HomeMy WebLinkAbout850s INSPECTIONS'~ a ~.
J&MHOME ~
_8930 LORELEI ROCK DRIVE
- --- --
lI
l~
i
l!
~1
i,
~~
STATE OF CALIFORNIA
FIRE SAFETY INSPECTION REf~UEST
sro ~~~ ,o-wl See Insfructlons on reverse.
AGENCY CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAM
COMMUNITY CARE LICENSING 559 243-8080 8/2/07 109
EVALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE
LORI BECK 157204024 1 A
RESPONSE REQUIRED CODES _
~
~ i. ORIGINAL A. FIRECLEARANCE
LICENSING
STATE DEPT. OF SOCIAL SERVICES 2. RENEWAL B. LIFE SAFETY
AGENCY
NAIIEAND COMMUNITY CARE LICENSING 3. CAPACITYCHANGE
ADDRESS 770 E. SHAW, SUITE 33O 4. OWNERSHIPCHANGE
FRESNO, CA 93710-778 5. ADDRESS CHANGE
6. NAME CHANGE
7. OTHER
AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY
CAPACITY PREVOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVOUS CAPACRY
0 0 4 0 0 0 4
FACILITY NAME LICENSE CATEGORY
J & M HOME _____ ADULT RESIDENTIAL
STREET ADDRESS (Adwl Loc~tlon) NUMBER OF BUILDINGS
8930 LORELEI ROCK DRIVE 1
CITY RESTRNNT
BAKERSFIELD, CA 93306 NONE
FACILITY CONTACT PERSON'S NAME Nouns
LATONYA JACK<SON (66.11 333-4462 24 HOURS
sPECIAL coNDmoNs
FlRE KERN COUNTY FIRE DEPARTMENT
AUTNOR(TY
NAYEAND 5642 VICTOR STREET
ADDRE8S BAKERSFIELD, CA 93308
J
MISPECioR'S NAME (TyP~d W PYtIAtdJ TELEPNONE NUMBER
DATE INSPECTOR'S (Typal a PrhNd)
EXPLAw DErxAL SPECUIL S
CFlRS NUMBER OCCUPANCY CLABS
~ ~~ 2 2
IpENIAL CODE
CODE8
E CLEARANCE GRANTED
2. FIRE CLEARANCE DENIEQ
A. EXITS
B. CONSTRUCTION
C. FIRE ALARM
D. SPRINKLERS
E. HOUSEKEEPING
F. BPECIAI HAZARD
G. oTHEa
,}°«F~ra.r k~, g, at "i+^ir~:. '~ ,?3f XR.2~',y~. '~ + .rte ~,n isr':~ii#n. t.$t1`~, ~ y~` ~.N",;n~;~.y~ i'v ^Tyia.-+ir«,w .y . «=,.. ~,s q~;p~
i~ j '°`e~`"t ,~„'Ti~w,~``~*•+~=~' ,#f ' ~ '~-~~ ~5?; 't~~a`- :t~' 1?~^`~?~M~.~"~ `'~2~$'A t: ~f.'~`~-'y ~' ~~
`'~'~~" BAKERSFIELD FIRE DEPT:
i
~~~
~.
` B 13 R"S P 1 o Prevention Services mm ~.
',.FIRE P~REVEl~T~ON INSPECTION FARE 90o Truxtun Ave'., ste: 2io - ~( ~'' g'" .. I
ARTM T `'~/1/
- Bakersfield, :CA 93301 (,/
Tel.: (661) 326-3979 , ~' Fax:. (661 52-2171.
, . ;.
DISTRICT BLOCK NO. ~ DATE ~,~" `~ ( """`7 EE ~.. , ~ j,
FACILITY ADDRESS' r ~ (J CITY, STATE, ZIP
FACILITY NAME + r ~ MANAGER'S NAME FACILITY PHONE NO.. .
BUSINESS OWNER'S NAME AND ADDRESS ~ ~ r' CITY, STATE, ZIP ( ~ ', OWNER'S PHONE.NO.• _ `~. '
BILL TO: (IF DIFFERENT FROM ABOVEI NAME, ADDRESS ,, CITY, STATE, ZIP, BILLING PHONE NO.
OCC~TIPE OCC LOAD
"~~ NO. OF FLOORS
j.. HIGH RISE BLDG
r
~~ RISER DAT,~ECL~.~ ,
~''
' F
'
~ ~~
.NO
^ YES '
_
/
CORRECT ALL VIOLATIONS vwc~noN ~• t '. REQUIREMENTS !r , r
CHECKED BELOW eo. ~ '
COMBUSTIBLE WASTE /DRY 1 Remove and safely dispose of alLhazardous 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 and r,tibbish:pending;ifs_,
safe disposal. (U:F.C.)
COMt3u$TIBLE. STORAGE 3. Relocate combustible storage to provide at least 3 feet clearance around motor ftise. box/fire door (N..E.C:) ,(U.F.C.)
j
v i
4 ,
Relocate fire ex(inguisher(s) so that they will be in a conspicuous location; hanging on~brackets with-the top to the .~
extinguisher not more than 5 feet abo4e the floor.; (N.F.P.A. No. 10) ,.%,j„- ,~, -
EXTINGUISHERS S Provide, arid install (amount) _____.approved (type & size) __________________ portable fire extinguisher to be; ,
' • .immediately accessible for use in .(area) ___ _______________ (U.F.C.) ; : '.
g Re-charge all fire extinguishers.. Fire extinguishers shall be.serviced at least once each. year, and/or"after each user. ,
by a Person having a valid license or certificate. (U.F.C.) '
~ Provide and maintain "EXIT" sign(s) with letters 5' or more inches in height over each required exit'(do'or/window) to
SIGNS. fire escape. (U.F.C,)
g Proyi,da and maintain appropriate numbers on.a co b kJ~L a~d i rom the street;to, indicate the
JV~
1
d
d
~ ~~1
,
. ~/ L~
correct address of the buil
ing. (B.M:C.) (U.F.C.)
*
g Repair all (cracks/holes/openings) in plaster in (location) ________ •____________________________. ,Plastering
FIRE DOORS/
FIRE SEPARATIONS shall return the surface to its original fire resistive condition. (II.B.C.)
10, Remove/repair (item 8 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)
fo 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 obstrtictions at all times.) (U.F.C:)
14 :Extension cords shall not be used in lieu of permanent approved wiring. Install .additional. approved electrical outlets
ELECTRICAL APPLIANCES- `' ~' where needed. (N.E:C.) (U.F.C.) ,
15 Remove multiple attachment cords from specific electricatconvenience outlet (one plug per outlet) (N.E.C.) (U.F:C.).
OUTDOORBURNINO 16 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 al Code B.M.C. re ardiri fireworks:
OTHER r''~ ~ X 18 ~ t / - e J .,~"~ n.
~'-~ ~.%~' ~ ~ . / rA ~ ~.!% ~ ! r"C_ ~ .! r~ .t . t~ . ~j 'a ~~~! ~ n ~> ~r2_-~ .mot '
- - /, -
%~'~
~~ R
~' - ~' r A,~' ~+
?, ~`"~~;:
{ '.~'"' f r `" ~~° ~~ ~
CUSTOMER:
.
~~'~.~
~;`
"! /
~ r •
,~~ ~ r~ r: lit r t' C Le~END: , .
.
,
.
.
.~
.
.
.
"''. I"r'(Slgnatu~e) ~ ~ (Please Print Name Legibly., TItIe)
f,,~ /'-*~,
f ~- 1
~ G.F:C. .CALIFORNIA FIRE.CODE
U.B C UNIFORM'BUILDINGCODE -
B.M C BAKERSFIELD MUNICIPAL CODE
.,
INSPECTOR:' r'`
~ t ~;h
/l J
~'i`~/i
`ti
(}}`
AP NO
'
~
t"~+ N
F
P
NATIONAL FIRE PROTECTION -
A
.
.-
,
,
,:._
.
.:
~:.~
..
~ .r, ., y. f
~(S19patUf@) ~ -
' ^
~ .
.
.
..
•. AS.SOCIAT.ION .
.
". „~ /
{
" N.E.C. NATIONAL~ELECTRIC CODE, . ,
~ ,.....
'I White- Customer/Original Yellow Station.Copy . , Pink -.Prevention Services
. FD 2022 (Rev. 09/05)
STATE C~F CaJFORNIA
FIRi' SAFETY INSPECTION REQUEST
srn. aso (REV. io-a~)
See lnstrucilons on reverse.
'r
AGENCY CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAM
COMMUNITY CARE LICENSING 559 243-8080 8/2/07 109
EVALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE
LORI BECK 157204024 1 A
RESPONSE REQUIRED cones
LICENSING ~ STATE DEPT. OF SOCIAL SERVICES ~ 1. ORIGINAL A. FIRE CLEARANCE
2. RENEWAL B. LIFE SAFETY '
AGENCY
NAME AND COMMUNITY CARE LICENSING s. CAPACITYCHANGE
ADDRESS 770 E. SHAW, SUITE 33O 4. OWNERSHIP CHANGE
FRESNO, CA 93710-778 5. ADDRESS CHANGE
6. NAME CHANGE
7. OTHER
AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY
CAPACITY PREVIOUS CAPAgTY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY
0 0 4 0 0 0 4
FAGUTY NAME LICENSE CATEGORY
J & M HOME ADULT RESIDENTIAL
STREET ADDRESS (Adw/ LocatbnJ NUMBER OF BUILDINGS
8930 LORELEI ROCK DRIVE 1
crTr RESTRaNr
BAKERSFIELD, CA 93306 NONE
FACIUTI CONTACT PERSON'S NAME HOURS
LATONYA JACi<SON (6611 333-4462 24 HOURS
sPEC~AL coaomoNs
..' ~2= 3:••,O" 1. ~', .f.;. '~1 .. ELI.,.
/DENIAL CODE
I
CODES
FlRE KERN COUNTY FIRE DEPARTMENT
AUTHORITY F ECLEARANCEGRANTEp
NAME AND 5642 VICTOR STREET 2. FlRECLEJIRANCEDENIED
ADDRESS gAKERSFIELD, CA 9.3308 '` °`I'~
B. CONSTRUCTION
C. FIRE ALARM
MtSPECTOR'S NAME (Tyyad a P~ TELEPHONE NUMBER CF1RS NUMBER OCCUPANCY CLASS D• $PRINFU.ERS
~
~~~'~~ 5...,tiJ r~_
~~ji (~ ~$"'~,
r ~~~,.~J~j
~ 2 E. HOUSEKEEPING
F. SPECIAL HAZARD
p! p9
ECnON DATE
X INSPECTORS R (1}padaPii~ta~ G. OTHER
r
C
J
EXPWN DENIAL U SPECIAL S