HomeMy WebLinkAboutBUSINESS PLAN~i~~CTION RECORD
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1715 Chester, Ave.
Bakersf field, CA 93301
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FACILITY NAME: ~LL~~~ ~~ ~ ~-~~--~ Q .--- r`
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MANAGER NAME: ~ a' 1~-t'/C..~/10U'Z.~'Q FACILITY PHONE ~~ ~ ` ~ ~0
BUSINESS OWNER NAME, ADDRESS, ZIP CODE ~~~~ ~ ~ ~~ "~~
BILL TO: (IF DIFFERENT FROM ABOVE}--NAME, ADDRESS, ZIP CODE, PHONE No. r ' "`` ,~' ~~ ~»i ~;: ' ~ ~ `-
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OCC TYPE
~~ OCC LOAD
/~ No. OF FLOORS HI RISE BLDG.
YES O NO ~ RISER DATE
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VIOLATION NOTICE CORRECTION:
i. j ~ DATEbFREINSPECTION
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ENT'D MAR 13 2D~6
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NOTES
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INSPECTOR: ` _
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AP No. - ~~~ FIRE PREVENTION SERVICES
(661) 326-3979
WHITE ORIGINAL-OWNER YELLOW-INSPECTOR'S COPY PINK-FILE
FD1952
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FI~tE SAFETY INSPECTION REQUEST
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See lnstructlons on reverse.
AC3ENCY CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAM
COMMUNITY CARE LICENSING 559 243-8080 1/25/06 109
EVALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE
SHELLY KINKEAD 157203362 1A
RESPONSE REQUIRED cones
LICENSING l STATE DEPT. OF SOCIAL SERVICES ~ 1. ORIGINAL A. FlRECLEARANCE
i. RENEWAL B. uFESAFETY
AGENCY
NAiIEAND COMMUNITY CARE LICENSING
3. CAPACITYCHANGE
ADDRESS 770 E. SHAW, SUITE 330 4. OWNERSHIP CHANGE
FRESNO, CA 93710-7TH 5. ADDRESS CHANGE
6. NAME CHANGE
7. OTHER
AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY
CAPACITY PREVOUS CAPACITY CAPACITY PREYIOUS CAPACITY CAPACITY PREVIOUS CAPACRY
0 0 6 0 0 0 6
FACILffY NAME u~cnse ~n i cuvrii
RICHARD'S RESIDENTIAL CARE ELDERLY
STREET' ADDRESS (Adwl Locaflon) NUMBEA OF BUILDINGS
2904 EDMONTON STREET 1
CITY RE8IAAINT
BAKERSFIELD, CA 93309 NONE
FACILITY CONTACT PERSON'S NAME HOURS
LESLIE RICHARD (661) 398-0664 24 HOURS
sPECaLCONDmoNs
FIRE BAKERSFIELD FIRE DEPARTMENT
AUTHORRY
NAIIEAND g00 TRUXTON AVE., #210
ADDRESS BAKERSFIELD, CA 93301
II
L.
NISPECTOR'S NAME (iH~d or PriMadJ TELEPHONE NUMBER
~S71?i~r ~~~ c6G I) 3
OiSPECTION DATE INSPECTORS SI A17JRE (T a
3- /t~-D~ ~ _ .p-
CRRS NUMBER ~ OCCUPANCY CLABS
~IIAL CODI
CODES
IRE CLEARANCE GRANTED
2. FlRE CLEARANCE DENIED
A. EXITS
B. CONSTRUCTION
C. FlRE ALARM
D. S+RRlNIa.ERB
E. HOUSEKEEPING
F. SPECIAL HAZARO
G. oTHER
EXPWN oe~aAL oR LIST SPECUIL