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Home My WebLink AboutFAI15-0042 Fire Annual Inspection ArchiveATE OF CALIFORNIA IRE SAFETY INSPECTION REQUEST See instructions on reverse. TD. 850 (REV. 10-94 ) GENCY CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAM CDSS/COMMUNITY CARE LICENSING 530 895-5033 1/18/07 CCL VALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE 0107/MARGIE WHITAKER 045404929 4A CODES 1. ORIGINAL A. FIRE CLEARANCE LICENSINGS DEPARTMENT OF SOCIAL SERVICE 2. RENEWAL B. LIFE SAFETY AGENCY COMMUNITY CARE LICENSING NAME AND 520 COHASSET ROAD, SUITE 6 3. CAPACITY CHANGE ADDRESS CHICO, CA 95926 4. OWNERSHIP CHANGE 5. ADDRESS CHANGE [__!FAX # (530) 895-5934 6. NAME CHANGE 7. OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY 21 0 21 FACILITY NAME LICENSE CATEGORY E CENTER HEAD START PROGRAMS - BOUCHER STREET CENTER 850 STREETADDRESS (ActualLocation) NUMBER OF BUILDINGS 1312 BOUCHER STREET CITY RESTRAINT CHICO NO FACILITY CONTACT PERSON'S NAME HOURS JOANNE AIELLO (53 0) 9 �r � 7LL 9exl.M-F 7AM - 6PM �� 1 SPECIAL CONDITIONS CHANGE OF OWNEERSHIP (THIS LOCATION IS CURRENTLY LICENSED FOR 21 CHILDREN) TO BE COMPLETED BY INSPECTING AUTHORITY CLEARANCE/DENIAL CODE F I CODES 1. FIRE CLEARANCE GRANTED FIRE BUTTE COUNTY FIRE DEPT. AUTHORITY 176 NELSON AVE. NAME AND 2. FIRE CLEARANCE DENIED OROVILLE, CA 95965.-3425 ADDRESS A. EXITS I ATTN: STEVE FOWLER I B. CONSTRUCTION ` C. FIRE ALARM D. SPRINKLERS INSPECTOR'S NAME (Typed orPrinted) TELEPHONENUMBER CFIRS NUMBER OCCUPANCY CLASS E. HOUSEKEEPING ( } F. SPECIAL HAZARD G. OTHER INSPECTION DATE INSPECTOR'S SIGNATURE(TypedorPrinted) EXPLAIN DENIALOR LIST SPECIAL CONDITIONS ire Prevention Bureau Butte County Fire Rescue ' ate Copy -Business 76 Nelson Avenue California Department of Forestry Yellow Copy —Occupancy File roville, CA 95965 and Fire Protection Pink Copy —Station File elephone 530-538-7888 Facility Insnection Report Occ. Class. S---3 Fax 530-538-2105 pddress:Business Name:LZ099, Owner g us: � � Hm: Fax: Assistant Manager: Bus:- Hm: Building Owner. Bus: Ham►: 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 19- Fire Drill Witnessed Yes 0 No 18. Other DETAILED EXPLANATION AND CORRtCTIONS: CORRECTED: S f Date: �/ Discussed ith:��" � Signed: l6 � ) % ' � J (Print) �L��Gi�if'�G< - ina Officer: Battalion 1 2 3 A 5 6 7 1 Station: FPB ...dZ I FIRE PREVENTI N SAVES LIVES, PROPERTY, AND BUS SS. Y COO TION WT CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED., RE -INSPECTION DATE: ,,�+'' � n I m - S 17ATE OF CALIFORNIA IRE SAFETY INSPECTION REQUEST See instructions on reverse. STD. 850 (REV. 10-94) ;ENCY CONTACTS NAME TELEPHONE NUMBER DSS/COMMUNITY CARE LICENSING 530 895-5033 ALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER vIARGIE WHITAKER 045404523 .ICENSING DEPARTMENT OF SOCIAL SERVICES AGENCY COMMUNITY CARE LICENSING JAIME AND 520 COHASSET ROAD, SUITE 6 ADDRESS CHICO, CA 95926 REQUEST DATE PROGRAM 9/29/05 CCL REQUEST CODE 4A 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 APACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY .21 _ 0 21 ACILITY NAME LICENSE CATEGORY BUTTE COUNTY HEAD START - BOUCHER STREET 850 TREETADDRESS (ActualLocation) NUMBER OF BUILDINGS 1312 BOUCHER STREET ITY RESTRAINT CHICO NO ACILITY CONTACT PERSON'S NAME HOURS ANGELA KREMER (530) 345-5496 DAYS IAL CONDITIONS DING CDI MANAGEMENT COMPANY TO EXISTING FACILITY LICENSEE TO BE COMPLETED BY INSPECTING AUTHORITY FIRE BUTTE COUNTY FIRE DEPARTMENT AUTHORITY 176 NELSON AVE. NAME AND OROVILLE, CA 95965-3425 ADDRESS NSPECTOR'S NAME (Typed orPrinted) TELEPHONE NUMBER 'ION DATE INSPECTOR'S SIGNATURE(TypedorPrinted) 011 DENIALOR LIST SPECIAL CONDITIONS ....._.....___..... _....._._._ _ _ _.. _._ . _ _..: _........ _ ---- CFIRS NUMBER r OCCUPANCYCLASS CLEARANCE/DENIAL CODE CODES 1. FIRE CLEARANCE GRANTED 2. FIRE CLEARANCE DENIED A. EXITS B. CONSTRUCTION C. FIRE ALARM D. SPRINKLERS E. HOUSEKEEPING F. SPECIAL HAZARD G. OTHER ire Prevention Bureau 76 Nelson Avenue )roville, CA 95965 telephone 530-538-7888 ax 530-538-2105 Address: 1 r2 Butte County Fire Rescue California Department of Forestry and Fire Protection Facility Inspection Report Business Name: Adw White Copy - Business Yellow Copy — Occupancy File Pink Copy — Station File Occ. Class. Owner/Manager: Bus -&-G Hm: Fax: Assistant Manager: Bus: Hm: Building Owner: Bus: Hm: / AN iNCPFVT1nN nF VnITR FACH.1 rV RFVRALFJ) THF. FOLLOWING: 1. Fire Extinguishers: Required, service due 0. Exit(s) obstructed, inadequate 2. Extension cords: Excess use, defective 11. Exit sign(s) required, illumination 3. Excessive rubbish, trash, debris V 12. Exit sign lights need replacing 4. Fire alarm system defective A13. 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 6. Heating system: Defective appliance, flue combustibles 8. Knox Box keys X V 17. Address posted and visible from road 9. Fire Drill Witnessed Yes No ❑ 18. Other DETAILED EXPLANATION AND CORRECTIONS: CORRECTED: Date: Discussed with: Signed' In a =g*., (34)Battalion 1 2 3 5 6 7 Station: r , } �_s_�_� FPB ,�� FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COOPERATIR W CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE: ire Prevention Bureau r 76 Nelson Avenue roville, CA 95965 elephone 530-538-7888 ax 530-538-2105 Address: T! ! Z Manager: Owner: Butte County Fire Rescue California Department of Forestry and Fire Protection Facility Inspection Report Business Name: Bus: Bus: Bus: White Copy - Business Yellow Copy — Occupancy File Pink Copy — Station File Occ. Class. C- 3 Hm: Hm: Hm: Fax: .,.T Ymolowg"rrrnxTnv vnrT]D Ti AI-n.FTV RFVF.AT.F.D TAF, FOI.I.OWING: 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. i Knox Box keys 17. Address posted and visible from road 9. Fire Drill Witnessed Yes ❑ No 18. Other - ` c S" t1TTAn'Un VVVI ANAWHIN ANI) 1 A)HH1HA 17UIry>: l %jXkr .l.irli. Date: Discuss d with: Signed: —, �� - Z v o - not 04 afR� �'�I lie Ins cti g Officer: Battalion 1 2 3( 5 6 7 Station: '-p-A C • c FPB FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINCSS. YOUK UUUrEJKA11UA W11I1 CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE: