(iv) Encroachment into the means of egress. Items such
as drinking fountains, telephone booths or stations, and vending
machines shall be so located as to not project into and restrict
exit corridor traffic or reduce the exit corridor width below the
required minimum. Portable equipment shall not be stored so as to
project into and restrict exit corridor traffic or reduce the exit
corridor width below the required minimum.
(v) Doors in means of egress. All door leaves in the
means of egress shall be not less than 36 inches wide or as otherwise
permitted for facilities by NFPA 101, §18-2.3.5.
(vi) Sliding doors. When sliding doors are provided
to a means of egress corridor, the sliding doors shall have break-away
provisions, positive latching devices, and shall be installed to resist
passage of smoke.
(vii) Control doors. Designs that include cross-corridor
control doors should be avoided. When unavoidable, cross-corridor
control doors shall consist of two 32-inch wide leaves which swing
in a direction opposite from the other, or of the double acting type,
and be provided with view panels.
(viii) Emergency access. Rooms containing bathtubs,
showers, or water closets, intended for patient use shall be provided
with at least one outswinging door or special frame and hardware which
will permit the door to swing out for staff access to a patient who
may have collapsed against the door. The width of such doors shall
not be less than 36 inches.
(ix) Obstruction of corridors. All doors which swing
towards the corridor must be recessed. Corridor doors to rooms not
subject to occupancy (any room that you can walk into and close the
door behind you is considered occupiable) may swing into the corridor,
provided that such doors comply with the requirements of NFPA 101,
§7-2.1.4.3.
(x) Stair landing. Doors shall not open immediately
onto a stair without a landing. The landing shall be 44 inches deep
or have a depth at least equal to the door width, whichever is greater.
(xi) Doors to rooms subject to occupancy. All doors
to rooms subject to occupancy shall be of the swing type except that
horizontal sliding doors complying with the requirements of NFPA 101,
§18-2.2.2.9 are permitted. Door leaves to rooms subject to occupancy
shall not be less than 36 inches wide unless noted otherwise.
(xii) Operable windows and exterior doors. Windows
that can be opened without tools or keys and outer doors without automatic
closing devices shall be provided with insect screens.
(xiii) Glazing. Glass doors, lights, sidelights, borrowed
lights, and windows located within 12 inches of a door jamb or with
a bottom-frame height of less than 18 inches and a top-frame height
of more than 36 inches above the finished floor which may be broken
accidentally by pedestrian traffic shall be glazed with safety glass
or plastic glazing material that will resist breaking and will not
create dangerous cutting edges when broken. Similar materials shall
be used for wall openings in activity areas such as recreation and
exercise rooms, unless otherwise required for fire safety. Safety
glass, tempered or plastic glazing materials shall be used for shower
doors and bath enclosures, interior windows and doors. Plastic and
similar materials used for glazing shall comply with the flame-spread
ratings of NFPA 101, §18-3.3.
(xiv) Fire doors. All fire doors shall be listed by
an independent testing laboratory and shall meet the construction
requirements for fire doors in National Fire Protection Association
80, Standard for Fire Doors and Fire Windows, 1999 edition. Reference
to a labeled door shall be construed to include labeled frame and
hardware.
(xv) Elevator doors. Elevator shaft openings shall
be protected with a B labeled one-hour fire protection rated doors
in buildings less than four stories; and one and one-half hour fire
protection rated doors in buildings four or more stories.
(xvi) Elevator lobbies. Elevator lobbies shall have
at least 10 feet of clear floor space in front of the elevator doors.
(xvii) Grab bars. Grab bars shall be provided at patient
toilets, showers and tubs. The bars shall have sufficient strength
and anchorage to sustain a concentrated vertical or horizontal load
of 250 pounds. Grab bars are not permitted at bathing and toilet fixtures
unless designed and installed to eliminate the possibility of patients
harming themselves. Grab bars intended for use by the disabled shall
also comply with ADA requirements.
(xviii) Soap dishes. Recessed soap dishes shall be
provided at all showers and bathtubs.
(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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