At least I see some pathways! I assume your appraisal is for a lender. What type of loan? If FHA, all the health & safety items need to be addressed, from feces, to trip and stumble. Usually for FHA, it's got to be cleared out, inside and outside. Often the stuff under the house, if there is a crawlspace, collects critters, which is another no-no and that must be cleared out as well. Then you have the likely issue of frayed or loose wiring, doors that don't lock securely, and when you get the piles of stuff out, you're likely to find rotted floor boards, or even split timbers or cracked foundations. Health and safety is a big thing with FHA, and the more that gets cleaned out, the more sins you find left behind. Also, when things are packed tight for a long time, it may look tidy to the folks living there, but there isn't air circulation, and that factor often leads to bugs, rodents and rot.
If its conventional, it's not quite as harsh, but lender wants to know if there's hazardous conditions that could adversely impact their collateral's structure and sale-ability of the property if it goes into foreclosure. So yeah, it should be pretty much cleared out for conventional as well.
Funny thing about ppl that live in these mouse-holes is that they often don't seem to see the mess. Often they'll decide not to do the loan because they don't want to let all their treasures go to the dump, or they find themselves so overwhelmed with deciding about each and every thing they have accumulated, that they get mentally stuck and can't go forward. Often that leads to the property with all its junk inside being foreclosed and the owner loses everything for being overwhelmed with his situation. And then he starts over elsewhere, broken hearted for everything he's "lost". Sad.
When I come across a property with problems like that, I don't try to tell them HOW to fix it or WHAT to do. I state how the place needs to be to likely qualify per their lender's criteria, and I state that finished condition it needs to be in, like Star Trek: "Make it so."
So it might be a statement such as the place needs to be habitable, safe, sound, sanitary, secure, no harbors for rodents or insect infestations, no rot, no leaks, and must be a functional living space with heating system, plumbing, waste disposal, functional electric etc. If in doubt call for City code inspection for safety. That will probably kill the loan right there. And after that, you can go back to do your final inspection to verify condition.