Section 1228 Acute Psychiatric Hospitals

The provisions of this section shall apply to acute psychiatric hospitals.

New buildings and additions, alterations or repairs to existing buildings subject to licensure shall comply with applicable provisions of the California Electrical Code, California Mechanical Code, California Plumbing Code, California Energy Code, California Fire Code (Parts 3, 4, 5, 6 and 9 of Title 24) and this section.

The definitions provided under Section 1224.3 apply to this section except as modified below:

ACUTE PSYCHIATRIC HOSPITAL. Acute psychiatric hospital means a hospital having a duly constituted governing body with overall administrative and professional responsibility and an organized medical staff which provides 24-hour inpatient care for mentally disordered, incompetent or other patients referred to in Division 5 (commencing with Section 5000) or Division 6 (commencing with Section 6000) of the Welfare and Institutions Code, including the following basic services: medical, nursing, rehabilitative, pharmacy and dietary services.

BASIC SERVICES. Basic services mean those essential services required by law for licensure as an acute psychiatric hospital including medical, nursing, rehabilitative, pharmaceutical, dietary and support services.

HOSPITAL. Hospital, where used in this section, means an acute psychiatric hospital.

SALLY PORT. A compartment provided with two or more doors where the intended purpose is to prevent continuous and unobstructed passage by allowing the release of only one door at a time.

Acute psychiatric hospitals shall comply with the provisions under Section 1224.4, General Construction, where applicable, except as supplemented, amended or modified below. Specific application shall respond to the patient injury and suicide prevention component of the Patient Safety Risk Assessment prepared under California Administrative Code (Part 1 of Title 24), Section 7-119.

Where provided, refer to Section 1224.4.5.

Refer to Section 1224.4.6 for requirements regarding station outlets, gas and vacuum systems, hyperbaric facilities, laboratories, and nurse call systems.

Refer to Section 1224.4.7

Refer to Section 1224.4.8 with the following modifications and amendments:

1. Where indicated by the Patient Safety Risk Assessment, toilet room doors shall be equipped with keyed locks that allow staff to control access to the toilet room.
2. Use of door closers is to be avoided unless required by other sections of this code.
3. Door hinges shall be designed to minimize accessible anchor points (e.g., cut hinge type, piano hinge, concealed hinge, etc.).
4. Except for specifically designed ligature-resistant hardware, door lever handles shall point downward when in the latched and in the unlatched position.
5. All hardware shall have tamper-resistant fasteners.

Refer to Section 1224.4.10 unless noted otherwise.

Interior finishes shall comply with Section 1224.4.11 as amended in this section. Special design consideration shall be given to injury and suicide prevention in the context of the Patient Safety Risk Assessment.

Refer to Section 1224.4.12

Refer to Section 1224.4.13.

Refer to Section 1224.4.14.

Refer to Section 1224.4.15

Refer to Section 1224.4.16.

Refer to Section 1224.4.17.

Refer to Section 1224.4.18 with the following modifications and amendments:

1. Grab bars, including those that are part of fixtures such as soap dishes, shall be sufficiently anchored to sustain a concentrated load of 250 pounds (113.4 kg).
2. Grab bars shall be graspable and shall be ligature resistant.

Refer to Section 1224.4.19.

All handwashing fixtures that are accessible to patients, including those located in patient rooms and patient toilet rooms, shall include ligature-resistant features that do not compromise compliance with the hot and cold water supply controls, laminar flow, and sink requirements of the California Plumbing Code. Handwashing fixtures within patient rooms and patient toilet rooms in psychiatric nursing units are not required to be equipped with gooseneck spouts and the discharge point may be less than 5 inches (127 mm) above the fixture rim.

Refer to Section 1224.5.

The psychiatric rehabilitation activities service space may be centralized for common use or may be located in each nursing unit in response to the Patient Safety Risk Assessment. The following areas are required in the psychiatric rehabilitation activities service space:

Where provided, the physical therapy service space shall comply with Section 1224.35.2.

Where provided, occupational therapy service space shall comply with Section 1224.35.3.

Where provided, the speech pathology service space shall comply with Section 1224.35.4.

Psychiatric nursing units shall comply with the requirements of this section. If the nursing unit is a locked unit, the primary access point to the unit shall be through a sally port. For "secure treatment facilities," alternate designs for locked unit access without individual sally ports may be approved by the enforcement agency when it can be demonstrated that the alternate design meets performance requirements without compromising any health or life-safety requirement.

Each patient bedroom shall meet the following standards:

Provision for the services listed below shall be in or immediately accessible to each psychiatric nursing unit. The size and location of each service area will depend upon the numbers and types of beds served. Identifiable spaces are required for each of the indicated functions. If a service area is specifically permitted to serve more than one nursing unit, there shall be at least one such service area located on each nursing unit floor.