| (a) Administration and public suite.
(1) Entrance. Entrances shall be located at grade level,
be accessible to individuals with disabilities, and protected against
inclement weather. When an SCF is located on a floor above grade level,
elevators shall be accessible and shall meet the requirements of §125.93
of this title (relating to Elevators).
(2) Waiting area. A waiting area or foyer shall be
provided which includes having access to the following rooms and items:
(A) public toilet facilities; and
(B) telephone(s) for public use.
(3) General or individual office(s). An office(s) shall
be provided for business transactions, records, and administrative
and professional staff.
(4) Resident records area. Resident record storage
space shall be located within a secure designated area under direct
visual supervision of administrative staff.
(b) Dietary suite. In addition to the requirements
of §125.32(d) of this title (relating to Resident Care and Services),
the facility shall provide the following.
(1) Dining area for ambulatory patients, staff, and
visitors. A dining area for ambulatory patients, staff, and visitors
with a minimum floor space of 15 square feet per person to be seated
shall be provided. The footage requirement does not include serving
area. The dining area and service areas shall be separate from the
food preparation and distribution area.
(2) Food service for a 50-bed residence or more. The
food service for a 50-bed residence or more shall be provided by an
on-site food preparation system or an off-site food service system
or a combination of the two. The following minimum functional elements
shall be provided on-site regardless of the type of dietary services.
(A) Receiving area. A receiving area shall be provided
and shall have direct access to the outside for incoming dietary supplies
or off-site food preparation service and shall be separate from the
general receiving area. The receiving area shall contain a control
station and an area for breakout for loading, unloading, uncrating,
and weighing supplies. The entrance area to the receiving area shall
be covered from the weather.
(B) Storage spaces. Storage spaces shall be convenient
to receiving area and food preparation area and shall be located to
exclude traffic through the food preparation area. Regardless of the
type of food services provided, the facility shall provide storage
of food for emergency use for a minimum of four calendar days.
(i) Storage space(s) shall be provided for bulk, refrigerated,
and frozen foods.
(ii) A cleaning supply storage room or closet shall
be provided to store non-food items that might contaminate edibles.
This storage area may be combined with the housekeeping room.
(C) Counter space. Counter space shall be provided
for food prep work, equipment, and an area to assemble trays for
distribution for patient meals.
(D) Hand washing fixtures. Hand washing fixtures with
hands-free operable controls shall be conveniently located at all
food preparation area and serving areas.
(E) Cart distribution system. When a cart distribution
system is provided, space shall be provided for storage, loading,
distribution, receiving, and sanitizing of the food service carts.
The cart traffic shall be designed to eliminate any danger of cross-circulation
between outgoing food carts and incoming soiled carts, and the cleaning
and sanitizing process. Cart circulation shall not be through food
processing areas.
(F) Ware washing room. A ware washing room equipped
with commercial type dishwasher equipment shall be located separate
from the food preparation and serving areas. Space shall be provided
for receiving, scraping, sorting, and stacking soiled tableware and
for transferring clean tableware to the using areas. Hand washing
facilities with hands-free operable controls shall be located within
the soiled dish wash area. A physical separation to prevent cross
traffic between "dirty side and "clean side" of the dish wash areas
shall be provided.
(G) Three-compartmented sink. A three-compartmented
sink of adequate size for pot washing shall be provided convenient
to the food preparation area. It shall have direct access to the SCF
waste collection and disposal facilities.
(H) Food waste storage room. A food waste storage
room shall be conveniently located to the food preparation and ware
washing areas but not within the food preparation area. It shall have
direct access to the SCF waste collection and disposal facilities.
(I) Storage areas and sanitizing facilities. Storage
areas and sanitizing facilities for garbage or refuse cans, carts,
and mobile tray conveyors shall be provided. All containers for trash
storage shall have tight-fitting lids.
(J) Housekeeping room. A housekeeping room shall be
provided for the exclusive use of the dietary department. Where hot
water or steam is used for general cleaning, additional space within
the room shall be provided for the storage of hoses and nozzles.
(K) Dietary office. An office shall be provided for
the use of the food service manager or the dietary service manager.
In smaller facilities, a designated alcove may be located in an area
that is part of the food preparation area.
(L) Toilet room. A toilet room shall be provided for
the exclusive use of the dietary staff. Toilets shall not open directly
into the food preparation areas, but must be in a close proximity
to them. For larger facilities, a locker room or space for lockers
shall be provided for staff belongings.
(M) Additional service areas, rooms and facilities.
When an on-site food preparation system is used, in addition to the
items required in subparagraphs (A) - (L) of this paragraph, the following
service areas, rooms, and facilities shall be provided.
(i) When food preparation systems are provided, there
shall be space and equipment for preparing, cooking, and baking.
(ii) A patient tray assembly and distribution area
shall be located within close proximity to the food preparation and
distribution areas.
(iii) When food is prepared on-site, the storage room
shall be adequate to accommodate food for a seven-calendar day menu
cycle.
(iv) An additional room(s) shall be provided for the
storage of clean cooking wares, extra trays, flatware, plastic and
paper products, and portable equipment.
(v) Provisions shall be made for drying and storage
of pots and pans from the pot washing room or area.
(N) Details.
(i) Food storage shelves shall not be less than four
inches above the finished floor and the space below the bottom shelf
shall be closed in and sealed tight for ease of cleaning.
(ii) Operable windows and doors not equipped with automatic
closing devices shall be equipped with insect screens.
(iii) Food processing areas in the central dietary
kitchen shall have ceilings height not less than nine feet. In a facility
classified as a RBCF, ceiling height shall not be less then eight
feet. Ceiling mounted equipment shall be supported from rigid structures
located above the finished ceilings.
(iv) Mirrors shall not be installed at hand washing
fixtures in the food preparation areas.
(O) Finishes.
(i) Floors in areas used for food preparations, food
assembly, and soiled and clean ware cleaning shall be water-resistance
and greaseproof. Floor surfaces, including tile joints, shall be resistant
to food acids.
(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 trims, including the joints between
the wall and the floor, shall be free of voids, cracks, and crevices.
(iv) The ceiling in food preparation and food assembly
areas shall be washable. Smooth moisture impervious materials such
as painted lay-in gypsum wallboard or vinyl faced acoustic tile in
a metal grid.
(v) The ceiling in the soiled and clean ware cleaning
area shall be 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.
(c) Laboratory suite. When a laboratory is located
on-site the following minimum items shall be provided:
(1) a room with work counter, utility sink, and storage
cabinets or closet(s); and
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