1. Who built or designed my house?
A. Built or designed by a licensed civil engineer/architect (1 point)
B. Not built by a licensed civil engineer/architect (0 point)
C. Not clear or unknown (0 point)
2. How old is my house?
A. Built in or after 1992 (1) C. Not clear or unknown (0)
B. Built before 1992 (0)
3. Has my house been damaged by past earthquakes or disasters?
A. NO or YES but repaired (1) C. Unknown (0)
B. YES but not yet repaired (0)
4. What is the shape of my house?
A. Regular (symmetrical, rectangular, box-type) (1)
B. Irregular/complicated (0)
C. Not clear or unknown (0)
5. Has my house been extended or expanded?
A. NO or YES but supervised by a civil engineer/architect (1)
B. YES but not supervised by a civil engineer/architect (0)
C. Unknown (0)
6. Are the external walls of my house 6 inches (150 mm) thick?
A. YES, they are. (1)
B. NO, they are thinner than 6 inches. (0)
C. Not clear or unknown (0)
7. Are the steel bars in the walls of standard size and properly spaced?
A. YES—10 mm in diameter, tied and spaced correctly (1)
B. NO—Sizes smaller than 10 mm (0)
C. None or unknown (0)
8. Are the unsupported walls more than 3 meters wide?
A. NO, all unsupported walls are less than 3 m wide. (1)
B. YES, at least one unsupported wall is more than 3 m wide. (0)
C. Not clear or unknown (0)
9. What is the gable wall of my house made of?
A. Light materials, properly anchored hollow blocks, no-gable wall (1)
B. Not properly anchored blocks, bricks, stone (0)
C. Not clear or unknown (0)
10. What is the foundation of my house?
A. Reinforced concrete (1) C. Not clear or unknown (0)
B. Stones or unreinforced concrete (0)
11. What is the soil condition under my house?
A. Hard (rock or stiff soil) (1)
B. Soft (muddy or reclaimed) (0)
C. Not clear or unknown (0)
12. What is the overall condition of my house?
A. Good condition (1)
B. Poor condition (0)
C. Not clear (0)