Private Sector H.C.S. Form Hampshire Consortium HCS 2009
General survey page
Address Label Here
Surveyor
Date
D
D
M
M
Y
Y
Survey outcome
For office use only
Full physical, with social
1
Form referred back to surveyor:
Full physical, social refused
2
Full physical, vacant
3
Survey Mgr
1
Project Mgr 2
Construction
Occupancy
Permanent
Tenure
Date
Residence?
pre 1850
1
Occupied
1
Yes
1
Owner occupied
1
1850 - 1899
2
Unlicensed occupation
2
N second home
2
Privately rented
2
1900 - 1918
3
Vacant awaiting new owner
3
N holiday home
3
Housing Association RSL
3
1919 - 1944
4
Vacant awaiting new tenant
4
N vacant
4
Other - specify
4
1945 - 1964
5
Vacant awaiting demolition
5
1965 - 1975
6
Vacant being modernised
6
1976 - 1981
7
New, never occupied
7
If occupied
1982 - 1992
8
Utilised non-res purpose
8
How long have current residents
Years ¦ Months
1993 - 1995
9
Other - specify below
9
lived here?
1996 - 2002
10
If vacant
Post 2002
11
How long has the dwelling been
Years ¦ Months
vacant?
Is the dwelling boarded up?
Y
N
Basement and attic
Storeys
Does dwelling have a habitable basement?
Y
N
No. of storeys excluding attic/loft/basement, in
building
Does dwelling have a habitable attic/loft
Y
N
No. of storeys excluding attic/loft/basement, in
conversion?
dwelling
Survey Building/Module and dwelling type and location within building/module
Purpose built block containing flats
1
If 1 then goto page 2
Where temp, is it a mobile
Y
N
End terrace house
2
Is the house sub-
home (caravan)
Mid terrace house
3
divided or shared?
Where mid terraced, is
Y
N
Semi detached house
4
}
Y N Ifno thereapassage?
Detached house
5
Temporary
6
Where terraced, is the
Y
N
If yes
Temporary: caravans, houseboats, prefab (not
property a back-to-back?
system built). If in doubt consult supervisor
Is the property Listed, or in
Y
N
a conservation area?
skip to page 4
Converted into flats
1
}
If 1 or 2 then goto page 2
Non res + flat
2
Shared house
3
Tenants renting 1 house as 1 group
if unsure if Shared
Bedsit
4
Typically occupied by individuals
House or Bedsit/Hostel,
Hostel
5
NOT renting as a group
treat as Bedsit/Hostel
If 3, 4 or 5
skip to page 3
Copyright CPC Ltd 2008
Page 1 of 10
Private Sector H.C.S. Form
Flats page
Nature of building
Where converted, est conversion date
Converted building
1
Purpose built flats
2
Use of basement
Number of flats in building
Common parts to building
No basement
0
Total
Are there common parts in
Y
N
Dwelling only
1
the building?
Owner occupied
Dwelling and services
2
Privately rented
If yes, answer the questions in this
Services only
3
column, if no, go to page 4
Location of flat in module
Dwelling and non res
4
Basement (B)
-1
Is there adequate fire protection in
Non residential only
5
common parts?
Dwelling and void
6
Ground floor (G)
0
Mains wired smoke detectors
Y
N
Other
7
number (if not B or G)
Fire extinguishers
Y
N
Use of ground floor
Percentages of wall exposed
Fire blankets
Y
N
Dwelling only
1
Must sum to 100%
Fire doors
Y
N
Dwelling and services
2
To outside air
% Protected escape route
Y
N
Services only
3
To internal accessway
% Fire safety notice
Y
N
Dwelling and no res
4
To other flats
% Any escape routes obstructed Y
N
Non residential only
5
Other notes on fire safety
Floor exposure
Dwelling and void
6
Other
7
Exposed ground floor
1
Exposed upper floor
2
Non residential use
Do the common parts provide
Part exposed upper
3
No non residential use
0
adequate access?
Un-exposed upper
4
Shop/business
1
They do not if entryways,
Y
N
Office
2
Roof exposure
stairs or passageways are
too narrow, if there is
Industrial/institutional
3
Exposed pitched
1
inadequate lighting, a lack of
Surgery
4
Exposed flat roof
2
handrails, or similar faults
Public house
5
Part exposed roof
3
affecting safe access to
Hotel
6
Un-exposed roof
4
Other - specify below
7
Please describe any faults to common
Heat loss corridor
parts in terms of condition issues
% non residential use
%
no corridor
1
Common part fault (a)
Total % floor area in
heated corridor
2
non residential use
unheated corridor
3
(estimated as a % of
corridor length
whole module)
(metres)
Sole use of amenities
External Dimensions
Common part fault (b)
No. units with sole use
Are external
Y
N
of amenities
dimensions of flat
Shared amenities
the same as for the
whole module?
No. units sharing
Common part fault (c)
amenities
IF no, give dimensions of this
flat (rectangularised):
Floors
Number of floors in flat
Main floor
Width (m)
Depth (m)
Common part fault (d)
maisonette only:
Second floor
Width (m)
Depth (m)
Upon completing this page, skip to page 4
Copyright CPC Ltd 2008
Page 2 of 10
Private Sector H.C.S. Form
HMO page
For bedsits
Shared parts of building
How many bedsit units
On the social section,
Is there adequate fire protection in
are there?
record details only for
common parts?
one bedsit unit
Mains wired smoke detectors
Y
N
For Hostels
Fire extinguishers
Y
N
How many people can the
On the social section,
Fire blankets
Y
N
hostel accommodate?
record details only for
Fire doors
Y
N
one resident
For Shared Houses
Protected escape route
Y
N
Fire safety notice
Y
N
How many people share
On the social section,
the house?
record details for all
Any escape routes obstructed Y
N
residents sharing
Other notes on fire safety
Shared amenities
How many bathrooms are
On the
Does the HMO provide adequate
in the whole building?
internal
access?
page, record
It does not if entryways,
Y
N
How many kitchens are in
if there are
stairs or passageways are
the whole building?
any works
too narrow, if there is
required to
inadequate lighting, a lack of
How many WCs are in the
any of the
handrails, or similar faults
whole building?
bathrooms,
affecting safe access to
kitchens or
How many living rooms
WCs
Please describe any faults to shared
(not bedrooms, kitchens
parts in terms of condition issues
etc) in the whole building?
Common part fault (a)
Common part fault (b)
Common part fault (c)
Common part fault (d)
Copyright CPC Ltd 2008
Page 3 of 10
Private Sector H.C.S. Form
Interior elements condition and amenities
Number of Double Bedrooms
Number of Single Bedrooms
Kitchen Circ Main
Other Main
2nd
Third
Any
Any
Bath
Tot
Urgent
Rooms
living living
bed
bed
bed
other other room
habitable
Habitable room
Y
Y
Y
Y
Y
Y
Y
Y
Sum of Y
Solid floor slab
2
M
Y
N
Solid floor screed
2
M
Y
N
Suspended floor structure
2
M
Y
N
Suspended floor cover
2
M
Y
N
Internal wall structure
2
M
Y
N
Plasterwork walls
2
M
Y
N
Plasterwork ceilings
2
M
Y
N
rep/ren rep/ren rep/ren rep/ren rep/ren rep/ren rep/ren rep/ren rep/ren rep/ren
rep/ren
Internal doors / frames
/
/
/
/
/
/
/
/
/
/
/
Y
N
Totals
Number of open chimneys
Number of flues
Number of fans
No. windows draughtproof
No. windows doubleglazed
Totals
Number of
No work
windows
Minor
requiring
Major
}Transfer
to boxes
on
work:
external
Renew
page
Total no. of windows in dwelling:
Age
No Work Repair Replace/
Build
None
Urgent
(years)
convert
install
and not
Ceiling height:
Kitchen
1
2
3
4
8
Y
N (ex basement/attic)
Hot and cold to sink
1
2
3
4
8
Y
N
(metres)
Kitchen cupboards
1
2
3
4
8
Y
N
House
Extension
Internal drainage
1
2
3
4
8
Y
ground
N
Hot + cold distribution
1
2
3
4
8
Y
1st
N
Staircase
1
2
3
4
8
Y
2nd
N
Gas supply
1
2
3
4
8
Y
3rd +
N
Electrical system
1
2
3
4
8
Y
Note: extension only applies
N
to extensions added since
Bath and/or shower
1
2
3
4
8
Y
N
built, not ORIGINAL additions
Wash-hand basin
1
2
3
4
8
Y
N Smoke detectors:
Hot + cold bathroom
1
2
3
4
8
Y
N Present and working Y N
W.C.
1
2
3
4
8
Y
N If yes:
Central heat distribute
1
2
3
4
8
Y
N Properly sited
Y
N
Central heating boiler
1
2
3
4
8
Y
N Mains wired
Y
N
Other heating
1
2
3
4
8
Y
N
Insulation to cylinder
1
2
3
4
8
Y
N Carbon monoxide
Insulation to loft
1
2
3
4
8
Y
N detectors:
Insulation to tank
1
2
3
4
8
Y
N Present and working
Y
N
Is the kitchen of adequate size
Y
N If no: does kitchen size affect HHSRS
Y
N Is there an external WC
Y
N
Noise:
Excess noise around the dwelling (e.g.
Y
N
Adequate noise insulation
Y
N
traffic, railways, airports, etc.
in dwelling?
Copyright CPC Ltd 2008
Page 4 of 10
Private Sector H.C.S. Form
Heating and energy efficiency
Total number of rooms in dwelling (habitable + non habitable)
Total number of habitable rooms
Are there any habitable rooms in the roof?
Y
N
If yes, total area of roof rooms
m2
Does the dwelling have mains gas supply?
Y
N
Is mains gas available in this location?
Y
N
Heating types
Main
2nd
Hot water type
Integral conservatory
Radiator system
1
1
Boiler/main heating
1
Permanent opening to heated
Storage heaters
2
2
From secondary heating
2
areas of the dwelling - cannot
Room heaters
3
3
Gas warm air system
3
be sealed off from air circulation
with remainder of dwelling
Underfloor
4
4
Gas instant single point
4
m2
Warm air
5
5
Gas instant multi point
5
Floor area
None
6
6
Electric instant
6
Double glazed
Y
N
Immersion (on peak)
7
m
Glazed perimeter
Heating fuel
Main
2nd
Water
Immersion (off peak)
8
Number of storeys
Mains gas
1
1
1
Immersion (dual)
9
LPG / bottled gas
2
2
2
Oil
3
3
3
Coal / wood
4
4
4
Hot water cylinder
Electricity meter
Anthracite
5
5
5
None
1
Single
1
Smokeless
6
6
6
Normal (90 - 130 ltr)
2
Dual
2
On-peak
7
7
7
Medium (131 - 170 ltr)
3
Off-peak
8
8
8
Large (171 + ltr)
4
Low energy light bulbs
Insulation type
%
Proportion of rooms
Main
2nd
None
1
Heating sys code
Jacket
2
Photo voltaic cells
Spray foam
3
% area of roof
Y
N
Heating controls
Main
2nd
Insulation thickness
None
Y
N
Y
N
12mm
1
Other renewables
Y
N
Programmer
Y
N
Y
N
25mm
2
Present - if yes, type:
Room stat
Y
N
Y
N
38mm
3
TRVs
Y
N
Y
N
50mm
4
Manual charge
Y
N
Y
N
80mm
5
Automatic charge
Y
N
Y
N
100mm
6
Other please speci Y
N
Y
N
Cylinder thermostat
Y
N
Solar water heating
Y
N
Loft Insulation
Cavity wall insulation
Solid wall insulation
Indicate the total amount of loft insulation, including
Indicate the total amount of
Indicate the type of solid wall
insulation that has been retrofitted. The minimums
cavity wall insulation. 'None'
insulation. 'None' should be
indicated are the lowest level fitted for dwellings beyond
should be indicated where there
indicated where walls are solid
the specified age, but insulation can be thicker
is a cavity but it is uninsulated
but uninsulated
No loft
0
No cavity
0
Not solid
0
None
1
None
1
None
1
25mm
2
Minimum for 1965 to 1975
25mm
2
Internal cladding
2
50mm
3
Minimum for 1976 to 1981
50mm
3
External cladding
3
75mm
4
100mm
5
Minimum for 1982 to 1989
Floor insulation
150mm
6
Minimum for 1990 to 1995
If the dwelling is on the ground floor, is the floor insulated?
Y
N
200mm
7
Minimum for 1996 to 2002
250mm
8
Minimum for 2002 onwards
300mm +
9
Copyright CPC Ltd 2008
Page 5 of 10
Private Sector H.C.S. Form
Socio-economic survey
How many households at this address?
How long has someone from the household lived here?
Working Status
Relationship to head
Sex
Family
Full-
Part-
Self-
Un-
Sick/dis Other
of household
Resident Male Female Age
unit
time
time employ employ abled
Disabled
2. Partner
Head
1
2
1
2
3
4
5
6
Y
N
3. Child
1
2
1
2
3
4
5
6
Y
N
4. Parent
1
2
1
2
3
4
5
6
Y
N
5. Grandparent
1
2
1
2
3
4
5
6
Y
N
6. Grandchild
1
2
1
2
3
4
5
6
Y
N
7. Other relative
1
2
1
2
3
4
5
6
Y
N
8. Lodger
1
2
1
2
3
4
5
6
Y
N
9. Sharer
1
2
1
2
3
4
5
6
Y
N
0. Other
1
2
1
2
3
4
5
6
Y
N
Does any member of your family have any longstanding disability, illness or infirmity?
Y
N
If yes:
Disability type
Person1 Person2
Disabled adaptations
Has
Needs
Bed bound
1
1
Wider doorways
1
2
Full time wheelchair user
2
2
Straight stair lift
1
2
Mainly wheelchair user (can't stand)
3
3
Curved stair lift / lift
1
2
Only uses wheelchair outdoors
4
4
Ramp
1
2
Walks using frame or other aid
5
5
Grab / hand rails
1
2
Walks unaided but unsteady
6
6
Hoist
1
2
Visually impaired
7
7
Redesign kitchen
1
2
Hearing impaired
8
8
Redesign / locate WC
1
2
Fully mobile
9
9
Redesign / locate bathroom
1
2
Other
10
10
Door answering / opening
1
2
Emergency alarm
1
2
Bathroom / bedroom extension
1
2
Other adaptation
1
2
Do you have difficulty in keeping warm
Black and Minority Ethnic
in the winter?
Y
N
How would you describe majority of your household?
White British
1
Do you keep the heating lower than
White Irish
2
you would like due to the cost?
Y
N
White Other
3
White/Black Caribbean
4
Has anyone in your household had a
White/Black African
5
trip or fall resulting in a visit to the
Y
N
White/Asian
6
doctor or hospital in the past year?
Other Mixed
7
Indian
8
Pakistani
9
Bangladeshi
10
Asian Other
11
Black Caribbean
12
Black African
13
Black Other
14
Chinese
15
Other
16
If other, please describe
How would you describe nationality of your household?
Copyright CPC Ltd 2008
Page 6 of 10
Private Sector H.C.S. Form
5QEKQGEQPQOKE UWTXG[
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Are you aware of any defects to the property?
Y
N
If yes, please describe
How much do you think these works will cost?
£
Can you afford to carry out these works?
Y
N
Would you consider a zero interest loan for these works
Y
N
From savings
1
What would your preference be for the work
Personal loan
2
Council loan
3
Other
4
Are you interested in shared ownership schemes
Y
N
Would you consider a flexible loan for repairs?
Y
N
Would you consider equity release for repairs?
Y
N
Have you received a grant/loan from the Council previously?
Y
N
Have you made any of the following improvements in the last 12 months?
Wall insulation
Y
N
Loft insulation
Y
N
Central heating
Y
N
New boiler
Y
N
Double glazing
Y
N
Renewable measures
Y
N
Please specify
What is the value of your property?
£
Do you have mortgage or other loan on the property?
Y
N
What is the current outstanding mortgage?
£
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Do you suffer significant levels of external noise?
Y
N
Please could you tell me what is yours and your partner's gross income, including any pension and or benefits
Annual
Month
Week
Refused
Don't know
Head
£
£
£
7
9
Partner
£
£
£
7
9
Does any of this income come from:
Yes
No 5HIXVHG 'RQ
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Are any of the following present?
Income support
1
2
7
9
Secure doors (deadlock)
Y
N
Housing benefit
1
2
7
9
Door viewer
Y
N
Council tax benefit
1
2
7
9
Door chain
Y
N
Inc based job seekers allowance
1
2
7
9
Secure windows (locks)
Y
N
Attendance allowance
1
2
7
9
Alarm
Y
N
Disabled living allowance
1
2
7
9
Industrial injuries disable benefit
1
2
7
9
War disablement pension
1
2
7
9
Pension credit (g'ranteed/savings)
1
2
7
9
Working tax credit
1
2
7
9
Child tax credit
1
2
7
9
State pension
1
2
7
9
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Y
N
If yes, contact details:
Name:
Tel:
Copyright CPC Ltd 2008
Page 7 of 10
Private Sector H.C.S. Form
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Gable
Roof Cover
front
Y
N
Primary
7\SH
$JH Secondary 7\SH
$JH
Back2
1DWXUDO VODWH
back
1
%
1 1DWXUDO VODWH
11
%
1
Y
N
Storeys
$VE FHP VODWH
2
%
2 $VE FHP VODW 22
%
2
left
Y
N
Roof Pitched
1
&OD\ WLOH
3
%
3 &OD\ WLOH
33
%
3
right
Y
N
Roof Flat
2
&RQFUHWH WLOH
4
%
4 &RQFUHWH WLOH
44
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Walls
Y
N
$VSKDOW
5
%
5 $VSKDOW
55
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insulated
Front
0
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6
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6 )HOW
66
%
6
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0
7
%
7 /DPLQDWH
77
%
7
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8
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8 7KDWFK
88
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8
Left
0
Back
6WRQH
9
%
9 6WRQH
99
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9
Right
0
Storeys
Wall Structure
Roof Pitched
1
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Y N
Primary
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2
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Walls
Y
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0DVRQ VLQJOH
2
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insulated
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3
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3 VROLG
33
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Right
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Storeys
7LPEHU
7
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7 7LPEHU
77
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7
Roof Pitched
1
Roof Pitched
1
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1
0HWDO IUDPH
8
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8 0HWDO IUDPH
88
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8
Roof Flat
2
Roof Flat
2
Roof Flat
2
&REE
Y
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Walls
Y
N
Walls
Y
N
Walls
Y
N
&RWVZROG VWRQH
Y
N
insulated
insulated
insulated
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Y
N
35&
Y
N
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Front
Wall Surface
Primary
7\SH
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0DVRQ SRLQW
1
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Roof Pitched
1
1DWXUDO
2
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2 1DWXUDO
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Roof Flat
2
5HQGHUHG
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Walls
Y
N
6KLSODS WLPE
4
%
4 6KLSODS WLPE
44
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4
insulated
7LOH KXQJ
5
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5 7LOH KXQJ
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7
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3LWFKHG URRI WLPEHUV
1
2
3
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8
Y
N
2WKHU
8
%
8 2WKHU
88
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8
3LWFKHG URRI FRYHU
1
2
3
4
8
Y
N
Window frame
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1
2
3
4
8
Y
N
Primary
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Y
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:RRG FDVH
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N
0HW WKHUP EUN
3
%
3 0HW WKHUP EUN 33
%
3
)RXQGDWLRQV
1
2
3
4
8
839&
Y
N
4
%
4 839&
44
%
4
3DYHG DUHDV
1
2
3
4
8
:RRG 6DVK
Y
N
5
%
5 :RRG 6DVK
55
%
5
0HWDO VDVK
6
%
6 0HWDO VDVK
66
%
6
:DOOV IHQFHV
1
2
3
4
8
Y
N
839& 6DVK
7
%
7 839& 6DVK
77
%
7
([WHUQDO VWHSV
1
2
3
4
8
Y
N
2WKHU
8
%
8 2WKHU
88
%
8
7RWDO QXP 0LQRU
0DMRU 5HSODFH
1D
8UJHQW" 5HQHZ SHULRG
Window glazing
&KLPQH\ VWDFNV
Y
N
1RWH 'RXEOH VKRXOG EH WKH QRUP IRU GZHOOLQJV EXLOW DIWHU
'RUPHUV
Y
N
WKLV GDWH EXW PD\ DOVR EH UHWURILWWHG 6KRXOG KDYH D NLWH PDUN
%D\V H[FO ZLQGRZV
ZLGHU VSDFLQJ DQG LV $UJRQ ILOOHG
Y
N
:LQGRZV DQG IUDPH
Y
N
Primary
7\SH
$JH Secondary 7\SH
$JH
'RRUV DQG IUDPHV
6LQJOH
Y
N
1
%
1 6LQJOH
11
%
1
'RXEOH
'RXEOH
1R :RUN
0LQRU 5SO,QVW 'HPROLVK 1D
8UJHQW" 5HQHZ SHULRG
2
%
2
22
%
2
'RXEOH
3
%
3 'RXEOH 33
%
3
'3&
1
2
3
4
8
Y
N
Doors
)DVFLD
1
2
3
4
8
Y
N
Primary
7\SH
$JH Secondary 7\SH
$JH
5RRI GUDLQDJH
1
2
3
4
8
Y
N
:RRG
1
%
1 :RRG
11
%
1
6RLO GUDLQDJH
1
2
3
4
8
Y
N
839&
2
%
2 839&
22
%
2
2XWEXLOGLQJV
1
2
3
4
8
Y
N
2WKHU
3
%
3 2WKHU
33
%
3
Copyright CPC Ltd 2008
Page 8 of 10
Private Sector H.C.S. Form
Housing Health and Safety Rating System
Hazards to be noted (no
Risk: Above
Extreme
Hazards to be scored in
Risk: Above Extreme
average
detailed scoring required)
detail (score on next page)
average
Excess heat
1
2
Falls on stairs etc
1
2
Lighting
1
2
Falls on level surfaces
1
2
Water supply for domestic purpose
1
2
Falling between levels
1
2
Food safety
1
2
Falls associated with baths etc
1
2
Personal hygiene, sanitation, drains
1
2
Fire
1
2
Position and operability of amenities
1
2
Flames hot surfaces etc
1
2
Uncombusted fuel gas
1
2
Damp and mould growth
1
2
Explosions
1
2
Entry by intruders
1
2
Electrical safety
1
2
Collision and entrapment
Carbon monoxide and fuel products
1
2
1
2
Domestic hygiene, pets, refuse
1
2
If any of these hazards score an above average risk of
Structural collapse, falling elements
1
2
harm, these MUST be scored individually on the page
Noise
1
2
9 of this form
Crowding and space
1
2
Falls on stairs etc
Average pre 1919
Likelihood of a person
5600
3200
1800
1000
560
320
180
100
56
32
18
6
2
over 60 having a fall
Class1 Extreme
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Must not
Likely outcome
Class2 Severe
add up to
if person over
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
>100.2%
60 should fall
Class3 Serious
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Install handrail
Y
N
Repair/replace external/common stairs
Y
N
Install balustrade
Y
N
Repair/replace external steps
Y
N
Cover dangerous balustrade/guarding
Y
N
Cover slippery stairs
Y
N
Repair/replace internal staircase
Y
N
Repair/replace/provide additional light
Y
N
Redesign stairs (design, not condition)
Y
N
Remove obstacle(s)
Y
N
Falling on level surfaces
Average
Likelihood of a person
5600
3200
1800
1000
560
320
180
100
56
32
18
6
2
over 60 having a fall
Class1 Extreme
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Likely outcome
Must not
if person over
Class2 Severe
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
add up to
>100.2%
60 should fall
Class3 Serious
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Repair floors
Y
N
Cover slippery floors
Y
N
Repair paths/external surfaces
Y
N
Repair/replace/provide additional light
Y
N
Remove trip steps
Y
N
Remove obstacle(s)
Y
N
Redesign external pathways
Y
N
Falling between levels
Average
Likelihood of a child
5600
3200
1800
1000
560
320
180
100
56
32
18
6
2
under 5 having a fall
Likely outcome Class1 Extreme
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Must not
if a child under Class2 Severe
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
add up to
5 should fall
>100.2%
Class3 Serious
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Window safety catches to install
Y
N
Repairs to plot level and falls
Y
N
Repair/replace lighting
Y
N
Repair/replace guarding/balustrading
Y
N
Brick up dangerous opening/raise cill
Y
N
Guard rails to install
Y
N
Repair/replace balconies
Y
N
Remove obstacle(s)
Y
N
Falls associated with baths etc Average
Likelihood of a person
5600
3200
1800
1000
560
320
180
100
56
32
18
6
2
over 60 having a fall
Likely outcome Class1 Extreme
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Must not
if person over
Class2 Severe
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
add up to
60 should fall
>100.2%
Class3 Serious
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Copyright CPC Ltd 2008
Page 9 of 10
Private Sector H.C.S. Form
Housing Health and Safety Rating System (cont...)
Fire
Average Avg flat
Likelihood of a person
5600
3200
1800
1000
560
320
180
100
56
32
18
6
2
over 60 being harmed
Likely outcome Class1 Extreme
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Must not
if person >60
Class2 Severe
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
add up to
should be hurt
>100.2%
Class3 Serious
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
repair/replace electrics
Y
N Extend kitchen and re-fit
Y
N Provide fire stops service duct
Y
N
Provide additional sockets
Y
N Re-site kitchen and re-fit
Y
N Provide fire stop wall loft space
Y
N
Repair/replace heaters
Y
N Reposition heater/heating
Y
N Provide self closing doors
Y
N
Replace inadequate heating
Y
N Remove inappropriate finish
Y
N Install smoke detectors
Y
N
Relocate cooker
Y
N Replace non fire resist struc
Y
N Provide suitable doors/windows
Y
N
Re-fit kitchen
Y
N Upgrade stairs protected route
Y
N Provide fire escape
Y
N
Flames hot surfaces etc
Average
Likelihood of a child
5600
3200
1800
1000
560
320
180
100
56
32
18
6
2
under 5 being burnt or
Likely outcome Class1 Extreme
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Must not
if child under 5 Class2 Severe
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
add up to
should be hurt Class3 Serious
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
>100.2%
Reposition heater/heating/pipes
Y
N Re-fit kitchen
Y
N
Re-site kitchen and re-fit
Y
N
Relocate cooker
Y
N Extend kitchen and re-fit
Y
N
Remove obstacle(s)
Y
N
Damp and mould growth
Average
Likelihood of person
5600
3200
1800
1000
560
320
180
100
56
32
18
6
2
under 15 becoming ill
Treat rising damp
Y
N
Condensation - install/fix fans
Y
N
Repair/replace/improve heating Y
N
Treat penetrating damp
Y
N
Condensation - improve windows Y
N
Improve insulation
Y
N
Entry by intruders
Average
Likelihood of a person
5600
3200
1800
1000
560
320
180
100
56
32
18
6
2
being affected
Make doors to dwelling secure
Y
N Provide further (security) lights Y
N Flats: concierge/entry phone
Y
N
Make windows to dwelling secure Y
N Install Alarm/CCTV to dwelling
Y
N Repair/provide defensible spce Y
N
Neighbourhood problems which require measures other than improving dwelling security
Collision and entrapment
Average
Likelihood of a child
5600
3200
1800
1000
560
320
180
100
56
32
18
6
2
under 5 being injured
Likely outcome Class1 Extreme
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Must not
if a child under Class2 Severe
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
add up to
5 is injured
Class3 Serious
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
>100.2%
Repair/replace jamming/poorly operating door(s)
Y
N
Raise doorway height where less than 1.9m
Y
N
Repair/replace jamming/poorly operating window(s)
Y
N
Raise/alter ceiling beam arrangement where <1.9m
Y
N
Replace windows that project over path/walk ways
Y
N
Relocate poorly positioned door
Y
N
Install safety glazing where not present
Y
N
Close unprotected gaps (e.g. banisters >100mm)
Y
N
Hazard title
Likelihood
1800
1000
560
320
180
100
56
32
18
6
2
Class1 Extreme
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Must not
Class2 Severe
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
add up to
Class3 Serious
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
>100.2%
Hazard title
Likelihood
1800
1000
560
320
180
100
56
32
18
6
2
Class1 Extreme
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
Must not
Class2 Severe
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
add up to
Class3 Serious
0.1
0.2
0.5
1
2.2
4.6
10
21.5
31.6
46.4
100
>100.2%
Copyright CPC Ltd 2008
Page 10 of 10
