HomeMy WebLinkAboutBUSINESS PLAN!1 GOLDEN SUNSET HOME ~
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GOLDEN SUNSET COURT
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FIRE~PREVENTION INSPECTION >I EF~RE I
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EAKERSFIELD FIRE DEPT. ~y
Prevention Services , _ . ~'.~~w
900 Truxtun Ave., Ste. 210 ~~
Bakersf eld, CA 93301
Tel.: (661) 326-3979 ^ Fax: (661) -2171
DISTRICT BLOCK NO. DATE ~"~I O~
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FACILITY ADDRESS O / L ~ („) ~ ~ ~j ~ ~ )
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FACILITY NAME ~ - j
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BUSINESS OWNER'S NAME AND ADDRESS CITY, STATE, ZIP OWNER'S PHONE NO.
BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BILLING PHONE NO.
OCC TYPE
~ OCC L/OAD NO. OF FLOORS
~ HIGH RISE~BLDG (RISER D~ATE~~
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CORRECT ALL VIOLATIONS VIOLATION v REQUIREMENTS T
CHECKED BELOW eo.
COMBUSTIBLE WASTE I DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.)
VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage of combustible .waste grid rubbish pending its
safe disposal. (U.F.C.)
COMBUSTIBLE STORAGE 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse box/fire door (N.E.C.) (U.F.C.)
4 Relocate fire extinguisher(s) so that they will be' in a conspicuous location, hanging on brackets with the top to the
extinguisher not more than 5 feet above the floor. (N.F.P.A. No: 10)
EXTINGUISHERS 5 Provide and install (amount) _____ approved (type 8 size) __________________ portable fire extinguisher to be
,; ~ immediately accessible for use in (area) _____________________________ (U.F.C.)
8 Re-charge all fire extinguishers. Fire extinguishers shall be serviced at least once each year,,andlor after each use,
by a person having a valid license or certificate. (U.F.C.)
7 ,t. ,
Provide and maintain "EXIT" sign(s) with letters 5 or more inches in height over each required exit (door/window) to
SIGNS fire escape.. (U.F.C.}.
g Protv~ide and maintain appropriate numbers on a contrasting back~r~~~n i o the street to indicate the
correct address of the building. (B. M.C.) (U.F.C.)
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9 tits .
Re air all cracks/holes/o enin s in taster in location ____^~trt,; Plastering
P ( P 9) P ( )-------------------------------
FIREDOORSI
FIRE SEPARATIONS shall return the surface to its original fire resistive condition. (U.B.C.) "~~
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10 Removelrepair (item & location) _________________________________________________________. Self=;closing
doors shall be designed to close by gravity, or by the action of a mechanical device, or by an approved smoke and
heat sensitive device. Self-closing doors shall have no attachments capable of preventing the operation of the
closing device. (U.F.C.)
EXITS 11 Remove all obstruction from hallways.. Maintain. all means of egress free of any storage. (U.F.C.)
12 Provide a contrasting colored and permanently installed electric light over or near required exit (location)
to clearly indicate it as an exit. (U.F.C.)
STORAGE 13 Remove all storage and/or other obstructions from fire escape landings and stairways stair shafts. (Fire
escapes/stair shafts are to be maintained free from obstructions at all times.)' (U.F.C.)
14 Extension cords shall not be used in lieu of permanent approved wiring. Iristall additional approved electrical outlets
ELECTRICAL APPLIANCES where needed. (N.E.C.) (U.F.C.)
15 Remove multiple attachment cords from specific electrical convenience outlet (one plug.per outlet) (N. E.C.) (U.F.C.)
OUTDOORBURNING
16 F .°"'-
Violation Of Section 1102 dealin With recreational fires Or.O en burnin U.F.C.
FIREWORKS 17 Violations of Section 7802 U.F.C. or 8.49.040 of the Bakersfield Munici aI Code B.M.C. re ardin fireworks.
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CUSTOMER: ~~ ~fi.~ s•... ~ ' t`~,ar...- ~t.%c.G'~L. (j LEGEND: fYttit ~C'> F'--
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(SI ature) (Please Print Name Legibly„Title) C.F:C. CALIFORNIA FIRE CODE r
U.B.C. UNIFORM BUILDING CODE~j ~-
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INSPECTOR: ~ ~ AP NO.: _ B.M.C. BAKERSFIELD'MUNICIPAL CODE
N.F.P.A. NATIONAL FIRE PROTECTION
(SlgnatUre) ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
White -Customer/Original Yellow -Station Copy Pink -Prevention Services ~ FD 2022 (ReV. 09/05)
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STATEOF ~l~(
FIRE SAFETY INSPECTION REQUEST ~ ~~~
' See lnstructlons on reverse.
sTD. eso IREV. ; o-e~)
AGENCY CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAM
COMMUNITY CARE LICENSING 559 243-8080 006/05/07 109
EVALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE
~#0200 DIANA CHAPMAN # 157204011 1A
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' CODES
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RESPONSE REQUIRED
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- FIRE CLEARANCE
ORIGINAL A
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Gr~S' U
.LICENSING STATE DEPT OF SOCIAL SERVICES
~ 2. RENEWAL B. LIFE SAFETY
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AGENCY ~ ~ %
NAME AND Community Care Licensing Branch ~j 3. CAPACITY CHANGE
ADDRESS 770 E. Shaw Avenue, Suite 330 4. OWNERSHIP CHANGE
Fresno, CA 9371 O 5. ADORESSCHANGE
B. NAME CHANGE
7. OTHER
AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY
CAPACITY PREVOUS CAPAgTY CAPACITf PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY
--0-- -0- -6- -0- -0- -0- 6
FACILTY NAME
GOLDEN SUNSET HOME
STREET ADDRESS (Adw/ LocatAmJ
_6004 GOLDEN SUNSET CT.
«TY
BAKERSFIELD, CA.
FACIUTY CONTACT PERSON'S NAME
DIVINIDAD LINES. C
sPECUL coNOmaNs
TELEPHONE: 1-661-
1
L{it1YJt (iA1CCiUYT
740 RCFE
NUMBER OF BUILDINGS
1
RESTRAINT
NONE
HOURS
24 HOURS
2 ~ `s
IAL CODE
TTY OF BAKERSFIELD
FIRE 1600 TRUXTON AVE. STE 401
AUTHORITY
NAMEAND BAKERSFIELD, CA. 93301
ADDRESS
----MISPECTOR'S-NAI~AE (Tjpd oa P~il(~ TELEPHONE NUMBER
-- -------- ------------------
N~SPECTION DATE INSPECTOR'S ypad a P
ExPLAIN DENUIL oR SPECIAL
ENT°D J u N 1 ~ 2ao~
CFiRS NUMBER OCCUPANCY CLASS
~l~
CODES
1~. SIRE CLEARANCE GRANTED
2. FlRECLEARANCEDENIED
A. EXITS
B. CONSTRUCTK)N
C, FIRE ALJIRM
D. SPRINKLER8
E. HOUSEKEEPING
F. SPECIAL HAZARD
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