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Based on observations the facility failed to provide the required 30 minute fire resistance rating for smoke barrier walls in accordance with 19.3.7.3, 19.1.6.3, 19.1.6.4. This condition has the potential to affect about 50% of the residents and staff.

Findings include:

While inspecting smoke barrier walls on March 4, 2014 at 9:30 a.m., the maintenance supervisor and the surveyor observed the Smoke Barrier Walls had the following unsealed penetrations in the following areas:

1. Smoke barrier wall on the 2nd floor across from labor & delivery
2. Smoke barrier wall on the 2nd floor near elevator lobby #2


This deficient practice has the potential of affecting 2 of 10 smoke compartments. These deficiencies were corrected prior to the exit conference.

The administrator and maintenance director were notified during the survey and in the exit conference.

Based on observations the facility failed to protect there electrical transformers in accordance with NFPA 70.

NFPA 70, National Electrical Code Article 450-21, which states:
Dry-Type Transformers Installed Indoors

(a) Not Over 112½ kVA. Dry-type transformers installed indoors and rated 112½ kVA or less shall have a separation of at least 12 in. (305 mm) from combustible material unless separated from the combustible material by a fire-resistant, heat-insulated barrier.

Exception: This rule shall not apply to transformers rated for 600 volts, nominal, or less, completely enclosed, with or without ventilating openings.

(b) Over 112½ kVA. Individual dry-type transformers of more than 112½ kVA rating shall be installed in a transformer room of fire-resistant construction. Unless specified otherwise in this article, the term fire resistant means a construction having a minimum fire rating of 1 hour.

Findings Include:

While inspecting the Electrical Rooms on March 3, 2014 the surveyor and maintenance supervisor observed the 4th floor Electrical Room behind the Central Nurse ' s Station had a 3 in. opening around left side wall.

This deficient practice has the potential of affecting 1 of 10 smoke compartments.

The administrator and maintenance director were notified during the survey and in the exit conference.

Based on observations the facility failed to provide the required 30 minute fire resistance rating for smoke barrier walls in accordance with 19.3.7.3, 19.1.6.3, 19.1.6.4. This condition has the potential to affect about 50% of the residents and staff.

Findings include:

While inspecting smoke barrier walls on March 4, 2014 at 9:30 a.m., the maintenance supervisor and the surveyor observed the Smoke Barrier Walls had the following unsealed penetrations in the following areas:

1. Smoke barrier wall on the 2nd floor across from labor & delivery
2. Smoke barrier wall on the 2nd floor near elevator lobby #2


This deficient practice has the potential of affecting 2 of 10 smoke compartments. These deficiencies were corrected prior to the exit conference.

The administrator and maintenance director were notified during the survey and in the exit conference.

Based on observations the facility failed to protect there electrical transformers in accordance with NFPA 70.

NFPA 70, National Electrical Code Article 450-21, which states:
Dry-Type Transformers Installed Indoors

(a) Not Over 112½ kVA. Dry-type transformers installed indoors and rated 112½ kVA or less shall have a separation of at least 12 in. (305 mm) from combustible material unless separated from the combustible material by a fire-resistant, heat-insulated barrier.

Exception: This rule shall not apply to transformers rated for 600 volts, nominal, or less, completely enclosed, with or without ventilating openings.

(b) Over 112½ kVA. Individual dry-type transformers of more than 112½ kVA rating shall be installed in a transformer room of fire-resistant construction. Unless specified otherwise in this article, the term fire resistant means a construction having a minimum fire rating of 1 hour.

Findings Include:

While inspecting the Electrical Rooms on March 3, 2014 the surveyor and maintenance supervisor observed the 4th floor Electrical Room behind the Central Nurse ' s Station had a 3 in. opening around left side wall.

This deficient practice has the potential of affecting 1 of 10 smoke compartments.

The administrator and maintenance director were notified during the survey and in the exit conference.