Public Accessibility Checklist Form
Please complete the checklist to ensure public accessibility standards are met.
Location/Facility Name
*
Date of Inspection
*
-
Month
-
Day
Year
Date
Is the entrance wheelchair accessible?
*
Yes
No
Partially
Are accessible parking spaces available?
*
Yes
No
Partially
Are accessible restrooms available?
*
Yes
No
Partially
Is there tactile signage for the visually impaired?
*
Yes
No
Partially
Are service counters at accessible heights?
*
Yes
No
Partially
Are elevators or ramps available for multi-level access?
*
Yes
No
Partially
Additional Comments
*
Inspector's Full Name
*
First Name
Last Name
Inspector's Signature
*
Submit
Should be Empty: