Accessibility Decal Program Screening Form

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Accessibility Decal Program Screening Form

Please use this checklist to document your screening. This form is only a basic guide for evaluation purposes, and is not a substitute for state and federal accessibility standards. Photos may also be emailed to adecalphotos.hcr@evansville.in.gov with a subject captioned with screening location and a description of the photograph.

* Denotes a required field
Submission Date*
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Screening Date*
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ZIP*
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Second portion of ZIP Code is optional.
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Contact Phone Number*
-- ext
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Surveyor(s) Phone Number(s)*
-- ext

Parking

1. Is there dedicated parking for the facility? (parking over which the facility has control) If No, skip to "Path of Travel."
Dedicated Parking 
a. How many total spaces are there?
 
b. How many accessible spaces are there?
 
c. Of those spaces, how many have upright signs saying they are accessible spaces?
 
d. How many van accessible spaces are there?
 
e. Of those van accessible spaces, how many have upright signs saying they are "Van Accessible"?
 
f. Do all accessible spaces have a striped access aisle (two spaces may share a common aisle)?
Striped Access Aisle 
g. Are the aisles at least 5 feet wide?
Appropriate aisle width? 
h. Is the width of each van accessible space plus adjacent aisle equal to at least 16 feet?
Van & access aisle appropriate width? 
2. Is the accessible parking on the closest (and/or safest) route to the accessible entrance?
Closest route to entrance? 
3. If there is a garage entrance, is it 8' 6" vertical clearance? 
 
Provided "Accessible Parking Spaces" Handout (only if there is an issue and the organization expresses interest in change)? 

Path of Travel (To get to entrance, common areas, etc.)

1. Is there a clear, accessible path of travel from parking to the facility entrance?*
2. Are there ramps and curbcuts? If No or N/A, skip to #6. 
 
 
 
 
 
 
3. Are ramps/curbcuts where the slopes begin and end at least 36" wide? 
4. Is any ramp longer than 6'? If No, skip to #5. 
a. If yes, does it have railings 34" to 38" high? 
5. Is any ramp longer than 30'? If No, skip to #6. 
a. If yes, are there landings at least 5' x 5' every 30' of length? 
6. Are there uneven areas along the path of travel, more than 1/2"?*
7. Is the path of travel clear of protruding objects between 27" and 80" from the ground?*
8. Is there a slope along the path of travel that is problematic?*
 

Entrance and Doors

For the Accessible Entrance

1. If there is more than one public entrance to a facility, is it clear (by signage or observation) which is the accessible entrance? 
2.a Is the exterior door an unobstructed, non-revolving, hinged door which can be opened with a closed fist (or automatically) and has an opening at least 32" wide? If No, indicate problem(s) in the Comments section.
Exterior doors meet appropriate requirements?*
Is the Height of threshold 3/4 inches or less?*
 
c. Is the edge of the threshold beveled (like a tiny ramp)?*
3. If there is a vestibule, is there at least 5' clearance between doors?*
4. Does the Exterior Door feel like it might be hard to open for a person with disability or a senior?*

For the Interior Doors Open to the Public

If there are interior doors (not including the bathroom doors), are they unobstructed, non-revolving, hinged, easily opened with a closed fist and with an opening at least 32" wide? If No, indicate inaccessible door location(s) and the problem(s) in the Comments section. If N/A, skip to #6.
5a. Interior doors meet appropriate requirements 
 
5c. Is the edge of the Interior Door beveled (like a tiny ramp)? 
6. Does the door feel like it might be hard to open for a person with disability or a senior?*
 
Provided "Door Poundage Guidelines" Handout (only if there is an issue of a door seeming particularly heavy and hard to open and the organization expresses interest in change)? If there is an issue, we will come and use the door poundage gauge to formally measure the opening force.
Handout provided?*

Elevators, Stairs, & Railings

1. How many levels owned by this business and open to the public are there? If One, skip to "Common Areas."*
2. Are all levels open to the public accessible by ramp or elevator? 
3. Is there an elevator? If No, skip to #5. 
4. If there are elevators, are controls no higher than 48", closed fist operable, marked with raised characters and Braille? If No, indicate problem(s) in Comments section.
Elevators meet appropriate requirements? 
a. Do elevators have both visual and audible floor indicators and Braille floor indicators on the exterior frame of the elevator on each floor? If No, indicate problem(s) in the Comments section.
Appropriate floor indicators? 
5. Are there interior ramps? If No, skip to #6. 
a. Do any ramps along the path(s) of travel exceed 6' in height or 72" in length? 
If yes, are there firm and stable handrails on both sides, parallel with the ground surface, with continuous grippable surfaces between 34" and 38" above ramp surface, and extending at least one foot beyond ramp, with a rounded end? If No, indicate problem(s) in Comments section.
b. Handrails meet appropriate requirements? 
c. If yes, are there landings at least 5' x 5' every 30' of length? 
6. Are there flights of stairs accessing the public areas? If No, skip to Common Areas section. 
a. If yes, are there firm and stable handrails on both sides, with continuous grippable surfaces between 34" and 38" above stair? If No, indicate the problem(s) in Comments section.
Stair handrails meet appropriate requirements? 
b. At the top of stairs, do all handrails extend at least one foot beyond the top riser, parallel with the ground surface? 
c. At the bottom of stairs, do handrails extend at the slope of the stair flight for a horizontal distance at least equal to the depth of one step?
Handrail extension at bottom of stairs? 
 

Common Areas (Interior & Exterior)

1. Are the aisles at least 36" wide? 
2. Are the aisle free from protrusions that stick out more than four inches into the aisle between the height of 27" to 80"?*
3. Is a service counter necessary for transactions? If No, skip to #5, but describe in the Comments section how staff accommodates a person's needs.
Service counter?*
 
 
5. Is the credit card machine less than 48" high? If you notice any other problem (touch screen, visibility issues, etc.), please mention them in the Comments section below.
Credit card machine 48" high or less?*
6. Are the seating/tables fixed? If no seating/tables, skip to Public Restrooms & Drinking Fountains.*
7. Is there an outdoor dinning areas? If No, skip to Public Restrooms & Drinking Fountains. 
a. Is it on the same level or ramped? 
 

Public Restrooms & Drinking Fountains

1. Are there public restrooms used by the business customers? If No, skip to #2.*
Is there accessibility signage (raised lettering, international symbol of accessibility) near the restroom? 
i. Is the width of the door opening at least 32" or more? 
b. If above answer is "No," answer this question. Measure the width in inches, and enter ONLY the numeric value. Do not enter any symbols such as ( " ) or type "in" or "inches".
 
c. For the bathroom doors, are they unobstructed, non-revolving, hinged, easily opened with a closed fist and with an opening at least 32" wide? If No, indicate inaccessible door location(s) and the problem(s) in the Comments section.
Restroom doors meet appropriate requirements? 
d. If there are multiple floors open to the public, is there one accessible restroom per floor? 
e. Is the restroom/stall at least 5' x 5' (measured wall to wall)? 
f. Are there grab bars at the back and side of the toilet? 
i. Is the distance from the floor to the operable part of the paper towel dispenser 48" or less? 
 
i. Is the distance from the floor to the operable part of the soap dispenser 48" or less? 
 
iii. Is the reach across the sink to the soap dispenser 25" or less? 
 
v. Is the knee clearance from the floor to the bottom of the sink at least 27"? 
 
vii. Is the hand dryer 48" or less from the floor? 
 
ix. Does the sink have levers (not knobs)? If the sink has something other than levers or knobs (such as automatic sensors or push buttons) describe them in the comments
Sink have levers? 
h. Is the toilet paper dispenser between 15" and 48" from the ground? 
I. Is the toilet paper dispenser no farther than 9" in front of the toilet? 
2. If there is a drinking fountain, is one of the spouts no higher than 36", measured from the floor to the spout outlet?*
 

Customer Service & Employment

1. Does staff receive information during orientation on how to serve customers with disabilities?*
2. Does the business want assistance in obtaining materials in alternative formats for people with visual disabilities ("Guidelines for Preparing Menus in Large Print")?
Business want format assistance?*
3. Does the business want assistance in obtaining materials to assist customers with disabilities ("ADA Guide for Small Businesses", "Disable Disrespect", "Access to Restaurants")?
Business want general assistance?*
 
 
Are there any barriers to accessibility at this facility?*
 
Send me a copy of my responses*