Académique Documents
Professionnel Documents
Culture Documents
Agency Information
Complete Section A only once, even though you may do several different programs or facilities for this agency.
A1
Name of agency
A2
Street address
A3
City
Ithaca
A4
State
NY
A5
Zip code
14883
A6
County
Tompkins
A7
Mailing address
TM
607-273-6260
A8
Telephone number
A9
A10
Website address
A11
Type of agency
A12
Activities offered
A13
http://www.priweb.org/index.php
Facility/amenity
Check if
present
Facility/amenity
Miniature golf
Museum/exhibit
Overlook/observation area/platform
Picnic area/grill/fire ring
Play area/playground
Sauna/steam room
Shooting facility
Skating rink
Ski/snowboard area
Spa/hot tub
Sport facility/field/court (indoor or outdoor)
Stadium/arena/grandstand
Swimming pool/wading pool
Theater/amphitheater
Trail
Section B:
Physical Inclusion
B1.
Complete an Additional Building Checklist for each major facility at the agency.
For Section B and the Specialty Checklists, you will need a tape measure, a clinometer, a 60 circle, and a fish scale.
Agency Name:
APPROACH
No
n/a
Photo?
B2. Transportation
B2a
Public Agency
B2b
B2c
B2d
B3. Parking
3
Total number of parking lots/areas assessed*: _________
B3a
Far Lot
Name of the first parking lot/area: _______________________________________________
B3b
Unlined
B3c
B3d
B3e
Lined
If yes, are the spaces clearly marked with upright signs designating them as accessible?
(international symbol of accessibility or clear wording)
B3f
B3g
B3h
B3i
Width of access aisles: _____ inches (at least 60; at least 96 in NY)
B3j
~100 feet
Distance from parking to entrance: _______
(if no designated accessible parking, measure distance from middle of parking lot/area to entrance)
B3k
B3l
B3m
Pavement
Describe the surface of the route of travel:____________________________________
B3n
12
Slope of route of travel (at its steepest incline): ________
% (enter 0% if flat)
B3o
>36
Width of route of travel (at its narrowest point): ________
inches (at least 36)
B3p
ENTER
B4. Entrance
No
n/a
1
Total number of entrances assessed*: _________
B4a
Main Entrance
Name/location of first entrance: _______________________________________________
B4b
Is the international symbol of accessibility displayed by entrance? (or signage designating accessibility)
B4c
B4d
B4e
B4f
Is a ramp provided?
B4g
Width of ramp (at its narrowest point): _________ inches (at least 36)
B4h
B4i
B4j
B4k
B4l
B4m
B4n
91
If yes, distance between doors:_____________
inches (at least 48)
B4o
B4p
Opening force: _____ pounds (8.5 pounds or less is desirable) (enter n/a if automatic door)
B4q
automatic
entry set-top button
knob
B4r
B4t
lever
pull
push plate
push/pull paddle/bar
other:
lever
pull
push plate
push/pull paddle/bar
other:
automatic
entry set-top button
knob
B4s
Photo?
42
Clear space on pull side of door: _______
inches (at least 18)
Comments/additional information about entrance:
USE
No
n/a
Is there a continuous unobstructed route of travel from entrance (if indoor facility) or parking (if
outdoor facility) to registration/check-in area?
B5b
B5c
B5d
0
Slope of route of travel (at its steepest incline): ________
% (enter 0% if flat)
B5e
>36
Width of route of travel (at its narrowest point): ________
inches (at least 36)
B5f
B5g
40
Height of counter: _______
inches (36 or less)
B5h
B5i
B5j
Is the registration area large enough for wheelchair maneuvering? (60 circle)
If no, provide dimensions of free space in registration area: ____ inches by ____ inches
B5k
Is signage clear in registration area (word, picture, and Braille or raised lettering provided)?
B5l
Photo?
large print
multiple languages
oral communication provided in print
pictorial
sign language
TDD/TTY
other:
1
B6. Public restroom/toilet Total number of restrooms assessed*: __________
B6a
B6b
Is there a continuous unobstructed route of travel from entrance (if indoor facility) or parking (if
outdoor facility) to restroom?
B6c
B6d
Concrete
Describe the surface of the route of travel:_____________________________________
B6e
17.6
Slope of route of travel (at its steepest incline): ________
% (enter 0% if flat)
B6f
49
Width of route of travel (at its narrowest point): ________
inches (at least 36)
B6g
B6h
Restroom assessed:
B6i
Is signage clear (word, picture, and Braille or raised lettering provided for restroom signs)?
B6j
41
Clear open width of door to restroom: ________
inches (at least 32)
B6k
7
Opening force of door: ________
pounds (5 pounds or less)
USE (cont.)
B6l
lever
pull
push plate
push/pull paddle/bar
other:
lever
pull
push plate
push/pull paddle/bar
other:
18
Clear space on pull side of door: ________
inches (at least 18)
B6o
B6p
Is the toilet area large enough for wheelchair maneuvering? (60 circle)
B6q
B6r
Is the center line of the toilet positioned 16-18 from the nearest side wall?
B6s
B6t
2
Number of grab bars: _____________
B6u
19
Toilet seat height: _______
inches (between 17-19)
B6v
Is the sink area large enough for wheelchair maneuvering? (60 circle)
B6w
Photo?
automatic
entry set-top button
knob
B6n
n/a
automatic
entry set-top button
knob
B6m
No
B6x
B6y
Sink is:
B6z
inches by
inches
wall-mounted cabinet
B6aa
B6bb
B6cc
B6dd
B6ee
B6ff
wall-mounted on sink
If wall-mounted, height of soap dispensers: _____ inches (no higher than 48 from floor)
Location of hand dryer/paper towels:
wall-mounted on sink
USE (cont.)
No
n/a
Photo?
0
B7. Lockers/showers/changing area Total number of locker rooms/changing areas assessed*: __________
B7a
B7b
Is there a continuous unobstructed route of travel from entrance (if indoor facility) or parking (if
outdoor facility) to lockers/showers/changing area?
B7c
B7d
B7e
Slope of route of travel (at its steepest incline): ________ % (enter 0% if flat)
B7f
Width of route of travel (at its narrowest point): ________ inches (at least 36)
B7g
B7i
B7j
automatic
entry set-top button
knob
lever
pull
push plate
push/pull paddle/bar
other:
lever
pull
push plate
push/pull paddle/bar
other:
automatic
entry set-top button
knob
B7l
B7h
B7k
Clear space on pull side of door: ____ inches (at least 18)
B7m
B7n
Are lockers available that can be accessed from a wheelchair (48 or less from floor, no benches
blocking access)?
B7o
B7p
Is the changing area large enough for wheelchair maneuvering? (60 circle)
inches by
B7r
Is there a clear path into the shower (level surface free of lip or steps)?
B7s
B7t
Hand-held shower spray unit height: ____ inches (48 or less from floor)
B7u
B7v
B7w
inches
B7q
Yes
USE (cont.)
B7x
B7y
Photo?
If shower bench/chair is FIXED and ACROSS from the shower controls, what is the
distance from the wall behind the chair/bench to the shower controls: _________ inches
Are grab bars mounted on at least two sides of the shower? (if indoor shower)
B7aa
B7bb
n/a
If shower bench/chair is provided and FIXED, what is the location of the shower controls in
relation to the fixed bench/chair?
B7z
No
*Attach Additional Locker Room/Changing Area Checklist for each locker room/changing area assessed
*Attach Additional Restroom Checklists for any restrooms located within the locker room or changing area
B8. Elevator(s)
B8a
B8b
B8c
B8d
B8e
Slope of route of travel (at its steepest incline): ________ % (enter 0% if flat)
B8f
Width of route of travel (at its narrowest point): ________ inches (at least 36)
B8g
Elevator control panel height: _____ inches (48 max above floor)?
B8h
Methods of communication for elevator controls: (check all that are present)
B8j
Does the elevator have a sensor that reopens the door or does the door stay open at least 20
seconds?
B8k
B8l
B8m
B9. Stairs
B9a
B9b
B9c
Concrete
Describe the surface of the route of travel:_____________________________________
USE (cont.)
B9d
17.6
Slope of route of travel (at its steepest incline): ________
% (enter 0% if flat)
B9e
>36
Width of route of travel (at its narrowest point): ________
inches (at least 36)
B9f
20
Number of stairs: ____________
B9g
B9h
B9i
Is a handrail provided?
B9j
No
n/a
Photo?
Stairs are outside past exit only on lower level. They lead to just outside the main entrance, wheelchairs
must use inside ramp.
B10. Specialty Checklists
Check the facilities/amenities present at this agency and check the ones you assessed.
Use the following specialty checklists (available on the IRRC website) to assess all of the recreation facilities/amenities present at
the agency.
Check if
present
Check if you
assessed
Facility/amenity
Check if
present
Check if you
assessed
Arcade/casino/pool hall
Beach
Boating facility
Bowling lane
Campsite
Concession area/cafe
Dance/martial arts studio
Equestrian mounting platform
Exercise equipment area
Fishing area/pier/platform
Gazebo/picnic shelter/pavilion
Gift shop/pro shop
Facility/amenity
Miniature golf
Museum/exhibit
Overlook/observation area/platform
Picnic area/grill/fire ring
Play area/playground
Sauna/steam room
Shooting facility
Skating rink
Ski/snowboard area
Spa/hot tub
Sport facility/field/court (indoor or outdoor)
Stadium/arena/grandstand
Swimming pool/wading pool
Theater/amphitheater
Trail
Social Inclusion
Social inclusion is comprised of three sections: administrative practices, adaptive equipment, and programming practices. For these three sections, you
will need to interview managers and staff, observe programs or services, and review written materials. You will likely need to do Section C:
Administrative Practices and Section D: Adaptive Equipment only once for an agency, but may need to do Section E: Program Practices for each unique
grouping of programs or services the agency provides. See the accompanying Manual for more specific information and definitions.
Yes
No
n/a
Does the agency mission clearly reflect a belief about inclusion of people with disabilities and other
differences?
C1b
Do agency vision and values articulate support for inclusion of people with disabilities and other
differences?
C1c
Does upper administration (e.g., board of directors, administrators, managers) show support for
inclusion?
C2b
When asked, do staff members state that serving people with disabilities is important?
C2c
C2d
If yes, list name, job title, phone number, and email address of the point of contact/coordinator:
Name:
Phone number:
Email:
C2e
C2f
Job Title:
Are managers and front line staff trained in disability awareness and inclusion as a routine part of staff
orientation?
If yes, list main topics covered in training:
C2g
When observed, or when asked in an interview, do staff members interact with people with disabilities in
a helpful and respectful manner?
C2h
No
n/a
C3b
Are people with disabilities and/or their families involved in agency planning efforts (e.g., board of
directors, advisory board, public input)?
If yes, list types of involvement/input:
C3c
C3d
C3e
C4b
C4c
C4d
Braille
close-captioned video
large print
multiple languages
oral communication provided in print
pictorial
sign language
TDD/TTY
other:
C4e
Do marketing and other printed agency materials reflect inclusion of people with disabilities (e.g., access
information provided, people with disabilities pictured in publications or on web site)?
C4f
Is the agency website usable by people of all abilities (e.g., simple design, consistent navigation, alt text
for graphics, high contrast, no flashing/blinking features)?
C4g
Are emergency warning and evacuation procedures in place for safe exit of people with disabilities?
(e.g., auditory and visual alarm systems, areas of rescue assistance identified)
C5b
Is all staff trained in the procedures for safe evacuation of people with disabilities in the event of an
emergency?
2011 Inclusive Recreation Resource Center
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C5d
C5e
Do personal care attendants attend free when accompanying a person with a disability?
C5f
C5g
C5h
List other policies and procedures that are helpful to people with disabilities and their families:
Yes
No
n/a
Volunteer opportunities
C5i
C6. Evaluation
C6a
Does the agency conduct evaluation on an ongoing basis and at the end of programs or services?
C6b
C6c
If yes, does evaluation include feedback on inclusion, accessibility or use of supports and
accommodations?
C6d
C7c
C7d
Does the agency have partnerships with other community or area organizations?
List partnerships and purpose of partnerships:
11
C7f
No
n/a
NOTE: If needed, ask about Transportation Services during the interview (from Section B, pg. 2)
Many accommodations available, agency is very flexible and will cooperate on request.
Yes
D1
D2
No
n/a
Wheelchairs
b.
c.
d.
e.
f.
g.
(add additional sheets if needed)
D3
12
Complete the Program Practices Section once for each uniquely different type of program at the agency. See the accompanying
Manual for more specific information and definitions.
Agency:
Offers programs (Complete Section E) (e.g., bowling leagues, lessons, activities, camp or sports programs)
___
___ Does not offer programs (skip to Section F on page 15)
Yes
No
n/a
Opening Day
E1. Name of Program(s):__________________________________________________________________________
E2. Registration
E2a
Does the registration or sign-up form ask if additional assistance or accommodations may be needed
for participation in the program or activity?
E2b
Is the inclusion point of contact (or ADA coordinator) listed on the registration form?
E2c
Is there a way to conduct a needs assessment or gather additional information for successful
participation, when needed? (e.g., an assessment or interview)
E2d
When needed, does staff conduct pre-program meetings or orientations with participants with
disabilities, prior to starting a program or activity?
E3b
E3c
When asked, is program staff able to list ways it modifies programs for people with disabilities?
E3d
E4b
Are peer orientations about disability and inclusion available, when needed?
E4c
E4d
Are positive behavioral supports used in the program or activity, when needed?
E4e
E4f
E4g
If yes, describe quiet area: Area outside by stairs, but would need assistance getting back in, the doors lock from inside and there is no wheelchair accessible route
Comments/additional information about supports:
13
No
n/a
E5b
activity space
length of activity
skill level
can be cooperative or competitive
rules of activity other:
E5c
E5d
E5e
Is task/activity analysis used to determine needs (breaking down activities into steps or parts)?
E5f
Can individuals partially participate in activities, when needed (e.g., take breaks, do only a portion of
the activity)?
E5g
E6b
Brief description:
ii
iii
iv
v
(add additional sheets if needed)
E6c
14
F1. Summary
Please provide a brief description of the agency; this summary will appear on the IRRC website
This Museum is very physically inclusive with potential for social inclusion. Some doors are heavy and
would recommend an able bodied companion for someone using a wheelchair. The agency should
staff someone as a specialist for full inclusion.
11/16/14
Last name:Mailloux
Catherine
cmaillo1@ithaca.edu
First name: Maija
Last name: Cantori
First name:
mlc334@cornell.edu
"Communicating Humanness" by Wilkins, Person First Law, Copy of IAT, and IRRC handout
Language, regular checks for inclusion in programming, change on locked doors to stairs
--
G10. Comments about the Inclusivity Assessment process and questions for follow-up:
Thanks!
For questions or further information, please contact us at: InclusiveRec@cortland.edu or 607-753-4833 or www.nysirrc.org
2011 Inclusive Recreation Resource Center
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