What can be the living conditions of a family. Living conditions of a child what to write
APPROVED
Director of the Slobodskaya Secondary School
T.V. Ivanova
examination of the living conditions and upbringing of a minor
1. Date of examination: 09/15/2010.
2. Surname, name, patronymic of a minor: Ivanova Marina Alexandrovna, Ivanov Alexander Alexandrovich
3. Age, year of birth, place of birth: Marina 14 years old, 05.05.1996, village Ratichi, Alexander 5 years old, 01.01.2005, village Ratichi
4. Address, telephone: Ratichi village, 23, t. 99-99-99 (indicate permanent residence)
5. Information about the parents (has one (both) of the parents, the place of residence of the parents, age, position or occupation, place of work, work experience, income (income is indicated in rubles for the previous month on the basis of a certificate from the place of work), whether married):
Father - Ivanov Alexander Maksimovich, born 01.01.1968, SPK "Niva - 2003", field grower, work experience 4 years, salary is 320 thousand rubles. per month.
Mother - Ivanova Natalya Viktorovna, born September 25, 1970, SPK "Niva - 2003", field grower, work experience 4 years, salary is 320 thousand rubles. per month.
Parents have been married since 03.03.1994, live at 23, Ratichi village.
6. Participation of each of the parents in the upbringing and maintenance of a minor: Parents improperly fulfill their responsibilities for the upbringing and maintenance of minors: they do not provide their children with the necessary clothing, are left unattended, are not interested in learning, and do not control the employment of children in their free time.
7. Family composition (surname, name, patronymic, relationship, age, employment, etc.):
Ivanov Alexander Maksimovich - father, born 01.01.1968, SPK "Niva - 2003", field grower;
Ivanova Natalya Viktorovna - mother, born September 25, 1970, SPK "Niva - 2003", field grower;
Ivanova Marina Aleksandrovna - daughter, born 05.05.1996, student of the 9th grade of the Ratich secondary school;
Ivanov Alexander Alexandrovich - son, born on 01.01.2005, pupil of the educational institution in the village of Podlabenie.
8. Information about the minor:
a) occupation (educational institution, group (class), does not receive a general basic education): Marina is a student of the 9th grade of the Ratich secondary school, Alexander is a pupil of the educational institution in the village of Podlabenie.
b) academic performance: average.
c) being busy in free time: Marina visits the "Image" studio, table tennis section, does her homework at home. Alexander - walking on the street.
d) the daily routine and living conditions of a minor: the daily routine is not observed, living conditions are unsatisfactory: a minimum supply of food, the room is dirty. The minors have sleeping places, and a place has been organized for Marina to prepare lessons. Alexander lacks toys in accordance with his age.
e) Who is caring for minors: Parents are inappropriate caring for their children.
f) the state of health of the minor (complaints about the state of health, whether there are any developmental abnormalities, registration with doctors of a narrow specialty, etc.): the health group is the main one, there are no complaints from the parents about the condition of the daughter. Alexander has 2 gr. health, the minor often suffers from colds.
g) organization of recreation (vacation time, summer): health improvement takes place in the Suzorie camp, visits the Image studio, table tennis sports section. Alexander attends preschool.
9. The relationship of the minor with the parents, other family members: there is no trusting relationship between the girl and the parents, emotional alienation and misunderstanding are characteristic. Mother pays more attention to Alexander. The father often scolds the children, corporal punishment is present.
A minor is paid a pension - no, an allowance - no, alimony - no, receives a salary - mother - 320,000 rubles, father - 320,000 rubles (indicated in rubles for the previous month based on information received from the committee (department, department) on labor, employment and social protection and other organizations).
11. Who is the tenant of this dwelling (owner or member of the organization of citizens of developers) (indicated on the basis of information from the housing maintenance service (partnership of owners): the house belongs to SEC "Niva - 2003", the tenant is Alexander Maksimovich Ivanov - father.
12. Living in this dwelling: 4 people, parents with minor children.
13. Total area of living quarters and type of improvement (water supply, sewerage, gas, etc.): Total area - 41 sq. M., Residential area - 32.5 sq. M. Accommodation is comfortable, consists of 2 rooms, kitchen.
14. What help does a minor (family) need:
Pedagogical: to monitor the attendance of minors in educational institutions, Marina's academic performance (class teacher, educator);
Provide parenting counseling,
relationship with a daughter (teacher-psychologist, social teacher);
To educate parents in order to form a critical attitude towards socially dangerous phenomena (social teacher, inspector for minors);
Carry out work aimed at developing hygiene skills (class teacher, pediatrician);
Psychological: to educate parents on the creation of conditions for the preservation and strengthening of the neuropsychic health of a minor (teacher-psychologist);
Conduct correctional and developmental measures aimed at stabilizing or establishing parent-child relations (teacher-psychologist, social teacher);
Material: provide family with firewood (chairman of the village council); provide humanitarian assistance in the form of clothing, bed linen (TTSSON).
15. Conclusions and a reasoned conclusion indicating appropriate assistance to a minor:
Parents are inappropriately involved in the upbringing and maintenance of minors, the house is a mess, it's cold, there is a minimum supply of food. It is necessary to consider at a meeting of the Council for Prevention the issue of the advisability of recognizing minors as socially dangerous.
The document is signed by all specialists who conducted the survey, and approved by the head of the institution.
Living conditions are the most important factor affecting human health. Higher hygienic requirements are imposed on the dwelling as an artificially created habitat.
It should satisfy the social and everyday needs of people, provide a healthy microclimate, have conditions favorable for rest, sleep, housework, recuperation, full psycho-emotional relaxation after a hard day. As a standard for the future, the optimum of a comfortable living space per person has been determined - 17.5 ± 0.5 m2.
Temperature, humidity, room air mobility - microclimate, as well as natural light are of paramount importance. Air conditioners are used to control the temperature in a modern apartment. If you need a quality installation of air conditioners, take a look here.
With the sun, ultraviolet rays also enter the home, which affect the body. Lack of ultraviolet radiation worsens health, reduces performance, resistance to various diseases. Children are especially affected. All living rooms, kitchens should have natural light, bedrooms should preferably be located in rooms that receive maximum light. The rational use of natural light should be facilitated by the arrangement of furniture. It is not recommended to obstruct the windows with thick curtains, large indoor plants, tall furniture; places for games and activities of children should be located near windows. Window frames and glass require constant maintenance, as dirty windows can absorb more than 55% of the light, which causes eye fatigue.
An important role is played by the interior of the apartment, the furnishings and shape of the premises, the choice of the color of the walls for them. A well-chosen color pleases the eye, creates a good mood, increases efficiency, has a beneficial effect on the human psyche and is even able to "warm". Research has shown that for well-being, the average temperature in a room with warm walls (orange, yellow, red) can be 3 ° C lower than usual. Therefore, warm colors are more suitable for the north side, for the south - cold ones (blue, blue, green). For the bedroom, it is advisable to select soft tones that promote relaxation: various shades and combinations of yellowish, grayish, greenish colors. Red and violet colors, which stimulate the nervous system, are not recommended for decoration of living quarters. In children's rooms and rooms for young people, brighter colors can be used, for older people - calm, desaturated tones. Color can influence the perception of space, so you can visually "change" the width, height, length, shape and volume of the room. For example, light colors of low saturation make a room appear more spacious. Conversely, dark tones shorten the distance and the room appears smaller.
The set and size of kitchen equipment should be selected in accordance with the physical data of the residents and the requirements for the cooking process. In an improperly equipped kitchen, the path that has to be overcome with daily household chores is extended to 5-6 km. Often, foil-coated wallpaper is used to decorate kitchen stacks - the so-called washable wallpaper. They are water and airtight, which can lead to a violation of the microclimate. Therefore, it is recommended to cover with washable wallpaper only those rooms in which people spend little time (front room, toilet). It is not recommended to paste over the walls of the kitchen with oilcloth - the walls do not absorb moisture, which disrupts moisture exchange. Gas stoves have become a must-have in kitchens. They have a drawback - the products of incomplete combustion of gas (sulfur compounds, carbon monoxide) enter the room. Therefore, it is not recommended to heat the premises with gas, even in cold weather. Very hygienic, economical and fireproof electric stoves are becoming more and more widespread.
Today one mother with many children from the Omsk region wrote to me:
“They came to us again today with a check. They didn't even knock, they went in with a question why my daughter was not at school for 2 days, but she got sick and we did not warn her, another question: why do children eat on credit at school? We went to see that there was order everywhere, they were wearing shoe covers, everything was as it should be, ... they didn't write anything and I didn't sign, .. On Monday, firemen will come and they will check the conditions of the stove, if everything is in order. all large families will be checked ... I thought they have already forgotten about us and will leave us alone, but no, they have arrived. "
It so happens that every day our personal-private-family life more and more, against our will, comes under the magnifying glass of the attention of state bodies.
And most of all they are interested in our children. We are assured that controls are being strengthened solely to protect their rights and best interests.
In general, it turned out that the parents, unexpectedly for themselves, have now become unwitting participants in some eerie game in the dark, where their children are at stake. And the rules of this game are known only by the one who sets them himself. The parents did not bother to inform both about the existence of the new rules and about their content.
The problem of interference in the private life of a family through examinations of the home where the family lives with children is becoming more and more urgent. The number of reasons for the penetration of unauthorized persons into our apartments is growing every day. Teachers need to give reports on the social status of their students, the police are forced to visit families after they call an ambulance for a child, guardianship authorities conduct "preventive" examinations of large families, which against their will were equated to disadvantaged and so on. Until recently, this was not the case. And this is our new unpleasant reality.
We, parents, are never told what exactly these uninvited visitors and other invaders are checking in our apartments and houses. From experience I can say that they check this:
odors in the apartment / house - dampness, dampness, decay
the appearance of all household members
repair status
degree of cleanliness and order
domestic insects - flies, cockroaches, bugs
availability of separate sleeping places for all children
availability of bed linen, including in wardrobes
freshness of bed linen
availability of clothing and footwear by season and size
the presence of a stock of food in the refrigerator, in kitchen cabinets
availability of baby food if young children
the presence of a cooked hot dish, soup
the presence of a play and / or training place
availability of toys, books, educational games, stationery
the presence of diapers, bath hygiene items
access of children to dangerous objects, dangerous places
the state of heating, if the stove
condition of electrical wiring
availability of water supply / sewerage
serviceability and cleanliness of plumbing / refrigerator
family composition
family income
cohabitation of a sick / drinker / old person
contact of children
the state of health of children at the time of examination
conflict in the family
presence of bottles or cans of alcohol
presence of pets
This is from life experience.
And here is a small document of the Ministry of Education of the Russian Federation, which tells about what exactly should be checked in our country according to the law.
The document is called Order conducting a survey of the living conditions of minors and their families
(approved by order Ministry of Education and Science of the Russian Federation of September 14, 2009 N 334). I made his points not in order, but according to the degree of practical value for each of us.
Of course, this is not exciting reading, everything is rather boring, but do not blame me, tediousness and dryness of the tongue are a common property of normative acts.
The whole order can be viewed
6. The survey reveals:
6.1 Level of provision of basic needs of the child.
6.1.1. Health status: general visual assessment of the level of physical development and its compliance with the child's age, the presence of diseases, special needs for medical care, drug provision; the presence of signs of physical and (or) mental abuse of the child.
6.1.2. Appearance: compliance with the norms of personal hygiene of the child, the availability, quality and condition of clothing and footwear, its compliance with the season, as well as the age and gender of the child, and so on.
6.1.3. Social adaptation: the presence of communication skills with others, self-service skills in accordance with the age and individual characteristics of the child's development, the adequacy of the child's behavior in different environments, and so on.
6.1.4. Upbringing and education: the form of mastering educational programs, visiting educational institutions, including institutions of additional education for children; successes and problems in the development of educational programs in accordance with the age and individual characteristics of the child's development; the child's daily routine (sleep, nutrition, their age-appropriateness and individual characteristics), the organization of the child's free time and rest; the presence of a developing and learning environment;
6.1.5. Safety assurance: lack of access to dangerous household items, medicines, electrical appliances, gas, etc., the risk of harm to the child both at home and outside the home.
6.1.6. Meeting the emotional needs of the child.
6.2. Family environment of the child.
6.2.1. The composition of the family who actually takes care and supervision of the child; the presence and place of residence of close relatives of the child, the degree of participation of parents and other cohabitants, relatives in the upbringing and maintenance of the child; the degree of attachment and relationship of the child with parents and family members.
6.2.2. Relationships between family members, their nature; peculiarities of communication with children, children among themselves; family values, traditions, family history, family lifestyle, distribution of roles in the family, parents' circle of friends; social ties of the child and his family with neighbors, acquaintances, contacts of the child with peers, teachers, educators.
6.3. Housing and living conditions and property conditions.
6.3.1. Housing and living conditions in which the child lives: the presence and ownership of the living quarters, its total and living area, the number of rooms, landscaping and sanitary and hygienic condition; the child has a separate equipped place (room, corner) for sleeping, playing, exercising, and so on.
6.3.2. Family income structure: main sources of income (income of parents and other family members, alimony, pensions, benefits, other social benefits); average monthly and per capita family income; information about the property and property rights of the child; Adequacy of family income to meet the basic needs of the child (food, clothing and footwear, medical care, toys and games, printed and audio-visual products, school writing and stationery, and so on).
6.4. The presence of circumstances that pose a threat to the life and health of the child, his physical and moral development, or violate his rights and interests protected by law; facts of contemptuous, cruel, rude, degrading treatment, abuse or exploitation of a child, physical or mental abuse of a child, an attempt on his sexual integrity.
7. In the course of the survey, such forms of obtaining information are used as a conversation with a child, his parents and other family members, a survey of persons who have data on the relationship of parents with a child, their behavior in everyday life, observation, study of documents, educational and creative work of the child, and other.
During the survey, the confidentiality of the personal data of citizens is ensured.
8. Based on the results of the survey, an act of examination of the living conditions of a minor citizen and his family is drawn up (hereinafter - the act of examination) in the form according to Appendix No. 3 to the order of the Ministry of Education and Science of Russia dated "____" _________ 2009 N ______, containing:
Assessment of the circumstances identified in the course of the survey, specified in paragraph 6 of this Procedure;
Conclusions on the presence of conditions that pose a threat to the life or health of the child or hinder his normal upbringing and development;
Conclusions about the presence of circumstances indicating the absence of parental care over the child;
It is necessary to know and remember that you must definitely get your hands on this act. And you also need to know that this inspection report can be challenged in court. And this can be done only by getting it in your hands and reading what the gentlemen visitors wrote there:
9. The inspection report is drawn up within 3 days from the date of the inspection, signed by the authorized specialist of the guardianship and trusteeship body or organization who conducted the inspection and approved by the head of the guardianship and trusteeship body or organization.
The inspection report carried out by the organization is drawn up in 2 copies, one of which is sent to the appropriate guardianship and trusteeship body within 1 day following the day of its approval, the second is stored in the organization.
A copy of the examination certificate, certified by the head of the guardianship and guardianship authority or the organization that conducted the examination, is sent to the parents (legal representatives) of the child within 3 days from the date of approval of the examination certificate, provided there is information about the place of residence or place of stay of the parents (legal representatives) of the child.
The examination report can be challenged by the parents (legal representatives) of the child in court.
10. If, based on the results of the survey, circumstances are revealed that indicate the absence of parental care of the child, the organization is obliged, within 1 day following the day of the survey, to report this to the guardianship and guardianship authority at the place of actual location of the child.
This explains why the survey can be carried out:
2. The survey is carried out in order to identify circumstances indicating the absence of parental care of a minor citizen (hereinafter referred to as a child, children) in cases of death of parents, deprivation of their parental rights, restriction of their parental rights, recognition of parents as incompetent, illness of parents, long absence of parents , evasion of parents from raising children or from protecting their rights and interests, including when parents refuse to take their children from educational organizations, medical organizations, organizations providing social services, or similar organizations, when the actions or inaction of parents create conditions that pose a threat life or health of children or hindering their normal upbringing and development, as well as in other cases of lack of parental care.
Who is authorized to carry out such inspections:
3. The examination is carried out by the guardianship and trusteeship body or by an educational organization, a medical organization, an organization providing social services, or another organization, including an organization for orphans and children left without parental care (hereinafter referred to as the organization), which, in accordance with the established procedure the powers of the guardianship and trusteeship body have been transferred to identify minor citizens who need to establish guardianship or trusteeship over them, including examining the living conditions of such minor citizens and their families.
Here is the additional beauty of the document - about the benefits of denunciation:
4. The basis for the survey is the oral and written appeals of legal entities and individuals received by the guardianship and guardianship authority or the organization at the place of actual location of children, containing information about the children specified in paragraph 2 of this Procedure (hereinafter referred to as information).
Well, who this mysterious "authorized specialist" is, how many grades of school he finished, whether he himself has a family or children, we, of course, will never know. We only learn that he has only three days after the denunciation:
5. The examination is carried out by an authorized specialist (specialists) of the guardianship and trusteeship body or organization within three days from the date of receipt of the information.
And in such a situation there is no other way out for us but to improve our legal literacy. And although occasionally there are dysfunctional families, and in general all sorts of things, but now we are talking primarily about ensuring that ordinary people are not touched by possible excesses and that the elementary disregard of laws by representatives of the authorities does not become the cause of someone's misfortune.
PS The guardianship authorities are not used to giving the inspection report. The law is not always written to them, as is well known.
Here is an approximate text of the application that can be submitted to the office of the local administration, social security agency, or others, having prepared it in two copies and be sure to receive an incoming registration number for one of them. It is also advisable to write down the date of submission of the application to yourself in order to demand an answer in time. Giving answers, including in writing, is also not always held in high esteem by officials:
Head of Administration or
SPO or Education Committee
(depending on who your guardianship is subordinate to)
city / town / district
from full name
mother / father
Full name of the child. Date of Birth
Contact phone
STATEMENT
ON PROVISION OF COPIES OF INSPECTION ACTS
LIVING CONDITIONS FOR MINORS
According to clause 9 of the "Procedure for examining the living conditions of minors and their families", approved by order No. 334 of the Ministry of Education and Science of the Russian Federation of September 14, 2009:
“A copy of the report on the examination of the living conditions of minors and their families, certified by the head of the guardianship and guardianship authority or the organization that conducted the examination, is sent to the parents (legal representatives) of the child within 3 days from the date of approval of the examination report if there is information about the place of residence or place of stay of the parents child. "
Therefore, I ask:
- provide me with copies of all examinations carried out by representatives of the subjects of prevention in my house at: ...
The specified copies, certified in due order, please send to the postal address:
Here is your address
Signature
Full name
date
City or town
The act of checking the living conditions is an accompanying sheet for examining the premises for compliance with the parameters. A sample filling can be downloaded free of charge.
Usually, such a document is applied by local governments. Housing inspection act- this is an accompanying sheet of the study of the premises for compliance with certain parameters. The discussed paper is used by the social protection authorities, guardianship, as well as police officers working with minors. On this page of the resource there is a form for the inspection of housing conditions. You can download it for free using a special link.
The citizens of the country have different standards of living. Many of them need the support of the state, since they cannot independently control the issues of their own provision. When such categories of citizens are identified, the local government establishes control over them and regularly checks them. When filling out the points of the report on the study of housing conditions, the civil servant, on the basis of his own analysis, must make a decision whether the premises are suitable for living or not.
Mandatory clauses of the certificate of inspection of housing conditions
:- Name, date, place of compilation and commission composition of the audit participants;
- The address of the object being checked;
- Technical parameters of housing and suitability of living conditions;
- Accomplishment, information about living people;
- Additional information, the conclusion of the commission, signatures, decoding.
Psychological and pedagogical service
MBOU SOSH №38
Norilsk
Housing and living conditions survey report
date of examination: _____________________
FULL NAME. position of the specialist (s) who conducted the survey:
________
____________________
A survey of the living conditions of a minor was carried out:
Full name, date of birth, student of class ____ MB (A) OU "Secondary School No. ___"
1. Information about the parents (guardians)
Mother: Full name date of birth, place of work
Father: Full name date of birth, place of work
2. Information about minors
2.1 Health status: the physical development of children corresponds to their age, no external signs of the presence of the disease have been identified (identified). There are no signs of physical or mental abuse of children (present).
2.2 Appearance: children are clean, well-groomed, have the necessary clothes and shoes for home, visiting an educational institution, walking. All things are in good condition, correspond to the age of the children, there are outerwear for the season and season.
2.3 Social adaptation: during the visit, the children (child) are calm, friendly, interested (indifferent) to the visit of a stranger. During the conversation, they make contact (they are shy), the answers to the questions are complete (monosyllabic). Relationships with other family members are good, friendly (tense, conflict). The nature of the relationship is built on trust, kindness (resentment, isolation). Whether I help or not in household chores, the attitude towards the instructions of the parents is responsible, they show initiative (the fulfillment of duties is formal, without initiative).
2.4 Upbringing and education: academic performance is good (if low, what is explained by: neglect, lack of conditions, lack of development of cognitive processes or other disorders). What are the difficulties, what is being done to correct and correct. Attitude towards the difficulties of other family members.
3. Housing and living conditions:
3.1 The family lives in an ____ apartment with an improved layout (Khrushchev, "gostinka"), privatized or not, total area ____ sq.m
3.2 The house in which the minors live is in good condition, the entrance is clean, renovated (the repair has been carried out for a long time, the entrance is not cleaned).
3.3 The apartment is clean, comfortable, there are no unpleasant odors (dirty, not cleaned, smoked, the smell of alcohol, acetone, etc.). The children (child) have a separate room, a place for study and rest, school supplies (upholstered furniture, a corner schoolchildren, repairs in the apartment and in the children's room, a wardrobe for storing clothes).
4. Approximate family income, whether material assistance is required, in what form.
1. Housing and living conditions are satisfactory (unsatisfactory)
2.who provides care and supervision over the children, the fulfillment of parental responsibilities is carried out in full (partially, parental responsibilities are not fulfilled)
3. Disadvantages of family education and training (conflicts in the family between parents, conflicts with the child, parenting styles, control over home assignments, parental awareness of the child's success in school, extracurricular employment of the child, family holidays, traditions) were noted.
1. Provide childcare
2. Cleaning the apartment, child's room
3. Assistance in preparing home assignments
4. Registration of material assistance (if necessary)
Housing and living conditions survey report (Sample filling)
survey of living conditions Savitsky A.G.
Grounds: clause 9 of the Regulations on the working conditions of homeworkers, approved by the resolution of the Ministry of Labor of the Republic of Belarus of 11.04.2000 N 48.
This act has been drawn up as follows:
Savitsky Andrey Georgievich, who submitted an application for employment at home on 05/10/2011 as a translator, owns a one-room apartment (certificate of ownership N 200D / 105 of 12/31/2010), located at the address: Vitebsk, st. Sovetskaya, 25, apt. 10. In addition to the owner of the living quarters in the specified apartment, no one is registered (certificate from the housing department of 05/10/2011 N 234).
In the living quarters of A.G. Savitsky. there is electricity, water supply and sewerage, heating, telephone service, high-speed Internet. Savitsky A.G. there is also a personal computer, licensed linguistic software (programs Promt 8.0 and Lingvo 14).
The living quarters as a translator's workplace meet the requirements for labor protection, sanitary and epidemiological standards and fire safety.
Thus, the living conditions of Savitsky A.G. allow you to perform work as a translator at home.
The act is drawn up in two copies:
1st copy - in case No. 1-7
2nd copy - to A.G. Savitsky
Search
surveys of living conditions
____________________________________________
(name of educational institution)
from "_____" _____________________________ 20___
This technique was proposed by the methodologist of the Center for methodological support of educational work of the UO RIPO Kapelevich T.S. The methodology helps to study the living conditions of a student in a family. The research is based on the data of observations and conversations. The methodology is intended for students who find themselves in an unfavorable life situation, families in a socially dangerous situation. It is carried out by the curator of the group, social teacher, deputy director for teaching and educational (educational) work, together with the inspector for juvenile affairs, as necessary.
The methodology is intended for a group curator, a master of industrial training, a social teacher, a teacher-psychologist, a chairman of the student trade union committee. A prerequisite is coordination with the child affairs officer and the student's parents or relatives of family visits. An act is drawn up after visiting the family and a conclusion of the commission is given on the living conditions of the student and the provision of the necessary assistance to him.
Commission consisting of ________________________________________________
_________________________________________________________________
_________________________________________________________________
examined the living conditions of the student:
Surname _________________________________________________________________
Name
Middle name _________________________________________________________________
Date of Birth ____________________________________________________________
Home address ___________________________________________________________
Information about parents
Father ______________________________________________________________________
Mother ______________________________________________________________________
Place of work ______________________________________________________________
Position _________________________________________________________________
Other relatives ________________________________________________________
____________________________________________________________________________
Financial situation of the family
Accommodations:
Student health information ______________________________________
_____________________________________________________________________________
Information about the health status of relatives _________________________________
_____________________________________________________________________________
Conclusions of the commission ___________________________________________________________
________________________________________________________________________________
Housing and living conditions survey report
ACT survey of living conditions
G. _______________
A commission consisting of: ________________________________________ checked the living conditions of a citizen _________________________________
(surname, name, patronymic in full)
working in __________________________________ in the position of __________________________, living in the house No. _________________________________ apartment No. _____ on the street __________________________________________ on the living space __________________________.
The house belongs to _________________________________.
The survey established:
the living area in which _________________________________ lives consists of rooms _____ sq. m, the size of each room: _____ sq. m, _____ sq. m on the _____ floor in the _____ storey building.
The quality of the house (brick, panel, wood, etc. in normal condition, dilapidated, emergency rooms are dry, light, walk-through, the number of windows, etc.) __________.
Improvement of the house and this living space (water supply, sewerage, what kind of heating, gas, bath, elevator, telephone, etc.) ____________________.
This square is inhabited by:
Act of control survey of living conditions
from______________________
(date of examination)
Minor (s) ______
_________________________________________________________________________________________________________________
(full name, date of birth, employment)
Residence address _________________________________________________________________________________________________
Place of registration___________________________________________________________________________________________________
Family composition (indicate where the parents of the minor, full name, year of birth, place of work) _____________________________
_______________________________________________________________________________________________________________
The state of health of the minor (their) _______________________________________________________________________
Where did you spend your summer vacation _______________________________________________________________________________________