Thank you for taking the steps to identify and remove accessibility barriers at your business Proudly Accessible Dubuque will spread the word to your customers – both existing and new.

There are four main categories in our General Survey:

Accessible Parking
Accessible Entrance
Access to Goods and Services
Accessible Restrooms

and a Special Section for Accessible Lodging. Complete only the categories that pertain to your business. For example, if you don’t have a parking lot available for your customers, do not complete the "parking" section. If your business does not have a restroom available to the public, do not complete "restrooms".

If you complete the survey and score 100%, you will receive:

1. Proudly Accessible Dubuque window clings for your place of business


2. Permission to use the Proudly Accessible Dubuque logo in all your advertising


3. Listing on this Proudly Accessible Dubuque web site.


4. Special listing on the Dubuque Area Chamber of Commerce web site


5. Special listing in this year's Dubuque Convention and Visitor's Guide


6. Inclusion in our regular media blitzes


7. Increased customer base and improved customer relations


8. Possible tax credits and deductions: Expenses for any changes that you make at your place of business to improve accessibility may entitle you to a tax credit and/or deduction. See Tax Advantages on this web site, Tax Incentives Packet on the Americans with Disabilities Act or obtain IRS Publications 334 and 535, and/or Form 8826.

If you don’t score 100%, submit your survey as is and we will get back to you with reasonable, practical, cost effective solutions to make your businesses more accessible for all your customers!

Survey Instructions

It's so easy! All the questions are Yes, No or N/A, and we’ve added lots of illustrations. You only need to complete the categories that pertain to your business. The only tools you’ll need are a tape measure and a level. It takes a typical business 45 minutes to an hour to complete the survey

Step 1: Download the worksheet, especially if you have a parking lot and/or a public restrooms. Having this document will make it easier for you to take the measurements (or give to your maintenance crew).

Step 2: If you can't answer "Yes" to some questions, we give you “Helpful Hints”. Just position your cursor over the “No" button of the question and the Helpful Hints will pop-up. Or type your question(s) in the Question/Comments Box, finish and submit your Survey and we’ll get right back to you. (If you are in the Lodging business, first complete and submit the Survey. We have a few extra questions for you, summarized on your own page. When we get your Survey, we’ll contact you to ask about the rest.)

Step 3: When you're ready, fill in your general information, complete the on-line survey and submit.

 

SURVEY

General information


Before we begin we need some information about your organization.

Business Name:

Telephone (as ###-###-####):

E-mail:

Owner/Manager:

Building Owner:

Person Completing Survey

  I certify that these answers are true and complete.




Accessible Parking Survey

Or
If Customers Can't Park
They Can't Come In

Parking and getting customers into the building is the top priority for accessibility improvements.

Please note:
Parking stalls and signs are often referred to as "Handicapped".
People with disabilities prefer the word "Accessible".

1.  Is your business served by a parking lot?

Yes No (If no, you may skip the parking portion of the survey)

2. The first accessible parking space must be the larger, van accessible space.



 
Is there at least one 8-foot-wide van accessible parking space with:
      a. a van-accessible parking sign placed 60 inches off the ground, and
      b. an 8 foot ( 96 inches) wide marked adjacent to the space, and
      c. an accessible route connecting the marked access area to an accessible entrance?


Yes No

3 .Parking lots need one van-accessible space for every 25 spaces. Does your lot have enough van-accessible spaces?

Total parking spaces		Required number of van-accessible spaces in Parking Lot
1 to 25		1 van space
26 to 50		1 standard space + van
51 to 75		2 standard spaces + 1 van
76 to 100		3 standard spaces + 1 van
101 to 150		4 standard spaces + 1 van
151 to 200		5 standard spaces + 1 van
201 to 300		6 standard spaces + 1 van
301 to 400		7 standard spaces + 1 van
401 to 500		7 standard spaces + 2 vans
501 to 1000		2 % of total spaces; 1 in every 8 accessible spaces must be van-accessible
1001 and over		20 + 1 extra space for each hundred spaces over 1000; 1 in every 8 accessible

Yes No

4. Is each additional accessible parking space 8 feet wide with:
      a. An accessible parking sign placed 60 inches off the ground, and




      b. A 5-foot-wide access aisle adjacent to the space, and




      c. an accessible route connecting the access aisle to an accessible entrance?

Yes No

5. Is the accessible parking located on the shortest accessible route to the accessible entrance?

Yes No

6.Is the accessible parking located on level ground with no more than a two percent cross slope (1 foot rise in 50 foot run) in any direction?



1 foot in 50 foot run

1/2 inch rise in 24 inch run

Yes No

7. Is there a route of travel from the accessible parking access aisle to the accessible entrance that:
      a. includes a curb cut and does not have steps, and




      b. is at least thirty-six inches wide, and
      c. is firm, stable, and slip-resistant, and
      d. is free of protruding or overhanging objects that would not be detected by a person using their cane? In order to be detected using a cane, an object must be within 27 inches off the ground. Objects hanging or mounted overhead must be higher than 80 inches from the ground. It is not necessary to remove object that protrude from the wall less than 4 inches. (Example: low hanging flag or sign, hanging plant)*



Yes No

 

 

 

 

 

 

Accessible Entrance Survey

Or
If Customers Can't Get In,
What's the Point?

Parking and getting customers into the building is the top priority for accessibility improvements.

Better access means more customers which means more business

1.  Do all ramps along the route from the parking and up to the accessible entrance have:
      a. a slope of 1:12 or less, and

1 inch rise in 12 inch run	2 inch rise in 24 inch run

             b. railings on both sides at 34 to 38 inches high, if the ramp is longer than 6 feet, and




      c. a clear width between railings of at least 36 inches, and
      d.  and a 5 foot square level rest area every 30 feet along the length of the ramp?



Yes No

2.  Is the exterior accessible entrance:
      a. Stepless or ramped, a beveled threshold that is less than ¾ inches high; with
      b. A door that provides at least a 32 inch wide clear opening, and




      c. A door handle that is no higher than 48 inches and operable with a closed fist, and




      d. A door that can be easily opened by someone with limited strength, and
     e. A threshold that is a maximum of ¾ inches high and beveled.

Yes No

3. Are there at least 18 inches of clear wall space on the pull side of the door next to the handles?



Yes No

 

4.  If the main entrance to your business is not accessible, does it have a sign directing people to the accessible entrance?



Yes No

 

 

 

 

 

 

Access To Goods & Services
Inside Your Business Survey

Or
This Is The Point

Ideally, customers should be able to obtain goods and services without assistance.

People with Disabilities have $220 Billion in Discretionary Spending Power. 63% make most of their purchases in a store. 66% chose businesses where they have received good service related to their disability**

1.  Can customers travel throughout the public areas to all goods and services by following a route that:
      a. is at least thirty six inches wide and free of obstructions, and




      b.  is free of protruding or overhanging objects that would not be detected by a person using their cane? In order to be detected using a cane, an object must be within 27 inches off the ground. Objects hanging or mounted overhead must be higher than 80 inches from the ground. It is not necessary to remove object that protrude from the wall less than 4 inches (Example: low hanging flag or sign, hanging plant) and






      c.  includes turn around areas that are either 5 foot circles or T-shaped spaces at the ends of aisles so wheelchair user don’t have to back out and




      d. has a surface that is firm, stable, and slip-resistant, and
      e.  is without rugs. (If rugs exist, are they low-pile, tightly woven and securely attached along the edges?)

Yes No

2.  Do all interior doors in public areas:
      a. Provide at least a 32 inch wide clear opening, and




      b. have door handles located no higher than 48 inches that are operable with a closed fist, and




      c. have an opening force of five pounds or less (light enough for a child to open), and
      d. have beveled thresholds of ½ inch or less?

Yes No

3.  Do seating areas have:
      a. have 36 inch aisles between them when in use, and




      b.  have tables that are between 28 and 34 inches high, with knee spaces at least 27 inches high, 30 inches wide, and 19 inches deep?



Yes No Not Applicable

4.  Is there at least one service counter or checkout area that is not more than 36 inches high?

Yes No

5.  Is a range of products available on shelving that someone in a wheelchair can reach (between 15 inches and 48 inches off the ground or up to 54 inches off the ground if a side approach is possible)?



Yes No

**U.S.Census Bureau and www.realisinf-potential.org/ews.the-walk-away-pound/findings.html

 

 

 

 

 

 

Accessible Restrooms Survey

Or
Well, You Know!

If the public is allowed to use restrooms, the restrooms should be accessible.

1.  Does your business contain any restrooms?

Yes No (if no, you may skip the restroom portion of the survey)

2.  Is there at least one public restroom, unisex if necessary, with a door that
      a. provides at least a 32 inch wide clear opening, and




      b. has door handles located no higher than 48 inches that are operable with a closed fist, and




      c. has a very light opening force, and
      d. has a beveled threshold of ½ inch or less and
      e. has enough maneuvering space for a person using a wheelchair? (A person using a wheelchair needs 36 inches clear floor space for forward movement and a five foot diameter or a T-shaped clear space to make turns.)



Yes No

3.  Is there a restroom or stall that has:
      a. door hardware operated with a closed fist, and




       b. an area at least 5 feet by 5 feet clear of the door swing, OR an area 36 by 69 inches, OR an area 48 by 69 inches, and




      c. grab bars behind and on the side wall nearest the toilet, and




      d. a toilet seat 17 to 19 inches high?



Yes No

4.  Is there a 36 inch unobstructed path to all fixtures in the restroom?

Yes No

5.  Is the sink:
      a. located so there is a 30x48 inch clear space in front for parking a wheelchair, and




      b.  rim no higher than 34 inches, and clearance at least 29 inches from the floor to the bottom of the sink, excluding pipes, and



 
      c. equipped with a faucet that can be operated with one closed fist?



Yes No

6. Are soap, towel and other dispensers usable with a closed fist and located where someone in a wheelchair can reach (between 15 inches and 48 inches off the ground or up to 54 inches off the ground if a side approach is possible)?



Yes No

7.  Is there mirror located so that the bottom edge of the mirror surface is 40 inches high or lower?



Yes No

 

 

 

 

 

 

 

 

Submit Your Survey

Thank you for taking the Proudly Accessible Dubuque Survey. We will contact you shortly about your awards Please share any questions or comments.