| (ii) Wall bases in food preparation, food assembly,
soiled and clean ware cleaning and other areas which are frequently
subject to wet cleaning methods shall be made integral and coved with
the floor, tightly sealed to the wall, constructed without voids
that can harbor insects, retain dirt particles, and be impervious
to water.
(iii) In the dietary and food preparation areas, the
wall construction, finishes, and trim, including the joints between
the walls and the floors, shall be free of voids, cracks, and crevices.
(iv) The ceiling in food preparation and food assembly
areas shall be washable as required by §134.122(d)(2)(B)(vi)(II).
(v) The ceiling in the food storage room, and soiled
and clean ware cleaning area shall be of the monolithic type as required
by §134.122(d)(2)(B)(vi)(III).
(3) Mechanical Requirements. Mechanical requirements
shall be in accordance with §134.122(d)(3) of this title and
this paragraph.
(A) Exhaust hoods handling grease-laden vapors in food
preparation centers shall comply with National Fire Protection Association
96, Standard for Ventilation Control and Fire Protection of Commercial
Cooking Operations, 1998 edition. All hoods over cooking ranges shall
be equipped with grease filters, fire extinguishing systems, and heat-actuated
fan controls. Clean out openings shall be provided every 20 feet and
at any changes in direction in the horizontal exhaust duct systems
serving these hoods. (Horizontal runs of ducts serving range hoods
should be kept to a minimum.)
(B) When air change standards in Table 3 of §134.131(c)
of this title do not provide sufficient air for proper operation
of exhaust hoods (when in use), supplementary filtered makeup air
shall be provided in these rooms to maintain the required airflow
direction and exhaust velocity. Makeup systems for hoods shall be
arranged to minimize "short circuiting" of air and to avoid reduction
in air velocity at the point of contaminant capture.
(C) Air handling units serving the dietary suite shall
be equipped with filters having efficiencies equal to, or greater
than specified in Table 4 of §134.131(d) of this title.
(4) Piping systems and plumbing fixtures. Piping systems
and plumbing fixtures shall be in accordance with §134.122(d)(4)
of this title and this paragraph.
(A) The kitchen grease traps shall be located and
arranged to permit easy access without the need to enter food preparation
or storage areas. Grease traps shall be of capacity required and shall
be accessible from outside of the building without need to interrupt
any services.
(B) Grease traps or grease interceptors shall be located
outside the food preparation area and shall comply with the requirements
in the National Association of Plumbing-Heating-Cooling Contractors
(PHCC), National Standard Plumbing Code, 2000 edition. This publication
may be obtained from the National Association of Plumbing-Heating-Cooling
Contractors, 180 South Washington Street, Falls Church, VA 22046;
telephone (703) 237-8100.
(C) The material used for plumbing fixtures shall
be non-absorptive and acid-resistant.
(D) Water spouts used at lavatories and sinks shall
have clearances adequate to avoid contaminating utensils and containers.
(E) Hand washing fixtures used by food handlers shall
be trimmed with valves that can be operated without hands. Single
lever or wrist blade devices may be used. Blade handles used for this
purpose shall not be less than four inches in length.
(F) Drainage and waste piping shall not be installed
in the space above the ceiling or installed in an exposed location
in food preparation centers, food serving facilities and food storage
areas unless special precautions are taken to protect the space below
from leakage and condensation from necessary overhead piping.
(G) No plumbing lines may be exposed overhead or on
walls where possible leaks would create a potential for food contamination.
(5) Electrical requirements. Electrical requirements
shall be in accordance with §134.122(d)(5) of this title and
this paragraph.
(A) Exhaust hoods shall have an indicator light indicating
that the exhaust fan is in operation.
(B) The electrical circuit(s) to equipment in wet areas
shall be provided with five milliampere GFCI.
(e) Emergency treatment room.
(1) Architectural requirements.
(A) Emergency treatment room. As a minimum requirement,
a facility shall provide at least one emergency treatment room to
handle emergencies. The emergency treatment room may be located anywhere
in the facility and shall meet the following requirements.
(i) The emergency treatment room shall have a minimum
clear area of 120 square feet clear floor area exclusive of fixed
and movable cabinets and shelves. The minimum clear room dimension
exclusive of fixed cabinets and built-in shelves shall be 10 feet.
The emergency treatment room shall contain cabinets, medication storage,
work counter, examination light, and hand washing fixtures with hands-free
operable controls. Exception: Crisis stabilization units are not required
to have medication storage in the emergency treatment room.
(ii) Storage space shall be provided within the room
or on an emergency cart and be under staff control for general medical
emergency supplies and medications. Adequate space shall be provided
for emergency equipment.
(B) Secured holding room. When provided, this room
shall be constructed to allow for security, patient and staff safety,
patient observation, and sound proofing.
(C) Service areas. The following service areas shall
be provided.
(i) Soiled workroom. The workroom shall contain a work
counter, a clinical sink or equivalent flushing type fixture, hand
washing fixture with hands-free operable controls, waste receptacles,
and soiled linen receptacles. The soiled workroom in the nursing suite
may be shared with the emergency treatment room if it is located
conveniently nearby.
(ii) Housekeeping room. The housekeeping room shall
be located nearby.
(iii) Patient toilet(s). A toilet room shall be provided
and located nearby.
(2) Details and finishes. Details and finishes shall
be in accordance with §134.122(d)(2) of this title and this paragraph.
(A) Flooring used in the treatment room, secure holding
area, and soiled workroom shall be of the seamless type as required
by §134.122(d)(2)(B)(iii)(III) of this title.
(B) Ceilings in soiled workrooms and secure holding
rooms shall be of the monolithic type as required by §134.122(d)(2)(B)(vi)(III)
of this title.
(3) Mechanical requirements. Mechanical requirements
shall be in accordance with §134.122(d)(3) of this title and
this paragraph. Duct linings exposed to air movement shall not be
used in ducts serving any treatment rooms and secure holding rooms.
This requirement shall not apply to mixing boxes and acoustical traps
that have special coverings over such lining.
(4) Piping systems and plumbing fixtures. Piping systems
and plumbing fixtures shall be in accordance with §134.122(d)(4)
of this title. When provided, medical gas systems shall be in accordance
with §134.122(d)(4)(A)(iii) of this title.
(5) Electrical requirements. Electrical requirements
shall be in accordance with §134.122(d)(5) of this title and
this paragraph.
(A) General.
(i) Each treatment room shall have a minimum of six
duplex electrical receptacles. Two duplex electrical receptacles shall
be located convenient to the head of the bed.
(ii) Each work counter and table shall have access
to two duplex receptacles connected to the critical branch of the
emergency electrical system and be labeled with panel and circuit
number.
(B) Nurses calling systems. A nurses regular calling
system shall be provided for the treatment room in accordance with
§134.122(d)(5)(K)(i) of this title.
(f) Employees suite. Lockers, lounges, toilets and
other amenities as determined by the facility shall be provided throughout
the facility for employees and volunteers. These amenities are in
addition to, and separate from, those required for the medical staff
and the public.
(g) Engineering suite and equipment areas.
(1) General. The following areas or rooms shall be
provided:
(A) an engineer's office with file space and provisions
for protected storage of facility drawings, records, manuals, etc.;
(B) a general maintenance shop(s) for repair and maintenance;
(C) a separate room(s) for building maintenance supplies
and equipment. Storage of bulk solvents and flammable liquids shall
be in a separate building and not within the facility building;
(D) a medical equipment room which includes provisions
for the storage, repair, and testing of electronic and other medical
equipment;
(E) a separate room or building for yard maintenance
equipment and supplies. When a separate room is within the physical
plant the room shall be located so that equipment may be moved directly
to the exterior. Yard equipment or vehicles using flammable liquid
fuels shall not be stored or housed within the facility building;
and
(F) sufficient space in all mechanical and electrical
equipment rooms for proper maintenance of equipment. Provisions shall
also be made for removal and replacement of equipment.
(2) Additional areas or room(s). Additional areas or
room(s) for mechanical, and electrical equipment shall be provided
within the physical plant or installed in separate buildings or weatherproof
enclosures with the following exceptions.
(A) An area shall be provided for cooling towers and
heat rejection equipment when such equipment is used.
(B) An area for the medical gas park and equipment
shall be provided. For smaller medical gas systems, the equipment
may be housed in a room within the physical plant in accordance with
National Fire Protection Association 99, Standard for Health Care
Facilities, 1999 edition (NFPA 99), Chapters 4 and 8.
(C) When provided, compactors, dumpsters, and incinerators
shall be located in an area remote from public entrances.
(h) General stores.
(1) General. In addition to storage rooms in individual
departments, a central storage room shall also be provided. General
stores may be located in a separate building on-site with provisions
for protection against inclement weather during transfer of supplies.
(2) Receiving. Central storage areas shall be provided
with an off-street unloading and receiving area protected from inclement
weather.
(3) General storage room. General storage room with
a total area of not less than 12 square feet per inpatient bed shall
be provided. The storage room may be within the facility, or separate
building on-site. A portion of the storage may be provided off-site.
(4) Outpatient suite storage room. A storage room for
the outpatient services shall be provided at least equal to 5.0% of
the total area of the outpatient suite. This required storage room
area may be combined with general stores.
(i) Geriatric, Alzheimer, and other dementia nursing
suites. When geriatric, Alzheimer, or other dementia nursing suites
are provided, the nursing suite shall comply with the requirements
in subsection (o) of this section with the following exceptions.
(1) A patient bedroom suite shall be 120 square feet
in a single patient bedroom suite and 200 square feet in multiple-bed
room suites.
(2) Each patient bedroom shall have storage for extra
blankets, pillows, and linen.
(3) Patient bedroom doors shall be a minimum of three
feet eight inches in width.
(4) Patients shall have access to at least one bathtub
in each nursing suite.
(5) A minimum of two separate social spaces, one appropriate
for noisy activities and the other for quiet activities, shall be
provided. The combined total area shall be not less than 30 square
feet per bed space with not less than 140 square feet for each of
the two spaces, whichever is greater. This space may be shared with
the dining area or room.
(6) Storage space for wheelchairs shall be provided
in the nursing unit.
(j) Imaging suite.
(1) Architectural requirements.
(A) General. When diagnostic imaging services are provided,
the minimum the facility shall provide is a diagnostic radiographic
(X-ray) room.
(i) Diagnostic radiographic (x-ray) room size(s) shall
be in compliance with manufacturer's recommendation. When portable
x-ray equipment is used, the portable unit shall be stored in a secured
room.
(ii) When radiation protection is required for any
diagnostic imaging room, a medical physicist licensed under the Texas
Medical Physics Practice Act, Occupations Code, Chapter 602, shall
specify the type, location, and amount of radiation protection to
be installed for the layout and equipment selections.
(iii) Each X-ray room shall include a shielded control
alcove. The control alcove shall be provided with a view window designed
to permit full view of the examination table and the patient at all
times.
Cont'd... |
