Attachment P_SVH DOM Large Board and Care Life Safety Checklist.pdf

VHA State Veterans Home Per Diem Program Domiciliary

Physical Environment Inspection Report

Checklist for Existing Large Board and Care Facilities

All Code References are from NFPA 101-2012 according to 38 CFR Part 51.350

This checklist is a summation of the requirements found in Chapter 33, Existing Residential Board and Care

Occupancies of the 2012 Edition of the Life Safety Code. This checklist is not intended to be comprehensive.

The user is cautioned to consult the code prior to answering the following questions. (current as of 1-10-2021)

Facility Name:

Facility Address:

Date Inspected:

Inspected By:

Number of Residents: Evacuation Capability: *

*Method used to determine evacuation capability, need to determine if Prompt, Slow or Impractical to begin the inspection:

1) Timed evacuation drills: (Time: minutes)

2) Definition in 3.3.76 and A.3.3.76:

3) NFPA 101A:

Item Standard Reference Yes No NA

General

1-1

If the board and care occupancy is in the same building with other occupancies, and if the board and care occupancy has a single means of egress, does the sole means of egress only pass through residential or healthcare occupancies?

33.1.3.1 33.1.3.3

1-2

In a building containing multiple occupancies, is the board and care occupancy NOT located above a non-residential or non-healthcare occupancy unless one of the following conditions is met?

(1) The board and care occupancy and exits therefrom are separated from the nonresidential or non-health care occupancy by construction having a minimum 2-hour fire resistance rating, or;

(2) The nonresidential or non-health care occupancy is protected throughout by an approved, supervised automatic sprinkler system and the occupancy is separated by construction having a minimum 1-hour fire resistance rating.

33.1.3.4

VHA State Veterans Home Per Diem Program

Existing Large Board and Care Facilities, NFPA 101-2012

Item Standard Reference Yes No NA

Minimum Construction Requirements

1-3 Does the building construction meet the basic requirements of NFPA 101, Table 33.3.1.3? [See last page for Table 33.3.1.3.]

[One and two-story facilities may be of any construction type that meets the requirements for one-hour or greater fire resistance rating, is Type IV (2HH), is fully sheathed, or is fully sprinkler protected.]

[One-story facilities having 30 or fewer residents with prompt evacuation capability with egress directly to the exterior at ground level may be of any type of construction.]

33.3.1.3

Means of Egress - Components

2-1 Do doors in exit enclosures and doors in high hazard content areas swing in the direction of egress and are all doors that are required to swing in the direction of egress tested annually?

[Doors of individual living units that open directly into an exit enclosure do not have to swing in the direction of exit travel.]

7.2.1.4.2 33.7.7

2-2 Are the doors in the means of egress compliant with the following?

(1) Doors complying with 7.2.1 shall be permitted. Minimum width shall be in accordance with 7.2.1.2.3.1(1) through 7.2.1.2.3.2(9).

(2) Doors within individual rooms and suites of rooms shall be permitted to be swinging or sliding.

(3) No door in any means of egress, other than those meeting the requirements of (4) or (5) below, shall be locked against egress when the building is occupied.

(4) Delayed-egress locks in accordance with 7.2.1.6.1 shall be permitted.

(5) Access-controlled egress doors in accordance with 7.2.1.6.2 shall be permitted.

(6) Revolving doors complying with 7.2.1.10 shall be permitted.

33.3.2.2.2

2-3 Are doors and associated hardware in good repair? 4.6.12.1

Item Standard Reference Yes No NA

Means of Egress - Capacity

2-4 Is the width of a corridor serving an occupant load of 50 or more in facilities having prompt or slow evacuation capability, and all facilities having impractical evacuation capability, a minimum of 44 inches?

[Corridors widths serving an occupant load less than 50 in facilities having a prompt or slow evacuation capability may be a minimum width of 36 inches.]

33.3.2.3.3

33.3.2.3.4

Means of Egress – Number

2-5 Are at least two separate exits provided on every story and are two separate exits accessible from every part of every story?

33.3.2.4

2-6 Are the exit stair enclosures (and space beneath, if present) free of storage?

[Enclosed, usable space is permitted under stairs, provided that the space is separated from the stair enclosure by the same fire resistance rating as the exit enclosure. Entrance to such enclosed usable space shall not be from within the stair enclosure. (See also 7.1.3.2.3.)]

7.2.2.5.3

7.2.2.5.3.2

Means of Egress – Arrangement

2-7 Are common paths of travel 110 feet or less in existing facilities?

[Common paths of travel are permitted up to 160 feet if the facility is sprinkler protected throughout.]

33.3.2.5.2

33.3.2.5.3

2-8 Are dead-end corridors no greater than 50 feet?

33.3.2.5.4

Means of Egress - Travel Distance

2-9 Is the travel distance within any room, suite or living unit to a corridor door 75 feet or less?

[Travel distance within any room suite or living unit to a corridor door may be up to 125 feet, if the building is sprinkler protected throughout.]

33.3.2.6.1

33.3.2.6.2

2-10 Is the travel distance between any room door and the exit 100 feet or less?

[Travel distance from a room door to an exit may be up to 200 feet for exterior ways of exit access. Travel distance from a room door to an exit may be 200 feet if the building is sprinkler protected and the exit access is separated by rated construction (1 hr., for 3 stories or less, 2 hr. for >3 stories.)]

33.3.2.6.3.1

33.3.2.6.3.2 33.3.2.6.3.3

Means of Egress - Discharge

2-11 Does the exit discharge comply with 7.7?

33.3.2.7

2-12 Are exit stairs that continue beyond the level of exit discharge provided with an approved means to dissuade occupants from traveling past the level of exit discharge (physical barriers)?

7.7.3.2

Item Standard Reference Yes No NA

Means of Egress - Lighting and Marking

2-13 Is emergency lighting provided to illuminate the means of egress for either of the following:

(1) in a facility having an impractical evacuation capability, or

(2) in a facility having a prompt or slow evacuation capability when the facility has more than 25 sleeping rooms?

[In a facility having prompt or slow evacuation capability, if each sleeping room has a direct exit to the outside of the building at ground level, no emergency lighting is required.]

33.3.2.9

2-14 Is the means of egress marked appropriately with exit signs?

33.3.2.10

Protection - Vertical Openings

3-1 Are vertical openings protected in accordance with 8.6?

[Unprotected vertical openings not part of required egress are permitted where such openings do not endanger required means of egress, provided that the building is protected throughout by an approved automatic sprinkler system and the exits and required ways of travel thereto are adequately safeguarded against fire and smoke within the building, or where every individual room has direct access to an exterior exit without passing through a public corridor.]

[In buildings two or fewer stories in height, unprotected vertical openings are permitted provided that the building is protected throughout by an approved automatic sprinkler.]

33.3.3.1.1

33.3.3.1.1.2

33.3.3.1.1.3

3-2 Are all floor openings, from floors below the level of exit discharge that are used only for storage, heating equipment, or purposes other than residential occupancy, to floors used for residential occupancy protected?

33.3.3.1.3

Protection - Hazardous Areas

3-3 Are exits arranged such that they are not adjacent to, or located above, rooms that contain high-pressure boilers, refrigerating machinery, transformers or other service equipment subject to possible explosion?

33.3.3.2.1

3-4 Are hazardous areas in facilities with prompt or slow evacuation capability protected in accordance with (1) or (2) below; and are hazardous areas in facilities having impractical evacuation capability protected in accordance with (3) below?

(1) One-hour fire-rated enclosures with self-closing fire doors, or

(2) Automatic sprinkler protection (no door required), or

(3) Automatic sprinkler protection and smoke partitions in accordance with 8.4.

33.3.3.2.2 33.3.3.2.3

Protection - Interior Finish

3-5 Are interior wall and ceiling finishes Class A or Class B?

[In sprinkler-protected facilities, Class B coverings may be used where Class A is required, and Class C may be used where Class B is required.]

33.3.3.3.2

10.2

Item Standard Reference Yes No NA

Protection - Corridors and Separation of Sleeping Rooms

3-6 The requirements for walls, doors, and door hardware for corridors and for sleeping rooms are based on one of the six following options. Select the option (in Items 3-6A to 3-6F below) for the facility and place an “X” in the N/A column for those options not used.

Option 1: Building sprinklered throughout.

Option 2: Prompt evacuation, not >2 stories, with a protected path from sleeping rooms.

Option 3: Prompt evacuation, not >2 stories, with not > 30 residents.

Option 4: Detection and limited furnishings in path to exit from other than sleeping rooms.

Option 5: Sprinklers in corridor and in center of each doorway on corridor.

Option 6: No sprinkler protection in facility.

Notes:

(1) Sleeping rooms are always required to be separated.

(2) At least one egress path that is separated from all other spaces (protected) to an exit is required from all resident use areas in all options except Options 1, 2, and 4.

(3) At least one egress path that is separated from all other spaces (protected) to an exit is required from sleeping rooms in all options except Option 1 and Option 4.

33.3.3.6

3- 6A

Option 1: Where sprinkler protection is provided throughout the facility:

Sleeping Rooms:

Walls constructed as smoke partitions, door must resist the passage of smoke (No hardware requirements but should have a latch.) (33.3.3.6.6.3)

Other than Sleeping Rooms:

No requirements (except for hazardous areas in impractical facilities).

33.3.3.6.1.1

33.3.3.6.3.2 33.3.3.6.4.3

33.3.3.6.6.3

Item Standard Reference Yes No NA

3- 6B

Option 2: Prompt evacuation capability facilities in buildings two or fewer stories in height, where not less than one required means of egress from each sleeping room provides a path of travel to the outside without traversing any corridor or other spaces exposed to unprotected vertical openings, living areas, and kitchens, shall not be required to comply with 33.3.3.6.1

Sleeping Rooms:

(1) Walls ½ hour fire resistance rating, and

(2) 20-minute doors or solid bonded wood core doors or equivalent, and

(3) Doors equipped with automatic closer or self-closer with occupant control locks.

Other than Sleeping Rooms: No requirements for walls and doors provided they are not part of the one required protected path from the sleeping rooms. If on the path from a sleeping room, then:

(1) Walls ½ hour fire resistance rating, and

(2) 20-minute doors or solid bonded wood core doors or equivalent, and

(3) Doors equipped with a self or automatic closer.

33.3.3.6.1 33.3.3.6.1.2

33.3.3.6.2

33.3.3.6.3.1

33.3.3.6.4

33.3.3.6.6.1 33.3.3.6.6.2

33.3.3.6.1.2

33.3.3.6.6

33.3.3.6.4

33.3.3.6.6.1

3- 6C

Option 3: Prompt evacuation capability facilities in buildings two or fewer stories in height, and that house not more than 30 residents.

Sleeping Rooms:

(1) Walls constructed as smoke partitions, and

(2) 20-minute doors or solid bonded wood core doors or equivalent, and

(3) Doors equipped with automatic closer or self-closer with occupant control locks.

Other than Sleeping Rooms:

(1) Walls constructed as smoke partitions, and

(2) 20-minute doors or solid bonded wood core doors or equivalent, and

(3) Doors equipped with a self or automatic closer.

33.3.3.6.1 33.3.3.6.3.3

33.3.3.6.2

33.3.3.6.3.3

33.3.3.6.4

33.3.3.6.3.3

Item Standard Reference Yes No NA

3- 6D

Option 4: Rooms or spaces, other than sleeping rooms, provided with a smoke detection and alarm system connected to activate the building evacuation alarm. Furnishings, finishes, and furniture, in combination with all other combustibles within the spaces, are of minimum quantity and arranged so that a fully developed fire is unlikely to occur. (Be careful when evaluating the item in bold.)

Sleeping Rooms:

(1) Walls ½ hour fire resistance rating, and

(2) 20-minute doors or solid bonded wood core doors or equivalent, and

(3) Doors equipped with automatic closer or self-closer with occupant control locks.

Other than Sleeping Rooms: No requirements.

33.3.3.6.1.3

33.3.3.6.4

33.3.3.6.6.1

33.3.3.6.1.3

3- 6E

Option 5: Where automatic sprinkler protection is provided in the corridor in accordance with 31.3.5.8 (sprinklers are required in the corridor and one in each corridor door opening inside the room centered on the door opening unless the door is 20-minute rated or solid bonded wood core).

Sleeping Rooms:

(1) Wall ½ hour fire resistance rating, and

(2) Door must resist the passage of smoke and have a latch.

(3) Doors equipped with automatic closer or self-closer with occupant control locks.

Other than Sleeping Rooms:

(1) Wall ½ hour fire resistance rating, and

(2) Door must resist the passage of smoke and have a latch.

33.3.3.6.4.4

33.3.3.6.4.4

33.3.3.6.4.4

3-6F Option 6: No sprinklers in existing building.

Sleeping Rooms:

(1) Wall ½ hour fire resistance rating, and

(2) 20-minute doors or solid bonded wood core doors or equivalent, and

(3) Doors equipped with automatic closer or self-closer with occupant control locks

Other than Sleeping Rooms:

(1) Wall ½ hour fire resistance rating, and

(2) 20-minute doors or solid bonded wood core doors or equivalent, and

(3) Doors equipped with a self or automatic closer.

33.3.3.6.1

33.3.3.6.2

33.3.3.6.3.1

33.3.3.6.4

33.3.3.6.6.1 33.3.3.6.6.2

33.3.3.6.6

33.3.3.6.3.1

Item Standard Reference Yes No NA

Protection – Subdivision of Building Spaces

3-7 Is every sleeping room floor divided into at least two smoke compartments of approximately the same size unless otherwise permitted by 1-3 below? [Smoke dampers are not required;

positive latching is not required on smoke barrier doors, and smoke partitions are permitted in lieu of smoke barriers on stories used for sleeping 30 residents or less]

(1) Buildings having a prompt or slow evacuation capability that are sprinkler protected are not required to have smoke barriers.

(2) Buildings having a prompt or slow evacuation capability where each sleeping room has an exterior way of exit access arranged in accordance with 7.5.3 are not required to have smoke barriers.

(3) Buildings having a prompt or slow evacuation capability where the aggregate length of the corridor on each floor is not more than 150 feet are not required to have smoke barriers.

33.3.3.7.1 33.3.3.7.2 33.3.3.7.7 33.3.3.7.8

33.3.3.7.4

33.3.3.7.5

33.3.3.7.6

Protection – Extinguishment Requirements

3-8 If there is a high-rise building, is it protected throughout by an automatic sprinkler system in accordance with NFPA 13?

33.3.3.5.3

3-9 If the facility has an impractical evacuation capability, is it protected throughout by a supervised automatic sprinkler system?

33.3.3.5.2

3-10 Where an automatic sprinkler system is installed in the facility and there is an attic in the facility, is the attic protected in accordance with (1) or (2) below?

(1) An attic used for living purposes, storage, or fuel-fired equipment is protected with automatic sprinklers that are part of the required, approved automatic sprinkler system in accordance with 9.7.1.1.

(2) An attic not used for living purposes, storage, or fuel-fired equipment meets one of the following criteria:

(A) Attic is protected throughout by a heat detection system arranged to activate the building fire alarm system in accordance with Section 9.6.

(B) Attic is protected with automatic sprinklers that are part of the required, approved automatic sprinkler system in accordance with 9.7.1.1.

(C) Attic is of noncombustible or limited-combustible construction.

(D) Attic is constructed of fire-retardant-treated wood in accordance with NFPA 703.

33.3.3.5.4

Item Standard Reference Yes No NA

3-11 Where an automatic sprinkler system is installed for either total or partial building coverage, is it electrically supervised?

[In buildings four or fewer, systems in accordance with NFPA 13R, are permitted.]

[In facilities having prompt or slow evacuation, automatic sprinklers are not required in closets 24ft2 or less or in bathrooms 55 ft2or less, provided that such spaces are finished with noncombustible or limited-combustible materials.]

33.3.3.5.1 33.3.3.5.5

33.3.3.5.1.1

33.3.3.5.1.2

3-12 Are portable fire extinguishers provided near all hazardous areas?

33.3.3.5.6

Protection – Fire Alarm System

3-13 Is there a fire alarm system installed in the facility unless all of the following are met?

(1) The facility has an evacuation capability of slow or prompt, and

(2) Each sleeping room has exterior exit access in accordance with 7.5.3, and

(2) The building is not more than three stories in height.

33.3.3.4.1

3-14 Where a fire alarm system is required (See 3-13), is the fire alarm system initiated by each of the following?

(1) Manual pull stations at exits unless there are other effective means (such a complete sprinkler or detection system) for notification of fire, and

(2) One manual pull box at a convenient central control point under continuous supervision of responsible employees, and

(3) Any required sprinkler system, and

(4) Any detection system other than sleeping room smoke alarms.

33.3.3.4.2

3-15 Where a fire alarm system is required (See 3-13), is there an audible occupant notification system provided that operates automatically and without delay that is audible in all sleeping areas?

33.3.3.4.4

3-16 Where the existing fire alarm system does not provide for automatic emergency forces notification in accordance with 9.6.4, are provisions made for the immediate notification of the public fire department or private fire brigade by telephone or other means?

33.3.3.4.6.1

Item Standard Reference Yes No NA

3-17 Are single station smoke alarms powered from the building electrical system provided in each sleeping room except as provided below?

[Existing battery-powered smoke alarms, rather than building electrical service-powered smoke alarms, are acceptable where, in the opinion of the Authority Having Jurisdiction, the facility has demonstrated that testing, maintenance, and battery replacement programs ensure the reliability of power to the smoke alarms.]

[Sleeping room smoke alarms are not required in facilities having an existing corridor smoke detection system that is connected to the building fire alarm system.]

33.3.3.4.7.1

33.3.3.4.7.2

33.3.3.4.7.3

3-18 Where a fire alarm system is required (See 3-13), is a smoke detection system installed in corridors and all living areas?

[A smoke detection system is not required in living areas of buildings having a prompt or slow evacuation capability that are protected throughout by an approved automatic sprinkler system.]

[A smoke detection system is not required in unenclosed corridors, passageways, balconies, colonnades, or other arrangements with one or more sides along the long dimension fully or extensively open to the exterior at all times.]

33.3.3.4.8.1

33.3.3.4.8.2

33.3.3.4.8.3

Inspection, Testing and Maintenance Requirements

4-1 Are fire extinguishers inspected on a monthly basis and serviced annually in accordance with NFPA 10?

4.6.12

4-2 Are fire alarm systems and smoke alarms inspected, tested, and maintained in accordance with NFPA 72?

9.6.1.3

4.6.12

4-3

Is a minimum of 18 inches vertical clearance maintained between the top of all storage and ceiling sprinkler deflectors?

NFPA 25-

2011 5.2.1.2

A.5.2.1.2

4-4

Are sprinkler system main drain tests performed annually and are records maintained?

NFPA 25-

13.2.5

4-5

Are electric fire pump churn tested monthly and diesel fire pumps churn tested weekly; and are all fire pumps flow tested annually?

NFPA 25-

2011, 8.3.

4-6

Where the fire alarm system is out of service (for more than 4 hours in a 24-hour period) or where the sprinkler system is out of service (for more than 10 hours in a 24-hour period) has the facility notified the fire department and established a fire watch or evacuated the building?

9.6.1.6

9.7.6.

NFPA 25-

2011, 15.5

4-7

If a generator set is utilized for emergency power, is it inspected weekly and tested under load for at least 30 minutes on a monthly basis? Permanent record of the EPSS inspections, tests, exercising, operation, and repairs shall be maintained and readily available.

19.5.1.1, 9.1.3

NFPA 110

8.4.1

Operating Features

5-1 Are stoves and combustion heaters located so they do not block escape in case of fire caused by malfunction of the unit?

33.3.6.2.2

Item Standard Reference Yes No NA

5-2 Are all fuel-fired heaters vented?

33.3.6.2.3

5-3 Does administration have, in effect and available to all supervisory personnel, written copies of a fire emergency plan for protecting residents in the event of fire, for keeping persons in place, for evacuating persons to areas of refuge, and for evacuating persons from the building when necessary?

33.7.1.1

5-4 Does the emergency plan include special staff responses to ensure the safety of any resident? This can require the plan to be amended or revised when any resident has special needs as they are admitted to the home.

[If the board and care facility has an evacuation capability classification of impractical, those residents who cannot meaningfully assist in their own evacuation or who have special health problems are not required to actively participate in the drill.]

33.7.1.2

33.7.3.6

5-5 Are all employees periodically instructed and kept informed with respect to their duties and responsibilities under the plan and is such instruction reviewed by the staff not less than every 2 months?

33.7.1.3

5-6 Are residents trained in the proper actions to take in event of a fire and does this training include what to do if the primary escape route is blocked?

33.7.2.1

5-7 Are emergency egress and relocation drills conducted not less than 6 times per year on a bimonthly basis with not less than 2 drills conducted during the night?

33.7.3.1

5-8 Do emergency egress and relocation drills involve the actual evacuation of residents to a designed assembly area and are residents required to use the designated means of egress during the drills?

33.7.3.3

5-9 Are smoking regulations established for the board and care facility?

33.7.4.1

5-10 Where smoking is permitted, are noncombustible safety-type ashtrays or receptacles provided in smoking areas?

33.7.4.2

5-11 Are new draperies, curtains and similar loose hanging furnishings and decorations flame resistant (NFPA 701)? [In a sprinkler protected building, they only have to be flame resistant in common areas.]

33.7.5.1.1 33.7.5.1.2