HomeMy WebLinkAboutBUSINESS PLANI DOUGLAS FAMILY CHILDCARE
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F~RE PREVENTION INSPECTION
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• BAKERSFIELD FIRE DEPT.
a ~ R s F , ,, D Prevention ~erbices ~ ~~ " ~2c
FIRE 900 Truxtun Ave., Ste. 210 ; ~jj ~~~
ARTM t Bakersfield, CA 93301 ~~
Tel.: (661) 326-3979 ^ Fax: r(661) 85 -2171 j
DISTRICT BLOCK NO. ' '% ~i , ,~ DATE yaw /"'1/
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FACILITY ADDRESS ~ ~ r ~ 9~ CITY, STA E, ZIP ,,,,,,
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FACILITY NAME. ~ - ^`h FACILIQTY PHONE NO.
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BUSINESS OWNER'S NAME AND ADDRESS V I CITY, STA ,ZIP ; WNE 'S PHONE NO.
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BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, ` BILLING PHONE'NO.
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OCC TYPE OCC LOA
~"'~ NO. OF F LOORS HIGH RISE BUG RISER D T
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CORRECT ALL VIOLATIONS VIOLATION , , REQUIREMENTS
CHECKED BELOW eo.
COMBUSTIB
E WASTEIDRY 1 Remove and safely dispose of all haiardous refuse and dry vegetation on the above premises (U.F.C.)
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VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage of combustible waste and rubbish pending its•,
safe disposal. (U.F.C.)
COMBUSTIBLE STORAGE 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse tiox/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 tha '`5 feet above the floor. (N.F.P.A. No. 10)
EXTINGUISHERS 5 Provide and install (amount)f'"____ approved (type & size) __________________ portable fire extinguisher t0 be
immediately accessible~fo~'use=in (area) _____________________________ (U.F.C.)
g Re-charge all~fi~ecextinguishers. Fire extinguishers shall be serviced 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~ma •ntain "EXIT" sign(s) with letters 5 or more inches in height over each required exit (doorlwindow) to
SIGNS fire escape. (U.F~'C.)
g Provide and maim 'n pP'~ I numbers on a contrasting background and visible from the street to indicate the
correct a of ~ui4dYh (B.M.C.)(U.F.C.)
g it II crackslholeslopenings) in plaster in (location) ______________________________________. Plastering
FIRE DOORS/ all return the surface to its original fire resistive condition. (U.B.C.)
FIRE SEPARATIONS
10 Removelrepair (item & location) ____________~ .r'f_ _______________________________________. 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
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closing device. (U.F.C.)
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ExlTS 11 Remove all obstruction from hallways. Maintain all means of egress free: of any storage. (U.F.C.)
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Proovid~e a contrasting colored and permanently in"sfalled*electric light ove~iornear required exit (location)
__ ___________ _____ to clearly indicate it as,an exit. (U.F.C.)
STORAGE 1g Remove all storage and/or other obstructions from fire escape landings and stairways stair shafts. (Fire
escapes/stair shafts arelto~-beF4maintained free from obstructions at all times.) (U.F.C'.)
14 Extension cords shall not be ulsed in lieu of permanent approved wiring. Install additional approved electrical outlets
ELECTRICAL APPLIANCES whe;emsneeded. (N. E. C.) (U.F.C.)
15 Remo~e multiple attachment cords from specific electrical convenience outlet (one plug per outlet) (N.E.C.) (U.F.C.)
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oUTDOORBURNING 16 V~i'ola"
-tiori"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 ardin fireworks.
OTHER 1g
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CUSTOMER: "'7 ,_.-gyn. -,~a n~,v- .L~ cs.a-a ~.,.:,-. i
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, LEGEND:
C.F.C. CALIFORNIA FIRE CODE
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Signature ~ (Please Print Name Legib U.B.C. UNIFORM BUILDING CODE
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~ B.M.C. BAKERSFIELD MUNICIPAL CODE
INSPECTOR: ~
AP NO.: N.F.P.A. NATIONAL FIRE PROTECTION
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(Signature) ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
Ktlh-/3CU
White -Customer/Original ~ Yellow -Station Copy Pink -Prevention Services
FD 2022 (Rev. 09105)
71
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STATE OF CNJFOFy~' : *`•y ~"
FIRE SAFETY INSPECTION REQUEST
sTD. eso (REV. io-e4)
See lnstructlons on reverse.
AGENCY CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAM
COMMUNITY CARE LICENSING 559 243-4023 09/26/06 109
EVALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE
PATRICIA POLANCO - 0399/MA 153806688 3A
RESPONSE REQUIRED coDEs
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~ i. ORIGINAL A. FIRE CLEARANCE
ucENSING-
STATE DEPT. OF SOCIAL SERVICES 2. RENEWAL B. LIFE SAFETY
AGENCY
NAEAEAND COMMUNITY CARE LICENSING ~ a. CAPACITYCHANGE
ADDRESS 770 E. SHAW AVENUE, SUITE 300 4. OWNERSHIP CHANGE
FRESNO, CA 93710-7785 s. ADDRESSCHANGe
6. NAME CHANGE
7. OTHER
AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY
CAPAGTY PREVIOUS CAPACITY CAPACITY PREVIDUS CAPACITY CAPACITY PREVIOUS CAPACITY
14 14
FACILITY NAME I-ICENSE CATEGORY
TYMARA DOUGLAS FCC
STREET ADDRESS (Actual Location) NUMBER OF BUILDINGS
5809 SPRING BLOSSOM one
GTY RESTRaNr
BAKERSFIELD, CA 93313 none
FAGUTY CONTACT PERSON'S NAME HOURS
DOUGLAS,. TYMARA 661 834-4558 DAYS
sPEGAL coNOmoNS
"PLEASE CHECK ALL ROOM INCLUDING THE GARAGE"
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s a's€ '~'~:TQ BE,~DMgPt~E.Tl~b ~Y IN3PEC€ ~ NQ A~~~ ~,~€° _ ~~"
CLEARANCE /DENIAL CODE
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CODES
FlRE gAKERSFIELD FIRE PREVENTIC 1. IRE CLEARANCE GRANTED
AUTHORITY
NAME AND g00 TRUXTON ST #210 2. FlRECI.EARANCEDENIED
ADDRESS gAKERSFIELD, CA 90001 " oars
B. CONSTRUCTION
C. FIRE ALARM
MtSPECTOR'S NAME (Tjyod or r1ntM) TELEPHONE NUMBER CRRS NUMBER OCCUPANCY CLASS D. SPRINKLERS
~y ~ ~ ) / / C E. HOUSEKEEPING
~S / /'l..~l °' ~...-• V 9 ~L ~Jr / ~ . 7L~ ~ .j J ~ ~`~ F. SPECIAL HAZARD
WSPECiIONDATE INSPECTORS (~TUR ypadorP' ) G. OTHER
EXPtAlN DENTAL OR SPEGAL CON TKNJS~ ) 1 ~
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