| (ii) Ceilings in the soiled workroom shall be monolithic
type as required by §133.162(d)(2)(B)(vi)(III) of this title.
(3) Mechanical Requirements. Mechanical requirements
shall be in accordance with §133.162(d)(3) of this title and
this paragraph. Room recirculating units shall not be used.
(4) Piping systems and plumbing fixtures. Piping systems
and plumbing fixtures shall be in accordance with §133.162(d)(4)
of this title.
(5) Electrical requirements. Electrical requirements
shall be in accordance with §133.162(d)(5) of this title and
this paragraph.
(A) General.
(i) Receptacles at each bed location in a CCU(s) shall
be served by two branch circuits, one or more from the critical branch
panel of the emergency electrical system and one or more from the
normal system. One critical branch circuit shall serve only one bed
location. All branch circuits from the normal system shall be from
a single panelboard. All branch circuits from the emergency electrical
system shall be from a single panelboard.
(ii) A minimum of seven hospital grade duplex outlets
shall be conveniently located at the head of each bed, crib or bassinet.
At least three of these duplex outlets shall be on the critical branch
of the emergency electrical system.
(iii) Hospital grade receptacles in the PCCU shall
be tamper-resistant or provided with GFCIs.
(B) Nurses calling systems. The nurse call system shall
be in accordance with §133.162(d)(5)(L) and Table 7 of §133.169(g)
of this title.
(e) Dietary suite.
(1) Architectural requirements.
(A) General. Construction, equipment, and installation
shall comply with Chapter 228 of this title (relating to Retail Food).
(B) Food service facilities. Food services shall be
provided by an on-site food preparation system or an off-site food
service system or a combination of the two. The following minimum
functional elements shall be provided on site regardless of the type
of dietary services.
(i) Dining area. Provide dining space(s) for ambulatory
patients, staff, and visitors. These spaces shall be separate from
the food preparation and distribution areas.
(ii) Receiving area. This receiving area shall have
direct access to the outside for incoming dietary supplies or off-site
food preparation service and shall be separate from the general receiving
area. The receiving area shall contain a control station and an area
for breakout for loading, unloading, uncrating, and weighing supplies.
The entrance area to the receiving area shall be covered from the
weather.
(iii) Storage spaces. Storage spaces shall be convenient
to receiving area and food preparation area and shall be located to
exclude traffic through the food preparation area. Regardless of the
type of food services provided, the facility shall provide storage
of food for emergency use for a minimum of four calendar days.
(I) Storage space(s). Storage space(s) shall be provided
for bulk, refrigerated, and frozen foods.
(II) Cleaning supply storage. This room or closet shall
be used to store nonfood items that might contaminate edibles. This
storage area may be combined with the housekeeping room.
(iv) Food preparation area. Counter space shall be
provided for food prep work, equipment, and an area to assemble trays
for distribution for patient meals.
(v) Ice-making equipment. Ice-making equipment shall
be provided for both drinks and food products (self-dispensing equipment)
and for general use (storage-bin type equipment).
(vi) Hand washing. Hand washing fixtures with hands-free
operable controls shall be conveniently located at all food preparation
areas and serving areas.
(vii) Food service carts. When a cart distribution
system is provided, space shall be provided for storage, loading,
distribution, receiving, and sanitizing of the food service carts.
The cart traffic shall be designed to eliminate any danger of cross-circulation
between outgoing food carts and incoming soiled carts, and the cleaning
and sanitizing process. Cart circulation shall not be through food
processing areas.
(viii) Ware washing room. A ware washing room equipped
with commercial type dishwasher equipment shall be located separate
from the food preparation and serving areas. Space shall be provided
for receiving, scraping, sorting, and stacking soiled tableware and
for transferring clean tableware to the using areas. Hand washing
facilities with hands-free operable controls shall be located within
the soiled dish wash area. A physical separation to prevent cross-traffic
between "dirty side" and "clean side" of the dish wash areas shall
be provided.
(ix) Pot washing facilities. A three compartmented
sink of adequate size for intended use shall be provided convenient
to the food preparation area. Supplemental heat for hot water to clean
pots and pans shall be by booster heater or by steam jet.
(x) Waste storage room. A food waste storage room shall
be conveniently located to the food preparation and ware washing areas
but not within the food preparation area. It shall have direct access
to the hospital's waste collection and disposal facilities.
(xi) Sanitizing facilities. Storage areas and sanitizing
facilities for garbage or refuse cans, carts, and mobile tray conveyors
shall be provided. All containers for trash storage shall have tight-fitting
lids.
(xii) Housekeeping room. A housekeeping room shall
be provided for the exclusive use of the dietary department. Where
hot water or steam is used for general cleaning, additional space
within the room shall be provided for the storage of hoses and nozzles.
(xiii) Office spaces. An office shall be provided for
the use of the food service manager or the dietary service manager.
In smaller facilities, a designated alcove may be located in an area
that is part of the food preparation area.
(xiv) Toilets and locker spaces. A toilet room(s) with
a hand washing fixture(s) with hands-free operable controls shall
be provided for the exclusive use of the dietary staff. Toilet room(s)
shall not open directly into the food preparation areas, but must
be in close proximity to them. For larger facilities, a locker room
or space for lockers shall be provided for staff belongings.
(C) Additional service areas, rooms and facilities.
When an on-site food preparation system is used, in addition to the
items required in subparagraph (B) of this paragraph, the following
service areas, rooms and facilities shall be provided.
(i) Food preparation facilities. When food preparation
systems are provided, there shall be space and equipment for preparing,
cooking, and baking.
(ii) Tray assembly line. A patient tray assembly and
distribution area shall be located within close proximity to the food
preparation and distribution areas.
(iii) Food storage. When food is prepared on site,
the storage room shall be adequate to accommodate food for a seven
calendar day menu cycle.
(iv) Additional storage room(s). An additional room(s)
shall be provided for the storage of cooking wares, extra trays, flatware,
plastic and paper products, and portable equipment.
(v) Drying storage area. Provisions shall be made for
drying and storage of pots and pans from the pot washing room.
(D) Equipment. Equipment for use in the dietary suite
shall meet the following requirements.
(i) Mechanical devices shall be heavy duty, suitable
for the use intended, and easily cleaned. Where equipment is movable,
provide heavy duty locking casters. Equipment with fixed utility connections
shall not be equipped with casters.
(ii) Floor, wall, and top panels of walk-in coolers,
refrigerators, and freezers shall be insulated. Coolers and refrigerators
shall be capable of maintaining a temperature down to freezing. Freezers
shall be capable of maintaining a temperature of 20 degrees below
0 degrees Fahrenheit. Coolers, refrigerators, and freezers shall be
thermostatically controlled to maintain desired temperature settings
in increments of two degrees or less. Interior temperatures shall
be indicated digitally and visible from the exterior. Controls shall
include audible and visible high and low-temperature alarm. The time
of alarm shall be automatically recorded.
(iii) Walk-in units may be lockable from the outside
but must have a release mechanism for exit from inside at all times.
The interior shall be lighted. All shelving shall be corrosion-resistant,
easily cleaned, and constructed and anchored to support a loading
of at least 100 pounds per linear foot.
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