Sprinkler System Out of Service Due to Equipment Failure
Penalty
Summary
A deficiency was identified when the facility failed to maintain compliance with sprinkler system regulations for one of its two dry sprinkler systems. On observation, system #1 was found to be out of service due to a malfunctioning air compressor, and the backup air compressor was not operational or connected to a power source. There was no documentation provided regarding the extent or duration of the system being out of operation. The maintenance technician confirmed that the dry system was out of service at the time of the survey. Subsequent surveys revealed that the deficiency remained uncorrected, as the facility had not completed the necessary repairs or inspections to restore the sprinkler system to service. The facility had received a bid from a vendor but had not secured funding or payment to proceed with the repairs. During this period, the facility maintained a continuous fire watch as the sprinkler system remained nonfunctional.
Plan Of Correction
1. Absolute Fire Protection has been contacted to ensure that any and all necessary parts needed to fix the malfunctioning air compressor will be ordered and installed, so that the dry sprinkler system can be turned back on prior to the "substantial compliance" date of 1/30/2026. Documentation WAS provided to the extent and duration of the dry system being out of operation in the form of "fire walk" documentation, from the day the system went down through present day. 2. The Administrator will assist the Environmental Services Director in ensuring that Absolute Fire Protection is contacted for service and that payment will be secured for any and all necessary parts to ensure the malfunctioning air compressor is operational, which will then allow for the dry sprinkler system to be turned back on. 3. The results of these corrective actions will be reviewed at the facility's next two quarterly Quality Assurance Performance Improvement meetings to ensure compliance.