“IT’S PERSONAL [CARE]”
JANUARY 2015
Most of us have what are known as personal care facilities in our community. Over the past years I have had the responsibility of inspecting and report writing to the Authority Having Jurisdiction (AHJ) to make recommendations and inform the administrators of any deficiencies that may be detrimental to the life safety of the occupants, residents and staff. Using N.F.P.A. 99, Health Care Facilities CODE a subchapter of N.F.P.A 1, I reference the Life Safety Chapters 12, 15 and Annex A4.2 as well as other sections. Also a very important guide is the Department of Health and Human Services (H.H.S./D.P.W.) Title 55 Chapter 2600. These documents along with the local A.H.J. are the basis for inspection and ‘certification’ of these personal care facilities.
In the Commonwealth of Pennsylvania (Pennsylvania is a Commonwealth, not a state) there are approximately 1500+-personal care facilities. There are 67 counties in Pennsylvania that interprets to 67 counties doing things 67 different ways. However, H.H.S./D.P.W Title 55, Chapter 2600 supersedes all local A.H.J.
Of special interest and a very important aspect is the local (first-due) fire department. Are the local firefighters career, with manned stations, or volunteer with an estimated response time? Have local firefighters inspected the facility, met the administrators and spoke with the residents? Did firefighters perform training for staff and in some cases the residents? How about witnessing a fire exercise (we are attempting to faze-out the terminology ‘fire-drill’) to determine efficiency and speed of reacting to the alarm-of-fire? Is an evacuation of the structure required? Are there ‘approved’ safe areas in the structure? How about an area for accountability with a med-cart and attendance chart? Is there a Knox Box and are the keys contained inside tagged and tested?
Are firefighters aware of the sensitivity of the residential situation and the occupants not wanting to evacuate the premise if necessary? There could be Hospice residents, non- ambulatory residents, folks on wheel chairs, walkers and crutches. Accountability is the primary issue. Does the facility have a PIO, Public Information Officer? A media spokes-person typically, and recommended, the PIO should wear a red ball cap. All questions should be directed to the ‘red cap’.
Are there provisions for a total evacuation of the occupants to a predetermined safe-haven off the immediate premise? Has a pre-arranged (contracted) method of transportation been established? Have arrangements been pre-made for food and water?
Now, here’s the BIG and most important question (in my opinion)………is the structure SPRINKLERED? Oh wow, what a welcomed site to enter into a personal care facility (or any facility) and ‘see’ sprinkler heads sticking out of the ceiling(s), and then to explain to the occupants the importance and function of the sprinkler system. TV and motion pictures have given the public a false sense of how and why these systems operate. Explain that only the sprinkler heads over the fire activate and that approximately 10-12 gallons of water in a fine spray flow from the activated head. You may get wet, you won’t get dead! Is a clearance of at least 18” maintained in all directions of the head(s)? Most fires are extinguished with the activation of 2 heads or less. Residential ‘heads’ typically activate at 165 degrees F, and most sprinkler systems are supervised by a central station that will automatically notify the fire department of a water flow and dispatch the necessary assistance. (Refer to N.F.P.A. 13)
Is the outside fire department Siamese free of obstructions and is it clearly marked as such?
Then there is the life safety system of smoke alarms. Are they interconnected, are they ionization and or photoelectric, do they have a battery back-up, are they central-station supervised? Are these devices in all rooms, hallway, basement and attic areas? Have they been cleaned and tested recently? (Refer N.F.P.A 72/ Life Safety 101)
Are fire extinguishers up-to-date, properly maintained, properly spaced and do occupants/staff have training on the usage? Are there Type K extinguishers in the kitchen? If cooking takes place in the kitchen, does the hooded system meet N.F.P.A. 96? Is there a remote D-ring to activate the hood-system? Emergency gas shut off, is it ‘marked’ and accessible? Is the fuel natural gas (lighter-than-air) or LP Liquefied Petroleum (heavier-than-air). Are all kitchen assistants familiar with the SOP for emergencies? (Refer N.F.P.A. 54)
Do emergency responders have a 360 degree access to the structure? This is important for ladder operations and rescue if necessary.
Is there a hydrant system on the site; is it municipal or private? Is the GPM flow known? Are the hydrant(s) color coded for quick reference (flow)? (Refer N.F.P.A. 291)
According to published reports, the chances exist of an external emergency that would necessitate an evacuation (total/partial) or a defend-in-place procedure to be put into play. It may be a vehicle burning in the parking lot; a fuel tanker overturned or leaking its product in your proximity; a plane crash nearby; a nuclear emergency; terrorist emergency/threats to the facility; or a disgruntledly resident or visitor. Whatever the emergency, a preplan policy must be established (in-writing) and practiced by ALL staff.
Keep in mind that the situation changes minute-to-minute; what was good [to-do] is now not good [to-do]. The plan(s) must be flexible and adaptable to change at a moment’s notice.
If you choose to inspect the structure for occupancy and safety, be certain that your findings will have to be documented and signed by the persons performing the site inspection. So, having said all-that, are you (they) certified (by HHS/DPW), qualified and experienced. Be aware responsibility and liability go hand-in-hand. Life safety (of the residents, staff and the first-responders) is the main concern, buildings can be replaced, they can’t.
Ed Knight is a Certified Fire and Explosion Investigator (CFEI/CFII) and a fire instructor; a retired municipal assistant fire marshal, forensic investigator having investigated several thousand fires and testified over 60 times throughout the United States and several foreign countries. He is Chairman of the Live Burn Facility, Pequea Lane, Lancaster, PA.