See Section 3416A.
Spaces for dietary, laundry, morgue, ambulance entrance, receiving areas, power plants, mechanical equipment, incinerator, garbage can cleaning, automobile parking and storage areas for garbage, trash and medical gases shall be located and constructed to minimize noise, steam, odors, hazards and unsightliness in patient-care areas and bedrooms.
Radiology, laboratory, pharmacy, physical therapy and service spaces serving only outpatients and similar outpatient service departments shall not be located in nursing units, surgical units, peri-natal units, nursery areas, central sterilization rooms, food-service' areas, power plants, mechanical equipment rooms, maintenance shops, general storage, laundry, employees' dressing or housekeeping facilities.
Exception: Physical and occupational therapy spaces of a rehabilitation service may serve both outpatients and inpatients.
Identifiable spaces shall be provided for each function indicated in all Basic and applicable Supplemental Service Space sections with requirements for support areas. The following rooms and spaces are common to most types of health care facilities and the requirements associated with each, as listed below, shall be used unless modified under a specific Service Space section.
Unless specified elsewhere, if an exam room is provided, it shall have a minimum clear floor area of 80 square feet (7.4 m2), the least dimension of which shall be 8 feet (2438mm). The room shall contain a handwashing fixture and accommodations for written or electronic documentation shall be provided.
Unless specified elsewhere, if a treatment room is provided, it shall have a minimum clear floor area of 120 square feet (11.15 m2), the least dimension of which shall be 10 feet (3048 mm). A minimum of 3 feet (914 mm) is required between the sides and foot of the bed/gurney/table and any wall or other fixed obstruction. The room shall contain an examination light, a work counter for medical equipment, a handwashing fixture, cabinets, medication storage and counter space for writing or electronic documentation. Multi-bed treatment rooms shall have separate patient cubicles with a minimum clear floor area of 80 square feet (7.4 m2) per cubicle. Each cubicle shall contain an examination light, counter and storage facilities, In multi-bed treatment rooms, a hand-washing fixture shall be provided in the room for each three or fewer cubicles.
When provided, the airborne infection isolation room shall be an exam/treatment room, shall be labeled with the words “Airborne Infection Room”, and provide the following:
- Capacity. Each airborne infection isolation exam/treatment room shall contain only one examination table or recliner.
- Handwashing station. A handwashing station shall be located in each airborne infection isolation exam/treatment room.
- Gowning and storage area. An area for gowning and storage of clean and soiled materials shall be located directly outside or inside the entry door to the airborne infection isolation exam/treatment room.
- Doors. Room doors shall be self-closing and include latching devices.
- Sealed-tight room. Room perimeter walls, ceiling, floors, doors and penetration shall be sealed tightly to minimize air infiltration from the outside or from other spaces.
- Ventilation. The ventilation shall be provided as required by the California Mechanical Code for airborne infection isolation room.
An airborne infection isolation anteroom is not required; however, when an anteroom is provided, it shall meet the following requirements:
- The anteroom shall provide space for persons to don personal protective equipment before entering the patient room.
- All doors to the anteroom shall have self-closing devices.
- The anteroom shall provide storage of personal protective equipment (e.g. respirators, gowns, gloves) and clean equipment.
- Ventilation shall be provided in the anteroom as required by the California Mechanical Code for airborne infection isolation anteroom.
- Capacity. Each room shall accommodate only one patient.
- Layout and access. Seclusion rooms shall be accessed through an anteroom or vestibule that also provides access to a toilet room. The door openings to the anteroom and the toilet room shall have a minimum clear width of 3 feet 8 inches (1118 mm).
- The room(s) shall be located to permit observation from the nurse station.
- Seclusion rooms shall be permitted to be grouped together and may share a common vestibule/anteroom.
- The walls, ceiling, and floor of the seclusion room shall be designed to withstand direct and forceful impact. If padded materials are used inside the room, they shall meet the interior finish requirements in Chapter 8, Interior Finishes, of this code.
- Minimum ceiling height shall be 9 feet (2743 mm).
- Door hardware shall be ligature resistant.
- The entrance door to the seclusion room shall swing outward.
- Doors shall permit staff observation of the patient through a view panel while also maintaining provisions for patient privacy. The maximum sill height shall be 36 inches (914 mm) above the finish floor. The view panel shall be fixed glazing with polycarbonate or laminate on the inside of the glazing.
- Seclusion rooms shall not contain outside corners or edges.
- All items in the room (e.g., lighting fixtures, sprinkler heads, HVAC grilles, and surveillance cameras, etc.) shall be tamper resistant.
- Electrical switches and receptacles are prohibited in the seclusion room.
This area shall have space for counters and storage and at least one hand-washing station shall be located in, adjacent to, or directly accessible to the administrative center or nurse station. It may be combined with or include centers for reception, charting and communication.
When provided, specimen collection facilities shall comply with the following requirements:
- Use of the toilet room provided within the examination and treatment room shall be permitted for specimen collection.
Provision shall be made for distribution of medications. This shall be done from a medication preparation room or from a self-contained dispensing unit.
If provided, this room shall be directly accessible from the nursing station. When a medicine preparation room is to be used to store one or more self-contained medicine dispensing units, the room shall be designed with adequate space to prepare medicines with the self-contained medicine dispensing unit(s) present. Medicine preparation rooms shall include:
- Work counter.
- Handwashing station.
- Locked storage for controlled drugs.
If provided, a self-contained medicine dispensing unit shall be located at the nurses’ station, in the clean utility room, or in an alcove.
Nourishment areas or rooms required in patient care areas shall include the following:
- Work counter
- Storage cabinets
- Equipment for hot and cold nourishment between scheduled meals.
- The nourishment shall include space for trays and dishes used for nonscheduled meal service.
- Provisions and space shall be included for separate temporary storage of unused and soiled dietary trays not picked up at mealtime.
- Handwashing fixtures separate from the nourishment sink shall be in or adjacent to the nourishment area.
The clean work-room or clean supply room shall be separate from and have no connection with the soiled workroom or soiled holding room. If the room is used for preparing patient care items, it shall contain the following:
- Work counter
- Handwashing station
- Storage facilities for clean and sterile supplies
If the room is used only for storage and holding as part of a system for distribution of clean and sterile materials, the work counter or a handwashing station may be omitted.
The soiled work-room or soiled holding room shall be separate from and have no connection with either clean workrooms or clean supply rooms. The soiled utility/workroom shall contain:
If x-ray examinations are to be performed on outpatients, outpatient access to the radiological spaces shall not traverse a nursing unit.
STATION OUTLETS FOR OXYGEN, VACUUM (SUCTION), AND MEDICAL AIR SYSTEMS1, 6
|1||Patient rooms (medical/surgical unit)||1/bed||1/bed||—||—|
|2||Examination or treatment (medical/surgical unit and postpartum care)||1/room||1/room||—||—|
|3||Airborne infection isolation or protective environment rooms (medical/surgical unit)||1/bed||1/bed||—||—|
|4||Seclusion room (medical/surgical unit and postpartum care)||1/bed||1/bed||—||—|
|5||Intensive care (general)||3/bed||3/bed||1/bed||—|
|6||Airborne infection isolation||3/bed||3/bed||1/bed||—|
|7||Coronary-care service space||3/bed||2/bed||1/bed||—|
|8||Pediatric intensive care||3/bed||3/bed||1/bed||—|
|9||Newborn intensive care||3/bassinet||3/bassinet||3/bassinet||—|
|10||Newborn nursery (full term)||1/4 bassinets2||1/4 bassinets2||1/4 bassinets2||—|
|11||Pediatric and adolescent||1/bed||1/bed||1/bed||—|
|13||Psychiatric patient room||—||—||—||—|
|14||Seclusion treatment room (psychiatric unit)||—||—||—||—|
|15||General operating room||2/room||5/room||1/room||1/room|
|16||Cardio and special procedures||2/room||5/room||1/room||1/room|
|18||Surgical cystoscopic and other endo-urologic procedures||1/room||3/room||—||—|
|19||Post-anesthesia care unit||2/bed||3/bed||1/bed||—|
|21||Endoscopy procedure room||1/room||3/room||—||—|
|23||Cesarean operating/delivery room||2/room||4/room||1/room||1/room|
|24||Recovery space for cesarean delivery||1/bed||3/bed||1/bed||—|
|25||Infant resuscitation space4||3/bassinet||3/bassinet||3/bassinet||—|
|27||OB recovery room||1/bed||3/bed||—||—|
|30||Initial emergency management||1/bed||1/bed||1/bed||—|
|31||Triage area (definitive emergency care)||1/station||1/station||—||—|
|32||Definitive emergency care examination or treatment rooms||1/bed||1/bed||1/bed||—|
|35||Orthopedic and cast room||1/room||1/room||—||—|
|36||Cardiac catheterization lab||2/bed||2/bed||2/bed||—|
|39||Interventional imaging procedure room||2/room||2/room||1/room||—|
|40||Hyperbaric suite pre-procedure/patient holding area||2/station||2/station||—||—|
|41||Electroconvulsive therapy procedure room||1/room7||1/room7||—||—|
- For any area or room not described above, the facility clinical staff shall determine outlet requirements after consultation with the enforcing agency.
- Four bassinets may share one outlet that is accessible to each bassinet.
- WAGD stands for “waste anesthesia gas disposal” system.
- When infant resuscitation takes place in a room such as cesarean section/delivery or LDRP, then the infant resuscitation services shall be provided in that room in addition to the minimum service required for the mother.
- One outlet for mother and one for each bassinet.
- Renovation projects of existing spaces where the existing function is not changed, are not required to comply with the requirements of this table.
- Use of portable equipment shall be permitted.
The design, installation and testing of medical gas and vacuum systems shall conform to Table 1184.108.40.206 and NFPA 99.
The design and construction of hospital laboratories shall conform to NFPA 99.
The location of nurse call devices shall comply with Table 1220.127.116.11. The design of call systems shall comply with the California Electrical Code, Part 3 of Title 24.
[OSHPD 1, 2, 3 & 4] LOCATION OF NURSE CALL DEVICES
KEY: ● Required
|AREA DESIGNATION||PATIENT STATION||BATH STATION||STAFF EMERGENCY STATION||CODE CALL STATION||NURSE MASTER STATION||DUTY STATION||NOTES|
|Nursing Unit bed location||●||1, 2, 3, 4|
|Patient showers and baths||●||2|
|Critical care bed locations, including NICU||●||●||●||1, 2, 4, 5|
|LDR/LDRP rooms||●||●||●||1, 2, 3, 4|
|Newborn and special care nurseries||●||●|
|Medication preparation room||●|
|Diagnostic and Treatment Areas|
|Psychiatric seclusion ante/exam rooms||●|
|Cesarean delivery rooms||●||2|
|Emergency exam, treatment, triage rooms||●||●||●||1, 2, 4|
|Observation unit patient station||●|
|Preoperative patient care area||●||●||1, 2|
|MRI, CT, stress testing areas||●||●||2, 4|
|Diagnostic radiology, fluoroscopy and ultrasound procedure rooms||●||2|
|Cardiac catheterization, interventional imaging, angiography||●||●|
|Nuclear medicine procedure room||●||2|
|Endoscopy procedure room||●||2|
|Electroconvulsive therapy procedure room||●|
- One device shall be permitted to accommodate both patient station and emergency staff assistance station functionality.
- A visible signal shall be activated in the corridor at the patient’s door, at the nurse/control station, and at all duty stations. In multicorridor nursing units, additional visible signals shall be installed at corridor intersections.
- Two-way voice communication shall be provided with the nurse/control station.
- One device shall be permitted to accommodate both emergency staff assistance and code call station functionality.
- A patient station shall not be required in the NICU.
The minimum width of corridors and hallways shall be 8 feet (2438 mm).
Exception: Patient-care corridors and hallways in hospitals for psychiatric care of patients who are not bedridden shall have a minimum clear and unobstructed width of 6 feet (1829 mm). For the purposes of this section, bedridden patients shall be defined as patients confined to beds who would be transported or evacuated in beds or litters.
Outpatient clinics or outpatient departments which contain facilities for out-patient use only, such as laboratory, x-ray, physical therapy or occupational therapy, shall have a minimum corridor or hallway width of 5 feet (1524 mm). Outpatient clinics and outpatient departments consisting only of waiting rooms, business offices, doctor's offices, and examining rooms, where there is no traffic through such area to other services or to exits from the building, shall have a minimum corridor or hallway width of 44 inches (1118 mm).
Pocket sliding doors are not permitted.
Exception: Administration and business areas.
Rooms approved for the housing of patients shall be provided with natural light by means of exterior glazed openings excluding clerestory windows, obscure glass and skylights, with an area not less than one tenth of the total floor area.
Patient room windows shall have sills not more than 36 inches (914 mm) above the floor. If operable windows are provided that require the use of tools or keys for operation, the tools or keys shall be located at the nurses’ station.
Exception: Window sills in intensive-care units may be 60 inches (1524 mm) above the floor.
If operable windows are provided in airborne infection isolation or protective environment rooms, they shall only be operable by the use of tools or keys which shall be located at the nurses’ station.
Safety glass or plastic glazing materials shall be used in windows in psychiatric patient areas.
Windows which may be frequently left in an open position shall be provided with insect screens of 16 meshes to the inch.
All portions of a building used by patients, personnel or other persons shall be provided with artificial light and a mechanically operated ventilating system as specified in the California Electrical Code and the California Mechanical Code.
The minimum height of ceilings shall be 8 feet (2438 mm).
Exception: Closet, toilet room and bathroom minimum ceiling heights shall not be less than 7 feet (2134 mm).
Operating rooms, emergency rooms, delivery rooms, radiographic rooms and other rooms containing ceiling-mounted, major fixed equipment or ceiling-mounted surgical light fixtures shall have ceiling heights to accommodate the equipment or fixtures and their normal movement. Suspended tracks, rails and pipes located in the traffic path for patients in beds and/or on stretchers, including those in inpatient service areas, shall be not less than 7 feet (2134 mm) above the floor.
Exception: Mobile suspended tracks such as traverse rails for overhead patient lifts that may be moved out of the traffic path shall provide a clearance of not less than 6 feet, 8 inches (2032mm) above the floor when in use.
ACCEPTABLE CEILING AND CARPET LOCATIONS
|AREAS/ROOMS3,4||GENERAL ACUTE CARE HOSPITAL CEILING/CARPET||ACUTE PSYCHIATRIC HOSPITAL CEILING/ CARPET||SKILLED NURSING AND INTERMEDIATE-CARE FACILITIES CEILING/CARPET||CLINIC CEILING/ CARPET|
|Airborne infection isolation rooms||2||N||2||N||2||N||2||N|
|Protective environment rooms||1||N||1||N||1||N||-||-|
|Nurses’ or administration station||3||Y||3||Y||3||Y||3||Y|
|Central sterile supply||2||N||2||N||2||N||2||N|
|Morgue and autopsy||3||N||—||—||—||—||—||—|
|General storage rooms||3||N||3||N||3||N||3||N|
|Dietary day storage||2||N||2||N||2||N||—||—|
|Labor rooms, LDRP and LDR||3||N||—||—||—||—||—||—|
|Speech pathology and audiology||3||Y||3||Y||3||Y||3||Y|
1 – Continuous monolithic surface equal in smoothness to enamel plaster.
2 – Smooth and easily cleanable without perforations or fissures.
3 – Pin perforated, fine fissured, or lightly textured.
4 – Any finish meeting code requirements.
Yes = Y
No = N
* Upon approval by the licensing agency with adequate maintenance procedure. However, should the carpet not be maintained adequately, the licensing agency has the right to have it removed and replaced with another acceptable material.
- Carpet permitted in mammography.
- Except those rooms specified otherwise.
- For rooms not listed, contact the Office of Statewide Health Planning and Development (OSHPD).
- Table applies to new construction, additions, remodels, and conversions. The patching and replacement of existing materials will be permitted.
- Lay-in ceiling meeting the requirements of Section 118.104.22.168.1.7 may be substituted in laundry and kitchens
Floor finishes shall be smooth, waterproof and durable. Flooring surfaces shall provide smooth transitions between different floor materials. Slip-resistant flooring products shall be used for flooring surfaces in wet areas (e.g., kitchens, shower and bath areas), ramps, stairways, entries from exterior to interior space, and other areas as determined by the functional program. Joints for floor openings for pipes, ducts and conduits shall be tightly sealed. Joints of structural elements shall be similarly sealed.
In all areas subject to frequent wet-cleaning methods, flooring materials shall not be physically affected by germicidal or other types of cleaning solutions.
These rooms and anterooms shall have seamless flooring with integral coved base.
The material and textures of bases and the installation thereof shall be such as to minimize dust-catching surfaces, moisture, infiltration and the harboring of vermin.
Exception: In locations where carpet is permitted as a floor finish material, the use of carpeted base (coved or strip base) up to a maximum height of 5 inches (127 mm) is also permissible.
- Operating rooms
- Interventional imaging rooms, including cardiac catheterization labs
- Cesarean delivery rooms
- Cystoscopy, urology, and minor surgical procedure rooms
- Endoscopy procedure rooms
- Endoscopy instrument processing rooms
- IV and chemotherapy preparation rooms
- Airborne infection isolation (AII) rooms
- Protective environment (PE) rooms
- Anterooms to AII and PE rooms, where provided
- Cast rooms
Wall finishes shall comply with the following requirements:
- Wall finishes shall be washable. In the vicinity of plumbing fixtures, wall finishes shall be smooth, scrubbable and water-resistant.
- Wall finishes in areas such as operating rooms, delivery rooms and trauma rooms shall be monolithic, scrubbable and able to withstand cleaning with chemicals.
- Wall finishes in operating rooms, cesarean delivery rooms, isolation rooms and sterile processing rooms shall be free of fissures, open joints or crevices that may retain or permit passage of dirt particles.
- Wall finishes in areas such as clean corridors, central sterile supply spaces, specialized radiographic rooms and minor surgical procedure rooms shall be washable, smooth and able to withstand cleaning with chemicals.
- Wall areas penetrated by pipes, ducts and conduits shall be tightly sealed to minimize entry of rodents and insects. Joints of structural elements shall be similarly sealed.
- Wall finish requirements of Section 122.214.171.124 do not apply to boiler rooms, mechanical equipment rooms, administration departments, other offices, enclosed stairways, maintenance shops and similar spaces.
Dietary and food preparation areas shall comply with the following requirements:
- In dietary and food preparation areas, wall construction, finish, and trim, including the joints between the walls and the floors, shall be free of spaces that can harbor insects and rodents.
- Wall surfaces in wet areas (e.g., kitchens, environmental services closets) shall be monolithic and all seams shall be covered and/or sealed.
Ceilings in areas occupied by patients and the public shall be cleanable with the use of routine housekeeping equipment. Acoustic and lay-in ceiling, where used, shall not create ledges or crevices.
Ceiling finishes shall comply with Table 1224.4.11 and the following requirements:
- Ceiling finishes in semirestricted areas such as airborne infection isolation exam/treatment rooms, surgical corridors, central sterile supply spaces and minor surgical procedure rooms, shall be nonabsorptive, nonperforated, capable of withstanding cleaning with chemicals, and without crevices that can harbor mold and bacterial growth.
- If a lay-in ceiling is provided in semi-restricted areas, it shall be gasketed or each ceiling tile shall weigh at least one pound per square foot to prevent the passage of particles from the cavity above the ceiling plane into the semirestricted environment. Perforated, tegular, serrated cut or highly textured tiles are not acceptable.
- 3. Ceilings in restricted areas shall be monolithic with no cracks or perforations.
- 4. Ceilings in restricted areas shall be scrubbable and able to withstand cleaning and/ or disinfecting chemicals.
- 5. All access openings in restricted area ceilings shall be gasketed.
Dietary and laundry areas:
- 6. Provide either a sealed monolithic and scrubbable gypsum board ceiling or a layin ceiling.
- A rust-free grid.
- Ceiling tiles that weigh at least one pound per square foot and are smooth, scrubbable, nonabsorptive, nonperforated and able to withstand cleaning with chemicals.
- 8. Ceiling finish requirements of Section 1126.96.36.199.1 do not apply to boiler rooms, mechanical equipment rooms, administration departments, other offices, enclosed stairways, maintenance shops and similar spaces.
At least one patient elevator and one service elevator shall be provided in hospitals with a capacity of from 60 to 149 beds on floors other than the main entrance floor.
Rooms or screening enclosures shall be provided for the washing and cleaning of garbage containers and for the storage of garbage, trash and other solid wastes. Such rooms or screening enclosures shall include the following:
- A concrete floor with a curb and with a drain connected to the sewer.
- Steam or hot-water and cold-water supply.
- A minimum floor area of 1/2 square foot (0.046 m2) per bed, but not less than 25 square feet (2.3 m2), the least dimension of which shall be 4 feet (1219 mm).
- A method of limiting access to the material except by authorized persons.
Gravity-type laundry and trash chutes shall have a minimum diameter of 2 feet (610 mm) and shall be designed to prevent distribution of airborne contaminating elements to all floors served.
Each floor accommodating patients shall have a telephone installed for patient use. Such telephones shall be readily accessible to patients who are limited to wheel chairs and stretchers. This may not be required in separate buildings having six or fewer beds which are restricted to occupancy by ambulatory patients.
SOUND TRANSMISSION LIMITATIONS IN HOSPITALS
|NEW CONSTRUCTION||AIRBORNE SOUND TRANSMISSION CLASS (STC)1|
|Patient room to patient room||45||40|
|Public space to patient room3||55||40|
|Service areas to patient room4||65||45|
|Patient room access corridor5||45||45|
|Exam room to exam room||45|
|Exam room to public space||45|
|Toilet room to public space||45|
|Consultation rooms/conference rooms to public space||45|
|Consultation rooms/conference rooms to patient rooms||45|
|Staff lounges to patient rooms||45|
- Sound Transmission Class (STC) shall be determined by tests in accordance with methods set forth in ASTM 90 and ASTM 413. Where partitions do not extend to the structure above, sound transmission through ceilings and composite STC performance shall be considered.
- Treatment rooms shall be treated the same as patient rooms.
- Public space includes corridors (except patient room access corridors), lobbies, dining rooms, recreation rooms, and similar space.
- Service areas for the purposes of this table include kitchens, elevators, elevator machine rooms, laundries, garages, maintenance rooms, boiler and mechanical equipment rooms, and similar spaces of high noise. Mechanical equipment located on the same floor or above patient rooms, offices, nurses stations, and similar occupied space shall be effectively isolated from the floor.
- Patient room access corridors contain composite walls with doors/ windows and have direct access to patient rooms.
- Renovation projects of existing spaces where the existing function is not changed, are not required to comply with the requirements of Table 1224.5.
Recreation rooms, exercise rooms, equipment rooms and similar spaces where impact noises may be generated, shall not be located directly over patient bed areas or delivery and operating suites, unless special provisions are made to minimize such noise.