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lip `~'L ABOARD CHILD CARE
i u~' 6809 RUSH POINT COURT~~
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4-~,~IRE PREVENTION INSPECTION
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BAKERSFIELD FIRE DEPT.
Prevention Services C
900 Truxtun Ave., Ste. 210 ~i V ~'
Bakersfield, CA 93301 ~r
Tel.: (661) 326-3979 ^ Fax: (661) 2-2171
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DISTRICT BLOCK NO. DATE ~ ~ EE rte.'
FACILITY ADDRES ~ CITY, STATE, ZIP `~ 33/3
F ILITY NAM
r ~ MANA ER'S NAME FACILITY PHONE N
ESS OWNER'S NAME AND ADDRESS -ems ~~ „~~,,,, CITY, STATE, 21P OWNER'S PHONE NO.
BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BILLING PHONE NO.
OC D NO. OF LOORS HIGH RISE BL G IS R ATE
""" OYES NO
CORRECT ALL VIOLATIONS v~o~~Tiow REQUIREMENTS
CHECKED BELOW wo.
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IB 1 Remove, and safely dispose of al'I azardous refuse and dry vegetati n on; t of above premises (U.F.C.)
LE WASTE /DRY
COMBUST
{
VEGETATION, 2 ombustible waste and rubbish pending its
Provide non _combustible containers with tight fitting lids for the s age of
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 & size) __________________ portable fire extinguisher to be
immediately accessible for use in (area) ___
- - g Re-charge all fire extinguishers. Fire extinguishers shal a viced at least once each year, and/or after each use,
by a person having a valid license or certificate. (U.F.C.)
7 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 Provide and maintain appropriate numbers on a contrasting background and visible from the street to indicate the
correct address of the building. (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. (U.B.C.)
10 Remove/repair (item & IocaGion) _________________________________________________________. 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 oftegress 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. Install 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.)
OUTDOOR BURNING 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 Baker field Munici al Code B.M.C. re ardin fireworks.
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OTHER 1g
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CUSTOMER: ~ ~ f ~ ~~ LEGEND:
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( g - ) (Please Print Name Legibly, Title) C.F.C. CALIFORNIA FIRE CODE
U.B.C. UNIFORM BUILDING CODE
B.M.C. BAKERSFIELD MUNICIPAL CODE
IN$PECTQR: AP NQ.: ~ N.F.P.A. NATIONAL FIRE PROTECTION
.
(Signature) ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
B E R S P I D
P/RE
ARTM T
White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05)
~~ -
TATE OF CAUF~NIA'F~'.
r
'IRE SAFETY INSPECTION REQUEST
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See Instructions on reverse.
i(`,ENCY CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAM
COMMUNITY CARE LICENSING 559 243-4042 11/22/06 109
VALUATORS NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE
GAYLE REMINE 153904190 5.A
RESPONSE REQUIRED coDEs
LICENSING ~TATE DEPT. OF SOCIAL SERVICES ~
AGENCY 1. ORIGINAL A. FIRE CLEARANCE
z. RENEWAL B. LIFE SAFETY
NAME AND COMMUNITY CARE LICENSING 3. CAPACITY CHANGE
ADDRESS 770 E. SHAW AVENUE, SUITE 300 4. OWNERSHIP CHANGE
FRESNO, CA 93710-778 s. ADDRESS CHANGE
6. NAME CHANGE
7. OTHER
AMBULATpRY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY
CAPACITY PREVIOUS CAPAgTY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY
14 8 - - - - 14
FACILITY NAME LICENSE CATEGORY
WEEKS. LETICIA FAMILY DAY CARE ~,
STREET ADDRESS (Adwl Location) NUMBER OF BUILDINGS
6809 RUSH POINT CT. ONE
cmr se~~-Tar.1.~r
BAKERSFIELD, CA 93313 NONE
FACILITY CONTACT PERSON'S NAME -
LETICIA WEEKS• ~- ~
y HOURS
DAYS
sPEaAL coNrxnoNs
PLEASE CHECK ALL ROOMS INCLUDING THE GARAGE.
_ ` y ~ r ' ; r '$ E, OMPI,EfEO'BY INSPECT1Nfi AUTtiLfRITY.•~t ~ , -
CLEARANCE IAL CODE
~
BAKERSFIELD FIRE DEPT CODES
.
FlRE p R EV E N TI O N SERVICES - F E CLEARANCE GRANTED
AUTHORITY
NAAIEAND g00 TRUXTUN AVE., ~21 O
ADDRESS BAKERSFIELD, CA 93301 2. FIRE CLEARANCE DENIED
B ONSTRUCTION
C, FIRE ALARM
PRINK
ERS
M~SPECTOR'S NAME (Typed or P
~ ~ t:,~( i t.~' j~G ~ TELEPHONE NUMBER
~~'~/ ~-~~ ~~X~~ CFIRS NUMBER
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l ~~v(•~ ~ OCCUPANCY CLASS L
D• S
E. HOUSEKEEPING
F.. $PECIAI.HAZ.AFiC
RiSPECT~DATE INSPECTORS ATU (Typed riitad)
~ _ G. OTHER
N DENIAL UST SPECYAL DI S