Form Cms-2786v - Fire Safety Survey Report - Icf-Iid (Small Facilities) 2012 Life Safety Code Page 37
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41Name of Facility
2012 LIFE SAFETY CODE
PART IV – BUILDING SERVICES
ID
NOT
MET
N/A
REMARKS
PREFIX
MET
(New and Existing Facilities)
K500
Building Services – Other
List in the REMARKS section any LSC Section 32.2.5 and 33.2.5 Building
Services 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.
K511
Utilities – Gas and Electric
Equipment using gas or related gas piping complies with NFPA 54, National
Fuel Gas Code, electrical wiring and equipment complies with NPFA 70,
National Electric Code.
32.2.5.1, 33.2.5.1, 9.1.1, 9.1.2
K521
HVAC
Heating, ventilation, and air-conditioning equipment comply with 9.2.1
and 9.2.2, except as otherwise permitted by Chapter 33.
32.2.5.2.1, 33.2.5.2.1
K522
HVAC – Any Heating Device
No stove or combustion heater are located to block escape in case of
fire caused by the malfunction of a heater or stove.
Unvented fuel-fired heaters shall not be used in any residential board
and care facility.
32.2.5.2.2, 33.2.5.2.2
Form CMS-2786V (10/2016)
Page
37
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