Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Expire Date

  • Total number of houses on site

  • Number of houses with legal occupants not working on farm (ESTA)

  • Number of houses with illegal occupants

  • Explanation of illegal occupancy

Housing Inspection

    House
  • Unit Number

  • Name of Occupant

  • Number of Occupants - Working on this farm

  • Number of Occupants - Not working on farm

  • General Neatness / Hygiene conditions

  • Sand bucket available

  • No Marijuana grown in garden

  • Pets kept on property

  • How many cats

  • How many dogs

Roof

  • Asbestos Free

  • Ceiling availability

  • Asbestos in good condition

  • Asbestos sign available

  • Skirtings and ceiling bord in good condition

  • Roof not leaking

  • Date of planned maintenance

Walls

  • Walls - Painted - Not peeling

  • Date of planned maintenance

  • Walls - Free of black mold

  • Walls - Damp Free

  • Walls - No Cracks

  • Walls - Higiene

Front Porch

  • Porch in good condition

Front Door

  • Weather Proof

  • Can Lock

  • Door knobs available

  • Door hinges working

  • Door handle available

Electricity

  • Electricity box in good condition

  • Electric sign on power box

  • No overloading of electricity

  • Plugs in working condition

  • Light fittings

Windows

  • Window in good condition (not broken, cracked or missing)

  • Window - Latch in good condition (not broken or missing)

  • Window - Arms in good condition (not broken or missing)

  • Window - fitted (no putty loose or missing)

Floors

  • Floor - Even

  • Planned maintenance date

Kitchen

  • Separate from sleeping are

  • Kitchen sink is not leaking

  • Kitchen tap - Water available

  • Kitchen tap - Not leaking

  • Cabinet in good condition

Bathroom

  • Toilet door can close for privacy

  • Geyser working

  • Shower head is in working condition

  • Shower tap has water

  • Shower higinic

  • Toilet lid available and in good repair

  • Toilet not leaking

  • Toilet flash working

  • Toilet has got water to flash

  • Toilet bowl in good condition

  • Sink is good condition

  • Sink taps not leaking

  • Sink taps has water

  • Bedrooms
  • Window not cracked or missing

  • Door in good condition

  • Signed by occupant as proof of inspection

  • Other comments

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