SURVEY FORM 16: TOILET ROOMS AND BATHROOMS

Section	Item	Technical Requirements	Comments	Yes	No
4.1.2(6) 4.1.3(11) 4.22.1	Public and Common Use Toilet Rooms:	If toilet rooms are provided, does each public and common use toilet room comply with 4.22 (See below)? (A common use toilet room is one used for a restricted group of people such as occupants of a building or employees of a company.)
	Private Use Toilet Rooms:	If other toilet rooms are provided for the use of an occupant of a specific space, (such as a private toilet room for a company president) is each toilet room adaptable (e.g., door clearance, clear floor space at fixtures and maneuvering space)?
4.1.2(6) 4.1.3(11) 4.23.1	Public and Common Use Bathing Facilities:	If bathrooms or bathing facilities are provided, does each public and common use bathroom or bathing facility comply with 4.23 (See below)?
4.1.3(5) Exception 1	Toilet/Bath Rooms in Buildings Eligible for Elevator Exemption:	In buildings eligible for the elevator exception, if toilet/bath rooms are provided on a level not served by an elevator, is a toilet/bath room complying with 4.22 or 4.23 provided on the accessible ground floor? If toilet or bathing facilities are also provided on floors above or below ground level, they must be accessible.
4.22.1	Accessible Route:	Are the toilet/bath rooms located on an accessible route? (Use Form 12: Building Lobbies and Corridors)
4.22.3 4.23.3		If provided, are each of the following accessible fixtures and controls located on an accessible route? (Use Form 12: Building Lobbies and Corridors) - 4.22.4 & 4.23.4 Water closets - 4.22.5 & 4.23.5 Urinals - 4.22.6 & 4.23.6 Lavatories and Mirrors - 4.22.7 & 4.23.7 Controls and Dispensers - 4.23.8 Bathing and Shower Facilities - 4.23.9 Medicine Cabinets
		4.22.3; 4.23.3 Maneuvering Space: Is there an unobstructed turning space (a 60-inch diameter circle or T-shaped space) in the toilet/bath room? (See Figure 3.) (The clear floor space of fixtures and controls, the accessible route, and the turning space may overlap.)
4.22.2; 4.23.3	Doors:	Do the doors comply with 4.13? (Use Form 11: Doors and Gates)
		Does the door swing not intrude into the clear floor space at any fixture?
4.1.3(16) 4.30.1	Room Identification Signage:	Do signs which designate toilet/bath rooms comply with 4.30.4, 4.30.5, and 4.30.6? (Use Form 19: Signage)
4.22.4 4.23.4	Toilet Stalls - Standard Stall:	If toilet stalls are provided, is at least one a standard stall at least 60 inches wide complying with 4.17 (See below)?
4.17.3	Size and Arrangement:	Does the size and arrangement of the standard toilet stall comply with Figure 30(a)? (Arrangements may be reversed.)
	Stall Width:	Is the stall at least 60 inches wide?
	Stall Depth:	If the toilet is wall mounted, is the stall at least 56 inches deep?
		If the toilet is a floor mounted model, is the stall at least 59 inches deep?
	Door Location:	Is the stall door located at the "open" side of the toilet stall?
4.17.4	Toe Clearance:	If the stall is less than 60 inches deep, does the front partition and at least one side partition have toe clearances of at least 9 inches above the floor?
4.17.5 4.13.5	Stall Door Width:	When the stall door is open 90 degrees, is there a clear opening of at least 32 inches measured between the face of the door and the edge of the partition on the latch side?
	Door Swing:	If the stall door swings into the stall, is there at least 36 inches additional depth in the stall so that it does not encroach on the clear floor space required at the toilet and is there at least 18 inches of maneuvering space at the latch side of the door? (See Figure 30 (a-1))
	Approach Aisle:	If the stall door swings out and the approach is from the latch side, is the aisle approaching the stall at least 42 inches wide? OR If the stall door swings out and the approach is from the hinge side, is the aisle approaching the stall at least 48 inches wide?
4.17.5 4.13.6	Maneuvering Space:	If the stall door opens out at the end of an aisle, is there at least 18 inches of maneuvering space at the latch side of the stall door?
4.17.6	Grab Bars In Standard Stall:	Are the grab bars in the standard stall placed as shown in Figure 30 (a), (c), and (d)?
		Do the grab bars comply with 4.26.2, 4.26.3, 4.26.4 (See below)?
4.22.4; 4.23.4	Additional Toilet Stall:	Where 6 or more toilet stalls are provided, in addition to the 60 inch wide standard stall, is at least one stall 36 inches wide with an outward swinging, self-closing door provided?
	Grab Bars in Additional Stall:	Do the parallel grab bars in the 36 inch wide stall comply with Figure 30(d)?
		Do the grab bars comply with 4.26.2, 4.26.3 and 4.26.4 (See below)?
4.16.2	Toilets Not in Stalls - Front Approach:	If the toilet is not in a stall and is approached from the front and there is a lavatory alongside the toilet, is there a clear floor space at least 48 inches wide by 66 inches long? (See Figure 28)
	Side Approach:	If the toilet is not in a stall and is approached from the side and there is a lavatory alongside the toilet, is there a clear floor space at least 48 inches wide by 56 inches long? (See Figure 28)
	Lateral Transfer:	If the toilet is not in a stall and there is provision for a lateral transfer (no lavatory alongside the toilet), is there a clear floor space at least 60 inches wide by 56 inches long? (See Figure 28)
4.16.4	Grab Bars for Toilets Not in Stalls:	If the toilet is not in a stall, is the back grab bar at least 36 inches long with the end closer to the side wall mounted at least 12 inches from the centerline of the toilet? (See Figure 29)
		Is the side grab bar at least 42 inches long and mounted a maximum 12 inches from the back wall? (See Figure 29)
		Are the grab bars horizontal and mounted between 33 and 36 inches above the floor?
		Do the grab bars comply with 4.26.2, 4.26.3, or 4.26.4 (See below)?
4.26.2	Grab Bars for All Accessible Toilets - Diameter:	Is the outside diameter of the grab bar between 1-1/4 and 1-1/2 inch? OR Does the shape provide an equivalent gripping surface? Note: Standard pipe sizes designated by the industry as 1-1/4 to 1-1/2 inches are acceptable for purposes of this section.
4.26.2	Wall Clearance:	Is the space between the grab bar and the wall exactly 1-1/2 inches?
4.26.3(5)	Fixed:	Are the grab bars secured so that they do not rotate within their fittings?
4.26.2	Clearance in Recess	If a grab bar is located in a recess, is the recess a maximum of 3 inches deep extending at least 18 inches above the rail? (See Figure 39(d))
4.26.3	Structural Strength:	Do the grab bars meet the structural strength requirements for bending stress and shear stress? (See 4.26.3(1) and (2))
		Do the fasteners meet structural strength requirements for shear force and tensile force? (See 4.26.3(3) and (4))
4.26.4	Hazards:	Are grab bars and adjacent walls free of sharp or abrasive elements?
		Do grab bars have edges with a minimum radius of 1/8 inch?
4.22.4 4.23.4	Accessible Toilets:	Is the centerline of the toilet 18 inches from a wall or partition?
4.16.3	Toilet Seat:	Is the top of the toilet seat between 17 and 19 inches from the floor?
		Is the seat a type that does not automatically spring back to a lifted position?
4.16.5; 4.27.4	Toilet Flush Controls:	Are flush controls automatic or operable with one hand without tight grasping, pinching or twisting of the wrist?
		Is the force required to operate the controls no greater than 5 lbf?
		Are they mounted on the wide side of the toilet where the clear floor space is provided?
		Are the controls no higher than 44 inches above the floor?
4.16.6	Toilet Paper Dispenser:	Is the paper dispenser mounted below the grab bar no more than 36 inches from the back wall and at least 19 inches from the floor?
		Is the dispenser located so that it does not obstruct the use of the grab bar?
		Does the dispenser allow continuous paper delivery?
4.22.5 4.23.5	Urinals:	Where urinals are provided, does at least one comply with 4.18 (See below)?
	Rim Height:	Does the urinal have an elongated rim no more than 17 inches above the floor?
4.18.3 4.2.4	Clear Floor Space:	Is there a clear floor space at least 30 by 48 inches which allows a forward approach to the urinal?
		Does the clear floor space adjoin or overlap an accessible route?
4.2.4.3	Surface:	Is the surface of the clear floor space stable, firm and slip resistant?
	Width Between Shields:	If urinal shields are provided and they do not extend beyond the front edge of the urinal rim, is there at least 29 inches between the two panels?
4.18.4 4.27.4	Urinal Flush Controls:	Are the flush controls automatic or operable with one hand without tight grasping, pinching, or twisting of the wrist?
		Is the force required to operate the controls no greater than 5 lbf?
		Are the controls mounted no more than 44 inches above the floor?
4.22.6 4.23.6	Lavatories:	If lavatories are provided, does at least one lavatory meet the following requirements?
4.19.2	Rim Height:	Is the lavatory rim or counter surface no higher than 34 inches above the finish floor?
	Knee Clearance:	Is there a clearance of at least 29 inches from the floor to the bottom of the apron? (See Figure 31)
	Wall Projection:	Does the front edge of the lavatory project at least 17 inches from the wall?
		Do the toe and knee clearances comply with Figure 31?
4.19.3 4.2.4	Clear Floor Space:	Is there a clear floor space at least 30 by 48 inches in front of the lavatory allowing a forward approach?
		Is no more than 19 inches of this clear floor space measured underneath the lavatory?
		Does the clear floor space adjoin or overlap an accessible route?
4.2.4.3	Surface:	Is the surface of the clear floor space stable, firm and slip resistant?
4.19.4	Pipe Shielding:	Are hot water pipes and drain pipes insulated or otherwise configured to protect against contact?
	Smooth Surfaces:	Is the area below the lavatory free of sharp or abrasive surfaces?
4.19.5 4.27.4	Faucet Operation:	Can the faucet be operated with one hand without tight grasping, pinching, or twisting of the wrist?
		Is the force required to operate controls no greater than 5 lbf?
		If the valve is self-closing, does it remain open for at least 10 seconds?
4.22.6 4.23.6 4.19.6	Mirrors:	Where mirrors are provided, does at least one mirror have a bottom edge of the reflecting surface no higher than 40 inches from the floor?
4.22.7 4.23.7	Dispensers - Location:	Is at least one of each dispenser type accessible and on an accessible route?
4.27.2 4.2.4	Floor Space:	Is there a clear floor space at least 30 by 48 inches in front of the dispenser allowing either a forward or a parallel approach to the dispenser?
4.2.4.3	Surface:	Is the surface of the clear floor space stable, firm and slip resistant?
4.27.3	Dispenser Height:	If a forward approach is provided, is the highest operable part no higher than 48 inches?
		If a parallel approach is provided, is the highest operable part no higher than 54 inches?
4.27.4	Dispenser Operation	Can the dispenser be operated with one hand without tight grasping, pinching, or twisting of the wrist?
4.23.9	Medicine Cabinet:	If medicine cabinets are provided, does at least one have a usable shelf no higher than 44 inches from the floor?
4.2.4	Clear Floor Space:	Is there a clear floor space at least 30 by 48 inches in front of the medicine cabinet allowing either a forward or parallel approach to the medicine cabinet?
4.2.4.3	Surface:	Is the surface of the clear floor space stable, firm and slip resistant?
4.25.2 4.2.4	Storage:	If fixed or built-in storage facilities are provided, does at least one of each type have a clear floor space 30 by 48 inches allowing either a forward or parallel approach?
4.25.3 4.2.5 4.2.6		If a parallel approach is provided, are clothes rods and shelves between 9 and 54 inches from the floor?
4.25.3	Shelf Height:	Where the distance between a wheelchair and clothes rod or shelf is between 10 - 21 inches (e.g., closets without accessible doors) is the accessible shelf no more than 48 inches from the floor and the reach no more than 21 inches? (See Figure 38)
4.25.3		If a front approach is provided, are clothes rods and shelves between 15 and 48 inches from the floor?
4.23.8	Bathtubs and Showers:	Where bathtubs or showers are provided, does at least one comply with 4.20 or 4.21? (Use Form 17: Bathtubs and Showers)
4.1.3(14) 4.28.1	Alarms:	Where alarms are provided, do they comply with 4.28? (Use Form 20: Alarms)

The T-shape space is 36 inches (915 mm) wide at the top and stem within a 60 inch by 60 inch (1525 mm by 1525 mm) square.

For a front transfer to the water closet, the minimum clear floor space at the water closet is a minimum 48 inches (1220 mm) in width by a minimum of 66 inches (1675 mm) in length. For a diagonal transfer to the water closet, the minimum clear floor space is a minimum of 48 inches (1220 mm) in width by a minimum of 56 inches (1420 mm) in length. For a side transfer to the water closet, the minimum clear floor space is a minimum of 60 inches (1525 mm) in width by a minimum of 56 inches (1420 mm) in length. (4.16.2, A4.22.3)

Fig. 29(a) Back Wall. A 36 inch (915 mm) minimum length grab bar is required behind the water closet mounted at a height between 33 and 36 inches (840-915 mm). The grab bar must extend a minimum of 12 inches (305) beyond the center of the water closet toward the side wall and a minimum of 24 inches (610 mm) toward the open side for either a left or right side approach.

The following knee and toe clearances are required underneath a lavatory: 8 inches (205 mm) minimum measured from the front edge underneath the lavatory back towards the wall, and a toe clearance 9 inches (230 mm) minimum high, measured a maximum 6 inches (150 mm) from the wall. A minimum 27 inches (685 mm) clear space is required underneath the lavatory bowl. (4.19.2, 4.19.6)

Figure 30
Toilet Stalls
Diagrams of various toilet stall configurations showing positions of water closets and grab bars. Alternate configurations for alterations are shown where use of the standard stall is not technically feasible

If the clear floor space allows a parallel approach by a person in a wheelchair and the distance between the wheelchair and the shelf exceeds 10 inches, the maximum high side reach shall be 48 inches (1220 mm) above the floor and the low side reach shall be a minimum of 9 inches (230 mm) above the floor. The shelves can be adjustable. The maximum distance from the user to the shelf shall be 21 inches (535 mm).

If the clear floor space allows a parallel approach by a person in a wheelchair and the distance between the wheelchair and the clothes rod exceeds 10 inches, the maximum high side reach shall be 48 inches (1220 mm). The maximum distance from the user to the clothes rod shall be 21 inches (535 mm).

Facility Name:
Toilet Room Location: