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Fire Safety Inspection for State Daycare Licensing
ew Daycare License Applicant ❑ Daycare License Renewal Applicant
Date Z62Aperator
O wner
Name of Facility
Address O
City
` kA State Zip
Facility Phone Number 1 /�r� Land Line or Cellular Phone
Note: The licensing authority is the Idaho Departn;ent of Health and Welfare. The minimum standards as outlined
in the state daycare licensing act will not preempt any local ordinance that is more stringent.
This inspection form was drafted within the confines of the legislated fire safety standards for daycare facilities
and does not mean to infer that the provisions within provide fora level of fire safety that would meet
nationally recognized standards. Nor does it mean that it would provide a level of fire safety that would meet
our awn adopted fire safety standards for ather occupancies in Idaho.
II. GENERAL REQUIREMENTS FOR ALL DAYCARE OCCUPANCIES
Exiting Requirements
Are the required exits located to provide an unobstructed path
outside the building to a public way or area of refuge? if
Can exit doors be opened from the inside without the use of a ;
key or any special knowledge or effort?
Are there at least two exits (travel distance between not to
exceed 7S feet) located a distance apart, not less than one-half
the diagonal dimension of the building or portion used for
daycare?
Exception: In buildings with automatic fire sprirVer systenss, the
distance may be increased to 110feet.
Are the required exits not less than 32 inches, of flea: er;t vidth
and not less than six feet, eight inches (68") in height?
Exception: Sliding patio doors will he accepted as a required second 1
exit in "Family and Group Daycare Facilities" oniv.
Page 1 of 4
Are sleeping rooms provided with at least one emergency
egress window having at least a minimum single net clear
opening of 5.7 square feet, minimum height 24 inches,
minimum width 20 inches, and maximum finished sill height not
over 44 inches?
Note: An approved exit door is acceptable in lieu of egress windows.
Also, an approved piece of furniture or platform, if anchored in
place, can be approved to sit in front of a window, if the sill height
is over 44 inches
Are approved egress windows from sleeping areas operable
from the inside without the use of separate tools?
Where children are located on a story below the level of exit
discharge (basement), are there at least two exits provided, one
of which is directly to the outside?
Note: More than one exit from the basement opening directly to the
outside may be required, depending on the structure of the building.
Daycare is prohibited on any upper floor beyond the first floor,
Exception: Daycare is permitted at the second floor level, provided
that the building has two (2) exits, one (1] of which must open
directly to the outside and be in compliance with building codes.
Is the facility in compliance?
Eire Extinguishers
For DAYCARE CENTERS:
Is there a portable fire extinguisher (minimum 2A-10BC) i
mounted securely in the kitchen area and one other approved
location that is visible, does not exceed five (5) feet from the
floor to the top of the extinguisher, and not more than seventy
five (75) feet travel distance, and is it maintained properly?
Note: Fire extinguishers shall be maintained properly.
For CYROUp DAYCARE FACILITIES and FAMILY DAYCARE HOMES:
is there a portable fire extinguisher (minimum 2A-IOBC)
mounted securely in the kitchen area that is visible, does not
/
exceed five (5) feet from the floor to the top of the
1!//
extinguisher, and not more than seventy five (75) feet travel
distance, and is it maintained properly?
Note: Fire extinguishers shall be maintained properly.
Is there a hood -type fire suppression system installed in the
kitchen area, if required?
In facilities over three thousand (3,000) square feet are
additional fire extinguishers present and approved by local fire
official or designee? _
V
In Facilities greater then twenty thousand (20,000) square feet
in area or when the number of children under the age of
eighteen (18) month exceeds one hundred (100) is there an
automatic sprinkler system?
Page 2 of 4
I
Telephone
Is there an operable telephone on the premises?
Smoke Detectors
Is there a smoke detector installed in the basement having a
stairway which opens from the basement into the facility (such
detector shall be connected to a sounding device or other
detector to provide an alarm which will be audible in the
sleeping area)?
Are approved smoke detectors provided on the ceiling or wall
outside each separate sleeping area or in the immediate vicinity
of bedrooms?
Is there a smoke detector in each room used for sleeping
purposes?
Is there a smoke detector in each story within the facility
includine the basement?
Fire Safety and Evacuation Plan
Note, Each doycore center, group doycore facility or family doycore home voluntarily licensed by the Department,
must hove an approved fire safety and evacuation pion prepared. Fire evacuation and safety plans must include the
elements fisted below.
Procedures and policies that accounts for all employees and V
children after an evacuation is completed.
Identifies evacuation routes, locations of facility exits, and
assembly point for an evacuation.
Includes location of smoke detectors, fire alarm appliances and
fire extinguishers.
A schedule of fire and emergency evacuation drills and annual r
reviews that all employees and children participate in with V
records of those drills available for reference and review.
For Facilities with an Occupancy Load of Fifty or More
Note. In addition to the requirements above, those facilities with an occupancy load of fifty (30) or more
occupants must also meet the criteria outlined below.
Do exit doors swing in the direction of egress? 93
Do exit doors from rooms having an occupant load to fifty (50)
or more, if provided with a latch, have panic hardware?
Are Exit signs installed at required exit doorways and where
otherwise necessaryto clearly indicate the direction of egress?
For facilities with over fifty (50) children, is an approved fire
alarm system installed? ;z
Page 3 of 4
Occupant Load
Note: Occupant load is determined by the local fire official or designee. Only those areas used for daycare
purposes will be used when determining occupant load.
To determine occupant load, calculate the square footage of
the space between the interior face of the exterior wails,
assigned to daycare use, and divide by the occupant load
factor of 35. Allowances for interior walls or partitions and
furnishings have been taken into account in the occupant load
factor, except Fixed seating. The occupant load for fixed
seating is determined by counting the seats.
Enter Occupant Load:
Is the facility in compliance?
Note: This inspection is for the purpose of meeting only the requirements of the Department of Health and
Welfare. The operator/owner may also be required to meet; zoning, building code, fire code or other agency
regulations within their local jurisdiction to conduct this type of business. In addition, a separate Health and
Safety inspection is required on all facilities that are required to be licensed.
REMARKS:
Facility passes fire inspectio
INSPECTION MADE BY:
TITLE AND AGENCY:
Signature of Inspector:
J C P 4
Yes No Occ ant load:
Residential ❑ Commercial
w I
Name of facility operator/owner (pleale print):�iU
Signature of facility operator/own r: JIr Date:
Idaho Department of Health and Welfare Daycare Licensing Fire Safety Inspection Form - Revisedlune 20, 2016
Page 4 of 4
jpAHQ Idaho Name -Based Search No Hit Notification
A name -based search of the Idaho Criminal History Record Central Repository has found NO MATCHING criminal
dry history based on the information provided by the requestor- Criminal history record information furnished as a result of non -
fingerprint based computerized search is based solely on a search of identifiers provided in the request Idaho law does not require a
person to give consent However, without a signed release from the subject of record, any arrest more than 12 months old, without a
dtsposiuon, cannot be given to a non -criminal justice agency.
Date Search Completed: 07/14/2020
Name: DUFFIN, TANIA AVEY, TANIA
Date of Birth: 08/1711972
SSN (if provided):
Idaho State Police
Bureau of Criminal Identification
700 S Stratford Dr. Ste 120
Meridian, ID 83642
The records maintained by the Idaho Bureau of Criminal Identification (BCI) are based upon the felony and serious misdemeanor arrests reported to
BCI from other Idaho criminal justice agencies. Be aware that it is not uncommon for criminal offenders to use alias names and false dates of birth,
which would adversely affect the completeness and accuracy of a non -fingerprint based search of the Idaho Central Repository of Criminal History
Records. No other state or federal agency records can be search under current law, The Idaho State Police Bureau of Criminal Identification
does not certify name -based search results.