s^u ^m^m~y 907 s mill st phone: (360)596-3900

CIQO^WASHi'ii.roh' sr.-.-r t-MW.

HT K:-'M'~_7

^M^M~ys^u

Washington State PatrolFire Protection Bureau

Phone: (360)596-3900

December 3, 2018

Cindy DvorakAdministratorPaul's Place

907 S MILL STColfaxWA99111

The Office of the State Fire Marshal conducted an annual fire and life safety inspection of Paul's Place.

Initial InspectionDuring the inspection, we identified a number of violations.We provided a copy of the inspection report to the facility.The inspection report outlined each violation and items to correct prior to a reinspection, scheduled on or after November 27,2018.

Required Reinspection• Today we conducted a reinspection of Paul's Place.• During the reinspection, one or more of the violations identified during the initial inspection remained uncorrected.

These two inspections found this facility failed to gain and maintain compliance as required by state law. These violations

place the residents, staff, and visitors at risk.

Required FolIow-Up• The facility administrator shall submit a letter to Deputy State Fire Marshal David Rogers, 143302, Law Lane,,

Kennewick, WA 98007 within 30 days. The letter shall explain, in detail, how the code violations were corrected andindicate the facility is ready for a final reinspection.

• Upon receipt of the letter, the Deputy State Fire Marshal will conduct a final reinspection.• If the letter is not received by the time specified, we shall notify the Department of Social and Health Services (DSH8)

Residential Care Services Division of the failure to correct violations. We will recommend enforcement action against thefacility. Enforcement actions available to DSHS under RCW 18.20.190 include civil fines, stop placements, and licensesuspension or revocation.

• If the option chosen by DSHS is a license revocation, a new fire and life safety inspection will be required prior torecommending relicensure.

If you have any questions regarding this process, please contact Deputy State Fire Marshal David Rogers at (509) 531-3384,

Letter Received By:

I

Letter Issued By:Deputy State FipjyiarshalDavid RO)

'cc: Residential Care ServicesEnclo^fires

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Ek2WASHHIC.TON STATF PATROL

MSSPWashington State PatrolFire Protection Bureau

Phone: (360)596-3900

Provider Number 2226

Approval Status Disapproved

Facility Type Residential Care

On 12/03/2018 the Office of the State Fire Marshal conducted a re-inspection at your facility. Listed below areviolations that have not been corrected.

Business Name Paul's Place

907 S MILL ST ,

City, State, Zip colfax. WA "111

Code Requirement Statement of Violation

1 System Test

Systems shall be inspected and tested for properoperation at 6-month intervals. Tests shall include acheck of the detection system, alarms and releasingdevices, including manual stations and otherassociated equipment. Extinguishing system unitsshall be weighed and the required amount of agentverified. Stored pressure-type units shall be checkedfor the required pressure. The cartridge ofcartridge-operated units shall be weighed andreplaced at intervals indicated by the manufacturer.

(IFC 904.5.1 (2009,2012,2015)

The following violation was re-observed upon reinspection:

The facility was unable to provide documentation indicating thecommercial kitchen hood's water-based suppression systemhas been serviced within the last 12 months.

2 Inspection, testing and maintenance.

Fire detection, alarm, and extinguishing systems,mechanical smoke exhaust systems, and smokeand heat vents shall be maintained in an operativecondition at all times, and shall be replaced orrepaired where defective. Nonrequired fireprotection systems and equipment shall beinspected, tested and maintained or removed.

(\PC 901.6 2012,2015)


The facility was unable to provide documentation indicatingquarterly and annual inspections have been completed on theautomatic fire sprinkler system since 12-9-2016. (Requiredevery 12 months)

1 of 2

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Phone: (360)596-3900

I Business Name Paul's Place Provider Number 2226

907 S MILL ST , Approval Status Disapproved

I City, State, Zip Colfax.WA 99111 Facility Type Residential Care

On 12/03/2018 the Office of the State Fire Marshal conducted a re-inspection at your facility. Listed below areviolations that have not been corrected.

L_ Code Requirement Statement of Violation

SMaintenance

Emergency and standby power systems shall bemaintained in accordance with NFPA 110 and NFPA111 such that the system is capable of supplyingservice within the time specified for the type andduration required.

(IFC 0604.4, 2015)


The facility was unable to provide documentation indicatingthey have conducted the required 30 minute load testing oftheir emergency generator at any point within the past 12months as required by NFPA 110.

Next inspection scheduled on or after: 01/02/2019

Right of appeal. Any person may appeal any decision made by the Fire Protection Bureau in accordance with WAG 212-12.

\

)wder or AuWrized

[M^^igf^ature

Deputy State Fire Marshal David RogersPO Box 19130

SpokaneWA 992199](509) 954-274J

Signature

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Phone: (360)596-3900

Business Name Paul's Place

Address 907 s MILL ST .

City, State, Zip C°lfax. WA 9911J_

Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care

On 11/07/2018 the Office of the State Fire Marshal conducted an inspection at your facility.


1 Admin New Requirements

For your information:

Quarterly sprinkler inspections are required in all state-licensedAssisted Living Facilities in accordance with NFPA25.

703.2 Opening protectives. Opening protective shall bemaintained in an operative condition in accordance with NFPA80.

NFPA80 Chapter 19 Installation, Testing, and Maintenance ofFire Dampers.19.4 Periodic Inspection and Testing.19.4.1 Each damper shall be tested and inspected 1 year afterinstallation.19.4.1.1 The test and inspection frequency shall then be every4 years, except in hospitals, where the frequency shall be every6 years.

EFFECTIVE JULY 1,2018.907.10 National Institute for Certification in EngineeringTechnologies.907.10.1 Scope. This section shall apply to new and existingfire alarms systems.907.10.2 Design review. All construction documents shall bereviewed by a NICET III in fire alarms or a licensed professionalengineer (PE) in Washington prior to being submitted forpermitting. The reviewing professional shall submit a stamped,signed, and dated letter; or a verification method approved bythe local authority having jurisdiction indicating the system hasbeen reviewed and meets or exceeds the design requirementof the Washington and the local jurisdiction (effective July 1 ,2018).907.10.3 Testing/maintenance: All inspection, testingmaintenance and programming not defined as "electrical trade"by chapter 19.28 RCW shall be completed by a NICET II in firealarms (effective July 1, 2018).

Facility still did not have documentation regarding the Annualand Quarterly Inspection of the Fire Sprinkler System

1 of 8 Initials of Authorized Facility Representative:

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WASHliteTdN STATE i?ATROL

WUHT


Phone: (360)596-3900

Business Name paul's place

Address 907 s MILL ST ,

City, State, Zip Colfax, WA99111

Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care



2 Fueled Equipment

Fueled equipment including, but not limited to, motorcycles,mopeds, lawn-care equipment, portable generators andportable cooking equipment, shall not be stored, operated orrepaired within a building.

Exceptions:

1. Buildings or rooms constructed for such use inaccordance with the International Building Code.

2. Where allowed by Section 314.

3. Storage of equipment utilized for maintenancepurposes is allowed in approved locations when the aggregatefuel capacity of the stored equipment does not exceed 10gallons (38 L) and the building is equipped throughout with anautomatic sprinkler system installed in accordance with Section903.3.1.1.

(IFC 313.1 2015)3 Frequency

Required emergency drills shall be held at the inten/alsspecified in Table 405.2 or more frequently where necessary tofamiliarize all occupants with the drill procedure.

IFC 405.2 2015_4 Maintenance

Emergency and standby power systems shall be maintained inaccordance with NFPA 110 and NFPA 111 such that thesystem is capable of supplying service within the time specifiedfor the type and duration required.

(IFC 0604.4, 2015)

Facility was still unable to provide documentation to showMonthly 30 minute load testing, facility did have documentationfor the Annual Inspection.


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Phone: (360)596-3900

Bus/ness Name paul's place

Address 907 S MILL ST ,

City, State, Zip Colfax, WA 99111

Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care



5 Abatement of electrical hazards.

Identified electrical hazards shall be abated. Identifiedhazardous electrical conditions in permanent wiring shall bebrought to the attention of the responsible code official.Electrical wiring, devices, appliances and other equipment thatis modified or damaged and constitutes an electrical shock orfire hazard shall not be used.

(IFC 605.1 2012,2015)6 Multiplug adapters.

Multiplug adapters, such as cube adapters, unfused plug stripsor any other device not complying with NFPA 70 shall beprohibited.

(IFC 605.4 20122015)7 Extension Cords.

Extension cords and flexible cords shall not be a substitute forpermanent wiring. Extension cords and flexible cords shall notbe affixed to structures, extended through walls, ceilings orfloors, or under doors or floor coverings, nor shall such cordsbe subject to environmental damage or physical impact.Extension cords shall be used only with portable appliances.

(IFC 605.5)8 Where required.

A Type I hood shall be installed at or above all commercialcooking appliances and domestic cooking appliances used forcommercial purposes that produce grease laden vapors.

Exceptions:

1. A Type I hood shall not be required for an electric cookingappliance where an approved testing agency providesdocumentation that the appliance effluent contains 5 mg/m3 orless of grease when tested at an exhaust flow rate of 500 cfm(0.236 m3/s) in accordance with Section 17 of UL 710B

2. A Type I hood shall not be required to be installed in an R-2occupancy with not more than 16 residents.

(IFC 609.2 2015 WAC 51-54A)


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WABHlBatBNSTSTE PATROLPl


Phone: (360)596-3900

Business Name paulls place



Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care



9 Cleaning.

Hoods, grease-removal devices, fans, ducts and otherappurtenances shall be cleaned at intervals as required bySections 609.3.3.1 through 609.3.3.3.

(IFC 609.3.3)10 Fire walls, fire barriers and fire partitions.

Required fire walls, fire barriers and fire partitions shall bemaintained to prevent the passage of fire. All openingsprotected with approved doors or fire dampers shall bemaintained in accordance with NFPA80.

(IFC 703.1.3 2015)11 Opening protectives.

Opening protectives shall be maintained in an operativecondition in accordance with NFPA 80. Where allowed by thefire code official, the application of field-applied labelsassociated with the maintenance of opening protectives shallfollow the requirements of the approved third-party certificationorganization accredited for listing the opening protective. Firedoors and smoke barrier doors shall not be blocked orobstructed, or otherwise made inoperable. Fusible links shall bereplaced promptly whenever fused or damaged. Fire doorassemblies shall not be modified.

iFC7p3,2_12 Door Operation

Swinging fire doors shall close from the full-open position andlatch automatically. The door closer shall exert enough force toclose and latch the door from any partially open position.

(IFC 703.2.3)


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VKsfllBETQN STATE PATROL[1 R


Phone: (360)596-3900


Address 907SMILLST,

City, State, Zip colfax. WA 9911 1

Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care




Fire detection, alarm, and extinguishing systems, mechanicalsmoke exhaust systems, and smoke and heat vents shall bemaintained in an operative condition at all times, and shall bereplaced or repaired where defective. Nonrequired fireprotection systems and equipment shall be inspected, testedand maintained or removed.

(IFC901.6 2012^2015)

Facility still was unable to provide documentation that the FireSprinkler System had been tested since 2016

14 System Test

Systems shall be inspected and tested for proper operation at6-month intervals. Tests shall include a check of the detectionsystem, alarms and releasing devices, including manualstations and other associated equipment. Extinguishing systemunits shall be weighed and the required amount of agentverified. Stored pressure-type units shall be checked for therequired pressure. The cartridge of cartridge-operated unitsshall be weighed and replaced at intervals indicated by themanufacturer.

(IFC 904.5.1 (2009, 2012, 2015)

Facility was unable to provide documentation showing theKitchen Hood Suppression System was tested (wet sprinklersystem)


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Phone: (360)596-3900

KJ^-^1


Address 907SMILLST,

City, State, Zip cdfax. WA 99111

Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care



15 Portable Fire Extinguishers - General Requirements

Portable fire extinguishers shall be selected, installed andmaintained in accordance with this section and NFPA 10.

Exceptions:

1. The distance of travel to reach an extinguisher shallnot apply The travel distance to reach an extinguisher shall notapply to the spectator seating portions of Group A-5occupancies.

2. Thirty-day inspections shall not be required andmaintenance shall be allowed to be once every three years fordry-chemical or halogenated agent portable fire extinguishersthat are supervised by a listed and approved electronicmonitoring device, provided that all of the following conditionsare met:

2.1. Electronic monitoring shall confirm that extinguishersare properly positioned, properly charged and unobstructed.

2.2. Loss of power or circuit continuity to the electronicmonitoring device shall initiate a trouble signal.

2.3. The extinguishers shall be installed inside of abuilding or cabinet in a noncorrosive environment.

2.4. Electronic monitoring devices and supervisorycircuits shall be tested every three years when extinguishermaintenance is performed.

2.5. A written log of required hydrostatic test dates forextinguishers shall be maintained by the owner to verify thathydrostatic tests are conducted at the frequency required byNFPA10.

3. In Group 1-3, portable fire extinguishers shall bepermitted to be located at staff locations.

IFC 906.2 2015


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Phone: (360)596-3900


Address 907 S MILL ST .


Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care



16 Bolt Locks

Manually operated flush bolts or surface bolts are notpermitted.

Exceptions:

1. On doors not required for egress in individualdwelling units or sleeping units.

2. Where a pair of doors serves a storage orequipment room, manually operated edge- or surface-mountedbolts are permitted on the inactive leaf.

3. Where a pair of doors serves an occupant load ofless than 50 persons in a Group B, F or S occupancy, manuallyoperated edge- or surface-mounted bolts are permitted on theinactive leaf. The inactive leaf shall contain no doorknobs,panic bars or similar operating hardware.

4. Where a pair of doors serves a Group B, F or Soccupancy, manually operated edge- or surface-mounted boltsare permitted on the inactive leaf provided such inactive leaf isnot needed to meet capacity requirements and the building isequipped throughout with an automatic sprinkler system inaccordance with Section 903.3.1.1. The inactive leaf shall notcontain doorknobs, panic bars or similar operating hardware.

5. Where a pair of doors serves patient care rooms inGroup 1-2 occupancies, self-latching edge- or surface-mountedbolts are permitted on the inactive leaf provided that theinactive leaf is not needed to meet the egress capacity widthsand the requirements and the inactive leaf shall not containdoorknobs, panic bars or similar operating hardware.

IFC 1010.1.9.4 201517 Obstruction.

The minimum width or required capacity of corridors shall beunobstructed

Exception: Encroachments complying with Section 1005.7.

(IFC 1020.3 2015)


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VBASHiilGTQNSTATFPATROL

WiBehf


Phone: (360)596-3900

Bus/ness Name paul's place



Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care



Next inspection scheduled on or after: 11/27/2018

Right of appeal. Any person may appeal any decision made by the Fire Protection Bureau in accordance with WAC 212-12.

Owner or Authorized Representative

Signature Print Name and Title

Deputy State Fire Marshal Clifton A. RogersPO Box 19130

SpokaneWA 99219(509) 227-6567

Signature


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WASHiNQtSNSTATEPAtROTIS) IB1


Phone: (360)596-3900

Business Name paulls Race

Address 907SMILLST,

City, State, Zip Colfax, WA 991^

Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care



1 Admin New Requirements

For your Information:

Quarterly sprinkler inspections are required in all state-licensedAssisted Living Facilities in accordance with NFPA 25.

703.2 Opening protectives. Opening protective shall bemaintained in an operative condition in accordance with NFPA80.NFPA80 Chapter 19 Installation, Testing, and Maintenance ofFire Dampers,19.4 Periodic Inspection and Testing.19.4.1 Each damper shall be tested and inspected 1 year afterinstallation,19.4.1.1 The test and inspection frequency shall then be every4 years, except In hospitals, where the frequency shall be every6 years,

EFFECTIVE JULY 1,2018.907,10 National Institute for Certification In EngineeringTechnologies.907.10.1 Scope. This section shall apply to new and existingfire alarms systems.907,10.2 Design review. All construction documents shall bereviewed by a NICET III in fire alarms or a licensed professionalengineer (PE) in Washington prior to being submitted forpermitting. The reviewing professional shall submit a stamped,signed, and dated letter; or a verification method approved bythe local authority having jurisdiction indicating the system hasbeen reviewed and meets or exceeds the design requirementof the Washington and the local jurisdiction (effective July 1 ,2018).907.10.3 Testlng/maintenance: All inspection, testingmaintenance and programming not defined as "electrical trade"by chapter 19,28 ROW shall be completed by a NICET II In firealarms (effective July 1,2018),


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WASHlHaTON STATE RATHOLRJ)


Phone: (360)596-3900

Business Name

Address

City, State, Zip

Paul's Place

907 S MILL ST ,

Colfax,WA99111

Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care



2 Fueled Equipment

Fueled equipment including, but not limited to, motorcycles,mopeds, lawn-care equipment, portable generators andportable cooking equipment, shall not be stored, operated orrepaired within a building.

Exceptions;

1. Buildings or rooms constructed for such use inaccordance with the International Building Code,

2. Where allowed by Section 314.

3. Storage of equipment utilized for maintenancepurposes is allowed in approved locations when the aggregatefuel capacity of the stored equipment does not exceed 10gallons (38 L) and the building is equipped throughout with anautomatic sprinkler system installed in accordance with Section903,3,1.1,

(IFC 313.1 2015)

The following violations were observed:

A lawn mower was being stored in the basement corridor.

Gas powered equipment was being stored in room B11

3 Frequency

Required emergency drills shall be held at the intervalsspecified in Table 405.2 or more frequently where necessary tofamiliarize all occupants with the drill procedure,

IFC 405.2 2015_

The following violations were obsen/ed:

The facility was unable to provide documentation of requiredquarterly fire drills on each shift

4 Maintenance

Emergency and standby power systems shall be maintained inaccordance with NFPA 110 and NFPA 111 such that thesystem Is capable of supplying service within the time specifiedfor the type and duration required.

(IFC 0604.4, 2015)


The facility was unable to provide documentation of weeklyinspection, monthly load test and annual maintenance of theemergency generator.


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Phone: (360)696-3900


Address 907 s MILL ST ,


Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care



5 Abatement of electrical hazards.

Identified electrical hazards shall be abated. Identifiedhazardous electrical conditions in permanent wiring shall bebrought to the attention of the responsible code official.Electrical wiring, devices, appliances and other equipment thatis modified or damaged and constitutes an electrical shock orfire hazard shall not be used.

(IFC 605.1 2012,2015)

The following violations were observed;

Electrical junction boxes did not have covers in the followingareas: generator room, laundry room and 105 storage,

An outlet did not have a cover in Room B7.

6 Multlplug adapters,

Multiplug adapters, such as cube adapters, unfused plug stripsor any other device not complying with NFPA70 shall beprohibited.

(IFC 605.4 20122015)

The following violation was observed:

A non-approved multlplug adapter was in use in Room 301.The violation was corrected during inspection.

7 Extension Cords.

Extension cords and flexible cords shall not be a substitute forpermanent wiring, Extension cords, and flexible cord$ shall notbe affixed to structures, extended through walls, ceilings orfloors, or under doors or floor coverings, nor shall such cordsbe subject to environmental damage or physical Impact.Extension c'ords shall be used only with portable appliances.

(IFC 605.5) __


An extension cord was observed in use in the business office.

8 Where required.

A Type I hood shall be installed at or above all commercialcooking appliances and domestic cooking appliances used forcommercial purposes that produce grease laden vapors.

Exceptions:

1. AType I hood shall not be required for an electric cookingappliance where an approved testing agency providesdocumentation that the appliance effluent contains 5 mg/m3 orless of grease when tested at an exhaust flow rate of 500 cfm(0.236 m3/s) in accordance with Section 17 of UL 71 OB

2. A Type I hood shall not be required to be installed in an R-2occupancy with not more than 16 residents.

(IFC 609.2 2015 WAG 51-54A)


During the inspection a portable deep fatfryerwas observed inthe kitchen. Staff stated the fryer is used periodically. Thefacility does not have a Type 1 kitchen hood.


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Phone: (360)596-3900

Business Name paurs place

Address 907SMILLST,


Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care



9 Cleaning.

Hoods, grease-removat devices, fans, ducts and otherappurtenances shall be cleaned at intervals as required bySections 609.3.3.1 through 609.3.3.3.

(IFC 609.3.3)


The facility was unable to provide documentation of kitchenhood cleaning.

10 Fire walls, fire barriers and Tire partitions.

Required fire walls, fire barriers and fire partitions shall bemaintained to prevent the passage of fire. All openingsprotected with approved doors or fire dampers shall bemaintained in accordance with NFPA80.

(IFC 703.1.3 2015)

The following violation was observed;

There was a unsealed penetration in the fire-rated ceiling inroom B11.

11 Opening protectives.

Opening protectives shall be maintained in an operativecondition in accordance with NFPA 80. Where allowed by thefire code official, the application of field-applied labelsassociated with the maintenance of opening protectives shallfollow the requirements of the approved third-party certificationorganization accredited for listing the opening protective. Firedoors and smoke barrier doors shall not be blocked orobstructed, or otherwise made inoperable. Fusible links shall bereplaced promptly whenever fused or damaged. Fire doorassemblies shall not be modified,

IFC 703.2


The door to Room B15 was held open with wire not allowingthe door's self closer to function and close the door.

Doors to the following rooms had gaps exceeding the NFPA80 allowance of 1/8 inch: 216, 226 and 227.

NFPA80,20136,3.1.7.1 The clearances between the top and vertical edgesof the door and the frame, and the meeting edges of doorsswinging in pairs, shall be 1/8 in. + 1/16 In. (3.18 mm ± 1.59mm) for steel doors and shall not exceed 1/8 in. (3.18 mm) forwooddoors.

12 Door Operation

Swinging fire doors shall close from the full-open position andlatch automatically. The door closer shall exert enough force toclose and latch the door from any partially open position.

(IFC 703.2.3}^


The door self closers did not provide enough force for the doorto close and latch in the following locations: Room 210, 216,227 and second floor door leading to the third floor.

4of8 Initials of Authorized Facility Representative:

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Phone; (360)596-3900


Address 907SM1LLST,


Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care




Fire detection, alarm, and extinguishing systems, mechanicalsmoke exhaust systems, and smoke and heat vents shall bemaintained in an operative condition at all times, and shall bereplaced or repaired where defective, Nonrequired fireprotection systems and equipment shall be inspected, testedand maintained or removed.

(IFC 901.6 2012,2015)

The following violations were observed;

The facility was unable to provide documentation of the annualfire alarm system and most recent smoke detector sensitivitytest report.

The facility was unable to provide documentation of the annualand quarterly fire sprinkler system.

14 System Test

Systems shall be inspected and tested for proper operation at6-month intervals, Tests shall include a check of the detectionsystem, alarms and releasing devices, Including manualstations and other associated equipment. Extinguishing systemunits shall be weighed and the required amount of agentverified. Stored pressure-type units shall be checked for therequired pressure, The cartridge of cartridge-operated unitsshall be weighed and replaced at intervals Indicated by themanufacturer.

(IFC 904.5.1 (2009, 2012, 2015)


The facility was unable to provide documentation of semiannual servicing of the kitchen suppression system.


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Phone: (360)596-3900

Business Name paulls place

Address 907SMILLST,


Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care



15 Portable Fire Extingulshers - General Requirements

Portable fire extinguishers shall be selected, installed andmaintained in accordance with this section and NFPA10.

Exceptions:

1. The distance of travel to reach an extinguisher shallnot apply The travel distance to reach an extinguisher shall notapply to the spectator seating portions of Group A-6occupancies.

2. Thirty-day inspections shall not be required andmaintenance shall be allowed to be once every three years fordry-chemical or halogenated agent portable fire extinguishersthat are supervised by a listed and approved electronicmonitoring device, provided that all of the following conditionsare met:

2.1. Electronic monitoring shall confirm that extingulshersare properly positioned, properly charged and unobstructed,

2.2. Loss of power or circuit continuity to the electronicmonitoring device shall initiate a trouble signal,

2.3. The extinguishers shall be installed inside of abuilding or cabinet In a noncorrosive environment,

2.4. Electronic monitoring devices and supervisorycircuits shall be tested every three years when extinguishermaintenance is performed,

2.5. Awritten log of required hydrostatic test dates forextinguishers shall be maintained by the owner to verify thathydrostatic tests are conducted at the frequency required byNFPA10.

3. In Group 1-3, portable fire extinguishers shall bepermitted to be located at staff locations.

IFC 906.2 2015


The facility had not documented monthly inspections of the fireextingulshers throughout the facility since February 2018.


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Phone: (360)596-3900

Business Name paurs place

Address 907SMILLST,

City, State, Zip cowax' WA 99111

Provider Number

Approval Status

Facility Type

2226

Disapproved

Residential Care



16 Bolt Locks

Manually operated flush bolts or surface bolts are notpermitted.

Exceptions:

1. On doors not required for egress in individualdwelling units or sleeping units.

2. Where a pair of doors serves a storage orequipment room, manually operated edge- or surface-mountedbolts are permitted on the inactive leaf.

3. Where a pair of doors serves an occupant load ofless than 50 persons in a Group B, F or S occupancy, manuallyoperated edge- or surface-mounted bolts are permitted on theinactive leaf. The inactive leaf shall contain no doorknobs,panic bars or similar operating hardware.

4. Where a pair of doors serves a Group B, F or Soccupancy, manually operated edge- or surface-mounted boltsare permitted on the inactive leaf provided such inactive leaf isnot needed to meet capacity requirements and the building isequipped throughout with an automatic sprinkler system Inaccordance with Section 903.3.1.1. The Inactive leaf shall notcontain doorknobs, panic bars or similar operating hardware.

5. Where a pair of doors serves patient care rooms inGroup 1-2 occupancies, self-latohing edge- or surface-mountedbolts are permitted on the inactive leaf provided that theInactive leaf is not needed to meet the egress capacity widthsand the requirements and the inactive leaf shall not containdoorknobs, panic bars or similar operating hardware.

IFC 1010.1.9,42015


A deadbolt was in use at main entrance door to the facility.

17 Obstruction.

The minimum width or required capacity of corridors shall beunobstr'ucted

Exception: Encroachments complying with Section 1005.7,

(IFC 1020,3 2015)

The following voilation was observed:

The corridors in the basements were obstructed by storage ofequipment, supplies and household items. No storage isauthorized In the exit corridors.


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Phone: (360)596-3900

Bus/ness Name paul's piace

Address 907 S MILL ST,

City, State, Zip Colfax,WA99111

Provider Number

Approval Status

Facility Type

2226Disapproved

Residential Care



Next inspection scheduled on or after:

Right of appeal. Any person may appeal any decision made by the Fire Protection Bureau in accordance with WAG 212-12.

iwner or Authorized

Signature

Deputy State Fire Marshal David RogersPO Box 19130

SpokaneWA 992199130(509) 954-2741,

~Ta^QTn)m^^(Print Name and Title

Signature/

8 of 8 Initials of Authorized Facility Representative;

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s^u ^m^m~y 907 s mill st phone: (360)596-3900

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