^ ^1...by chapter 19.28 rcw shall be completed by a nicet ii in fire alarms (effective july 1,...

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Washington State Patrol Fire Protection Bureau Phone: (360)596-3900 Business Name Address City, State, Zip Dungeness Courte Alzheimers 651 CARRY OAK DR, Sequim, WA 98382 Community Provider Number Approval Status Facility Type 001328 Approved Residential Care On 08/27/2018 the Office of the State Fire Marshal conducted an inspection at your facility. All violations noted during previous related inspection(s) have been corrected. Owi isentative Print NSme aiTdjTitle 7il^ \^ ^1 Deputy State Fire Marshal Kenneth R. Dellsite 210 HthAVESW OlympiaWA 98501 (360)561-1732 <r~%<. Signature Right of appeal. Any person may appeal any decision made by the Fire Protection Bureau in accordance with WAC 212-12. 1 of 1 Initials of Authorized Facility Representative:

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Page 1: ^ ^1...by chapter 19.28 RCW shall be completed by a NICET II in fire alarms (effective July 1, 2018). 2 Means of ergess illumination Emergency power shall be provided for means of

Washington State PatrolFire Protection Bureau

Phone: (360)596-3900

Business Name

Address

City, State, Zip

Dungeness Courte Alzheimers

651 CARRY OAK DR,

Sequim, WA 98382

Community Provider Number

Approval Status

Facility Type

001328

Approved

Residential Care

On 08/27/2018 the Office of the State Fire Marshal conducted an inspection at your facility.

All violations noted during previous related inspection(s) have been corrected.

Owi isentative

Print NSme aiTdjTitle7il^ \^ ^1

Deputy State Fire Marshal Kenneth R. Dellsite210 HthAVESWOlympiaWA 98501(360)561-1732

<r~%<.

Signature

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

1 of 1 Initials of Authorized Facility Representative:

Page 2: ^ ^1...by chapter 19.28 RCW shall be completed by a NICET II in fire alarms (effective July 1, 2018). 2 Means of ergess illumination Emergency power shall be provided for means of

Washington State PatrolFire Protection Bureau

Phone: (360)596-3900

Business Name

Address

City, State, Zip

Dungeness Courte Atzheimers Community

651 GARRYOAKDR,

Sequim, WA 98382

Provider Number

Approval Status

Facility Type

001328

Disapproved

Residential Care

On 07/24/2018 the Office of the State Fire Marshal conducted an inspection at your facility.

Code Requirement Statement of Violation

1 Admin New Requirements

For your information:

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 programing not defined as "electrical trade"by chapter 19.28 RCW shall be completed by a NICET II in firealarms (effective July 1, 2018).

2 Means of ergess illumination

Emergency power shall be provided for means of egressillumination in accordance with section 1008.3 and 1104.5.1.

Findings were: ^]Needd emergency lighting in generator switch gear room.

1 of 3 Initials of Authorized Facility Representative:

Page 3: ^ ^1...by chapter 19.28 RCW shall be completed by a NICET II in fire alarms (effective July 1, 2018). 2 Means of ergess illumination Emergency power shall be provided for means of

Washington State PatrolFire Protection Bureau

Phone: (360)596-3900

Business Name

Address

City, State, Zip

Dungeness Courte Alzheimers Community

651 GARRYOAKDR,

Sequim, WA 98382

Provider Number

Approval Status

Facility Type

001328

Disapproved

Residential Care

On 07/24/2018 the Office of the State Fire Marshal conducted an inspection at your facility.

Code Requirement Statement of Violation

3 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)

Findings were:Found three sets of corridor doors not closing properly.Doors by lobbyDoors by Activity roomDoors by Staff room ^

4 Inspection, testing and maintenance.

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)

Findings were:Sprinkler heads in walk-in cooler and freezer over 10 yearsold.

5 Cooking Grease fires

Fire extinguishers provided for the protection of cooking greasefires shall be of an approved type compatible with the automaticfire-extinguishing system agent and in accordance with Section904.12.5.

IFC 906.4

Findings were:Kitchen missing K Type extinguisher for deep fat fryers.

2 of 3 Initials of Authorized Facility Representative:

Page 4: ^ ^1...by chapter 19.28 RCW shall be completed by a NICET II in fire alarms (effective July 1, 2018). 2 Means of ergess illumination Emergency power shall be provided for means of

Washington State PatrolFire Protection Bureau

Phone: (360)596-3900

Business Name

Address

City, State, Zip

Dungeness Courte Alzheimers Community

651 GARRYOAKDR,

Sequim, WA 98382

Provider Number

Approval Status

Facility Type

001328

Disapproved

Residential Care

On 07/24/2018 the Office of the State Fire Marshal conducted an inspection at your facility.

Code Requirement Statement of Violation

Next inspection scheduled on or after:

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

Owner or Au. itative

"7^f- s^u^Signature

Deputy State Fire Marshal Kenneth R. Dellsite210 HthAVESWOlympiaWA 98501(360)561-1732

Print Name a^PTitle

/^^ 0^2^-Signature

3 of 3 Initials of Authorized Facility Representative: