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PRINTED: 07/14/2023 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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How to fill out a pre-occupancy life safety

01
Obtain the pre-occupancy life safety form from the appropriate authority or organization.
02
Fill out the form with accurate and complete information regarding the safety measures in place at the premises.
03
Provide any necessary documentation or proof of compliance with safety regulations as required by the form.
04
Review the completed form for any errors or missing information before submitting it for approval.

Who needs a pre-occupancy life safety?

01
Property owners or managers who are responsible for ensuring the safety of occupants in a building or facility.
02
Construction companies or contractors who are completing a new construction or renovation project.
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A pre-occupancy life safety is an assessment or inspection conducted before a building is occupied to ensure it meets safety standards.
The building owner or manager is usually required to file a pre-occupancy life safety report.
To fill out a pre-occupancy life safety report, you typically need to provide information about the safety features of the building and any necessary documentation.
The purpose of a pre-occupancy life safety assessment is to ensure that a building is safe for occupancy and meets all necessary safety requirements.
Information such as fire alarm systems, sprinkler systems, emergency exits, and overall building safety features must be reported on a pre-occupancy life safety form.
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