Checklist 1 Put a check mark when risk/hazard is found

Some areas in the home have visible fire hazards

Hoarding of excrement and/or urine

Bathroom has no running water

Bathroom is unusable and unsanitary

Emergency personnel will be unable to enter the house quickly due to hoard

Windows cannot be opened from the inside

Doors cannot be opened or can barely be opened

Stairs are unsafe to use

Living room floor has clutter

Bedroom floor has clutter

Dining room floor has clutter

Materials are piled high from floor to ceiling

There are piles of heavy materials

There are unstable piles of materials that can shatter or break (e.g. glass)

There are sharp items mixed with the floor clutter or piles

Electrical wiring is unsafe

There are no smoke alarms

Smoke alarms are present but are defective

An area or several areas inside the home have pooled water

Structural damage is present

Stairways are physically damaged and are not usable

Rotting food is present

Insect infestation found

Rodent infestation found

Dead animals are found mixed with the clutter

There is presence of animal waste inside the house

There is presence of fluids such as blood and vomit

Some parts of the home are structurally compromised due to molds and other fungus

Running water is not present in other parts of the home

Electricity has been shut off