| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 01C0001000 | (X3) Date Survey Completed 11/14/2023 |
| Name of Provider or Supplier Montgomery Surgical Center Llc | Street Address, City, State 470 Taylor Road, Montgomery, AL | |
| For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency. | ||
| (X4) ID Prefix Tag | Summary Statement of Deficiencies
(Each deficiency should be preceded by full regulatory or LSC identifying information) |
| K0351 | Sprinkler System - Installation CFR(s): NFPA 101 Sprinkler System - Installation Sprinkler systems (if installed) are installed per NFPA 13. Where more than two sprinklers are installed in a single area for protection, waterflow devices shall be provided to sound the building fire alarm system or to notify a constantly attended location such as a PBX, security office, or emergency room. 20.3.5.1, 20.3.5.2, 21.3.5.1, 21.3.5.2, 9.7.1.2, 9.7, NFPA 13 This STANDARD is not met as evidenced by: . Based on observation, the facility failed to provide an electronic supervising (tamper switch) for the backflow preventer valve for the automatic sprinkler system per the requirements of: 2012 NFPA 101, 21.3.5.1, and 9.7.2.1 2010 NFPA 72, 10.7.4, and 10.16.2 This deficiency affects the entire sprinkler system. Findings include: During a tour of the facility, the surveyor observed the backflow preventer valve for the automatic sprinkler system did not have an electronic supervising device (tamper switch) installed. A member of the maintenance staff and the administrator were present, when this deficiency was identified. . |