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Home My WebLink AboutBUSINESS PLAN 2/19/2007~i . -~~~.~:, ' ~ ~ "f CALIFORNIA CARE CENTER ~° ~ ~i!~~37ll MOUNT VERNON ~, ,~ -~ I (9'Yt-- ,,. i ~, , -, ~~~ .;~~ CALIFORNIA CARE CENTER Manager ROCIO BUSBY Location: 2211 MT VERNON AVE City BAKERSFIELD CommCode: BFD STA 08 EPA Numb: SiteID: 015-021-000375 BusPhone: (661) 872-2121 Map 103 CommHaz Extreme Grid: 22C FacUnits: 1 AOV: SIC Code:8051 DunnBrad: Emergency Contact ROCIO BUSBY Business Phone: 24-Hour Phone Pager Phone Hazmat Hazards: / Title / ADMINISTRATOR (661) 872-2121x4012 (661) 302-3924x ( ) - x Emergency Contact FRANK GUTIERREZ Business Phone: 24-Hour Phone Pager Phone / Title / ENV DIRECTOR (661) 872-2121x4015 (661) 871-1479x (661) 472-7517x Fire Press ImmHlth Contact ~pGiD ~CNbI~~ U~{zs~ Phone: (661) 872-2121x MailAddr: 2211 MT VERNON AVE State: CA City BAKERSFIELD Zip 93306 Owner KINDRED HEALTHCARE Phone: (661) 872-2121x Address 680 S FOURTH AVE State: KY City LOUISVILLE Zip 40202 Period to Preparers Certif'd: ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurat nd co e ~ 1 ~lv~ Signature Date TotalASTs: = Gal TotalUSTs: = Gal RSs: No ~N~B ~~ . ,~ ~ ~~D 7 -1- ~ 01/26/2007 F CALIFORNIA CARE CENTER SitelD: 015-021-000375 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP LAUNDRY BLEACH IH L 200.00 GAL Hi PROPANE E F P IH G 200.00 FT3 Hi OXYGEN F P IH G 2000.00 FT3 Low -2- 01/26/2007 -3- O1j26j2007 F CALIFORNIA CARE CENTER ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME LAUNDRY BLEACH Location within this Facility Unit SEVERAL LOCATIONS STATE TYPE ~~~ PRESSURE Liquid TMixture I Ambient SiteID: 015-021-0003?5 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# TEMPERATURE ~ CONTAINER TYPE Ambient - I PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 5.00 GAL 200.00 GAL 100.00 GAL riHGHKLVU~ 1:V1~lYV1VL'1V15 owt. Rs cAS# 100.00 Clorox Bleach No 7681529 tiE'.GEiKL L~~ J~JS1~11;1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Hi ~ Inventory Item 0003 .COMMON NAME / CHEMICAL NAME PROPANE Location within this Facility Unit SE REAR BLDG STATE TYPE PRESSURE _ Gas TPure ~-Above Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 74-98-6 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 FT3 200.00 FT3 200.00 FT3 ritiGtiISLVV~ 1.V1~lYV1VL'1V1J oWt. RS CAS# 100.00 Propane Yes 74986 t1HGEiKL 1~J ~JtSJ.71~11;1V-1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi -4- 01/26/2007 F CALIFORNIA CARE CENTER SiteID: 015-021-000375 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: SEVERAL LOCATIONS CAS# 7782-44-7 ~GasATE T TYPE PRESSURE ~ TEMPERATURE ~~ CONTAINER TYPE I Pure Above Ambient I Ambient I PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 2000.00 FT3 2000.00 FT3 I 1000.00 FT3 - t~~r~ttLUUS wlnrulv~iv l,~ %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 ri1~GL~i1[L A~~1";~51~11"~1V 17 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low -5- 01/26/2007 F CALIFORNIA CARE CENTER SiteID: 015-021-000375 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/09/1999 ~ CALL 911. Employee Notif./Evacuation 10/16/2006 ALL DISASTER WARNINGS OR REQUESTS FOR ASSISTANCE WILL BE CONFIRMED, IF POSSIBLE, AND THE FACILITY ADMINISTRATOR WILL BE INFORMED. IF THE ADMINISTRATOR DETERMINES THE SITUATION WARRANTS DISASTER PLAN PROCEDURES, ALL STAFF ON DUTY WILL BE INFORMED BY THE CODE WORD CODE TRIAGE BEING PAGED THREE TIMES. Public Notif./Evacuation DETAILED EVACUATION PLAN POSTED THROUGHOUT FACILITY. 05/12/1992 Emergency Medical Plan 12/09/1999 NEAREST HOSPITAL. -6- 01/26/2007 F CALIFORNIA CARE CENTER SiteID: 015-021-000375 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 05/11/2006 ~ CONTINUOUS TRAINING AND FREQUENT UPDATES ON ALL MATERIAL THAT MAY PRESENT A HAZARD TO LIFE OR PROPERTY. Release Containment 05/11/2006 OXYGEN AND LAUNDRY BLEACH ONLY. Clean Up OXYGEN AND LAUNDRY BLEACH ONLY. 05/11/2006 v~.ucl iCC.7vuLl.:C 1'il:l.lVdl.lVil -7- 01/26/2007 F CALIFORNIA CARE CENTER SiteID: 015-021-000375 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ _, ,_ ..~Nc~.ia.-. naaaiu~ Utility Shut-Offs 01/26/2007 A) GAS - W SIDE EXIT NEAR LAUNDRY RM B) ELECTRICAL - ELECT RM S SIDE NEAR DELIVERY ENT C) WATER - S SIDE NEAR DELIVERY ENTR D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 05/11/2006 NEAREST FIRE HYDRANT - ALL CRNRS OF BLDG. Building Occupancy Level 01/23/2006 145 EMPLOYEES -$- 01/26/2007 .. .% F CALIFORNIA CARE CENTER Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 05/11/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: REGULAR MONTHLY TRAINING MEETING. t'dl~. C L nciu ivi ru~.uic vac raciu ivt ru~uic ~~c -9- 01/26/2007 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACIIJT'/ NAME ADDRESS FACILITYCONTACT ~rr' `~ SPED VN DATE I Ij+IJPtl.11Vrv IIMt it ~ 3 -- -, ZONE No. No. of Employees siness ID Number 15-021- da"~375 Section 1: Business Plan and Inventory Pn~gram ^ Routine ^ Combined ^ Joint Agency ^Mu1ti-Agency O Complaint ^ Re-inspection C V l V=V'o aplonnce l OPERATION COMMENTS ^ ` APPROPRIATE PERMIT ON HAND ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE / ,~ ~ ~ Q'~L' ~~ ~ N/~ijyl/j / ~~ - VISIBLE ADDRESS ~(/Qi _ -~ . _ - _ - - _ __- p- y RRECT OCCUPANCY ~ ---~ ^ VERIFICATION OF INVENTORY MATERIALS ~o v~ _ - /~- .~ -- --ate/6s ~ ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAtLABILITYE ^ VERIFICATION OF FIAT MAT TRAINING '~~ ~^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES I~~~r n~ '---N /)7-0Q 9 ---------- - -- - ~ 1 ^ EMERGENCY PROCEDURES ADEQUATE - - ~/~-((// ~ = ~-~ ~~ ~ ~ - CONTAINERS PROPERLY LABELED -- - --~ --_ - d I,,IOUSEKEEPING ! r~ ^ ~ FIRE PROTECTION ~ v ~~ ~~'~ v ~~^ SITE DIAGRAM ADEQUATE $c ON HAND ANY HAZARDOUS WASTE ON SITE?: ^ YES rI0 \\~_ EXPLAIN: tiv~ r~,~-~ i6~ ~~ QUESTIONS REG NG THIS INSPECTIONS PLEASE CALL US AT (661 ~ 3ZG-3979 ----- r ~ O__ ~_T_r_ y ___ Inspecto~ ~ Badge Nod White • Environmental Services ......_ Business Site Responsible Party Yellow - Stettin Copy Pink -Business Copy ~~ ~. -_ ;, CALIFORNIA CARE CENTER SiteID: 015-021-000375 Manager ROCIO RUBIO-BUSBY Location: 2211 MT VERNON AVE City BAKERSFIELD BusPhone: (661) 872-2121 Map 103 CommHaz Extreme Grid: 22C FacUnits: 1 AOV: CommCode: BFD STA 08 EPA Numb: SIC Code:8051 DunnBrad: Emergency Contact / Title Emergency Contact / Title ROCIO RUB IO-BUSBY / ADMINISTRATOR FRANK GUTIERREZ / ENV DIRECTOR Business Phone: (661) 872-2121x4012 Business Phone: (661) 872-2121x4015 24-Hour Phone (661) 302-3924x 24-Hour Phone (661) 871-1479x Pager Phone ( ) - x Pager Phone (661) 472-7517x Hazmat Hazards: Fire Press ImmHlth Contact ROCIO RUBIO-BUSBY Phone: (661) 872-2121x MailAddr: 2211 MT VERNON AVE State: CA City BAKERSFIELD Zip 93306 Owner KINDRED HEALTHCARE Phone: (661) 872-2121x Address 680 S FOURTH AVE State: KY City LOUISVILLE Zip 40202 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD ENT'D 0 C T 15 2007 C3ased on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that 1 have personally examined and am familiar with the information submitted and believe the information is true, a crate, , d com ete. o.~.~ _ 1~ . d~~ ~ Signature Date -1- 07/10/2007 r F CALIFORNIA CARE CENTER ~ Hazmat Inventory ~ MCP+DailyMax Order = = SiteID: 015-021-000375 ~ By Facility Unit ~ Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP LAUNDRY BLEACH IH L 200.00 GAL Hi PROPANE E F P IH G 200.00 FT3 Hi OXYGEN F P IH G 2000.00 FT3 Low -2- 07/10/2007 5 -3- 07/10/2007 F CALIFORNIA CARE CENTER SiteID: 015-021-000375 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME LAUNDRY BLEACH Days On Site 365 Location within this Facility Unit Map: Grid: SEVERAL LOCATIONS CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture T Ambient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Cont5100rGAL Daily 200100m GAL I Daily 100r00e GAL t11jLGKKLV U.7 1.V1~lYV1VI;1V 1.7 %Wt. RS CAS# 100.00 Clorox Bleach No 7681529 t'lL-~LGLitCL 1d.7.7JJJ.71~1~1V 1 ~J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Hi ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: SE REAR BLDG CAS# 74-98-6 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas TPure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 FT3 200.00 FT3 200.00 FT3 I1HI~KCCLVU.'~ 1..V1~lYV1VrJ1V 1.7 %Wt. RS CAS# 100.00 Propane Yes 74986 ntiatucl~ tj ~al;~~ril;lyt~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT#$ MCP No No No No/ Curies F P IH j / / Hi -4- 07/10/2007 F CALIFORNIA CARE CENTER SiteID: 015-021-000375 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: SEVERAL LOCATIONS CAS# 7782-44-7 = STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas TPure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 2000.00 FT3 2000.00 FT3 1000.00 FT3 T 1'fTT /Y/1LlT l~LtT17T PY rujc~xtcLVU~ ~.vi~irvlvr.ivla oWt. RS CAS# 100.00 Oxygen, Compressed No 7782447 tif~iGF~tCL F1:uJL' aJP/11";1V'1"~7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No Noj Curies F P IH / / / Low -5- 07/10/2007 s. ~ S F CALIFORNIA CARE CENTER SiteID: 015-021-000375 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/09/1999 ~ CALL 911. Employee Notif./Evacuation 10/16/2006 ALL DISASTER WARNINGS OR REQUESTS FOR ASSISTANCE WILL BE CONFIRMED, IF POSSIBLE, AND THE FACILITY ADMINISTRATOR WILL BE INFORMED. IF THE ADMINISTRATOR DETERMINES THE SITUATION WARRANTS DISASTER PLAN PROCEDURES, ALL STAFF ON DUTY WILL BE INFORMED BY THE CODE WORD CODE TRIAGE BEING PAGED THREE TIMES. Public Notif./Evacuation 05/12/1992 DETAILED EVACUATION PLAN POSTED THROUGHOUT FACILITY. Emergency Medical Plan 12/09/1999 NEAREST HOSPITAL. -6- 07/10/2007 F CALIFORNIA CARE CENTER SiteID: 015-021-000375 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 05/11/2006 ~ CONTINUOUS TRAINING AND FREQUENT UPDATES ON ALL MATERIAL THAT MAY PRESENT A HAZARD TO LIFE OR PROPERTY. Release Containment 05/11/2006 OXYGEN AND LAUNDRY BLEACH ONLY. Clean Up OXYGEN AND LAUNDRY BLEACH ONLY. 05/11/2006 V1.11Ci 1<C w7VULl.,C Yll. l.lVQl~1 V11 -7- 07/10/2007 F CALIFORNIA CARE CENTER SiteID: 015-021-000375 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ oNc~:.~.ai naaaiua Utility Shut-Offs 02/28/2007 GAS - W SIDE EXIT NEAR LAUNDRY RM ELECTRICAL - ELECT RM S SIDE NEAR DELIVERY ENT WATER - S SIDE NEAR DELIVERY ENTR Fire Protec./Avail. Water NEAREST FIRE HYDRANT - ALL CRNRS OF BLDG. 05/11/2006 Building Occupancy Level 145 EMPLOYEES 01/23/2006 -8- 07/10/2007 w' e~ F CALIFORNIA CARE CENTER SiteID: 015-021-000375 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 05/11/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: REGULAR MONTHLY TRAINING MEETING. rc~yC L riclu ivt r u~.utc vac nciu i.vi ru~..uic vac -9- 07/10/2007 UNIFIED PROGRAM INSPECTION CHECKLIST. SECTION 1 Business .Plan and Invry Program • Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661) .326-3979 __ _ _ FACILITY NAME (" ~ ~ WSPECTION DATE INSPECTION TIME ---CA~1~Q~1-~-- ~E----`~'-~'° lE~_._....._._..._.._..._._....__._.__....._._.._..........___..__._.. /0._2-0.5.-- -~-~---~?i-"~.._- AODRESS PHONE No. No. of Employees FACILITYCONTACT Business ID Number 15-021- ~Do 3 ~7S Section 1: Business Plan and Inventory Program ^ Routine Combined ^ Joint Agency OMulti-Agency O Complaint ^ Re-inspection C V \ V=vro ationnCe l OPERATION COMMENTS ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE r 1 L J ^ APPROPRIATE PERMIT ON HAND ANY HAZARDOUS WASTE ON SITE?: ^ YES @/ NO EXPLAIN: • QUESTIONS REGARDING THIS SPECTION~ PLEASE CALL US AT ~6t)~ ~ 326-3979 --- -~~f -~--- - _ ._.._--- ------ ------- ---- --~~ ---- ---- ... - ---- Inspector (PI Print) Fire Prevention 1st-In/Shik of Site While -Environmental Services Yelkrnr - Station Copy Busi Site Responsible Party (Plea Print) Pink -Business Copy