Burien/Normandy Park Fire Department 900 SW 146 th ST PO Box Burien, WA BP (206) Fax (206)

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Burien/Normandy Park Fire Department 900 SW 146 th ST PO Box 66029 Burien, WA 98166 BP (206) 242-2040 Fax (206) 433-6042 HOME DAYCARE SELF-INSPECTION CHECKLIST ` Complete the following daycare checklist, correct any problems, sign and return this form to the Burien/Normandy Park Fire Department @ 900 SW 146 th ST. Burien, WA 98166. Allow 7 days for processing and call to set up a site visit with an inspector. If you have additional questions, please contact the inspection department at 206 242-2040. HOME COMPLIES EMERGENCY PROCEDURES & FIRE PREVENTION WAC 170-296A-2525 through 3050 If a portion of the home is used for purposes that could pose a hazard such as an automotive repair shop, cabinet or furniture making or refinishing or similar use, a firewall is required between the dwelling and the other use. If you have rooms or spaces containing any of the following commercial-type items or utilities, they must be separated from the family home child care or any exits by a fire wall: Kitchen, Boiler, Maintenance shop, Janitor closet, Laundry, Woodworking shop, Flammable or combustible storage, Painting operation, or Parking garage. You must: (1) Conduct a fire evacuation drill for each shift of operation at least once each month; (2) Maintain and post in the licensed area of your home: (a) The fire safety record including date and time of fire drills; and (b) Your evacuation plan. You must have a written fire evacuation plan. Bathroom door lock must open from outside in an emergency, opening device must be readily available for staff use. No area in the home that is accessible only by ladder, folding stairs or trap doors may be used for child care. No obstructions are allowed in corridors, aisles, doorways, stairways or ramps. Combustible rubbish not allowed to accumulate; removed from home or stored in closed metal containers. Waste must be removed daily to disposal containers (made of non-combustible material with lids). Furnace room must be kept free of lint, grease, rubbish and suitably isolated, enclosed or protected. Open flame devices are not left on, unattended or used improperly. Candles or incense are not used. House numbers must be plainly visible and legible from the street fronting the property. Electrical circuits devices and appliances must be properly maintained and not overloaded. You must not use extension cords and multiplug adapters in place of permanent wiring and proper receptacles. Use of portable space heaters is prohibited. You must have a flashlight in working condition available for use as an emergency light source. The local building official must approve fire places wood stoves or similar devices and any connections when installed. Fireplaces and stoves must have an approved barrier erected to prevent children from coming in contact with open flames or hot surfaces. Sprinkler system if installed, tested annually by a licensed contractor with documentation maintained on site.

HOME DAYCARE SELF-INSPECTION CHECKLIST Page 2 of 5 EXITS and DOORS WAC 170-296A-4400 through 4750 One exit door must be of the pivoted or side hinged swinging type. You may use an approved siding door for the other exit (two exits are required). Each floor level used for family home child care purposes must have two exits, usually located at opposite ends of the building or floor. The maximum distance between the exit door and any point in the home is 150 feet. Flammable or combustible materials stored away from exits, in areas not accessible by children. Each exit door opens easily (to full open position from the inside) without using a key. Every room used for child care (except bathrooms) must have: Doors leading to two separate exit ways; or A door leading directly to the exterior of the building. Every room used for child care (except bathrooms) must have: At least one working window or door approved for emergency escape or rescue that opens directly into a public street, public alley, yard or exit court. The units must work from the inside to provide a full clear opening without the use of separate tools. Exit doors must be easy to open to the full open position. Exit doors and windows must be of the type that can be opened from the inside without using a key. No night latches, dead bolts, security chains, manually operated edge or surface mounted flush bolts can be used during childcare hours. The locking arrangement on outside exit doors must automatically unlock when the doorknob is turned from the inside. You must ensure that obstructions are not placed in corridors, aisles, doorways, doors, stairways or ramps. You must not use for child care purposes any space that is accessible only by ladder, folding stairs or trap doors. Every bathroom door lock must be designed to permit the opening of the locked door from the outside in an emergency. The opening device must be readily accessible to the staff. Every closet door latch must be the type that children can open the door from inside the closet. ESCAPE OR RESCUE WINDOW WAC 170-296A-4550 Every escape or rescue window must have: 24 inches minimum net clear open height dimension 20 inches minimum net clear open width dimension 5.7 square feet of net clear open area 44 inches maximum sill height above floor (stationary platforms are allowed to attain the required 44 inch max).

HOME DAYCARE SELF-INSPECTION CHECKLIST Page 3 of 5 FIRE SAFETY & SMOKE ALARMS WAC 170-296A-2950 Smoke detectors must be tested monthly. Documentation of monthly smoke detector testing must be kept on the premises. Smoke detectors must be installed in all nap/sleeping areas. When sleeping or napping rooms are on an upper level, you must place the smoke detector on the ceiling of the upper level in close proximity to the stairway and in each sleeping or napping room. Smoke detectors must sound an alarm that is audible in all area of building. Smoke detectors must be installed on each story and in the basement. Extra batteries (proper type and size) for your battery operated smoke detectors must be available on site. Hard-wired smoke alarms must be permanent, without a disconnecting switch. Commercial or biohazard areas must be separated from the child care areas with a fire wall. You must have at least one 2A:10:BC fire extinguisher on each floor level used for child care and have written documentation of yearly maintenance. Fire extinguisher kept on shelf or mounted with the top not more than 5 feet above the floor and within 75 feet of an exit. In addition to single station smoke detectors, you must provide an alternate method for sounding a fire alarm in your family home child care. A police type whistle or similar device is adequate for meeting this requirement, as long as you use that method only for emergency evacuations. BASEMENTS WAC 170-296A-4500 More than 4 feet below grade level - must have ONE of the following or must Not be used for childcare: One of the two exit discharges directly to the exterior from the basement level and a self-closing door is installed at the top or bottom of the interior stair leading to the floor above, OR Two exit stairways from the basement open directly to the exterior of the building without entering the first floor OR One of the two required exits is a working window or door, approved for emergency escape or rescue, that opens directly to a public street, public alley, yard or exit court, and the other may be an approved interior or exterior stairway; OR A residential sprinkler system is installed for the entire home and meets National Fire Protection Association Standards (NFPA). SECOND STORY WAC 170-296A-4500 Any floor more than 4 feet above grade level - must have ONE of the following or must NOT be used for child care: Two exit stairways from second story open directly to exterior of the building without entering the first floor, OR One of two exits discharges directly to exterior from second story level and a self-closing door is installed at the top or bottom of interior stair leading to the floor, OR A residential sprinkler system is installed for the entire home and meets National Fire Protection Association Standards (NFPA). 3 rd floor/story use is not allowed for in-home day cares

HOME DAYCARE SELF-INSPECTION CHECKLIST Page 4 of 5 CONTACT INFORMATION Date: Name of Day Care: Address: Business Owner: Phone: License Type: (How many children are you licensed for?) (Age range) DECLARATION My name is Date: I have identified and corrected all conditions and hazards as set forth in the Home Day Care Self-Inspection form. I declare and under penalty of perjury under the laws of the State of Washington that the information contained herein is true and correct. Print Full Name Signature