Form Cms-2786u - Fire Safety Survey Report - Asc & Esrd 2012 Life Safety Code Page 26
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39Name of Facility
2012 LIFE SAFETY CODE
ID
NOT
MET
N/A
REMARKS
PREFIX
MET
Engineered Smoke Control Systems
K771
When installed, engineered smoke control systems are tested in
accordance with established engineering principles. Test documentation is
maintained on the premises.
20.7.7.1 through 20.7.7.3, 21.7.7.1 through 21.7.7.3
Portable Space Heaters
K781
Portable space heating devices shall be prohibited in all health care
occupancies. Except, when used in nonsleeping staff and employee areas
where the heating elements do not exceed 212 degrees Fahrenheit (100
degrees Celsius).
20.7.8, 21.7.8
Construction, Repair, and Improvement Operations
K791
Construction, repair, and improvement operations shall comply with 4.6.10.
Any means of egress in any area undergoing construction, repair, or
improvements shall be inspected daily to ensure its ability to be used
instantly in case of emergency and compliance with NFPA 241.
20.7.9.1, 20.7.9.2, 21.7.9.1, 21.7.9.2
PART II – HEALTH CARE FACILITIES CODE REQUIREMENTS
Health Care Facilities Code – Other
K900
List in the REMARKS section, any NFPA 99 requirements (excluding
Chapter 7, 8, 12, and 13) that are not addressed by the provided K-Tags,
but are deficient. This information, along with the applicable Health Care
Facilities Code or NFPA standard citation, should be included on Form
CMS-2567.
Fundamentals – Building System Categories
K901
Building systems are designed to meet Category 1 through 4 requirements
as detailed in NFPA 99. Categories are determined by a formal and
documented risk assessment procedure performed by qualified personnel.
Chapter 4 (NFPA 99)
Gas and Vacuum Piped Systems – Other
K902
List in the REMARKS section, any NFPA 99 Chapter 5 Gas and Vacuum
Systems requirements that are not addressed by the provided K-Tags, but
are deficient. This information, along with the applicable Life Safety Code or
NFPA standard citation, should be included on Form CMS-2567.
Chapter 5 (NFPA 99)
Form CMS-2786U (10/2016)
Page 26
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