ࡱ> `b_@ ]!jbjb&& ~DDqlZZZZ8,Z<      FHHHHHH,= ]t     t   :  F,., F  $G\}ZZFf   Name of person being interviewed: Interviewer Which congregation: Date of interview: Relationship to the congregation: FacilitiesYesNo Comment1. Does your congregations parking area have designated Accessible parking spaces?   2. Does the parking area have Van Accessible parking spaces?   o N/A3. Does your building(s) have a wheelchair accessible entrance?    4. Are there weight-bearing handrails at all ramps and stairways in the building(s)?   5. Can all doors be opened by a person in a wheelchair?    6. Can all doors be opened by a person having limited use of their hands and arms? 7. Are all areas of the building(s) accessible by a person in a wheelchair?   o N/A8. Are the restrooms wheelchair accessible?    9. Are the countertops and tables wheelchair accessible?10. Are the countertops and tables accessible to short participants?   11. Are seats with armrests available in the building(s) for those needing such assistance?12. Are seats without armrests available in the building(s) for those needing non-restrictive seating?13. Are there accessible wheelchair locations in the sanctuary?    o N/A14. Is the chancel wheelchair accessible?   o N/A15. Do you have a moveable, adjustable-height podium?   o N/A16. Are there fluorescent lights in the building(s)?    FacilitiesYesNo Comment17. Is alternate lighting available on request?  18. Which rooms are carpeted?   19. Are gas appliances vented to the outdoors? (HVAC units, water heaters, stove/oven)   o N/A20. Are copiers, printers, fax machines, and computers vented to the outdoors?   21. Does the building(s) have adequate lighting for people with low vision?22. Is there adequate lighting in the sanctuary for people with low vision or limited hearing to clearly see the speakers face?23. Is the public telephone wheelchair accessible?24. Is the public telephone equipped with a volume or clarity control? Program and PolicyYesNo Comment25. Does your church provide the following:   a. Hymnals with large print   b. Orders of Service with large print   c. Sound amplification (PA system) for people with hearing impairments   d. Assistive listening devices for people with hearing impairments   e. American Sign Language interpreters for people with hearing impairment   f. Printed sermons at the service   g. Printed sermons, later on   h. Taped sermons   i. Printed meeting minutesj. Taped meeting minutes   k. Portable lightingl. Low-vision signage (tactile, Braille, high-contrast)    Program and PolicyYesNo Comment26. Does the R.E. staff have resources and information for including students with disabilities (including cognitive disabilities)?27. Is there a policy regarding the use of least-toxic pesticides and herbicides in the building(s) and on the grounds?   28. Are people asked to attend services and events fragrance-free?   29. Is there a policy regarding the maintainance of fragrance-free restrooms? (no scented soaps, no air fresheners, no toilet bowl fresheners)   30. Is there a policy regarding the use of least-toxic cleaning supplies? (no chlorine, no ammonia, no pine, no petroleum, no fragrances, no acrylics, no solvents)   31. Is there a policy regarding the use of least-toxic supplies for building maintenance? (caulk, paint, sealers, wall/floor finishes)    32. Is there a policy regarding the use of beeswax candles instead of paraffin candles?33. Is there a policy regarding smoking in and around the building(s)?  AttitudeYesNo Comment34. Does the congregation indicate its accessibility in its newsletter, Yellow Pages section, newspaper items, and the PSWD/UUA directories?   35. Are directions to accessible entrances and restrooms clearly indicated?   o N/A36. Are greeters or ushers informed how to greet and assist people with disabilities?   37. Does the congregation provide guidelines for including people with disabilities in services and events?   38. Does the congregation have an accessibility committee?39. If not, which committee(s) addresses accessibility issues? o N/A OtherYesNo Comment40. Does your congregation regularly plan and budget for improvements to its accessibility?41. In addition to the items we have covered, does your congregation have any other accessibility needs that you are aware of?42. Would your Board or congregation be interested in having an Accessibility Audit by the PSWD Accessibilities Committee, which includes recommendations for improvement?43. Do you have any further comments or questions? 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