HUD Office of Healthy Homes and Lead Hazard Control
Healthy Homes Toolbox
The following tools have been collected from various organizations, including HUD Office of Healthy Homes and Lead Hazard Control (OHHLHC) grantees. They are arranged by five major subjects:
- Program Development and Start-up
- Specifications and Guidelines
- Assessment
- Evaluation, and
- Training and Outreach
In addition, these tools have been categorized within at least one of ten additional categories shown in the top row.
Tools are in one of three locations:
--On the web with a direct web link provided
--On the Healthy Homes Electronic Exchange. The Healthy Homes Electronic Exchange is a web site where grantees, partners, and other stakeholders can ask questions, share tools and ideas, learn
about other programs, and support the HH community. To access the tools through the Exchange, click on the link provided and choose the "View Discussion" option. Then, choose the search option
and type in all or part of the title (often using, say, "owner" to find the "owner-occupant notification forms" is more successful, as the titles occasionally change slightly.) Be sure to search "All"
documents, as postings are automatically archived after six months. Alternatively, a user can sort the Exchange postings by date and look under the date offered in the Organization/Source column.
--Available only through hard copy
Categories
l
n
t/
n/
nt
n
re
me tal
n
ial
tee
l
r
ct
mb e
nt
me
oo
ria
the
Nu renc
en nsen
tio
tio
tio
urc tio
bje
me
air
me
nt
er
ter
en
nT
(Y/ Gran
Na
ate
ca
ca
rip
h/O
Ma ram
So niza
nn
As onm
Su
ss
Ma
ge
fe
Qu dent
As l
Co
tifi
Lo
tio
hM
e
sc
ua
tio
ss
se
arc
Re
na
t
N)
og
ga
To LHC
ng
No
en
De
Vis
vir
ed
se
es
ac
si
se
Pr
lm
Or
ini
erv
En
orm
tre
Re
H
Re
ol
rol
Tra
Int
OH
Ou
En
Inf
#01001 Boston Intake/Screening Boston Medical Center Three-page questionnaire explains how the intervention process http://www.hud.gov/offices/lead/
Prgm Devt & form HH Grantee (also on HHI will work and determines if family is eligible for the study. hhi/4A_Boston_Intake_Screenin
Startup website) g.pdf Y X X X
#01024 Indoor Environmental Fungal Research Group Screening questionnaire identifies possible health complaints or http://www.fungalresearchgroup
Prgm Devt & Quality-Medical Screening problems that may be associated with work or home environmental .com/new%20questionaire.htm
Startup Questionnaire exposures. N X
#01025 Model Resident - The Community 3 page form available in .pdf “This form is a plain language http://www.cehrc.org/exposing/r
Organization Agreement Environmental Health agreement between advocates undertaking projects to investigate esidents/modelagree.cfm
Prgm Devt & Resource Center housing-related health hazards and residents of homes where
Startup (CEHRC) website investigations are being formed.” N X X
#01076 Working with Community Community Tool Box This chapter is from a general guide geared toward community http://ctb.lsi.ukans.edu/tools/EN
Residents/ Recruitment Web site - Link from The development organizations. Covers recruiting and training of /chapter_1011.htm
(Chapter 11. Recruiting and Community volunteers.
Prgm Devt & Training Volunteers) Environmental Health
Startup Resource N X X
#01098 Intake Form Boston Medical Center 3 pages Boston Medical Center Grantee
Prgm Devt & HH Grantee Binder (hard copy available
Startup from ICF) Y X
#01099 Consent Form Boston Medical Center 7 pages. Explains responsibilities to potential participants, as well Boston Medical Center Grantee
Prgm Devt & HH Grantee as risks, benefits, and confidentiality. Binder (hard copy available
Startup from ICF) Y X
#01100 Owner-Occupant National Center for 10 pages. Notification for owner-occupants explaining the http://icfhosting.com/hh/healthy
Notification Forms Healthy Housing-- environmental results for samples collected in their h.nsf/
Providence Healthy homes/properties . The letter summarizes lead dust wipe, dust
Homes Study (posted to mite allergen vacuum (der f1 and der p1) and cockroach allergen
Prgm Devt & the Exchange 5/6/2003) (bla g1 and some limited bla g2) results for samples collected pre-
Startup and immediate post-intervention. Y X
#01101 Rental Property Owner National Center for 8 pages. Notification for the rental property owners explaining the http://icfhosting.com/hh/healthy
Notification Forms Healthy Housing-- environmental results for samples collected in their h.nsf/
Providence Healthy homes/properties . The letter summarizes lead dust wipe, dust
Homes Study (posted to mite allergen vacuum (der f1 and der p1) and cockroach allergen
Prgm Devt & the Exchange 5/6/2003) (bla g1 and some limited bla g2) results for samples collected pre-
Startup and immediate post-intervention. Y X
Last updated: May 5, 2003 Healthy Homes Toolbox Page 1
HUD Office of Healthy Homes and Lead Hazard Control
l
n
t/
n/
nt
n
re
n
me tal
ial
tee
l
r
ct
mb e
nt
me
oo
ria
the
Nu renc
en nsen
tio
tio
tio
urc tio
bje
me
air
me
nt
er
ter
en
nT
(Y/ Gran
Na
ate
ca
ca
rip
h/O
Ma ram
So niza
nn
As onm
Su
ss
Ma
ge
fe
Qu dent
As l
Co
tifi
Lo
tio
hM
e
sc
ua
tio
ss
se
Re
arc
na
t
N)
og
ga
To LHC
ng
No
en
De
Vis
vir
ed
se
es
ac
si
se
Pr
lm
Or
ini
erv
En
orm
tre
Re
H
Re
ol
rol
Tra
Int
OH
Ou
En
Inf
#01102 Tenant Notification Forms National Center for 11 pages. Notification for tenants explaining the environmental http://icfhosting.com/hh/healthy
Healthy Housing-- results for samples collected in their homes/properties . The letter h.nsf/
Providence Healthy summarizes lead dust wipe, dust mite allergen vacuum (der f1 and
Homes Study (posted to der p1) and cockroach allergen (bla g1 and some limited bla g2)
Prgm Devt & the Exchange 5/6/2003) results for samples collected pre- and immediate post-intervention.
Startup Y X
#01103 Asthmatic Home Education Erie County grantee 1-page checklist on home visit http://icfhosting.com/hh/healthy
Prgm Devt & Visit Record (posted to the Exchange h.nsf/
Startup 6/11/03) Y X
#01104 Mount Sinai Hospital Mount Sinai School of 4-page HIPAA authorization form. http://icfhosting.com/hh/healthy
Research Subject Medicine grantee (posted h.nsf/
Prgm Devt & Authorization to the Exchange
Startup 6/17/2003) Y X
#01105 IRB Consent Form Mount Sinai School of 6-page information document and IRB consent form. http://icfhosting.com/hh/healthy
Medicine grantee (posted h.nsf/
Prgm Devt & to the Exchange
Startup 6/17/2003) Y X
#01106 Mount Sinai Referral Form Mount Sinai School of 2-page referral form. http://icfhosting.com/hh/healthy
Medicine grantee (posted h.nsf/
Prgm Devt & to the Exchange
Startup 6/17/2003) Y
#01107 Mount Sinai Mount Sinai School of 1-page intake/qualification form. http://icfhosting.com/hh/healthy
Intake/Qualification Form Medicine grantee (posted h.nsf/
Prgm Devt & to the Exchange
Startup 6/17/2003) Y
#02007 Cleaning Guidelines: ZAP HHI Website One-page with cleaning suggestions to control mites/dust, http://www.hud.gov/offices/lead/
Asthma Cleaning Guidelines cockroaches, and mold/mildew. hhi/4D_ZAPAsthmaCleaningGui
Specs and – Development Group delines.pdf
Guidelines Recommendations N X
#02008 Effective Environmental HHI Website 9 pages of research-oriented guidelines on controlling allergens http://www.hud.gov/offices/lead/
Specs and Control Methods: What hhi/4E_EffectiveEnvironmental
Guidelines Works and What Doesn‟t ControlMethods.pdf N X X
#02009 Master Mold Specs Cuyahoga County (also 27 pages – work specs covering interior and exterior methods to http://www.hud.gov/offices/lead/
Specs and on HHI Website) control or remove mold. hhi/4F_Cuyahoga_MASTERMO
Guidelines LDSPEC3.pdf Y X
#02010 Mold Clean-up Guidelines micro ecologies inc. (also 6-pages of mold information geared toward residents. Includes a http://www.hud.gov/offices/lead/
Specs and for Residents on HHI Website) mold-cleaning protocol. hhi/4G_microecologiesInc.pdf
Guidelines N X X
#02011 Physical Interventions Harvard School of Public 2-page table that lists possible interventions and links the Ihttp://www.hud.gov/offices/lead
Specs and Health (also on HHI intervention to research demonstrating their benefit. Also includes /hhi/4H_Physical_Interventions.
Guidelines Website) the approximate cost of interventions. pdf Y X
#02012 Protecting Small Children John Roberts, 3-page leaflet/handout that discusses cleaning methods residents http://www.hud.gov/offices/lead/
Specs and from Toxins in House Dust Engineering Plus (also on can use to reduce dust. Focuses on carpets and furnishings. hhi/4I_Protect_Small_Children.
Guidelines HHI Website) pdf N X
#02013 Cuyahoga County Urban Cuyahoga County (also 3-pages. Identifies standards for operating the program in http://www.hud.gov/offices/lead/
Mold & Moisture Program on HHI Website) Cuyahoga County. hhi/4J_Cuyahoga_Stds_Guideli
(Draft 12/1/00 PART A: nes.pdf
Specs and STANDARDS &
Guidelines GUIDELINES) Y X
#02023 Fungal Abatement Safe Environmental Health and Intended for facilities management personnel. Covers procedures http://www.dehs.umn.edu/iaq/so
Specs and Operating Procedure Safety, University of for projects and job tasks that require the removal of mold bearing p.html
Guidelines Minnesota building materials. N X
#02062 Contractor Procedures City of Long Beach 2-pages of instructions for remediating mold, rodents, etc. http://icfhosting.com/hh/healthy
Specs and (Posted to Exchange h.nsf/
Guidelines 4/9/2002) Y X
Last updated: May 5, 2003 Healthy Homes Toolbox Page 2
HUD Office of Healthy Homes and Lead Hazard Control
l
n
t/
n/
nt
n
re
n
me tal
ial
tee
l
r
ct
mb e
nt
me
oo
ria
the
Nu renc
en nsen
tio
tio
tio
urc tio
bje
me
air
me
nt
er
ter
en
nT
(Y/ Gran
Na
ate
ca
ca
rip
h/O
Ma ram
So niza
nn
As onm
Su
ss
Ma
ge
fe
Qu dent
As l
Co
tifi
Lo
tio
hM
e
sc
ua
tio
ss
se
Re
arc
na
t
N)
og
ga
To LHC
ng
No
en
De
Vis
vir
ed
se
es
ac
si
se
Pr
lm
Or
ini
erv
En
orm
tre
Re
H
Re
ol
rol
Tra
Int
OH
Ou
En
Inf
#02063 List of Contractor Tools City of Long Beach 2-pages of examples of tools, equipment and materials that can http://icfhosting.com/hh/healthy
Specs and (Posted to Exchange assist in completing HHI work lists. h.nsf/
Guidelines 4/9/2002) Y X
#02064 Extensive Cleaning City of Long Beach 2-pages. Seems geared for staff or contractors. Includes http://icfhosting.com/hh/healthy
Specs and Procedures (Posted to Exchange instructions on treating carpets, walls, bare floors, cabinets, etc. h.nsf/
Guidelines 4/9/2002) Y X
#02065 Contractor – Intervention City of Long Beach 2-pages of instructions and procedures for treating apartments in http://icfhosting.com/hh/healthy
Specs and Instructions (Posted to Exchange this HHI program. h.nsf/
Guidelines 4/9/2002) Y X
#02075 Guidelines on Assessment New York City Guidelines from NYC Dept of Health “This document revises and http://www.ci.nyc.ny.us/html/doh
and Remediation of Fungi in Department of Health & expands the original guidelines to include all fungi (mold). …. It is /html/epi/moldrpt1.html
Indoor Environments Mental Hygiene, Bureau intended for use by building engineers and management, but is
of Environmental & available …to anyone concerned about fungal contamination.”
Specs and Occupational Disease
Guidelines Epidemiology N X X
#02084 Treatment Menus Cuyahoga County HH Details options for treating moisture hazards. Cuyahoga County Grantee
Specs and Grantee Binder (hard copy available
Guidelines from ICF) Y X
#02092 Environmental Sampling Bedford Stuyvesant HH 20 pages – covers lead-based paint, mold, and allergen Bedford Stuyvesant Grantee
Specs and and Evaluation Protocols Grantee assessment. Binder (hard copy available
Guidelines from ICF) Y X
#02093 Remediation Protocols Bedford Stuyvesant HH 25 pages of protocols used in the project Bedford Stuyvesant Grantee
Specs and Grantee Binder (hard copy available
Guidelines from ICF) Y X
#02103 Lead and Healthy Homes Providence HH Grantee Contains a range of instructions, forms, and checklists – most are Providence Grantee Binder
Specs and Rehab Specialist Project associated with the lead portion of the program, but some are (hard copy available from ICF)
Guidelines Procedures healthy home specific. Y X X X X X
#02104 Wisconsin Healthy Homes Wisconsin HH Grantee One page for Allergy Skin Test with educational component. http://icfhosting.com/hh/healthy
Specs and Initiative Skin Test Record (posted to the Exchange h.nsf/
Guidelines 6/02/2003) Y X
#02105 Mount Sinai Environmental Mount Sinai School of Six pages of environmental review information, including problem http://icfhosting.com/hh/healthy
Review Medicine grantee (posted areas, intervention activities, products provided, referrals, and h.nsf/
Specs and to the Exchange statute authority reference.
Guidelines 6/17/2003) Y X
#02106 Extended Intervention Form Mount Sinai School of 2-page extended intervention form. http://icfhosting.com/hh/healthy
Medicine grantee (posted h.nsf/
Specs and to the Exchange
Guidelines 6/17/2003) Y X
#02107 Standard Intervention Mount Sinai School of 7-page intervention checklist. http://icfhosting.com/hh/healthy
Activities Checklist Medicine grantee (posted h.nsf/
Specs and to the Exchange
Guidelines 6/17/2003) Y X
#02108 Bi-Monthly Telephone Mount Sinai School of 2-page script/form for the bi-monthly telephone call with resident. http://icfhosting.com/hh/healthy
Contact form Medicine grantee (posted h.nsf/
Specs and to the Exchange
Guidelines 6/17/2003) Y X X
#03001 Wisconsin Healthy Homes Wisconsin HH Grantee 3-page questionnaire on asthma http://icfhosting.com/hh/healthy
Initiative Asthma Screening (posted to the Exchange h.nsf/
Assessment Questionnaire 6/02/2003) Y X
#03002 Wisconsin Healthy Homes Wisconsin HH Grantee Healthcare Utilization form for asthma. http://icfhosting.com/hh/healthy
Asthma Healthcare (posted to the Exchange h.nsf/
Assessment Utilization Form 6/02/2003) Y X
#03003 Wisconsin Healthy Homes Wisconsin HH Grantee Dust Mite Cover Sizing Cards. http://icfhosting.com/hh/healthy
Initiative Dust Mite Cover (posted to the Exchange h.nsf/
Assessment Sizing Cards 6/02/2003) Y X
Last updated: May 5, 2003 Healthy Homes Toolbox Page 3
HUD Office of Healthy Homes and Lead Hazard Control
l
n
t/
n/
nt
n
re
n
me tal
ial
tee
l
r
ct
mb e
nt
me
oo
ria
the
Nu renc
en nsen
tio
tio
tio
urc tio
bje
me
air
me
nt
er
ter
en
nT
(Y/ Gran
Na
ate
ca
ca
rip
h/O
Ma ram
So niza
nn
As onm
Su
ss
Ma
ge
fe
Qu dent
As l
Co
tifi
Lo
tio
hM
e
sc
ua
tio
ss
se
Re
arc
na
t
N)
og
ga
To LHC
ng
No
en
De
Vis
vir
ed
se
es
ac
si
se
Pr
lm
Or
ini
erv
En
orm
tre
Re
H
Re
ol
rol
Tra
Int
OH
Ou
En
Inf
#03004 Healthy Homes Checklist HHI Website 12-page .pdf file includes questionnaire for family on health http://www.hud.gov/offices/lead/
conditions and house structure and assessment forms for each hhi/4B_Boston_HHI_Checklist.p
Assessment room of the house. df N X X
#03005 Pollution Source Survey Building Performance Six-page survey on pollution and ventilation. http://www.hud.gov/offices/lead/
Center, Washington State hhi/4C_NewPOLLUTION%20S
(also on HHI Website) URVEYv3_.pdf
Assessment Y X X
#03026 CROSS-HAZARD The Community Several pdf downloads, including a report form for visual surveys http://www.cehrc.org/tools/index
ASSESSMENT TOOLS: Environmental Health and instructions. The web site also includes forms for a floor plan .cfm
Visual Survey Resource Center and site plan.
Assessment (CEHRC) website N X
#03027 CROSS-HAZARD The Community Two pdf downloads – report and instructions for taking samples. http://www.cehrc.org/tools/index
ASSESSMENT TOOLS: Environmental Health .cfm
Sampling Results Report Resource Center
Assessment (CEHRC) website N X X X X
#03028 ASSESSMENT TOOLS The Community Includes background materials on lead dust, a decisions guide, http://www.cehrc.org/tools/lead/l
FOR: Lead Dust Environmental Health sampling instructions, sampling checklist, and chain of custody. eaddust/index.cfm
Resource Center (Some are pdf files, the rest are from the web page.)
Assessment (CEHRC) website N X X X
#03030 ASSESSMENT TOOLS The Community Includes background materials on lead contamination in soil, a http://www.cehrc.org/tools/lead/l
FOR: Lead in Soil Environmental Health decision guide, sampling instructions, sampling checklist, and chain eadsoil/index.cfm
Resource Center of custody.
Assessment (CEHRC) website N X X X
#03031 ASSESSMENT TOOLS The Community Background materials on cockroaches not yet available, but http://www.cehrc.org/tools/cock
FOR: Cockroaches Environmental Health includes decision guide, sampling instructions, sampling checklist, roaches/index.cfm
Resource Center and a report form.
(CEHRC) website
Assessment N X X X
#03032 HOME ASSESSMENTS: EnviRN About 6 pages --- “This checklist was developed at the University http://envirn.umaryland.edu/Kell
Environmental Health of Maryland School of Nursing Environmental Health Education ogg%20Curriculum/1_HPDP_F
Assessment Guide for a Center for identifying potential environmental health hazards in the amily_Assessment.pdf
Assessment Home and Family home." N X X X
#03033 Moisture Audit Tool Environmental Health 14 pages - pdf - Moisture audit tool developed by Environmental http://icfhosting.com/hh/healthy
Watch (Posted to Health Watch and Housemender. h.nsf/
Assessment Exchange 5/1/2002) Y X X X X
#03034 Protocol for sampling Posted to Exchange 3 pages – excerpted from larger file (ref number #03035) with http://icfhosting.com/hh/healthy
allergens – (short) 6/25/2002 slight modifications. Protocol for sampling allergens in house dust. h.nsf/
This protocol was used in the HUD/NIEHS National Survey of Lead
and Allergens in Housing, and was adapted from the Inner City
Assessment Asthma Study (ICAS). N X X
#03035 Protocol for sampling Posted to Exchange About 15 pages. Protocol for sampling allergens in house dust, HH Grantee Exchange (HUD –
allergens – (long) 6/25/2002 from a training manual chapter for field staff in the HUD/NIEHS Inner City Asthma Study)
National Survey of Lead and Allergens in Housing (adapted from
Assessment the Inner City Asthma Study (ICAS)). N X X
#03038 Visual Assessment City of Long Beach 12 page assessment form used by the City of Long Beach for their http://icfhosting.com/hh/healthy
(Posted to Exchange HH initiative program. h.nsf/
Assessment 4/9/2002) Y X
#03040 Injury and Asthma Wisconsin (Posted to Two-page test of caregiver‟s knowledge of asthma, including http://icfhosting.com/hh/healthy
Assessment Knowledge Tests Exchange 4/16/2002) symptoms and triggers. h.nsf/ Y X X
#03042 Injury risk knowledge test Wisconsin (Posted to Two-page form to test general knowledge of dangers in the home. http://icfhosting.com/hh/healthy
Assessment Exchange 4/16/2002) h.nsf/ Y X X
#03043 Healthcare utilization history Wisconsin (Posted to One-page form to record child‟s history with injuries. http://icfhosting.com/hh/healthy
Assessment Exchange 4/16/2002) h.nsf/ Y X
#03044 Brief Asthma Screening Wisconsin (Posted to One-page form for parents to record information on child‟s asthma, http://icfhosting.com/hh/healthy
Assessment Questionnaire Exchange 4/16/2002) including family history and environment conditions. h.nsf/ Y X
Last updated: May 5, 2003 Healthy Homes Toolbox Page 4
HUD Office of Healthy Homes and Lead Hazard Control
l
n
t/
n/
nt
n
re
n
me tal
ial
tee
l
r
ct
mb e
nt
me
oo
ria
the
Nu renc
en nsen
tio
tio
tio
urc tio
bje
me
air
me
nt
er
ter
en
nT
(Y/ Gran
Na
ate
ca
ca
rip
h/O
Ma ram
So niza
nn
As onm
Su
ss
Ma
ge
fe
Qu dent
As l
Co
tifi
Lo
tio
hM
e
sc
ua
tio
ss
se
Re
arc
na
t
N)
og
ga
To LHC
ng
No
en
De
Vis
vir
ed
se
es
ac
si
se
Pr
lm
Or
ini
erv
En
orm
tre
Re
H
Re
ol
rol
Tra
Int
OH
Ou
En
Inf
#03045 Injury Screening Wisconsin (Posted to Four-page (54 questions) on home conditions that prevent home http://icfhosting.com/hh/healthy
Assessment Questionnaire Exchange 4/16/2002) injuries. h.nsf/ Y X
#03046 Dwelling Unit Assessment Erie County (Posted to 9 page Word doc that includes checklists and risk degree http://icfhosting.com/hh/healthy
Tool Exchange 5/9/2002) assessments for dwelling units as well as adjacent structures and h.nsf/
Assessment common areas. Y X
#03047 Asthma Severity Scale (in Alameda Co. (Posted to Each form is 3-pages of questions for caregivers of participating http://icfhosting.com/hh/healthy
English and Spanish) Exchange 12/12/2002) asthmatic children. To be asked every two weeks for six months. h.nsf/
Assessment Y X
#03049 Asthma Severity Scale (in Alameda Co. (Posted to (Not sure how this differs from #47, except the layout is different) http://icfhosting.com/hh/healthy
Assessment English) #2 Exchange 12/12/2002) h.nsf/ Y X
#03050 Daily Asthma Journal (in Alameda Co. (Posted to One-page form for recording asthma symptoms and resulting http://icfhosting.com/hh/healthy
Assessment English and Spanish) Exchange 12/12/2002) treatments. h.nsf/ Y X
#03053 Knowledge Survey (in Alameda Co. (Posted to Each version is 2 pages. Asks yes/no and choose-best-answer http://icfhosting.com/hh/healthy
Assessment English and Spanish) Exchange 12/12/2002) questions about asthma triggers and home safety. h.nsf/ Y X
#03055 Pre- and Post-Knowledge Alameda Co. (Posted to 2-pages. Questionnaire for caregivers – intended to be verbally http://icfhosting.com/hh/healthy
Assessment Test Exchange 12/12/2002) administered. h.nsf/ Y X
#03056 Breath of Fresh Air - 2nd Stamford.(Posted to 9 pages. Collects information on risks, current medications, http://icfhosting.com/hh/healthy
Visit Assessment Test / Exchange 12/31/2002) asthma symptoms and treatment, and rates asthma severity and h.nsf/
Assessment Assessment protocols adequacy of treatment. Y X
#03067 Asthma Knowledge Test – 2 Wisconsin (Posted to 2 pages of questions in Spanish. http://icfhosting.com/hh/healthy
Assessment (in Spanish) Exchange 4/16/2002) h.nsf/ Y X
#03068 IRB / Injury Consent Form Wisconsin (Posted to 4-pages. http://icfhosting.com/hh/healthy
Assessment (in Spanish) Exchange 4/16/2002) h.nsf/ Y X X
#03069 HOME Moisture Audit NC State Univ/A&T Coop Several pages on website – includes forms (within web text) http://www.ces.ncsu.edu/copub
Extension s/house/care/005/
Assessment N X X
#03081 Visual Assessment and Developed by Cleveland Has long Visual Assessment and Testing form for the Cleveland Cuyahoga County Grantee
Testing form Dept. of Public Health and Dept. of Public Health and EHW – says EHW last revised 3/23/99 Binder (hard copy available
EHW – last revised from ICF)
Assessment 3/23/99 Y X X X X
#03082 Lead Safe Cuyahoga Cuyahoga County HH Includes almost 50 questions for the resident and a number ofCuyahoga County Grantee
Questionnaire Grantee questions for the interviewer (assessment forms, for room Binder (hard copy available
Assessment sketches and home conditions, are also attached. from ICF) Y X X
#03083 Instructions and Form for Cuyahoga County HH (See #03081 – this form was revised by EHW in 3/6/2000) Cuyahoga County Grantee
Visual Assessment and Grantee Binder (hard copy available
Assessment Testing from ICF) Y X X X
#03089 Remediation Scope Sheet Bedford Stuyvesant HH One-page form and instructions for assessing homes. Bedford Stuyvesant Grantee
Grantee Binder (hard copy available
Assessment from ICF) Y X X
#03091 Initial Visual Assessment Bedford Stuyvesant HH Detailed form (about 25 pages) for use in the grantee‟s HHI Bedford Stuyvesant Grantee
Protocol and Grantee program. Binder (hard copy available
Assessment Interview/Checklist from ICF) Y X X
#03092 Healthy Homes Assessment Alameda County HH Thirteen page report to residents containing the results of an http://icfhosting.com/hh/healthy
Checklist Grantee (Posted 1/10/03) assessment of their home. The document contains information on h.nsf/
environmental hazards in the home to place the home assessment
Assessment in context. Y X X X X
#03093 Healthy Homes Report Alameda County HH Three page report to residents contains condensed results of an http://icfhosting.com/hh/healthy
Tenant Summary Grantee (Posted 1/10/03) assessment of their home. Contains tips on reducing h.nsf/
Assessment environmental hazards in the home. Y X X X X
#03094 Healthy Homes Visual Alameda County HH Seventeen page assessment for containing guidance for http://icfhosting.com/hh/healthy
Assessment Form with Grantee (Posted 1/10/03) inspectors. h.nsf/
Assessment Instructions Y X X
#03095 Healthy Homes Visual Alameda County HH Twelve page report to residents containing the results of a visual http://icfhosting.com/hh/healthy
Assessment Report Grantee (Posted 1/10/03) home inspection and recommendations for mitigating h.nsf/
Assessment environmental hazards. Y X X
Last updated: May 5, 2003 Healthy Homes Toolbox Page 5
HUD Office of Healthy Homes and Lead Hazard Control
l
n
t/
n/
nt
n
re
n
me tal
ial
tee
l
r
ct
mb e
nt
me
oo
ria
the
Nu renc
en nsen
tio
tio
tio
urc tio
bje
me
air
me
nt
er
ter
en
nT
(Y/ Gran
Na
ate
ca
ca
rip
h/O
Ma ram
So niza
nn
As onm
Su
ss
Ma
ge
fe
Qu dent
As l
Co
tifi
Lo
tio
hM
e
sc
ua
tio
ss
se
Re
arc
na
t
N)
og
ga
To LHC
ng
No
en
De
Vis
vir
ed
se
es
ac
si
se
Pr
lm
Or
ini
erv
En
orm
tre
Re
H
Re
ol
rol
Tra
Int
OH
Ou
En
Inf
#03096 Asthma Assessment Tools Erie County (Posted to Tools for assessing Asthma in residents http://icfhosting.com/hh/healthy
Assessment Exchange 1/24/03) h.nsf/ Y X X
#03097 Asthma Assessment Tool, Erie County (Posted to Tools for educating residents about mitigating environmental http://icfhosting.com/hh/healthy
In-Home Education Exchange 1/24/03) hazards that cause and aggravate asthma. h.nsf/
Assessment Management Y X X
#03098 Post-Intervention Health City of Long Beach 7-page questionnaire for public health nurses on resident's asthma http://icfhosting.com/hh/healthy
Interview (Public Health (posted to the Exchange h.nsf/
Assessment Nurses) 6/04/2003) Y
#03099 Demographic and Baseline Erie County Health 6-page questionnaire on baseline information and quality of life. http://icfhosting.com/hh/healthy
Information/QOL and Department (posted to h.nsf/
Assessment Knowledge Pre-Post Test Exchange 6/11/2003) Y X
#03100 Follow-Up Quality of Life Erie County Health 1-page quality of life survey. http://icfhosting.com/hh/healthy
Survey Department (posted to h.nsf/
Assessment Exchange 6/11/2003) Y X
#03101 Erie County Healthy Homes Erie County Health http://icfhosting.com/hh/healthy
Initiative Asthma Department (posted to h.nsf/
Environmental Assessment Exchange 6/11/2003)
Assessment Tool
#03102 Mount Sinai In-Person Mount Sinai School of 3-page interview form for the first in-person interview. Mostly http://icfhosting.com/hh/healthy
Interview Medicine grantee (posted demographic information. h.nsf/
to the Exchange
Assessment 6/17/2003) Y X
#03103 Home Environment Mount Sinai School of 2-page home environment assessment form. http://icfhosting.com/hh/healthy
Assessment Medicine grantee (posted h.nsf/
to the Exchange
Assessment 6/17/2003) Y X
#03104 Environment Assessment Mount Sinai School of 4-page scoring guidance for the environment assessment. http://icfhosting.com/hh/healthy
Scoring Guidance Medicine grantee (posted h.nsf/
to the Exchange
Assessment 6/17/2003) Y X
#03105 Medications Compliance Mount Sinai School of 3-page medications compliance form. http://icfhosting.com/hh/healthy
Form Medicine grantee (posted h.nsf/
to the Exchange
Assessment 6/17/2003) Y Y
#04003 Tobari Logic Model (Project HHI Website 90-pages – available on-line. http://www.hud.gov/offices/lead/
Planning and Evaluation hhi/4L_GuidebookHUD_withLog
Guidebook: A Manual for icModel.PDF
Practitioners and Managers
of Self-Sufficiency
Demonstration Projects)
Prgm Eval N X X
#04041 Employee Assessment Wisconsin (Posted to One-page evaluation form for project employees. http://www.icfhosting.net/HUD/
Guide Exchange 4/16/2002) HH/HealthyH.nsf/MasterDiscFr
Prgm Eval ameset?OpenFrameSet Y X
#04066 Logic Model City of Long Beach Logic model developed by Long Beach for evaluating their http://icfhosting.com/hh/healthy
(Posted to Exchange program. h.nsf/
Prgm Eval 4/9/2002) Y X
#04067 Owner Interview City of Long Beach Owner Interview Questionnaire assessing changes in http://icfhosting.com/hh/healthy
Questionnaire (Posted to Exchange owner/manager's attitude/awareness after Healthy Homes h.nsf/
Prgm Eval 5/19/2003) intervention. Y X
#05002 Risk Assessment Guide HOME*A*Syst Program “Home*A*Syst: An Environmental Risk-Assessment Guide for the http://www.uwex.edu/homeasys
(University of Wisconsin) Home is comprised of eleven chapters to help you learn about, t/
investigate and take action on environmental health risks in and
Training & around your home.
Outreach N X X
Last updated: May 5, 2003 Healthy Homes Toolbox Page 6
HUD Office of Healthy Homes and Lead Hazard Control
l
n
t/
n/
nt
n
re
n
me tal
ial
tee
l
r
ct
mb e
nt
me
oo
ria
the
Nu renc
en nsen
tio
tio
tio
urc tio
bje
me
air
me
nt
er
ter
en
nT
(Y/ Gran
Na
ate
ca
ca
rip
h/O
Ma ram
So niza
nn
As onm
Su
ss
Ma
ge
fe
Qu dent
As l
Co
tifi
Lo
tio
hM
e
sc
ua
tio
ss
se
Re
arc
na
t
N)
og
ga
To LHC
ng
No
en
De
Vis
vir
ed
se
es
ac
si
se
Pr
lm
Or
ini
erv
En
orm
tre
Re
H
Re
ol
rol
Tra
Int
OH
Ou
En
Inf
#05014 Help Yourself to a Healthy HOME*A*Syst Program This resource from Home*A*Syst is a 24-page booklet that can http://www.hud.gov/offices/lead/
Home: Protect Your (University of Wisconsin) help you make sure your home is a safe and healthy place to be. healthyhomes/healthyhomeboo
Children's Health (also on HHI Website) Find answers to questions like: Is the air in your home healthy? and k.pdf
Can your children be poisoned by lead in your home? (58-pages
when downloaded)
Training &
Outreach N X X
#05015 Quick Tips CHEC Website List of steps to protect families that is regularly updated. http://www.checnet.org/healthe
house/education/tip.asp
Training &
Outreach Y X X
#05017 How To CHEC Website Series of guidelines to help residents deal with specific home http://www.checnet.org/healthe
health issues, ranging from IAQ to drinking water to pest house/education/top10.asp
management.
Training &
Outreach Y X X
#05019 Chemicals CHEC Website List of chemicals that may be harmful to children (includes scientific http://www.checnet.org/healthe
Training & and common names). Categorized as prevent, avoid, or limit house/chemicals/chemicals.asp
Outreach exposure. Y X X
#05020 A Brief Guide to Mold, Mold Resources from the 20-page booklet from EPA on how to treat mold and why it is a http://www.epa.gov/iaq/molds/i
Moisture, and Your Home U.S. Environmental hazard. Geared toward homeowners and renters. mages/moldguide.pdf
Protection Agency
Training &
Outreach N X X
#05021 A Guide for Creating a American Lung 20 page informational booklet ---“For tips on how to reduce indoor http://www.lungusa.org/press/e
Healthier Home Association air pollution” nvir/download/creating_guidehh
Training & .pdf
Outreach N X X
#05022 Health House Rx Home Health House (American An interactive checklist, available online. Intended for homeowners http://www.healthhouse.org/iaq/
Checklist Lung Association) to help them identify home environment problems and sources of checklist.htm
pollution.
Training &
Outreach N X X
Training & #05039 Asthma Action Plan Wisconsin (Posted to One-page form for parents to help them act when child suffers an http://icfhosting.com/hh/healthy
Outreach Exchange 4/16/2002) asthma attack h.nsf/ Y X X
Training & #05052 How to Maintain A Healthy Alameda Co. (Posted to 2-pages. Addresses homeowners or tenants on home maintenance http://icfhosting.com/hh/healthy
Outreach Home Exchange 12/12/2002) and risk prevention in the home. h.nsf/ Y X X
#05057 Asthma Powerpoint – “What City of Long Beach About 18 powerpoint slides. http://icfhosting.com/hh/healthy
Training & is Asthma” (in English and (Posted to Exchange 4/9) h.nsf/
Outreach Spanish) Y X X
#05058 Healthy Homes Brochure City of Long Beach Flyer promoting the grantee‟s program (appears to be for http://icfhosting.com/hh/healthy
Training & (Posted to Exchange recruiting). h.nsf/
Outreach 4/9/2002) Y X X
#05059 Non-Toxic Cleaning Tips (in City of Long Beach 1-page flyer promoting the use of vinegar for household cleaning. http://icfhosting.com/hh/healthy
Training & English and Spanish) (Posted to Exchange h.nsf/
Outreach 4/9/2002) Y X X
Last updated: May 5, 2003 Healthy Homes Toolbox Page 7
HUD Office of Healthy Homes and Lead Hazard Control
l
n
t/
n/
nt
n
re
n
me tal
ial
tee
l
r
ct
mb e
nt
me
oo
ria
the
Nu renc
en nsen
tio
tio
tio
urc tio
bje
me
air
me
nt
er
ter
en
nT
(Y/ Gran
Na
ate
ca
ca
rip
h/O
Ma ram
So niza
nn
As onm
Su
ss
Ma
ge
fe
Qu dent
As l
Co
tifi
Lo
tio
hM
e
sc
ua
tio
ss
se
Re
arc
na
t
N)
og
ga
To LHC
ng
No
en
De
Vis
vir
ed
se
es
ac
si
se
Pr
lm
Or
ini
erv
En
orm
tre
Re
H
Re
ol
rol
Tra
Int
OH
Ou
En
Inf
#05060 Unintentional Injures Info (in City of Long Beach 14 pages each – to inform residents about preventing injuries like http://icfhosting.com/hh/healthy
Training & English and Spanish) (Posted to Exchange burns, poisoning, fires, etc. h.nsf/
Outreach 4/9/2002) Y X X
#05061 House Cleaning Tips (in City of Long Beach About 2 pages of cleaning methods that do not require chemicals. http://icfhosting.com/hh/healthy
Training & English and Spanish) (Posted to Exchange h.nsf/
Outreach 4/9/2002) Y X X
#05070 HealtheHouse CHEC Website Online interactive quizzes that assesses structure/practices that http://www.checnet.org/healthe
contribute to home health. (Full and mini quiz available) house/profiler/
Training &
Outreach Y X X
#05072 What Breeds Between the CHEC Website Website information and tips for residents on how to reduce http://www.checnet.org/healthe
Walls: Allergens and pollution in the home. house/education/articles-
Asthma Triggers detail.asp?Main_ID=384
Training &
Outreach Y X X
#05073 How to Reduce Dust Mites CHEC Website List of 6 tips to reduce dust mites. http://www.checnet.org/healthe
in Your Home house/education/top10-
detail.asp?Top10_Cat_ID=18
Training &
Outreach Y X X
#05074 "The Inside Story: A Guide EPA Web site (Frequently Booklet from EPA and Consumer Product Safety Commission to http://www.epa.gov/iaq/pubs/ins
to Indoor Air Quality" Asked Questions) help residents decide whether to take actions that can reduce the idest.html#order"
Training & level of indoor air pollution in the home.
Outreach N X X
Training & #05085 Cockroach Control Guide EHW HH Grantee Short flyer (2 pages) on cockroaches EHW Grantee Binder (hard
Outreach copy available from ICF) Y X X
Training & #05086 Controlling Asthma Triggers EHW HH Grantee 2-page flyer on home conditions that trigger asthma. EHW Grantee Binder (hard
Outreach in the Home copy available from ICF) Y X X
Training & #05087 Flyer for the Rainbow Flyer promoting the HHI program. EHW Grantee Binder (hard
Outreach Asthma Study copy available from ICF) Y X X
#05088 Flyer for the Bedford Bedford Stuyvesant HH Flyer promoting their HHI program. Bedford Stuyvesant Grantee
Training & Stuyvesant Healthy Homes Grantee Binder (hard copy available
Outreach Initiative from ICF) Y X X
#05090 Introductory letters to Bedford Stuyvesant HH Letters that inform both landlords and tenants about the program, Bedford Stuyvesant Grantee
Training & owners and tenants Grantee with promise to follow-up. Binder (hard copy available
Outreach from ICF) Y X X
#05094 Bed-Stuy Training Curricula Bedford Stuyvesant HH Stamped „draft‟. Comprehensive guide. Covers everything from Bedford Stuyvesant Grantee
Training & for Project Staff Grantee asthma and medications to safe work conditions to cockroach and Binder (hard copy available
Outreach rodent control from ICF) Y X
#05095 Boston Healthy Homes Boston Medical Center About 25 pages. Cleaning instructions for residents with tips to Boston Medical Center Grantee
Training & Partnership Take Home HH Grantee reduce pests, toxins, and safety risks. Binder (hard copy available
Outreach Points from ICF) Y X X
#05096 Community Health Educator Boston Medical Center Comprehensive Powerpoint training session (does not give timeline Boston Medical Center Grantee
Training & Training HH Grantee Binder (hard copy available
Outreach from ICF) Y X
#05097 Role of Healthy Educator Boston Medical Center 3-page instruction guide on the responsibilities of the health Boston Medical Center Grantee
Training & HH Grantee educator in their HHI program. Binder (hard copy available
Outreach from ICF) Y X X
#05100 Protect Your Child from Boston Medical Center 30 page handbook covering environmental risks, lead, indoor air Boston Medical Center Grantee
Environmental Health HH Grantee pollution, first aid, and healthy habits. Binder (hard copy available
Training & Hazards in the Home: A from ICF)
Outreach Parent‟s Handbook Y X X
#05101 Curriculum and Boston Medical Center Wide-ranging list of questions (almost 40 pages) on home Boston Medical Center Grantee
Training & Questionnaire HH Grantee conditions, health violations, etc. Corresponding panel explains why Binder (hard copy available
Outreach the questions are asked. from ICF) Y X X
Last updated: May 5, 2003 Healthy Homes Toolbox Page 8
HUD Office of Healthy Homes and Lead Hazard Control
l
n
t/
n/
nt
n
re
n
me tal
ial
tee
l
r
ct
mb e
nt
me
oo
ria
the
Nu renc
en nsen
tio
tio
tio
urc tio
bje
me
air
me
nt
er
ter
en
nT
(Y/ Gran
Na
ate
ca
ca
rip
h/O
Ma ram
So niza
nn
As onm
Su
ss
Ma
ge
fe
Qu dent
As l
Co
tifi
Lo
tio
hM
e
sc
ua
tio
ss
se
Re
arc
na
t
N)
og
ga
To LHC
ng
No
en
De
Vis
vir
ed
se
es
ac
si
se
Pr
lm
Or
ini
erv
En
orm
tre
Re
H
Re
ol
rol
Tra
Int
OH
Ou
En
Inf
#05102 How to Maintain a Healthy Alameda County HH Three-page summary of tips for residents on establishing a safe http://icfhosting.com/hh/healthy
Training & Home Form with Graphics Grantee (Posted 1/10/03) home environment. h.nsf/
Outreach Y X X
#05103 Healthy Homes Training Alameda County HH Seve-page training on asthma triggers, home maintenance, and http://icfhosting.com/hh/healthy
Training & Curriculum Grantee (Posted 3/10/03) lead hazard mitigation for residents. h.nsf/
Outreach Y X X
Training & #05104 Healthy Homes Brochure Alameda County HH Two pdf files containg the front and back of this marketing piece for http://icfhosting.com/hh/healthy
Outreach Grantee (Posted 4/7/03) the Alameda County HH Grantee. h.nsf/ Y X
#05105 The Privacy Rule of the Wisconsin (Posted to A 63-page training on the Privacy Rule of the Health Insurance http://icfhosting.com/hh/healthy
Health Insurance Portability Exchange 4/11/2003) Portability and Accountability Act, intended for clinicians. h.nsf/
and Accountability Act:
Training & Training for Clinicians
Outreach Y X X
Training & #05106 HIPAA and Informed Wisconsin (Posted to Three page form documenting residents' permission for the release http://icfhosting.com/hh/healthy
Outreach Consent Exchange 4/11/2003) of their children's health information to researchers. h.nsf/ Y X X X
#05107 MOLD: Cause, Effect, and U.S. Department of Forty-three page informational booklet on mold. http://icfhosting.com/hh/healthy
Response Housing and Urban h.nsf/
Development (Posted to
Exchange 4/11/03)
Training &
Outreach Y X
Last updated: May 5, 2003 Healthy Homes Toolbox Page 9