Form Cms-2786v - Fire Safety Survey Report - Icf-Iid (Small Facilities) 2012 Life Safety Code Page 36
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41Name of Facility
2012 LIFE SAFETY CODE
ID
NOT
PART III– NEW RESIDENTIAL BOARD & CARE OCCUPANCIES
MET
N/A
REMARKS
MET
PREFIX
IF NEW RESIDENTAL BOARD AND CARE OCCUPANCY,
STOP HERE & CONTINUE TO PART IV AND PART V.
Form CMS-2786V (10/2016)
Pag
e
36
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