| (a) Administration and public suite.
(1) Architectural requirements. The following rooms
or areas shall be provided.
(A) Primary entrance. An entrance at grade level shall
be accessible and protected from inclement weather with a drive under
canopy for loading and unloading passengers.
(B) Lobby. A main lobby shall be located at the primary
entrance and shall include a reception and information counter or
desk, waiting space, public toilet facilities, public telephones,
drinking fountain, and storage room or alcove for wheelchairs.
(C) Admissions area. An admissions area shall include
a waiting area, work counters or desk, private interview spaces, and
storage room or alcove for wheelchairs. The waiting area and wheelchair
storage may be shared with similar areas located in the main lobby.
(D) General or individual offices. Office space shall
be provided for business transactions, medical and financial records,
and administrative and professional staffs.
(E) Multipurpose rooms. A multipurpose room or rooms
shall be provided for conferences, meetings, and health education
purposes including provisions for showing visual aids.
(F) Storage. Storage for office equipment and supplies
shall be provided. The construction protection for the storage room
or area shall be in accordance with National Fire Protection Association
101, Life Safety Code, 2012 edition (NFPA 101) §18.3.2.
(2) Details and finishes. Details and finishes shall
comply with §511.162(d)(2) of this subchapter (relating to General
Construction Requirements).
(3) Mechanical requirements. Mechanical requirements
shall comply with §511.162(d)(3) of this subchapter.
(4) Piping systems and plumbing fixtures. Piping systems
and plumbing fixtures shall comply with §511.162(d)(4) of this
subchapter.
(5) Electrical requirements. Electrical requirements
shall comply with §511.162(d)(5) of this subchapter.
(b) Cart cleaning and sanitizing unit.
(1) Architectural requirements.
(A) Facilities. Cart cleaning, sanitizing, and storage
facilities shall be provided for carts serving central services, dietary
services, and linen services.
(B) Location. Cart facilities may be provided for each
service or be centrally located.
(C) Hand washing fixtures. Hand washing fixtures shall
be provided in cart cleaning, sanitizing, and storage areas.
(2) Details and finishes. When interior cart cleaning
facilities are provided, details and finishes shall comply with §511.162(d)(2)
of this subchapter and this paragraph.
(A) Flooring. Flooring in the cart cleaning and sanitizing
unit shall be of the seamless type, or ceramic or quarry tile as required
by §511.162(d)(2)(B)(iii)(III) or (IV) of this subchapter.
(B) Ceilings. Ceilings in the cart cleaning and sanitizing
unit shall be the monolithic type as required by §511.162(d)(2)(B)(vi)(III)
of this subchapter.
(3) Mechanical requirements. Mechanical requirements
shall comply with §511.162(d)(3) of this subchapter.
(4) Piping systems and plumbing fixtures. Piping systems
and plumbing fixtures shall comply with §511.162(d)(4) of this
subchapter and this paragraph.
(A) Hand washing fixtures. Hand washing fixtures shall
be provided with hot and cold water. Hot and cold water fixtures shall
be provided in cart cleaning and sanitizing locations regardless of
whether they are interior or exterior.
(B) Floor drains and floor sinks. Where floor drains
or floor sinks are installed, they shall be of a type that can be
easily cleaned by removal of the cover. Removable stainless steel
mesh shall be provided in addition to a grilled drain cover to prevent
entry of large particles of waste that might cause stoppages. Floor
drains and floor sinks shall be located to avoid conditions where
removal of covers for cleaning is difficult.
(5) Electrical requirements. Electrical requirements
shall be in accordance with §511.162(d)(5) of this subchapter.
(c) Central sterile supply suite.
(1) Architectural requirements.
(A) General. When surgical services are provided, the
following rooms or areas shall be provided.
(i) Decontamination room. This room shall be physically
separated from all other areas of the suite. The room shall include
work counters or tables, flush type utility sink, equipment for initial
disinfection, and hand washing facilities with hands-free operable
controls. Materials shall be transferred from the decontamination
room to the clean assembly room by way of pass-through doors, windows,
or washer equipment. The dirty side of the decontamination room may
be combined with a soiled utility room if all functions for each space
are provided within the room.
(ii) Clean and assembly room. The room shall include
counters or tables, equipment for sterilizing, and hand washing facilities
with hands-free operable controls. Clean and soiled work areas shall
be physically separated.
(iii) Breakdown storage room. A storage room for breakdown
of supplies shall be provided. The storage room shall have adequate
areas and counters for breakdown of prepackaged supplies.
(iv) Sterile and clean supply room. A sterile and clean
supply room shall be provided. Storage of sterile and clean supplies
shall not occur within the breakdown room.
(v) Equipment storage. An equipment storage room shall
be provided.
(vi) Cart storage room. The storage room for distribution
carts shall be adjacent to clean and sterile storage and close to
main distribution points.
(vii) Multipurpose room. The equipment storage and
cart storage room may be combined into a multipurpose room.
(B) Service areas. The central supply suite shall provide
the following service areas.
(i) Office space. Office space for director of central
services.
(ii) Staff toilets. Facilities may be outside the unit
but must be convenient for staff use and shall contain hand washing
fixtures with hands-free operable controls.
(iii) Locker room. When provided, the locker room for
staff shall include lockers, toilets, lavatories, showers, and male
and female dressing rooms or cubicles. A central changing locker room
may be shared and made available within the immediate area of the
central sterile supply suite.
(iv) Housekeeping room. A housekeeping room shall be
provided and contain a floor receptor or service sink and storage
space for housekeeping supplies and equipment. The housekeeping room
shall be located on the decontamination or soiled side of the central
sterile supply suite.
(2) Details and finishes. Details and finishes shall
comply with §511.162(d)(2) of this subchapter and this paragraph.
(A) Details. Mirrors shall not be installed at hand
washing fixtures in clean and sterile supply areas.
(B) Finishes.
(i) Flooring. Flooring used in the decontamination
room and the clean assembly room shall be of the seamless type as
required by §511.162(d)(2)(B)(iii)(III) of this subchapter.
(ii) Ceilings. Ceilings in the decontamination room,
clean assembly room, and supply storage room shall be the monolithic
type as required by §511.162(d)(2)(B)(vi)(III) of this subchapter.
(3) Mechanical Requirements. Mechanical requirements
shall comply with §511.162(d)(3) of this subchapter and this
paragraph.
(A) Ventilation, humidity, and temperature control.
The sterile supply room and the clean and assembly room shall include
provisions for ventilation, humidity, and temperature control.
(B) Ethylene oxide (EO) sterilizers. When provided,
installations of EO sterilizers shall comply with the requirements
of 30 TAC §106.417 (relating to Ethylene Oxide Sterilizers) administered
by the Texas Commission on Environmental Quality (TCEQ), and the following
requirements.
(i) EO sterilizer requirements. All source areas shall
be exhausted, including the sterilizer equipment room, service and
aeration areas, over sterilizer door, and the aerator. If the EO cylinders
are not located in a well-ventilated unoccupied equipment space, an
exhaust hood shall be provided over the cylinders. The relief valve
shall be terminated in a well-ventilated, unoccupied equipment space,
or outside the building.
(ii) Airflow. General airflow shall be away from sterilizer
operators and towards the sterilizers.
(iii) Exhaust. A dedicated exhaust fan and an exhaust
duct system shall be provided for EO sterilizers. The exhaust outlet
to the atmosphere shall be located on the highest roof, directed upward,
and not less than 25 feet from any air intake. A legible warning sign
shall be provided to identify the exhaust stack on the roof.
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