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464.1 Scope
Assisted living facilities shall comply with the following design and construction standards as described herein.
Note: Other administrative and programmatic provisions may apply. See Agency of Health Care Administration (AHCA) Rule 58A-5, Florida Administrative Code and Chapter 400 Part III, Florida Statutes.
464.2 Definitions
AGENCY. The Agency for Health Care Administration.
AHCA CENTRAL OFFICE. The Assisted Living Unit, Agency for Health Care Administration.
ASSISTED LIVING FACILITY. Any building or buildings, section or distinct part of a building, private home, boarding home, home for the aged or other residential facility, whether operated for profit or not, which undertakes through its ownership or management to provide housing, meals and one or more personal services for a period exceeding 24 hours to one or more adults who are not relatives of the owner or administrator. The following are exempted from this definition:
  1. Any facility, institution, or other place operated by the federal government or any agency of the federal government.
  2. Any facility or part of a facility licensed under Chapter 393, Florida Statutes, or Chapter 394, Florida Statutes.
  3. Any facility licensed as an adult family care home under Part VII Chapter 400, Florida Statutes.
  4. Any person who provides housing, meals and one or more personal services on a 24-hour basis in the person's own home to not more than two adults who do not receive optional state supplementation. The person who provides the housing, meals, and personal services must own or rent the home and reside therein.
  5. Any home or facility approved by the United States Department of Veterans Affairs as a residential care home wherein care is provided exclusively to three or fewer veterans.
  6. Any facility that has been incorporated in this state for 50 years or more on or before July 1, 1983, and the board of directors of which is nominated or elected by the residents, until the facility is sold or its ownership is transferred; or any facility, with improvements or additions thereto, which has existed and operated continuously in this state for 60 years or more on or before July 1, 1989, is directly or indirectly owned and operated by a nationally recognized fraternal organization, is not open to the public, and accepts only its own members and their spouses as residents.
  7. Any facility certified under Chapter 651, Florida Statutes, or a retirement community, may provide services authorized under this section or Part IV of Chapter 400, Florida Statutes to its residents who live in single-family homes, duplexes, quadruplexes, or apartments located on the campus without obtaining a license to operate an assisted living facility if residential units within such buildings are used by residents who do not require staff supervision for that portion of the day when personal services are not being delivered and the owner obtains a home health license to provide such services. However, any building or distinct part of a building on the campus that is designated for persons who receive personal services and require supervision beyond that which is available while such services are being rendered must be licensed in accordance with this section. If a facility provides personal services to residents who do not otherwise require supervision and the owner is not licensed as a home health agency, the buildings or distinct parts of buildings where such services are rendered must be licensed under this section. A resident of a facility that obtains a home health license may contract with a home health agency of his or her choice, provided that the home health agency provides liability insurance and workers' compensation coverage for its employees. Facilities covered by this exemption may establish policies that give residents the option of contracting for services and care beyond that which is provided by the facility to enable them to age in place. For purposes of this section, a retirement community consists of a facility licensed under this section or under Part II of Chapter 400, Florida Statutes, and apartments designed for independent living located on the same campus.
  8. Any residential unit for independent living which is located within a facility certified under Chapter 651 Florida Statutes, or any residential unit which is colocated with a nursing home licensed under Part II of Chapter 400 Florida Statutes. or colocated with a facility licensed under this section in which services are provided through an outpatient clinic or a nursing home on an outpatient basis.
CAPACITY. The number of residents for which a facility has been licensed to provide residential care.
DEPARTMENT. The Department of Elderly Affairs.
DISTINCT PART. Designated bedrooms or apartments, bathrooms and a living area; or a separately identified wing, floor or building which includes bedrooms or apartments, bathrooms and a living area. The distinct part may include a separate dining area, or meals may be served in another part of the facility.
DOEA ASSISTED LIVING PROGRAM. The Assisted Living Program, Department of Elder Affairs.
EXTENDED CONGREGATE CARE. Acts beyond those authorized in subsection (5) that may be performed pursuant to Part I of Chapter 464, Florida Statutes, by persons licensed thereunder while carrying out their professional duties. The purpose of such services is to enable residents to age in place in a residential environment despite mental or physical limitations that might otherwise disqualify them from residency in a facility licensed under this part.
FOOD SERVICE. The storage, preparation, serving and cleaning up of food intended for consumption in a facility or a formal agreement that meals will be regularly catered by a third party.
PERSONAL SERVICES. Direct physical assistance with or supervision of the activities of daily living and the self-administration of medication and other similar services which the department may define by rule. Personal services shall not be construed to mean the provision of medical, nursing, dental or mental health services.
RELATIVE. An individual who is the father, mother, stepfather, stepmother, son, daughter, brother, sister, grandmother, grandfather, great-grandmother, greatgrandfather, grandson, granddaughter, uncle, aunt, first cousin, nephew, niece, husband, wife, father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-inlaw, sister-in-law, stepson, stepdaughter, stepbrother, stepsister, half brother or half sister of an owner or administrator.
RENOVATION. Additions, repairs, restorations or other improvements to the physical plant of the facility within a five-year period that costs in excess of 50 percent of the value of the building as reported on the tax rolls, excluding land, before the renovation.
RESIDENT. A person 18 years of age or older, residing in and receiving care from a facility.
RESIDENT'S REPRESENTATIVE OR DESIGNEE. A person other than the owner, or an agent or employee of the facility, designated in writing by the resident, if legally competent, to receive notice of changes in the contract executed pursuant to Section 400.424, Florida Statutes; to receive notice of and to participate in meetings between the resident and the facility owner, administrator or staff concerning the rights of the resident; to assist the resident in contacting the ombudsman council if the resident has a complaint against the facility; or to bring legal action on behalf of the resident pursuant to Section 400.429, Florida Statutes.
464.3 Codes and Standards for the Design and Construction of Assisted Living Facilities
464.3.1
Except as modified and required by this section of the code, Chapter 59A-36, Florida Administrative Code or Chapter 429 Part I, Florida Statutes, all new assisted living facilities and all additions, alterations, or renovations to existing assisted living facilities with more than 16 licensed beds shall also be in compliance with The Guidelines for the Design and Construction of Residential Health, Care, and Support Facilities (The Guidelines) Part 1 General, and Chapter 4.1 Special Requirements for Assisted Living Facilities as referenced in Chapter 35 of this code.
464.4 Additional Physical Plant Requirements for Assisted Living Facilities
In addition to the codes and standards referenced in Section 464.3 of the code, the following minimum essential facilities shall apply to all new assisted living facilities.
464.4.1
Indoor radon testing as mandated by Section 404.056(5), Florida Statutes, shall be completed by all facilities.
464.4.2 Heating and Cooling
464.4.2.1
Mechanical systems shall be designed to maintain dry-bulb temperatures between 70°F (18°C) and 81°F (27°C) in resident-occupied areas and in areas intended for resident occupancy. Residents who have individually controlled thermostats in their bedrooms or apartments shall be permitted to control temperatures in those areas, including maintaining temperatures outside the range stated previously.
464.4.2.2
A new facility shall be equipped with either a permanent on-site alternate power source to operate at least the equipment necessary to maintain safe indoor air temperatures, life safety systems and equipment for resident care needs, or there shall be a permanently installed predesigned electrical service entry for the electrical system that will allow a quick connection to a temporary alternate power source to operate at least the equipment necessary to maintain safe indoor air temperatures, life safety systems and equipment for resident care needs. This quick connection shall be installed inside of a permanent metal enclosure rated for this purpose and may be located on the exterior of the building. See Chapter 59A-36.025, Florida Administrative Code, "Emergency Environmental Control for Assisted Living Facilities" for additional requirements.
464.4.2.2.1
If the alternate power source is a generator, it shall comply with the requirements of NFPA 70 for either an optional standby system or a legally required system.
464.4.2.2.2
If the alternate power source is a generator, gasoline shall not be permitted as a fuel source.
464.4.3 Common Areas
464.4.3.1
A minimum of 35 square feet (3 m2) of living and dining space per resident, live-in staff and livein family member shall be provided except in facilities comprised of apartments. This space shall include living, dining, recreational or other space designated accessible to all residents, and shall not include bathrooms, corridors, storage space or screened porches which cannot be adapted for year round use. Facilities with apartments may count the apartment's living space square footage as part of the 35 square footage (3 m2) living and dining space requirement.
Those facilities also serving as adult day care centers must provide an additional 35 square feet (3 m2) of living and dining space per adult day care client. Excess floor space in residents' bedrooms or apartments cannot be counted toward meeting the requirement of 35 square feet (3 m2) of living and dining space requirements for adult day care participants. Day care participants may not use residents' bedrooms for resting unless the room is currently vacant.
464.4.3.2
A room, separate from resident bedrooms, shall be provided where residents may read, engage in socialization or other leisure time activities. Comfortable chairs or sofas shall be provided in this communal area.
464.4.3.3
The dining area shall be furnished to accommodate communal dining.
464.4.4 Bedrooms
464.4.4.1
Resident sleeping rooms designated for single occupancy shall provide a minimum inside measurement of 80 square feet (7 m2) of usable floor space. Usable floor space does not include closet space or bathrooms.
464.4.4.2
Resident bedrooms designated for multiple occupancy shall provide a minimum inside measurement of 60 square feet (6 m2) of usable floor space per room occupant.
464.4.4.3
Resident bedrooms designated for multiple occupancy in facilities newly licensed or renovated 6 months after October 17, 1999, shall have a maximum occupancy of two persons.
464.4.4.4
All resident bedrooms shall open directly into a corridor, common use area or to the outside. A resident must be able to exit his bedroom without having to pass through another bedroom unless the two rooms have been licensed as one bedroom.
464.4.4.5
All resident bedrooms shall be for the exclusive use of residents. Live-in staff and their family members shall be provided with sleeping space separate from the sleeping and congregate space required for residents.
464.4.5 Bathrooms
464.4.5.1
There shall be at least one bathroom with one toilet and sink per six persons, and one bathtub or shower per eight persons. All residents, all live-in staff and family members, and respite care participants must be included when calculating the required number of toilets, sinks, bathtubs and showers. All adult day care participants shall be included when calculating the required number of toilets and sinks.
464.4.5.2
Each bathroom shall have a door in working order to assure privacy. The entry door to bathrooms with a single toilet shall have a lock which is operable from the inside by the resident with no key needed. A nonlocking door shall be permitted if the resident's safety would otherwise be jeopardized.
464.4.5.3
There shall be nonslip safety devices such as bath mats or peel off stickers in the showers and bathtubs of all facilities. Showers and bathtubs with a nonskid surface require a separate nonskid device only if the surface is worn. Grab bars shall be required in showers and bathtubs. Grab bars, whether portable or permanent, must be securely affixed to the floor or adjoining walls. Facilities newly licensed or renovated six months after October 17, 1999 must have grab bars next to the commode.
464.4.5.4
Sole access to a toilet or bathtub or shower shall not be through another resident's bedroom, except in apartments within a facility.
464.4.6 Security
External boundaries of a facility or a distinct part of a facility, including outside areas, may be secured using egress control or perimeter control devices if the following conditions are met.
464.4.6.1
The use of the device complies with all lifesafety requirements.
464.4.6.2
Residents residing within a secured area are able to move freely throughout the area, including the resident's bedroom or apartment, bathrooms and all common areas, and have access to outdoor areas on a regular basis and as requested by each resident.
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