Get Licensed Facilities Referral For Fire Safety Inspection

This guide provides clear and comprehensive instructions on filling out the Licensed Facilities Referral For Fire Safety Inspection form online. Whether you are new to this process or seeking clarification, the following steps will help you navigate the required fields effectively.

Follow the steps to complete the form with ease.

1. Click ‘Get Form’ button to access the Licensed Facilities Referral For Fire Safety Inspection form and open it in your preferred editor.
2. Begin by providing the licensing agency information. Enter the licensing contact name, date, agency name, address, phone number, ZIP code, and city. Ensure that all fields are completed as incomplete information may delay processing.
3. Specify the occupancy type by selecting the relevant option from the provided types, including but not limited to 24-hour residential home, children’s residential facility, or health care facility. Include the maximum capacity for the selected occupancy.
4. Document any areas of concern regarding the facility. This may include safety hazards or compliance issues observed during inspections.
5. Provide facility/site information, including the provider/agency name, street address, ZIP code, county, and the name of the provider or manager. Also, indicate the license expiration date and the number of residents or children at the site.
6. Select the reason for the referral from the options available, such as 'new facility/new license' or 'renewal of licensed facility'. If there are other reasons, provide an explanation in the space provided.
7. The deputy or inspector will fill in their name, inspecting agency, and contact details in the designated section. They will also note the inspection date and fire inspection number.
8. Finally, confirm the inspection results. Indicate whether the facility was approved for occupancy, approved with corrections, or not approved until all deficiencies are addressed. The inspector will sign the form upon completion.
9. Once all sections are accurately filled, you can save changes, download, print, or share the form as needed. Completed forms may be emailed to OSFM.FLSS@state.or.us or mailed to the specified address.

Begin completing your Licensed Facilities Referral For Fire Safety Inspection form online today to ensure your facility meets all fire safety requirements.