Get Fses Form

The Fses Form is an essential document for evaluating fire and smoke safety in healthcare facilities. This guide provides a clear and detailed approach to filling out the Fses Form online, ensuring you understand each section and the required information.

Follow the steps to complete the Fses Form online effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by reviewing the first section titled 'Zone and Facility Information'. Here, you will enter the zone, facility details, provider or vendor number, and date of survey. Ensure that all information is accurate and corresponds to the facility being assessed.
3. In the 'Occupancy Risk Parameter Factors' section, reference Table 1 provided in the form. For each risk parameter, select and circle the appropriate risk factor value. Choose only one for each parameter, such as patient mobility or density.
4. Proceed to the 'Compute Occupancy Risk Factor' section. Transfer the circled risk factor values from Table 1 to Table 2 and multiply them to compute the occupancy risk factor (F). Input the calculated F value as required.
5. Next, determine the adjusted building status by referring to either Table 3A or Table 3B based on whether the building is classified as 'new' or 'existing'. Transfer the computed F value accordingly and calculate R.
6. Move on to the 'Determine Safety Parameter Values' section. Review Table 4 and select the safety value for each parameter that best describes your zone conditions, marking only one value for each in the corresponding section.
7. For the 'Compute Individual Safety Evaluations', transfer the circled values from Table 4 to the unshaded blocks in Table 5. Add the values, ensuring to account for any negative numbers, then transfer totals to the appropriate blocks in Table 7.
8. Finally, complete the 'Mandatory Safety Requirement Values' section using Table 6 based on the facility classification. Transfer the results from Table 6 to Table 7, and check off 'Yes' or 'No' based on the values recorded.

Complete the Fses Form online today to ensure compliance and safety in your healthcare facility.