1224.4 General Construction
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.
- 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.
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.
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:
|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 1220.127.116.11 and NFPA 99.