111024233853_0001.pdfFROM : Panasonic FAX SYSTEM
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Sep. 15 1994 01:30AN P3
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FROM : Panasonic FAX SYSTEM PHONE NO. Sep. 15 1994 01:30AM P2
AGING AND ADULT SERVICES ADMINISTRATUN
FIRE SAFETY EVACUATION PLAN ......
" WAC 368.76.200(11)
An Adult Family Home shell have a posted {flan for evacuation to safe areas in event of fire. Draw a diagram of the floor plan
of your home in the space proveded below. Indicate escape routes and designate where staff and residents should meet
outaide the residence- Indicate the location of fire extinguisher(s) and smoke detector(s).
INSTRUCTIONS: Provider/Resident Manager compiat®s and p�t� in e a on5,cu„icc.�xtio�,
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