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WALDO COUNTY GENERAL HOSPITAL
Building Construction Type and Height
Tag No.: K0161
Based on observation and record review of surveyors 16732 and 37695
1) The boiler room ceiling that is 1957 is also a Type 2 (111) and designed with 1 hour rating. Sheet missing from ceiling and no longer has the correct rating.
the maintenance worker was present during this observation.
Doors with Self-Closing Devices
Tag No.: K0223
Based on observation of surveyors 16732 and 37695
Stairtower door 2nd floor was not latching
The maintenance worker was present during this observation
Stairways and Smokeproof Enclosures
Tag No.: K0225
Based on observation of surveyors 37695 and 16732 on November 28, 2016
1) Conduit in stairtower by Central Sterile does not have fire rated fire stopping material applied to penetration of conduit.
maintenance worker was preset during this observation
Hazardous Areas - Enclosure
Tag No.: K0321
Based on observation of surveyors 37695 and 16732 on November 28, 2016
1) Maintenance door to hallway does not latch
2) Housekeeping storage room over 50 square feet in basement does not have self closer on door
3) battery storage room for IT big batteries does no have self closer on door
4) Storage room basement is not smoke tight as it is missing ceiling tiles.
5) elevator machine room door will not self close as door is dragging against the floor
6) laundry room door has foot peg attached to door so it does not self close
7) Central storage room does not self close.
maintenance worker was present during the observation
Cooking Facilities
Tag No.: K0324
Based on observation and interview with staff by surveyors 16732 and 37695
1) There is a small griddle that is being used in kitchen that is not under a commercial cooking hood. The griddle has grease on the machine and the dispenser beside the griddle has grease on the side.
the maintenance worker, chef and dietary director was present during this observation
Utilities - Gas and Electric
Tag No.: K0511
Based on observation of surveyors 37695 and 16732 on November 28, 2016
1) Old boiler room has open 3 wire with wire nuts on wires and not secured in a junction box
2) Emergency Light not working in conference room
3) Missing junction box cover in loading dock ceiling
maintenance worker was present during this observation
Building Construction Type and Height
Tag No.: K0161
Based on observation and record review of surveyors 16732 and 37695
1) The boiler room ceiling that is 1957 is also a Type 2 (111) and designed with 1 hour rating. Sheet missing from ceiling and no longer has the correct rating.
the maintenance worker was present during this observation.
Doors with Self-Closing Devices
Tag No.: K0223
Based on observation of surveyors 16732 and 37695
Stairtower door 2nd floor was not latching
The maintenance worker was present during this observation
Stairways and Smokeproof Enclosures
Tag No.: K0225
Based on observation of surveyors 37695 and 16732 on November 28, 2016
1) Conduit in stairtower by Central Sterile does not have fire rated fire stopping material applied to penetration of conduit.
maintenance worker was preset during this observation
Hazardous Areas - Enclosure
Tag No.: K0321
Based on observation of surveyors 37695 and 16732 on November 28, 2016
1) Maintenance door to hallway does not latch
2) Housekeeping storage room over 50 square feet in basement does not have self closer on door
3) battery storage room for IT big batteries does no have self closer on door
4) Storage room basement is not smoke tight as it is missing ceiling tiles.
5) elevator machine room door will not self close as door is dragging against the floor
6) laundry room door has foot peg attached to door so it does not self close
7) Central storage room does not self close.
maintenance worker was present during the observation
Cooking Facilities
Tag No.: K0324
Based on observation and interview with staff by surveyors 16732 and 37695
1) There is a small griddle that is being used in kitchen that is not under a commercial cooking hood. The griddle has grease on the machine and the dispenser beside the griddle has grease on the side.
the maintenance worker, chef and dietary director was present during this observation
Utilities - Gas and Electric
Tag No.: K0511
Based on observation of surveyors 37695 and 16732 on November 28, 2016
1) Old boiler room has open 3 wire with wire nuts on wires and not secured in a junction box
2) Emergency Light not working in conference room
3) Missing junction box cover in loading dock ceiling
maintenance worker was present during this observation