Bureau of Fire Prevention & Public Safety
SCHOOLS, CHURCHES & INSTITUTIONS 200 N. Main Street, Suite 1710 Los Angeles, CA 90012 (213) 978-3730
LAFD USE ONLY
LOS ANGELES FIRE DEPARTMENT
APPROVED UFSO REQUIRED APPROVED SPOT CHECK DENIED
HOSPITAL FILMING LOCATION EVALUATION REPORT
INSTRUCTIONS: (1) COMPLETE FORM (2) FOLLOW EMAIL ROUTING INSTRUCTIONS ON PAGE 2 FACILITY NAME*
FACILITY ADDRESS*
TODAY’S DATE*
PRODUCTION COMPANY & PRODUCTION TITLE
FilmLA Permit Number
DATE(S) OF FILMING*
PRODUCTION COMPANY ADDRESS*
FilmLA Coordinator
TIME(S) OF FILMING*
*Required Field
Approval of filming location(s) is contingent upon the area(s) meeting the following criteria: A.
B. C. D. E. F.
A walk-through inspection of the proposed filming area is to be done a MINIMUM OF 48 BUSINESS HOURS IN ADVANCE of the proposed filming date. An Institution Inspector will do the walk through inspection and shall identify the areas for filming. a. A representative from the hospital and production company shall be present during the walk-through inspection. b. Approved areas shall provide no disruption to hospital activities and shall be remote from the patient care (e.g. vacant wings or floors, etc.) PROHIBITED: Filming and filming-related activities in hospital main lobbies, elevator lobbies and emergency room areas, etc. L.A.M.C. (57.325.1 & 57.325.2) It is NOT permissible to tie into the hospital’s main electrical power supply to provide electrical power to ANY production equipment, or to plug appliances into ANY hospital electrical outlet. L.A.M.C. (57.4701.4) Cables are to be run directly to the floor of use (i.e. through windows, etc.). Cables shall not be placed in patient care areas, nor be placed in stair shafts that could be used for patient evacuation. L.A.M.C. (57.4701.4) Corridors, hallways, stairways, exit signs, and Fire Department connections shall be maintained, well-lit and unobstructed at all times. L.A.M.C. (57.4701.4) All equipment not in use shall be stored or placed in a vacant room. Equipment on “stand-by” in any corridor is prohibited.
The above list does neither covers all code sections applicable to hospitals nor does it negate the authority or responsibility of the Uniform Fire Safety Officer (UFSO) assigned to any hospital filming location. UFSO will provide a brief description of approved location(s) and restriction(s) if applicable:
NOTE: Any alterations, modifications and/or changes in written conditions are subject to UFSO approval. By signing below, I agree to the above conditions and accept the responsibility of ensuring that all safety requirements are adhered to: Location Manager (Type Name)*
Phone* Email*
Hospital Representative (Type Name)*
Phone* Email*
Fire Inspector (Type Last Name & Inspector #)
Phone Email
LAFD Institutions Unit
Metro Area (213) 978-3730 Valley Area (818) 374-1110
*Required Field
Revised December 2016
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HAWTHORNE
1 - Find your location on the map 2 - Match area with color & Inspector # 3 - Email completed form to Metro or Valley 4 - Call Metro or Valley to confirm receipt of form
GARDENA COMPTON
LAWNDALE
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HERMOSA BEACH TORRANCE
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Valley Office#: (818) 374-1110 lafdvpsu@lacity.org
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REDONDO BEACH
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CARSON
Metro - Downtown Office#: (213) 978-3730 lafdsci@lacity.org
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PALOS VERDES ESTATES
RANCHO PALOS VERDES
4 Miles
State Plane Coordinate System North American Datum 1983 California, Zone 5 Prepared by the GIS Maps & Graphics Unit Don Silla, GIS Specialist Jacky Lu, SPW Updated Date: July, 2016 H:\SharedFiles\Inspections_Maps\Institution_Insp_Dist\Institutions_Insp_Dist_Film.mxd G :\Map_Library\Office_Maps\Inspection_Maps\Institution_Insp_Dist\Institutions_Insp_Dist.pdf
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