| (5) An existing building either occupied as an adult
day care facility at the time of initial inspection by DADS, or converted
to occupancy as an adult day care facility, must meet all local requirements
pertaining to the building for that occupancy. DADS may require the
facility sponsor or licensee to submit evidence that local requirements
(6) Adult day care facilities must be of recognized
permanent type construction as distinguished from movable buildings
or construction. Buildings must be structurally sound with regard
to actual or expected dead, live, and wind loads. DADS may require
submission of evidence to this effect. Foundations must be permanent,
structurally sound for local soil conditions, and in good repair.
A letter from a registered professional engineer may be required as
validation of a permanent and structurally sound foundation.
(7) The walking surface in a facility and at the exit
discharge must be consistent, nominally level, and without abrupt
changes in elevation, trip hazards, or gaps. Floor surfaces may be
on different elevations if connected with ramps or steps in accordance
with the Life Safety Code, NFPA 101, 2000 edition, means of egress
(8) DADS will consider a written request from the facility
for a waiver of requirements which, if strictly applied, would clearly
be impractical in DADS' judgment for existing buildings and structures
that have been converted to adult day care occupancy. Any of these
modifications will be allowed only to the extent that reasonable life
safety against the hazards of fire, explosion, structural, or other
building failure and panic are provided and maintained.
(c) Personal safety.
(1) Fire safety.
(A) The facility must maintain an onsite copy of the
annual fire marshal inspection report by the local fire marshal.
(B) Storage items must be neatly arranged and placed
in the facility to minimize fire hazard. Gasoline, volatile materials,
paint, and similar products must not be stored in the building housing
clients unless approved by the local fire marshal. Accumulations of
extraneous material and refuse are not permitted in the facility.
(C) The building must be kept in good repair.
(D) The facility's electrical, mechanical, heating,
and cooling systems must be maintained in a safe manner and in working
order. DADS may require the facility sponsor or licensee to submit
evidence to this effect, consisting of a report from the fire marshal
or city or county building official having jurisdiction or a report
from a registered professional engineer.
(E) Electrical appliances, devices, and lamps used
in the facility must be used in a manner that prevents overloaded
(F) If the facility uses extension cords in excess
of six feet, they must be shielded or protected.
(G) Smoking regulations must be established and enforced
by the facility and conspicuously posted in the facility.
(i) All smoking must be supervised.
(ii) The facility must prohibit smoking in any room,
ward, or compartment where flammable liquids, combustible gas, or
oxygen are used or stored and in any other hazardous location. The
facility must post a "No Smoking" sign in these areas.
(iii) Ashtrays of noncombustible material and safe
design must be provided in all areas where smoking is permitted.
(iv) Metal containers of substantial gauge or any UL-
or FM-approved containers with self- closing cover devices into which
ashtrays can be emptied must be provided in all areas where smoking
(H) The facility must have an emergency fire lane for
access of fire apparatus if required by local authorities.
(I) An initial pressure test of facility gas lines
from the meter must be provided. Additional pressure tests are required
when the facility has major renovations or additions during which
the gas service is interrupted. Testing must be performed by a person
licensed with the State Board of Plumbing Examiners.
(J) The facility must have all gas heating systems
checked for proper operation and safety before the heating season
by a person licensed by the Texas Department of Licensing and Regulation
to perform maintenance work on gas-fired equipment. Any unsatisfactory
conditions must be corrected promptly.
(K) Curtains or draperies in public spaces and individual
rooms in which smoking is allowed must be flame retardant.
(L) Portable fire extinguishers of appropriate type
and placed in the appropriate location must be provided by the facility
in accordance with NFPA 10.
(M) The facility must inspect and maintain portable
(i) Portable fire extinguishers must be visually inspected
monthly by facility staff. Facility staff conducting the monthly visual
inspection must assure portable fire extinguishers are protected from
damage, kept on their mounting brackets or in cabinets at all times,
and kept in proper condition and working order.
(ii) Portable fire extinguishers must be inspected
and maintained at least once every 12 months in accordance with NFPA
10 by a person licensed by the State Fire Marshal's office, to include
hydrostatic testing as recommended by the manufacturer.
(iii) A record of all fire extinguisher inspections
and maintenance performed must be kept onsite by the facility.
(N) Garbage, waste, or trash containers provided for
kitchens, janitor closets, laundries, mechanical or boiler rooms,
general storage, and similar places must be made of metal or any UL-
or FM-approved material, having a close fitting cover. Disposable
plastic liners may be used in these containers for sanitation.
(2) General requirements.
(A) All exterior site conditions must be designed,
constructed, and maintained in the interest of clients' safety. Newly
constructed ramps must not exceed 1:12 slope. Ramps, walks, and steps
must be of slip-resistive texture and be smooth and uniform, without
irregularities. Guard rails, fences, and hand rails must be provided
(B) All stairways must have substantial hand rails
(C) Tubs or showers for client use must have non-slip
bottoms or floor surfaces, either built in or applied to the surface.
(D) Elevators for client use must be in safe operating
(E) An adequate supply of hot water must be provided.
The hot water system connected to all client-use fixtures must deliver
warm water no hotter than 120 degrees Fahrenheit at the fixture. Hot
water for other sanitary usages must be provided at the temperatures
required for the appliance or fixture served, or for the operation
(F) There must be no occupancies or activities adversely
affecting the safety of the clients in the buildings or on the premises
of the facility.
(G) Licensure capacity will be calculated at 40 square
feet per client. This space may not include the kitchen/food service
area, rest rooms, bath areas, office, corridors, stairways, storage
areas, and outdoor space. Facilities licensed before October 1, 2000,
will be allowed to meet the requirements in effect before October
1, 2000, of 35/50 square feet for ambulatory and semi- ambulatory
clients. If a facility licensed before October 1, 2000, chooses to
increase its capacity, changes ownership, or relocates, the facility
will be required to meet the current standards for usable space, outdoor
area, and rooms for privacy.
(H) An office area must be provided in a central location
to record and maintain files for each client.
(I) An area for rest, other than the treatment and/or
exam room, must be provided with a sufficient number of reclining
lounge chairs or beds to accommodate the needs of clients.
(J) The facility must provide a separate room or rooms
with beds and with walls from floor to ceiling for those clients who
prefer privacy. Facilities licensed on or after May 1, 1999, must
ensure that the room(s) with beds provide space for a minimum 5% of
the licensed capacity. The usable space in the room(s) must provide
not less than 80 square feet per bed for a one-bed room and not less
than 60 square feet per bed for multiple-bed rooms. A bedroom shall
be not less than eight feet in its smallest dimension, unless otherwise
approved by DADS.
(K) The facility must have at least one room available
as a treatment or examination room for use by the nursing staff or
the client's physician. The client may not be treated or examined
in an area other than the treatment room.
(L) The facility must have a safe, secure, and suitable
outdoor recreation or relaxation area for clients. This area must
be connected to, be a part of, be controlled by, and be directly accessible
from the facility. This area must be enclosed by a wall or a fence
or located in a courtyard and supervised by staff to prevent wandering
and large enough to conduct outdoor activities. A chain- link fence
must provide protection on top to prevent injury from wire points.
This area must be suitably furnished. A minimum of 20% of the required
outdoor space must be shaded. The required outdoor space for facilities
licensed on or after May 1, 1999 is:
(i) 400 square feet for facilities up to 59 clients;
(ii) 600 square feet for facilities up to 99 clients;
(iii) 800 square feet for facilities with 100 or more