HomeMy WebLinkAbout49 Ash Road - License - Fire Marshal (2) State of ConnecticutDDS
Department of Developmental Services
Terrence W.Masy,Ph.D.
Dannel P. Malloy Commissioner
Governor
Joseph W. Drexler,Esq.
December 30,2013 Deputy Commissioner
Ms. Laurie Desjardin Eugene Harvey
Allied Rehabilitation Centers Director
3 Pearson Way
Enfield, CT 06082 R-418 49 Ash Road South Windsor
RE:Ash Road
Dear Ms.Desjardin;
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 consumers 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 consumers not listed below,or of changes in consumers 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: December 14,2013 DDS Region: NR
DDS Numbe gkol Individual E-Score Evacuation Capability: SLOW
00016482 Stavinsky,J Robert 20 E-Score Status: Annual
00024003 Quagliaroli,J Sylvio 1 Vertical Distance: .08—All bedrooms on floors with direct exits
00010874 Kardatzke,E Raymond 1 Staff Score: 20—1 staff immediately available
00015232 Chapman,Kenneth 3 Provider Survey By: Cheryl Cunningham
00025846 Ulrich,William 20 E-Score Evaluator: Rasmussen
E-Scores are calculated using the following formula:
E-Score: 2.24 Sum of all individual a-scores times the vertical distance
divided by the staff score.
Sincere __
;-�othy E. Baldwin, Fire Chief
cc: Fire Marshal Department of Developmental Services
Regional Director
File
FIRE MARSHAL PLEASE NOTE:DDS must comply with the Healthcare Insurance Portability and Accountability Act of 1996(HIPAA).This law provides for the privacy
and security of healthcare information and has regulations which'covered entities'such as DDS must follow.The sharing or disclosure of Information Is allowed only as
required and permitted by law,or when an individual has given DDS permission.The privacy rule Includes Information that can be used to Identify individuals,such as
but not limited to name,DDS number,locations or addresses.You are not covered by HIPAA,but we ask that you help us respect the rights of the consumers we serve
and,therefore,request that you keep the identities of Individuals released In this report confidential
Southbury Training School
Phone:Voice 203 586-2000 • Toll Free 866 274-3888 • Fax:203 586-2700
P.O.Box 872 Southbury, Connecticut 06488
www.ct.gov/dds • e-mail: ddsct.west(@cLgov
An Afrmative Action/Equal Opportunity Emplqyer