General Information

  • Document No.

  • Owner (College)

  • Building Name

  • Room Number

  • Suite Name/Number (OPTIONAL)

  • Common Name (optional)

  • Assessment Date/Time

  • Prepared by (email)

  • Prepared by (email 2)

  • Prepared by (email 3)

  • Location

Space Attributes

  • Link to AVDB Record (OPTIONAL)

  • Sketch of Room Floor Plan

  • Room Dimensions (Width, Length, Ceiling Height) Approx

  • Approx Age of Room, since last renovation (OPTIONAL)

  • Posted Seating Capacity

  • Room Type

  • Current Technology Tier

  • Projected Type Classification

  • Room Front

  • Room Rear

  • Podium/Teaching Station

  • AV Control Interface

  • Approximate Current Technology Value

Space Features

  • Lighting Type

  • Is Lighting acceptable to allow for note taking and instructional media?

  • Light level at average student desk measurement (OPTIONAL)

  • Light level at presentation wall (display system off), window coverings closed and lights on measurement. (OPTiONAL)

  • External Light Control Type

  • Do window coverings sufficiently prevent direct light from impacting presentation media?

  • Light level at presentation wall with window coverings closed and lights off measurement. (OPTIONAL)

  • Acoustics Type

  • Is the room without distracting echo?

  • RT-60 (echo) Decay Time Measurement (OPTIONAL)

  • Unwanted Noise Source

  • Is the room relatively quiet (no ambient noise)?

  • SPL Ambient Noise Level Measurement (OPTIONAL)

  • Room Controls ( screen, lights, shades, other) Co-Located?

  • Potential hazard or access issue (notes)

  • Potential Hazard Noted

AV Features

  • Audio- Sound System

  • Is there a sound system?

  • Sound System Approx Age in Years

  • Is sound system loud enough, balanced frequency response and generally equal coverage of seating area?

  • SPL nominal sound system measurement for level sufficient above ambient level (OPTIONAL)

  • RTA frequency response with pink noise measurement. (OPTIONAL)

  • Video Display

  • Is there a video display system?

  • Video Display Approx Age in Years

  • Is the video display system large enough, bright enough, and with sufficient contrast?

  • Size of video display with respect to furthest viewer.

  • Surface brightness of video display measurement. (OPTIONAL)

  • AV Control Interface

  • Are the basic functions of On/Off, Source selection, and Volume Control consistent with local standard?

  • Enhanced Technology

  • Does the room have dedicated ALS system?

  • Does the room have simplified usage instructions, including contact information for support?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.