HomeMy WebLinkAboutFAI15-0063 Fire Annual Inspection Archive6
ire Prevention Bureau Butte County Fire Rescue White Copy - Business
76 Nelson Avenue California Department of Forestry Yellow Copy — Occupancy File
roville, CA 95965 and Fire Protection Pink Copy — Station File
lephone 530-538-7888 Facility Inspection Report Occ. Class.
,ax 530-538-2105
Address: Business Name:
Owner/Mamger. Bus: Hm: Fax
Assistant Manager: Bus: Hm:
Building Owner. Bus: Hm:
Address:
AN INSPECTION OF YOUR FACILITY REVEALED THE FOLLOWING:
1. Fire Extinguishers: Required, service due 10. Exit(s) obstructed, inadequate
2. Extension cords: Excess use, defective 11. Exit sign(s) required, illumination
3. Excessive rubbish, trash, debris 12. Exit sign lights need replacing
4. Fire alarm system defective 13. Exit lighting: Required, defective
5. Sprinkler system: Service required, defective 14. Smoke detectors: Required, defective
6. Kitchen hood extinguishing system service due 15. Wiring: Exposed, damaged connectors, etc.
7. Fire walls, ceilings, fire doors, draft stops 16. Heating system: Defective appliance, flue combustibles
8. Knox Box keys ; "' 17. Address posted and visible from road
9. Fire Drill Witnessed Yes 0 No 0 18. Other
DETAILED EXPLANATION AND CORRECTIONS: CORRECTED:
:_ G
tJ i:do1114'C VA
Date:
Discussed with:
Signed:
Inspecting Officer:
Battalion 1 2 3 4 5,"6 7
Station: FPB,:
-
FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COOPERATION WITH
CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE:
Fire Prevention Bureau Butte County Fire Rescue White Copy - Business
176 Nelson Avenue California Department of Forestry Yellow Copy — Occupancy File
Oroville CA 95965 and Fire Protection Pink Copy — Station File
Telephone 530-538-7888 Facility Inspection Report Occ. Class.
Fax 530-538-2105
Address: Business Name: �'..
Owner/Manager: ., v h U Bus. k 2 - iL, % 7 Hm: Fax.
Assistant Manager: Bus: Hm:
Building Owner: Bus: Hm:
Address:
.,.r TxTe1D'VlrT7nAT n -U Vn1T1D Ti A!`TI.1TV RF.VF.A1.VD TAF FOLLOWING:
1.
Fire Extinguishers: Required, service due
10.
Exit(s) obstructed, inadequate
2.
Extension cords: Excess use, defective
11.
Exit sign(s) required, illumination
3.
Excessive rubbish, trash, debris
12.
Exit sign lights need replacing
4.
Fire alarm system defective
13.
Exit lighting: Required, defective
5.
Sprinkler system: Service required, defective
14.
Smoke detectors: Required, defective
6.
Kitchen hood extinguishing system service due
15.
Wiring: Exposed, damaged connectors, etc.
7.
Fire walls, ceilings, fire doors, draft stops
16.
Heating system: Defective appliance, flue combustibles
8.
Knox Box keys
17.
Address posted and visible from road
9.
Fire Drill Witnessed Yes ❑ No ❑
18.
Other
DETAILED EXPLANATION AND CURKLUTIUNno: %.UKRr%-1LJoe
Date: /
Discussed with:
Sign:
ed
(Print)g �j 0LTA/�11�'G '
, --- _ .=:-'
Officer:
_Inspecting
Battalion 1 2 3 4 5 6; 7
Station: T FPB
' (-
FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COUPERA-1.10N W11ti
CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE:
R E SAFETY INSPECTION REC' 'ST
STD. 00 (REV. 10-94) See instruc,._ ..ns on reverse.
A
Y CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAM
530 895-5033 09/25/98
TOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE
7/DONNA GURRIERE 045000712 1A
LICENSING � DEPARTMENT OF SOCIAL SERVICES
A ENCY COMIlM[JNITY CARE LICENSING
NA EAND 520 COHASSET ROAD, SUITE 6
A DRESS CHICO, CA 95926
L
CODES
1. ORIGINAL A. FIRE CLEARANCE
2. RENEWAL B. LIFE SAFETY
3. CAPACITY CHANGE
4. OWNERSHIP CHANGE
5. ADDRESS CHANGE
6. NAME CHANGE
7. OTHER
AMBULATORY
NONAMBULATORY
BEDRIDDEN
TOTAL CAPACITY
CAPACITY
PREVIOUS CAPACITY
CAPACITY
PREVIOUS CAPACITY
CAPACITY
PREVIOUS CAPACITY
0
6
6
FACT TY NAME
LICENSE CATEGORY
D NIELA'S COUNTRY HOME CARE
13RCF
STRE ET ADDRESS (Actual Location)
NUMBER OF BUILDINGS
17 COUNTRY WOOD LANE
1
CITY
RESTRAINT
0 OVILLE, CA 95965
NO
FAC1 UTY CONTACT PERSON'S NAME
HOURS
D NIELA OLTEANU (530) 532-1577
24
Al
N
CLEARANCE /DENIAL CODE
1. I-Nt UU AHANUL UHAN I tU
2. FIRE CLEARANCE DENIED
A. EXITS
B. CONSTRUCTION
C. FIRE ALARM
D. SPRINKLERS
E. HOUSEKEEPING
F. SPECIAL HAZARD
G. OTHER