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Section 452 Birthing Centers
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All birthing centers 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 59A-11, Florida Administrative Code and Chapter 383, Florida Statutes.
At least one birthing room shall be maintained which is adequate and appropriate to provide for the equipment, staff, supplies and emergency procedures required for the physical and emotional care of a maternal client, her support person and the newborn during labor, birth, and the recovery period.
The birth center shall be designed to provide adequate space for the following:
Birth rooms shall be located to provide unimpeded, rapid access to an exit of the building which will accommodate emergency transportation vehicles.
A separate space for a clean area and a contaminated area; if it is not feasible to provide such separate areas, special procedures shall be established for the disposal of infectious waste. Sanitary waste containers, soiled linen containers, storage cabinets and an autoclave, pressure cooker or other effective sterilization equipment shall be available.
Prenatal and postpartum examinations which will provide privacy for the patient, hand-washing facilities and the appropriate equipment for staff.
Medical record storage, client interviews, instruction and waiting rooms.
A toilet and lavatory shall be maintained in the vicinity of the birth room.
Hand-washing facilities shall be in or immediately adjacent to the birth room.
A bathtub or shower shall be available for client use.
There shall be provisions and facilities for secure storage of personal belongings and valuables of clients.
There shall be provisions for visual privacy for each maternal client and her support person.
Hallways and doors providing access and entry into the birth center and birth room shall be of adequate width and conformation to accommodate maneuvering of ambulance stretchers and wheelchairs.
All housing facilities shall have adequate ventilation and be kept free of offensive odors.
If natural ventilation is utilized, the opened window area for ventilation purposes shall be equal to one-tenth of the floor space in the residential area.
When mechanical ventilation or cooling systems are employed, the system shall be properly maintained and kept clean. Intake air ducts shall be designed and installed so that dust or filters can be readily removed. In residence areas and segregation rooms with solid doors, mechanical ventilation systems shall provide a minimum of 10 cubic feet (0.3 m3) of fresh or filtered recirculated air per minute for each client occupying the area.
All toilet rooms shall be provided with direct openings to the outside or provided with mechanical ventilation to the outside.
Adequate heating and cooling facilities shall be provided to maintain a minimum temperature of 68°F (20°C) and maximum temperature of 78°F (26°C) at a point 20 inches (508 mm) above the floor.
All heating devices shall comply with fire prevention provisions found in Rule 69A-3, Fire Prevention, General Provision, Florida Administrative Code.
Where laundry facilities are provided, laundry facilities shall be of sound construction and shall be in good repair and clean. Adequate space shall be provided and areas shall be designated for the separation of clean and soiled clothing, linen and towels.
Laundry rooms shall be well lighted and properly ventilated. Clothes dryers shall be vented to the exterior.
Facilities shall be kept free of all insects and rodents. All outside openings shall be effectively sealed or screened with 16 mesh screening or equivalent to prevent entry of insects or rodents.
Drinking water shall be accessible to all clients. When drinking fountains are available, the jet of the fountain shall issue from a nozzle of nonoxidizing impervious material set at an angle from the vertical. The nozzle and every other opening in the water pipe or conductor leading to the nozzle shall be above the edge of the bowl so that such nozzle or opening will not be flooded in case a drain from the bowl of the fountain becomes clogged. The end of the nozzle shall be protected by nonoxidizing guards to prevent persons using the fountain from coming into contact with the nozzle. Vertical or bubbler drinking fountains shall be replaced with approved-type water fountains or be disconnected. When no approved drinking fountains are available, clients shall be provided with single service cups which shall be stored and dispensed in a manner to prevent contamination. Common drinking cups are prohibited.
Hot and cold running water under pressure and at safe temperature, not to exceed 110°F (43°C) to prevent scalding, shall be provided to all restrooms, lavatories and bathing areas.
All sanitary facilities shall comply with the requirements of the Florida Building Code, Plumbing.
For facilities with nine or more birth rooms, mop sinks or curbed areas with floor drains shall be available in convenient locations throughout the facility to facilitate cleaning and for the proper disposal of cleaning water.
Each birth center shall provide fire protection through the elimination of fire hazards, the installation of necessary safeguards such as extinguishers and smoke alarms to insure rapid and effective fire control.
To safeguard all clients, the birth center shall have:
"No Smoking" signs prominently displayed in those areas where smoking is not permitted.
Fire regulations and evacuation route prominently posted.
The written fire control plan approved by the appropriate local fire authority shall contain provisions for prompt reporting of all fires, extinguishing fires, protection of personnel and guests, evacuation, and cooperation with fire-fighting authorities.
New centers' carpeting must comply with the maximum flame spread rating of 75 in accordance with ASTM E84 test as required under Chapter 69A-3.012 Standards of the National Fire Protection Association Adopted, Florida Administrative Code. Those existing centers not having affirmative evidence of complying with such flame spread rating shall establish fire control measures including the prohibition of smoking in carpeted areas. Such procedures shall be approved by the authority having jurisdiction.
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