(xix) Hand washing facilities. Location and arrangement
of fittings for hand washing facilities shall permit their proper
use and operation. Hand washing fixtures with hands-free operable
controls shall be provided within each procedure room, workroom, examination
and treatment room and all toilet rooms unless noted otherwise. Hands-free
includes blade-type handles, and foot, knee, or sensor operated controls.
Particular care shall be given to the clearances required for blade-type
operating handles. Lavatories and hand washing facilities shall be
securely anchored to withstand an applied vertical load of not less
than 250 pounds on the front of the fixture. In addition to the specific
areas noted, hand washing facilities shall be provided and conveniently
located for staff use throughout the facility where patient care and
services are provided.
(xx) Hand drying. Provisions for hand drying shall
be included at all hand washing facilities except scrub sinks. There
shall be hot air dryers or individual paper or cloth units enclosed
in such a way as to provide protection against dust or soil and ensure
single unit dispensing.
(xxi) Mirrors. Mirrors shall not be installed at hand
washing fixtures where asepsis control and sanitation requirements
would be lessened by hair combing.
(xxii) Ceiling heights. The minimum ceiling height
shall be eight feet with the following exceptions.
(I) Minor rooms. Ceilings in storage rooms, toilet
rooms, and other minor rooms shall be not less than 7 feet 6 inches.
(II) Boiler rooms. Boiler rooms shall have ceiling
clearances not less than 2 feet 6 inches above the main boiler header
and connecting piping.
(III) Overhead clearance. Suspended tracks, rails,
pipes, signs, lights, door closers, exit signs, and other fixtures
that protrude into the path of normal traffic shall not be less than
6 feet 8 inches above the finished floor.
(xxiii) Areas producing impact noises. Recreation rooms,
exercise rooms, and similar spaces where impact noises may be generated
shall not be located directly over patient bed area unless special
provisions are made to minimize noise.
(xxiv) Noise reduction. Noise reduction criteria in
accordance with the Table 1 in §134.131(a) of this title (relating
to Tables) shall apply to partitions, floor, and ceiling construction
in patient areas.
(xxv) Rooms with heat producing equipment. Rooms containing
heat-producing equipment such as heater rooms, laundries, etc. shall
be insulated and ventilated to prevent any occupied floor surface
above from exceeding a temperature differential of 10 degrees Fahrenheit
above the ambient room temperature.
(xxvi) Chutes. Linen and refuse chutes shall comply
with the requirements of National Fire Protection Association 82,
Standard on Incinerators and Waste and Linen Handling Systems and
Equipment, 1999 edition, and NFPA 101, §18-5.4.
(xxvii) Thresholds and expansion joint covers. Thresholds
and expansion joint covers shall be flush with the floor surface to
facilitate the use of wheelchairs and carts. Expansion and seismic
joints shall be constructed to restrict the passage of smoke and fire
and shall be listed by a nationally recognized testing laboratory.
(xxviii) Housekeeping room.
(I) In addition to the housekeeping room(s) required
in certain suites, sufficient housekeeping rooms shall be provided
throughout the facility as required to maintain a clean and sanitary
environment.
(II) Each housekeeping room shall contain a floor receptor
or service sink and storage space for housekeeping equipment and
supplies.
(xxix) Public toilets. In addition to the public toilets
required for the main lobby, a public toilet(s) shall be provided
convenient to each public and visitor waiting area. This may be a
single unisex toilet for small waiting areas.
(B) General finish requirements.
(i) Cubicle curtains and draperies.
(I) Cubicle curtains, draperies and other hanging fabrics
shall be noncombustible or flame retardant and shall pass both the
small scale and the large scale tests of National Fire Protection
Association 701, Standard Methods of Fire Tests for Flame-Resistant
Textiles and Films, 1999 edition. Copies of laboratory test reports
for installed materials shall be submitted to the department at
the time of the final construction inspection.
(II) Cubicle curtains shall be provided to assure patient
privacy.
(ii) Flame spread, smoke development and noxious gases.
Flame spread and smoke developed limitations of interior finishes
shall comply with Table 2 of §134.131(b) of this title and NFPA
101, §10-2.1. The use of materials known to produce large or
concentrated amounts of noxious or toxic gases shall not be used in
exit accesses or in patient areas. Copies of laboratory test reports
for installed materials tested in accordance with National Fire Protection
Association 255, Standard Method of Test of Surface Burning Characteristics
of Building Materials, 2000 edition, and National Fire Protection
Association 258, Standard Research Test Method for Determining Smoke
Generation of Solid Materials, 1997 edition, shall be provided.
(iii) Floor finishes. Flooring shall be easy to clean
and have wear resistance appropriate for the location involved. Floors
that are subject to traffic while wet (such as shower and bath areas,
kitchens, and similar work areas) shall have a nonslip surface. In
all areas frequently subject to wet cleaning methods, floor materials
shall not be physically affected by germicidal and cleaning solutions.
The following are acceptable floor finishes:
(I) painted concrete;
(II) vinyl and vinyl composition tiles and sheets;
(III) monolithic or seamless flooring. Where required,
seamless flooring shall be impervious to water, coved and installed
integral with the base, tightly sealed to the wall, and without voids
that can harbor insects or retain dirt particles. Welded joint flooring
is acceptable;
(IV) ceramic and quarry tile;
(V) wood floors;
(VI) carpet flooring. Carpeting installed in patient
rooms and similar patient care areas shall be treated to prevent bacterial
and fungal growth;
(VII) terrazzo; and
(VIII) poured in place floors.
(iv) Wall finishes. Wall finishes shall be smooth,
washable, moisture resistant, and cleanable by standard housekeeping
practices. Wall finishes shall comply with requirements contained
in Table 2 of §134.131(b) of this title, and NFPA 101, §18-3.3.
(I) Wall finishes shall be water resistant in the immediate
area of plumbing fixtures.
(II) Wall finishes in areas subject to frequent wet
cleaning methods shall be impervious to water, tightly sealed and
without voids.
(v) Floor, wall and ceiling penetrations. Floor, wall
and ceiling penetrations by pipes, ducts, and conduits shall be tightly
sealed to minimize entry of dirt particles, rodents and insects. Joints
of structural elements shall be similarly sealed.
(vi) Ceiling types. All occupied rooms and spaces shall
be provided with finished ceilings. Ceilings which are a part of
a rated roof/ceiling assembly or a floor/ceiling assembly shall be
constructed of listed components and installed in accordance with
the listing. Three types of ceilings that are required in various
areas of the facility are:
(I) Ordinary ceilings. Ceilings such as acoustical
tiles installed in a metal grid which are dry cleanable with equipment
used in daily housekeeping activities such as dusters and vacuum cleaners.
(II) Washable ceilings. Ceilings that are made of washable,
smooth, moisture impervious materials such as painted lay-in gypsum
wallboard or vinyl faced acoustic tile in a metal grid.
(III) Monolithic ceilings. Ceilings which are monolithic
from wall to wall (painted solid gypsum wallboard), smooth and without
fissures, open joints, or crevices and with a washable and moisture
impervious finish.
(vii) Special construction. Special conditions may
require special wall and ceiling construction for security in areas
such as storage of controlled substances and areas where patients
are likely to attempt suicide or escape.
(viii) Materials finishes. Materials known to produce
noxious gases when burned shall not be used for mattresses, upholstery,
and wall finishes.
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