Public Accommodation Disability Access Survey
Exit this survey
*
1
. Name of Facility Surveyed, Date and Location (include city or county)
Name of Facility Surveyed, Date and Location (include city or county)
*
2
. (1) Route of travel ( ADAAG 4.3, 4.4, 4.5, 4.7 )
Is there a route of travel that does not require the use of stairs?
(1) Route of travel ( ADAAG 4.3, 4.4, 4.5, 4.7 ) Is there a route of travel that does not require the use of stairs?
Yes
No
3
. (1) Route of travel ( ADAAG 4.3, 4.4, 4.5, 4.7 )
Is the route of travel stable, firm and slip-resistant?
(1) Route of travel ( ADAAG 4.3, 4.4, 4.5, 4.7 ) Is the route of travel stable, firm and slip-resistant?
4
. (1) Route of travel ( ADAAG 4.3, 4.4, 4.5, 4.7 )
Are the accessible parking spaces closest to the accessible entrance?
(1) Route of travel ( ADAAG 4.3, 4.4, 4.5, 4.7 ) Are the accessible parking spaces closest to the accessible entrance?
Yes
No
5
. (1) Route of travel ( ADAAG 4.3, 4.4, 4.5, 4.7 )
Are accessible spaces marked with the International Symbol of accessibility?
(1) Route of travel ( ADAAG 4.3, 4.4, 4.5, 4.7 ) Are accessible spaces marked with the International Symbol of accessibility?
Yes
No
6
. (1) Route of travel ( ADAAG 4.3, 4.4, 4.5, 4.7 )
Is there an enforcement procedure to ensure that accessible
parking is used only by those who need it?
(1) Route of travel ( ADAAG 4.3, 4.4, 4.5, 4.7 ) Is there an enforcement procedure to ensure that accessible parking is used only by those who need it?
*
7
. Entrance ( ADAAG 4.13, 4.14, 4.5 )
If there are stairs at the main entrance, is there also a ramp or lift,
or is there an alternative accessible entrance?
Entrance ( ADAAG 4.13, 4.14, 4.5 ) If there are stairs at the main entrance, is there also a ramp or lift, or is there an alternative accessible entrance?
yes
no
*
8
. Vertical Circulation ( ADAAG 4.1.3(5), 4.3 )
Are there ramps, lifts, or elevators to all public levels?
Vertical Circulation ( ADAAG 4.1.3(5), 4.3 ) Are there ramps, lifts, or elevators to all public levels?
Yes
No
9
. On each level, if there are stairs between the entrance and / or elevators and essential public areas, is
there an accessible alternate route?
On each level, if there are stairs between the entrance and / or elevators and essential public areas, is there an accessible alternate route?
Yes
No
10
. Comments/Observations:
Comments/Observations:
Powered by
SurveyMonkey
Check out our
sample surveys
and create your own now!
Javascript is required for this site to function, please enable.