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Home My WebLink About021-320-011 CF ArchiveSeptember f2, 1994 r- A j nzwII1. mra- �f 3dA2Sc OPS 94-1 FIRE cLEEARANCE REQUESTS FOR ALCOHOLISM OR DRUG A13USE RECOVERY TREATMENT FACiLMES (R -S'S) `There are two r9cent changes in State iaw which affect your p ores In processing a fire clearance, (Standard Form 550, Fire Safety inspeot;on Request) from the Department of Alcohol and Drug ProgrMs (ADP) for licensed .Alcoholism or Drug Amuse, Recovery Treatment Facilities. The first involves. how you will be racerAng inspection requests. The second, an how to fll out ttw fire clearance farm. In th® past, when a prospective Ccamee submittod 2 licensing appncaflon, ADP in turn requested a fire clearance from you, tfie local fire authority. An inspection was then conducted relative to the number and ambulatory stag of the clients, teased upon the iron the provider subatted on their appr=tlon. However, �mbly j3�i 2160 (pier 741, S s -of U93) changed SeCtiOn 71834.x3 of the Health arm Safaty Code. This swtion deals with the d=m n to be suss milled by the pmt pecfive iii to ADP. Now, a person or entity aP*n9 for rrcerz= mast submit to ADP a Swndard Form 850 appraved by tht local fine authonty r -o . in other words, it is up to the provider to obtain an approved fire dcar=e before subrnlmg the Gcensinq package to ADP. You wi l naw tie wed diredY by ft Pier to obtain an approved fire cleararx-P- The Dgmrtrnert of Alcohol and DrUg Pro9t3M is a} -'D requesting that tonal fire s paciors indi to the trteo(rMum akowable capacity, including dependent e#ffldren, in t -)e *Total CapaW bock on ttv Standard Farm SM AAprovirs0 the n of the y w►T help assure ti -)e safety of cl@dren residing in Mable ooauanoy - Sion O AIBP ficenstd #aces- {:hMr'en edng n 2s defined � �$ V eir parent (s) and are not reeeiv � recovery regulzions- VAM fimg out the Foe Safety Inspedian Request, you must $PAY an the form the m=ber c f beds for ambulatory residents and the number of beds for nonarnbuWxry residents. You must also int'lude any restrictions regarding nonatmbutatory cieararCM, such as bmitafion to spec badmonm or the use of only DEPAK. MENT OF ALCOHOL AND DRUG ..06RAM8 ADDITIONAL INSTRUCTIONS FOR COMPLETING FIRE SAFELY INSPECTION REQUEST FORM A complete license.application requires a valid fire clearance for the facility to be- licensed.o ' The applicant is responsible for acquiring the fire clearance from the local fire Guth my. If you have questions regarding haw to fill out the form, please call the Department of Alcohol. and Drug Programs, Residential and Outpatient Programs Compliance Branch's Officer -of the -Day at (916) 322-2911. The following are instructions for completing the Fre Safety Inspection Aequest Form (STD 854): 1. Fill In- the Request Date" on the upper right hand side of the form. 2, X11 in the "total capacity' you are requesting in your facility. The "total capacit}�' . requested should equal to total occupancy' of the facility requested in Item 2B on portion A-1 of the application for licensure in the Initial Licensing Appocation Booklet You and the fire inspector should discuss the ambulatory and . nogambulatory capacities of the facility and complete those items on the request. It is also Important to note the follow/ng: a) 'Total occupancy' includes residents receiving recovery, treatment or detoxification services, children of the residents, and staff ('Wring at the facility.. b) If the "total occupancy( includes children of the residents, the maximum number of the children and their age limit shalt be specified on the fire clearance (e.g., total o«wpancY may include up to 6 children under 10 years of age). 3.. Fill in the facility name street address(s), number of buildings, city (state and zip code), contact person and special conditions. tf you are requesting one license for more than one address, list each address and capacity on the Std. 850 corm under the box titled "Special Cottdit{ons.' Please note that multiple addresses may require more than one license which would also require more than one fire clearance- . 4. The lower part of the form will be completed by the Fire Depa enta* 5. Also attached is an Information Bulletin (SFM 94-1) issued by the State dire Marshal which can be shown to fire inspection authoniies, if they question the inspection request procedure. 6. Contact your -local fire authority to schedule the inspection. Ensure they have jurisdiction for the address of the facility. to be licensed. (Note: This form should not be su6mitfed to the local Bre Inspector unless the applicant Intends to submit a complete 11canoe application booklet to the Department of Alcohol and Drug Program.) 7, P► completed licensing applicaUon must include_ an approved fire clearance prior to mailing the application to the Depafinent Imp -.... .� ,. rru'i ter+ c.�niC certain ftors.-As a reminder, a coca( jurisdiction ma}r not enforce any. fire and panic swblY re9utaiion in -an AAP facifiry unless the t egutadon has been adopted by the State Fie Marshal. If you have any questions regarding the processing of thg Fn Safety irIVOCU011 Request form for ADP ftolides, please C01 ON Department Ai Alwhol End tag Programs Liceming and CeMcqtjon Stanch . 1700 K Stream _ S8CM-Menb, C+4 95814 (JCC) 322,*2911 If �Osase ou hm any q r.�garriin9 aPAlic�on of any State FirsMMarsha!reguWom, . CCt'itact the ReglorjW Omee senft yow ares Northam Region Coastal Region Southam Region 1131 "S' Street 135 8ridgeway Ave. 1501 W. Cameron Ave. Sacramento 95$14 Santa Rosa 95407 West Covina 9179.0 (916) 445-8200 (707) 576-2993 (626).960.,6441. . nil A��r) F') .6 n ONE CODE$ 1 � ' j �11W � �.y • . • '4{1.�•'.M�A'�il••. w ^� .. •.. • . .M�. . �r I . .a...�M ./ �f • � ... .. .. f f 2. IMIEWAL -MM eDa,r#�t of Al 301 4& a.io �-r;gmS .. W AND 'de.� 6t Pi-o6�m �p!Fanoe Branch .. 3 s I:CAO K S.-Weet, T i"M moor ,�, rr , rte• i' E. t � � _.�....._._._..�..�_�._.�..�www..�..�.�. - �ttv,r..�,er• - lw. +.—�-�--�7e7R� +t i N /6 �r-er. e.b. 1A-11�C r •II •I I � � NOW I' roll - DOMES eft 6wAoo7 17!F: / �r ` v