individual with a disability an
opportunity to participate in and benefit from any program.

An agency may not afford an opportunity that is not equal to or not as
effective as that provided others.

An agency may not impose eligibility criteria for participation in programs
that screen out people with disabilities either directly or indirectly, unless
such criteria are necessary for the provision of the programs activities.




Yes No

Does your agency have a policy and process to train
personnel on the requirements of the ADA?

If yes, please describe:









Develop and implement a
personnel ADA training
policy.

Appoint a person to be
primarily responsible for
personnel ADA training.

Does your agencys written policies and procedures, and its
current practices for each program, service, and/or activity
ensure non-discrimination on the basis of a disability?

If yes, please describe:










Review written policies and
procedures and make changes
accordingly. See page 23 in
the ADA Compliance Manual
for examples.
Are there any circumstances in which the participation of a
person with a disability in the program would be restricted or
excluded?

If so, please describe:










Change or develop alternative
programming that wont
restrict or exclude persons
with disabilities.
1 Checklist for Existing Facilities
Adaptive Environments Center and Barrier Free Environments
QUESTIONS
POSSIBLE SOLUTIONS



Yes No

Are any of these exclusions or restrictions necessary to the
operation of the program or to the safety of the participants
who do not have disabilities?

If yes, please describe:












Make equitable
accommodations available to
persons with disabilities.

Reasonable Program Modifications

Agencies are required to make reasonable modifications to policies
or practices in order to avoid discrimination towards people with
disabilities. A modification is not required, however, if it would
fundamentally alter the nature of the program or activity.



Yes No

Is staff aware that it may be necessary to modify program
policies or practices to enable people with disabilities to
participate in and benefit from the program?




Annually train staff on ADA
policies. See pages 22 in
ADA Compliance Manual.

Is the public informed that the program is prepared to make
reasonable modifications?

If yes, please describe:







If no, what needs to be done:











Make statement available on
a medium such as a brochure,
flier or poster. See page 23
for example of wording. Checklist for Existing Facilities
Adaptive Environments Center and Barrier Free Environments
QUESTIONS
POSSIBLE SOLUTIONS



Yes No

Does the program have a formal or informal process for
responding to requests for modifications?

If yes, please describe:





If no, what needs to be done:








Implement a procedure for
dealing with such requests.

Designate a staff member
responsible for handling all
modification requests.

Does the program have a process for determining whether a
policy or practice modification would fundamentally alter the
nature of the program?

If yes, please describe:




If no, what needs to be done:







Create a process of checking
if modifications will
fundamentally change a
program.

Evaluate the program on a
regular basis i.e., annually.


Surcharges and Additional Requirements

Agencies may not impose extra charges upon people with disabilities
to cover the cost of effective communication, program modifications,
or access features, and may not impose any additional requirements
or burdens on people with disabilities that they do not require of all
other participants in the program.



Yes No

Are there any circumstances in which a person with a
disability would be asked to pay a fee or meet any other
requirements not imposed on other program participants?

If yes, please describe:








Review all activities, i.e.,
social events, recreational
activities, day care,
transportation.

Remove any such fees from
the program. Checklist for Existing Facilities
Adaptive Environments Center and Barrier Free Environments
QUESTIONS
POSSIBLE SOLUTIONS



Yes No

If buildings and/or facilities cannot be made physically
accessible, have you taken steps to ensure that your programs,
services and/or activities, when viewed in their entirety, are
accessible?



Relocate activities to an
accessible location.

Modify or redesign
equipment.

Make home visits.

Provide other alternative
methods for delivering
services.

Has your agency taken steps to ensure that all employees and
consumers have been instructed and notified regarding their
rights under the ADA?

If yes, please describe:











Review the Program Access
section on suggested wording
for policy of non-
discrimination, ADA
Compliance Manual pages
23.

Has your agency provided information to the public, in an
accessible format, explaining its policy to provide accessible
policies, programs, services or activities, and practices?

If yes, please describe:











Make such information
readily available to the
public. See page 23 of ADA
Compliance Manual for
example of wording.
Have you ensured that written and/or audio visual materials
portray persons with disabilities in an appropriate manner?

If yes, please describe:












Review the section on the
Americans with Disabilities
Act: What are the Correct
Disability-Related Words to
Use? in the ADA
Compliance Manual, pages
14.






I certify that the foregoing statements are true and correct to the best of my understanding.


Completed by:





Name


Phone Number




Title Date


Adapted from ADA Title II Action Guide for State and Local Governments by Adaptive Environments Center, Inc., National Institute on
Disability and Rehabilitation Research, LRP Publications, Horsham, PA 1992, pp.101 & 102.



























Priority A = Fiscal year

Program Access Plan
B = Fiscal year






C = Fiscal year








Priority


Barrier
Solution(s)
Costs
Funding
Source

Due Date
Responsible
Person


























Checklist for Existing Facilities
Adaptive Environments Center and Barrier Free Environments
QUESTIONS
POSSIBLE SOLUTIONS

Physical Access Checklist
1
Priority 1 Accessible Entrance

People with disabilities should be able to arrive on the site, approach
the building, and enter the building as freely as everyone else. At
least one path of travel should be safe and accessible for everyone,
including people with disabilities.
Note: ADAAG citations in
parenthesis refer to The
Americans with Disabilities
Act Accessibility Guidelines
issued by the Architectural and
Transportation Barriers
Compliance Board. See page
33 of the ADA Compliance
Manual for more information.
Path of Travel (ADAAG 4.3, 4.4, 4.5, 4.7)
Yes No

Is there a path of travel that does not require the use of stairs?



Add a ramp if the path of
travel is interrupted by stairs.

Add an alternative pathway
on level ground.

Is the path of travel stable, firm and slip-resistant?



Repair uneven paving.

Fill small bumps and breaks
with beveled patches.

Replace gravel with hardtop.

Is the path at least 36 inches wide?



Change or move landscaping,
furnishings, or other features
that narrow the path of travel.

Widen pathway.

Can all objects protruding into the path be detected by a
person with a visual disability using a cane?

In order to be detected using a cane, an object must be
within 27 inches of the ground. Objects hanging or
mounted overhead must be higher than 80 inches to
provide clear head room. It is not necessary to remove
objects that protrude less than 4 inches from the wall.




Move or remove protruding
objects.

Add a cane-detectable base
that extends to the ground.

Place a cane-detectable object
on the ground underneath as a
warning barrier.

Do curbs on the pathway have curb cuts at drives, parking
and drop offs?



Install curb cut.

Add small ramp up to curb.



Checklist for Existing Facilities
Adaptive Environments Center and Barrier Free Environments
QUESTIONS
POSSIBLE SOLUTIONS


Ramps (ADAAG 4.8)
Yes No

Are the slopes of ramps no greater than 1:12?

Slope is given as a ratio of the height to the length.
1:12 means for every 12 inches along the base of the
ramp, the height increased on inch. For a 1:12
maximum s