Home Repair

HOME VISIT ASSESSMENT FORM

Applicant Name(s):______Date of Assessment:______

Home Assessors: ______

The Home Repair program is designed to help low income homeowners who are affected by age, disability or family circumstances and who struggle to maintain the critical integrity of their home. BAHFH will give equal access to eligible special needs applicants on a first come first served basis. Projects will be chosen based on highest priority of special needs and income guidelines, and other program requirements.

BAHFH will assess the project in three basic areas: Need, Ability to Pay, and Willingness to Partner. These areas will be given a ranking of 1-3:

3High level of (Need, Ability to Pay, and Willingness to Partner)

2Medium level of (Need, Ability to Pay, and Willingness to Partner)

1Low level of (Need, Ability to Pay, and Willingness to Partner)

Overall Ranking: ______/63

(Total Ranking of all areas)

NEED for Home Repair: √ one box in each row then total

Ranking(High, Medium, Low, unless otherwise stated) / 3 / 2 / 1
Elderly Head of Household
(62 years old or older) / _____ (62 years or older) / _____ all others
Disabled/Head of Household / _____ Head of Household is disabled / _____ Disabled or elderly household member (not head of household) / _____ all others
Household Demographics / _____ Single-Parent Household with 1 or more children / _____ Large family (5 or more) / _____ all others
Health Concerns
Please Note: / _____ High / _____ Medium / _____ Low
Safety Concerns
Please Note: / _____ High / _____ Medium / _____ Low
Quality of life Concern
Please Note: / _____ High / _____ Medium / _____ Low
Code Violations
Please Note: / _____ Yes / _____ No
Overall Scope of project
Please Note: / _____ High / _____ Medium / _____ Low
Reside in Home? / _____ Yes / _____ No (application declined)
Own home and land? / _____ Yes / _____ No (application declined)

Section Ranking Score: ______/ 30

Other Notes:

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ABILITY TO PAY:(completed after Application, part two review by underwriting team)

Ranking (High, Medium, Low, unless otherwise stated) / 3 / 2 / 1
Current on Mortgage Payments? / _____ Yes / _____ No (application declined)
Basic Guideline: Current on property taxes? / _____ Yes / _____ No (application declined)
Basic Guideline: Current on homeowner’s Insurance? / _____ Yes / _____ No (application declined)
Tax Value of Property does not exceed $ ______(which is 100% of median value of owner occupied housing in Deschutes or Crook County) / _____ Yes / _____ No (application declined)
If loan repayment, Long-Term Debt to Income Ratio (from underwriting form) / _____ <36% / _____ 36-40% / _____ 41% or more
If loan amount over $5,000, Credit history (from Underwriting form) / _____ Good / _____ None or Fair
(some late, some debts but repaying, not excessive) / _____ Poor
(often late, not repaying or can’t repay debts)
Is willing to re-pay loan amount (not to exceed 10% of gross monthly income) / _____ Yes / _____ Expresses concern over amount / _____No
Has a bankruptcy less than 2 years old / _____ No / _____ Yes

Section Ranking Score______/ 24

Additional notes:

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WILLINGNESS TO PARTNER: √ one box in each row then total

Ranking (High, Medium, Low, unless otherwise stated) / 3 / 2 / 1
Willingness to compete Sweat Equity hours
(min. of 8) / _____ Yes / _____ No
Willing to repay the cost of the repairs with a 0% Interest Mortgage / _____ Yes / _____ No
Home Visitors recommend project to team / _____ Yes / _____ No

Section Ranking Score______/ 9

Additional notes:

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Selection criteria are as follows. Please check one:

_____Scope of work too small, does not meet BAHFH criteria, decline application

_____Small, but quick job, meets BAHFH criteria

_____ Acceptable, meets BAHFH criteria

_____ Medium repairs needed, meets BAHFH criteria

_____ Many repairs needed, large job, meets BAHFH criteria

_____ Critical Repairs needed for quality of life, meets BAHFH criteria