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Questionnaire for a Company I Name quompuny 2 Address: 3 Name of person completing questionnaire: Title: 4 Type of Manufacturing urServiec: _ I 5 Type ofyobs within the Company (Please indicate the numbers ofjobs in each area or (NA) Ifnot applicable to your Company) Clerical Labour/Millmm‘dflcc Sales Managerial Positionsâ€"___,â€" Other (Please Spectfy) b Is the Company unionized? yes no 7 Number ofcmployees. male female H Are you now employing physically handicapped individuals‘.l yes ___ no _â€" 9 Have any building adaptions been made in your facility to allow these workers to be employed at your Company? yes no NA It) Would you be interested in hiring mobility impaired employees who have marketable competitive skills? yes no â€" It 'Would work areas be suitable for the mobility impaired individuals (egt lowered work tables, space for a wheelchair. etc.) Clerical Areas: yes no Maintenance Areas: yes ___ no Managerial Areas: yes no Labourng Areas. yes __ no Sales Areas: yes no Other Areas: yes __ no Entrances Name of Building:- l ls- all least one primary entrance ramped or at ground level with no steps? yes _ no 2 ffsteps. how muny'.’ yes ___. n0 _â€" 3 Is the ramp built to slope no more steeply than the ratio of 1 inch rise for twelve inches of length? yes __ no 4 Where there are steps or ramps, are handrails of 32" in height provided? yes no 5 Are doors at least 32 inches wide? ycs â€" no 6 Art: doors lightweight (8 lbs. or under) and slow closing? yes no 7 Where turnstiles or revolving doors are used. is there a clearly marked, alternate. accessible route provided? yes no â€" 8 Are thresholds at entrances to the rooms and buildings no greater than 1,“: inch in height? yes â€" no â€" 9 Does the entrance provide access to the remainder of the building? yes â€" no Mobility Within the Building I. Are all floors of u non»slip texture? yes __ no 2. Are corridors at least 36 inches wide'! yes Â¥_ no 3. Are all level changes connected by ramps or elevators? yes no 4. Within elevators, are all controls reachable (45" high) by it wheelchair baund individual? yes __ no 5. Do the doors of the elevator remain open long enough to allow sufficient time to enter or leave the elevator cab? yes ; no â€" 6, Are fixtures such as telephones. drinking fountains. and light switches within easy reach by all? yes _ n0 7. Can a handicapped person in a wheelchair. enter and use your facilities unaided. yes _â€" no 14