HomeMy WebLinkAboutBUSINESS PLAN-_~, .,,.+,..y...nr-iv.~r4v'nw4..W. -r .i , .•...IY- ._- .., .y..sv:..v, r . w .. .A, .. r..:y._........~ryd ° ~ - .. ~ ,. -. .. .... ~ , .
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;~~ ~ II~~PECTiON RECORD
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Bakersfield Fire Dept.
1715 Chester Ave.
Bakersf i~eld~CA 933J0.1~
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DATE: FACILITY ADDRESS: ZIP: FEE:
e
FACILITY NAME: -
MANAGER NAME: '
BUSINESS OWNER NAME, ADDRESS, IP CODE FACILI PHONE ~D
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BILLTO: (tF DIFFERENT FROM ABOVE}---NAME, ADDRESS, ZIP CODE, PHONE No.
OCC TYP • OCC LOAD/
C ~ No. OF FLOORS
l HI RISE BLD~
YES O NO'~ RISER DAT
VIOLATION NOTICE CORRECTION:
1. DATEbFREINSPECTION ~
2. ~, ~ ~ ~ e! A n.4 C" rM
3.
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5. ~~ ' l ~ ..~it,~ (~
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15.
NOTES
CUSTOMER: ~' ~~
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INSPECTOR: ~ ~ v.. r ~ ~ r----~-- AP No, ~ FIRE PREVENTION SERVICE
(661) 326-3979
WHITE ORIGINAL-OWNER YELLOW-INSPECTOR'S COPY PINK-FILE
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FD1952
STATE OF CALIFORNIA
IRE SAFETY INSPECTION REQUEST
srD. eso IaEV. To-tar>
See Jnstructions on reverse.
AOENCV CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAM
COMMUNITY CARE LICENSING 559 243-8080 1/26/06 109
EVALUATOR'S NAME REOUESTIN4 AGENCY FACILITY NUMBER REQUEST CODE
SHELLY KINKEAD 157203313 1A
RESPONSE RE
UIRED cones
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LICENSING STATE DEPT. OF SOCIAL SERVICES ~ - 1. ORIGINAL A. FIRE CLEARANCE
i. RENEWAL e. uFESAFETY
AGENCY
NAME AND COMMUNITY CARE LICENSING 3. CAPACITY CHANGE
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 PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY
0 0 6 0 0 0 6
FACILTY NAME uCitnDt Get tt3clrsr
JOHN'S HAVEN ASSISTED LIVING ELDERLY
STREET ADDRESS (Adwl Location) NUMBER OF BUILDINGS
3717 MOUNT CELESTE 1
CRY RESTRAINT
BAKERSFIELD, CA 93313 NONE
FACILITY CONTACT PERSONS NAME HOURS
MARGUERITE BRUTON (6611 664-7673 24 HOURS
sPECUL coNDmo-+s
ARE BAKERSFIELD FIRE DEPARTMENT
AUTHORRY
NAYEAND g00 TRUXTON AVENUE #210
ADDRESS BAKERSFIELD, CA 93301
RIfiP£CTOR'S NAME (Tjgoad or PrkNa~ TELEPHONE NUMBER
M~SPECTION DATE tNSPE (rypW a P
~RE CLEARANCE GRANTED
2. FIRE CLEARANCE OENIED
A. ExITs
B. CONSTRUCTION
C. FIRE ALARM
CFIRS NUMBER OCCUPANCY CLASS D. SPRINKLERS
E. HOUSEKEEPING
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5 i ~ ~,~j ~,v~-- F. SPECIAL FiA7ARD
G. oTHER
E7~WN DETNAL QR uST SPECIAL GONDITK>rIS