HomeMy WebLinkAbout9 Cliffwood Drive - License - Fire Marsh (2) is
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State of Connecticut DDS p
Department of Developmental Services
"Terrence\ ". Macy, Ph.D.
Dannel P. Malloy
(.OI111171SSIUi1L'r I
Governor
Joseph W. Drexler,1?sq.
March 09, 2014 De�utv Comn�issioncr
Mr. Paul Rosin 1
Communitv Residences,Inc. Fritz Gorst
I
732 West Street Suite 12 West Region i
Southington, CT 06489 Regional Director I
I
RE Cliffwood Drive R-1190 9 Cliffwood Drive South Windsor
Dear Mr. Rosin
Based on a review of documentation provided by your agency,the Department of Developmental Services has
established your facility's"Evacuation Difficulty Score"(E-Score"), under the 2003 NFPA 101, Life Safety Code. This
score and related information is detailed below.
This"E-Score"is valid only as long as the information listed below is still valid, and only for the clients listed below,
provided there are no changes in their physical or mental condition, since the survey date.It is your responsibility to
notify this office of any new clients not listed below, or of changes in client conditions or staffing levels that have
changed since the date of the survey. Please contact Fire Chief Timothy E. Baldwin at Southbury Training School Fire
Department, P.O. Box 872, Southbury, CT 06488-0901. Telephone: 203-586-2638/Fax: 203-586-2722.
This documentation, along with a copy of the survey provided by your agency, should be kept in your files to be made
available for the fire marshal's use during the annual licensure inspection of your facility.
E-Score Evaluation Date:February 20, 2014 DDS Region:NR
DMR Number Client Individual E-Score Evacuation Capability:L-1
00043699 MCCALL, K RASHALIN 1 E-Score Status:Annual
Vertical Distance: I -Any bedroom one floor from exit
00037467 ANSELMO, MICHAEL 1 Staff Score:56-2 staff available, 1 standby or asleep
00051060 RENDA JR,M JOSEP 1 Provider Survey By:Jennifer Garcia
00045353 CARO, HECTOR 8 E-Score Evaluator:Marshall
00042226 GIANNINI, GABRIEL 1
00048717 KNIGHT, ALEXANDER 1 E-Scores are calculated using the following formula:
Sum of all individual e-scores times the vertical distance
E-Score: 0.232142857 divided by the staff score.
Sinc
Timothy E. Baldwin, Fire Chief
Dept. of Developmental Services
cc: Fire Marshal
Regional Director
File
FIRE MARSHAL PLEASE NOTE:DMR must comply with the Healthcare Insurance Portabil end Ac�p nt b'li A t�� 6 WIPAA). This law provides for the privacy and security of healthcare information and
has regulations which"covered entities"such as DMR must follow. The sharing or disclosure o�il�t�ir�h�a MPIN b o rl t s required and ermitted by law,or when an individual has given DMR permission. The
privacy rule includes information that can be used to identify individuals,suFl��9 tfmt116 �ffiM>R ntmF%_1aca W oba-bdreX7You are not covered by HI PAA but we ask that you help us respect
the rights of the consumers we serve ther ore r t that you kee th i ntities of in i'd rel a in thi ort c n d I.
lowlian�r overnm�n enter, � ' es� am�r��eet° ` 'aterUuLy Connecticut 06702
www.ct.gov/dds • e-mail: ddsct.westQct.gov
Atr AiTrmative Action/Equal Opportunity Eniplo}-or
�� .. State of Connecticut DDS
Department of Developmental Services
Terrence\V. Macy, I'h.D.
Dannel P. Malloy Commissioner
(.7overnor
Joseph W. Drexler, Esq.
Deputy Commissioner
,RE: Cliffwood Drive, South Windsor CT Fritz Gorsr
Date: 3-9--14 West Region
Re&)iial Director
To Whom It May Concern:
Based on a review of documentation provided by your Agency and subsequent discussions with staff we
are unable to establish an "Evacuation Difficulty Score (E-Score)" at this time for the above referenced
facility. (Reference: CT Life Safety Code, 2003 NFPA 101 Life Safety Code).
A basic tenet of establishing E-Scores is that certain criteria detailed in NFPA 101A (2004 Edition) must
be met before establishing an E-Score.
The criteria that was NOT met by this facility is:
"Section 101A-6.5.2.2.1 —The total available staff at any given time shall be able to handle the individual
evacuation needs of each resident who might be in the facility. In calculating evacuation capability, it
might be possible to have a ratio of staff to residents that appears to be favorable, but still is unacceptable
under this system. This would be the case where a resident needs assistance from two staff members
where only one staff member is present. Thus, the situation should be such that every resident can be
evacuated by the available staff."
In the survey form completed by facility staff, and subsequent discussions with staff, it appears that the
above criterion is not met.
There are various ways to address this issue and offered below are just some suggestions:
1. If practical, provide additional training or techniques to staff so that existing staff can meet
resident's evacuation needs.
2. If practical, provide training and provide a resident "buddy" to assist another resident in
evacuation.
3. Provide additional staffing so that at any given time available staff, shall be able to handle the
individual evacuation needs of each resident who might be in the facility.
4. Review the individual resident's evacuation needs and this facilities ability to meet those
evacuation needs.
5. If appropriate, the Emergency Fire Evacuation plan can be modified to utilized staged
evacuations to the outside, using Interior Points of Safety.
NOTE: The Authority Having Jurisdiction (Local Fire Marshal in most homes, State Fire
Marshal in state operated homes) must be consulted and approve this arrangement in writing.
Please contact the Authority Having Jurisdiction (Local Fire Marshal in most homes, State Fire Marshal in
state o es) to review this matter, and if I can be of any further assistance, please do not
,-he as'It to contact me.
a�
Timothy E. Baldwin, Fire Chief
State of Connecticut, Dept of Mental Retardation
Southbury Training School
Department of Fire and Emergency Medical Services
Voice 203-586-2638, Fax 203-586-2722
mailto:TimothyBaldwin(o),Po.state.ct.us
cc: Daniel A. Micari, Dir.Quality Management Services., Fire Marshal, File
West Regional Office
Phone: 203 574-8814 • Fax: 203 574-8857
Form Letter 1 I `L I I l LcL�kLqat Street • Waterbury, Connecticut 06702
www.ct.gov/dds • e-mail: ddsct.westQct.gov
An Af rmative Action/Equal Opportun ty Emp1q),er