| (a) A center must ensure a sanitary environment by
following accepted standards of practice and maintain a safe physical
environment free of hazards for minors, staff, and visitors.
(b) A center must ensure that the following conditions
are met.
(1) Wastewater and sewage must be discharged into a
state-approved municipal sewage system. An on-site sewage facility
must be approved by the Texas Commission on Environmental Quality
(TCEQ) or authorized agent.
(2) The water supply must be from a system approved
by the Public Drinking Water Section of the TCEQ, or from a system
regulated by an entity responsible for water quality in the jurisdiction
where the center is located as approved by the Public Drinking Water
Section of the TCEQ.
(3) Waste, trash, and garbage must be disposed of from
the premises at regular intervals in accordance with state and local
practices. Excessive accumulations are not permitted. Outside containers
must have tight-fitting lids left in closed position. Containers must
be maintained in a clean and serviceable condition.
(4) Center grounds must be well kept and the exterior
of the building, including sidewalks, steps, porches, ramps, and fences,
must be in good repair.
(5) The interior of the center's buildings including
walls, ceilings, floors, windows, window coverings, doors, plumbing
and electrical fixtures must be in good repair.
(6) Pest control must be provided by a licensed structural
pest control applicator with a license category for pests. The center
must maintain documented evidence of routine efforts to remove rodents
and insects.
(7) The center must be kept free of offensive odors,
accumulations of dirt, rubbish, dust, and hazards. Storage areas,
attics, and cellars must be free of refuse and extraneous materials.
(c) A center must adopt and enforce a written work
plan for housekeeping operations, with categorization of cleaning
assignments as daily, weekly, monthly, or annually within each area
of the center.
(d) A center must ensure the provision of housekeeping
and maintenance of the interior, exterior and grounds of the center
in a safe, clean, orderly and attractive manner. The center must provide
housekeeping and maintenance staff with equipment and supplies if
needed. A center must designate staff to be responsible for overseeing
the housekeeping services.
(e) A center must develop procedures for the selection,
use, and disposal of housekeeping and cleaning products and equipment.
The center must ensure:
(1) the use of EPA approved cleaning products appropriate
for the application and materials to be sanitized;
(2) the following of manufacturer instructions for
use and disposal of cleaning products;
(3) all bleaches, detergents, disinfectants, insecticides,
and other poisonous substances are kept in a safe place accessible
only to staff; and
(4) all products are labeled.
(f) A center must ensure a sufficient supply of clean
linens is available to meet the needs of minors. Clean laundry must
be provided in-house by the center, through a contract with another
health care center, or with an outside commercial laundry service.
(g) A center must ensure:
(1) linens are handled, stored, and processed so as
to control the spread of infection;
(2) linens are maintained in good repair;
(3) linens are washed, dried, stored, and transported
in a manner which will produce hygienically clean linen;
(4) the washing process has a mechanism for removing
soil and killing bacteria;
(5) clean linens are stored in a clean linen area easily
accessible to the staff;
(6) soiled linens and clothing are stored separately
from clean linen and clothing;
(7) soiled linens and clothing are stored in well ventilated
areas, and are not permitted to accumulate at the center;
(8) soiled linens and clothing are transported in accordance
with procedures consistent with universal precautions;
(9) soiled linens are not sorted, laundered, rinsed,
or stored in bathrooms, corridors, food preparation area, or food
storage areas;
(10) a minor's clothing stored at the center is cleaned
after each use; and
(11) staff wash their hands both after handling soiled
linen and before handling clean linen.
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