| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 010006 | (X3) Date Survey Completed 04/11/2019 |
| Name of Provider or Supplier North Alabama Medical Center | Street Address, City, State 1701 Veterans Drive, Florence, 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) |
| K0353 | Sprinkler System - Maintenance and Testing CFR(s): NFPA 101 Sprinkler System - Maintenance and Testing Automatic sprinkler and standpipe systems are inspected, tested, and maintained in accordance with NFPA 25, Standard for the Inspection, Testing, and Maintaining of Water-based Fire Protection Systems. Records of system design, maintenance, inspection and testing are maintained in a secure location and readily available. a) Date sprinkler system last checked _____________________ b) Who provided system test ____________________________ c) Water system supply source __________________________ Provide in REMARKS information on coverage for any non-required or partial automatic sprinkler system. 9.7.5, 9.7.7, 9.7.8, and NFPA 25 This STANDARD is not met as evidenced by: . Based on observation and interview, the facility failed to maintain the automatic sprinkler system per the requirements of: 2012 NFPA 101, 18.3.5.1, and 9.7.5 2011 NFPA 25, 5.2.4.1, and 5.2.2.2 Findings include: 1. On 04/09/2019, during a tour of the facility from 1:00 pm to 4:15 pm, the facility failed to provide documentation for the monthly inspections on the wet sprinkler system gauges. 2. On 04/10/2019, during a tour of the facility from 8:00 am to 2:00 pm, the surveyor observed an HVAC supply air duct resting on the automatic sprinkler system pipes above ceiling near the Education Work Room and Room 1C191. A member of the maintenance staff was present when this deficiency was identified. . 39327 |