before 1940 1940 - 59 1960 - 77 After 1978

Unknown

Multifamily

CondoTownhomeTriplexDuplexHouse

OtherRuralSuburbanUrban

Approximate Age:

2#of Full Bathrooms:3 # of Bedrooms:

Building Type:

Building Location:

Owner-occupied

Vacant

General Description of the Building:

Occupied

Rental

Current Occupancy:

Ownership Status: Pre-purchase

Age 4 to 10Newborn to age 3

Reported Age Categories of Current Occupants:

Age 11 to 18 Age 19 to 60

Age 61 to 75 Over age 75

Asthma or asthma symptomsAllergies

Reported Health Ailments/Conditions of Current Occupants :

Frequent headaches/migraines

Suppressed immunity

Sinus problems Skin infection/rashHay fever

Other

Other respiratory problems

Outside Weather Conditions:

Description

5% Overcast

Relative Humidity

65ºF

Temperature

< 4 PIC/LResults:

Short Term TestWhat Kind:

Other Environmental Assessment

Mold or other microbial assessment

Lead risk assessment

Lead-based paint inspection

Asbestos inspection

Radon test

Energy audit

Home inspection

Assessments Completed within the Last Year:

WhereElectrical problems

WhereUnusually cold rooms/areas

WhereUnusually hot rooms/areas

WhereFire/smoke damage

WherePests (what kind)

WhereCold spots/draftiness/air leaks

WhereUnusual odors

Crawl SpaceWhereMold/Mildew

master bathroom sink, crawl spaceWhereMoisture/water leaks

Reported Problems Identified in the Home within the Last Year:


Priority X – Extreme Priority

5/7/2016Project ID #: 089/2016-0180 Date of Site Visit:

On the date of the Healthy Home Checkup, no conditions were identified that justify Extreme Repairs.


Priority 1 – Critical Repairs


The following hazards/deficiencies pose serious threats to the health and/or safety of the occupants ofthis home and should be repaired or corrected as soon as possible:

Bedroom (Bedroom 3):

Comments: No Comments

Locations: No Locations

Space heater poses potential fire hazard, including lack of tip-over safety switch3760.

Deficiency / Potential Hazard

Recommend Repairs:

Correct fire safety hazard by removing unsafe space heater (N/A)3765.

Bathroom (Bathroom 1):



No GFCI for receptacle within 6 feet of water9110.


Recommend Repairs:

Have qualified electrician install GFI receptacles or GFCI circuit for all outlets within 6 feet of

water (E)9115.

Family Room:



Frayed electrical cord or extension cord or cabling poses tripping hazard9120.


Recommend Repairs:

Reroute cords or make wiring changes to correct tripping hazard (E)9126.



Creosote buildup (for wood fireplace, gas fireplace, wood burning stove, pellet burning stove, coal burning stove)3720.


Recommend Repairs:

Have a qualified technician repair or correct. (S)3727.



Smoke detector not present on each floor (including basement) and outside each sleeping area3800.

Laundry/Utility Room:



Standing water or moisture around washing machine3400.


Recommend Repairs:

Recommend appliance repair contractor check washer and repair or replace (A)3405.



Dryer exhaust duct does not vent directly outside or does not flow freely3520.


Recommend Repairs:

Install 4-inch rigid metal duct to exhaust outside as directly as possible with cover to keep

out pests (A, C)3525.

Attic (unfinished):


Locations: Ceiling

Active roof leak into living space or attic7000.


Recommend Repairs:

Repair roofing and flashing as needed (R)7006.

Garage (attached):



Electric garage door opener safety sensor is missing or not working9800.


Recommend Repairs:

Repair garage door opener or adjust sensor to engage as designed for safety (H, S)9805.

Carbon Monoxide & Smoke Detectors:





Recommend Repairs:

Install smoke detector on every floor and outside every sleeping area, to meet code

requirements, following manufacturer’s instructions with preference for hard-wired units

(N/A)

3805.

Mechanical:



No GFCI for receptacle within 6 feet of water9110.


Recommend Repairs:

Have qualified electrician install GFI receptacles or GFCI circuit for all outlets within 6 feet of

water (E)9115.

Exterior:



Play equipment components missing, damaged, not well secured, or pose risk of injury1850.


Recommend Repairs:

Repair hazardous playground equipment or remove and dispose of safely (H)1855.


Priority 2 – Recommended Repairs


The following hazards/deficiencies should be repaired to avoid conditions that could affect the healthand/or safety of the occupants within this home:




Supply vent missing, damaged, blocked, or obstructed5000.


Recommend Repairs:

Move furniture or belongings obstructing vent (N/A)5005.



Carpeting worn, musty, or damaged6080.


Recommend Repairs:

Remove carpeting to reduce the risk of moisture problems and pests (F)6085.



Musty or damp odor7100.


Recommend Repairs:

Identify source and correct cause of musty smell, addressing moisture problem and/or poor

air flow and circulation (S)7105.

Consider testing for the presence of mold7124.



Home located in EPA Zone recommended for Radon testing7190.


Recommend Repairs:

Consider testing for the presence and concentration of Radon.7214.





Bathroom exhaust fan has low air flow5110.


Recommend Repairs:

Clean grill if dirty or dusty (N/A)5115.



Wall-to-wall carpeting in bathroom poses risk of moisture and allergens6060.


Recommend Repairs:

Remove carpeting from bathroom to reduce the risk of moisture problems and allergens (F)6065.



Caulking missing, damaged or has broken seal7260.


Recommend Repairs:

Remove damaged caulking and repair (H)7265.

Kitchen:



Grease build-up on range hood or on walls or cabinets5050.


Recommend Repairs:

Increase kitchen ventilation by having qualified contractor install vent hood and fan that

exhausts at least 100 CFM to the outside with a sone rating of 3 or less (A, C)5055.

Always use kitchen exhaust fan when cooking (N/A)5057.



Grout missing7250.


Recommend Repairs:

Remove damaged grout and repair (H, S)7255.





Yellow flame indicates improper combustion3110.

Recommend Repairs:

Recommend qualified appliance contractor repair burner or replace stove/cook top (A)3115.



Garbage disposal is not working or has water leak3250.


Recommend Repairs:

Recommend qualified appliance contractor or plumber repair or replace garbage disposal

(A, P)3255.

Family Room:



Excessive clutter, debris or trash6000.


Recommend Repairs:

Remove and properly dispose of nonessential items and organize belongings in storage

bins (N/A)6005.

Living Room:



Ungrounded outlet9100.


Recommend Repairs:

Have qualified electrician provide ground (E)9105.

Attic (unfinished):


Locations: Ceiling

Attic insulation with vapor barrier to cold side5200.


Recommend Repairs:


Reinstall/replace attic insulation using insulation of R-value recommended for climate (H)5205.


Locations: Ceiling

Suspect mold or mildew7150.


Recommend Repairs:

Consider testing for the presence of mold7174.


Locations: Ceiling

Lighting is missing, damaged, or inadequate9150.


Recommend Repairs:

Change burned out light bulbs (N/A)9155.

Crawlspace:



Standing water, moisture or mold in crawlspace7030.


Recommend Repairs:

Have qualified crawlspace contractor evaluate and take steps as needed to correct moisture

problem (S)7035.



Sump pump does not activate when float is raised7300.


Recommend Repairs:

Recommend qualified contractor repair or replace sump pump (P)7305.

Garage (attached):



Gaps/cracks/holes allow air flow between attached garage and living space5400.


Recommend Repairs:


Seal openings to prevent airflow between garage and conditioned space (H)5405.



Signs of pests6300.


Recommend Repairs:

Seal unvented/conditioned crawlspace to keep out pests/animals (S, H)6308.



Open or unguarded chemical containers8020.


Recommend Repairs:

Remove open or unguarded chemical containers and dispose of safely (N/A)8025.

Mechanical:



Furnace filter is missing, improperly sized, or dirty2160.


Recommend Repairs:

Install properly sized filter, at least MERV 8 (N/A)2165.



Water temperature at tap exceeds 120°F9400.


Recommend Repairs:

Adjust hot water heater temperature to 110-130 F (H, P)9405.



Electrical panel box cover missing, openings in the box2510.


Recommend Repairs:

Recommend qualified electrical contractor correct hazards in electric panel (E)2515.



Pool chemicals are not stored or contained4810.



Lighting is missing, damaged, or inadequate9150.

Recommend Repairs:

Change burned out light bulbs (N/A)9155.

Exterior:



Top of chimney less than 3 feet above penetration through roof or less than 2 feet higher than the roof line

within 10 feet1170.


Recommend Repairs:

Recommend assessment by qualified contractor based on local code requirements for

chimney height (M)1175.



Ground slopes toward foundation1250.


Recommend Repairs:

Grade yard as needed to divert water away from the foundation (S)1256.



Exterior door has visible air leaks1520.


Recommend Repairs:

Install weather-stripping (H)1525.



Baluster damaged, missing or spacing >4 inches9040.


Recommend Repairs:

Repair balusters to meet applicable code requirements (C)9045.





Recommend Repairs:

Store pool chemicals in safe and secure location (N/A)4815.


Priority 3 – Opportunities for a Healthier Home


The following hazard/deficiency repairs, maintenance practices, and/or "behavior changes" could bemade in order to improve the health and/safety of the occupants within this home:




Signs of frequent use of candles or incense8001.


Recommend Repairs:

Avoid frequent use of candles or incense due to particulates and chemical exposure (N/A)8006.

Kitchen:



Icemaker has plastic supply line3310.


Recommend Repairs:

Replace plastic supply line for icemaker with copper or braided steel supply line to reduce

risk of plumbing leak (A, P)3315.

Attic (unfinished):


Locations: Ceiling

Gaps/cracks/holes around hatch or stairs to attic5250.


Recommend Repairs:

Weather-strip or air seal to prevent airflow from conditioned space into the attic (H)5255.

Garage (attached):



Signs of pests6300.


Recommend Repairs:


For future pest control, use gels, baits, and traps, and boric acid in crevices, instead of

insecticide sprays (N/A)6307.

Mechanical:



Furnace filter is missing, improperly sized, or dirty2160.


Recommend Repairs:

If unit is more than 10 years old, consider replacing with an Energy Star-rated unit (V)2168.

Exterior:



Exterior doorway lacks interior doormat to reduce dust track-in1540.


Recommend Repairs:

Install doormat with level loop woven nylon pile with non-slip rubber backing to reduce

track-in (N/A)1545.


Date of Site Visit:089/2016-0180Project ID #: 5/7/2016

Priority 4 - N0 Visible Hazard/Deficiency Observed

Room/Area Misc CommentRoom/Area Photo

No Comments

Bedroom 1

No Comments

Bedroom 2

No Comments

Bedroom 4

No Comments

Bathroom 2

No Comments

Dining Room

No Comments

Study/Office


No Comments

Powder Room/Half Bath

No Comments

Stairs – Interior

No Comments

Hallway/Foyer

No Comments

Enclosed Porch

No Comments

Basement (unfinished)


General Recommendations for Keeping Every HomeHealthy and Safe:

1. Do not allow smoking in the home.

2. Use “green” cleaning supplies, such as distilled vinegar, baking powder, Simple Green or Murphy’s Oil Soap.

3. Avoid frequent use of candles, air fresheners, and chemical sprays.

4. Use a doormat with dense level-loop woven nylon pile with non-slip rubber backing, and vacuum/clean it monthly

to reduce tracking in dirt and dust.

5. Vacuum frequently with a HEPA vacuum to remove small dust particles.

6. Keep humidity in the desired range of 30-50%, using a dehumidifier as needed.

7. Avoid using a humidifier, except in arid climates.

8. For forced air furnace and/or air conditioning systems, change filters every 2-3 months, and use at least a MERV 8

filter.

9. When cooking, use an exhaust fan to exhaust moisture and fumes to the exterior of the home.

10. When showering, use a bath exhaust fan for 20-30 minutes to exhaust moisture to the exterior of the home.

11. Install and then check smoke detectors and carbon monoxide detectors twice a year, and change batteries as

needed.

12. Store food in closed containers to protect against pests.

13. Avoid using pesticide sprays and bombs, particularly indoors; instead, use gels, baits, and traps, and boric acid in

crevices to control and eliminate pests.

14. Do a visual check for water leaks and moisture problems twice a year, and have repairs or service performed by a

professional as needed.

15. Keep at least one 10 pound fire extinguisher handy, particularly in the kitchen, and have a family fire evacuation

plan.

16. Perform annual checkups on the furnace, water heater, and fireplace/chimney, and have repairs or service

performed by a professional as needed.

17. Clean the lint trap of your closths dryer after every use and make sure the dryer is vented to the outside with no

obstructed airflow.


Additional Recommendations if a Young Child Lives inYour Home:

nstall window guards for upper story windows.5.

Modify cords of curtains, drapes, and blinds to correct choking hazards.4.

Use child-proof locking gates at the top and bottom of stairs.3.

Install child-proof locks on cabinet doors.2.

Install plastic covers on electrical receptacles.1.

Do not use an ozone-generating unit.10.

Use a HEPA air filter unit in the bedroom.9.

Limit the amount of upholstered furniture and window coverings in the bedroom.8.

Dust frequently using wipes that pick up dust more efficiently, such as Grab-It or Swiffer.7.

Limit the number of stuffed toys in child’s bed and wash them weekly and dry in a hot dryer for at least 30

minutes to kill dust mites.6.

Wash bedclothes weekly and dry in a hot dryer for at least 30 minutes to kill dust mites.5.

Use an allergen proof mattress cover and pillow covers to reduce dust mite exposures.4.

Keep pets out of the bedroom to reduce allergens.3.

Wash pets and their bedding frequently to reduce allergens.2.

Remove carpeting from the bedroom of occupant with asthma and dust bedroom floor frequently.1.

Additional Recommendations if an Occupant of YourHome has Asthma or Allergies:


Appendix A - Full Listing

Project ID #: Date of Site Visit:089/2016-0180 5/7/2016

No Visible Issues Observed4

Additional Opportunity to Reduce Risk3

Recommended Repair2

Priority Repair1

Extreme PriorityX

Reduced Asthma RiskA

Maintenance/Behavior ChangeM

Low Cost RepairL


Locations; CommentsTagsPrioritiesAir Flow and Circulation

No Locations; No CommentsAML2Supply vent missing, damaged,

blocked, or obstructed5000.

No Locations; No Comments4Return vent missing, damaged,


Locations; CommentsTagsPrioritiesAllergens and Dust

No Locations; No Comments4Excessive clutter, debris or trash6000.

No Locations; No CommentsA2Carpeting worn, musty, or damaged6080.

No Locations; No Comments4Gaps/cracks/holes in ceiling, floor

or walls6200.

No Locations; No Comments4Signs of pests6300.

Locations; CommentsTagsPrioritiesMoisture

No Locations; No Comments4

Standing water, visible moisture,

water staining or high humidity

indoors

7010.

No Locations; No Comments4Signs of plumbing system leak7020.

No Locations; No Comments2Musty or damp odor7100.

No Locations; No Comments4Suspect mold or mildew7150.

Locations; CommentsTagsPrioritiesChemical Exposure

No Locations; No Comments4Tobacco smoke/odor8000.

No Locations; No CommentsAML3Signs of frequent use of candles or

incense8001.

No Locations; No Comments4Chemical odor, sewer gas, or other

strong odor8010.

No Locations; No Comments4Paint is peeling, damaged, or

deteriorated8030.

Locations; CommentsTagsPrioritiesSafety and Accessibility

No Locations; No Comments4Carpeting worn, musty, or damaged6080.

No Locations; No Comments4Slip/trip/fall hazard9000.

No Locations; No Comments4Flooring/subflooring is damaged9070.

No Locations; No Comments4Window or room fan has no safety

cover9090.

No Locations; No Comments4Ungrounded outlet9100.


Frayed electrical cord or extension

cord or cabling poses tripping

hazard

9120.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL

No Locations; No Comments4Apparent structural damage or

structural problem9850.

No Locations; No Comments4No emergency egress where

required9900.

No Locations; No Comments2Home located in EPA Zone

recommended for Radon testing7190.

Locations; CommentsTagsPrioritiesSpace Heater


Unvented fuel-burning space

heater poses risks of carbon

monoxide

3750.

No Locations; No CommentsL1

Space heater poses potential fire

hazard, including lack of tip-over

safety switch

3760.




hazard

9120.

No Locations; No Comments4Elevated carbon monoxide level

detected-Above 100ppm9500.

No Locations; No Comments4Elevated carbon monoxide levels

detected9600.


Gasoline or other petroleum

products not stored in secure

container

9700.

Locations; CommentsTagsPrioritiesWindow Air Conditioner

No Locations; No Comments4Signs of water leak related to

window air conditioner3600.


Signs of water infiltration or visible

air leaks around window air

conditioner

3610.




hazard

9120.



No Locations; No Comments4Supply vent missing, damaged,


No Locations; No Comments4Lack of exhaust fan in bathroom5100.

No Locations; No CommentsML2Bathroom exhaust fan has low air

flow5110.


Bathroom exhaust fan not vented

to outside poses potential moisture

problem

5120.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL



No Locations; No CommentsA2Wall-to-wall carpeting in bathroom

poses risk of moisture and allergens6060.

No Locations; No Comments4Gaps or cracks around perimeter of

cabinets and/or countertops6100.


or walls6200.






indoors

7010.




No Locations; No Comments4Toilet not firmly secured to floor or

tank not firmly secured to bowl7200.

No Locations; No Comments4Floor tile missing, loose or

damaged7220.

No Locations; No Comments4Wall tile missing, loose or damaged7230.

No Locations; No Comments4Grout missing7250.

No Locations; No Comments2Caulking missing, damaged or has

broken seal7260.



No Locations; No Comments4Signs of frequent use of candles or

incense8001.


strong odor8010.

No Locations; No Comments4Open or unguarded chemical

containers8020.


deteriorated8030.



No Locations; No Comments4Occupant at risk of falling4300.



No Locations; No Comments1No GFCI for receptacle within 6 feet

of water9110.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL




hazard

9120.

No Locations; No Comments4Lighting is missing, damaged, or

inadequate9150.

No Locations; No Comments4Water temperature at tap exceeds

120°F9400.







monoxide

3750.




safety switch

3760.

Kitchen:






No Locations; No CommentsAML2Grease build-up on range hood or

on walls or cabinets5050.




Wall-to-wall carpeting in kitchen

poses risk of moisture, allergens,

and pests

6050.

No Locations; No Comments4Gaps or cracks around perimeter of

cabinets and/or countertops6100.


or walls6200.






indoors

7010.







Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL



No Locations; No Comments4Floor tile missing, loose or

damaged7220.

No Locations; No Comments4Wall tile missing, loose or damaged7230.

No Locations; No Comments2Grout missing7250.

No Locations; No Comments4Caulking missing, damaged or has

broken seal7260.




incense8001.


strong odor8010.


containers8020.


deteriorated8030.

No Locations; No Comments4Any spray pesticide container

indicates risk of chemical exposure8100.






of water9110.




hazard

9120.


inadequate9150.

No Locations; No Comments4Class ABC fire extinguisher not

present or expired9300.

No Locations; No Comments4Water temperature at tap exceeds

120°F9400.



Locations; CommentsTagsPrioritiesDishwasher/Garbage Disposal

No Locations; No Comments4Signs of dishwasher leaking3200.

No Locations; No Comments4Dishwasher lacks backflow

prevention3210.

No Locations; No Comments2Garbage disposal is not working or

has water leak3250.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL




hazard

9120.

No Locations; No Comments4Exposed electric wire, wire splice, or

junction box9130.

Locations; CommentsTagsPrioritiesRefrigerator/Freezer

No Locations; No Comments4Signs of water leak/moisture

problem around refrigerator3300.

No Locations; No CommentsA3Icemaker has plastic supply line3310.




hazard

9120.

Locations; CommentsTagsPrioritiesStove/Vent Hood

No Locations; No Comments4Stove lacks anti-tipping bracket3100.

No Locations; No Comments4Burners or oven not functioning3101.

No Locations; No CommentsA2Yellow flame indicates improper

combustion3110.

No Locations; No Comments4Vent hood re-circulates air instead

of exhausting outside3120.

No Locations; No Comments4Exhaust fan fails to exhaust outside

with adequate air flow3130.




hazard

9120.

No Locations; No Comments4Noticeable smell of natural gas9450.




detected9600.

Locations; CommentsTagsPrioritiesAlternate Heating

No Locations; No Comments4Wood Fireplace101.

No Locations; No Comments4Gas Fireplace102.

No Locations; No Comments4Wood Burning Stove102.

No Locations; No Comments4Pellet Burning Stove104.

No Locations; No Comments4Coal Burning Stove105.


Fire hazard (for wood fireplace, gas

fireplace, wood burning stove,

pellet burning stove, coal burning

stove)

3700.


Flue will not open or close (for

wood fireplace, gas fireplace, wood

burning stove, pellet burning stove,

coal burning stove)

3710.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL


Creosote buildup (for wood

fireplace, gas fireplace, wood


coal burning stove)

3720.


Carbon monoxide detected (for



coal burning stove)

3730.


Too close to combustible materials

(for wood fireplace, gas fireplace,

wood burning stove, pellet burning

stove, coal burning stove)

3740.





monoxide

3750.




safety switch

3760.

Family Room:







No Locations; No CommentsML2Excessive clutter, debris or trash6000.



or walls6200.






indoors

7010.









Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL




incense8001.


strong odor8010.


deteriorated8030.






cover9090.


No Locations; No CommentsAL1



hazard

9120.









monoxide

3750.




safety switch

3760.




hazard

9120.




detected9600.




container

9700.









Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL




conditioner

3610.




hazard

9120.











stove)

3700.





coal burning stove)

3710.





coal burning stove)

3720.





coal burning stove)

3730.






3740.

Living Room:














Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL


or walls6200.






indoors

7010.







incense8001.


strong odor8010.


deteriorated8030.






cover9090.





hazard

9120.









monoxide

3750.




safety switch

3760.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL




hazard

9120.




detected9600.




container

9700.







conditioner

3610.




hazard

9120.











stove)

3700.





coal burning stove)

3710.





coal burning stove)

3720.





coal burning stove)

3730.






3740.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL

Laundry/Utility Room:






Locations; CommentsTagsPrioritiesDryer

No Locations; No Comments4Lint/dust buildup around dryer3500.


Dryer exhaust duct is not solid

metal, posing risk of lint blockage

and fire

3510.

No Locations; No CommentsA1

Dryer exhaust duct does not vent

directly outside or does not flow

freely

3520.

No Locations; No Comments4Dryer exhaust components are

missing, damaged, or blocked3530.




hazard

9120.





detected9600.

Locations; CommentsTagsPrioritiesWashing Machine

No Locations; No CommentsA1Standing water or moisture around

washing machine3400.




hazard

9120.

Attic (unfinished):


No Locations; No Comments4No visible attic ventilation1160.

Ceiling; No Comments2Attic insulation with vapor barrier

to cold side5200.

Ceiling; No CommentsL3Gaps/cracks/holes around hatch or

stairs to attic5250.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL




Ceiling; No Comments1Active roof leak into living space or

attic7000.



Ceiling; No CommentsAML2Suspect mold or mildew7150.



strong odor8010.


containers8020.

No Locations; No Comments4Suspect hazardous insulation

materials8040.



No Locations; No Comments4Step/stair risers inconsistent height

(>3/8 inch difference) or >7 inches9020.



cover9090.





hazard

9120.


junction box9130.

Ceiling; No CommentsL2Lighting is missing, damaged, or

inadequate9150.



Crawlspace:


No Locations; No Comments4Vented crawlspace has vents

obstructed or not functioning5300.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL


Unvented or conditioned

crawlspace has visible air leaks

allowing outside air to enter

crawlspace

5312.


Conditioned crawlspace is missing

insulation on foundation walls or

insulation is damaged

5320.


Gaps/cracks/holes allow air to flow

from crawlspace into basement or

conditioned interior space

5330.


Any exhaust fan or dryer vented

into crawlspace poises moisture

problem

5340.








indoors

7010.


No Locations; No Comments2Standing water, moisture or mold in

crawlspace7030.


Insulation in crawlspace hanging

from floor above suggests moisture

problem

7040.



No Locations; No Comments2Sump pump does not activate

when float is raised7300.

No Locations; No Comments4Cardboard boxes or cloth

belongings stored on concrete floor7400.



strong odor8010.


containers8020.





hazard

9120.







Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL




container

9700.



Garage (attached):



Gaps/cracks/holes allow air flow

between attached garage and living

space

5400.



No Locations; No Comments4Wall-to-wall carpeting on concrete

poses risk of moisture problems6070.


or walls6200.

No Locations; No CommentsAM32Signs of pests6300.





indoors

7010.




No Locations; No Comments4Cardboard boxes or cloth

belongings stored on concrete floor7400.




strong odor8010.

No Locations; No CommentsML2Open or unguarded chemical

containers8020.


deteriorated8030.

No Locations; No Comments4Any spray pesticide container

indicates risk of chemical exposure8100.







Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL


No Locations; No Comments4Outdoor electric receptacle is not

GFCI or lacks weather-tight cover9080.





hazard

9120.


junction box9130.


inadequate9150.




container

9700.

No Locations; No Comments1Electric garage door opener safety

sensor is missing or not working9800.



Carbon Monoxide & Smoke Detectors:

Locations; CommentsTagsPrioritiesCarbon Monoxide Detector


Carbon monoxide alarm not

present on each floor and near

each bedroom

3900.

No Locations; No Comments4Carbon monoxide alarm fails test

button check3910.

Locations; CommentsTagsPrioritiesSmoke Detector


Smoke detector not present on

each floor (including basement)

and outside each sleeping area

3800.

No Locations; No Comments4Smoke detector fails to respond to

reset button3810.

Mechanical:

Locations; CommentsTagsPrioritiesHeating System

No Locations; No Comments4Suspect hazardous material on

furnace, boiler, or heating pipes2090.


Furnace exhaust not properly

attached or sealed to chimney/flue

pipe

2100.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL


Furnace is more than 20 years old

or shows signs of operating

problems

2110.

No Locations; No Comments4Accessible HVAC ducts have visible

gaps or leaks2130.

No Locations; No CommentsAML32Furnace filter is missing, improperly

sized, or dirty2160.


Furnace filter location is open and

drawing air from unconditioned

space

2170.

No Locations; No Comments4Signs of fuel oil leak2180.


Use of whole house humidifier or

evaporative (swamp) cooler poses

potential moisture problems

2190.





detected9600.

Locations; CommentsTagsPrioritiesCentral Air Conditioning

No Locations; No Comments4Condensate line does not empty

into drain fixture2210.

No Locations; No Comments4Standing water or signs of moisture

around air handler2200.


A/C condenser/heat pump

compressor is more than 10 years

old or shows signs of physical

damage

2220.

Locations; CommentsTagsPrioritiesWater Heater

No Locations; No Comments4Signs of fuel oil leak2180.

No Locations; No Comments4Standing water or signs of moisture

around water heater2300.


Water heater Temperature and

Pressure Relief valve/down pipe

missing or damaged

2310.


Water heater exhaust gas vent not

properly attached or sealed to

chimney/flue pipe

2330.


Water heater is more than 10 years

old or shows signs of operating

problems

2350.

No Locations; No CommentsAL2Water temperature at tap exceeds

120°F9400.









Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL


detected9600.

Locations; CommentsTagsPrioritiesMain Plumbing, Gas and Waste Lines

No Locations; No Comments4Main water shutoff is inaccessible

or not labeled2400.

No Locations; No Comments4Gas main shutoff is inaccessible or

not labeled2410.




indoors

7010.


No Locations; No Comments4Signs of gas line or main leak2420.

Locations; CommentsTagsPrioritiesElectrical System


Electrical service drop line damaged

or meter not properly anchored to

building

2500.

No Locations; No Comments2Electrical panel box cover missing,

openings in the box2510.

No Locations; No Comments4Knob and tube wiring is covered by

insulation or other material2540.



of water9110.




hazard

9120.


junction box9130.

No Locations; No CommentsL2Lighting is missing, damaged, or

inadequate9150.

Exterior:

Locations; CommentsTagsPrioritiesRoof/Chimney

No Locations; No Comments4Active roof leak into living space or

attic7000.

No Locations; No Comments4Roofing material missing or

damaged1100.

No Locations; No Comments4Drip edge missing or damaged1110.

No Locations; No Comments4Flashing missing or damaged1120.

No Locations; No Comments4Chimney damaged or chimney cap

missing or damaged1150.

No Locations; No Comments4No visible attic ventilation1160.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL


Top of chimney less than 3 feet

above penetration through roof or

less than 2 feet higher than the roof

line within 10 feet

1170.



Locations; CommentsTagsPrioritiesGutter/Downspouts

No Locations; No Comments4Gutter blocked with leaves or debris1200.

No Locations; No Comments4Gutter/downspout components are

missing, damaged, or leaking1210.

No Locations; No Comments4Downspout discharges water next

to foundation1230.


deteriorated8030.

Locations; CommentsTagsPrioritiesFoundation/Grading

No Locations; No Comments4Signs of standing water or erosion

next to foundation1240.

No Locations; No Comments2Ground slopes toward foundation1250.

No Locations; No Comments4Foundation components/materials

are missing or damaged1300.

No Locations; No Comments4Gaps/cracks/holes in foundation1310.


deteriorated8030.



Locations; CommentsTagsPrioritiesSiding/Trim

No Locations; No Comments4Gaps/cracks/holes in exterior

siding/trim1320.

No Locations; No Comments4Siding or trim missing or damaged1330.

No Locations; No Comments4Suspect hazardous materials in

siding or trim1340.


deteriorated8030.

Locations; CommentsTagsPrioritiesDoors/Windows


Exterior door does not

open/close/lock properly, or

components are missing or

damaged

1500.

No Locations; No CommentsL2Exterior door has visible air leaks1520.

No Locations; No Comments4Caulking around door frame/trim







Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL

No Locations; No CommentsAL3Exterior doorway lacks interior

doormat to reduce dust track-in1540.

No Locations; No Comments4Caulking/flashing around window

frame/trim is missing or damaged1550.

No Locations; No Comments4Broken glass or other visible

window problems1560.


deteriorated8030.

Locations; CommentsTagsPrioritiesDriveways/Steps/Decks/Porches/Patios

No Locations; No Comments4Steps/porch/deck components


No Locations; No Comments4Driveway/walkway/patio is

damaged1610.

No Locations; No Comments4House numbers not visible from

street1620.

No Locations; No Comments4Grilling or smoking equipment

poses potential fire hazard1800.


deteriorated8030.


No Locations; No Comments4Step/stair risers inconsistent height

(>3/8 inch difference) or >7 inches9020.

No Locations; No Comments2Baluster damaged, missing or

spacing >4 inches9040.



inadequate9150.



Locations; CommentsTagsPrioritiesElectric/Plumbing

No Locations; No Comments4Hose bib/faucet leaking or lacks

backflow prevention1730.

No Locations; No Comments4Signs of septic system seepage to

surface1740.

No Locations; No Comments4Outdoor electric receptacle is not

GFCI or lacks weather-tight cover9080.



of water9110.




hazard

9120.


junction box9130.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL


Radon mitigation system motor

and ducting not functioning

properly

2600.

Locations; CommentsTagsPrioritiesYard/Landscaping/Walkways/Driveways

/Steps/Decks.

No Locations; No Comments4Grilling or smoking equipment

poses potential fire hazard1800.

No Locations; No Comments4Materials, debris, vegetation offers

harborage to pests1810.


Bushes/ivy/trees encroach on home

posing potential risk of moisture

and pests

1820.


Dead or rotting tree/limb poses

potential risk of injury or damage to

home

1830.

No Locations; No Comments4Garbage/trash/recycling not stored

or contained1840.

Locations; CommentsTagsPrioritiesFence/Gate/Play Equipment


Play equipment components

missing, damaged, not well

secured, or pose risk of injury

1850.

No Locations; No Comments4Fence components missing,

damaged, or fail to operate1880.

No Locations; No Comments4Well is uncapped or improperly

capped1890.


deteriorated8030.




container

9700.

Locations; CommentsTagsPrioritiesPool/Hot Tub/Spa

No Locations; No Comments4Pool or spa pipes and fitting are

leaking4800.

No Locations; No CommentsML2Pool chemicals are not stored or

contained4810.

No Locations; No Comments4Pool not guarded by fence4820.

No Locations; No Comments4Pool gate(s) not self-closing with

self-latching childproof latch4830.

No Locations; No Comments4Pool main drain grate appears to be

missing or not secure4840.

No Locations; No Comments4Electrical wiring passes directly

overhead pool or spa4850.


Pool water height is insufficient to

provide continuous overflow

through gutters and skimmer

4880.






Recommended Repair2

Priority Repair1

Extreme PriorityX



Low Cost RepairL

No Locations; No Comments4Pool water is discolored or suspect

algae growth is present4890.

No Locations; No Comments4Hot tub/spa is uncovered when not

in use4910.

No Locations; No Comments4Electrical receptacle within 20 feet

of pool/spa is not GFCI4860.

No Locations; No Comments4Electrical receptacle (even if GFCI) is

within 10 feet of pool4870.


Healthy Home Checkup Assessment€¦ · Recommend Repairs: 7006. Repair roofing and flashing as...

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Transcript of Healthy Home Checkup Assessment€¦ · Recommend Repairs: 7006. Repair roofing and flashing as...