Form Cms-2786w - Fire Safety Survey Report - Icf-Iid (Large Facilities) 2012 Life Safety Code Page 28
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31Name of Facility
2012 LIFE SAFETY CODE
ID
MET
NOT
N/A
REMARKS
PART V – OPERATING FEATURES
PREFIX
MET
(New and Existing Facilities)
K700
Operating Features – Other
List in the REMARKS section any LSC Section 33.7 or 32.7 Operating
Features requirements 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.
K711
Evacuation and Relocation Plan
The administration of every resident board and care facility shall have in
effect and available to all supervisory personnel written copies of a plan for
protecting all persons in the event of fire, for keeping persons in place, for
evacuating persons to areas of refuge, and for evacuating person from the
building when necessary. The plan shall include special staff response,
including fire protection procedures needed to ensure the safety of any
resident, and shall be amended or revised whenever any resident with
unusual needs is admitted to the home. All employees shall be periodically
instructed and kept informed with respect to their duties and responsibilities
under the plan. Such instruction shall be reviewed by the staff not less than
every 2 months.
A copy of the plan shall be readily available at all times within the facility.
All residents participating in the emergency plan shall be trained in the proper
actions to be taken in the event of fire. Training shall include proper actions to
be taken if the primary escape route is blocked. If the resident is given
rehabilitation or habilitation training, training in fire prevention and the actions
to be taken in the event of a fire shall be part of the training program.
Residents shall be trained to assist each other in case of fire to the extent that
their physical and mental abilities permit them to do so without additional
personal risk.
32.7.1, 32.7.2, 33.7.1, 33.7.2
Form CMS-2786W (10/2016)
Page 28
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