unWASHiNaTONSTATEMTBOl
Washington State PatrolFire Protection Bureau
Phone: (360)596-3900
Business Name
Address
City, State, Zip
Ashley Gardens of Bremerton
3231 Pine RD,
Bremerton, WA 98337
Provider Number
Approval Status
Facility Type
001947
Approved
Residential Care
On 4/5/2018 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 ROW shall be completed by a NICET II in firealarms (effective July 1, 2018).
Ensure your Fire Sprinkler company verifies placement ofsprinkler heads and light fixtures and documents the findingsfor your records.
All tests shall be conducted each quarter and documentedbelow.
These are minimum requirements. Check with your firesprinkler contractor for the specific needsof your system.NOTE: NOTIFY MONITORING AGENCY PRIOR TOCONDUCTING TESTS.Main Drain TestRecord the static water supply pressure in psi as indicated ofthe lowerpressure gauge.Open the main drain and allow water flow to stabilize.Record the residual water supply pressure while water isflowing from the 2"main drain as indicated on the lower pressure gauge in psi.Close the main drain (slowly).Wet Pipe System Flow AlarmTest water flow alarms by opening the inspectors test valve.(Notify alarmcompany to avoid false alarms).Wet Pipe System Gauges Inspect & Alarm Test (monthly)Gauges are in good condition and normal pressures aremaintained.Alarm Devices - Inspect exterior.Fire Department ConnectionsVerify connection is visible and accessible, not damaged, capsor plugs arein place, identification sign is in place, and automatic drain isworkingproperly.Hydraulic NameplateIf system was hydraulically calculated, assure nameplate islegible and
1 of 5 Initials of Authorized Facility Representative:
Washington State PatrolFire Protection Bureau
Phone: (360)596-3900
Business Name
Address
City, State, Zip
Ash ley Gardens of Bremerton
3231 Pine RD,
Bremerton, WA 98337
Provider Number
Approval Status
Facility Type
001947
Approved
Residential Care
On 4/5/2018 the Office of the State Fire Marshal conducted an inspection at your facility.
Code Requirement Statement of Violation
securely attached to riser.Valves all Types - Visually inspect pressure reducing andrelieve valves.Dry Pipe System Flow AlarmOpen the alarm bypass valve. (Notify alarm company to avoidfalse alarms).Caution: opening the inspectors test connection can cause thesystem totrip accidentally, allowing the pipes to fill with water andcreating a potentialfor a serious freeze problem.Dry Pipe Priming LevelCheck dry priming water level by opening the test valve andchecking for asmall amount of water to discharge. If no water flows out of thetest line,add priming water.Dry Pipe system Low-Air-Pressure AlarmLow air pressure alarms, if provided, shall be .tested quarterlyin accordancewith the manufacturers instructions.NOTIFY MONITORING AGENCY THAT TEST ISCOMPLETED ANDSYSTEM IS BACK IN SERVICE.
2 Ceiling clearance.
Storage shall be maintained 2 feet (610 mm) or more below theceiling in nonsprinklered areas of buildings or a minimum of 18inches (457 mm) below sprinkler head deflectors in sprinkleredareas of buildings.
(IFC 315.3.1 2052)
2 of 5 Initials of Authorized Facility Representative:
Washington State PatrolFire Protection Bureau
Phone: (360)596-3900
Business Name
Address
City, State, Zip
Ashley Gardens of Bremerton
3231 Pine RD,
Bremerton, WA 98337
Provider Number
Approval Status
Facility Type
001947
Approved
Residential Care
On 4/5/2018 the Office of the State Fire Marshal conducted an inspection at your facility.
Code Requirement Statement of Violation
3 Operational Inspection and Testing
Emergency power systems, including all appurtenantcomponents shall be inspected and tested under load inaccordance with NFPA 110 and NFPA 111.
Exception: Where the emergency power system is used forstandby power or peak load shaving, such use shall berecorded and shall be allowed to be substituted for scheduledtesting of the generator set, provided that appropriate recordsare maintained.
(IFC 604.5 2015)
4 Activation test record.
Records of tests shall be maintained The record shall includethe location of the emergency lighting tested, whether the unitpassed or failed, the date of the test, and the personcompleting the test.
(IFC 604.5.1.1 2015)5 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.
(IFC 901.6 2012,2015)
3 of 5 Initials of Authorized Facility Representative:^
RJWASH
Washington State PatrolFire Protection Bureau
Phone: (360)596-3900
Business Name
Address
City, State, Zip
Ashley Gardens of Bremerton
3231 Pine RD,
Bremerton, WA 98337
Provider Number
Approval Status
Facility Type
001947
Approved
Residential Care
On 4/5/2018 the Office of the State Fire Marshal conducted an inspection at your facility.
Code Requirement Statement of Violation
6 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
4 of 5 Initials of Authorized Facility Representative:
WAsmwaTON STATE P»TROL
Washington State PatrolFire Protection Bureau
Phone: (360)596-3900
Business Name
Address
City, State, Zip
Ashtey Gardens of Bremerton
3231 Pine RD,
Bremerton, WA 98337
Provider Number
Approval Status
Facility Type
001947
Approved
Residential Care
On 4/5/2018 the Office of the State Fire Marshal conducted an inspection at your facility.
Code Requirement Statement of Violation
7 Smoke detector sensitivity.
Smoke detector sensitivity shall be checked within one yearafter installation and every alternate year thereafter. After thesecond calibration test, where sensitivity tests indicate that thedetector has remained within its listed and marked sensitivityrange (or 4-percent obscuration light grey smoke, if notmarked), the length of time between calibration tests shall bepermitted to be extended to a maximum of five years. Wherethe frequency is extended, records of detector-causednuisance alarms and subsequent trends of these alarms shallbe maintained. In zones or areas where nuisance alarms showany increase over the previous year, calibration tests shall beperformed.
(IFC 907.8.3 2012)
Next inspection scheduled on or after: 3/31/2019
Right of appeal. Any person may appeal any decision made by the Fire Protection Bureau in accordance with WAC 212-12.
Owpe^or Authorized Representative
( ^^^-(C}^^\ . fl^S!>^^ ^c^^a-0,^h/^
Print Name and Title
Deputy State Fire Marshal Scott Campos2803 156AVESEBellevueWA 98007(360)481-9360
Signature
5 of 5 Initials of Authorized Facility Representative:
WABIIIUQTONiiTATC FATOai
Washington State PatrolFire Protection Bureau
Phone: (360)596-3900
Business Name
Address
City, State, Zip
Ashley Gardens of Bremerton
3231 Pine RD,
Bremerton, WA 98337
Provider Number
Approval Status
Facility Type
001947
Disapproved
Residential Care
On 03/06/2018 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.NFPA 80 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).
1 of 4 Initials of Authorized Facility Representative:
BJB.Washington State PatrolFire Protection Bureau
Phone: (360)596-3900
Business Name
Address
City, State, Zip
Ashley Gardens of Bremerton
3231 Pine RD,
Bremerton, WA 98337
Provider Number
Approval Status
Facility Type
001947
Disapproved
Residential Care
On 03/D6/2018 the Office of the State Fire Marshal conducted an inspection at your facility.
Code Requirement
2 Ceiling clearance.
Statement of Violation
Storage shall be maintained 2 feet (610 mm) or more below theceiling in nonsprinklered areas of buildings or a minimum of 18inches (457 mm) below sprinkler head deflectors in sprinkleredareas of buildings.
HFC 315.3.1 2052)
The linen closets in Buildings A, B, C,and D had storagewithin 24 inches of the ceiling. No sprinkler head was observedin the closets.
3 Operational Inspection and Testing
Emergency power systems, including all appurtenantcomponents shall be inspected and tested under load inaccordance with NFPAHOand NFPA111.
Exception: Where the emergency power system is used forstandby power or peak load shaving, such use shall berecorded and shall be allowed to be substituted for scheduledtesting of the generator set, provided that appropriate recordsare maintained.
(IFC 604.5 2015)
The monthly load bank test records for the run hours were notaccurate. The hours were going up and down from week toweek and month to month. The facility was made aware of theerrors. Run hours should only go up.
4 Activation test record.
Records of tests shall be maintained The record shall includethe location of the emergency lighting tested, whether the unitpassed or failed, the date of the test, and the personcompleting the test.
(IFC 604.5.1.1 2015)
The facility was missing the December 2017 and February2018 emergency light testing records.
5 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.
(IFC 901.6 2012,2015)
The sprinkler heads in D building kitchen had excessive dirt onit.
The annual sprinkler report stated that the majority of sprinklerheads in the building were blocked by light fixtures.
The annual sprinkler report stated that the tamper switch wiresneeded to be switched.
2 of 4 Initials of Authorized Facility Representative:
BHWSliiUOTONSrAf^PA'rBSl
kM
Washington State PatrolFire Protection Bureau
Phone: (360)596-3900
Business Name
Address
City, State, Zip
Ashley Gardens of Bremerton
3231 Pine RD,
Bremerton, WA 98337
Provider Number
Approval Status
Facility Type
001947
Disapproved
Residential Care
On 03/D6/2018 the Office of the State Fire Marshal conducted an inspection at your facility.
Code Requirement
6 Portable Fire Extinguishers - General Requirements
Statement of Violation
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
D Building:
Extinguisher by D4 was missing the February sign off.The extinguisher by the food pantry was undercharged and inthe red.
C Building:
Extinguisher by C9 and C3 missing February sign off
B Building:
Extinguisher by B3 missing February sign off
3 of 4 Initials of Authorized Facility Representative;
WAtllHHGTQNSrATI: IWIR31.I^P^^^J^^^
Washington State PatrolFire Protection Bureau
Phone: (360)596-3900
^Business Name
[Address
City, State, Zip
Ashley Gardens of Bremerton
3231 Pine RD ,
Bremerton, WA 98337
Provider Number
Approval Status
Facility Type
001947
Disapproved
Residential Care
On 03/U6/201 8 the Office of the State Fire Marshal conducted an inspection at your facility.
Code Requirement
7 Smoke detector sensitivity.
Statement of Violation
The facility had not been keeping a nuisance log.I Smoke detector sensitivity shall be checked within one yearI after installation and every alternate year thereafter. After thesecond calibration test, where sensitivity tests indicate that the
I detector has remained within its listed and marked sensitivity[range (or 4-percent obscuration light grey smoke, if notmarked), the length of time between calibration tests shall be
[permitted to be extended to a maximum of five years. Wherethe frequency is extended, records of detector-caused
[nuisance alarms and subsequent trends of these alarms shallbe maintained. In zones or areas where nuisance alarms showany increase over the previous year, calibration tests shall beperformed.
/IFC 907.8.3 2012) _.Next inspection scheduled on or after; 04/05/2018
Right of appeal. Any person mayafipeal any decision made by the Fire Protection Bureau in accordancs with WAC 212-12.
Ownqr or/iUthorizecl Regi-^sentative
a--
Deputy State Fire Marshal Kimberiy BloorPO Box 42600Olympia WA 985042600
l_^/_j^r^^ l3^VA—;i r^Print Name and Title
(360)596-3922
^\^x^&lLSignahire
-<l^iixil—
4of4 Initials of Authorized Facility Representative: