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XXX DO NOT USE Annual Unit Inspections, HQS Pre-inspection

Check where a deficiency is noted Mark "all is well" where no deficiencies are present Mark "N/A" where rooms don't exist
YWCA SEATTLE
03/14/2023

XXX DO NOT USE Annual Unit Inspections, HQS Pre-inspection

Check where a deficiency is noted Mark "all is well" where no deficiencies are present Mark "N/A" where rooms don't exist

    IF NOT ABLE TO ENTER (AUTOMATIC FAIL)

    • Pass
    • Flag
    • Fail
    if the answer is "oneOf [FAIL,FLAG]"

    NO ENTRY ALLOWED EXPLANATION

    KITCHEN

    if the answer is "oneOf [OTHER]"

    NOTES FOR KITCHEN OTHER

    LIVING ROOM

    LIVING ROOM NOTES

    BATHROOM 1

    BATHROOM 1 NOTES

    BATHROOM 2

    BATHROOM 2 NOTES

    BEDROOM 1

    BEDROOM 1 NOTES

    BEDROOM 2

    BEDROOM 2 NOTES

    BEDROOM 3

    BEDROOM 3 NOTES

    BEDROOM 4

    BEDROOM 4 NOTES

    GENERAL UNIT CONDITIONS (FAIL)

    GENERAL UNIT CONDITIONS (FLAG)

    NOTES/COMMENTS

    Evidence of Unauthorized Occupant(s) (FLAG)

    • Yes
    • No
    • N / A
    if the answer is "oneOf [Yes]"

    WHAT IS THE EVIDENCE?

    Evidence of pet(s) in Unit? (FLAG)

    • Yes
    • No
    • N / A
    if the answer is "oneOf [Yes]"

    DESCRIPTION AND NAMES OF PETS ALL INFO

    OVERALL STATUS? PASS OR FAIL (FLAG)

    • Pass
    • Flag
    • Fail

    INSPECTOR SIGNATURE

    Click here to sign

    Date Signed

Source: YWCA SEATTLE (Community Member)

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