Below is a detailed and professional version of the SayPro Staff Housing Condition Self-Assessment Form, designed to be used by employees to evaluate and report the condition of their assigned SayPro staff housing unit.

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SayPro Staff Housing Condition Self-Assessment Form

Under SayPro Housing Management and Staff Welfare Monitoring Framework

Issued by: SayPro Housing and Facilities Office
Effective Date: May 13, 2025

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Purpose of the Form

The SayPro Staff Housing Condition Self-Assessment Form is a structured tool used by employees to evaluate, document, and report the current condition of their staff housing unit. This form supports SayPro’s commitment to quality living conditions, preventive maintenance, and staff welfare oversight.

Staff are expected to complete this assessment:

• Upon initial occupancy
• Quarterly as part of SayPro’s ongoing housing condition monitoring
• Before vacating the property
• Anytime a maintenance or repair concern arises

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SECTION A: STAFF INFORMATION

Field	Details
Full Name	[Employee Full Name]
Employee ID	[SayPro Employee ID]
Job Title	[Current Designation]
Department	[SayPro Department]
Contact Number	[Phone Number]
Email Address	[Work Email]
Date of Assessment	[MM/DD/YYYY]

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SECTION B: HOUSING UNIT DETAILS

Field	Details
Property Address	[Full Housing Unit Address]
Unit Type	[e.g., 1-Bedroom, 2-Bedroom, Apartment]
Date of Occupancy	[MM/DD/YYYY]
Furnished / Unfurnished	[Select One: Furnished / Unfurnished]
Number of Occupants	[Total Number of People in Unit]

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SECTION C: CONDITION ASSESSMENT CHECKLIST

Please check the condition of each item using the following key:
✔ Good  ✖ Needs Repair  N/A Not Applicable

Category	Item	Condition	Comments / Notes
General	Cleanliness of entire unit	[✔/✖/N/A]
	Walls & Paint Condition	[✔/✖/N/A]
	Doors & Locks	[✔/✖/N/A]
Living Room	Flooring	[✔/✖/N/A]
	Windows & Curtains/Blinds	[✔/✖/N/A]
	Lights and Switches	[✔/✖/N/A]
Kitchen	Sink & Faucets	[✔/✖/N/A]
	Cabinets and Countertops	[✔/✖/N/A]
	Stove / Oven (if provided)	[✔/✖/N/A]
	Fridge (if provided)	[✔/✖/N/A]
Bedrooms	Bed Frames (if furnished)	[✔/✖/N/A]
	Storage / Closets	[✔/✖/N/A]
Bathroom	Toilet & Flush Function	[✔/✖/N/A]
	Shower/Bath	[✔/✖/N/A]
	Water Pressure	[✔/✖/N/A]
	Mold / Dampness Signs	[✔/✖/N/A]
Utilities	Electrical Outlets	[✔/✖/N/A]
	Plumbing System	[✔/✖/N/A]
	Water Supply	[✔/✖/N/A]
	Hot Water Functionality	[✔/✖/N/A]
Safety	Smoke Detector	[✔/✖/N/A]
	Fire Extinguisher (if applicable)	[✔/✖/N/A]
	Emergency Exits Clear	[✔/✖/N/A]

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SECTION D: MAINTENANCE REQUEST (IF ANY)

Please list any issues that need immediate repair or inspection:

Issue / Problem	Description & Location	Urgency (Low / Medium / High)
[Example: Leaking Faucet]	Kitchen sink – slow drip	Medium

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SECTION E: DECLARATION

I hereby confirm that the above information is a true and accurate reflection of the current condition of the assigned SayPro housing unit. I understand that I am responsible for reporting any further issues and for the proper use and care of the housing provided.

Employee Signature: ___________________________
Date: [MM/DD/YYYY]

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FOR OFFICIAL USE ONLY

(To be completed by SayPro Housing Officer)

Reviewed By	[Full Name of Officer]
Designation	[Housing Management Position]
Review Date	[MM/DD/YYYY]
Follow-up Required?	[Yes / No]
Remarks	[Insert Notes or Actions Required]

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Submission Instructions

• Method: Submit electronically via the SayPro Staff Housing Portal or deliver a physical copy to the Housing Office.
• Frequency: Upon move-in, quarterly self-assessment, or as needed.
• Support: For assistance, contact the SayPro Housing Management Team at [Insert Email/Contact].

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