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Home My WebLink AboutXC2022-1932 - PermitsSTATE OF CALIFORNIA -FORESTRY AND FIRE PROTECTION FIRE SAFETY INSPECTION REQUEST STD. BSO (REV. 4-20018 See instructions on reverse. AGENCY CONTACTS NAME California Department of Public Health TELEPHONE NUMBER (7 (4) 567-2906 REQUEST DATE 02/15/2023 PROGRAM Licensing and Certification EVALUATOR'S NAME '' Tu Tonnu, RN, MSN, HFES REQUESTING AGENCY FACILITY NUMBER--- 060000122 -REQUEST CODE --- IA . LICENSING California Department of Public Health n AGENCY Licensing and Certification NAME AND ADDRESS Orange County District Office 681 S. Parker Street, Suite 200 Orange, CA 92868 L J _ - _.... CODES..... 1. ORIGINAL A. FIRE CLEARANCE 2, RENEWAL 8. LIFE SAFETY ' 3. CAPACITY CHANGE 4. OWNERSHIP CHANGE 5. ADDRESS CHANGE 5. NAME CHANGE 7. OTHER _ AMBULATORY _ NONAMBULATORY . BEDRIDDEN TOTAL CAPACITY CAPACITY I PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY II CAPACITY — PREVIOUS CAPACITY .. N/A _ FACILITY NAME — Hoag Hospital Newport Beach LICENSECATEGORY -•.. GACH STREET ADDRESS (Actual Location) - -' One Hoag Drive ..... _.. NUMBER OF BUILDINGS 1 CITY _ Newport Beach, CA 92658 0 RESTRAINT FACILITY CONTACT PERSONS NAME Monica D. Dang FACILITY CONTACT PERSON'S TELEPHONE NUMBER (949) 422-5418 HOURS Acute Care Rehabilitation - Phase 2 3 North TO BE COMPLETED BY INSPECTING AUTHORITY FIRE AUTHORITY NAME AND ADDRESS i 14ewport Beach Fire Department PO Box 1768 Newport Beach, CA 92658 L 7 J CLEARANCE /DENIAL CODE 1. Fire Clearance Granted CODES 1. FIRE CLEARANCE GRANTED 2. FIRE CLEARANCE DENIED • A EXITS B. CONSTRUCTION C. FIRE ALARM D. SPRINKLERS E HOUSEKEEPING F. SPECIAL HAZARD G. OTHER INSPECTOR'S NAME (typed or Printed Nadine Morris TELEPHONE NUMBER 949-644-3105 CFIRS NUMBER 30055 OCCUPANCY CLASS 1-2 INSPECTION DATE INSPECTORS SIGNATU E(Typed or Pen 02/15/2023 N EXPLAIN DENIAL OR LIST SPECIAL CONDITIONS Department of Health Care Access and Information FACILITIES DEVELOPMENT DIVISION 355 South Grand Avenue, Suite 1900, Los Angeles, CA 90071 2020 West El Camino Avenue, Suite 800, Sacramento, CA 95833 CERTIFICATE OF SUBSTANTIAL COMPLIANCE Phone (213) 897-0166 Fax(213)217-8511 Phone (916) 440-8300 Fax (916)274-0102 Page 1 of 1 SC Facility Name and Address Hoag Memorial Hospital Presbyterian 1 Hoag Drive Newport Beach, CA 92663 Facility No. 10428 Project No. 1200002-30-04 Submitted Date 2/14/2023 Parent Project No. 1200002-30-00 Cont actor HOWARD BUILDING CORPORATION Inspector of Record Dennis Baltbardis (A20159) Telephone No. (949) 254-6437 Construction Documents Written Approval 8/17/2021 Project % Complete 90 Title or Scope of Project 126253 HHNB North Building Restack CERTIFICATE OF SUBSTANTIAL COMPLIANCE: The building project, or a designated portion of the project, is sufficiently complete in accordance with the approved construction plans and applicable California Building Standards Code such that the owner may use or occupy the building project, or designated portion thereof, for the intended purpose. Any exceptions or conditions related to this CERTIFICATE OF SUBSTANTIAL COMPLIANCE, if any, are noted below: PATIENT ADMITTING, TREATMENT OR CARE: This Certificate of Substantial Compliance is not an approval for patient admitting, treatment or care, if applicable. The owner/health care provider must contact Licensing and Certification for their review and approval prior to patient admitting, treatment or care in the affected room, space or area. Clearances may also be required from the local Fire Department and/or the State Fire Marshal. Comments or Additional Conditions Certificate of Substantial Compliance Granted for Milestone #4. Okay to proceed to local fire for review of the space. HCAI FDD Staff: Nathan Steele, Compliance Officer Date Printed: 2/14/2023 SMOKE COMPARIAENI02: WE SF love: 'I cauxsimattimaitvabaett atraellni•Of Fit LIMO 2 LEVEL03- SMOKECOMPARIMENI$ OCCCIWAXGY SYMBOLOGY 1 LIFE SAFETYPLAN -LEVEL 09.... OCCUPuura 9ErCAlCUTA1WXs EaDOOR &STAWWMITN I .....G.e.nl.. F� u �, r aM.asaim =1:a paE �_ ate"® �iasri niNi Tam -C —Ca Sam MN{ IN .0701111 ACCESSORY USECACS TACTILE SWAGE WEB M w. �s ®4=c.0 uv. oas.e®Mn =® 15114FICITIME IMF SlintUr Slat Hoag Memorial Presbyterian **Mani.. Nava Em0.O15® Gensler SN�F�b�u'..r�Ao4 ReEe4 ✓ snake OP2152@5 '.- FREUSamraewG P.mer A0.113