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1224.4.1 Services/Systems and Utilities
1224.4.2 Environmental Engineering and Support Service Spaces
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.
1224.4.3 Treatment Spaces
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.
1224.4.4 Support Areas for Patient Care
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.
1224.4.4.1 Examination and Treatment Rooms
1224.4.4.1.1 Examination Room
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.
1224.4.4.1.2 Treatment Room
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.
1224.4.4.1.3 Airborne Infection Isolation Exam/Treatment Room
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:
  1. Capacity. Each airborne infection isolation exam/treatment room shall contain only one examination table or recliner.
  2. Handwashing station. A handwashing station shall be located in each airborne infection isolation exam/treatment room.
  3. 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.
  4. Doors. Room doors shall be self-closing and include latching devices.
  5. 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.
  6. Ventilation. The ventilation shall be provided as required by the California Mechanical Code for airborne infection isolation room.
1224.4.4.1.3.1 Airborne Infection Isolation Exam/Treatment Anteroom
An airborne infection isolation anteroom is not required; however, when an anteroom is provided, it shall meet the following requirements:
  1. The anteroom shall provide space for persons to don personal protective equipment before entering the patient room.
  2. All doors to the anteroom shall have self-closing devices.
  3. The anteroom shall provide storage of personal protective equipment (e.g. respirators, gowns, gloves) and clean equipment.
  4. Ventilation shall be provided in the anteroom as required by the California Mechanical Code for airborne infection isolation anteroom.
1224.4.4.1.4 Seclusion Room
Where provided, seclusion rooms shall comply with the following requirements:
1224.4.4.1.4.1 General
  1. Capacity. Each room shall accommodate only one patient.
  2. 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).
  3. The room(s) shall be located to permit observation from the nurse station.
  4. Seclusion rooms shall be permitted to be grouped together and may share a common vestibule/anteroom.
1224.4.4.1.4.2 Space Requirements
Seclusion rooms shall have a minimum clear floor area of 60 square feet (5.57 m2) with a minimum wall length of 7 feet (2134 mm) and a maximum wall length of 11 feet (3353 mm).

Exception: Where a room for restraining patients is authorized by the California Department of Public Health, it shall have a minimum clear floor area of 80 square feet (7.43 m2) with a minimum wall length of 7 feet (2134 mm) and a maximum wall length of 11 feet (3353 mm).
1224.4.4.1.4.3 Special Design Elements
Seclusion rooms shall be designed and constructed in compliance with the following requirements:
  1. 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.
  2. Minimum ceiling height shall be 9 feet (2743 mm).
  3. Doors.

    1. Door hardware shall be ligature resistant.
    2. The entrance door to the seclusion room shall swing outward.
    3. 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.
  4. Seclusion rooms shall not contain outside corners or edges.
  5. All items in the room (e.g., lighting fixtures, sprinkler heads, HVAC grilles, and surveillance cameras, etc.) shall be tamper resistant.
  6. Electrical switches and receptacles are prohibited in the seclusion room.
1224.4.4.2 Administrative Center(s) or Nurse Station(s)
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.
1224.4.4.3 Specimen and Blood Collection Facilities
1224.4.4.3.1 Specimen Collection Facilities
When provided, specimen collection facilities shall comply with the following requirements:
  1. Urine collection rooms shall be equipped with a water closet and handwashing station.
    Exception: The handwashing station may be located immediately outside the collection room when the specimen is used for drug testing.
  2. Use of the toilet room provided within the examination and treatment room shall be permitted for specimen collection.
1224.4.4.3.2 Blood Collection Facilities
When provided, blood collection facilities shall comply with the following requirements:
  1. Space for a chair and work counter shall be provided.
  2. A handwashing station shall be provided.
1224.4.4.4 Medication Station
Provision shall be made for distribution of medications. This shall be done from a medication preparation room or from a self-contained dispensing unit.
1224.4.4.4.1 Medication Preparation Room
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:
  1. Work counter.
  2. Handwashing station.
  3. Refrigerator.
  4. Locked storage for controlled drugs.
1224.4.4.4.2 Self-Contained Medication Dispensing Unit
If provided, a self-contained medicine dispensing unit shall be located at the nurses' station, in the clean utility room, or in an alcove.
1224.4.4.5 Nourishment Area or Room
Nourishment areas or rooms required in patient care areas shall include the following:
  1. Sink
  2. Work counter
  3. Refrigerator
  4. Storage cabinets
  5. Equipment for hot and cold nourishment between scheduled meals.
  6. The nourishment shall include space for trays and dishes used for nonscheduled meal service.
  7. Provisions and space shall be included for separate temporary storage of unused and soiled dietary trays not picked up at mealtime.
  8. Handwashing fixtures separate from the nourishment sink shall be in or adjacent to the nourishment area.
1224.4.4.6 Clean Utility/Workroom
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:
  1. Work counter
  2. Handwashing station
  3. Storage facilities for clean and sterile supplies
1224.4.4.6.1 Clean Supply Room
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.
1224.4.4.7 Soiled Utility/Workroom
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:
  1. Clinical sink (or equivalent flushing-rim fixture).
  2. Handwashing station
  3. Work counter
  4. Space for separate covered containers for soiled linen and/or waste
1224.4.4.7.1 Soiled Holding Room
Rooms used only for temporary holding soiled material may omit the clinical sink and work counter. If the flushing-rim clinical sink is eliminated, facilities for cleaning bedpans shall be provided elsewhere.
1224.4.4.8 Toilet Rooms
Separate toilet rooms shall be provided for the use of patients, staff, and public. When provided, single-user toilets shall include a doormounted geometric symbol, as identified in Section 11B703.7.2.6.3, Unisex toilet and bathing facilities, and wall signage designating use for patients, staff or public. When existing toilet rooms are not compliant with Section 11B-603, Toilet and bathing rooms, directional signage in compliance with Section 11B-216.8, Toilet rooms and bathing rooms, shall also be provided.

Exception: Patient toilet rooms accessed directly from patient bedrooms are not required to include signage.
1224.4.5 Outpatient Waiting Rooms
Waiting rooms for outpatients shall provide a seating area and space for wheelchairs and have public corridor access. Public toilets, drinking fountains and telephones shall be readily accessible.
Note: One waiting area may serve more than one department or service.
1224.4.5.1 Outpatient Access
If x-ray examinations are to be performed on outpatients, outpatient access to the radiological spaces shall not traverse a nursing unit.
Exception: Satellite radiology, laboratory, pharmacy, and physical and occupational therapy space serving inpatients may be located in nursing units and inpatient treatment areas.
1224.4.6 Miscellaneous Requirements
1224.4.6.1 Station Outlets
Station outlets for oxygen, vacuum, and medical air shall comply with Table 1224.4.6.1.

TABLE 1224.4.6.1
STATION OUTLETS FOR OXYGEN, VACUUM (SUCTION), AND MEDICAL AIR SYSTEMS1, 6


LOCATIONS OXYGEN VACUUM MEDICAL AIR WAGD3
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
12 Pediatric nursery 1/bassinet 1/bassinet 1/bassinet
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
17 Orthopedic surgery 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
20 Anesthesia workroom 1/workstation 1/workstation
21 Endoscopy procedure room 1/room 3/room
22 Postpartum bedroom 1/bed 1/bed
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
26 Labor room 1/room 1/room
27 OB recovery room 1/bed 3/bed
28 Labor/delivery/recovery (LDR)5 1/bed 1/bed
29 Labor/deliver/recovery/postpartum (LDRP)5 1/bed 1/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
33 Observation unit 1/bed 1/bed
34 Trauma/cardiac room(s) 2/bed 3/bed 1/bed
35 Orthopedic and cast room 1/room 1/room
36 Cardiac catheterization lab 2/bed 2/bed 2/bed
37 Autopsy room 1/workstation
38 MRI 1/room 1/room 1/room
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
  1. For any area or room not described above, the facility clinical staff shall determine outlet requirements after consultation with the enforcing agency.
  2. Four bassinets may share one outlet that is accessible to each bassinet.
  3. WAGD stands for "waste anesthesia gas disposal" system.
  4. 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.
  5. One outlet for mother and one for each bassinet.
  6. Renovation projects of existing spaces where the existing function is not changed, are not required to comply with the requirements of this table.
  7. Use of portable equipment shall be permitted.
1224.4.6.2 Gas and Vacuum Systems
The design, installation and testing of medical gas and vacuum systems shall conform to Table 1224.4.6.1 and NFPA 99.
1224.4.6.3 Hyperbaric Facilities
The design and construction of hyperbaric facilities shall conform to NFPA 99; Health Care Facilities and Section 1224.39.5.
1224.4.6.4 Laboratories
The design and construction of hospital laboratories shall conform to NFPA 99.
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