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Checklist for Preparing for your Initial/Annual TA Inspection (The Tulalip Tribes)

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Checklist for Preparing for your Initial/Annual TA Inspection
Submitted to the Tax & Licensing Division:
Application for TA License, Fee(s), Self-inspection Form, all Required Attachments, and if applicable,
Written Plan of Correction for deficiencies / cited violation(s)
Progress Report providing the status in correcting deficiencies found in self-inspection or cited
violation(s)
Please ensure the following are available for your Onsite Inspection:
The following certificates, licenses, permits and reports are posted (if required by ordinance) or
readily available for inspection:
Tulalip Business License
Certificate of Occupancy (Use & Occupancy Permit)
Transient Accommodation License
Health Certificate (IHS) and Tulalip Food Permit
Tulalip Liquor License
Indian Trader’s License
Fire Inspection (Local Fire Dept)
Elevator Inspection (L&I)
Electrical Inspection (L&I)
Water Recreation Facility Permit (IHS/DOH)
Franchise Inspection Report
Construction Permits
The following plans readily available for inspection:
Written Emergency Preparedness Plan
Water Recreation Facility Plan
Proof of Employee Credential:
Proof of valid licensure for all employees providing regulated personal services
Proof of Food Handlers Card for all employees assisting in the preparation and service of food
Proof of Class 12 Mixologist Permit or Class 13 Servers Permit for all employees who supervise,
prepare, or serve alcoholic beverages
Other Considerations:
List of all unoccupied lodging units
Hotel map or floor plans
Staff ready and available to escort TLD inspector with:
• Appx 1-3 hours available for inspection
• Master Room Key Card
• Keys to restricted areas
The Tulalip Tribes of Washington
Community Development Department
TAX & LICENSING DIVISION
6406 Marine DR NW
Tulalip, WA 98271
Telephone: (360) 716-4211
Fax: (360) 716- 0180
“Adequate Lighting” means there is enough light to safely do usual things such as reading,
walking, writing, etc.
“Certificates, Approvals, Permits, Reports, and other compliance documents” mean a written
statement of acceptability issued by a governmental agency and/or other certified agency
verifying equipment meets a nationally recognized testing standard.
“Clean” means without visible or tangible soil or residue.
“Cleanable” means the item, material, or finish is a made to be cleaned or fabricated to permit
complete removal of residue through normal cleaning methods.
“Construction” means:
(a) A new building intended for use as a transient accommodation or part of a transient
accommodation;
(b) An addition, modification or alteration that changes the functional use of an existing transient
accommodation or portion of a transient accommodation;
(c) An existing building or portion thereof to be converted for use as a transient accommodation;
or
(d) A modification requiring a building permit by a local authority having responsibility for
enforcing state and local building codes or local ordinances.
“Cross-Connection” is a plumbing connection between a source of clean water and dirty water.
Here are some examples to watch for:
Pipes connected between your source of clean water and a washing machine that has a
submerged inlet;
• A sink faucet that has a hose that does not have a vacuum breaker. That is a part that prevents
siphoning water back up through the hose.
• Ice machines with submerged inlets;
• Lawn sprinkler systems;
• Pressurized soda dispensing equipment.
EPA Cross Connection Control Manual
http://www.epa.gov/safewater/pdfs/crossconnection/crossconnection.pdf
“Food Service Permit or Certificate” certifies a business can prepare and serve food to the public and is
not the same as a food worker permit.
“Food Worker Permit or Food Permit” certifies that a particular employee or individual is qualified to work
in food service. Each employee working for a food service must have a current food worker permit.
“In Good Repair” means that a specific thing works as it is intended to work and is safe.
“Lodging unit” means an individual room or group of interconnected rooms, intended for sleeping, that are
for rent or use by a guest, and is individually designated by number, letter, or other means of
identification. A lodging unit may or may not include areas for cooking and eating.
“Non-potable water source” is any water source that is not an approved source of drinking water. Non-
potable sources may include watering and utility hoses and sprinkler systems.
“Sanitary” means hygienic conditions that are conducive to good health.
“Sanitize” means to treat a surface or object with a chemical or physical process, such as heat, to control
or limit the presence of germs. For purposes of these regulations, “sanitize” and “disinfect” are equivalent.
“Utensil” means any food contact implement used in storing, preparing, transporting, dispensing, serving,
or selling food or drink, excluding commercial vending and storage equipment.
The licensee must provide a safe, adequate means of maintaining an ambient air temperature of at least
65 degrees Fahrenheit in each lodging unit.
An emergency preparedness plan (EPP) talks about how you will make certain everyone in your business
is protected or cared for if something very serious happens. The kinds of events to consider are fire,
earthquake, or bomb threat. You can add any other situation you think appropriate to your location, such
as a flood.
A basic EPP might include basic facility information such as important telephone numbers, a call list,
notification procedures, a way to identify current guests, guest evacuation routes, response action for
specific events, and training.
We consider the best EPP to be one that can work. It does not have to be “fancy.” It needs to be
something that can be used and will work. The best ones may be the shortest ones. You only need to
have the really important things covered. If your business is in a tall, modern building, it may have to be
more complicated than if you offer rustic cabins
American Red Cross - http://www.redcross.org/
Water temperatures between 100 and 120 degrees minimize the risk of scalding for your guests.
Third-degree burns can be caused by just two seconds in 150 degree water.
Burns also happen with a six-second exposure to 140 degree water or with a thirty second exposure to
130 degree water. It is easy to see how water that is too hot is particularly dangerous to the very young
and the very old.
Even if the temperature is 120 degrees, a five-minute exposure could result in third-degree burns.
In rare cases, very high water temperature can make water tanks explode.
In addition to preventing accidents, a lower temperature will save energy and money.
Be sure staff is familiar with chemicals and their proper use. Cornell University makes available “Material
Safety Data Sheets” for almost all toxic chemicals.
Tulalip Tribes - Community Development
TAX & LICENSING DIVISION
6406 Marine DR NW
Tulalip, WA 98271
__________________________________________________________________
Firm / Trade Name
www._____________________________
Website
__________________________________________________________________
Business Address (Primary Physical Location)
City
_______________
State
__________________
Zip
( ______ ) _______ - _________
Business Telephone Number
( ______ ) _______ - _________
Alt or Toll Free Number
( ______ ) _______ - _________
FAX Number
UINSTRUCTIONS:
U If a question does not apply to your facility, put a check in the “NA” (Not Applicable) Column.
UIf the answer is “Yes," put a check in the “Yes” column.
U If the answer is “No," put a check in the “No” column,
UFor all areas not applicable to your facility, indicate such in the “N/A” column.
UDescribe how you will correct any deficiencies using the space in the next column; AND
UWrite the date by which you will complete the correction in the last column.
UAttach additional pages, if necessary, for correction plans and/or make comments.
USIGN and DATE this form and submit with application and fees to:
If further assistance is required, please contact Tax & Licensing at (360) 716-4204 or visit us on the web at Hwww.tulaliptribes-nsn.govH.
LIC NUMBER
DATE OF INSPECTION
/ /
APPLICABLE YEAR
CHECK / MONEY ORDER #
RECEIPT NUMBER
The Tulalip
Tribes of Washington
Community
Development Department
TAX & LI
CENSING DIVISION
6406 Marine
DR NW
Tulalip, WA
98271
Telephone: (360) 716-4204
REQUIRED FOR LICENSURE
TRANSIENT ACCOMMODATION SELF-INSPECTION
Tulalip Tribes Tax & Licensing Division
6406 Marine Drive NW – Tulalip, WA 98210
Items of Inspection
Yes No N/A
How will you correct?
Date
RESPONSIBILITIES – LICENSEE
1. Do you have local approval for new construction?
2. Is your license posted where the public can view it?
3. Have you adequately supervised employees to ensure the
TA is clean, safe, sanitary, and in good repair?
4. Have you established policies and procedures requiring
employees to maintain good personal hygiene?
5. Do you have a written basic emergency preparedness plan?
6. Have you conducted any other self-inspections this year?
WATER SUPPLY AND TEMPERATURE CONTROL
7. Are you on an approved water system? If not, please
explain.
8. Is the water supply free of cross connections? (Submerged
inlets on ice machine drain pipes, water faucets, hose
attachments, toilet tank filler, etc.)
9. Is the hot and cold water under adequate pressure?
10. Is the hot water at sinks/bathing fixtures 100-120° F?
11. Have you labeled any water unsafe for domestic use “Do
Not Drink” at the outlet?
SEWAGE AND LIQUID WASTE DISPOSAL
12. Are you on an approved sewer system? If not, please
explain.
13. Is the property free of surface wastewater?
REFUSE AND VECTORS
14. Is a washable leak-proof trash container provided in each
unit complete with a leak-proof disposable liner?
15. Is facility maintained in a clean and sanitary manner?
16. Is the trash removed from each unit after each occupancy
and handled in a clean, safe, and sanitary manner?
17. Is the trash removed at least every three days in each guest
room?
18. Is the outside trash stored in a washable, leak proof, and
closed covered containers and removed from premises no
less than every two weeks?
19. Are the buildings free from insects, rodents, and pests?
CONSTRUCTION AND MAINTENANCE
20. Is TA, including construction, TA buildings and facilities,
fixtures, furnishing and general surroundings structurally
sound and in good repair and, meeting the requirements of:
a. This Ordinance
b. International Building Code
c. International Mechanical Code
d. Uniform Plumbing Code
e. Washington State Energy Code
f. International Fuel Gas Code
g. Other applicable laws
TRANSIENT
ACCOMMODATION
SELF-INSPECTION
FORM
Items of Inspection
Yes No N/A
How will you correct?
Date
LODGING UNITS
21. Is there an adequate clear path of egress from each bed in
case of a fire?
22. Are the carpets and floors, especially under beds,
cleaned/vacuumed between guests?
23. Wall, floor, and ceiling surfaces and mounted fixtures are in
good repair and easily cleanable?
BATHROOMS, WATER CLOSETS, AND HANDWASHING SINKS
24. Provide private and common-use bathrooms, water closets,
and hand washing areas with cleanable floors, walls,
ceilings, fixtures and furnishings
25. Provide adequate private or common-use bathrooms, water
closets, and hand washing sinks to meet the needs of
guests;
a. Provide an uncarpeted, easily cleanable area around
each water closet and adjacent to each bathing fixture
b. Are fixtures and drains safe and working properly and
sink drain stems cleaned frequently?
c. Are the bathing facilities caulked and free of mold and
mildew?
d. Are the bath fixtures and the floors in bathrooms
sanitized between guests?
26. Are slip-resistant surfaces or devices provided for in
bathtubs and showers?
27. Upon arrival, are guests supplied w/ an adequate supply of
clean towels, washcloths, and floor mats?
28. Are single use towels or drying devices provided near
common-use sinks?
29. Is toilet tissue provided by each toilet?
30. Is there soap by hand washing and bath fixtures?
LODGING UNIT KITCHENS
31. Do the kitchens/food preparation areas have? Clean floors
and walls in good repair
32.
Is the kitchen ventilation compliant w
/ FDA Food Code as
incorporated under Tribal Tile 11 #11.20?
33. Is there a sink other than the hand washing sink large
enough to handle the largest utensil in the lodging unit?
34. Does sink provide hot and cold water?
35. Do you provide leak-proof waste containers in sanitary
condition or a container with a disposable leak-poof liner?
36. Do the refrigerator(s):
a. Maintain temperature(s) at ° or lower?
b. Get cleaned and sanitized between guests?
c. Stay in good repair and in sanitary condition?
37. Are the food preparation areas cleaned and sanitized
between guests?
38. Is the cooking equipment permanently installed, and does it
meet nationally recognized testing?
39. Between guests, are utensils, dishes, and glasses washed,
rinsed, and sanitized?
40. Are the table and chairs cleanable and in good repair?
HEATING AND COOLING
41. Is there a safe means of maintaining an ambient air
temperature in each unit to 65°F?
42. If provided, is the heating and cooling system safe, and are
vents and filters cleaned regularly?
Items of Inspection
Yes No N/A
How will you correct?
Date
LIGHTING & VENTILATION
43. Is there adequate lighting in all areas, including exterior?
a. Is additional lighting available upon guest request?
44. Is there sufficient emergency lighting for guests to exit safely
in event of a power outage?
45. Are the gas or oil space and water heaters vented outdoors?
46. All areas of the building are ventilated to minimize odors and
moisture and are compliant with the WA Ventilation and
Indoor Air Quality Code?
BEDS AND BEDDING
47. Are the beds, mattresses, pads, pillows, mattress pads,
bedding, and linens clean, sanitary, and in good repair?
48. Is the bedding changed between guest occupancies and at
least weekly or when requested for continuing guests?
49. Are the blankets, spreads, etc. kept off the floor while beds
are changed?
50. All other furnishings are clean, safe, and in good repair?
FOOD AND BEVERAGE SERVICES
51. A licensee providing food service to guests must meet the
following requirements:
a.
Tribal Title 11 #11.20 and the FDA Food Code provisions
as incorporated under Tribal Title 11 #11.20; and
b.
Have all food worker permits as required under Tribal
Title 11 #11.20.100; and
c. All other applicable Tribal and Quil Ceda Village
Ordinances
52. Is the food stored off the floor and away from toxic material?
53. Does all staff that prepares or serves food have current food
service worker permits?
54. Are the single use ice buckets, plastic glasses, etc.,
disposed of, and replaced between occupancies?
55. Are the multiple-use ice buckets washed, rinsed, and
sanitized between guest occupancies?
56. Are the ice machines:
a. Cleaned on the outside, including coils?
b. Cleaned and sanitized on the inside at least twice a
year?
c. Self-dispensing, with no common bins accessible to
guests?
57. Are reusable cooking utensils and ice buckets in good
conditions?
58. Are the multiple-use utensils washed, rinsed, sanitized, and
stored in a safe and sanitary manner?
59. Are the drinking fountains kept clean with adequate water
pressure?
LAUNDRY
60. Is the laundry done on site or by a commercial laundry
service?
61. Is laundry room flooring is uncarpeted and covered with a
cleanable floor covering?
62. Is the clean laundry in a designated area, off the floor,
protected from contamination and moisture, and
inaccessible to guests, pets, and other animals?
63. Is the soiled laundry kept separate from clean laundry during
storage and transport?
64. Is a hand washing facility readily accessible to employees?
Items of Inspection
Yes No N/A
How will you correct?
Date
SAFETY, CHEMICAL AND PHYSICAL HAZARDS
65. Do you have policies and procedures for safely storing,
labeling, and using any hazardous chemical agents?
66. Are the containers with chemicals labeled with exact
contents?
67. Are the chemicals stored and used correctly?
68. Is a secure handrail present where needed?
69. Are the gas or oil space and water heaters vented outdoors?
70. Are the pressure relief valve(s) on hot water tank(s) pointed
toward wall(s) and/or the floor?
71. Is the facility free of physical hazards such as uneven
surfaces, damaged equipment, or furnishings?
72. Is there adequate exterior lighting?
73. Are the doors provided with suitable locking security
devices?
74. Have there been unusual circumstances in any TA units
during the past year for example fire or floods?
75. Have the units contaminated by methamphetamine been
reported to the local health officer and cleaned by
contractors approved by the Department of Health?
AUQATIC RECREATION AMENTITIES
76. Do you have a written plan for pool and spa operations
addressing the protection of public health, safety, and water
quality that establishes standard practices for maintenance
and ensuring compliance with WAC 246-260?
77. All pools and spas are compliant with the requirements of
the International Building Code, Section 3109?
78. Signage posted specifying user rules and safety information
79. Pools and spas are routinely drained, cleaned, and refilled
as required?
80. Is a First Aid kit readily available and stored in a
conspicuous location?
SPAS – THERAPUETIC & COSMETIC
81. Do you have proof of valid licensure for all massage
practitioners, cosmetologists, and other employees
providing regulated personal services to customers?
FIRE SAFETY
82. The licensee must ensure that gas, oil-fired, or other fuel-
burning appliances including fireplaces, dryers, stoves and
water heaters, are vented to the out-of-doors as specified in
the manufacturer’s instructions and current code(s).
83. Have all the extension cords been approved by the local fire
authority?
84. Is there a clear and marked path to fire exits?
85. Have all the portable space heaters been approved by the
local fire authority?
86. If candle holders and other open flame candles, lanterns or
other open flame light sources and decorations are present
a. Candle holders and other open flame devices must be
designed to return to the upright position after being tilted
to an angle of forty-five degrees from vertical.
87. Establish and implement a written plan to ensure the provisions in Section 10.40.320 Fire Safety of Title 10 #10.40:
1. In addition to the fire and safety inspection regulations required by local fire, the licensee must establish and implement
a written plan to ensure:
a. Smoke detectors are installed and maintained in all sleeping rooms or sleeping areas. Non-rechargeable
batteries in smoke detectors must be replaced each year or per manufacturer’s instructions. Rechargeable
bat
teries must be charged and maintained or replaced per the manufacturer’s instructions; OR
b. C
entralized smoke-fire detection alarm system;
c. F
ire extinguishers are inspected when initially placed in service and at approximately thirty-day intervals or at
more frequent intervals when circumstances require. Fire extinguishers must be inspected manually or by
electronic monitoring. Periodic inspection of fire extinguishers must include a check of at least the followi
ng
items:
i. Loc
ation in designated place;
ii. No obstruction to access or visibility;
iii. Operating instructions on nameplate, legible and facing outward;
iv. Safety seals and tamper indicators not broken or missing;
v. Fullness determined by weighing or “hefting”;
vi. Examination for obvious physical damage, corrosion, leakage, or clogged nozzle;
vii. Pressure gauge reading or indicator in the operable range or position;
viii. Condition of tires, wheels, carriage, hose, and nozzle checked (for wheeled units); and
ix. Hazardous material identification system label in place.
d. I
f a fire alarm system is installed:
i. T
he system, including initiating devices and notification appliances, is regularly inspected, tested,
and
maintained by the owner or the owner’s designated representative in accordance with the requirements
of the International Fire Code.
ii. U
nless otherwise recommended by the manufacturer, single and multiple station smoke alarms
installed in one- and two-family dwellings must:
(A
) Be replaced when they fail to respond to operability tests; and
(B
) Must not remain in service longer than ten years from the date of manufacture.
e. If an automatic fire suppression system is installed:
i. T
he system must be inspected, tested and maintained in accordance with requirements of t
he
I
nternational Fire Code.
ii. Valves designed to be open under normal system operation must be kept in open position and only
closed with approval of the authority having jurisdiction.
*Obstructions, including storage, are not placed in the required means of egress, except projections allowed by the building
c
ode. Means of egress must not be obstructed in any manner and must remain free of any material or matter where its
presence would obstruct or render the means of egress hazardous. Exit doors must not be locked in the direction of egress
unless a special egress control device is installed per the building code.
DEFICIENCIES: In the event deficiencies are found, applicant/ licensee shall refer to 10.40.090 (3) of Title 10
#10.40. For your convenience, instructions under 10.40.090 (3) are paraphrased below.
Submit a response to a statement of deficiencies (written notice of any violation of this ordinance, or other
applicable tribal law or regulation, or the rules adopted hereunder) to the department by the date spec
ified
above, describing the reasons for noncompliance.
Responses shall also include a plan of correction via written proposal of specific actions to be performed by
the applicant/ license correction for each deficiency stated in the report. The plan of correction must meet the
approval of the department.
C
omments: __________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
___________________________________________ ______________________
Name of TA Representative Date of Self-Inspection
______________________ ______________________
Total # of Areas Inspected Total # of Defects Found
______________________
Date Deficiencies To Be Corrected
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Checklist for Preparing for your InitialAnnual TA Inspection (The Tulalip Tribes)

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Completed 20 July 2020

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