Survey on Usage and Functionality of Smoke Alarms and Carbon Monoxide Alarms (SCOA) in US Households In-Home Administration

Appendix J: Consumer Product Safety Commission (CPSC) Survey on Usage and
Functionality of Smoke Alarms and Carbon Monoxide Alarms in Households
Interviewer:
Do not read aloud the “Don’t know”, “Unsure”, or “Refused” options at any time during the
interview. Only record this option if the respondent provides it him or herself. If the respondent
indicates that they don’t know the answer to a question, mark the appropriate answer or fill in
“DK” in the space provided.

Section A should be completed by the surveyor, prior to entering the residence. Once contact has
been made with the resident, the surveyor should begin collecting information from the
respondent.
A. RESPONDENT INFORMATION

Date of visit: _________________________
Name of surveyors making the visit: ________________________________________________
Name of occupant: ______________________________________________________________
Street address: ____________________________________ Apt. #: _______________________
City and state: ______________________________________ ZIP ________________________
Home phone: _________________________
IF THE ANSWER TO A QUESTION IS “0” OR “NONE”, ENTER “0”.
Do not leave it blank, please.
Time visit started: ____________________
1a.

What is the type of home in which the resident resides?
Single Family Detached Housing
Single Family Attached Housing (e.g., townhouse, rowhouse)
Apartment/Condo (GO TO 1b)
Mobile/Other Manufactured Housing
Trailer/RV
Other (specify) _____________________________________________________

Code to enter building

If Q1a = 3, CONTINUE
ELSE, SKIP TO PREAMBLE

18

Introduction to get into apartment building
The following script is to be read in the instances where there is a front desk concierge. If there is
no front desk concierge present, skip script and proceed to appointment.
“Hello. We are with EurekaFacts, an independent research firm, conducting research on behalf
of the Consumer Product Safety Commission (CPSC).”
Show them your EurekaFacts provided identification and credentials.
“Part of our research requires us to interview a resident of this building. We spoke with the
property manager prior to coming here.”
1b.

Do we have permission to enter the building?
Yes (PROCEED TO RESIDENCE)
No
(SKIP TO Q3a)

If refused entry, say thank you and terminate.
B. SURVEY INFORMATION
Suggested Preamble to get in the door- surveyors can alter as applicable):
“Hello. I am firefighter/ Red Cross volunteer [First and Last Name] from [your [XYZ] fire
department/ [Organization], and this is [First and Last Name] from an independent research firm,
EurekaFacts.”
Show them a fire department or American Red Cross credentials, preferably not a badge. Have
copies of letters endorsing the survey from the local fire department, CPSC, and/or American
Red Cross, to show if needed.
“We are conducting a nationwide survey on household safety for the U.S. Consumer Product
Safety Commission (CPSC). The survey is very important and will help the CPSC improve home
safety. We called earlier and discussed this study with [Name] from this residence, and
scheduled a visit for today.”

2a.

Is [Name of respondent previously contacted] available to speak with us?
Yes (CONTINUE WITH PREAMBLE)
No

2b.

Is there another person available we may speak with, who is 18 years or
older and may be considered one of the heads of the household?
Yes
No
(TERMINATE)
19

If respondent is not available: When would be a good time to reach them?
Terminate: Thank you for speaking with us today. Unfortunately, we need to speak with an
adult who can answer questions regarding the home. Have a nice day.
“We are asking people in your community a few questions about their smoke and carbon
monoxide detectors, and doing some simple tests to make sure the detectors work. If the batteries
in your detector need to be replaced, we have new batteries to give out, free of charge. Also, if
any of your detectors do not work, we have new ones to replace them, again free of charge. We
would like to collect any detectors that don’t work and send them to the Consumer Product
Safety Commission’s lab to find out why they don’t work. This interview will take up to 60
minutes, and at the end of the interview we will provide you with a $25 gift card in appreciation
for your participation.
“Before we begin, we’d like for you to review a consent form with information about the study.”
Pull up the informed consent form, and hand the tablet to the respondent.
“This is the informed consent form. It explains the reason for our visit today. Could you please
read this, and if you agree to allow this interview to proceed, please sign the bottom. Let me
know if you have any questions.
If participant refused, say thank you and terminate
3a.

If entry to residence was not possible, what was the main reason?
Participant refused (TERMINATE)
Participant rescheduled (GO TO Q3b)
Refused entry to building (TERMINATE)
No one home (TERMINATE)
Only a minor was home (TERMINATE)
Vacant/commercial home/lot—bad address (TERMINATE)
Language barrier (TERMINATE)
Occupant refused entry (Why?_______________________________)
Other (specify) _____________________________________________________
3b.

If participant rescheduled, please fill out the following information

Date
Time
Contact information

____________
____________
____________

“Let’s begin.”
4a.

Do you have any smoke detectors in your home? When considering whether you do,
please do not include any uninhabited outbuildings or apartment hallways. (DO
NOT READ LIST)
20

Yes
No (SKIP To 5a)
Don’t know (ASK TO INSPECT. IF YES CONTINUE, BUT IF NO TREAT AS
“NO” SMOKE DETECTOR)
4b.

Are any of your smoke detectors connected to a central alarm or security
system that notifies the police or fire department? (DO NOT READ LIST)

[If needed: What we mean by this is if the smoke detector detected smoke, it would
automatically notify the police or fire department.]
Yes (SKIP TO 4d)
No (SKIP TO 5a)
Don’t Know (CONTINUE)

4c.

Thinking of all fire or smoke related incidents at your residence, has the
police or fire department ever arrived in response to a notification from a
central alarm or security system? (READ ALL OPTIONS BEFORE
SELECTING A RESPONSE)
Yes
No
Never had a fire or smoke related incident

IF 4b = 1 or 4c = 1 or 3 CONTINUE
ELSE, SKIP TO 5a
4d.

Please tell me to what extent do you believe your home is safe with your current
smoke detectors? Would you say... (READ LIST)

Interviewer: Read the descriptors but do not read the numbers. Circle the descriptor and
its associated number. If participant is experiencing difficulty during in-home interview,
show them the scale.
Not at Slightly Moderately Mostly
all safe
safe
safe
safe
(1)
5a .

(2)

(3)

(4)

Very
safe
(5)

(DON’T (DON’T
READ) READ)
DK
RF
(8)
(9)

Do you have any carbon monoxide detectors in your home? When considering
whether you do, please do not include any uninhabited outbuildings or apartment
hallways.
Yes
No (SKIP TO Q6)

21

Don’t know (ASK TO INSPECT. IF YES CONTINUE, BUT IF NO TREAT AS
“NO” CO DETECTOR)
5b.

Are any of your carbon monoxide detectors connected to a central alarm or
security system that notifies the police or fire department?

[If needed: What we mean by this is if the carbon monoxide detector detected carbon
monoxide, it would automatically notify the police or fire department.]
Yes (SKIP TO Q5d)
No (SKIP TO Q6)
Don’t Know (CONTINUE)
5c.

Thinking of all carbon monoxide related incidents at your residence, has the
police or fire department ever arrived in response to a notification from a
central alarm or security system? (READ ALL OPTIONS BEFORE
SELECTING A RESPONSE)
Yes
No
Never had a carbon monoxide related incident

IF 5b = 1 or 5c = 1 or 3, CONTINUE
ELSE, SKIP TO 6
5d.

Please tell me to what extent do you believe your home is safe with your current
carbon monoxide detectors? Would you say... (READ LIST)

Interviewer: Read the descriptors but do not read the numbers. Circle the descriptor and
its associated number. If participant is experiencing difficulty during in-home interview,
show them the scale.
Not at Slightly Moderately Mostly
all safe
safe
safe
safe
(1)

(2)

(3)

(4)

Very
safe
(5)

(DON’T (DON’T
READ) READ)
DK
RF
(8)
(9)

6.

Do you or another member of your household own or rent your home? (DO NOT
READ LIST)
Own
Rent
Don’t know
Refused

7.

How long have you lived in this (apartment/ house)? Would that be… (READ LIST)
Less than 6 months
6 to 11 months
22

1 to 5 years
6 to 10 years
11 years or more
Don’t know (DON’T READ)
Refused (DON’T READ)
8.

Please tell me to the best of your knowledge, in what year was this (apartment/
house) built? Was it… (READ LIST)
2010 or later
Between 2000 and 2009
Between 1990 and 1999
Between 1980 and 1989
Before 1980
Don’t know (DON’T READ)
Refused (DON’T READ)

If Q1a = 1, CONTINUE
ELSE, SKIP TO 10a
9a.

What types of fuel-burning appliances, if any, do you own or have in your home? By
fuel burning appliances, we mean appliances that use gas, propane, oil, wood, wood
pellets, coal, or kerosene. Do not include electric-powered appliances. (READ LIST,
SELECT ALL THAT APPLY)
Gas powered generator
Wood or pellet burning fireplace or stove
Furnace or boiler
Kitchen applicances (e.g., stove, oven)
Water heater
Other (Specify) ________________________
Charcoal grill
Do not own any fuel-burning appliances
Gas Dryer
Don’t know (DON’T READ)
Refused (DON’T READ)

9b.

Does this residence have an attached garage unit? (DO NOT READ LIST)
Yes
No (SKIP TO Q10a)
Don’t know (SKIP TO Q10a)
Refused (SKIP TO Q10a)
9c.

For what purposes is the attached garage used? Would you say… (READ
LIST, SELECT ALL THAT APPLY)
Workshop/ workspace
Store tools or lawn/ sports equipment
Store vehicle(s) (e.g., motorcycle, car, SUV, van, etc.)
Fuel burning appliances (e.g., furnace, water heater, grill, etc.)
Other (Specify:)___________________________
Don’t know (DON’T READ)
Refused (DON’T READ)
IF Q4a = 2 or 3 SKIP TO Q12
ELSE, CONTINUE
23

SMOKE DETECTOR
10a.

11a.

About how often do you use the test button to test the smoke detector or detectors in
your home? Would you say… (READ LIST)
Never
Once every few years (SKIP TO Q11a)
Once every year (SKIP TO Q11a)
Once every 6 months (SKIP TO Q11a)
Once every 3 months (SKIP TO Q11a)
Once every month (SKIP TO Q11a)
Once every week (SKIP TO Q11a)
Other (specify)___________________________ (SKIP TO Q11a)
Don’t know(SKIP TO Q11a) (DON’T READ)
Refused (SKIP TO Q11a) (DON’T READ)

10b.

Please tell me, what are some of the reasons that you have not tested your
smoke detector or detectors? (DO NOT READ LIST, SELECT ALL THAT
APPLY):
Did not know you should test
Did not think it was important enough
Did not know how to test (SKIP Q10c)
Don’t need to test because they go off occasionally
Physically unable to reach
Other (Specify) _______________________________
Don’t know
Refused

10c.

Do you know how to test your smoke detector or detectors, or not? (DO NOT
READ LIST)
Yes
No
Unsure
Refused

Do you think most or all of your smoke detectors are working? By working, I mean
they would make a sound if they detected smoke right now. (DO NOT READ LIST)
Yes (SKIP to 12a)
No
Don’t know (SKIP TO Q12a)
Refused (SKIP TO Q12a)

24

11b.

What are some of the reasons your smoke detectors may not be working?
Again, by working, I mean they would make a sound if it detected smoke
right now. (DO NOT READ LIST, SELECT ALL THAT APPLY)
Did not get around to fixing it
Do not know how to fix or replace it
Unable to install or fix it
Unable to afford new ones
Disconnected it (GO TO Q11c)
It is the landlord’s responsibility
Removed battery (GO TO Q11d)
Batteries never installed
Batteries not working and not yet replaced
Other reason ____________________________________________
Don’t know
Refused

11c.

You mentioned that one or more of your smoke detectors was disconnected.
For what reason(s) were the smoke detectors disconnected? (DO NOT READ
LIST, SELECT ALL THAT APPLY)
Nuisance when they go off
Detector frequently went off
Would not stop beeping/ chirping
No longer worked
No reason in particular
Other reason __________________________________________
Don’t know
Refused

11d.

You mentioned that the batteries were removed from one or more of your
smoke detectors. For what reason(s) were the batteries removed from the
smoke detector or detectors? (DO NOT READ LIST, SELECT ALL THAT
APPLY)
Batteries no longer worked
Batteries were leaking/ discharge
Batteries expired
Detector would not stop beeping/chirping
Intended to replace batteries, but forgot to install new ones
Installed wrong type of batteries
Needed batteries for another device
Other reason __________________________________________
Don’t know
Refused

25

12.

Do you know how to… (INSERT ITEM), or not?

Yes

No

(DON’T
READ)
Unsure

(DON’T
READ)
Refused

a. Install a smoke detector?
b. Maintain a smoke detector
in good working order?

IF Q4a = 2 or 3 SKIP TO Q14a
ELSE, CONTINUE
13.

To the best of your knowledge, how often should you replace your old smoke
detector with a new smoke detector in your home? Would you say… (READ LIST)
Never, unless the detector stops working
Once every 6 months
Once a year
Once every 2 – 5 years
Once every 6 – 9 years
Once every 10 years
Once every 10+ years
Don’t know (DON’T READ)
Refused (DON’T READ)

FIRE HISTORY
14a.

In the past 12 months, have you had any accidental fires – that is unintended or
unwanted smoke or flames - in your home? Please include fires that were too small
to call the fire department. (DO NOT READ LIST)
Yes (CONTINUE)
No (SKIP TO Q15a)
Don’t know (SKIP TO Q15a)
Refused (SKIP TO Q15a)

IF Q4a = 2 or 3 SKIP TO Q16
ELSE, CONTINUE

26

If Yes:
14b. Thinking of the most recent accidental fire(s), how did you become alerted to
the incident? (DO NOT READ LIST, SELECT ALL THAT APPLY)
Saw the fire
Smelled the fire
Heard the fire
Felt the heat of the fire
Smoke detector (SKIP Q14c)
Someone notified me
Other (Specify) _________________________________________
Don’t remember
Don’t know
Refused

15a.

14c.

Thinking of the most recent accidental fire(s), did any of the smoke detectors
go off during the fire(s)? (DO NOT READ LIST)
Yes (SKIP TO Q15a)
No
Don’t know (SKIP TO Q15a)
Refused (SKIP TO Q15a)

14d.

Thinking of the most recent accidental fire(s), do you think that enough
smoke reached the smoke detector that it should have sounded? (DO NOT
READ LIST)
Yes
No
Don’t know
Refused

In the past 12 months, have any of your smoke detectors gone off when there was no
fire, other than when the smoke detector was being tested? (DO NOT READ LIST)
Yes
No (SKIP TO Q16)
Don’t know (SKIP TO Q16)
Refused (SKIP TO Q16)

27

15b.

Why do you think the smoke detector went off when there was no fire? (DO NOT
READ LIST, SELECT ALL THAT APPLY).
Cooking
Fireplace
Tobacco
Steam from bathroom
Low battery
Other (Specify:) _________________
No apparent reason
Don’t know
Refused

CO DETECTORS
16.

How would you know if high levels of carbon monoxide (CO) were present in your
home? (DO NOT READ LIST, SELECT ALL THAT APPLY).
You can smell it
You can taste it
You can see it
You can feel it
Carbon monoxide detector
Other (Specify:)___________________________
Respondent does not believe there is a way to know if CO is present
Don’t know
Refused

17.

How much do you believe you know about carbon monoxide detectors? (READ
LIST)
Nothing at all
A little
Some
A lot
Don’t know(DON’T READ)
Refused (DON’T READ)

IF Q5a =2 or 3, SKIP TO Q21
ELSE, CONTINUE

28

18a.

If CO detectors present (Yes in 5a), ask:
About how often do you use the test button to test your carbon monoxide detector or
detectors? Would you say… (READ LIST)
Never
Once every few years (SKIP TO Q19a)
Once every year (SKIP TO Q19a)
Once every 6 months (SKIP TO Q19a)
Once every 3 months (SKIP TO Q19a)
Once every month (SKIP TO Q19a)
Once every week (SKIP TO Q19a)
Other (specify) _______________________________ (SKIP TO Q19a)
Don’t know (SKIP TO Q19a) (DON’T READ)
Refused (SKIP TO Q19a) (DON’T READ)

18b.

What were the reasons that you have not tested your carbon monoxide
detector or detectors? (Open ended, capture their response)
________________________________________________________________________
________________________________________________________________________

19a.

Do you think most or all of your carbon monoxide detectors are working? By
working, I mean they would make a sound if it detected carbon monoxide right now.
(DO NOT READ LIST)
Yes (SKIP TO 20)
No
Don’t know (SKIP TO Q20)
Refused (SKIP TO Q20)
If No:
19b. What are some of the reasons your carbon monoxide detectors may not be
working? Again, by working, I mean they would make a sound if it detected
carbon monoxide right now. (DO NOT READ LIST, SELECT ALL THAT
APPLY)
Did not get around to fixing it
Do not know how to fix or replace it
Unable to install or fix it
Unable to afford new ones
Disconnected it (GO TO 19c)
It is the landlord’s responsibility
Removed battery (GO TO 19d)
Batteries never installed
Batteries not working and not yet replaced
Other reason ____________________________________________
Don’t know
Refused
29

20.

19c.

You mentioned that one or more of your carbon monoxide detectors was
disconnected. For what reason(s) were the carbon monoxide detectors
disconnected? (DO NOT READ LIST, SELECT ALL THAT APPLY)
Nuisance when they go off
Detector frequently went off
Would not stop beeping/ chirping
No longer worked
No reason in particular
Other reason __________________________________________
Don’t know
Refused

19d.

You mentioned that the batteries were removed from one or more of your
carbon monoxide detectors. For what reason(s) were the batteries removed
from the carbon monoxide detector or detectors? (DO NOT READ LIST,
SELECT ALL THAT APPLY)
Batteries no longer worked
Batteries were leaking/ discharge
Batteries expired
Detector would not stop beeping/chirping
Intended to replace batteries, but forgot to install new ones
Installed wrong type of batteries
Needed batteries for another device
Other reason __________________________________________
Don’t know
Refused

For what reasons do you have a carbon monoxide detector? (DO NOT READ LIST,
SELECT ALL THAT APPLY)
It is required by law
It makes me feel safe
It is helpful in detecting carbon monoxide
It came with the residence
I own generators/ fuel-burning appliances
Other (Specify:)___________________________
Don’t know
Refused

30

21.

To the best of your knowledge, how often should the carbon monoxide detectors in
your home be replaced? Would you say… (READ LIST)
Never, unless the detector stops working
Once every 6 months
Once a year
Once every 2 – 5 years
Once every 6 – 9 years
Once every 10 years
Once every 10+ years
Don’t know (DON’T READ)
Refused (DON’T READ)

IF Q5a = 2 or 3, SKIP TO Q24
ELSE, CONTINUE
CO History
22a. In the past 12 months, has your carbon monoxide detector or detectors ever gone
off, other than when the carbon monoxide detector was being tested? (DO NOT
READ LIST)
Yes
No (SKIP TO Q23)
Don’t know(SKIP TO Q23)
Refused (SKIP TO Q23)
If Yes:
22b. Thinking of the last time your carbon monoxide detector went off, how did
you react when you heard the detector? (DO NOT READ LIST, SELECT
ALL THAT APPLY)
Left the house
Called the fire department
Ventilated home (opened windows, door, used fan, etc.)
Unplugged or disconnected it
Reset it
Removed battery
Other action (specify)_____________________________________
Don’t remember
Don’t know
Refused

31

23.

Do you know how to… (INSERT ITEM). or not?

Yes

No

(DON’T
READ)
Unsure

(DON’T
READ)
Refused

a. Install a carbon monoxide
detector?
b. Maintain a carbon monoxide
detector in good working
order?

24.

In the past 12 months, were you aware that any of your friends, relatives, neighbors,
or coworkers experienced…

Yes

No

(DON’T
READ)
Unsure

(DON’T
READ)
Refused

a. An accidental fire?
b. A carbon monoxide incident?
(e.g., effects of carbon
monoxide poisoning)

-TESTING DETECTORSNow we’d like to test your detector(s) to make sure that they are working properly.
25.

How many floors (levels) are there in your home? Please include the basement and
finished attic, if you have one.
_____________
(NOTE: For an apartment, treat the entire apartment as one floor unless more than one
level. Do NOT report the number of floors in the apartment building.)

Would you show me the first detector? (Then ask to see the next one)
For each detector, fill in the following data. The computer will automatically cue up another set
of these questions for the second, third, etc. detector. The first smoke detector data elements will
be numbered 26-1a, 26-1b, 26-1c, etc. The second smoke detector data elements will be 26-2a,
26-2b, etc. The third detector will be 26-3a, 26-3b, etc.

32

The questions in this section to be addressed and answered by the survey team

26-1a. What level of the home are you currently on?
Detector #
Basement
First level
Second level
Third level
Finished Attic
Other ______________

#1
1
2
3
4
5
6

#2
1
2
3
4
5
6

#3
1
2
3
4
5
6

#4
1
2
3
4
5
6

#5
1
2
3
4
5
6

#6
1
2
3
4
5
6

(NOTE: For an apartment, treat the entire apartment as first level unless more than one
level. Do NOT report what floor of the building it is on.)
26-1b. What area or room of home are you currently in?
Detector #
Inside the bedroom
Hallway outside of bedrooms
Hallway - other
In Family room/Living room
In Kitchen
In Dining area
In Bathroom
In Closet
In Stairwell
In Laundry room /Storage room
Other area
______________

#1
1
2
3
4
5
6
7
8

#2
1
2
3
4
5
6
7
8

#3
1
2
3
4
5
6
7
8

#4
1
2
3
4
5
6
7
8

#5
1
2
3
4
5
6
7
8

#6
1
2
3
4
5
6
7
8

9

9

9

9

9

9

26-1c. (READ) What type of detector is this? Would you say it is a smoke detector, carbon
monoxide detector, both a smoke and CO detector, or you don’t know?
Detector #
Smoke detector
CO detector
Smoke/CO Combined
Don’t know or other (INSPECT)

#1
1
2
3
4

#2
1
2
3
4

#3
1
2
3
4

#4
1
2
3
4

#5
1
2
3
4

#6
1
2
3
4

(NOTE: IF Q26c = 3, test the smoke and CO portions of the detector separately.)

33

IF Q26c = 4
[If “Don’t Know or other”] – Please follow the following steps:
1. Inspect back of detector for manufacturer information- look for name/ type of detector.
2. If unclear, refer to your Detector reference sheet. Use either the UL number or model
number to identify the type of detector.
Please select correct type of detector, if still unknown, continue.
26-1d. (READ) For quality control purposes, we’d like to collect three photographs of this
detector. Do we have your permission?
Detector #
Yes
No
Could not take picture

#1
1
2
3

#2
1
2
3

#3
1
2
3

#4
1
2
3

#5
1
2
3

#6
1
2
3

[If yes] – Please obtain three photographs including the following items:
• Front of detector (to capture image of detector)
• Back of detector (UL and Manufacturer information)
• Side of detector (may have a install/replacement sticker)
[If no] “Okay. No problem.”
IF Q26c = 1, 3, or 4 CONTINUE
ELSE IF Q26c = 2, GO TO INSTRUCTION SET B
26-1e. (OBSERVE) Approximately, what is the horizontal distance between the stove or
cooktop in the kitchen and the closest smoke detector on the same floor?
Detector #
Less than 6 feet
6 – 10 feet
11 – 20 feet
More than 20 feet
No detector on the same floor
Don’t know

#1
1
2
3
4
5
6

#2
1
2
3
4
5
6

#3
1
2
3
4
5
6

#4
1
2
3
4
5
6

#5
1
2
3
4
5
6

#6
1
2
3
4
5
6

IF Q26c = 1, 3, or 4, SHOW INSTRUCTION SET A
ELSE IF Q26c = 2, SKIP 26f, AND GO TO INSTRUCTION SET C

34

A. INSTRUCTIONS ON TESTING SMOKE DETECTOR WITH AEROSOL
PROCEED TO FIRST/NEXT DETECTOR – SMOKE TEST
Warn consumer of loud noise when the smoke detector sounds.
Use hearing protection, if needed.
•

Using aerosol spray and wand, point tube at detector from a distance of 1 – 2 feet.

•

Spray a three second burst of aerosol, and wait 10 seconds,

•

If detector sounds, testing is complete. Collect identification data.
(Spray short burst of canned air to accelerate and clear smoke detector)

•

If no detector sounds:
o Brush to lightly clear the grille and surface of detector.
o

•

Spray again for 5 seconds, and wait 10 seconds.

If detector does not sound, proceed to instructions on testing using Test Button.

26-1f. (OBSERVE) Did smoke detector sound in response to this smoke test?
Detector #
#1
#2
#3
#4
Yes
1
1
1
1
No
2
2
2
2
Could not test
3
3
3
3
IF SMOKE DETECTOR SOUNDS, SKIP TO INSTRUCTION SET D
ELSE, CONTINUE TO BUTTON TEST

#5
1
2
3

#6
1
2
3

35

B. INSTRUCTIONS ON TESTING USING TEST(S) BUTTON
IF NO IN Q26f – (SMOKE) BUTTON TEST
Warn consumer of loud noise when the smoke detector sounds.
Use hearing protection, if needed.
•

Press and hold the “Test” button.
o

Read directions on the detector – some models’ “test” function requires push and
release, others require push and hold.

•

•

If detector sounds, testing is complete.
o

However, label for collection due to inoperative sensor.

o

Collect identification data.

If no detector sound, proceed to instructions on replacing batteries/ restoring power.

PROCEED TO INSTRUCTION SET D

36

C. INSTRUCTIONS ON TESTING CO DETECTOR
CO BUTTON TEST
Warn consumer of loud noise when the smoke detector sounds.
Use hearing protection, if needed.
•

Press and hold the “Test/ Reset” until the detector sounds:
o

Place your fingers over the sounder opening and check the power and detector by
depressing the “Test/Reset” button.

•

If detector sounds, testing is complete. Collect identification data.

•

If no detector sounds, proceed to instructions on replacing batteries/ restoring power.

26-1g1. (OBSERVE) Did detector sound in response to the smoke test button?
Detector #
Yes
No
No test button on unit
Could not test

#1
1
2
3
4

#2
1
2
3
4

#3
1
2
3
4

#4
1
2
3
4

#5
1
2
3
4

#6
1
2
3
4

IF COMBINATION DETECTOR , CONTINUE (IF Q26c = 3, continue to 26-1g2)
ELSE, SKIP TO INSTRUCTION SET D
26-1g2. (OBSERVE) Did detector sound in response to the second (CO) test button?
Detector #
Yes
No
No additional button on
unit

#1
1
2
3

#2
1
2
3

#3
1
2
3

#4
1
2
3

#5
1
2
3

#6
1
2
3

37

D. INSTRUCTIONS ON HOW TO PROCEED (SMOKE DETECTOR)
•
•
•

If smoke detector sounded in response to Q26f, continue collecting identification data.
If smoke detector did not sound in response to Q26f, but did sound in response to Q26g, label
for collection (due to inoperative sensor), and continue with collecting identification data.
If smoke detector did not sound in response to Q26f and Q26g, continue with Q26h.

E. INSTRUCTIONS ON HOW TO PROCEED (CO DETECTOR)
•
•

If CO detector sounded in response in response to Q26g, continue collecting identification
data.
If CO detector did not sound in response to Q26g, continue with Q26h.

IF DETECTOR FAILS TO SOUND, ATTEMPT TO REPLACE/ INSTALL BATTERY
ELSE, SKIP TO INSTRUCTIONS ON HOW TO PROCEED
If the smoke detector uses a 10-year seal battery, the battery cannot be replaced. A smoke
detector that uses a 10-year seal battery can be identified if:
• The unit does not have any battery door or compartment.
•

The label states “10-year seal battery” or similar.

26-1h. (READ) May I put a new battery in this detector to determine whether the detector
needs to be replaced?
Detector #
Yes
No (Label)
No – 10-year Seal Battery Present

#1
1
2
3

#2
1
2
3

#3
1
2
3

#4
1
2
3

#5
1
2
3

#6
1
2
3

IF BATTERY REPLACED/ INSTALLED, CONTINUE WITH RESTESTING
ELSE, SKIP TO INSTRUCTIONS ON HOW TO PROCEED
F. INSTRUCTIONS ON RETESTING SMOKE DETECTOR
After replacing battery/ restoring battery, repeat SMOKE TEST using up to 3 one second
sprays, ten seconds apart with tube positioned against the grill.

38

26-1i. (OBSERVE) Did the detector sound in response to this smoke test?
Detector #
Yes
No (label)

#1
1
2

#2
1
2

#3
1
2

#4
1
2

#5
1
2

#6
1
2

IF DETECTOR SOUNDS, SKIP TO INSTRUCTIONS ON HOW TO PROCEED
ELSE, CONTINUE

G. INSTRUCTIONS ON RETESTING SMOKE DETECTOR TEST BUTTON
IF NO IN Q26i –BUTTON TEST
•

Press and hold the “Test” button.
o

Read directions on the detector – some models’ “test” function requires push and
release, others require push and hold.

•

If detector sounds, testing is complete.
o

However, label for collection due to inoperative sensor.

o

Collect identification data.

IF DETECTOR SOUNDS, SKIP TO INSTRUCTIONS ON HOW TO PROCEED
ELSE, SKIP TO Q26j

H. INSTRUCTIONS ON RETESTING CO DETECTOR TEST BUTTON
IF NO in Q26g – CO BUTTON TEST
•

Press and hold the “Test/ Reset” until the detector sounds:
o

Place your fingers over the sounder opening and check the power and detector by
depressing the “Test/Reset” button.

•

If detector sounded in response to test in, testing is complete. Collect identification data.

•

If no detector sounds, label for collection, and collect identification data.

39

26-1j1. (OBSERVE) Did detector sound in response to this button test?
Detector #
Yes
No (Label)

#1
1
2

#2
1
2

#3
1
2

#4
1
2

#5
1
2

#6
1
2

IF SMOKE DETECTOR, SKIP TO INSTRUCTION SET I
ELSE IF, CO DETECTORS, SKIP TO INSTRUCTION SET J
ELSE, COMBINATION DETECTOR, CONTINUE

26-1j2. (OBSERVE) Did detector sound in response to the second test button?
Detector #
Yes
No (Label)
No additional button on
unit

#1
1
2
3

#2
1
2
3

#3
1
2
3

#4
1
2
3

#5
1
2
3

#6
1
2
3

I. INSTRUCTIONS ON HOW TO PROCEED (SMOKE DETECTOR)
•
•
•

If smoke detector sounded in response to Q26i, continue collecting identification data.
If smoke detector did not sound in response to Q26i, but did sound in response to Q26j, label
for collection (due to fault inoperative sensor), and continue with collecting identification data.
If smoke detector did not sound in response to Q26e and Q26f, label for collection, and
continue collecting identification data.

J. INSTRUCTIONS ON HOW TO PROCEED (CO DETECTOR)
•
•

If CO detector sounded in response to Q26j, continue collecting identification data.
If CO detector did not sound in response to Q26j, label for collection, and continue with
collecting identification data.

26-1k. If could not test, why not?
Detector #
#1
Could not reach
1
Homeowner would not
2
allow
No time
3
Other
4
______________
IF Q26c = 1, 3, or 4 CONTINUE

#2
1
2

#3
1
2

#4
1
2

#5
1
2

#6
1
2

3

3

3

3

3

4

4

4

4

4

40

ELSE IF Q26c = 2, GO TO Q26i
26-1l. (OBSERVE) What type of smoke detector is this?
Detector #
Photoelectric
Ionization
Combined photo/ion
Combined ion with CO
Combined photo with CO
Don’t know
Other ________

#1
1
2
3
4
5
6
7

#2
1
2
3
4
5
6
7

#3
1
2
3
4
5
6
7

#4
1
2
3
4
5
6
7

#5
1
2
3
4
5
6
7

#6
1
2
3
4
5
6
7

IF Q26l = 2 or 4 CONTINUE
ELSE IF Q26c = 1 or 3, GO TO Q26j
26-1m. (OBSERVE) What type of CO detector is this?
Detector #
Electrochemical
Metal Oxide
Biomimetic
Don’t know
Other
______________

#1
1
2
3
4

#2
1
2
3
4

#3
1
2
3
4

#4
1
2
3
4

#5
1
2
3
4

#6
1
2
3
4

5

5

5

5

5

5

#5
1
2
3
4
5

#6
1
2
3
4
5

#5
_____
1

#6
_____
1

26-1n. (OBSERVE) What type of power source does the detector have?
Detector #
Replaceable battery
Sealed battery
AC Only
AC with battery
Don’t know

#1
1
2
3
4
5

#2
1
2
3
4
5

#3
1
2
3
4
5

#4
1
2
3
4
5

26-1o. (OBSERVE) What is the manufacture date of the detector?
Detector #
Year
Don’t know

#1
_____
1

#2
_____
1

#3
_____
1

#4
_____
1

41

26-1p. (OBSERVE) What is the model number of the detector?
Detector #
Model number
Don’t know

#1
_____
1

#2
_____
1

#3
_____
1

#4
_____
1

#5
_____
1

#6
_____
1

26-1q. (OBSERVE) Is the detector (wired or wireless) interconnected with other detectors?
Detector #
Yes
No
Don’t know

#1
1
2
3

#2
1
2
3

#3
1
2
3

#4
1
2
3

#5
1
2
3

#6
1
2
3

#5
1
2
3

#6
1
2
3

26-1r. (OBSERVE) Is the detector part of a private detector system?
Detector #
Yes
No
Don’t know

#1
1
2
3

#2
1
2
3

#3
1
2
3

#4
1
2
3

26-1s. (OBSERVE) Did the detector have strobe lighting for hearing impaired?
Detector #
Yes
No
Don’t know

#1
1
2
3

#2
1
2
3

#3
1
2
3

#4
1
2
3

#5
1
2
3

#6
1
2
3

IF Q26c = 1, 3, or 4 CONTINUE
ELSE IF Q26c = 2, SKIP TO Q26u

26-1t. (OBSERVE) Is this detector connected to a tactile notification device (bed shaker or
pillow shaker) for the hearing impaired or blind?
Detector #
Yes
No
Don’t know

#1
1
2
3

#2
1
2
3

#3
1
2
3

#4
1
2
3

#5
1
2
3

#6
1
2
3

42

FOR BATTERY ONLY
26-1u. (OBSERVE) Was this detector found to have a dead battery, that is, the old battery
was connected but the detector responded to aerosol smoke after battery replacement?
Detector #
Yes
No
IF Q26u = 2, CONTINUE
ELSE, SKIP TO Q26w

#1
1
2

#2
1
2

#3
1
2

#4
1
2

#5
1
2

#6
1
2

FOR EITHER BATTERY OR AC DETECTORS:
26-1v. (OBSERVE) Was the detector found without a battery, with battery disconnected,
or AC power disconnected?
Detector #
Yes
No

#1
1
2

#2
1
2

#3
1
2

#4
1
2

#5
1
2

#6
1
2

26-1w. (READ): How old do you think this detector is? Would you say…
Detector #
Less than 1 year old
1 – 5 years old
6 – 10 years old
More than 10 years old
Don’t know (DON’T
READ)
Refused (DON’T READ)

#1
1
2
3
4
5

#2
1
2
3
4
5

#3
1
2
3
4
5

#4
1
2
3
4
5

#5
1
2
3
4
5

#6
1
2
3
4
5

6

6

6

6

6

6

IF DETECTOR DOES NOT WORK, CONTINUE
ELSE, SKIP TO POST INSPECTION
IF DETECTOR DOES NOT WORK
(READ) It is important that we determine why detectors don’t work.
I would like to collect this detector and send it to the U.S. Consumer Product Safety
Commissions lab for analysis to find out why it does not work properly. We will provide you
with a free replacement detector.

43

26-1x. (READ) May I collect this detector?
Detector #
Yes
No

#1
1
2

#2
1
2

#3
1
2

#4
1
2

#5
1
2

#6
1
2

IF Q26x = 2, CONTINUE
ELSE, SKIP TO PACKAGING INSTRUCTIONS
IF NO
(READ) That is fine. You may keep the detector. However, I will still provide you with a
new detector, and give you this box so you may send your old detector to the U.S.
Consumer Product Safety Commission’s lab for analysis, if you may choose to do so.
IF Q26x = 1, CONTINUE
ELSE, SKIP TO Q26z
CAREFULLY PACKAGE
DETECTOR
(AFTER DETECTOR HAS BEEN REMOVED/BOX GIVEN) Here is a replacement
(smoke/CO) detector. I’m going to test it now to be sure it works.
PERFORM BUTTON TEST:
• If detector sounded, give respondent replacement detector.
•

If detector does not sound, select & test another detector.

26-1y. (OBSERVE) Post inspection actions taken: (SELECT ALL THAT APPLY)
Detector #
No action required
Battery replaced
Installed missing battery
Refused battery
installation/ replacement
Collected detector
Advised replacement
(AC/ hard wired)
Could not replace
detector/ Refused

#1
1
2
3

#2
1
2
3

#3
1
2
3

#4
1
2
3

#5
1
2
3

#6
1
2
3

4

4

4

4

4

4

5

5

5

5

5

5

6

6

6

6

6

6

7

7

7

7

7

7

44

26-1z. (READ) Are there any other detectors on this floor? This could include smoke
detectors or carbon monoxide detectors.
Yes (GO BACK to Q26-b)
No
Don’t know (ASK TO INSPECT. IF YES, INSPECT FLOOR, IF “NO”, TREAT
AS NO AND CONTINUE
IF Q25 = 1, SKIP TO NEXT SECTION
ELSE, CONTINUE
26-1aa. (READ) What about other floors? Are there any smoke or carbon monoxide
detectors on any other floors in this (apartment/house)?
Yes (GO BACK to Q26-a)
No
Don’t know (ASK TO INSPECT ADDITIONAL FLOORS. IF YES, GO TO
THE OTHER FLOOR, IF NO, TREAT AS “NO”, AND CONTINUE)

DETECTORS
IF Q4a = 1, CONTINUE
ELSE, SKIP TO Q28
27.

Did the occupant know the location of the smoke detectors?
Knew all
Knew at least one but not all
Knew none

IF Q5a = 1, CONTINUE
ELSE, SKIP TO NEXT SECTION
28.

Did the occupant know the location of the CO detectors?
Knew all
Knew at least one but not all
Knew none

45

NO SMOKE DETECTORS PRESENT
IF Q4a = 2 CONTINUE
ELSE, SKIP TO NEXT SECTION
If no smoke detectors are present, ask:
29. On a scale of 1 to 5, where 1 is Not at All Necessary, and 5 is Extremely
Necessary, how necessary do you feel it is to have a smoke detector installed in
your home?

1

2

3

4

5

DK

RF

30. Please tell me what are some of the reasons you don’t have a smoke detector
installed in your home. (DO NOT READ LIST, SELECT ALL THAT APPLY)
Don’t think I need one
Did not come with residence
They are a nuisance
They did not or don’t work
Never got around to replacing previous detectors
It is the landlord’s responsibility
Other reason ____________________________________________
Don’t know
Refused

NO CO DETECTORS PRESENT
IF Q5a = 2 CONTINUE
ELSE, SKIP TO Q32a
If no CO detectors present, ask:
31. On a scale of 1 to 5, where 1 is Not at All Necessary, and 5 is Extremely
Necessary, how necessary do you feel it is to have a carbon monoxide detector
installed in your home?
1

2

3

4

5

DK

RF

32. Can you tell me what are some of the reasons you don’t have a carbon monoxide
detector installed in your home?
(Open ended, Probe: Anything else?)
________________________________________________________________________
________________________________________________________________________
46

IF Q4a = 2 or 3 or Q5a = 2 or 3 SKIP TO Q34a
ELSE, CONTINUE
Post-inspection Follow up Questions with Respondent
Now I would like to ask a few additional questions about your detectors.
33a.

34a.

After we contacted you to arrange for this visit, did you buy any additional smoke
or carbon monoxide detectors, or replace any batteries in your detectors? (DO NOT
READ LIST, SELECT ALL THAT APPLY)
Yes
No (SKIP TO Q34a)
Don’t Know (SKIP TO Q34a)
Refused (SKIP TO Q34a)
If Yes:
33b. How many new smoke detectors?

____________

33c.

How many new carbon monoxide detectors?

____________

33d.

How many detectors were installed with new batteries?
____________

In the past 12 months, have you looked for any information about either fire safety
or carbon monoxide safety, or not? (DO NOT READ LIST)
Yes
No
Unsure
Refused

IF Q34a = 1, CONTINUE
ELSE, SKIP TO Q35

47

34b.

Where do you obtain information about fire safety? (READ LIST ONE AT A
TIME) (SELECT ALL THAT APPLY)
Sources of information
TV news, or radio
Internet search engines like Google
Family or friends
Community or religious organizations
Social media like Facebook
Local fire department
Other (SPECIFY) (DON’T READ)___________
None of these (DON’T READ)
Don’t know or remember (DON’T READ)
Refused (DON’T READ)

34c.

Fire safety

Where do you obtain information about carbon monoxide safety? (READ LIST
ONE AT A TIME) (SELECT ALL THAT APPLY)

Sources of information

Carbon
monoxide safety

TV news, or radio
Internet search engines like Google
Family or friends
Community or religious organizations
Social media like Facebook
Local fire department
Other (SPECIFY) (DON’T READ)_____________
None of these (DON’T READ)
Don’t know or remember (DON’T READ)
Refused (DON’T READ)

35.

How often do you or another member of the household cook at home using a stove
or oven? Does a member of this household cook… (READ LIST)
Never
Less than once a month
A few times per month
A few times per week
Every day
Rarely
Don’t know (DON’T READ)
Refused (DON’T READ)

48

DEMOGRAPHICS
Great! To ensure that we interview a broad mix of residents, I have a few brief demographic questions to
ask about you and others within this household. It should only take a few minutes of your time.

36.

How many people live or stay in your household? This can include:
• Anyone who is living or staying here for more than 2 months
• Yourself, if you are living here for more than 2 months
• Anyone else staying here who does not have another place to stay, even if they are
here for 2 months or less
Please do not include anyone who is living somewhere else for more than 2 months,
such as a college student living away or someone in the Armed Forces on deployment.
Enter number of people

37.

__________

Thinking of the individual(s) who live here, is there anyone…(INSERT ITEM)

Yes

No

(DON’T
READ)
Don’t
know

(DON’T
READ)
Refused

If yes,
how
many?

Under 5 years old?
5 - 17 years old?
18 – 64 years old?
65 years old or older?

38.

What is the highest level of education you have completed or the highest degree you
have received? (DO NOT READ LIST)
Less than high school, no diploma
High school diploma, or high school equivalent (GED)
Trade or Vocational school degree
Some college, no degree
Associate’s degree
Bachelor’s degree
Master’s degree or higher
Don’t know
Refused

49

39.

Is anyone in the household of Hispanic or Latino origin or descent? (DO NOT
READ LIST)
Yes
No
Don’t know
Refused

40.

What is your race?
(SELECT ALL THAT APPLY)
White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or other pacific islander
Some Other Race (Specify) (DON’T READ)____________________________
Don’t know (DON’T READ)
Refused (DON’T READ)

41.

Is anyone in the household deaf or hard of hearing? (DO NOT READ LIST)
Yes
No
Don’t know
Refused

42.

Does anyone in the household have a physical, mental, or other health condition that
has lasted 6 or more months which makes it difficult for them to carry out day to
day activities? (DO NOT READ LIST)
Yes
No
Don’t know
Refused

43.

Do any people in the home smoke cigarettes, cigars, hookahs, or pipes? Please do
not include e-cigarettes or vaping devices. (DO NOT READ LIST)
Yes
No
Don’t know
Refused

50

44.

In the last 12 months, what was your total household income from all sources,
before taxes? Just stop me when I get to the right category (READ LIST) (If
necessary, read)
Less than $15,000
$15,000 to under $25,000
$25,000 to under $35,000
$35,000 to under $50,000
$50,000 to under $75,000
$75,000 to under $100,000
$100,000 to under $150,000
$150,000 to under $200,000
$200,000 or more
Don’t know (DON’T READ)
Refused (DON’T READ)

Thank you so much for participating in this survey. You can call us if you have any questions
about fire or CO safety.
Time visit ended: _____________________

51