INSPECTIONS PREPARED 7/14/10, 13:57:52 INSPECTION TICKET PAGE 44
Harnett County INSPECTOR: IVR DATE 7/15/10
ADDRESS . : *UNASSIGNED SUBDIV:
CONTRACTOR : PHONE
OWNER . . : REFUGE TABERNACLE OF PHONE
PARCEL . . : 13 -0528- - -0078- -02-
APPL NUMBER: 10- 50024589 CP DAYCARE
DIRECTIONS : T /S: 06/10/2010 10:31 AM VBROWN - - --
REFUGE TABERNACLE OR VICTORY
TABERNACLE, 27W APPROX 7MI, THE CHURCH
WILL BE ON RIGHT, BEIGE BRICK VICTORY
TABERNACLE.
STRUCTURE: 000 000
FLOOD ZONE • FLOOD ZONE X
PROPOSED USE • DAYCARE SEPTIC - EXISTING • EXISTING
WATER SUPPLY • COUNTY
PERMIT: CPLU 00 CP LAND USE PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
Z818 01 7/15 10 TI PZ *ZONING INSPECTION TIME: 17:00 . VRU #: 001954403
7 s P.B.) T /S: 07/14/2010 12:38 PM VBROWN
COMMENTS AND NOTES n
Q y i o' �'a'"- p j .- 15 r*ot c°.xlo
W:14.
M. reLlurrece 1 '�'v� • " "'�'3' urt t-
6P1)
L • - o°°o-ym oa °male ht tt MEM mg as! d sr as
l �
a a a a
01 :
f- rc k 1 a _ a a s w
e w 0 / . i. Fa a RR:
b, r. I flit 888 8 >
s . .r . � � 0 , as F - RY»
as!iaa sa��1� A o a W os 1 ill c
r e i ° rgM°
R
r
ih, .. is..
-
d� � _� i Ili �
h
i-
I
i
0 r N §
dam.
1y
g 1 4
- 'ili /
f � i
o OS
/ ' .
' W .
U
is /,
ic
2 '4 II
. it - 7 • .
ill
P
a
NORTf r�
' ..
7 • . ----. •
•
'IE$ � : " (►; f. iv ‘ t a I". and OflJ - - --
•
Li M WiP3 ao es svruionis
us • roue w
' envie rr �1 '
r
is. .0-V
US OC
` O Q at us ca
tam . v • • c ccc
u ctccccccccc c • 00 •
• LL t ••• • S d 3 3 U.S o 1111141161 mor '�� ��
..
401148 . •
............. •
.
.. � L S*Od 18 DO • c •
IE L• . • , . •
•
90 .f. • • •
1,0 40 t. a • ea Nil Al to► • 101100 W1
S ]..\\ ' • ..„----- . ' ' •
bi Li ' . . Lt L1. • AN
Z O*dM b • e - % ., :T.... • .:.::. .
• 4 , .
•
.., • ........ . aisi r: •
j , utsvni .
. - . • • ONUS ' ' •
SIPMS UN WAN . noise � `
„ter . I . . - •
. _este
• - _ 1 Y 1 � 1 + 0 .:]' J+f ^.Lk ' [rid \. i yjf- q;
• h s J r j l ( i J .0t:',',11. e v a te . .. •
a) 1.7,2:V&-,C41;:-..l.' 4 e ? . ...' t yi j jam. .. 1' .- jty + " ( � y '" � . •`
! J\° 1 �' pY� icir'rk• Z � b i fi ! k S al f fir
c ° ' + � ', j � 1 A * ., r}}-� P i � 7 t rr } x. s. e .
i , . + - >r y• i
, F,�.s�u t . f ))• Pk r . r ^ M Y '+e' ..
� • h �` C am` :Ft ` .l �., 1.' 11.;•.(4)1 I�,aP ---k--7. f k � FYI " y 1
+ `
+ + tw' : + ,� s '. + •� j i ;: 6 t 7a r "ar Yoh fl �,,// +u 4 t � r
' 4 I S. s #. a { C71F,1 2 '� . .k.wr 4 n . 114.4 Eti ; S • . . + : ;
� t .,_: i+T�na;v -'. �� • 9sEUS � t z ^r " r Iy ( �, .. ` .t: -... � � .
.- p jQQ�
PREPARED 8/23/10, 13:58:00 INSPECTION TICKET PAGE 27
Harnett County INSPECTOR: IVR DATE 8/24/10
ADDRESS . : *UNASSIGNED SUBDIV:
CONTRACTOR : PHONE :
OWNER . . : REFUGE TABERNACLE OF PHONE :
PARCEL . . : 13 -0528- - -0078- -02-
APPL NUMBER: 10- 50024589 CP DAYCARE
DIRECTIONS : T /S: 06/10/2010 10:31 AM VBROWN - - --
REFUGE TABERNACLE OR VICTORY
TABERNACLE, 27W APPROX 7M1, THE CHURCH
WILL BE ON RIGHT, BEIGE BRICK VICTORY
TABERNACLE.
STRUCTURE: 000 000 NEW DAYCARE IN EXIST STRUCT ALREADY BLT
FLOOD ZONE • FLOOD ZONE X
PROPOSED USE • DAYCARE SEPTIC - EXISTING' • EXISTING
WATER SUPPLY • COUNTY
PERMIT: CPLU 00 CP LAND USE PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
Z818 01 7/15/10 RS PZ *ZONING INSPECTION TIME: 17:00 VRU #: 001954403
7/15/10 DA T /S: 07/14/2010 12:38 PM VBROWN
T /S: 07/15/2010 03:11 PM RBAKER
Outdoor activity area must be surrounded by a security
fence that measures six feet in height. Present fence is
only four feet in height.
Z818 02 8/24/10 TI PZ *ZONING INSPECTION VRU #: 001974054
Si?Altc 2.6.1Q
COMMENTS AND NOTES
C0.4 11\6
tett
PREPARED 8/24/10, 14:05:43 INSPECTION TICKET PAGE 14
Harnett County INSPECTOR: IVR DATE 8/25/10
ADDRESS . :` *UNASSIGNED SUBDIV:
CONTRACTOR PHONE :
OWNER : REFUGE TABERNACLE OF PHONE
PARCEL . . : 13 -0528- - -0078- -02-
APPL NUMBER: 10- 50024589 CP DAYCARE
DIRECTIONS : T /S: 06/10/2010 10:31 AM VBROWN - - --
REFUGE TABERNACLE OR VICTORY
TABERNACLE, 27W APPROX 7MI, THE CHURCH
WILL BE ON RIGHT, BEIGE BRICK VICTORY
TABERNACLE.
STRUCTURE: 000 000 NEW DAYCARE IN EXIST STRUCT ALREADY BLT
FLOOD ZONE FLOOD ZONE X
PROPOSED USE • DAYCARE SEPTIC - EXISTING' • EXISTING
WATER SUPPLY COUNTY
PERMIT: CPDC 00 CP DAY CARE INSPECTION
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
H822 01 7/16/10 GG ENVIR. HLTH /SANITATION FINAL TIME: 17:00 VRU #: 001955566
7/16/10 AP T /S: 07/16/2010 08:13 AM SSTEWART
T /S: 07/16/2010 08:14 AM SSTEWART
D830 01 8/25/10 TI C *DAY CARE INSPECTION TIME: 17:00 VRU #: 001974658
R-24'.1) NA M p T /S: 08/24/2010 01:53 PM JBROCK
COMMENTS AND NOTES
DCD - 0304 Identification # f 0 00 44 S 2.
Rev. 9/08 County
Date of Inspection
BUILDING INSPECTORS INSPECTION FORM FOR CHILD CARE CENTERS
NAME OF OPERATION k /tctur S'cve /i -e Cr C c( De L/cIc,-t, ,,,,,-f
ADDRESS 7 "3 J \I C 27 IiL/ • TELEPHONE: q? 1 =' -, 4 T- 2 N ti
CITY Lt11 7 no STATE Ai C. ZIP 2_. A
BUILDING INSPECTORS CERTIFICATE
1. The areas in the building that are designated as the licensed space are required by the licensing agency
to meet the Building Code in effect when an application for licensure is submitted to the regulating agency.
Does the building listed above, to the extent observable, meet the current North j ) k1
Carolina Building Code? Yes . No ,\
2. If no, list question numbers which do not comply, explain the violation and whether equivalent protection
for the safety of the children is provided:
1 ) Fr-olet Steps roc. ttr.1 Pp C ode
2).
3)
4)
3 Are any of the above violations of a life safety concern? Yes_K No_
If yes, please list question numbers
4. In your opinion based on the violations listed above, do you recommend that the
Division of Child Development issue a provisional license to allow time for
correction of the violations? Yes $< No
If yes, how long (30 -60 -90 days) and for which violations? C ) CI)
(Note: All violations must be corrected before a license can be issued unless a provisional time period is
recommended or equivalent protection is documented.)
5. Number of rooms approved for occupancy by children?
(Attach sketch of building with rooms identified)
6. Specify any local zoning restriction: 27,1
Signature of Inspector 7 / i bt, Aft, / /Date e=4 c,;1 C
Jurisdiction H C V /Phone: et i (] •- 9 e 1 7 7 72 --
The Inspectors Certificate and Building Inspection Form is required to be completed in its entirety before the Division of Child
Development (DCD) can consider the document complete. All questions must be answered; any NO answers must have a written
explanation.
This form was developed through the cooperation of the Division of Child Development and the Engineering Division of the Department of
Insurance. Please note that the inspection forms do not cover all areas of the Code, but are intended to be used as a guide for the local inspector.
If additional Code items which are not addressed on these forms are found to be in violation of the Code, please document them on the back of this
form.
Prepare in quadruplicate: Original & copy to DCD, 1 copy kept by inspector, 1 copy kept by operator.
t
Identification N 'f 3 0 'l O i 0 ,1-
1-i ci r t4 c tf
Date of Inspection r i "l
CHILD CARE BUILDING INSPECTION FORM
SECTION A: The following general questions should be answered for BOTH Educational and Institutional type occupancies.
LIGHT & VENTILATION
1. Is the total area of all windows in the child care room equal to or greater
than 8% of the floor area or is artificial light provided? Yes ik No
2.a Does the room have natural ventilation from a minimum amount of operable window
or door area to the outside that would allow a clear opening that is
equal to or greater than 4% or more of the floor area?
(If NO, go to question 2b). Yes No " v
b Is space mechanically ventilated as required by North Carolina Mechanical Code?
(N /A if an existing building) N/A >f Yes No
FIRE
3. Does this building have a manually operated fire alarm system
(electrically installed system with pull box stations)? Yes 'f( No
EXITS
4. Are there at least 2 exits (doors, stairs, smoke proof towers, ramps, or
horizontal exits) remote from each other on each floor or fire section
of the building? Yes )( No
5. Is the exit capacity adequate? Yes X No
6. Are all means of egress adequately illuminated at all times that the building
is occupied? Yes X No
7. Are the means of egress identified by readily visible exit signs when the exit
or way to reach it is not immediately obvious to the occupants? Yes X No
8. Is emergency power provided for centers with more than 300 occupants
or for centers providing night care as required by the Building Code? N/A - : i < Yes No
CORRIDORS AND ACCESS TO EXITS
9. Are all means of egress unobstructed without passing through a closet,
storage area, kitchen, restroom, or other hazardous space? Yes X. No
J0: Are all exit corridors a minimum 1 -hour fire resistance? N/A i ` Yes No '
(If yes, go to Question 12) (N /A applies only if there are no corridors)
11. If corridors are not 1 hour fire rated, do all child care rooms, spaces, and areas
have a direct level of discharge exit to the outside? Yes 3 ' No
12. a. Do all corridors, ramps, and passageways have a minimum 6 feet
clear width in all areas serving as means of egress for capacity of 100 or more?
(N /A if capacity is less than 100) N/A .. Yes No
b. Are all corridors, ramps, and passageways not less than 44" clear width in all 1'
areas serving as means of egress for capacity of less than 100?
(N /A if capacity is more than 100) N/A a,r Yes X No
13. Are all dead -end corridors no more than 20 feet in length? N/A X Yes No
(N /A applies only if no dead -end occurs)
Page 2 of 5
14. Do all doors have a minimum clear opening width of 32" (min. door width of 36 ")
in the following locations:
a. between occupied rooms and required exits? Yes Y No
b. exit doors leading to the exterior? Yes No -
15. Are all doors in the line of exit travel a swinging door (side hinged)? Yes V No
16. Do doors to rooms that accommodate more than 50 people swing in the •
direction of travel ? N/A Yes No X
(N /A applies if room accommodates less than 50 people)
17.a Do all required egress and exit doors have single motion, self - unlocking type
handle, lever, push pad, or panic hardware? Yes X No
b. If room accomdates 100 or more people, do all required egress and exit doors
have push pads or panic hardware? N/A - "S . Yes _ No
STAIRS (NOTE: If no stairs, interior or exterior, check N /A= and go to Question 22. If applicable, all questions must be
answered)
18.a Are all stairs serving 50 or more occupants at least 44 inches in width? N/A -' Yes No
b Are all stairs serving less than 50 occupants, at least 36" in width? N/A Yes No
19. Are all stairs with four or more steps provided with proper handrails ,
and guardrails? - Yes No
20. Are all interior stairs enclosed with 1 -hour rated walls and 1 -hour
rated "B" labeled doors that are at (east 36" wide? Yes_ No
21. Are the stair enclosure doors self - closing? Yes No
WALLS AND CEILINGS
22. a. Are all wall and ceiling coverings throughout building non - combustible?
(Use of untreated combustible fiber boards, wood, and other combustible X
fiber boards, wood and other combustible finishes is prohibited). Yes No
b. Do interior wall and ceiling finish materials meet the flame spread ratings
as required by the Minimum Interior Finish Classification Table, NCBC Yes f No
23. Do ceilings in habitable rooms have a minimum of 7' -6" clear height? Yes `,< No
HEATING SYSTEMS /MECHANICAL
24. Is the building free of unvented fuel burning or portable electric space heaters? Yes X No
25. Have air conditioning, ventilation, heating, cooking, and other service
equipment been inspected and approved by the appropriate inspectors? Yes 't No
Date Inspected d. '1 • ' C'
26.. a. Is combustion and ventilation air for boiler or heater rooms taken directly
from and discharged to the outside of the building? N/A Yes No
(N /A if electric heat is installed)
b. If inside air is used for fuel - burning appliance does it meet the requirements of i I"I"':
Chapter 7 of the North Carolina Mechanical Code. N/A Yes X No
(N/A if inside air is not used)
PLUMBING
27. Does the number of waterclosets and lavatories comply with the Plumbing
Code as determined by the appropriate inspector? Yes X No
(1 watercloset per 15 children, 1 lavatory per 25 children)
Maximum # of persons allowed by plumbing facilities? L r'
Date Inspected , 1 c ' "
Page 3 of 5
ELECTRICAL
28. Do the visible and accessible portions of the electrical system comply with applicable
sections of the Electrical Code as determined by the appropriate inspector? Yes .-\ No
Date Inspected ,s? - : C ir)
MIXED AND MULTI -USE OCCUPANCIES
29. Are all child care areas separated from adjacent occupancies in accordance with
the requirement of mixed occupancies and the Occupancy Separation
Requirements Table? (N /A if no mixed occupancies) N/A Y Yes No
30. Do all multi -use areas comply with the most restrictive applicable sections of the
State Building Code for each intended use? N/A X Yes No
(N /A if no multi -use areas)
(Multi -use is defined as an area which will be used for different functions
at different times and not concurrent. Example: child care to fellowship hall.)
ACCESSIBILITY CODES
31. Does this building comply with applicable State Building Codes for access /use
by persons with disabilities? Yes No Y,
SECTION B: The following questions should be answered only for educational occupancy in addition to the questions answered in
Section A above.
32. Does the building comply with the Allowable Heights and Building Areas Table
for Educational Occpancy? (If NO, go to Section C). Yes ` - -� No
33. a. Are all rooms, approved for use by children below grade 2, on the
level of exit discharge? (If NO go to Section C) Yes >: No
b. Are rooms used by children in grades 2 and higher no more than one story above the
level of exit discharge? Yes ,:< No
34. a. Do rooms used by children who are less than 2 h years have a direct exit to the outside?
(N /A applies only if center does not serve children under 2 ' yrs) N/A Yes c No
b. Do rooms used by childen under 2 '/ years qualify as alcoves to adjacent spaces with
direct exit to the outside? Yes: No
c. If the square footage of the child care area is >20,000 square feet, do all rooms
for all children have direct exits? (N /A if sq. footage is < 20,000) N/A `r' Yes _ No
- (If NO to both a and b or c, go to Section C)
35. Are all rooms approved for use by children provided with an operable
window which complies with Special Exit Requirements for Educational Occupancy? N/A ,> Yes No
(N /A if direct exit to outside)
36. Is the most remote point in every room occupied by children, including
dining room, not more than 200 feet from the nearest exterior exit ?
(non - sprinklered building) • Yes X No
37. Are smoke detectors provided in the corridors in accordance with
Automatic Fire Detection and NFPA72 for child care use? Yes >, No
•
SECTION C: The following questions should be answered only for institutional occupancy in addition to the questions answered in
Section A above.
38. Does the building comply with the Allowable Heights and Building Areas Table
for Institutional Occupancy? Yes No
Page 4 of 5
r at, o°".'✓ rth w.-vvor ...
SECTION C cont.:
39. Are smoke detectors provided in the corridors in accordance with Automatic
Fire Detection and NFPA72? Yes No
40. Does the building provide protection from hazardous areas as required by
Special Institutional Occupancies, Group I Unrestrained Occupancies, Protection •
from Hazardous Areas? Yes No
41. Does the building have an approved automatic sprinkler system in accordance with Special
Institutional Occupancies Group I Unrestrained Occupancies? Yes No
42. Is the most remote point in every room occupied by children, including the dining room,
not more than 200 feet from the nearest exterior exit? Yes No
Page 5of5
PREPARED 10/11/10, 14:05:30 INSPECTION TICKET PAGE 16
Harnett Count) INSPECTOR: IVR DATE 10/12/10
ADDRESS . : *UNASSIGNED SUBDIV:
CONTRACTOR : PHONE :
OWNER . . : REFUGE TABERNACLE OF PHONE :
PARCEL . . : 13 -0528- - -0078- -02-
APPL NUMBER: 10- 50024589 CP DAYCARE
DIRECTIONS : T /S: 06/10/2010 10:31 AM VBROWN - - --
REFUGE TABERNACLE OR VICTORY
TABERNACLE, 27W APPROX 7MI, THE CHURCH
WILL BE ON RIGHT, BEIGE BRICK VICTORY
TABERNACLE.
STRUCTURE: 000 000 NEW DAYCARE IN EXIST STRUCT ALREADY BLT
FLOOD ZONE • FLOOD ZONE X
PROPOSED USE • DAYCARE SEPTIC - EXISTING' • EXISTING
WATER SUPPLY • COUNTY
PERMIT: CPDC 00 CP DAY CARE INSPECTION
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
H822 01 7/16/10 GG ENVIR. HLTH /SANITATION FINAL TIME: 17:00 VRU #: 001955566
7/16/10 AP T /S: 07/16/2010 08:13 AM SSTEWART
T /S: 07/16/2010 08:14 AM SSTEWART
D830 01 8/25/10 MR C *DAY CARE INSPECTION TIME: 17:00 VRU #: 001974658
8/25/10 AP T /S: 08/24/2010 01:53 PM JBROCK
T /S: 08/25/2010 11:24 AM MREARIC
inspection was completed form was left with staff onsite
D830 02 10/12/10 TI C *DAY CARE INSPECTION TIME: 17:00 VRU #: 001992502
/ T /S: 10/11/2010 10:16 AM NTART
COMMENTS AND NOTES
.
ti 3cory5 - 2-
DCD- 0306 Identification #4444 •
Rev. 09108 County Ha rH e 4t
Date of Inspection 1 0 - 2 - f A
BUILDING INSPECTORS INSPECTION FORM FOR CHANGE OF OWNERSHIP /CONTINUED USE
NAME OF OPERATION (/1Gt fy J / Seery Cant `t7l' peve. Op rite 1,1
ADDRESS 7 33O IV C. 2.7 W • TELEPHONE:
CITY Lt III OA et f - Gin STATE (VG ZIP
C
BUILDING INSPECTOR'S CERTIFICATE
1. For Change of Ownership and continued use, the areas in the building that are designated as the licensed space are required
by the licensing agency to meet the 2006 NC Rehabilitation Code. Does the building listed above, to the extent observable,
meet the 2006 NC Rehabilitation Code? Yes V No
2 a For any question answered "No" but meeting prior code, list item number and attach proof of prior code certification.
Item Number Description Prior Code Certification
Yes No
b. For any question answered "No" that DOES NOT meet applicable prior code, list item number, explain the violation and
whether equivalent protection for the safety of the children is provided:
Item Number Description Equivalent Protection
Yes No
4i
3 Are any of the above items of a life safety concern? Yes No N/A
If yes, please list question numbers
4. In your opinion based on the items listed above where prior code certification is not available, do you recommend that
Division of Child Development allow time for correction of these items? Yes No •/'A
If yes, how long (30 -60 -90 days) and for which items?
5. Number of rooms approved for occupancy by children? l ()
(Attach sketch of building with rooms identified)
6. Specify any local zoning restriction: I/ /A
•
Signature of Inspector ° j, hj,j` /) 'u -7s't' /Date / 0 - / -
Jurisdiction kg a e C t /Phone: c/o-c) `3 4 4 - 4 17 7 2-
:Vote: By signing above 1 acknowledgethat I have seen and agree with all required prior code certification documentation.
The Inspectors Certificate and Building Inspection Form is required to be completed in its entirety before the Division of Child
Development can consider the document complete. All questions must be answered; any NO answers must have a written
explanation.
This farm was developed through the cooperation of the Division of Child Development and the Engineering Division of the Department of
Insurance. Please note that the inspection forms do not cover all areas of the Code, but are intended to be used as a guide for the local inspector.
If additional Code items which are not addressed on these forms are found to be in violation of the Code, please document them on the hack of this
form.
Prepare in quadruplicate: Original and copy to DCD, 1 copy kept by inspector, 1 copy kept by operator.
3 000
Identification
County HO me
Date of Inspection 1 C — t - /0
CHILD CARE BUILDING INSPECTION FORM
SECTION A: The following general questions should be answered for BOTH Educational and Institutional type occupancies.
LIGHT & VENTILATION
1. Is the total area of all windows in the child care room equal to or greater
. than 8% of the floor area or is artificial light provided? Yes : No
2.a Does the room have natural ventilation from a minimum amount of operable window
or door area to the outside that would allow a clear opening that is
equal to or greater than 4% or more of the floor area?
(If NO, go to question 2b). Yes No
b Is space mechanically ventilated as required by North Carolina Mechanical Code?
(N /A if an existing building) N/A Yes i.' No
FIRE
3.a What type of fire alarm system is being used? 1 ;••,t r,4
b. Does it meet the applicable code? Yes L i No
EXITS
4. Are there at least 2 exits (doors, stairs, smoke proof towers, ramps, or
horizontal exits) remote from each other on each floor or fire section
of the building? Yes No
5. Is the exit capacity adequate? Yes ✓ No
6. Are all means of egress adequately illuminated at all times that the building
is occupied? Yes . -- No
7. Are the means of egress identified by readily visible exit signs when the exit
or way to reach it is not immediately obvious to the occupants? Yes • No
8. Is emergency power provided for centers with more than 300 occupants
or for centers providing night care as required by the Building Code? N/A cX Yes No
CORRIDORS AND ACCESS TO EXITS
9. Are all means of egress unobstructed without passing through a closet,
storage area, kitchen, restroom, or other hazardous space? Yes No
10. Are all exit corridors a minimum I -hour fire resistance? N/A Yes No
(If yes, go to Question 12) (NA applies only if there are no corridors)
11. If corridors are not 1 hour fire rated, do all child care rooms, spaces, and areas
have a direct level of discharge exit to the outside? Yes ' No
12. a. Do all corridors, ramps, and passageways have a minimum 6 feet
clear width in all areas serving as means of egress for capacity of 100 or more?
(N /A if capacity is less than 100) N/A /. Yes No
b. Are all corridors, ramps, and passageways not less than 44" clear width in all
areas serving as means of egress for capacity of less than 100?
(N /A if capacity is more than 100) N/A Yes' No .
13. Are all dead -end corridors no more than 20 feet in length? N/A f Yes No
(N /A applies only if no dead -end occurs)
Page 2 of 5
•
14. Do all doors have a minimum clear opening width of 32" (min. door width of 36 ")
in the following locations:
a. between occupied rooms and required exits? Yes ' No
b. exit doors leading to the exterior? Yes No
15. Are all doors in the line of exit travel a swinging door (side hinged)? Yes f No
16. Do doors to rooms that accommodate more than 50 people swing in the
direction of travel ? N/A Yes No
(N /A applies if room accommodates less than 50 people)
17.a Do all required egress and exit doors have single motion, self - unlocking type
handle, lever, push pad, or panic hardware? Yes • No
b. If room accomdates 100 or more people, do all required egress and exit doors
have push pads or panic hardware? N/A • Yes _ No
STAIRS (NOTE: If no stairs, interior or exterior, check N/A _and go to Question 22. If applicable, all questions must be
answered)
18.a Are all stairs serving 50 or more occupants at least 44 inches in width? N/A Yes No
b Are all stairs serving less than 50 occupants, at least 36" in width? N/A Yes No
19. Are all stairs with four or more steps provided with proper handrails
and guardrails? Yes No
20. Are all interior stairs enclosed with 1- hour.rated walls and 1 -hour
rated "B" labeled doors that are at least 36" wide? Yes No
21. Are the stair enclosure doors self- closing? Yes No
WALLS AND CEILINGS
22. a. Are all wall and ceiling coverings throughout building non - combustible?
(Use of untreated combustible fiber boards, wood, and other combustible
fiber boards, wood and other combustible finishes is prohibited). Yes_ No
b. Do interior wall and ceiling finish materials meet the flame spread ratings 411'
as required by the Minimum Interior Finish Classification of the applicable code? Yes No
23. Do ceilings in habitable rooms have a minimum of 7' -6" clear height? Yes_ No
HEATING SYSTEMS /MECHANICAL
24. Is the building free of unvented fuel burning or portable electric space heaters? Yes No
25. Have air conditioning, ventilation, heating, cooking, and other service
equipment been inspected and approved by the appropriate inspectors? Yes = No
Date Inspected , 7-
26. a. Is combustion and ventilation air for boiler or heater rooms taken directly
from and discharged to the outside of the building? N/A Yes No
(N /A if electric heat is installed)
b. If inside air is used for fuel - burning appliance does it meet the requirements of
Chapter 7 of the North Carolina Mechanical Code. N /A_ Yes No
(N /A if inside air is not used)
PLUMBING
27. Does the number of waterclosets and lavatories comply with the Plumbing
Code as determined by the appropriate inspector? N/A Yes No
(1 watercloset per 15 children, 1 lavatory per 25 children)
Maximum # of persons allowed by plumbing facilities? 1 2 6
Date Inspected 1 0 . 1 "A • /r3
Page 3 of 5
ELECTRICAL
28. Do the visible and accessible portions of the electrical system comply with applicable
sections of the Electrical Code as determined by the appropriate inspector? Yes = No
Date Inspected. 1 G - t ! t?
M IXED AND MULTI -USE OCCUPANCIES
29. Are all child care areas separated from adjacent occupancies in accordance with
the requirement of mixed occupancies and the Occupancy Separation t
Requirements of' the applicable code? (N /A if no mixed occupancies) N/A , Yes 1/ No
30. Do all multi -use areas comply with the most restrictive applicable sections of the
State Building Code for each intended use? N/A Yesa" No
(N /A if no multi -use areas)
(Multi -use is defined as an area which will be used for different functions
at different times and not concurrent. Example: child care to fellowship hall.)
ACCESSIBILITY CODES
31. Does this building comply with applicable State Building Codes for access
by persons with disabilities? Yes --y' No
SECTION B: The following questions should be answered only for educational occupancy in addition to the questions answered in
Section A above.
32. Does the building comply with the Allowable Heights and Building Areas Table
for Educational Occpancy? (If NO, go to Section C). Yes No
33. a. Are all rooms, approved for use by children below grade 2, on the
level of exit discharge? (If NO go to Section C) Yes e -' No
b. Are rooms used by children in grades 2 and higher no more than one story above the
level of exit discharge? Yes ✓ No
34. a. Do rooms used by children who are less than 2'/2 years have a direct exit to the outside? /
(N /A applies only if center does not serve children under 2 'h yrs) N/A Yes '' No
b. Do rooms used by childen under 2 ' years qualify as alcoves to adjacent spaces with
direct exit to the outside? Yes . , No
c. If the square footage of the child care area is >20,000 square feet, do all rooms
for all children have direct exits? (N /A if sq. footage is < 20,000) N/A _ Yes .,- No
(If NO to both a and b or c, go to Section C)
35. Are all rooms approved for use by children provided with an operable
window which complies with Special Exit Requirements for Educational Occupancy? I\ -7 No
(N /A if direct exit to outside)
36. Is the most remote point in every room occupied by children, including
dining room, not more than 200 feet from the nearest exterior exit ?
(non - sprinklered building) Yes v' No
37. Are smoke detectors provided in the corridors in accordance with
Automatic Fire Detection and NFPA72 for child care use? Yes i_ ' No
SECTION C: The following questions should be answered only for institutional occupancy in addition to the questions answered in
Section A above.
38. Does the building comply with the Allowable Heights and Building Areas Table
for Institutional Occupancy? Yes °W-t. No
Page 4 of 5
SECTION C cont.:
39. Are smoke detectors provided in the corridors in accordance with Automatic
Fire Detection and NFPA72? Yes No
40. Does the building provide protection from hazardous areas as required by
Special Institutional Occupancies, Group I Unrestrained Occupancies, Protection
from Hazardous Areas? Yes No
41. Does the building have an approved automatic sprinkler system in accordance with Special
Institutional Occupancies Group I Unrestrained Occupancies? Yes No
42. Is the most remote point in every room occupied by children, including the dining room,
not more than 200 feet from the nearest exterior exit? Yes No
For change of ownership /continued use inspections, questions answered "No" or "N /A" are allowable if the building met applicable
code at the original time of licensure.
,r
•
Page 5 of 5