HomeMy WebLinkAboutBUSINESS PLAN
~yLEANO'S RESIDENTIAL CARE HOM~EI
~ ~ (2804 TAR SPRING ~~
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BAKERSFIELD FIRE DEBT.
Prevention Services ~F""~~ ~~uf ~
." FIRE PREVENTION INSPECTION a EF11BE t ~ 90o Truxtun Ave., Ste. 210 ~ ~~ ~ r~nn.
AR111I T Bakersfield, CA 93301
Tel.: (661) 326-3979 ^ Fax: (661) 852-2171
DISTRICT BLOCK NO. DATE
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FACILI Jib '~µ ( ft
t I CITY, STATE, ZIP ~
FACILIT NAME
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,1 ~ FACILIT.>P ONE Ny -~ (
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BUSINESS OWNER'S NAME AND ADDRESS CITY, STATE, IP PHONE N~O. r
OW~R'S
BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BIL4ING PH NE NO.
~ ~
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OGC ~E OCC •9AD NO. OF FLOORS HIGH RISE BL G R D TE
RI E
(/ "Q)~ ^ YES NO /
/
CORRECT ALL VIOLATIONS vio~~rioN REQUIREMENTS /'
CHECKED BELOW No.
COMBUSTIBLE WASTE /DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above pr s
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 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.)
g Re-charge all fire extinguishers. 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 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 contrastin k o d i f 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 & 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. 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 Bakersfield Munici al Code B.M.C. re ardin fireworks.
OTHER 1g A
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CUSTOMER: LEGEND:
C.F.C. CALIFORNIA FIRE CODE
(S~ tUre) (Please Print Name Legibly tle) U.B.C. UNIFORM BUILDING CODE
B.M.C. BAKERSFIELD MUNICIPAL CODE
INSPECTOR: /
AP NO.: _ N.F.P.A. NATIONAL FIRE PROTECTION
_
(Signature ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05)
~i
STATE OF CALIFORNIA
FIRE SAFETY INSPECTION REQUEST
See lnstructlons on reverse.
sTV. esa IREV. ~as4)
AGENCY CONTACTS NAME TELEPHONE NUMBER REpUEST DATE PROGRAM
COMMUNITY CARE LICENSING 559 243-8080 11/08/06 109
EVALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE
#200 DIANA CHAPMAN #155801090 7A
RESPONSE REQUIRED cones
1. ORIGINAL A. FIRE CLEARANCE
l1CENSING ~ TATE DEPT OF SOCIAL SERVICES 2. RENEWAL B. LIFE SAFETY
AGENCY
NAI~AEAND Community Care Licensing Branch 3. CAPACITY CHANGE
ADDRESS 770 E. Shaw Avenue, Suite 330 4. OWNERSHIP CHANGE
Fresno, CA 93710 5. ADDRESS CHANGE
6. NAME CHANGE
7. OTHER
AMBULATORY NONS.9~BULATORY BEDRIDDEN TOTAL CAPACITY
CAPAgTY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY
-0- -0- -6- -6- - - 6
FAGUTY NAME LICENSE CATEGORY
LEANO'S RESIDENTIAL CARE HOME 740 RCFE
STREET ADDRESS (Actwl Loceflon) NUMBER OF BUILDINGS
2804 TAR SPRING AVENUE 1
CITY RESTAAIN7
BAKERSFIELD CA. 93313 ~ NONE
FAgUTY CONTACT PERSON'S NAME HOURS
LUCY LEANO LICENSEE 24 HOURS
sPEgAL coNDmoNs
TELEPHONE:: 1-661-831-3430
REQUESTING USE OF MASTER BEDROOM FOR RESIDENTS
CITY OF BAKERSFIELD
ARE 900 TRUXTON AVE
STE #210
AUTHORITY ,
NA~IEAND BAKERSFIELD, CA. 93301
ADDRESS .
L
NrSPECTOR'S NAME (Tjyod a PrhbdJ ~ TELEPHONE NUMBER
CFlRS NUMBER I OCCUPANCY CLASS
1. FIRE CLEARANCE GRANTED
2. FIRE CLEARANCE DENIED
A. EXITS
B. CONSTRUCTION
C. FIRE ALARM
D. SPRINKLERS
E. HOUSEKEEPING
F. 6PECULHAZARD
G. OTHER
EXPlA1N DENIAL OR LIST SPEGI
****** HP MFP Digital Sending: Delivery Confirmation ******
The following job has been successfully delivered to the
i specified recipient(s) and/or intermediate server.
---------------- Original message header ------------------
From: BFD HazMat 900 Truxtun - 10.1.17.55
Date: Wednesday, November 15, 2006 7:42:57 AM
Subject:
--------------------- Recipient List ----------------------
15592438088 [successful transmission]
G
l
11/08/2006 16:08 15592438088
CCLD FRESNO OFFICE
J 5~ t'~--I; ~ ~
CALIFORNIA DE~'A.RTMENT OF SOCIAL SERVICES
CO MMU.NI'I'k cARE LICENSING
CF,I~TTRAI:. CAL.T.FORNIA CHILDREN'S RESIDIr.NTIhL
PRF5N0 LOCAL UNIT
PAGE 01/02
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PI•IONE NIJT.tNls7t: SrND>ssli'S PNONTi NliMB$R:
(559) 243-80.'3D
R E:
Sr-.IVnr.,R'S FAX NUMbtsli:
(559) 243-888
CI URC:I•.rti'C Cl fiC)R R;;;\~1GW ^ YLCA.SF•. CUMMI;hIT ~ PLCA$F. REPLY D YLI:A$F. RL+'CYC.LR
77(1 >;. Slrnvn Av>?. suJ-rr•. 3~n
rrst;sNO, cn 9~7~n
PFiOAiPs: (559) 445-5G47
FAX: (354} d+FS-St197
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FIRE PREVENTION INSPECTION
,'4
t r~C`~
BAKERSFIELD FIRE DEPT.
B E R S P I D Prevention Services
FIRE 900 Truxtun Ave., Ste. 210
wwrir r Bakersfield, CA 93301
Tel.: (661) 326-3979 ^ Fax: (661) 85c12~-2~711c
DISTRICT BLOCK NO. DATE ~ EE ® ~
FACILITY ADDRESS CITY, STATE, 2 ~ /~
FACILITY NAME O t ~`~ , ~
-~'(/`~._ MANA R'S NAME FA ILITY PHONE NO.
BUSINESS OWNER'S NAME AND ADDRESS CITY, STATE, ZI OWNER S PHONE N
BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BILLING PHONE NO.
O PE OCC OAD NO. OF FLOORS HIGH RISE BLDG RIS T
^ YES NO
CORRECT ALL VIOLATIONS VIOLATION REQUIREMENTS
CHECKED BELOW No.
LE WASTE /DRY
OMBUS ~ Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.)
C
TIB
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 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) _ (U.F.C.)
----------------------------
6 Re-charge all fire extinguishers. 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.)
~ Provide and maintain "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 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 RemoveJrepair (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. 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 Bakersfield Munici al Code B.M.C. re ardin fireworks.
OTHER 16
CUSTOMER: LEGEND:
C.F.C. CALIFORNIA FIRE CODE
S' re (Please Print Name Legibl ,Title) U.B.C. UNIFORM BUILDING CODE
B.M.C. BAKERSFIELD MUNICIPAL CODE
INSPECTOR: AP NO.: N.F.P.A. NATIONAL FIRE PROTECTION
nature) ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
Knr-i~~u
White -Customer/Original Yellow -Station Copy Pink -Prevention Services
FO 2022 (Rev. 09/05)
11/0812006 16:08 15592438088
~~
m,~teaFCNt
Fif1E $r14FETY INSPECTIL7N REQUEST
AGB~IL7 CpMY1C19 M~fAE
COMMUNITY CARE LIGENSING
EV/YJIA70p'9 MnME
CCLD FRE5N0 OFFICE
~EPNONE NuM6E~+
(559 243-E3(380
REauE871NO AO~NG"f FiIC~TY ~
#155801094
RESPONSE REQUIRED
STATE DEPT OF SOCIAL SERVICES
w~iMEiu+a Gammunity Care Licensing Branch
,~noeESS 770 E. Shaw Avenue, Suite 33C)
Fresno, CA 937'Ip
L_ --,
-Q^ I -Q- ~ -fY- I '17-
RAC~I1YtMrE
LEAN4'S RESIDENTIAL CARE HOME
BtAF~T Aooa~e (Ashur iao~BOn)
2804 TAR SPRING AVENUE
Bee /nstruCNolw C~ft ro+~nos.
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PAGE 02102
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LUCY EANO LI ENSEE 24 HOURS
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TELEPHONE:: 1-661-837-3434
CITY OF BAKERSFIELD
~ 80fl TRUXTON AVE, STE #2'10
~~ BAKERSI"IELQ, CA. 933x1
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