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, <br /> y c�r-� <br /> Q '.�1 x .. <br /> CYHtn • <br /> � � <br /> H �� � <br /> Ky� 2 <br /> �H� <br /> ��� Re¢. ,ur AREA AalD IlE•i YES IIO <br /> p � C KITCY.�d (cont ' d) � <br /> H � � Is stove D.^o�erlv instnlledT I I <br /> H" � Is stove in good repair end Sit Sor <br /> z H� the use intended7 <br /> y .e Is there one electrical lightinG fixture I <br /> y '� in c_ood renair? <br /> g��y Is there one electrical wall outlet in I I <br /> rtood reoai:? <br />� �i� �i Are the windous equal to 10p of the I I <br /> y o c�i� floor sDace? <br />'� Are the uindoxs in ood reDair? I I <br />� Are tha c:indous c:eatherti¢ht? I I <br /> I Are the sc:eens/storm windo�;s in <br /> ood reoair? <br /> Are the doors in cood reDai:? I <br /> Are the doors croatho?•ti.^:�7 I I <br /> Are the ualls in aood reDai^? ( <br /> Is Lhe ceilin in ¢ood reoair? I <br /> Is the Sloor in ood reDair? I <br /> Is the floor imnerviou5 io water7 <br /> Is there a �ro�e; t^ash �a:'oa¢e rece�ticl'e? <br /> Are the facilities and roo� keot clean? <br /> Co;.imants: <br /> � � <br /> ��� LIVIIIGROOTi <br />� '�' Is the space heater, iP any, proporly I I <br /> installed and in �ood reoai:? <br />� ' ' Are there two elect:ical wall outlets <br /> � in good repair OR is there one electri- <br /> � cal wall outlet end one electrical <br /> � � lic.htina fixture in qood r=�ai:? � <br /> ��' Are the uindous in ood renairT <br /> Are the w:ndous �reathertir_ht? <br /> Ara the scroens storm xindows in <br /> ' ood revair? �Yo = <br /> � Are the doors in ood renair? <br /> f� Are tha doors weathertieht? <br /> ! Are the ualls in ood re:.ai;? I <br /> ' Is the ceilin in ood renair? <br /> �' Is the f1oDr in bod re�air? <br /> ' Is this room kent clean? <br /> ' Comments: <br /> SLEE2Ii1G 1200_[ 1 <br /> Is thera a properly installed heatin� <br /> racilitv7 <br /> Are there tsro electrical Nall outlets <br /> in good repair OR is there one electri- � <br /> cal uall outlet and one electrical i <br /> li htin Sizture in ood renair7 � <br /> I <br />