2010 

This project is supported by Grant No. 2007-FW-AX-K008 
awarded by the Office on Violence Against Women, 
ÒEducation, Training, and Enhanced Services to End 
Violence Against and Abuse of Women with Disabilities 
Grant ProgramÓ, U. S. Department of Justice. The opinions, 
findings, conclusions and recommendations expressed in 
this publication are those of the authors (the H.O.P.E. 
Collaborative) and do not necessarily reflect the views of 
the Department of Justice, Office on Violence against 
Women. 

H.O.P.E. Collaborative 
Haywood County North Carolina 

 

 

 

 

 

 

 

 

 ACCESSIBILITY AND 

 SAFETY AUDIT TOOL 

 

 

 

 mountain good.jpg


 

 


 


 

 

 

 

 

 

This project was supported by Grant No. 2007-FW-AX-K008 awarded by the Office on Violence 
against Women, United States Department of Justice. The opinions, findings, conclusions, and 
recommendations of the authors do not necessarily reflect the views of the Office on Violence 
against Women or the U. S. Department of Justice. 

 

 

 


 

H.O.P.E. Collaborative 

Accessibility and Safety Audit 

 

The following document provides an overview of the systems change work of the H.O.P.E. 
Collaborative of Haywood County, North Carolina as we strive to improve services for survivors 
with disabilities in our area. The primary purpose of the document is to provide background on 
the initiative and to create the framework for conducting accessibility and safety audits for 
agencies working with survivors with disabilities. The framework includes the process for 
scheduling and conducting the audit, the tool that will be utilized to conduct the audit, how we 
will report the findings and the action planning documents that will be utilized to achieve the 
short and long term objectives identified from the audit. 

 

Introduction to the Collaborative 

 

The H.O.P.E. Collaborative of Haywood County, a three year project funded in October 2007 by 
the Department of Justice, Office on Violence against WomenÕs Education, Training, and 
Enhanced Services to End Violence Against and Abuse of Women with Disabilities Grant, is 
located in the Appalachian Mountains of Western North Carolina. It is a Collaborative group of 
six agencies joining together to improve the way that we respond, both as individual 
organizations and as an inter-connected system, to survivors with disabilities and Deaf persons 
who experience violence and abuse in our county. The acronym ÒH.O.P.E.Ó means ÒHelping Our 
People EmergeÉ.from crisis to healing,Ó reflecting our community and our sense of shared 
responsibility. 

 

The H.O.P.E. Collaborative brings together six agencies, and an experienced consultant with a 
background in statewide adult protective services. Five of these organizations directly serve 
persons with disabilities and survivors of violence and abuse. They have pledged to be sites of 
change, working together to remove barriers to services and supports for survivors with 
disabilities and Deaf persons experiencing violence or abuse and promoting universal 
accessibility. The sixth agency is the convening agency. Specifically, these agencies are: 

 

¥ 
REACH of Haywood County, the local domestic violence-sexual assault agency, which 
assists victims and survivors of domestic violence, sexual assault, stalking and rape; 


 

 reachlogo.jpg


 

 

 


 

¥ 
Haywood Vocational Opportunities, a non-profit organization providing work force 
training and employment for persons with disabilities; 


 

 HVO complete logo.jpg
HVO.jpg


 

¥ 
The Arc of Haywood County, offering group homes, transitional and independent living 
apartments for persons with developmental disabilities in Haywood County; 


 

Arc new logo 


 

 

 

 

 

¥ 
The Haywood County Department of Social Services, which receives and evaluates 
reports concerning adults with disabilities alleged to be abused, neglected or exploited; 


 

 Haywood County DSS logo.gif


¥ 
Smoky Mountain Center, a Local Mental Health Management Entity of the North 
Carolina Department of Health and Human Services, Division of Mental Health, 
Developmental Disability and Substance Abuse Services. The agency manages a provider 
network for mental health, developmental disability and substance abuse services. 


 

 Smoky Mountain Center logo.jpg


 

The sixth agency in the Collaborative is the Thirtieth Judicial District Domestic Violence-Sexual 
Assault Alliance, a nonprofit, regional coalition based in Haywood County that provides 
education, outreach, and community capacity building to improve the response to victims and 


survivors of domestic violence, sexual assault, stalking and elder abuse. The Alliance acts as the 
convening agency of the H.O.P.E. Collaborative. 

 

 30th JD Alliance logo.jpg


 

 

 

The Vision for the H.O.P.E. Collaborative 

 

Organizations in Haywood County take collective responsibility to provide a seamless system of 
quality, inclusive, and responsive services that empower survivors with disabilities and Deaf 
persons who experience violence and abuse to move from crisis to healing. 

 

The Mission of the H.O.P.E. Collaborative 

 

The H.O.P.E. Collaborative will remove barriers to services and supports for survivors with 
disabilities and Deaf persons who experience violence and abuse by fostering agency 
collaboration, creating a collective response, and changing organizational policies and 
procedures, which will be fully integrated into the culture of our agencies. 

Affects of violence on women with disabilities 

Types of violence experienced by survivors with disabilities may include: physical violence; 
sexual assault; emotional/psychological abuse; financial exploitation and identity theft; 
destroying adaptive and/or communication equipment; forced restraint and seclusion; refusing 
or neglecting to attend to an important personal need such as using the bathroom, eating or 
drinking; refusing to give the correct amount of medication; or threatening to do any of these 
above behaviors. These behaviors are violence and abuse tactics for maintaining control of the 
individual. 

 

All women are at risk of experiencing domestic violence, sexual assault and stalking. However, 
women with disabilities are also at increased risk for disability-targeted abuse, and they may 
experience this abuse over a longer period of time at the hands of multiple perpetrators, 
including paid personal care attendants, partners, spouses, family members, healthcare staff 
and staff who work as care givers within publicly-funded services organizations. 

There are many reasons why women may not talk about the violence they are experiencing. It 
may be because they do not want to be seen as vulnerable; they fear not being believed if they 
do tell someone, or they may believe that nothing can or will be done about the violence. By 
developing a responsive system where women with disabilities feel safe in disclosing violence 


and abuse and where they are comfortable requesting the accommodations they need, we will 
provide the supports for them as they break free of the violence and abuse. 

 

Accessibility and Safety Audit Plan 

 

In order to achieve our mission of removing barriers to services and supports for survivors with 
disabilities and Deaf survivors of violence and abuse, it will be necessary to assess each of our 
organizations for their individual degree of accessibility and safety. In our needs assessment 
that was conducted during the winter of 2008-2009 we found that staff and persons receiving 
services in agencies that serve individuals with disabilities had concerns about the accessibility 
as well as the safety of some of our collaborative agencies. For this reason, we will utilize the 
same tool for all of the agencies in an attempt to ensure uniform accessibility and safe 
environments. 

 

The audit team, consisting of disability service staff, domestic violence program staff, 
individuals with disabilities and survivors will conduct each assessment. The audit team will be 
led by one of the two project directors or the team leader for the accessibility and safety group. 
All team members will receive Òaccessibility and safety audit trainingÓ prior to beginning their 
work. 

 

The process for conducting each audit will be: 

 

1. The agency CEO/Executive Director will be contacted via letter to explain the process 
(see attachment B) if the CEO/Executive Director has not been a member of the 
collaborative team. If the CEO/Executive Director is on the collaborative team, the first 
step will be to set an audit date with the CEO/Executive Director and begin with step 3. 


 

2. A phone call will be made a week later to follow up on the letter as needed and/or to 
set an audit date for the agency. At this time, the ÒOrganization QuestionnaireÓ 
(Attachment C) will be completed to determine the number of team members needed 
for the audit. 


 

3. The audit team (collaborative members, individuals with disabilities, survivors) will be 
contacted with the date and time. If any additional training is needed prior to beginning 
the audit, it will be conducted prior to the audit date. 


 

4. The team will meet at the agency at the assigned time and the audit will be conducted 
as scheduled. 


Process: 

 

i. The team will meet with the CEO/Executive Director and agency staff of his/her 
choice to explain the process for the audit. 
ii. The team, assisted by the CEO or agency staff will conduct the audit. 



iii. At the conclusion of the audit, the team will meet with the CEO/Executive 
Director to provide general feedback to the organization and discuss preliminary 
findings. 


 

5. Following the audit, the audit team will have a meeting to review the findings and 
complete the Accessibility and Safety Report (see Appendix D). 


 

6. Next the report will be reviewed by the collaborative. The accessibility and safety needs 
will be further refined to look at what things are within the scope of the current grant 
funding and what things will need to be looked at as Òlong termÓ, agency-funded, or 
projects funded through other sources. The collaborative will approve the short term, 
grant funded changes and will explore funding and options for the items outside the 
scope of the grant funding. 


 

7. The report will be finalized and presented to the CEO/Executive Director by the Project 
Directors and/or the accessibility and safety team leaders no later than three weeks 
after the audit. The report will be reviewed and discussed. At this point any changes or 
amendments that the CEO/Executive Director may suggest will be added to the report. 
The CEO/Executive Director will be asked to sign the report. 


 

8. The Project Directors will work closely with each agency to ensure the grant funded 
items are completed and or purchased. The Project Directors will work with the 
collaborative team as well as the organization and will be available to assist with the 
long-term needs that cannot be accomplished during the funding cycle. 


 

Accessibility and Safety Audit Tool 

 

The following tool has been developed to provide this audit in each of the agencies that make 
up the H.O.P.E. Collaborative. Elements in the audit process can be skipped if the section is not 
applicable to a particular agency. Blank templates are available as needed for areas not 
addressed in the standard audit tool. 

 

I. PURPOSE OF THE TOOL 

 

This Accessibility and Safety Audit Tool is designed to be used to assess Disability Organizations 
and Domestic Violence Organizations as to their accessibility, safety and their ability to provide 
a welcoming environment to survivors with disabilities and Deaf survivors of experience 
violence and abuse. The questions in this Accessibility and Safety Audit Tool address 
organizational environments, attitudes, and safety practices, such as: the physical accessibility 
of the organization for all survivors with disabilities; the overall atmosphere of the organization; 
the availability of materials in alternate formats about violence against survivors with 
disabilities; providing a safe environment to disclose a need for accommodations or disclosure 
of violence and abuse. This tool will assist organizations as they look at ways to provide 


responsive services to all survivors with disabilities that experience violence and abuse in their 
lives. 

 

II. DEFINITION OF TERMS 

 

The following list of terms and definitions are those which will be frequently referred to during 
the course of the Accessibility and Safety Audit Tool. These are the definitions agreed upon by 
the HOPE Collaborative in order to retain common ground and understanding of the terms that 
are used. 

 

Abuse - Abuse is the infliction of physical, mental, or emotional pain upon a person and can 
include acts by a stranger in addition to family or caregiver. This can include withholding basic 
needs, denying personal care, denying access to information that will help increase 
independence, creating barriers, and all other acts that impede the emotional, mental and 
physical health of a person. Domestic violence, sexual assault, rape and stalking are forms of 
abuse. 

 

Accommodation Ð Modifications or adjustments to programs, environments or 
communications, (i.e., language, speech), that allow for equal access and receipt of services by 
persons with disabilities and Deaf persons. 

 

Collaboration Ð Two or more agencies agreeing together to commit to mutual relationships and 
goals, a jointly developed structure and responsibility, mutual authority and accountability for 
success and sharing of resources and awards. 

 

Consumer or Client Ð a person served by or utilizing the services of the Collaborative agencies 
whereby this person may use the services or authorize another to act for her. These terms will 
be used interchangeably. 

 

Deaf Persons - The term Deaf person reflects those individuals who identify with, understand 
and are a part of the language, culture and community of Deaf people. 

 

Deaf and hard of hearing - Individuals who have severe or profound hearing loss or who 
acquire deafness at some point in their life. 

 

Disability Ð A functional limitation that requires an accommodation to perform functions 
required to carry out daily life activities, whether situational or pervasive over time. Functional 
limitations may include balance, cognitive functions, dimensional extremes, mental health, 
movement, and mobility, respiratory functions, sensory functions, stamina and fatigue, as well 
as voice, speech and language. 

 

Disclosure -- Act of sharing personal information about violence and abuse that might 
otherwise not be shared. 


 

Domestic Violence -- Domestic violence is a form of abuse characterized by a pattern of power 
and coercive control in a relationship. The means used to gain and maintain control can include: 
physical, mental, emotional, financial, sexual abuse and stalking. Domestic violence occurs 
within intimate relationships, and abusers can involve spouses, partners, boyfriends or 
girlfriends, family members, or caregivers, paid or unpaid. 

 

Duty To Warn Ð The duty possessed by a mental health professional who has a therapeutic 
relationship with a client to disclose otherwise confidential information to an intended victim 
for their protection. 

 

Exploitation - The illegal or improper use of an adult with disability (ies), who is vulnerable or at 
risk, through misuse or manipulation of the adultÕs resources such as money, food, clothing, 
medications and shelter for anotherÕs profit or advantage and may include using the adult with 
disability (ies) for labor or sexual acts. 

 

Mandatory Reporter Ð State law requires anyone who suspects that an adult individual with a 
functional disability or who is incapacitated is being abused, neglected or exploited to report 
the suspicion to their county Department of Social ServicesÕ Adult Protective Services Division. 

 

Perpetrator Ð A person who commits criminal behavior such as domestic violence, sexual 
assault, rape and stalking. 

 

Rape Ð Under North Carolina law, the term rape only refers to penile penetration of the vagina. 
All other forms of unwanted or non-consensual penetration (as defined below) are referred to 
as sexual assault. 

 

Sexual Assault -- This is an umbrella term which includes nonconsensual, unwanted touching, 
being forced or pressured to perform sexual acts, forced anal or oral penetration by body parts 
or foreign objects, unwanted touching of the breasts, vagina, penis, or anus for which consent 
is not given, sexual name calling, and sexual harassment. 

 

Stakeholder -- Those who have a vested interest in the work of the Collaborative as it relates to 
systems change and how it will affect persons with disabilities and Deaf persons who are 
victims or survivors of violence and abuse. 

 

Stalking -- Obsessively following or harassing another person with threatening behavior or 
unwanted advances. Stalkers create emotional distress, fear and intimidation and may use the 
Internet or other forms of technology to accomplish their goals. 

 

Survivor -- A person who is living and functioning after a traumatic event such as domestic 
violence, sexual assault, rape and stalking. 

 


Systems ChangeÐ Focusing on systems addressing the needs of persons with disabilities and 
Deaf persons who are victims or survivors of violence and abuse. It is a process involving the 
changing of organizational responses through review and alterations of policies and procedures 
that become embedded in the culture of the organization so that they last over time. These 
changes are of strategic importance and occur not only at the level of management but also at 
the level of the individual employee. 

 

Victim Ð A person against whom a crime has been committed. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


HOPE COLLABORATIVE 

ACCESSIBILITY AND SAFETY AUDIT TOOL 

 

Table of Contents 

 

The following Audit Tool will be used by agencies interested in evaluating how accessible 
their organization is for survivors with disabilities. The Audit Tool has fifteen parts. Each part 
provides information related to one section of the accessibility and safety audit. All agencies 
may not need to be evaluated in all sections depending on their organizational type and 
structure. Each agency will determine the relevant sections required for a comprehensive 
audit. The information collected from the Audit will then be used to inform a Plan of Action 
to create a more accessible and safe environment for survivors with disabilities. 

 

 

Assessment Part 

Topic 

Part 1 

Parking lot, drop off zone and access paths 

Part 2 

Building entrance 

Part 3 

Lobby or Reception Area 

Part 4 

Hallways 

Part 5 

Stairways and elevators 

Part 6 

Office(s) 

Part 7 

Common area meeting rooms 

Part 8 

Restrooms for public use 

Part 9 

Security and Rescue Assistance 

Part 10 

Adaptive Equipment, Assistive Technology & Printed Materials 

Part 11 

Common areas including living room 

Part 12 

Kitchen and kitchen eating areas 

Part 13 

Residential/shelter bathrooms including tubs & showers 

Part 14 

Bedrooms 

Part 15 

Blank template/other areas 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 


 

PART I: PARKING LOT, DROP- OFF ZONE, AND ACCESS PATHS 

 



 

 

This section addresses the ease of access a survivor with a disability will have upon arrival at the 
building site. This includes ease of entrance into the parking lot, ease of parking and drop-off, 
access paths for building approach, welcoming signage, and safety assurance. 

 

 

PART IA: Entrance into parking lot/parking area 

What is the first overall impression of the parking lot? 

 

 

 



 

What makes it easy to enter the parking area? (e.g. large entry way into lot, signage, traffic 
patterns) 

 

 

 

 



 

Describe the location of the parking lot. (e.g. in a neighborhood, busy section of the city, 
industrial area) 

 

 

 

 

 

 

 

 



 

 

Is there a lot of congestion and traffic when trying to enter the parking area? 

 

 

 

 

 



 


 

PART IB: Ease of Parking and Drop- Off 



 

Describe the location of the accessible parking. 

 

 

 

 



 

 

Are the accessible parking spaces easy to find? What makes this so? 

 

 

 

 

 



 

 

From the staffÕs perspective, describe the usage of these spaces. Are they generally always full, 
partially full, and never full? 

 

 

 

 

 

 



 

Are the spaces clearly marked with paint lines and signage? 

 

 

 

 

 

 

 



 

 

 

 

 

 

 


PART IB: Ease of Parking and Drop- Off (ADAAG 4.6) 

Parking and Accessible Spaces 

Yes 

No 

NA 

Is each accessible space 8Õ wide with a plus 5Õ accessible aisle for cars? 

 

 

 

Is each accessible space 8Õ wide with a minimum 8Õ wide access aisle and 98 Ò 
of vertical clearance for lift-equipped vans? 

 

 

 

For agencies with 1-25 parking spaces, is there 1 accessible parking space? 

 

 

 

For agencies with 26-50 parking spaces, are there 2 accessible parking spaces? 

 

 

 

For agencies with 51-75 parking spaces, are there 3 accessible parking spaces? 

 

 

 

For agencies with 76-100 parking spaces, are there 4 accessible parking 
spaces? 

 

 

 

Is there at least a minimum of one van-accessible space? 

 

 

 

Is at least one of every 8 accessible spaces designated at van accessible? 

 

 

 

Are the accessible spaces closest to the building entrance? 

 

 

 

Is there more than one accessible entrance to the building? 

 

 

 

Parking and Accessible Spaces 

Yes 

No 

NA 

Are accessible spaces marked with the International Symbol of Accessibility? 

 

 

 

 

Are there ÒVan AccessibleÓ signs at the van space(s)? 

 

 

 

 

Does the agency use passenger loading and unloading zones? 

 

 

 

Do passenger loading zones provide an access aisle at least 60Ó wide and 20Õ 
long adjacent and parallel to the vehicle pull up space? 

 

 

 

Are there curbs between the access aisle and the vehicle pull-up space? 

 

 

 

Are there curb cuts at the drop-off point for passenger loading and unloading? 

 

 

 

Is the minimum width of the curb ramp at least 36Ó exclusive of flared sides? 

 

 

 

Is the surface of the curb ramp stable, firm and slip-resistant? 

 

 

 

Are there handrails or guardrails on the curb ramp(s)? 

 

 

 

Do parked vehicles obstruct the curb ramps? 

 

 

 



 

 

When coming into the parking lot, is it clear where the drop-off point is? What makes it clear? 

 

 

 

 

 

 

 



 

 


If someone is exiting a car or transportation vehicle at the drop-off point, does it appear to be a 
simple process? Are any barriers noted related to exiting the vehicle and entering the access 
path to the front entry of the building? 

 

 

 

 



 

 

If alternative drop off locations have been established for safety reasons, where are these 
located? Describe these locations as related to access for someone with a disability? What 
accommodation can be made? 

 

 

 

 

 



 

 

PART IC: Access Paths for Building Approach (ADAAG 4.3) 

Access Paths 

Yes 

No 

NA 

Is there an accessible path of at least 36Ó wide? 

 

 

 

Is the surface of the accessible path stable, firm and slip resistant? (4.5.1.) 

 

 

 

Is the accessible path clear of barriers? 

 

 

 

Does the accessible path lead directly to the front or main entrance? 

 

 

 

Is the accessible path level? 

 

 

 

If the path is not level, is the change in level greater than ¥¥¥Ó? (4.5.2) 

 

 

 



 

Overall, does the access path appear to be easy to maneuver? Any suggestions? 

 

 

 

 

 

 

 

 

 

 

 



 

 


PART ID: Welcoming Signage Exterior (ADAAG 4.30) 

Welcoming Signage 

Yes 

No 

NA 

Are there exterior signs with agency name? 

 

 

 

Are there exterior signs noting the building entrance? 

 

 

 

Are there exterior signs noting the drop-off zone? 

 

 

 

Do the letters and numbers on the signs have a width-to-height ratio between 
3:5 and 1:1? 

 

 

 

Are signs sized according to distance from which they will be read? 

 

 

 

Is the background of the signs an eggshell, matte or other non-glare finish? 

 

 

 

Do the characters or symbols used on the sign contrast with their background? 

(e.g. either light characters on dark background and vice versa) 

 

 

 

Does the exterior of the building display any symbols of accessibility? 

 

 

 

Is the International Symbol of Accessibility Sign posted on the building 
exterior? 

 

 

 

 

Is the International TDD Symbol posted on the building exterior if the 
organization has a TDD? 

 

Welcoming Signage 

 

 

 

 

 

 

Yes 

 

 

 

 

 

 

No 

 

 

 

 

 

 

NA 

Is the International Symbol of Access for Hearing Loss posted on the building 
exterior if accommodations are available? 

 

 

 

 

If the organization has volume controlled telephones and/or assistive listening 
devices, is there a sign near the entrance that depicts availability? 

 

 

 

 

Is there signage stating ÒService Dogs WelcomeÓ? 

 

 

 

 

 



 


 

Are there other forms of welcoming signage on the exterior of the building? For example, 
landscaping to include flowers, trees, outdoor benches or seating areas? 

 

 

 

 

 



 

PART IE: Safety Assurance 

Safety Assurance 

Yes 

No 

NA 

Is there lighting in the parking area? 

 

 

 

Do all areas of the parking lot appear well lit? 

 

 

 

Does the access path appear to be well lit? 

 

 

 

Is the area around the building entrance well lit? 

 

 

 

Are there areas that are not well lit or are shaded by objects? 

 

 

 

Are there large bushes or objects that obstruct the ability to see what is near 
or behind the bushes? 

 

 

 

Is the building entrance clearly in the open? 

 

 

 

Is the building entrance along the side or back of the building? 

 

 

 

Is this area clearly lit? 

 

 

 

Is there lighting near curb cuts for visibility? 

 

 

 

If there are exterior ramps, is this area well lit? 

 

 

 



 

 

Overall, is the feel and appearance of the parking lot a safe one? What types of things exist in 
the parking lot to create a safe environment? (i.e. lighting, signs, security guards, patrol, etc.) 

 

 

 

 

 

 

 



 

Is the agency located in a low crime neighborhood? Describe accessibility to law enforcement. 
What safety concerns might an individual have about coming to the location alone? 

 

 

 

 

 




 

 

 

PART 2: BUILDING ENTRANCE 

 



 

This section of the Accessibility and Safety Audit evaluates the building entrance that will most 
likely be used by a survivor with a disability. It includes doors, ramps, stairs, welcoming signage 
(interior), and safety assurance. 

 

PART 2A: Building Entrance: Doors 



 

What is the first overall impression of the building entrance? Is it inviting and welcoming? What 
makes it that way? Is it clear that this is the building entrance? Where does the entrance lead a 
person to? (i.e. down a hall, to the reception desk, to an elevator?) 

 

 

 

 

 

 

 



 

 

Describe how access to the building is made. Are there ramps and/or stairs? 

 

 

 

 



 

Describe the doors used to access the main entrance to the building? I.e. single door, double 
doors, automated door, revolving door? 

 

 

 



 

Building Entrance: Doors (ADAAG 4.13) 

Yes 

No 

NA 

If there is a revolving door, is there also another door provided adjacent to the 
revolving door that provides for entrance? 

 

 

 

If there is a single door, does the door have a minimum clear opening of 32Ó? 

 

 

 

Does the door, if not automated, have at least a level, clear minimum 
approach of 18Ó (clear wall space by the handle) by 60Ó for a front approach? 

 

 

 




Building Entrance Doors (ADAAG 4.13) 

Yes 

No 

NA 

Does the door have a minimum of 24Ó by 48Ó of level, clear space for a side 
approach? 

 

 

 

 

 

 

If the door has two independent door leaves, does at least one door have a 
minimum clear opening of 32Ó? 

 

 

 

If there are two doors in a series, is the minimum space between the two 
hinged doors at least 48Ó plus the width of the actual door? 

 

 

 

Do the doors swing in the same direction? 

 

 

 

Can the entry door be opened with hardware that does not require grasping, 
pinching, or twisting? 

 

 

 

Can the entry door be operated with one hand? 

 

 

 

Can the entry door be opened with no greater than 5 lb. of force? 

 

 

 

Is the exterior door handle no higher than 48Ó from the ground? 

 

 

 

Is there an automatic door option? 

 

 

 

Is the automatic door option easy to find? 

 

 

 

Is there a threshold edge ¥¥¥Ó high or less or is there a beveled edge from ¥¥¥Ó to 
¥¥¥Ó high? 

 

 

 



 

 

PART 2B: Building Entrance: Ramps 



 

Describe the use of ramps to enter the building. 

 

 

 

 

 

 

 

 



 

Describe the condition of the ramps. Do they appear to be new or well used? Are they in need 
of maintenance? Describe the surface of the ramps. In reviewing the surface, would it be easy 
for someone in a wheelchair or scooter to use? What about an individual with a visual 
impairment or an individual with limited mobility using a cane or walker? 

 

 

 

 

 

 

 




 

 

Describe the railings used for the ramps. What are the materials used for the railings? Are the 
railings in good shape or in need of maintenance? For example, if the railings are made of 
wood, is the wood splintered? If metal, is the metal rusted? Are the railings sturdy or do they 
move easily when grabbed? 

 

 

 

 

 

 



 

 

Ramps 

Yes 

No 

NA 

If there is a ramped entry, does it have a 1Ó slope or less for each 12Ó of ramp? 

 

 

 

Is the ramp longer than 6Õ? 

 

 

 

If the ramp is longer than 6Õ, does it have sturdy railings on both sides between 
34Ó and 38Ó high? 

 

 

 

Are all ramps accessible with railings? 

 

 

 

Do all ramps have non-skid surfaces? 

 

 

 

Is the ramp available at the main entry to the building? 

 

 

 

Are the external doors wide enough to access when using a wheelchair or 
scooter (32Ó of clear opening space)? 

 

 

 

Is there enough space for persons using wheelchairs and/or crutches/cane to 
open any entrance door (at least a 32Ó clear opening)? 

 

 

 



 

 

PART 2C: Building Entrance: Stairs 



 

Describe the location of any stairs used to access the entrance to the building. How many steps 
are there? What is the condition of the stairs? Do they need maintenance? Describe the 
surface. Is the texture smooth or rough? Are there stair treads? Describe any lighting used to 
illuminate the steps i.e. overhead, in the steps, etc. Describe the width and depth of the steps. 

 

 

 

 

 

 

 

 




 

Describe how the stairs might be easy or difficult to navigate for someone who is elderly, who 
has limited mobility with a cane, or other types of disabilities where stair usage is a possibility? 

 

 

 

 

 

 



 

Describe the stair handrails. What material has been used? What is the condition of the 
materials? Are the handrails sturdy or do they move when used? Are the railings in need of 
maintenance due to paint peelings, rust, etc.? 

 

 

 

 

 

 

 

 



 

 

Describe any route of travel into the building that does not require the use of stairs. Does the 
sidewalk provide an accessible route right to the building entrance? Describe the ease or 
difficulty in using this path of travel. 

 

 

 

 

 

 

 



 

Part 2C: Stairs (ADAAG 4.9) 

Yes 

No 

NA 

Does the exterior flight of stairs have continuous handrails on both sides? 

 

 

 

Are there handrail extensions beyond the top of the stairs? 

 

 

 

Are there handrail extensions beyond the bottom of the stairs? 

 

 

 

Do all of the stairs have a non-slip surface? 

 

 

 

Is there a flat landing at the bottom of the stairs? 

 

 

 

Is there a flat landing at the top of the stairs? 

 

 

 



 


 

PART 2D: Building Entrance: Welcoming Signage Interior 



 

 Describe easily visible signage in the entry area. Where is the signage? Are signs flat against 
the wall? Are signs hung overhead as you travel down the hall? What types of directional 
signage is there? i.e. restrooms, exit, lobby, intake, elevators, etc. Are signs easy to read? Are 
signs in Braille? Are signs in secondary languages i.e. Spanish? 

 

 

 

 

 

 

 

 

 



 

Does the signage clearly tell you which way to go for check in or for services? Where is this 
signage located? 

 

 

 

 

 

 

 

 

 



 

Part 2D: Signage (ADAAG 4.30) 

Yes 

No 

NA 

Does the interior signage at the entrance have a background that is matte, 
eggshell or have another non-glare finish? 

 

 

 

Do characters and symbols contrast with the background? 

 

 

 

Are signage letters at least 3 inches high? 

 

 

 

Are all permanent signs in the entry no higher than 60Ó from the floor to the 
center of the sign? 

 

 

 

Do permanent signs have raised characters (characters sized between 5/8Ó 
and 2Ó) or Braille text? 

 

 

 

Is notification signage, such as notices on a bulletin board, no higher than 60Ó 
from the floor to the center of the sign? 

 

 

 



 

 


 

PART 2E: Building Entrance: Safety Assurance 



 

Describe the lighting in the building entrance. Is the area well lit? Why or why not? Describe the 
type of lighting used for the building entrance. Is this area lit in a similar manner 24 hours per 
day? 

 

 

 

 



 

Describe any evidence of a security or alarm system upon entering the building. e.g. alarm 
company monitoring, security cameras, emergency buttons 

 

 

 

 

 



 

 

Describe the types of things that are in the entry that would help to create a safe environment 
(i.e. security alarm, security guards, panic button, security cameras ). 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

PART 3: LOBBY OR RECEPTION AREA 

 



 

 

This section addresses the ease of access and welcoming environment for a survivor with a 
disability who is entering the lobby or reception area while they are waiting for services. This 
includes accessibility to the lobby or reception area, welcoming environment, signage, 
telephones, and safety assurance. 

 

 

 

PART 3A: Lobby or Reception Area: Accessibility 



 

 

Describe the location of the lobby or reception area. i.e. Is it near the front entrance? Is it easy 
to find? 

 

 

 

 

 



 

 

Describe your first impression of the lobby or reception area. i.e. What colors are the walls? 
Are multiple colors used? Are they bright, earth tones, distracting, patterned? Describe what is 
on the walls. I.e. posters, photographs, printed materials. Describe the furniture in the 
seating/waiting area. Are there various seating arrangements? Are there allowances for 
wheelchairs and walkers? 

 

 

 

 

 

 

 

 

 

 

 



 

 


Describe the noise level. What mechanisms are in place to ensure confidential information 
exchange when checking in for services? (i.e. white noise machine to mask conversations, two 
way communication board for private computer entry, separate cubicles away from other 
people, etc). 

 

 

 

 

 

 



 

 

 

Part 3A: Lobby or Reception Area/Common Area (ADAAG 9.5.2) 

Yes 

No 

NA 

Is there a common area with doorways that are at least 32Ó wide? 

 

 

 

Is the threshold entering the reception area ¥¥¥Ó high or less or if it has a slanted 
edge, ¥¥¥Ó high or less? (ADAAG 4.13) 

 

 

 

Is there maneuvering space between furniture that is at least 36Ó wide for 
passing space? 

 

 

 

Is there turning space for wheelchairs of at least 60Ó in diameter? 

 

 

 

Are there spaces that will accommodate a wheelchair in various locations 
throughout the common area? (ADAAG 4.32.2) 

 

 

 



 

 

Describe the flooring of the reception area. I.e. carpet, tile, wood. Describe any flooring 
barriers. i.e. floor mats, throw rugs. Are there patterns on the floor that make movement easier 
or more difficult? 

 

 

 

 

 

 

 

 

 



 

Part 3A: Lobby or Reception Area/Common Area (ADAAG 4.5) 

Yes 

No 

NA 

If there is carpeting, is the carpet low pile of a woven type with no loose 
edges? 

 

 

 

 



 


 

Describe the lighting of the reception area. Is it well lit? Dark? What type of lighting is used? Is 
the entire area well lit? 

 

 

 

 

 

 

 

 



 

 

 

PART 3B: Lobby or Reception Area: Welcoming Environment 



 

Upon entering the lobby, was there someone there to greet you? Is this standard? What is the 
procedure for signing in for services? What is in place so that a person can sign in without 
divulging any confidential information? Describe what is in place so that others in the reception 
area cannot hear check in conversations. 

 

 

 

 

 

 

 



 

Describe any alternate forms of communication that may be available. For example, are there 
language interpreters available for people who use sign language or who use English as a 
Second Language? What types of adaptive equipment is available? 

 

 

 

 

 

 

 

 

 

 

 

 




 

 

Part 3B: Lobby or Reception Area: Welcoming Environment (ADAAG 7.2) 

Yes 

No 

NA 

Is the reception counter or window no higher than 36Ó at some point? 

 

 

 



 

Describe the counter or window where a person has face to face contact with a staff person. Is 
it user friendly for a person in a wheelchair? What barriers may exist for interactions with a 
staff person? 

 

 

 



 

 

Describe welcoming features about the reception area. Is there a television available? What is 
the noise level like? Is there music playing, people talking loudly or quietly, children playing. 
What is the temperature of the waiting area like? Is the area crowded? 

 

 

 

 

 



 

 

Part 3B: Lobby or Reception Area: Welcoming Environment (ADAAG ) 

Yes 

No 

NA 

Are any controls (television/electrical, etc) used in the common room located 
at no greater than 48Ó and no lower than 15Ó for a front approach and 54Ó/9Ó 
for a side approach? (ADDAG 4.27) 

 

 

 

Can controls be operated with one hand and not require tight grasping, 
pinching, or twisting of the wrist? 

 

 

 



 

PART 3C: Lobby or Reception Area: Signage 



 

Describe the signage in the reception area. What types of signage is there? Where is signage 
located? How do the signs direct people to the receptionist, restrooms, exits, etc? Is the 
signage well lit? Is there tactile signage, Braille, symbols? Are signs in secondary languages i.e. 
Spanish? 

 

 

 

 

 

 




 

Part 3C: Lobby or Reception Area: Signage (ADAAG 4.30) 

Yes 

No 

NA 

Does the signage have a background that is matte, eggshell or other nonglare 
finish? 

 

 

 

Do characters and symbols contrast with the background? Either light on dark 
or dark on light? 

 

 

 

Are all permanent signs or notifications in the building no higher than 60Ó 
(from the floor to the center of the sign) above the floor? This includes notices 
on the bulletin boards, signage by the doorways, etc. 

 

 

 

Can a person get within 3Ó of the sign without encountering protruding 
objects? 

 

 

 



 

 

PART 3D: Lobby or Reception Area: Telephones 



 

Does the lobby or reception area have telephones available for public use. Where are they 
located? On the walls? On the table? How many are there? Are there chairs to sit on while 
using the phone? Is there space for a person in a wheelchair to use the phone? Are telephones 
in a place where an individual can make a call without violating confidentiality? 

 

 

 

 

 

 

 

 

 



 

 

Part 3C: Lobby or Reception Area: Telephones (ADAAG 4.31) 

Yes 

No 

NA 

Are telephones that are for public use in a place that has a 30Ó by 48Ó ground 
space that allows for either a forward approach or parallel approach by a 
person using a wheelchair? 

 

 

 

Does the organization have volume control telephones? 

 

 

 

Does the organization have a TTY? 

 

 

 

Does the organization have assistive listening devices available? 

 

 

 



 

 

 

 

 


 

 

What makes it easy for someone to use the phone? Is there a large keypad? Are there useful 
numbers posted by the phone in large print? In Braille? Is the phone in an easily accessible 
location? 

 

 

 

 



 

If the phone is a pay phone, describe how a person could get change to use the phone? Is there 
information by the phone on how to get assistance in using the phone? How far is the phone 
from the reception desk? 

 

 

 

 



 

PART 3E: Lobby or Reception Area: Safety Assurance 



 

Describe the overall feeling of safety in the lobby or reception area. What things are in place to 
create a safe feeling? (i.e. security guard, panic button, security camera) 

 

 

 

 

 

 

 



 

Describe the exit door(s) out of the reception area. Is there more than one way out of the 
reception area? Are the exit areas clearly marked? Is there a clear path for exiting out of the 
area? 

 

 

 

 

 

 

 

 

 



 


 

Describe how information confidentiality is ensured in the reception area? What are the 
methods in place to ensure that private information is kept confidential? i.e. are client full 
names used? Is other identifying information stated out loud? What methods are evident to 
ensure confidentiality when there are other people in the waiting area? 

 

 

 

 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

PART 4: HALLWAYS 

 



 

This section addresses the ease of access a survivor with a disability will have in moving down 
hallways from one section of the building to the next. This includes hallway accessibility, water 
fountains, signage and safety assurance. A review of each hallway that is used for direct 
services should be completed. Additional pages may be reproduced as needed. 

 

PART 4A: Hallways: Accessibility 



 

Describe Hallway #1. What are the overall impressions of the hallway? Is there lots of space to 
move around? Describe any barriers that would make it difficult for a person in a wheelchair or 
a person with a visual impairment to travel through the hallway? Does the lighting make it easy 
to see where a person is going? Describe the type and condition of flooring in the hallway? 
(i.e. carpet, tile, wood) 

 

 

 

 

 

 

 

 

 



 

Describe the noise level in Hallway #1. What mechanisms are in place to ensure confidential 
information exchange when traveling through the hallway for services? (i.e. white noise 
machine to mask conversations, music) 

 

 

 

 

 

 

 

 

 



 

 

 


 

Describe Hallway #2: What are the overall impressions of the hallway? Is there lots of space to 
move around? Describe any barriers that would make it difficult for a person in a wheelchair or 
a person with a visual impairment to travel through the hallway? Does the lighting make it easy 
to see where a person is going? Describe the type and condition of flooring in the hallway? 
(i.e. carpet, tile, wood) 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

Describe the noise level in Hallway #2. What mechanisms are in place to ensure confidential 
information exchange when traveling through the hallway for services? (i.e. white noise 
machine to mask conversations; music) 

 

 

 

 

 

 

 

 

 



 

 

 

Part 4A: Hallway #1: Accessibility (ADAAG 4.3) 

Yes 

No 

NA 

Is the minimum width of the hallway 32Ó 

 

 

 

If the hallway is less than 60Ó wide, is there a place at least 60Ó by 60Ó (circular 
or T-shape) to pass or turn? 

 

 

 

If there is carpeting, is it low pile of a woven type with no loose edges? 

 

 

 



 

 

 


 

Part 4A: Hallway #2: Accessibility (ADAAG 4.3) 

Yes 

No 

NA 

Is the minimum width of the hallway 32Ó 

 

 

 

If the hallway is less than 60Ó wide, is there a place at least 60Ó by 60Ó (circular 
or T-shape) to pass or turn? 

 

 

 

If there is carpeting, is it low pile of a woven type with no loose edges? 

 

 

 



 

 

Describe the length of the hallways. For someone using a cane or walker or for an elderly 
person seeking services, does the length of the hallway create a barrier? Are there resting areas 
along the way? (i.e. chairs outside office doors, couches) 

 

 

 

 

 

 

 

 

 

 



 

 

 

Describe the walls in the hallway. Are there protruding objects? Are there plants or trees along 
the wall? Supply carts? Copy machines? Decorations? Any other objects that could create 
barriers? 

 

 

 

 

 

 

 

 

 

 



 

 

 

 

 

 


 

Part 4A: Hallways: Accessibility (ADAAG 4.4.1) 

Yes 

No 

NA 

In hallways, are there things mounted on the walls? 

 

 

 

For objects mounted between 27Ó and 80Ó from the floor, do they protrude 
more than 4Ó into the hallway space? 

 

 

 

For objects mounted below 27Ó from the floor, do they allow at least a 32Ó 
passage space in the hallway? 

 

 

 



 

 

PART 4B: Hallways: Water Fountains 



 

 

Describe any water fountains in the hallway. What condition are they in? Are they easy to use? 
Is there usable water pressure? What is the temperature of the water? Is the fountain clean? 
Are the fountains easy to find? 

 

 

 

 

 

 

 



 

 

Part 4B: Hallways: Water Fountains (ADAAG 4.15) 

Yes 

No 

NA 

Does the organization or agency have an accessible drinking fountain? 

 

 

 

Is the drinking spout no higher than 36Ó high? 

 

 

 

Is the spout in the front of the unit? 

 

 

 

Is the water flow parallel or nearly parallel to the front of the unit? 

 

 

 

Is the flow at least 4Ó high to allow for the insertion of a cup or glass? 

 

 

 

Are the water fountain controls in the front or on the side near the front edge 
of the unit? 

 

 

 

Does the space under the drinking fountain have at least 27Ó high, 30Ówide 
and 19Ó deep of clear knee space? 

 

 

 

Is there at least 30Ó by 48Ó of clear space to allow front approach or parallel 
approach by a wheelchair? 

 

 

 

Are the controls operable without grasping, twisting or turning (Òclosed fistÓ 
test) 

 

 

 



 

 

 

 


 

If there are no accessible water fountains available in the agency, how does an individual get a 
drink of water if needed? Are there sanitation procedures in place? 

 

 

 

 

 

 

 

 



 

PART 4C: Hallways: Signage 



 

Describe easily visible signage in the hallway. Are signs flat against the wall? Are signs hung 
overhead as you travel down the hall? What types of directional signage is there? i.e. 
restrooms, exit, lobby, intake, elevators, etc. Are signs easy to read? Are signs in Braille? Are 
signs in secondary languages i.e. Spanish? 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

What is the condition of the signage? Is it old and faded? Clear and easy to read? Outdated? In 
need of replacement? 

 

 

 

 

 

 

 



 

 


 

Part 4D: Hallways: Signage (ADAAG 4.30) 

Yes 

No 

NA 

Does the signage have a background that is matte, eggshell or other nonglare 
finish? 

 

 

 

Do characters and symbols contrast with the background? Either light on dark 
or dark on light? 

 

 

 

Are all permanent signs or notifications in the building no higher than 60Ó 
(from the floor to the center of the sign) above the floor? This includes notices 
on the bulletin boards, signage by the doorways, etc. 

 

 

 

Can a person get within 3Ó of the sign without encountering protruding 
objects? 

 

 

 



 

PART 4D: Hallways: Safety Assurance 



 

What types of things exist in the hallways that help to create a safe environment? (i.e. no dark 
spaces, walls not blocked by large objects such as plants and carts, no hidden doorways) What 
type of lighting exists in the hallways? Is the area well lit with high visibility? Is the lighting the 
same 24 hours per day? 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

PART 5: STAIRWAYS AND ELEVATORS 

 



 

 This section addresses the ease of access a survivor with a disability will have in moving 
throughout the building as necessary for receiving services. This includes stairways, elevators, 
signage and safety assurance. 

 

PART 5A: Stairways 



 

 

Describe any stairs located in the building. Describe their location and number of steps in each 
stairway. What is the condition of the stairs? Do the stairs progress straight up or down or is 
there a platform separating the complete flight of stairs? 

 

 

 

 

 

 

 

 

 

 

 



 

 

Describe the handrails. What material are they made out of? (metal, wood, etc.) What is the 
condition of the finish on the handrails? Is the finish smooth? Do the rails feel sturdy when they 
are grabbed? If there are no handrails, describe if there is anything to hold on to for balance 
and safety. 

 

 

 

 

 



 

 

 

 

 

 


Part 5A: Stairways (ADAAG 4.9) 

Yes 

No 

NA 

Do all of the stairs have a non-slip surface? 

 

 

 

Are there rails on both sides of the stairs? 

 

 

 

Are there handrail extensions at the bottom of the handrails? 

 

 

 

Are there handrail extensions at the top of the handrails? 

 

 

 

Is there a flat landing at the bottom of the stairs? 

 

 

 

Is there a flat landing at the top of the stairs? 

 

 

 



 

Describe the lighting on the stairs. Do the stairs appear well lit? Are the lights on the side walls 
as you go up the stairs? Are the lights overhead? If light switches need to be used to turn on the 
stair lighting, can someone in a wheelchair or scooter reach the switch? Are there any dark and 
shaded areas on the staircase and/or stairwell? 

 

 

 

 

 

 



 

Describe whether someone who used a cane or was visually impaired would be able to use the 
stairs. 

 

 

 

 

 

 

 



 

PART 5B: Elevators 



 

Are there elevators in this building? If so, describe the number and location of the elevators. 
Where are the elevators in relation to the reception or waiting area? What is the overall 
appearance of them? What is the condition of them? Are they easy to use? Are they old and 
loud? Where are the buttons located to call for an elevator? Where are the emergency 
buttons? 

 

 

 

 

 

 




 

Describe the process for entering the elevator. Does the opening of the elevator floor meet 
with the building floor without having to step up? Do the doors start to close before someone 
completely enters the elevator cab? 

 

 

 

 

 

 

 

 



 

 

Part 5B: Elevators (ADAAG 4.10) 

Yes 

No 

NA 

Are there audible indicators when the elevator door opens? 

 

 

 

Are there visual indicators when the elevator door opens? 

 

 

 

Do floor buttons have raised Braille characters? 

 

 

 

Do other elevator controls have raised Braille characters? 

 

 

 



 

 

Describe any information posted in the elevator? On the elevator walls? Describe the 
information. Is the information easy to read? Is any information in Braille? Is the information in 
alternate large print format? Is any information is alternative language format, such as 
Spanish? What is the content of the information? Is any of the information related to violence 
and abuse? 

 

 

 

 

 

 

 

 

 

 

 



 

 

 

 

 

 


 

PART 5C: Signage for Stairs and Elevators 



 

Describe any signs that would indicate the location of the stairs and/or elevators. Where are 
the signs located? Are they posted along the wall? Are they posted overhead? Are they easy to 
read? What makes them easy to read? Are signs in Braille? Are signs in secondary languages 
i.e. Spanish? 

 

 

 

 

 

 

 

 

 

 

 

 



 

Describe any tactile signs, either by the stairs or with the elevators. Are there tactile signs on 
the inside of both door jams of the elevator(s) that indicates the floor number for each floor? 
Do the controls in the elevator cab have raised and Braille lettering? 

 

 

 

 

 

 



 

 

Part 5C: Stairs and Elevators: Signage (ADAAG 4.30) 

Yes 

No 

NA 

Does the signage have a background that is matte, eggshell or other nonglare 
finish? 

 

 

 

Do characters and symbols contrast with the background? Either light on dark 
or dark on light? 

 

 

 

Are all permanent signs or notifications in the building no higher than 60Ó 
(from the floor to the center of the sign) above the floor? This includes notices 
on the bulletin boards, signage by the doorways, stairs, elevators, etc. 

 

 

 

Can a person get within 3Ó of the sign without encountering protruding 
objects? 

 

 

 



 


 

 

PART 5D: Safety Assurance for Stairs and Elevators 



 

Describe what safety measures are in place to make the stairways a safe environment? (alarm 
buttons, panic buttons, security cameras, well lit area) 

 

 

 

 

 

 

 

 

 

 

 

 



 

Describe what safety measures are in place to make the elevators a safe environment? (alarm 
buttons, panic buttons, security cameras, well lit area) 

 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

 

PART 6: OFFICES 

 



 

This section addresses the ease of access a survivor with a disability will have upon entering an 
office related to intake and direct services. This includes accessibility within the office, 
welcoming environment, and safety assurance. A review of each office that is used for direct 
services should be completed. Additional pages may be reproduced as needed. 

 

 

PART 6A: Offices for Intake and Direct Services: Accessibility 



 

 

Describe your overall impression of the office. What is in place to make it easy to find? What 
made it easy to enter the office? Was the office easy to find? What did you notice first about 
the area? What about it made you want to enter and talk to someone about services? 

 

 

 

 

 

 

 

 

 

 

 



 

Office Doors (ADAAG 4.13) 

Yes 

No 

NA 

If there is a single door, does the door have a minimum clear opening of 32Ó? 

 

 

 

Does the door have a minimum of 24Ó by 48Ó of level, clear space for a side 
approach? 

 

 

 

 

Can the door be opened with hardware that does not require grasping, 
pinching, or twisting? 

 

 

 

Can the door be operated with one hand? 

 

 

 

Can the door be opened with no greater than 5 lb. of force? 

 

 

 



 

 

 

 


 

 

Describe the space given for this office. How many people could comfortably fit in the area? 
Could the office accommodate a wheelchair and/or a service dog? Can the service dog remain 
close to the consumer? Could it accommodate several family members, guardians or other 
support personnel such as an interpreter? 

 

 

 

 

 

 

 

 



 

 

Describe the seating in the office. Are the chairs a variety of sizes? Is there room to transfer 
from a wheelchair to an office chair? Are there chairs with and without arm rests? Are there 
chairs that roll and others that do not? Which way do the chairs face? 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

Part 6A: Office Area: Accessibility (ADAAG 4.32) 

Yes 

No 

NA 

Is seating space provided for people in wheelchairs provided at fixed tables, 
counters, or desks? 

 

 

 

Is there clear floor space that does not overlap knee space by more than 19 
inches? 

 

 

 

If seating is provided for people in wheelchairs at a table, is the knee space at 
least 27Ó high, 30Ó wide, and 19Ó deep? 

 

 

 

Is the height of the top of the accessible table 28Ó to 34Ó above the finish floor 
or ground? 

 

 

 



 


 

PART 6B: Offices for Intake and Direct Services: Welcoming Environment 



 

 

Describe how you were greeted upon entering the office. Did you see a name plate on or near 
the door telling the name of the person you were going to be talking with? Did you 
immediately feel that you were in a welcoming place? 

 

 

 

 

 

 



 

 

Describe the colors used in the office. Are the colors warm and inviting? Are the colors too 
bright or too dull? Are there patterns used? Describe what is hung on the walls. Are there 
photographs on the walls? Framed prints? Are there plants or other items that would make a 
person feel welcome? 

 

 

 

 

 

 



 

Describe the floor covering. Is it warm and inviting? Is the floor covering old, worn and/or dirty? 
Is the floor patterned or designed for ease of use? 

 

 

 

 

 

 

 

 

 

 



 

 

 

 

 


 

Describe any information posted on the wall. What kind of information is it? Is it educational? Is 
it in simple language? In alternate format? Is it comforting? What is the content of the 
information? Is any of the content related to violence and abuse? 

 

 

 

 

 



 

 

Part 6B: Offices for Intake and Direct Services (ADAAG 4.30) 

Welcoming Environment: Signage 

Yes 

No 

NA 

Does the signage have a background that is matte, eggshell or other nonglare 
finish? 

 

 

 

Do characters and symbols contrast with the background? Either light on dark 
or dark on light? 

 

 

 

Are all permanent signs or notifications in the building no higher than 60Ó 
(from the floor to the center of the sign) above the floor? This includes notices 
on the bulletin boards, signage by the doorways, etc. 

 

 

 

Can a person get within 3Ó of the sign without encountering protruding 
objects? 

 

 

 



 

 

PART 6C: Offices for Intake and Direct Services: Safety Assurance 



 

 Are there windows in the office? Do they have blinds, curtains, bars? Do the windows open? 
Can they provide an escape route if needed? Is there an alternate exit door in the office? 

 

 

 



 

Can you see all around the office? Are their hidden places in the room that are difficult to see? 
Could someone walk in behind you without you seeing them? What other things in the office 
might make a person feel unsafe? 

 

 

 

 

 

 

 




 

Describe the lighting in the office. Is it dim? Bright? Are the lights flickering? Would a person 
with low vision be able to see the materials? 

 

 

 

 

 

 



 

 

 

What mechanisms are in place to create a feeling of safety? Are there locks on the door? 
Where are the locks located? Is there a way to call for help within the office? (phone, alarm 
button, e-panic button, TTY) 

 

 

 

 

 

 



 

 

Describe the noise level in the office. Is it private or can you hear people talking down the hall, 
in adjacent offices, or in other areas where you cannot see? Describe what mechanisms are in 
place to protect confidentiality and private conversations? (white noise machine, two way 
communication boards, music) 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

 

 


 

 

PART 7: COMMON AREA MEETING ROOMS 

 



 

This section addresses the ease of access a survivor with a disability will have in using a 
common area meeting room for services. This includes room accessibility, welcoming 
environment, and safety assurance. 

 

PART 7A: Common Area Meeting Rooms: Accessibility 



 

Describe your overall impression of the common area. What was in place to make this area 
easy to find? What made it easy to enter the common room area? What did you notice first 
about the area? What about it made you want to enter and talk to someone about services or 
be a part of the group meeting there? 

 

 

 

 

 

 

 



 

Describe the noise level in the common room area. What mechanisms are in place to ensure 
confidential information exchange during meetings and large group gatherings? (i.e. white 
noise machine, music, etc) 

 

 

 

 

 



 

 

Part 7A: Common Area Meeting Room Doors (ADAAG 4.13) 

Yes 

No 

NA 

If there is a single door, does the door have a minimum clear opening of 32Ó? 

 

 

 

Does the door have a minimum of 24Ó by 48Ó of level, clear space for a side 
approach? 

 

 

 

 

Can the door be opened with hardware that does not require grasping, 
pinching, or twisting? 

 

 

 

Can the door be operated with one hand? 

 

 

 

Can the door be opened with no greater than 5 lb. of force? 

 

 

 




 

Describe the space given for this common area. Describe the overall room space. Is it one large 
room or is the room sectioned by partitions? How many people could comfortably fit in the 
room? Can the common area accommodate a wheelchair and/or a service dog? Can the service 
dog remain close to the consumer? Could the room accommodate several family members, 
guardians or other support personnel such as an interpreter? 

 

 

 

 

 

 

 

 



 

 

Describe the seating in the common area. Are the tables in a circle, rectangle, etc.? Are the 
chairs a variety of sizes? Is there room to transfer from a wheelchair to an office chair? Are 
there chairs with and without arm rests? Are there chairs that roll and others that do not? 
Which way do the chairs face? What about the seating would make it comfortable for a person 
seeking services? 

 

 

 

 

 

 

 

 



 

Part 7A: Common Area Meeting Rooms: Accessibility (ADAAG 4.32) 

Yes 

No 

NA 

Is seating space provided for people in wheelchairs provided at fixed tables, 
counters, or desks? 

 

 

 

Is there clear floor space that does not overlap knee space by more than 19 
inches? 

 

 

 

If seating is provided for people in wheelchairs at a table, is the knee space at 
least 27Ó high, 30Ó wide, and 19Ó deep? 

 

 

 

Is the height of the top of the accessible table 28Ó to 34Ó above the finish floor 
or ground? 

 

 

 



 

 

 


 

PART 7B: Common Area Meeting Rooms: Welcoming Environment 



 

Describe how you were greeted upon entering the common area. Did you see a sign on or near 
the door identifying the room that you were entering? What would make a person feel that 
they were in a welcoming place? 

 

 

 

 

 

 



 

 

Describe the colors used in the common area. What about the colors create a warm and 
inviting environment? Are the colors too bright or too dull? Are there patterns used? Describe 
what is hung on the walls. Are there photographs or framed art/prints on the walls? Are there 
plants or other items that would make a person feel welcome? 

 

 

 

 

 

 

 



 

Describe the floor covering. Is it warm and inviting? Is the floor covering old, worn and/or dirty? 
Is the floor patterned or designed for ease of use? What about the floor covering would make it 
difficult for someone using a wheelchair or walker to use? What about the floor covering would 
make it difficult for someone with a visual impairment to use? Does the flooring appear level, 
stable, and slip resistant? 

 

 

 

 

 

 

 

 

 

 



 


Describe any information posted on the wall. What kind of information is it? Is it educational? Is 
it in simple language? In alternate format? In an alternate language, such as Spanish? Is any of 
the information in Braille? 

 

 

 

 

 

 

 



 

Part 7B: Common Area Meeting Rooms (ADAAG 4.30) 

Welcoming Environment: Signage 

Yes 

No 

NA 

Does the signage have a background that is matte, eggshell or other nonglare 
finish? 

 

 

 

Do characters and symbols contrast with the background? Either light on dark 
or dark on light? 

 

 

 

Are all permanent signs or notifications in the meeting room no higher than 
60Ó (from the floor to the center of the sign) above the floor? This includes 
notices on the bulletin boards, signage by the doorways, signage in the room, 
etc. 

 

 

 

Can a person get within 3Ó signs or information without encountering 
protruding objects? 

 

 

 



 

Describe the noise level in the common area meeting room. Is it private or can you hear people 
talking down the hall, in adjacent offices, or in other areas where you cannot see? Describe 
whether you feel that information discussed is confidential given the noise factor. What is in 
place to help create white noise? (i.e. music, white noise machines, other sound buffers) 

 

 

 

 

 

 

 

 

 

 

 

 



 

 


PART 7C: Common Area Meeting Rooms: Safety Assurance 



 

What types of things exist in the common area meeting rooms that help to create a safe 
environment? (i.e. no dark spaces, walls not blocked by large objects such as plants and carts, 
no hidden doorways) Are there windows in the room? Do they have blinds, curtains, bars? Do 
the windows open? Can they provide an escape route if needed? Is there an alternate exit door 
in the common area? 

 

 

 

 



 

Can you see all around the common area? Are their hidden places in the room that are difficult 
to see? E.g. room partitions, boxes stacked. Could someone walk in behind you without you 
seeing them? What other things in the common area might make a person feel unsafe? 

 

 

 

 

 

 



 

Describe the lighting in the common area. Is it dim? Bright? Are the lights flickering? Would a 
person with low vision be able to see the materials? Would a person with low vision be able to 
move around the room in a safe manner? 

 

 

 

 

 

 



 

Are there locks on the door(s) in the common area? Where are the locks located? Is there a way 
to call for help within the common area? (phone, alarm button, e-panic button, TTY) 

 

 

 

 

 

 



 

 


 

 

PART 8: PUBLIC RESTROOMS 

 



 

 

This section addresses the ease of access a survivor with a disability will have in using the public 
restrooms available at the service delivery agency. This includes restroom accessibility, 
welcoming environment, and safety assurance. 

 

 

PART 8A: Public Restrooms: Accessibility 



 

Describe the availability of public restrooms for persons with disabilities. Is there a restroom for 
each sex or is there a unisex restroom available? Is it easy to locate the restroom? How far is 
the restroom from the main entrance? 

 

 

 

 

 



 

 

Describe the accessible stall in the public restroom. Does the stall door open inward or open 
out towards you? What type of handle is used on the door? i.e. does the handle turn, slide, etc) 
Is the stall door operable with a closed fist? Does the stall door lock? Can you lock it with a 
closed fist? 

 

 

 

 



 

Describe the space in the accessible stall. Is there enough clear floor space for a person in a 
wheelchair to open the door and enter the stall and turn the wheelchair to close the door? Is 
the surface of the floor space stable, firm and slip resistant? 

 

 

 

 

 

 




 

Part 8A: Public Restrooms Door entry(ADAAG 4.13) 

Yes 

No 

NA 

If there is a single door, does the door have a minimum clear opening of 32Ó? 

 

 

 

Does the door have a minimum of 24Ó by 48Ó of level, clear space for a side 
approach? 

 

 

 

 

Can the door be opened with hardware that does not require grasping, 
pinching, or twisting? 

 

 

 

Can the door be operated with one hand? 

 

 

 

Can the door be opened with no greater than 5 lb. of force? 

 

 

 

Do doors swing into any of the clear floor space that is needed to access 
bathroom fixtures? (4.22.22) 

 

 

 

Restrooms General (ADAAG 4.22) 

 

 

 

Is there at least one stall for up to 6 stalls that is accessible? 

 

 

 

Is there a 60Ó diameter space to allow for turning? 

 

 

 

Toilets (ADAAG 4.16 and 4.17) 

Yes 

No 

NA 

Is there a minimum floor space of 48Ó wide and 69Ó long (56Ó if the toilet is 
wall mounted) for an accessible stall? 

 

 

 

Is the toilet seat height between 16Ó and 19Ó high? 

 

 

 

Is the grab bar behind and beside the toilet no lower than 36Ó? 

 

 

 

Is the diameter of the bar between 1 ¥¥¥ and 1 ¥¥¥ Ò? 

 

 

 

Are toilets self flush or can they be operated with one hand and not require 
tight grasping, pinching, or twisting of the wrist and no greater than 5 lbs. of 
force? 

 

 

 

Are toilet paper dispensers no lower than 19Ó from the floor? 

 

 

 

When approaching the stall from the latch side of the stall door, is there a 
minimum approach of 42Ó? 

 

 

 

Urinals (ADAAG 4.18) 

Yes 

No 

NA 

Are urinal rims no higher than 17Ó above the floor? 

 

 

 

Is there clear floor space of at least 30Ó by 48Ó in front of at least one urinal? 

 

 

 

Do any urinal shields that extend beyond the urinal rim have at least a 29Ó 
clearance between them? 

 

 

 

Are urinals self flush or have controls mounted no higher than 44Ó above the 
floor? 

 

 

 

Lavatories and Mirrors (ADAAG 4.19) 

Yes 

No 

NA 

Are sinks no higher than 34Ó from the floor? 

 

 

 

Is there at least a 27Ó high, 30Ó wide and 19Ó deep knee clearance at the sink? 

 

 

 

Is there a clear floor space of 30Ó by 48Ó to allow for a forward approach (this 
can include 19Ó under the lavatory)? 

 

 

 

Are hot water and drain pipes under the sink insulated or configured to 
protect against contact? Are there any sharp or abrasive surfaces under the 
sink area? 

 

 

 

 




Lavatories and Mirrors (ADAAG 4.19) contÕd 

Yes 

No 

NA 

Are faucets automatic or can they be operated with one hand and not require 
tight grasping, pinching or twisting of the wrist? 

 

 

 

Do faucets require no more than 5 lbs. of force (acceptable designs are lever-
operated, push-type and electronic)? 

 

 

 

Are mirrors mounted with the bottom edge of the reflecting surface no higher 
than 40Ó above the floor? 

 

 

 



 

Describe the hand washing features in the public restroom. Are soap and other dispensers 
within reach ranges and usable with one closed fist? Are hand dryers and/or drying towels 
within reach ranges and usable with one closed fist? If there is a towel dispenser that will be 
used, describe the ease or difficulty in using it. How could someone with a visual limitation find 
the supplies needed for hand washing? 

 

 

 

 

 

 

 

 

 

 



 

PART 8B: Public Restrooms: Welcoming Environment 



 

What features of the public restroom create a welcoming feeling? Is the restroom in good 
shape or is it old and in need of repair? What color are the walls? Are they bright, dull, 
patterned, painted, or tiled? Is the restroom clean? i.e. floors, walls, corners, sinks, trash 
receptacles 

 

 

 



 

Are there chemicals or air fresheners in use? Is there hypoallergenic soaps available or marked 
for use? 

 

 

 

 

 

 




 

Describe any information posted on the wall. What kind of information is it? Is it educational? Is 
it in simple language? In alternate format? Are signs in alternate languages? ( i.e. Spanish) 

 

 

 

 

 

 

 

 



 

Describe the flooring in the public restroom. Is the flooring old and in need of repair? Is it 
stable, firm and slip resistant? Are there sections of the floor that are slippery? Can the 
flooring be easily used by a person in a wheelchair, with a cane or walker or with visual 
impairments? 

 

 

 

 

 

 

 

 



 

PART 8C: Public Restrooms: Safety Assurance 



 

Describe what measures have been taken to make the public restroom feel safe. Is there more 
than one way out of the restroom? Is the entry into the restroom open or do you enter by a 
door that closes after you? Is the restroom in an isolated part of the building? 

 

 

 

 

 

 

 

 

 

 

 



 

 


 

Can you see all around the open area of the restroom? Is it difficult to see if someone else is in 
the restroom? Describe the lighting. Is the area well lit? Is the lighting dim and the area 
somewhat dark? Would someone with low vision be able to see and make their way safely 
around the restroom? 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

Describe any methods available in the public restroom that a person with a disability can access 
for help or assistance while in the restroom. 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 


 

 

PART 9: SECURITY AND RESCUE ASSISTANCE 

 



 

This section addresses the type of security and rescue assistance available in buildings used by 
survivors with disabilities for services. 

 

Describe your overall impression of the type of security provided in the building. Was security 
noticeable? i.e. security systems, alarms, security guards. Describe any equipment being used 
by the organization for security and safety related reasons. (i.e. e-panic button, intercom 
system) 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

Describe the alarm system used in the building. Is it a new system? Do staff report that the 
alarm system in use is effective? What makes it effective? How are staff informed of a security 
risk if a perpetrator is in the building? 

 

 

 

 

 

 

 

 

 

 



 

 

 


 

 

 

Part 9: Security and Rescue Assistance: Alarms (ADAAG 4.28) 

Yes 

No 

NA 

Do alarm systems provide visual signals? 

 

 

 

Do alarm systems provide auditory signals? 

 

 

 

Do the visual and auditory alarms work in restrooms, hallways, lobbies and 
other common areas? 

 

 

 



 

Would a survivor with a disability be able to reach the alarm or emergency warning system if 
they needed to? Describe how this would be possible. 

 

 

 

 

 

 



 

 

 

Describe any policies in place with the agency that describe security response if an abuser 
enters the building or if there is a consumer or employee exhibiting abusive behaviors? Is there 
a policy for lockdown? Is there a procedure for lockdown? How often does staff training occur 
to address lockdown? 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

 

 

 

 


 

 

Describe rescue assistance services in the building? Are evacuation maps posted? If so, where 
are they posted and what do they look like? Are they posted no higher than 60Ó above the 
floor? Are they in large print or alternate format? Are they adequate size, height, and 
contrast? Are they posted in the restrooms, hallways, lobbies and other common areas? 
Describe the existence of emergency procedures. Do they require staff to visually check all 
facility areas to ensure the all clients are aware of the emergency evacuation announcement? 

 

 

 

 

 

 

 



 

Describe the number and location of fire extinguishers. Are they stored at a reasonable height 
for someone using a wheelchair or of small stature (48Ó or less)? 

 

 

 

 

 

 

 

 



 

If the building has multiple floors, describe the agency plan for evacuation of persons with 
disabilities from floors above the first floor? Is the plan in writing? How often are staff trained 
in evacuation procedures? How is training documented? Is there an evacuation chair on site? If 
yes, is the staff aware of the chairÕs location? 

 

 

 

 

 

 

 

 

 

 

 



 


 

Part 9: Security and Rescue Assistance (ADAAG 4.3.11) 

Buildings with multiple floors 

Yes 

No 

NA 

Is there a portion of a stairway landing within a smoke-proof enclosure? 

 

 

 

Does the landing have access to the exterior of the building? 

 

 

 

Is the area of rescue assistance at least 30Ó by 48Ó? 

 

 

 

Is there a minimum width between stairway rails of at least 48Ó 

 

 

 

Is there a method of communication, with both visible and audible signals that 
provides communication from the area of rescue assistance to the entrance? 

 

 

 

Is there signage that designates the area as the Òarea of rescue assistanceÓ ? 

 

 

 

Does this area display the international symbol of accessibility? 

 

 

 



 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

PART 10: ADAPTIVE EQUIPMENT, ASSISTIVE TECHNOLOGY, AND ACCESSIBLE 
PRINTED MATERIALS 

 



 

 This section of the Accessibility and Safety Audit evaluates the type and presence of 
adaptive equipment, assistive technology and accessible printed materials available to survivors 
with disabilities who are seeking and/or receiving services. The purpose of this portion of the 
evaluation is to determine if the means are available to facilitate disclosure and request for 
services by survivors with disabilities. 

 

PART 10A: Adaptive Equipment and Assistive Technology 



 

Describe whether the agency has a variety of adaptive equipment and assistive technology to 
assist a person with a disability. Identify the types available in the chart below. 

 

 

 

 

 



 

Part 10a: Adaptive Equipment and Assistive Technology 

Yes 

No 

NA 

Adaptive computers 

 

 

 

Communication Boards 

 

 

 

Other Communication devices 

 

 

 

Enhanced vision equipment 

 

 

 

TTY 

 

 

 

State relay systems for Deaf and hard-of-hearing clients 

 

 

 

Voice amplifiers 

 

 

 

Assistive devices for meal preparation (residential; shelter) 

 

 

 

Assistive devices for eating 

 

 

 

Assistive devices for personal assistance (bathing; dressing, medications, 
clocks) 

 

 

 

Presence of service dogs 

 

 

 

Extra wheelchairs, walkers, canes, etc. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 


Describe any training that staff has received in using the adaptive equipment and assistive 
technology in the organization. How often is training offered? Who receives the training? How 
is this training documented? How often is the equipment tested for maintenance needs? 
Complete the table below listing types of training offered. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

Part 10a: Training in Adaptive Equipment and Assistive Technology 

Yes 

No 

NA 

Adaptive computers 

 

 

 

Communication Boards 

 

 

 

Other Communication devices 

 

 

 

Enhanced vision equipment 

 

 

 

TTY 

 

 

 

State relay systems for deaf and hard-of-hearing clients 

 

 

 

Voice amplifiers 

 

 

 

Assistive devices for meal preparation (residential services/shelter) 

 

 

 

Assistive devices for eating 

 

 

 

Assistive devices for personal assistance (bathing, dressing, medications) 

 

 

 

Protocol for Service Dogs 

 

 

 

Wheelchairs and walkers 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

 

 


 

 

 

Describe the use of language interpreters in the agency. This could include interpreters for 
communication for people who use sign language or who use English as a second language. Are 
interpreters hired or contracted to facilitate communication? Are they available during the 
intake process? During the service delivery process? Is there a policy in place on accessing 
interpreters if they are not regular employees of the agency? Is the procedure posted in a place 
easily and readily used by employees? Is there a policy in place on accessing auxiliary aids and 
Deaf interpreters when needed? 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

PART 10B: Accessible Printed Materials 



 

This section evaluates whether printed materials used in the agency for intake and service 
provision are accessible for survivors with disabilities. This includes the use of printed materials 
for individuals with low level reading skills, individuals using English as a second language, and 
individuals with vision challenges. 

 

Describe the types of accessible printed materials that staff report as currently being used. 
Please complete the checklist below to identify the accessible formats. What alternate formats 
are available? 

 

 

 

 

 

 

 

 



 


Part 10B: Intake Materials (complete if client reads and completes intake 
materials on their own) 

Yes 

No 

NA 

Overall, are the intake materials easy to read? 

 

 

 

Are some items boxed or bulleted to make important information stand out? 

 

 

 

Are the intake materials available in large print? 

 

 

 

Are the intake materials available in Braille? 

 

 

 

Are the intake materials available in audio format? 

 

 

 

Do the intake materials use color contrast with either dark print on a light 
background or light print on a dark background? 

 

 

 

Is there a lot of background clutter on the intake form? 

 

 

 

Is the font used on the intake form easy to read? e.g. at least a 14 pt. font? 

 

 

 

Are letters evenly spaced? 

 

 

 

Does the spacing between lines allow for materials to be easily read? 

 

 

 

Are the pages right justified? 

 

 

 

Are whole words split between lines? 

 

 

 

Are simple, short sentences used? 

 

 

 

Is jargon used? 

 

 

 

Are acronyms or abbreviations used? 

 

 

 

Is the information written in active, personal language such as ÒyouÓ and 
ÒweÓ? 

 

 

 

Are numbers written out? E.g. nine versus 9; one hundred percent versus 
100% 

 

 

 



 

Part 10B: Brochures 

Yes 

No 

NA 

Overall, are the brochures easy to read? 

 

 

 

Are some items boxed or bulleted to make important information stand out? 

 

 

 

Are the brochures available in large print? 

 

 

 

Are the brochures available in Braille? 

 

 

 

Are the brochures available in audio format? 

 

 

 

Is the brochure paper glossy with a high level of glare? 

 

 

 

Does the brochure color contrast use either dark print on a light background or 
light print on a dark background? 

 

 

 

Are color contrasts used throughout the brochure? 

 

 

 

Are simple, clear photos used throughout the brochure? 

 

 

 

Is there a lot of background clutter in the brochure? 

 

 

 

Do pictures used depict the appropriate age group? 

 

 

 

Do pictures represent the population receiving services? 

 

 

 

Is the font used in the brochure easy to read? e.g. at least a 14 pt. font? 

 

 

 

Are letters evenly spaced? 

 

 

 

Does the spacing between lines allow for materials to be easily read? 

 

 

 

Are the pages right justified? 

 

 

 

Are whole words split between lines? 

 

 

 




Part 10B: Brochures contÕd 

Yes 

No 

NA 

Are simple, short sentences used? 

 

 

 

Is jargon used? 

 

 

 

Are acronyms or abbreviations used? 

 

 

 

Is the information written in active, personal language such as ÒyouÓ and 
ÒweÓ? 

 

 

 

Are numbers written out? E.g. nine versus 9; one hundred percent versus 
100% 

 

 

 



 

 

Part 10B: Handbooks 

Yes 

No 

NA 

Overall, are the handbooks easy to read? 

 

 

 

Are some items boxed or bulleted to make important information stand out? 

 

 

 

Are the handbooks available in large print? 

 

 

 

Are the handbooks available in Braille? 

 

 

 

Are the handbooks available in audio format? 

 

 

 

Is the handbook paper glossy with a high level of glare? 

 

 

 

Does the handbook color contrast use either dark print on a light background 
or light print on a dark background? 

 

 

 

Are color contrasts used throughout the handbook? 

 

 

 

Are simple, clear photos used throughout the handbook? 

 

 

 

Is there a lot of background clutter in the handbook? 

 

 

 

Do pictures used depict the appropriate age group? 

 

 

 

Do pictures represent the population receiving services? 

 

 

 

Is the font used in the handbook easy to read? e.g. at least a 14 pt. font? 

 

 

 

Are letters evenly spaced? 

 

 

 

Does the spacing between lines allow for materials to be easily read? 

 

 

 

Are the pages right justified? 

 

 

 

Are whole words split between lines? 

 

 

 

Are simple, short sentences used? 

 

 

 

Is jargon used? 

 

 

 

Are acronyms or abbreviations used? 

 

 

 

Is the information written in active, personal language such as ÒyouÓ and 
ÒweÓ? 

 

 

 

Are numbers written out? E.g. nine versus 9; one hundred percent versus 
100% 

 

 

 



 

 

 

 

 

 


Describe the types of client handbooks that are currently being used. This can include rules and 
guidelines for residential services and domestic violence shelters. Please complete the checklist 
below to identify the handbook format. What alternate formats are available for the 
handbooks? 

 

 

 

 

 

 



 

Describe the content of the materials being used by the agency. Which materials include 
information related to violence and abuse? What references are made to safety? (i.e. safety 
planning, etc) What are the primary topics reflected in the materials? 

 

 

 

 

 

 

 

 

 

 



 

Describe what is used in the materials that make them welcoming? What types of techniques 
are used that make the materials interesting and inviting? (i.e. colors, photos, symbols) 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 

 


 

 

RESIDENTIAL SERVICES AND DOMESTIC VIOLENCE SHELTERS 

The following section of the Accessibility and Safety Audit Tool applies to 
agencies that offer residential services, such as group homes and to agencies 
that offer domestic violence shelters. 



 

 Each agency offering residential services and domestic violence shelters will complete 
the above Accessibility and Safety Audit Tool. In addition, the following sections will assist in 
evaluating specific areas for accessibility, welcoming and safety. 

 

 

PART 11: COMMON AREAS INCLUDING LIVING ROOMS 

 



 

This section addresses the ease of access a survivor with a disability will have in using a 
common area meeting room for services. This includes room accessibility, welcoming 
environment, and safety assurance. 

 

 

PART 11A: Common Area/Living Room: Accessibility 



 

 

Describe your overall impression of the common area. What mechanisms were in place to 
make the area easy to find? Was it easy to enter the common area? What did you notice first 
about the area? What about it made you want to enter and be a part of the group there? 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



 


 

Describe the space given for this common area. Describe the overall room space. Is it one large 
room or is the room sectioned by partitions? How many people could comfortably fit in the 
room? Can the common area accommodate a wheelchair and/or a service dog? Can the service 
dog remain close to the consumer? 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

Describe the flooring in the common area/living room. Is the flooring old or in need of repair? 
Is it stable, firm and slip resistant? Are there sections of the floor that are slippery? Can the 
flooring be easily used by a person in a wheelchair, with a cane or walker or with visual 
impairments? 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

 


 

PART 11B: Common Area: Welcoming Environment 



 

Describe the colors used in the common area. What about the colors make them warm and 
inviting? Are the colors too bright or too dull? Are there patterns used? Describe what is hung 
on the walls. Are there photographs or framed art/prints on the walls? Are there plants or 
other items that would make a person feel welcome? 

 

 

 

 

 

 

 



 

Describe the floor covering. Is it warm and inviting? Is the floor covering old, worn and/or dirty? 
Is the floor patterned or designed for ease of use? What about the floor covering would make it 
difficult for someone using a wheelchair or walker to use? What about the floor covering would 
make it difficult for someone with a visual impairment to use? Does the flooring appear level, 
stable, and slip resistant? 

 

 

 

 

 

 

 

 

 

 



 

 

Describe any information posted on the wall. What kind of information is it? Does it refer to 
domestic violence and abuse? Is it educational? Is it in simple language? In alternate format? In 
alternate language, such as Spanish? 

 

 

 

 

 

 

 




 

Describe any accommodations or adaptive equipment available in the common room. i.e. 
television control device with large print or not requiring operation through tight grasping, 
pinching or twisting of the wrist? 

 

 

 

 

 

 



 

 

PART 11C: Common Area Meeting Rooms: Safety Assurance 



 

Describe what mechanisms are in place that would make a person feel safe. Are there windows 
in the room? Do they have blinds, curtains, bars? Do the windows open? Can they provide an 
escape route if needed? Is there an alternate exit door in the common area? 

 

 

 

 

 

 



 

Describe the visibility in the common room. Are their hidden places in the room that are 
difficult to see? E.g. room partitions Could someone walk in behind you without you seeing 
them? What other things in the common area might make a person feel unsafe? 

 

 

 

 

 

 



 

Describe the lighting in the common area. Is it dim? Bright? Are the lights flickering? Would a 
person with low vision be able to see the materials? Would a person with low vision be able to 
move around the room in a safe manner? 

 

 

 

 

 




 

 What methods are in place to call for help within the common area? (telephone, alarm button, 
e-panic button) 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

PART 12: KITCHEN AND KITCHEN EATING AREAS 

 



 

This section addresses the ease of access a survivor with a disability would have in using the 
kitchen and kitchen area for services. This includes room accessibility, welcoming environment, 
and safety assurance. 

 

PART 12A: Kitchen and Kitchen Eating Areas: Accessibility 



 

Describe your overall impression of the kitchen area. What did you notice first about the area? 
Describe what is in place to make the kitchen area easily accessible. 

 

 

 

 

 

 

 

 

 

 

 



 

 

Describe the flooring in the kitchen area. Is the flooring old and in need of repair? Is it stable, 
firm and slip resistant? Are there sections of the floor that are slippery? Can the flooring be 
easily used by a person in a wheelchair, with a cane or walker or with visual impairments? 

 

 

 

 

 

 

 

 

 

 

 

 

 




 

Part 12a: Kitchen and Kitchen Eating Areas (ADAAG 9.2.2) 

Yes 

No 

NA 

Are counter tops no higher than 34Ó above the floor level? 

 

 

 

Are sinks no higher than 34Ó above the floor level? ADAAG 4.19 

 

 

 

Is there at least a 27Ó high, 30Ó wide and 19Ó deep knee clearance at the sink? 

 

 

 

Are hot water and drain pipes under the sink insulated or configured to 
protect against contact? Are there any sharp or abrasive surfaces under the 
sink area? 

 

 

 

Are faucets automatic or can they be operated with one hand and not require 
tight grasping, pinching or twisting of the wrist? 

 

 

 

Do faucets require no more than 5 lbs. of force (acceptable designs are lever-
operated, push-type and electronic)? 

 

 

 

Are soap dispensers at a reachable level of 48Ó or less? 

 

 

 

Are towel dispensers at a reachable level of 48Ó or less? 

 

 

 

Are outlets at a reachable level of 48Ó or less? 

 

 

 

Is there shelf space in cabinets within the reach range of no higher than 48Ó 
and no lower than 15Ó above the floor? 

 

 

 

Are any of the counters open underneath with a clear floor space of at least 
30Ó x 48Ó in front? 

 

 

 

Is there shelf space in refrigerators/freezers within the reach range of no 
higher than 48Ó and no lower than 15Ó above the floor? 

 

 

 

Is hardware for accessible storage areas either touch latches or u-shaped? 
ADAAG 4.25.4 

 

 

 

Can storage cabinet doors be operated with one hand and not require tight 
grasping, pinching, or twisting of the wrist? 

 

 

 

Can storage cabinet doors be operated using no greater than 5 lbs. of force? 

 

 

 

Does the refrigerator have a clear floor space of at least 30Ó x 48Ó centered on 
that feature? 

 

 

 

Does the range have a clear floor space of at least 30Ó x 48Ó centered on that 
feature? 

 

 

 

Does the sink have a clear floor space of at least 30Ó x 48Ó centered on that 
feature? 

 

 

 

Does the dishwasher have a clear floor space of at least 30Ó x 48Ó centered on 
that feature? 

 

 

 



 

 

 

 

 

 

 

 


 

Describe the seating in the kitchen eating area. Is the table(s) in a circle, rectangle, etc.? Are 
the chairs a variety of sizes? Is there room to transfer from a wheelchair to a kitchen chair? Are 
there chairs with and without arm rests? Are there chairs that roll and others that do not? Is 
there room for a wheelchair at the kitchen table? 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

Describe what mechanisms are in place to address dietary needs of survivors with disabilities. 
(i.e. alternate menus) 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

 

 

 


 

PART 12B: Kitchen and Kitchen Eating Area: Welcoming Environment 



 

What about the kitchen makes it a welcoming environment? Describe the colors used in the 
kitchen area. Are the colors warm and inviting? Are the colors too bright or too dull? Are there 
patterns used? Describe what is hung on the walls. Are there photographs or framed art/prints 
on the walls? Are there plants or other items that would make a person feel welcome? 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

Describe the floor covering. What makes the floor warm and inviting? Is the floor covering old, 
worn and/or dirty? Is the floor patterned or designed for ease of use? What about the floor 
covering would make it difficult for someone using a wheelchair or walker to use? What about 
the floor covering would make it difficult for someone with a visual impairment to use? Does 
the flooring appear level, stable, and slip resistant? 

 

 

 

 

 

 

 

 

 

 

 




 

 

Describe any information posted on the wall. What kind of information is it? Is it educational? 
Does it describe how to operate the equipment in the kitchen? Is it in simple language? In 
alternate format? In alternate languages? (i.e. Spanish) Is it comforting information? Does any 
of the information reflect issues related to domestic violence and abuse? 

 

 

 

 

 

 

 

 

 

 



 

Describe any accommodations or adaptive equipment available in the kitchen. i.e. timers, 
measuring supplies, cooking utensils, etc. or not requiring operation through tight grasping, 
pinching or twisting of the wrist? 

 

 

 

 

 

 

 

 



 

PART 12C: Kitchen and Kitchen Eating Area: Safety Assurance 



 

Describe what exists in the kitchen that would make a person feel safe? Are there windows in 
the room? Do they have blinds, curtains, bars? Do the windows open? Can they provide an 
escape route if needed? Is there an alternate exit door in the kitchen? 

 

 

 

 

 

 

 

 




 

What would make visibility difficult in the kitchen area? Are there hidden places in the kitchen 
that are difficult to see? E.g. pantry, recessed wall. Could someone walk in behind you without 
you seeing them? What other things in the kitchen area might make a person feel unsafe? 

 

 

 

 

 

 



 

Describe the lighting in the kitchen. Is it dim? Bright? Are the lights flickering? Would a person 
with low vision be able to see? Would a person with low vision be able to move around the 
kitchen in a safe manner? 

 

 

 

 

 

 

 

 

 



 

 Is there a way to call for help in the kitchen? (telephone, alarm button, e-panic button, TTY) 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

 

 

 


 

PART 13: RESIDENTIAL/SHELTER BATHROOMS INCLUDING TUBS & SHOWERS 

 



 

This section addresses the ease of access a survivor with a disability will have in using the 
residential/shelter bathrooms. This includes room accessibility, welcoming environment, and 
safety assurance. 

 

 

PART 13A: Residential/Shelter Bathrooms: Accessibility 



 

Describe your overall impression of the bathrooms. What did you notice first about the area? 
Does it feel large enough to accommodate a person with a wheelchair? Are accommodations 
evident in looking around the bathroom? 

 

 

 

 

 

 

 

 

 

 

 



 

Describe the flooring in the bathroom area. Is the flooring old and in need of repair? Is it stable, 
firm and slip resistant? Are there sections of the floor that are slippery? Can the flooring be 
easily used by a person in a wheelchair, with a cane or walker, or with visual impairments? 

 

 

 

 

 

 

 

 

 

 

 

 



 


Part 13A: Bathroom Door entry(ADAAG 4.13) 

Yes 

No 

NA 

If there is a single door, does the door have a minimum clear opening of 32Ó? 

 

 

 

Does the door have a minimum of 24Ó by 48Ó of level, clear space for a side 
approach? 

 

 

 

 

Can the door be opened with hardware that does not require grasping, 
pinching, or twisting? 

 

 

 

Can the door be operated with one hand? 

 

 

 

Can the door be opened with no greater than 5 lb. of force? 

 

 

 

Do doors swing into any of the clear floor space that is needed to access 
bathroom fixtures? (4.22.22) 

 

 

 

Toilets (ADAAG 4.16 and 4.17) 

Yes 

No 

NA 

Is there a minimum floor space of 48Ó wide and 69Ó long (56Ó if the toilet is 
wall mounted) for an accessible toilet? 

 

 

 

Is the toilet seat height between 16Ó and 19Ó high? 

 

 

 

Is the grab bar behind and beside the toilet no lower than 36Ó? 

 

 

 

Is the diameter of the bar between 1 ¥¥¥ and 1 ¥¥¥ Ò? 

 

 

 

Is the toilet self flush or can they be operated with one hand and not require 
tight grasping, pinching, or twisting of the wrist and no greater than 5 lbs. of 
force? 

 

 

 

Is the toilet paper dispensers no lower than 19Ó from the floor? 

 

 

 

Is there a 60Ó diameter space to allow for turning in a wheelchair? 

 

 

 

Lavatories and Mirrors (ADAAG 4.19) 

Yes 

No 

NA 

Is the sink no higher than 34Ó from the floor? 

 

 

 

Is there at least a 27Ó high, 30Ó wide and 19Ó deep knee clearance at the sink? 

 

 

 

Is there a clear floor space of 30Ó by 48Ó to allow for a forward approach (this 
can include 19Ó under the lavatory)? 

 

 

 

Are hot water and drain pipes under the sink insulated or configured to 
protect against contact? Are there any sharp or abrasive surfaces under the 
sink area? 

 

 

 

Are faucets automatic or can they be operated with one hand and not require 
tight grasping, pinching or twisting of the wrist? 

 

 

 

Do faucets require no more than 5 lbs. of force (acceptable designs are lever-
operated, push-type and electronic)? 

 

 

 

Are mirrors mounted with the bottom edge of the reflecting surface no higher 
than 40Ó above the floor? 

 

 

 

Bathtubs (ADAAG 4.20) 

Yes 

No 

NA 

Is there a minimum of 30Ó by 60Ó clear floor space in front of the tub? 

 

 

 

Is there a secure (will not slip during use) in-tub seat or seat at the head end of 
the tub? 

 

 

 

Are there grab bars? 

 

 

 

Are the grab bars between 33Ó and 36Ó from the bottom of the tub? 

 

 

 

Is the diameter of the bar between 1 ¥¥¥Ó and 1 ¥¥¥ inches? 

 

 

 




Bathtubs (ADAAG 4.20) contÕd 

Yes 

No 

NA 

Can water controls be operated with one hand? 

 

 

 

Can water controls be operated without tight grasping pinching, or twisting of 
the wrist? 

 

 

 

Can water controls be operated without exerting more than 5 lbs. of force? 

 

 

 

If there a shower spray unit? 

 

 

 

Can the shower spray unit be used as a hand-held unit? 

 

 

 

If the tub has an enclosure, does it have ÒtracksÓ on the tub rim that obstruct 
wheelchair transfer onto the seat? 

 

 

 

Showers (ADAAG 4.21) 

Yes 

No 

NA 

Is there a minimum clear floor space of 36Ó by 48Ó in front of the shower stall? 

 

 

 

Is the shower stall a minimum of 36Ó by 36Ó 

 

 

 

In a 36Ó by 36Ó stall, is the seat mounted opposite of the controls? 

 

 

 

In a larger 30Ó by 60Ó shower stall, is the seat mounted on the wall adjacent to 
the controls? 

 

 

 

Are there grab bars for the shower? 

 

 

 

Are the grab bars mounted between 33Ó and 36Ó above the shower floor? 

 

 

 

Is the diameter of the bar between 1 ¥¥¥Ó and 1 ¥¥¥Ó? 

 

 

 

Can water controls be operated with one hand? 

 

 

 

Can water controls be operated without tight grasping, pinching, or twisting of 
the wrist using no greater than 5 lbs. of force? 

 

 

 

Does the shower spray unit have a hose that is at least 60Ó long? 

 

 

 

Can the shower spray be used as a hand-held unit? 

 

 

 

Are the curbs in the shower stall no higher than ¥¥¥Ó 

 

 

 



 

 

PART 13B: Residential/Shelter Bathrooms: Welcoming Environment 



 

What features are in place that would create a welcoming environment? Describe the colors 
used in the bathroom. Are the colors warm and inviting? Are the colors too bright or too dull? 
Are there patterns used? Describe what is hung on the walls. Are there plants or other items 
that would make a person feel welcome? 

 

 

 

 

 

 

 

 

 



 


 

Describe any information posted on the wall. What kind of information is it? Is it educational? 
Does it refer to domestic violence and abuse? Does it describe how to operate the equipment 
in the kitchen? Is it in simple language? In alternate format? In alternate language (i.e. Spanish) 

 

 

 

 

 

 

 

 

 

 



 

 

Describe any accommodations or adaptive equipment available in the bathrooms. (i.e. pull 
cords for help, etc. or not requiring operation through tight grasping, pinching or twisting of 
the wrist) 

 

 

 

 

 

 

 

 

 



 

PART 13C: Residential/Shelter Bathrooms: Safety Assurance 



 

Describe what mechanisms are in place to create a safe environment in the restroom area. Are 
there windows in the bathroom? Do they have blinds, curtains, bars? Do the windows open? 
Can they provide an escape route if needed? Is there an alternate exit door in the bathroom? 

 

 

 

 

 

 

 

 




 

Describe the visibility in the bathroom. What makes it easy to see all around the area? Are their 
hidden places in the bathroom that are difficult to see? e.g. shower curtain, linen closet. Could 
someone walk in behind you without you seeing them? What other things in the bathroom 
area might make a person feel unsafe? 

 

 

 

 

 

 



 

Describe the lighting in the bathroom. Is it dim? Bright? Are the lights flickering? Would a 
person with low vision be able to see? Would a person with low vision be able to move around 
the bathroom in a safe manner? 

 

 

 

 

 

 



 

Describe methods of calling for help from the bathroom? (i.e. telephone, alarm button) 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

 

 

PART 14: RESIDENTIAL/SHELTER BEDROOMS 

 



 

This section addresses the ease of access a person with a disability will have in using the 
residential/shelter bedrooms. This includes room accessibility, welcoming environment, and 
safety assurance. 

 

PART 14A: Residential/Shelter Bedrooms: Accessibility 



 

Describe your overall impression of the bedroom. What did you notice first about the area? 
Does it feel large enough to accommodate a person with a wheelchair? Are accommodations 
evident in looking around the bedroom? 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

Describe the flooring in the bedroom. Is it stable, firm and slip resistant? Are there sections of 
the floor that are slippery? Can the flooring be easily used by a person in a wheelchair, with a 
cane or walker, or with visual impairments? If there is carpet, is it secured on the edges? 

 

 

 

 

 

 

 

 




 

Part 14A: Bedroom Door entry(ADAAG 4.13) 

Yes 

No 

NA 

If there is a single door, does the door have a minimum clear opening of 32Ó? 

 

 

 

Does the door have a minimum of 24Ó by 48Ó of level, clear space for a side 
approach? 

 

 

 

 

Can the door be opened with hardware that does not require grasping, 
pinching, or twisting? 

 

 

 

Can the door be operated with one hand? 

 

 

 

Can the door be opened with no greater than 5 lb. of force? 

 

 

 

Do doors swing into any of the clear floor space that is needed for entry? 
(4.22.22) 

 

 

 

Part 14A: Bedroom (ADAAG 9.0) 

Yes 

No 

NA 

Is there at least one accessible bedroom in residences with less than 25 
bedrooms? 

 

 

 

Are there at least two accessible bedrooms in residences with 26 to 50 
bedrooms? 

 

 

 

 

Is there a bedroom(s) for persons with hearing impairments? 

 

 

 

Is there at least 36Ó of maneuvering space on each side of the bed? 

 

 

 

If there are two beds in the room, is there at least a 36 inch wide maneuvering 
space located between the two beds? 

 

 

 

Is there either a 60Ó diameter or T-shaped turning space in the room? 

 

 

 

Is the bed adequate height for people transferring from a wheelchair? 

 

 

 

Is there a hospital bed on site? 

 

 

 

Is there an installed telephone with volume control in the bedroom? 

 

 

 

Is there an accessible electrical outlet within 4 ft. of a telephone connection 
for use with a text telephone? 

 

 

 

Part 14A: Bedroom Storage/Closets(ADAAG 4.25.1) 

Yes 

No 

NA 

Is there at least a 30Ó by 48Ó clear floor space in front of the storage area? This 
includes dressers, closets, and cabinets. 

 

 

 

Are there accessible storage areas no higher than 48Ó and no lower than 15Ó 
from the floor? 

 

 

 

Is hardware for accessible storage areas either touch latches or u-shaped? 

 

 

 

Can the door be opened with hardware that does not require grasping, 
pinching, or twisting? 

 

 

 

Can the door be operated with one hand? 

 

 

 

Can the door be opened with no greater than 5 lb. of force? 

 

 

 



 

 

 

 

 

 


PART 14B: Residential/Shelter Bedrooms: Welcoming Environment 



 

 

Describe the colors used in the bedroom. Are the colors warm and inviting? Are the colors too 
bright or too dull? Are there patterns used? Describe what is hung on the walls. Are there 
plants or other items that would make a person feel welcome? 

 

 

 

 

 

 

 

 

 



 

 

Describe the floor covering. Is it warm and inviting? Is the floor covering old, worn and/or dirty? 
Is the floor patterned or designed for ease of use? What about the floor covering would make it 
difficult for someone using a wheelchair or walker to use? What about the floor covering would 
make it difficult for someone with a visual impairment to use? Does the flooring appear level, 
stable, and slip resistant? 

 

 

 

 

 

 

 



 

 

Describe any information posted on the wall. What kind of information is it? Is it educational? 
Are there any references to domestic violence and abuse? Is the information in simple 
language? In an alternate language (i.e. Spanish) In an alternate format? Describe what would 
make the information comforting (i.e. photos, colors, content) 

 

 

 

 

 

 

 




 

Describe any accommodations or adaptive equipment available in the bedrooms. (i.e. pull 
cords for help, etc. or not requiring operation through tight grasping, pinching or twisting of the 
wrist) Are there visual notification devices to alert room occupants of incoming telephone 
calls? Are there adaptive alarm clocks or other personal assistance devices? 

 

 

 

 

 

 

 

 



 

PART 14C: Residential/Shelter Bedrooms: Safety Assurance 



 

Describe what mechanisms are in place that would make the bedroom feel safe. Are there 
windows in the room? Do they have blinds, curtains, bars? Do the windows open? Can they 
provide an escape route if needed? Is there an alternate exit door in the bedroom? 

 

 

 

 

 

 

 

 



 

Describe the visibility in the bedroom. Can you see all around the bedroom area? Are their 
hidden places that are difficult to see? e.g. long drapes, closets. Could someone walk in 
behind you without you seeing them? What other things in the bedroom area might make a 
person feel unsafe? 

 

 

 

 

 

 

 

 

 

 




 

Describe the lighting in the bedroom. Is it dim? Bright? Are the lights flickering? Would a 
person with low vision be able to see? Would a person with low vision be able to move around 
the bedroom in a safe manner? 

 

 

 

 

 

 



 

 Describe how to call for help in the bedroom? (i.e. telephone, alarm button) Describe whether 
the bedroom door locks. What is the policy for this? What is the procedure to accessing the 
room if it is locked in order to provide assistance? 

 

 

 

 

 

 



 

Part 14C: Bedroom Alarms: Safety Assurance (ADAAG) 

Yes 

No 

NA 

Are auxiliary visual alarms provided in the accessible rooms? 

 

 

 



 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

PART 15: BLANK TEMPLATE FOR AREAS/ROOMS NOT LISTED 

 



 

 

This section can be used for areas or rooms not listed in the Audit Tool above. It is formatted 
for a generic response and can be adapted as needed for the area under review. 

 

PART 15A: Accessibility 



 

Describe your overall impression of the area. What did you notice first about the area? Does it 
feel large enough to accommodate a person with a disability? Are accommodations evident in 
looking around the area? 

 

 

 

 

 

 

 

 

 

 

 



 

Describe the flooring in the area. Is the flooring old and in need of repair? Is it stable, firm and 
slip resistant? Are there sections of the floor that are slippery? Can the flooring be easily used 
by a person in a wheelchair, with a cane or walker, or with visual impairments? 

 

 

 

 

 

 

 

 

 

 

 



 

 

 


PART 15B: Welcoming Environment 



 

 

Describe the colors used in the area. Are the colors warm and inviting? Are the colors too bright 
or too dull? Are there patterns used? Describe what is hung on the walls. Are there plants or 
other items that would make a person feel welcome? 

 

 

 

 

 

 

 

 

 



 

 

Describe the floor covering. Is it warm and inviting? Is the floor covering old, worn and/or dirty? 
Is the floor patterned or designed for ease of use? What about the floor covering would make it 
difficult for someone using a wheelchair or walker to use? What about the floor covering would 
make it difficult for someone with a visual impairment to use? Does the flooring appear level, 
stable, and slip resistant? 

 

 

 

 

 

 

 



 

 

Describe any information posted on the wall. What kind of information is it? Is it educational? 
Are there any references to domestic violence and abuse? Is the information in simple 
language? In an alternate language (i.e. Spanish) In an alternate format? Describe what would 
make the information comforting (i.e. photos, colors, content) 

 

 

 

 

 

 

 




 

Describe any accommodations or adaptive equipment available in the area. i.e. pull cords for 
help, etc. or not requiring operation through tight grasping, pinching or twisting of the wrist? 

 

 

 

 

 

 

 

 



 

PART 15C: Safety Assurance 



 

Describe what mechanisms are in place that would make the aqrea feel safe. Are there 
windows in the room? Do they have blinds, curtains, bars? Do the windows open? Can they 
provide an escape route if needed? Is there an alternate exit door in the area? 

 

 

 

 

 

 

 

 



 

Describe the visibility in the area. Can you see all around the area? Are their hidden places that 
are difficult to see? e.g. long drapes, closets. Could someone walk in behind you without you 
seeing them? What other things in the area area might make a person feel unsafe? 

 

 

 

 

 

 

 

 

 

 

 

 



 


Describe the lighting in the area. Is it dim? Bright? Are the lights flickering? Would a person 
with low vision be able to see? Would a person with low vision be able to move around the 
area in a safe manner? 

 

 

 

 

 

 



 

 Describe how to call for help in the area? (i.e. telephone, alarm button) 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Attachment A 

 

 

 Accessibility and Safety Audit Letter 

 

H.O.P.E. Collaborative Date 

P.O. Box 554 

Waynesville, North Carolina 28786 

 

CEO/Executive Director Name 

Organization Address 

 

Dear ______________: 

 

 As you know, the H.O.P.E. Collaborative is currently working in Haywood County to 
develop services and supports that are responsive to the unique needs of individuals with 
disabilities and Deaf individuals that experience violence and abuse. Throughout the process 
your agency has been very involved and we appreciate the contributions _________ has made 
to this process. We are now beginning to implement the initiatives that we have been planning. 

 

 Our first step is to conduct accessibility and safety audits of each of our agencies. We 
will be using an Accessibility and Audit Tool that our group, with input from other professionals, 
survivors and individuals with disabilities, has developed. This tool has also been approved 
through the U.S. Department of Justice for use on this project. 

 

 The questions in this Accessibility Audit Tool address organizational accessibility, 
welcoming environments, and safety practices. This includes areas such as: the physical 
accessibility of the organization for all individuals with disabilities; the overall welcoming 
atmosphere of the organization; the availability of materials about violence against people 
with disabilities in alternate formats; and the provision of a safe environment to disclose a 
need for accommodations or disclosure of violence and abuse. This Tool will assist 
organizations as they look at ways to provide accessible and welcoming services to all 
individuals with disabilities that experience violence and abuse in their lives. 

 

 A team of 3 to 5 individuals will conduct the audit. The audit should take between two 
and four hours to complete, depending on the size of your organization. Following the audit, 
our collaborative team will look closely at the needs of your organization and assist you in 
making any changes that can be provided through our grant funded initiatives. If additional 
changes are recommended that are beyond our scope, we will work with you to explore ways 
of achieving these as well. We will work with you to build on your agencyÕs strengths and 
address any challenges as you move toward increased capacity to serve women with disabilities 
who experience violence or abuse. 

 


 We will call you next week to discuss the process further and set up a convenient time 
to conduct the audit of your organization. In the mean time if you have any questions, please 
contact us at 452-2122. 

 

Sincerely, 

 

Sue Fowler, Co-Project Director Denise Coleman, Co-Project Director 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Attachment B 

Accessibility and Safety Audit 

 Organization Questionnaire 

 

This questionnaire is to be completed prior to the organization audit. Information from this 
questionnaire will be used to inform the review team of potential size of organization, number of 
surveyors that will be needed, and projected length of the audit. 

 

Organization/Agency Date of Request: 

 30th Judicial District DV-SA Alliance ______________________________ 

 Arc of Haywood County 

 Haywood County Department of Social Services Date Scheduled for Assessment: 

 Haywood Vocational Opportunities ______________________________ 

 REACH of Haywood County 

 Smoky Mountain Center Date Assessment Completed: 

 

 ______________________________ 

Site Address: 

 

Street: ________________________________________________________________________ 

City: _________________________________________________________________________ 

 

 

Contact Person for Organization 

 

Name: ________________________________________________________________________ 

Office Phone: __________________________________ Cell: ___________________________ 

Email: _________________________________________ Fax: ___________________________ 

Hours of Operation: _____________________________________________________________ 

 

 



 

 

 

 

Request for Accessibility and Responsiveness Evaluation for: (Please check all that apply.) 

 

_____ Agency/Office building 

_____ Residential Living Space (Home/Apartment) 

_____ Shelter 

 

 

 


Organization Questionnaire page 2 of 2 

 

Areas to Be Evaluated: 

 X 

Area 

Quantity 

 

Parking lot, drop off zone and access paths 

 

 

Building entrance 

 

 

Lobby or Reception Area 

 

 

Hallways 

 

 

Stairways and Elevators 

 

 

Offices 

 

 

Common area meeting rooms 

 

 

Restrooms for public use 

 

 

Security and Rescue Assistance 

 

 

Adaptive equipment, assistive technology & printed materials 

 

 

Common areas including living room 

 

 

Kitchen and kitchen eating areas 

 

 

Residential/shelter bathrooms including tubs & showers 

 

 

Bedrooms 

 

 

Other area(s) 

 



 

 

Special Requests or Accommodations: 

 

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________ 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Attachment C 

Accessibility and Safety Audit 

Report Form 

 

Organization: 

Date of Audit: 

Date of Report: 

Members of Audit Team: 
__________________________________________________________________________________________________________________________________________________________________ 

 



 

The following is a review of the accessibility and safety audit conducted by the H.O.P.E. 
Collaborative Audit Team. The report is meant to be consultative and assist each organization in 
building on their strengths and addressing any challenges as they move toward increased 
capacity to serve individuals with disabilities who experience violence or abuse. 

 

 

 

PART I: PARKING LOT, DROP- OFF ZONE, AND ACCESS PATHS 

 



 

This section addressed the ease of access a survivor with a disability has upon arrival at the 
organization. This included the ease of entrance into the parking lot, ease of parking and drop 
off, access paths for the building approach, welcoming signage and how organization provides 
for the safety of participants. 

 

Strengths 

 

 

 

 

 

 

 



 

Findings: Accessibility 

 




 

 

 

 

 

 



 

Findings: Welcoming Environment 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 

 

 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 




 

 

 

 

 

 



 

 

 

PART 2: BUILDING ENTRANCE 

 



 

This section evaluated the building entrances that are the most likely to be used by a survivor 
with a disability. It included doors, ramps, stairs, welcoming signage (interior) and safety 
considerations. 

 

Strengths 

 

 

 

 

 



 

Findings: Accessibility 

 

 

 

 

 

 



 

Findings: Welcoming Environment 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 




 

 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 

 

 

 

 

 

 



 

 

PART 3: LOBBY OR RECEPTION AREA 

 



 

This section addressed the ease of access and the welcoming environment for a survivor with a 
disability who is entering the lobby or reception area or who is waiting for services. This 
includes accessibility to the lobby or reception area, how welcome they feel as they enter the 
organization, the signage, telephone accessibility and safety considerations. 

 

Strengths 

 

 




 

 

 



 

Findings: Accessibility 

 

 

 

 

 

 

 



 

Findings: Welcoming Environment 

 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 

 

 




 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 

 

 

 

 

 

 



 

 

PART 4: HALLWAYS 

 



 

This section assessed the ease of access a survivor with a disability has in navigating from one 
section of the building to another. This section included the actual hallway accessibility, water 
fountains, signage and safety considerations. 

 

Strengths 

 

 

 

 

 



 

Findings: Accessibility 

 

 

 

 

 



 

Findings: Welcoming Environment 

 




 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 

 

 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 

 

 

 

 

 

 



 

 




PART 5: STAIRWAYS AND ELEVATORS 

 



 

This section addressed the ease of access a survivor with a disability has in moving throughout 
the building to receive services. This section assessed stairways, elevators, signage and safety 
considerations. 

 

Strengths 

 

 

 

 

 



 

Findings: Accessibility 

 

 

 

 

 



 

Findings: Welcoming Environment 

 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 




 

 

 

 

 

 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 

 

 

 

 

 

 

 



 

 

PART 6: OFFICES 

 



 

This section assessed the ease of access a survivor with a disability has for entering offices in 
the organization. This includes accessibility within the office, how welcoming the office is to 
them and how safety and confidentiality is provided in the office area. 

 

Strengths 

 

 

 

 

 



 

Findings: Accessibility 

 

 




 

 

 

 

 



 

Findings: Welcoming Environment 

 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 

 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 

 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 




 

 

 

 

 

 

 



 

 

PART 7: COMMON AREA MEETING ROOMS 

 



 

This section assessed the ease a person with a survivor would have in utilizing the 
meeting/common room for services. This included the accessibility of the environment, how 
the design gave a welcoming feeling and any safety considerations. 

 

Strengths 

 

 

 

 

 



 

Findings: Accessibility 

 

 

 

 

 

 



 

 

Findings: Welcoming Environment 

 

 

 

 

 



 

Findings: Safety Assurance 

 




 

 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 

 

 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 

PART 8: PUBLIC RESTROOMS 




 



 

This section evaluated the ease of access a survivor with a disability would have in using the 
restrooms provided at the agency. This included physical access, the ease of use regarding the 
location and any safety considerations. 

 

 

Strengths 

 

 

 

 

 



 

Findings: Accessibility 

 

 

 

 

 

 

 

 

 

 

 



 

 

Findings: Welcoming Environment 

 

 

 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 




 

 

 

 

 

 

 

 

 



 

 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

 




PART 9: SECURITY AND RESCUE ASSISTANCE 

 



 

This section assessed the availability and type of security and/or rescue assistance available for 
a survivor with a disability in the agency. 

 

Strengths 

 

 

 

 

 

 



 

Findings: Accessibility 

 

 

 

 

 

 

 

 

 

 

 



 

 

 

Findings: Welcoming Environment 

 

 

 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 




 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 

 

 

 

 

 

 



 

 

 

 

 

PART 10: ADAPTIVE EQUIPMENT, ASSISTIVE TECHNOLOGY, AND ACCESSIBLE 
PRINTED MATERIALS 

 



 

 

PART 10-A: Adaptive Equipment and Assistive Technology 



 


This section evaluated the availability of adaptive equipment and/or assistive technology at the 
agency and assessed whether or not the agency has the means to facilitate disclosure by 
survivors with all disabilities and Deaf individuals. The section also assessed this availability in 
regard to general service provision in the agency. 

 

Strengths 

 

 

 

 

 

 

 

 



 

Findings: Accessibility 

 

 

 

 

 



 

 

Findings: Welcoming Environment (Format) 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 

 

 

 

 

 

 

 



 


 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 

 

 

 

 

 

 

 

 



 

 

 

PART 10-B: Accessible Printed Materials 

 



 

This area assessed whether printed materials used in the agency for intake and service 
provision for survivors with disabilities are available in a variety of accessible formats. This 
included a review for reading level, availability in other languages as appropriate and 
accessibility for individuals with low vision. 

 

Strengths 

 

 

 

 

 



 


Findings: Accessibility 

 

 

 

 

 



 

 

Findings: Welcoming Environment (Format) 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 

 

 

 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 

 

 

 

 

 

 



 


Long-term Recommendations/Resources 

 

 

 

 

 

 

 

 

 

 

 



 

 

PART 11: COMMON AREAS INCLUDING LIVING ROOMS 

 



 

This section assessed the ease a survivor with a disability would have in utilizing the common or 
living room during service delivery. This included the accessibility of the environment, how the 
design gave a welcoming feeling and any safety considerations. 

 

Strengths 

 

 

 

 

 

 

 

 



 

Findings: Accessibility 

 

 

 

 

 

 

 

 



 


Findings: Welcoming Environment 

 

 

 

 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 

 

 

 

 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 

 

 

 

 

 



 

 

 

 

 


Long-term Recommendations/Resources 

 

 

 

 

 

 

 

 



 

 

PART 12: KITCHEN AND KITCHEN EATING AREAS 

 



 

This section addressed the ease of access a survivor with a disability will have in using the 
kitchen and kitchen area for services. This included room accessibility, welcoming environment, 
and safety considerations. 

 

Strengths 

 

 

 

 

 

 

 



 

Findings: Accessibility 

 

 

 

 

 

 

 

 

 

 

 



 

 


Findings: Welcoming Environment 

 

 

 

 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 

 

 

 

 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 

 

 

 

 



 

 


 

 

 

 

PART 13: RESIDENTIAL/SHELTER BATHROOMS INCLUDING TUBS & SHOWERS 

 



 

This section evaluated the ease of access a person with a disability would have in using the 
residential/shelter bathrooms. This included physical access, the ease of use regarding the 
fixtures and any safety considerations. 

 

Strengths 

 

 

 

 

 

 

 



 

Findings: Accessibility 

 

 

 

 

 

 

 

 

 

 



 

 

Findings: Welcoming Environment 

 

 

 

 

 

 

 



 


Findings: Safety Assurance 

 

 

 

 

 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 

 

 

 



 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

PART 14: RESIDENTIAL/SHELTER BEDROOMS 

 



 

This section assessed the configuration of the bedrooms, the space available, how welcoming 
the environment is to a survivor with a disability and safety consideration. 

 

 

Strengths 

 

 

 

 

 



 

Findings: Accessibility 

 

 

 

 

 



 

 

Findings: Welcoming Environment 

 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 

 

 

 

 

 

 




 

 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 

 

 



 

 

 

PART 15: BLANK TEMPLATE FOR AREAS/ROOMS NOT LISTED 

 



 

This section was used to assess any other type of room or space in the agency that was not 
covered in the other sections. The area listed above was assessed for physical access, how 
welcoming the space is and for safety considerations. 

 

 

Strengths 

 

 

 

 

 



 

Findings: Accessibility 

 

 

 

 

 

 



 


 

Findings: Welcoming Environment 

 

 

 

 

 

 

 



 

Findings: Safety Assurance 

 

 

 

 

 

 

 

 



 

 

Short-term Recommendations/Proposed Solutions 

 

 

 

 

 



 

Long-term Recommendations/Resources 

 

 

 

 

 



 

 

 

 

 

 

 

 

 


 

 

 

 

 

This report has been explained and reviewed with the agency CEO/Executive Director. Only 
specific short-term expenditures that are in accordance with OVW funding guidelines and the 
strategic plan initiatives of the H.O.P.E. Collaborative of Haywood County, North Carolina can 
be made utilizing funds during this funding cycle. The CEO/Executive Director also commits to 
continued work with the agencies of the H.O.P.E. Collaborative to create an accessible, 
welcoming, and safe environment for survivors with disabilities that experience violence and 
abuse. 

 

____________________________________________________________________________ 

 Agency CEO/Executive Director (printed name) 

 

 

____________________________________________________________________________ 

Agency CEO/Executive Director (signature) Date