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INSPECTION RECORD
Bakersfield Fire Dept.
1715 Chester Ave.
Bakersf ie)d, CA 93301,x,
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2 ~ 66 FACILITY ADDRESS:
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FACILITY NAME: ~,; .,
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MANAGER NAME: FACILITY PHONE ~ .~ ~` ""
BUSINESS OWNER NAME, ADDRESS, ZIP CODE ---" " - _
BILL TO: (IF DIFFERENT FROM ABOVE}-NAME, ADDRESS, ZIP CODE, PHONE No.
OCC TYPE OCC LOAD No. OF FLOORS HI RISE BLDG.
YES O NO O RISER DATE
VIOLATION NOTICE CORRECTION: DATE OFREINSPECTION
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CUSTOMER: ~~ B~ ~ mod? /ice /1/'J
INSPECTOR: •
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AP No. ~c~ ~ ~ ~'J FIRE PREVENTION SERVICES
(661) 326-3979
WHITE ORIGINAL-OWNER YELLOW-INSPECTOR'S COPY PINK-FILE
FD1952
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STATE OF CAUFOANIA
FARE SAFETY INSPECTION REQUEST
sro. eso tREV. iaes>
See Jnsfruct/ons on reverse.
AGENCY CONTACT'S NAME TELEPHONE NUMBER REQUEST DATE PROGRAM
COMMUNITY CARE LICENSING 559 243-4023 2-2-06 109
EVALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE
PATRICIA POLANCO 153903329 1A
RESPONSE REQUIRED coDEs
~ 1. ORIGINAL A. FIRECLEARANCE
LICENSING ~TATE DEPT. OF SOCIAL SERVICES 2. RENEWAL B. UFESAFETY
AGENCY
NAME AND COMMUNITY CARE LICENSING
3. CAPACITY CHANGE
ADDRESS 770 E. SHAW, SUITE 3OO 4. OWNERSHIP CHANGE
FRESNO, CA 93710 5. ADDRESS CHANGE
6. NAME CHANGE
7. OTHER
AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY
CAPACITY PREVIOUS CAPAgTY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY
1~ 14
FAGLITY NAME
RENARDO, MERAB & VICTORIO FCC
STREET ADDRESS (AcYw/ Location)
2902 GRANDVIEW LANE
CITY
BAKERSFIELD 93313
FACILITY CONTACT PERSONS NAME
MERAB RENARDO (661
sPEaAL coNanoNs
LICENSE CATEGORY
FAMILY CHILD CARE
NUMBER OF BUILDINGS
1
RESTRAINT
HOURS
DAYTIME
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,
~ ~ ~ :. -~ BI: COhIPL~T~D ~Y {N8PECT{NO, AUT}}0 =Y .„
CLEARANCE /DENIAL CODE
BAKERSFIELD FIRE DEPT. ~ cones
FlRE g00 TRUXTON AVE. #210
AUTHORITY
NAME AND BAKERSFIELD, CA 93301
ADDRESS
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MISPECTOR'S NICE (Tjyad a P~iMad) TELEPHONE NUMBER
~ECT10N DATE INSPECTORS SIGNATURE (fypW a Printed}
25a _~i~ ~---
2. FIRE CLEARANCE DENIED
A. EXITS
B. CONSTRUCTION
C. FIRE ALARM
CFlRS NUMBER OCCUPANCY CLASS i]. SPRINRLER3
E. HOUSEKEEPING
'~'Z3 S ~-~ F. SPECIAL HAZARD
G. OTHER
EXPwN DEeaAL. oR usT SPECIAL coNanoNs