Appendix B

1. Side Walk
   1. Accessibility
      1. Check List

Identify a place to perform the assessment walk. If you are completing the checklist as a group, try brainstorming collectively to identify important pedestrian routes throughout your community. If you are completing the checklist as an individual, you might want to focus on routes you use regularly, such as from your house to the bus stop. Your walk should be no longer than six blocks.

Complete the contact information and review the checklist questions before you begin your walk. In addition to this form, you may want to bring a notebook, camera and/or sketch pad to record additional information, and a map of the area to mark your route.

Developed by Beneficial Designs

Contact Information

Name: ________________________________________________________________

Address: ______________________________________________________________

City: ________________ State: ________________ Zip: _______________________

Phone: _____________________ Email: ____________________________________

Gender: male/female Age: ________________________________________________

Description of Disability (if any): ___________________________________________

Type of Assistive Technology (if any): _______________________________________

Location of Route: ______________________________________________________

______________________________________________________________________

______________________________________________________________________

If you are not able to answer yes to a question, check as many problems as are applicable. In addition, please note the approximate locations where you encountered each problem.

1. Did you have enough room to walk safely?

• Yes
• Some Problems:
  • Sidewalks started and stopped
  • Sidewalks were too narrow
  • Sidewalks were blocked with poles, signs, or other obstacles
  • Sidewalks were blocked by branches or other vertical obstacles
  • Adequate passing spaces were not provided
  • No sidewalk existed

  • Other:______________________________________________________

    ___________________________________________________________

    Locations of problems: ________________________________________

    ___________________________________________________________

2. Could you easily negotiate the sidewalk grades and cross slopes?

• Yes
• Some problems:
  • Sidewalks were excessively steep
  • Sidewalks had severe cross slopes
  • Adequate rest areas and/or level areas were not provided
  • Adequate shaded areas were not provided

  • Other:______________________________________________________

    ___________________________________________________________

    Locations of problems: ________________________________________

    ___________________________________________________________

3. Was the surface easy to walk on?

• Yes
• Some problems:
  • Sidewalk surfaces was not firm
  • Sidewalks were covered with snow or ice
  • Sidewalks were covered with leaves or other debris
  • Sidewalk surfaces were slippery
  • Sidewalks were broken or cracked
  • Gratings for trees and drainage were unavoidable

  • Other:______________________________________________________

    ___________________________________________________________

    Locations of problems: ________________________________________

    ___________________________________________________________

4. Were the curb ramps easy to use?

• Yes
• Some problems:
  • No curb ramps were provided
  • Curb ramps needed repair
  • Puddles or debris were collected at the bottom of the curb ramp
  • No tactile warning was provided
  • Curb ramps were too steep
  • No landings were provided
  • Extreme street slope made entering or leaving the curb ramp difficult
  • Obstacles such as poles or grates blocked the curb ramps
  • Curb ramps were exposed to traffic

  • Other:______________________________________________________

    ___________________________________________________________

    Exact Location of problematic Curb ramps: _______________________

    ___________________________________________________________

5. Was it easy to cross streets?

• Yes
• Some problems:
  • Difficult to differentiate between the sidewalk and the street
  • Road was too wide
  • Traffic signals made you wait too long
  • Traffic signals did not give you enough time to cross
  • Pedestrian controls were difficult to locate
  • Pedestrian signal controls were difficult to activate
  • Parked cars blocked your view of traffic
  • Trees or plants blocked your view of traffic

  • Other:______________________________________________________

    ___________________________________________________________

    Locations of problems: ________________________________________

    ___________________________________________________________

6. Was your walk pleasant?

• Yes
• Some unpleasant things:
  • Needs more grass, flowers, or trees
  • Too much exposure to traffic
  • Suspicious activity
  • Not well lit
  • Dirty; lots of litter or trash

  • Other:______________________________________________________

    ___________________________________________________________

    Locations of problems: ________________________________________

    ___________________________________________________________