Pre-Inspection Form 
Asset Management and 
Compliance Inspections	
Applicability
This pre-inspection form is an essential and required element of an asset management and/or compliance inspection. It is to be completed by the property owner or management company.  
Instructions
Step 1. All inspections, complete Section 1. Complete Section 2 only when instructed.
Step 2. Submit the completed form via email to the Minnesota Housing staff member that made the request. Include all applicable supporting records as noted in the Administrative Records Checklist.
	
Section 1 – Asset Management and Compliance Inspections
Property Name:                 MHFA Property ID	D     
Date this form was completed: 	     
Name, title, phone number and email address of person completing this form: 	     
1.1	Inspection Contact
Name, title, phone number and email address of person to contact for scheduling inspection and communication during inspection process: 		     
Property Site Manager name, phone # and email:	     
Are any units currently used as non-rental (e.g., model, office occupied by site staff or other reason)?  Yes     No   If yes, provide building address(es), unit number(s), and describe the unit(s) use and duties of staff:      
1.2	HUD Real Estate Assessment Center (REAC) Inspections
Date of last REAC inspection:        or
 This property is not subject to REAC inspections.
If a REAC inspection has occurred in the current year, submit a copy of the inspection report. 
1.3	Housing Type
Is Housing Type (family, workforce, senior, single room occupancy, supportive housing) different from what was originally stated in the application or otherwise approved by Minnesota Housing?       	
Yes  No   If yes, describe change:      
1.4	Occupancy Information
Current number of units occupied by single head of household with minor children: 	     
Total number of children living in the property age 18 and under: 		     
Number of current heads of household who are of the following race or ethnicity:  White:       Black/African American:       Hispanic:       Asian Pacific:       Subcontinent Asian Race or ethnicity:       Native American/Pacific Islander:       Other community of color       (if other; state:      )
Average occupancy percentage for previous 12 months: 	     
1.5	Vacancy Information
Number of units currently vacant: 	     
Total number of days vacant: 	     
If property is currently experiencing vacancy issues, explain why and what actions the owner/agent are taking to resolve:      
Number of unit turnovers in the past 12 months:	     
Average number of days to turn units: 	     
Number of rejected applications in the past 12 months:	     
Reason for rejection(s):      
Number of evictions in the past 12 months: 	     
1.6	Tenant Rent Subsidies
List all sources of rental assistance currently benefiting tenants (Section 8 voucher, PBRA, Housing Support, NAHASDA RA, etc.)      
Number of occupied units receiving project-based assistance:	     
Number of units occupied by households with a Section 8 housing choice voucher (HCV) (not including project-based section 8 vouchers):       If this is zero (0), check the applicable box:     
 N/A – property is subject to rental assistance contract for 100% of the units                
 N/A – property is an emergency shelter or transitional housing                                        
 N/A – property is public housing                                                                                                       
 Other reason. Provide explanation:                       
In the past year, have any applicants with an HCV been denied occupancy?   no    yes   If yes, explain the reason(s):      
1.7	Accessibility
Number of fully accessible units:      
Number of adaptable units or with features for people with visual or hearing impairments:      
Are all unit(s) designed for people with mobility or other impairments occupied by households that require these features?     yes    no                                                            
 If no, is the lease or addendum in conformance with the Minnesota state law offering non-disabled households a comparable unit if a household that needs these features applies and a comparable unit is available?  yes    no         
If no, explain why and what action the owner is taking to comply:      
1.8	Marketing and Affirmative Marketing
Enter the URL(s) where the property is advertised/marketed on the internet:       or
 The property is not advertised/marketed on the internet.
Describe other marketing efforts (newspaper ads, TV, radio, supermarket flyers, etc.)	     
Do you notify the local housing authority when there are vacancies   yes    no     
If no explain why:      
Do you list vacancies on www.housinglink.org    yes     no       If no explain why:      
Check the appropriate box below:
 Property’s Affirmative Fair Housing Marketing Plan (AFHMP) is reviewed by staff at:
a.	 HUD-Date of last review:      
b.	 USDA Rural Development-Date of last review:      
c.	 Minnesota Housing for Section 8 contract administration. Date of last review:      
When was this property’s AFHMP last updated?      
If the AFHMP was last updated more than 5 years ago and there are changes to any of the form worksheets, submit a completed Affirmative Fair Housing Marketing Plan (AFHMP) including HUD Form 935.2A and Minnesota Housing’s AFHMP Addendum along with evidence of review updates. To assist in creating or updating the AFHMP refer to the forms, guidance, and Fair Housing Toolkit.
 Property is not required to have an AFHMP because it has four units or fewer; is operated as an emergency shelter; is transitional housing or 100% supportive housing with funding that requires applicants referred through Coordinated Entry or other approved homeless referral system(s) or where service providers do outreach to homeless through service programs (at shelters, encampments, rehabilitation facilities, etc.); is public housing or public owner; is on located within the limits of an Indian reservation, dependent Indian community or Indian allotment.
1.9	Waitlist and Tenant Selection Plan
Minnesota Housing’s Tenant Selection Plan (TSP) Guidelines are a requirement for projects that are selected for an applicable Minnesota Housing funding source after March 31, 2021. Refer to the Applicable Funding Sources. 
Is clientele currently being served different from what was originally stated in the application or otherwise approved by Minnesota Housing?       	Yes  No  
If yes, explain:      
Does the development require or maintain a waitlist? 	  yes     no                                                                                                        If yes, state the number of applicants on the waitlist:      
 The property has a TSP. Date the TSP was last updated:       
If the TSP has been updated since Minnesota Housing’s last inspection, submit a copy with this form.
This property’s TSP is subject to review by staff from:
 HUD                                          USDA Rural Development
 Minnesota Housing for Section 8 contract administration
Date the TSP was last reviewed:      
 The property does not have a TSP. Explain why and describe how residents/clients are selected:      
1.10	Fair Housing Activity
Have there been any fair housing complaints in the prior year?  yes     no                                                                                                        If yes, state how many and provide a brief description and status:      
1.11	Incident Reporting/Police Calls
How often do you receive police reports and what is the process for addressing concerns?       
Who receives notification if the police are called to the property (names, titles)?      
Do you have an incident reporting system (ways you respond to reports from staff, security, and police calls)?    yes - briefly describe the process:      .   no - explain why:      
Submit a summary or copies of police reports from the past 12 months.
1.12	Changes in Revenue
Do you anticipate a loss in income/revenue for next year (loss of project-based rent assistance, operating subsidy expiring, HUD funds not awarded, other)?     yes     no   If yes, describe the change and when it will occur:      
1.13	Services and Fees
Is there a separate fee charged for any services?  Yes    No
If yes, describe which services require a fee and list the charges:      
Are any services required as a condition of occupancy?  Yes    No
If yes, describe which services are required:      
1.14	Lead Based Paint Information - Applies under NSPIRE Inspection Standards
 Property is built in 1978 or later                                                                                                                   Property is senior housing or single room occupancy
 Property was built before 1978 and has a lead-free certificate                                                           Property was built before 1978 and does not have a lead-free certificate NOTE: if this box is checked, lead based paint monitoring records must be made available upon request.
1.15	Physical Condition and Inspection Certificates- Applies under NSPIRE Inspection Standards
Are all buildings and units currently suitable for occupancy, considering local health, safety and building codes? Yes  No   If no, list the building(s) and unit(s), explain why and what actions owner is taking to make them suitable for occupancy:      
How often do you conduct unit inspections?      
Do you have a system for additional inspections if the unit does not pass?  yes     no                                                                                                        If no, explain:      
Building has current inspection certificate for: 
 Boiler   Fire alarm system  Elevator  Call for aid   N/A – property has no boiler, fire alarm, elevator or call-for-aid
      Date of most recent Fire Extinguisher servicing
Copies of inspection certificates must be made available on the inspection date.
Questions
Enter any questions you have regarding Minnesota Housing asset management, compliance, inspection or reporting requirements.      

Section 2 – Compliance Inspections Only
2.1	Compliance with the Violence Against Women Act (VAWA) 
Refer to this list of VAWA-covered programs. 
Check a, b, or c as applicable:
a.	 Owner is in compliance with the statutory and regulatory provisions of VAWA (including, where applicable, establishment of an emergency transfer plan for HOME properties with written agreements on or after 12/16/2016 and all NHTF properties) and owner/agent distributes the required forms to applicants/residents when an application has been denied, at the time the household is admitted and approved for occupancy and at lease renewal, with any notice of eviction or with any notice of tenancy termination (required for all  HTC, HOME and NHTF properties) 
b.	 Owner is not in compliance with the statutory and regulatory provisions of VAWA. Explain why and what actions owner is taking or will take to comply:      
c.	 Property has no funding that requires VAWA compliance.
2.2	HOTMA Implementation
 HOTMA does not apply to this property; tenant income is not calculated consistent with Section 8.
 Tenant income is calculated consistent with Section 8, but this property has not yet implemented any elements of HOTMA. 
 Tenant income is calculated consistent with Section 8. Some or all HOTMA changes have been implemented. Submit a copy of the property’s HOTMA implementation plan, including the specific elements of HOTMA that have been implemented and the respective implementation date(s).
2.3	Leases, Addenda and Riders
Initial leases are for a term of       months. 
Applicable to HOME and NHTF properties monitored by Minnesota Housing: If lease terms are less than 12 months, describe how applicants are informed of lease options:      
Submit a blank form of the lease currently being used, including all addenda, riders and attachments. 
2.4	Utility Allowance
 Owner pays all utilities or  Resident pays one or more utilities as indicated below:

Utility Type	Check if Resident Pays for the Utility	Utility is Individually Metered (resident is billed by utility supplier)	Utility is Sub-Metered (resident is billed by owner or 3rd party billing)	Determined and billed by owner or 3rd party on a Ratio Utility Billing System (RUBS)	
Unit Heat					
Water Heat					
Unit Electric					
Cooking					
Water					
Sewer					
Trash					
If tenant paid utilities are different for different unit types (e.g., heat included in rent for apartments but in townhomes residents pay separately for heat), explain the differences:       
UA Source
 HUD-Regulated/Project-Based Section 8                                    USDA-Regulated
 HUD Utility Schedule Model                                                          Energy Consumption Model
 Average of Actual Consumption                                                   Letter from Utility Company
 Local Public Housing Agency (PHA) that administers Housing Choice Vouchers in the area.
Enter name of PHA:      
Submit Utility Allowance Information Form and source/supporting documentation for current year and previous 2 years (three years total).
2.5	Tenant Amenities and Fees
Number of garages:         No garages  
Number of storage lockers:          No storage lockers  
Is a separate fee charged for garages, parking and/or storage lockers?  yes     no                                                       If yes, list the item(s) and monthly fee: $                                                                                                      Were garages, parking, or storage lockers included in the tax credit eligible basis (if unsure, confirm with the owner or investor partner)?  Yes    No  
If yes, which items were included in basis?                                                                                                                       
 N/A – not a Housing Tax Credit property                                                                 
List all resident amenities/facilities including pool, community room, playground, computer lab, etc. 
                 No resident facilities                                                  
Is a nonrefundable fee charged for any of the facilities?  Yes    No                                                                                                                          If yes, how much is the fee $                                                                                                       
Were resident facilities included in the tax credit eligible basis (if you are unsure, confirm with the owner or investor partner). ?  Yes    No If yes, which items were included in basis?                                                                                                                       
  N/A – not a Housing Tax Credit property                                                       
2.6	Smoke Free Policy
Does a loan declaration or tax credit LURA require the owner to have a smoke free policy?    
 yes    no. If yes, submit a copy of the policy.  
2.7	Properties that Operate as Transitional Housing
Describe the process or submit a written plan (if available) to move residents/clients to permanent housing:      
2.8	Properties that are Publicly Owned
 Property is not operated under a master lease, memorandum of understanding or other agreement                                                                                                                                                 
 Property is operated under a master lease, memorandum of understanding or other agreement Submit a copy

Administrative Records Checklist
The items checked below are submitted to Minnesota Housing as part of the inspection review:
Section 1 – Compliance and Asset Management Inspections
	REAC inspection report for current year
		Affirmative Fair Housing Marketing Plan and Minnesota Housing Addendum 
		Updated tenant selection plan, house rules, and/or occupancy policy
		Summary of police calls for last 12 months
Copies of inspection certificates must be made available on the inspection date.
Section 2 – Compliance Inspections Only
	HOTMA Implementation Plan
	Current form of lease and all addenda, riders, and attachments
	Utility Allowance Information Form and source documentation for current year and prior 2 years. 
•	Refer to the HTC or HOME/NHTF compliance guides for a list of supporting documentation. 
•	If the property consists of townhouse units and the PHA utility allowance is used, submit the PHA’s policy as to whether the townhouse/duplex or apt/multi utility allowance is used, as PHA polices may differ. 
	Smoke free policy
Transitional Housing only	Publicly owned only		
 Written plan to move residents	 Copy of master lease, MOU, or other agreement