D.26 TJC Life Safety Code Business Occupancy Requirements.pdf

Prepublication Requirements

• Issued December 18, 2020; Updated December 30, 2020 •

Life Safety (LS) Chapter

LS.05.01.10

Building and fire protection features are designed and maintained to minimize the effects of fire, smoke, and heat.

Element(s) of Performance for LS.05.01.10

1. When building rehabilitation occurs, the organization incorporates NFPA 101-2012: Chapters 38, 39, and 43 (For full text, refer to NFPA 101-2012: 38/39.1.1.3; 4.6.7)

2. Business occupancies are separated from parking structures by a 2-hour or greater fire barrier.

(For full text, refer to NFPA 101-2012: 38/39.1.3.2.1)

3. The fire protection rating for opening protectives in fire barriers, fire-rated smoke barriers, and fire-rated smoke partitions is as follows:

- Three hours in three-hour barriers and partitions

- Ninety minutes in two-hour barriers and partitions

- Forty-five minutes in one-hour barriers and partitions

- Twenty minutes in ½-hour barriers and partitions Labels on fire door assemblies must be maintained in legible condition. (For full text, refer to NFPA 101-2012: 8.3.4.2; Table 8.3.4.2; 8.3.3.2.3; NFPA 80-2010: 5.2.13.3)

New Life Safety Code Business Occupancy Requirements

The Joint Commission has approved the following revisions for prepublication. While revised requirements are published in the semiannual updates to the print manuals (as well as in the online E-dition®), accredited organizations and paid subscribers can also view them in the monthly periodical The Joint Commission Perspectives®. To begin your subscription, call 800-746-6578 or visit http://www.jcrinc.com.

Please note: Where applicable, this report shows current standards and EPs first, with deleted language struck-through. Then, the revised requirement follows in bold text, with new language underlined.

APPLICABLE TO THE BEHAVIORAL HEALTH CARE AND HUMAN SERVICES ACCREDITATION PROGRAM

Effective July 1, 2021

© 2020 The Joint Commission

Prepublication Standards Effective July 1, 2021

Prepublication Requirements continued

December 18, 2020; Updated December 30, 2020

4. Vertical openings must be protected in the following manner (For full text, refer to NFPA 101- 2012: 38/39.3)

- Enclosures serving four or more floors in new construction must have a 2-hour fire rating.

- Enclosures serving three or less floors in new construction must have a 1-hour fire rating.

- Enclosures in existing construction must have a ½-hour fire rating.

- A vertical opening below the street level that contains storage or communicates with a different occupancy, must be protected.

5. The space around pipes, conduits, bus ducts, cables, wire, air ducts, or pneumatic tubes penetrating the walls or floors are protected with an approved fire-rated material.

Note: Non-approved polyurethane expanding foam is not an accepted fire-rated material for this purpose. (For full text, refer to NFPA 101-2012: 8.3.5)

6. Doors requiring a fire rating of 3/4 of an hour or longer are free of coverings, decorations, or other objects applied to the door face, with the exception of informational signs, which are applied with adhesive only. (For full text, refer to NFPA 80-2010: 4.1.4)

7. The organization meets all other Life Safety Code requirements related to NFPA 101-2012:

38/39.1

LS.05.01.20

The organization maintains the integrity of the means of egress.

Element(s) of Performance for LS.05.01.20

1. Interior open stairways and ramps are permitted to serve as part of the egress system if not more than one level below the street floor. (For full text, refer to NFPA 101-2012 38/39.2.1.3.2)

2. In occupancies that serve 50 or more persons, the corridors or passageways must be a minimum of 44 inches of clear width. (For full text, refer to NFPA 101-2012: 38/39.2.3.2)

3. Dead-end corridors cannot exceed 50 feet in existing facilities. In new facilities, dead-end corridors cannot exceed 50 feet unless fully sprinklered or cannot exceed 20 feet if they are not fully sprinklered. (For full text, refer to NFPA 101-2012: 38/39.2.5)

4. Travel distance to an exit must not exceed 200 feet, unless the facility is fully sprinklered, in which case the distance may be increased to 300 feet. (For full text, refer to NFPA 101-2012:

38/39.2.6)

5. Means of egress must be continuously illuminated while occupied. (For full text, refer to NFPA 101-2012: 38/39.2.8)

6. Emergency powered lighting for existing construction must be provided if the building is three or more stories in height, if the building has 100 occupants or more in the stories above or below the level of exit discharge, or the building has 1000 or more total occupants. (For full text, refer to NFPA 101-2012: 39.2.9)

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7. Emergency powered lighting for new construction must be provided if the building is three or more stories in height, if the occupancy has 50 occupants or more in the stories above or below the level of exit discharge, or the building has 300 or more total occupants. (For full text, refer to

NFPA 101-2012: 38.2.9)

8. Doors in a means of egress are not equipped with a latch or lock that requires the use of a tool or key from the egress side unless a compliant locking configuration is used, such as a delayed-egress locking system or an access-controlled egress door assembly. (For full text, refer to

NFPA 101-2012: 7.2.1.6.1, 7.2.1.6.2)

9. The organization meets all other Life Safety Code means of egress requirements related to

NFPA 101-2012: 38/39.2.

LS.05.01.30

The organization provides and maintains building features to protect individuals from the hazards of fire and smoke.

Element(s) of Performance for LS.05.01.30

1. Hazardous areas are protected from other areas by a one-hour fire resistance–rated barrier (45-minute opening protectives) or a smoke resistive barrier and automatic sprinklers. Doors must be self-closing or automatic closing with latching hardware. (For full text, refer to NFPA 101-2012: 38/39. 3.2)

2. Interior wall and ceiling finishes must be Class A or B for exits and exit access corridors. All other areas should be Class A, B, or C. (For full text, refer to NFPA 101-2012: 38/39.3.3)

3. Alcohol-based hand rubs (ABHR) are stored and handled in accordance with NFPA 101-2012:

8.7.3.1 and as follows:

- Corridor clear width of 44 inches is not compromised by dispenser

- ABHR does not exceed 95% alcohol

- Maximum individual dispenser capacity is 0.32 gallon of fluid (0.53 gallon in suites or rooms separated from corridors) or 18 ounces of NFPA Level 1–classified aerosols

- Dispensers have a minimum of four feet of horizontal spacing between them

- Dispensers are not installed within one inch of an ignition source

- If floor is carpeted, the building is fully sprinkler protected

- Operation of the dispensers must comply with the manufacturers’ instructions for use

- ABHR is protected against inappropriate access

- Not more than an aggregate of 10 gallons of fluid or 1135 ounces of aerosol are used in a single smoke compartment outside a storage cabinet, excluding one individual dispenser per room

- Storing more than five gallons of fluid in a single smoke compartment complies with NFPA 30

4. The organization meets all other Life Safety Code fire and smoke protection requirements related to NFPA 101-2012: 38/39.3.

LS.05.01.34

The organization provides and maintains fire alarm systems.

Element(s) of Performance for LS.05.01.34

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1. Fire alarm systems for existing construction are required if the building is three or more stories in height, there are 100 occupants or more below or above the level of exit discharge, or the building has 1000 or more occupants. The fire alarm system is initiated by manual means, a fire/smoke detection system, or a fire suppression system. The occupant notification system must activate a general alarm; however, in existing occupancies, notification can be made via a voice communication or a public address system. A fail-safe process must be provided to notify emergency forces. (For full text, refer to NFPA 101-2012: 39.3.4)

2. Fire alarm systems for new construction are required if the building is three or more stories in height, there are 50 occupants or more below or above the level of exit discharge, or the building has 300 or more occupants. The fire alarm system is initiated by manual means, a fire/smoke detection system, or a fire suppression system. The occupant notification system must activate a general alarm; however, in existing occupancies, notification can be made via a voice communication or a public address system. A fail-safe process must be provided to notify emergency forces. (For full text, refer to 2012 NFPA 101-2012: 38.3.4)

3. The organization meets all other Life Safety Code fire alarm requirements related to NFPA 101- 2012: 38/39.4.

LS.05.01.35

The organization provides and maintains equipment for extinguishing fires.

Element(s) of Performance for LS.05.01.35

1. For new construction, a process for emergency response notification is provided and includes notifying both of the following:

- Fire department in accordance with 9.6.4

- Local emergency organization, if provided (For full text, refer to NFPA 101-2012: 38.3.4.4)

2. For existing construction, notification of emergency forces is accomplished in accordance with NFPA 101-2012: 9.6.4 when the existing fire alarm system is replaced. (For full text, refer to

NFPA 101-2012: 39.3.4.4)

3. The travel distance from any point to the nearest portable fire extinguisher is 75 feet or less.

Portable fire extinguishers have appropriate signage, are installed in a cabinet or secured on a hanger made for the extinguisher and are at least four inches off the floor. Those fire extinguishers that are 40 pounds or less are installed so the top is not more than 5 feet above the floor. (For full text, refer to NFPA 101-2012: 38/39.3.5; 9.7.4.1)

4. Sprinklers are not damaged. They are also free from corrosion, foreign materials, and paint and have necessary escutcheon plates installed.

5. There is 18 inches or more of open space maintained below the sprinkler to the top of storage.

Note: Perimeter wall and stack shelving may extend up to the ceiling when not located directly below a sprinkler head.

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6. The organization meets all other Life Safety Code extinguishing requirements related to NFPA 101-2012: 38/39.3.5.

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