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Means of Egress - General

Tag No.: K0211

Based on observations and interviews surveyors 35163 on 11/15/18, in the presence of the maintenance director, facility safety officer, chairman of the health services foundation and safety manager the following was not met;

1. The main concourses located to the left of the main entrance reception area had 25 artificial Christmas trees and associated gifts that extended into the corridor approximately 3-4' and could create a obstruction to egress.
Upon interview with the facility CEO he advised the "festival of trees" had been operating in this capacity for the last 8-9 years.

Portable Fire Extinguishers

Tag No.: K0355

Based on observations surveyors 35163 on 11/15/18, in the presence of the maintenance director, facility safety officer, chairman of the health services foundation and safety manager the following was not met;

1. One of the artificial Christmas trees located in the concourse to the left of the main entrance reception area was blocking access to the recessed portable fire extinguisher cabinet.

Combustible Decorations

Tag No.: K0753

Based on observations and interviews surveyors 35163 on 11/15/18, in the presence of the maintenance director, facility safety officer, chairman of the health services foundation and safety manager the following was not met;


1. The main concourses located to the left of the main entrance reception area had 25 artificial Christmas trees, associated gifts and decorations and no documentation could be provided to indicate that the items were flame retardant from the manufactures or that they had been treated with a flame retardant product.

Electrical Equipment - Power Cords and Extens

Tag No.: K0920

Based on observations surveyors 35163 on 11/15/18, in the presence of the maintenance director, facility safety officer, chairman of the health services foundation and safety manager the following was not met;

1. The main concourses located to the left of the main entrance reception area had 25 artificial Christmas trees, with lighting and most were powered with the use of electrical extension cords.

2. The main concourses located to the left of the main entrance reception area had 25 artificial Christmas trees, with lighting and 6 of the trees had extension cords that were interconnected (daisy chained) with other extension cords or powers strips.