New facility construction and additions, refurbishing, renovations and alterations to existing facilities shall comply with the following codes and standards:
1. The building codes described in the Florida Building Code.
2. The fire codes contained in Chapter 69A-44, “Minimum Fire Safety Standards for Residential Alcohol and Drug Abuse Treatment and Prevention Programs, Mental Health Residential Treatment Facilities and Crisis Stabilization Units,” Florida Administrative Code, as described in the NFPA 101, Chapters 12 and 13, “Special Definitions,” as adopted by the Florida Fire Prevention Code, as applicable to limited health care facilities, which is included by reference in Chapter 59A-3, Florida Administrative Code.
3. The accessibility requirements of the Florida Building Code, Accessibility.
All plumbing shall comply with the requirements of the Florida Building Code, Plumbing.
No unsprinklered building classification as defined in this code, is allowed. All facilities shall be protected throughout by an approved automatic sprinkler and smoke detection system to include a smoke detector in every bedroom. Provision shall be made for automatic emergency forces notification.
Surge protection in compliance with the National Electric Code, Article 280, as incorporated by reference in Chapter 27 of this code shall be installed to protect each service entrance equipment and have integral visual indication of surge protector failure. Additional surge protection shall be provided for all low-voltage and power connections to all electronic equipment and conductors entering or exiting the building and other life safety systems equipment such as fire alarm, telephone, and nurse call. Protection shall be in accordance with appropriate IEEE standards for the type of equipment being protected.
The CSU or SRT shall be designed to provide a locked perimeter around a living unit and fenced exercise area within which individuals can reside 24 hours a day in an environment designed to minimize potential for injury. The CSU or SRT structure shall be single-story ground level facility. These facilities shall have separate off-unit reception and administration areas which may also be locked. Service corridors and pathways to other nonunit activities shall not be through the locked CSU or SRT unit.
The walls throughout all client areas of the CSU or SRT shall either be concrete block or a double layer of gypsum wallboard or 3/4-inch (19 mm) thick plaster on metal lath to minimize maintenance of the facility. The general architecture of the unit shall provide for optimal line-of-sight observation from the nurses’ station throughout the unit, minimizing hidden spots and blind corners.
The CSU or SRT shall be designed to create a pleasant functional therapeutic environment throughout, by the use of sunlight, colors, designs, textures, and furnishings. The design shall achieve a secure unit which looks more residential than institutional in its construction and furnishings, while incorporating substantial safety considerations throughout.
The CSU or SRT shall be designed in order that the general unit be divided into a close observation area and a general observation area based upon the need for frequent physical proximity, singular observation of individuals, and lowered stimulation levels. These areas do not need physical separation; for example, they may be the left and right sides of the unit.
This area shall include persons brought onto the CSU or SRT needing initial observation or restraints, individualized observation, and lowered stimulation levels, all of which require the frequent physical proximity of nurses. This area shall be directly adjacent to the primary unit doorway and nurses’ station. The immediately adjacent rooms shall be used for single occupancy and restraint or seclusion. These rooms shall be remote from routine high activity areas and corridors.
This shall include areas where persons routinely congregate or walk through such as multioccupant bedrooms, activity rooms, smoking areas, dining room and routine traffic corridors, or pathways. The dining and activity areas shall be directly observable, or under constant staff supervision, but may be a greater distance from the nurses’ station.
All areas of CSUs and SRTs shall be ventilated by central, ducted supply and return forced air systems. Toilets, bathrooms and soiled function rooms shall be mechanically exhausted to the outside. Ventilation units shall distribute tempered heated or cooled air to all spaces and shall supply outside air in the quantity of either the sum of all exhausts or 20 cfm (.009 m3/s) per person whichever is greater. The quality of all exhausts must match the intake volume of all outside air. Supply, exhaust, and return fans shall run continuously while the building is occupied. Areas in which smoking is permitted shall be well vented by at least 35 cfm (.02 m3/s) per person to the outside in order to minimize smoke diffusion throughout the unit.
All doors opening directly onto the unit from nonclient rooms or office areas shall be equipped with locksets which are key released to leave the client area and permit unobstructed return to the client area. Door closures are required to deny persons receiving services accidental unsupervised access to the contents of staff offices, janitorial closets, and mechanical areas.
Corridors shall ensure maximum clear distances by recessing water fountains and fire extinguishers, or placing them in alcoves. Corridors in client areas must be at least a 6 foot (1829 mm) clear width; nonclient areas must be at least 44 inches (1118 mm) minimum clear width. Corridor ceilings shall be a minimum height of 7 feet 6 inches (2284 mm).
Hot and cold running water under pressure shall be readily available in all washing, bathing, food preparation, and food handling areas. Hot water in client areas shall be at least 100°F (38°C), but not exceed 120°F (49°C).
The minimum size for doors shall be no less than 3 feet (914 mm) wide and 6 feet 8 inches high (2032 mm). Areas accessible to persons with physical disabilities shall comply with applicable codes and standards.
Since glass fragments are a safety hazard throughout the unit, the use of glass shall be minimal.
All television sets must be securely fastened.
Door closures shall not be utilized in unobserved client areas.
All CSUs and SRTs equipped with electronic locks on internal doors or egress doors shall ensure that such locks have manual common key mechanical override that will operate in the event of a power failure or fire. Egress pathways and doors shall be locked as provided for in the Life Safety Code, NFPA 101, Chapter 12, as incorporated by reference in Chapter 59A-3, Florida Administrative Code as adopted by the Florida Fire Prevention Code.
CSUs and SRTs with electronic or magnetic door locks or other fundamental operational components which are electric shall have either: a battery back-up system rated for facility emergency power draw and capable of sustaining door locks and emergency operations for a minimum period of 6 hours; or an emergency generator with transfer switch with a battery pack back-up system capable of operating for 2 hours at facility emergency power draw level.
The use of door vision panels and windows shall minimize the opportunity for isolation of staff or persons served in unobserved areas. This does not include privacy provisions such as bathrooms and bedrooms.
The design shall ensure that each person receiving services in a CSU or SRT is provided a minimum of 175 square feet (16 m2) of usable client space.
All electrical switches and outlets in wet areas shall be ground-fault protected with a remote breaker switch. Tamperproof, safety-type duplex outlets shall be used in all areas accessible to persons receiving services.
Air ducts shall be covered with a perforated-type metal grille not residential louvered grilles, throughout the unit in all areas accessible to persons receiving services.
All hose bibbs shall be equipped with a vacuum breaker device.
The unit shall have a minimum of one drinking fountain.
Ceiling height in bedrooms, activity areas, and bathrooms shall be at least 9 feet (2743 mm).
The operation of all perimeter locks shall ensure reasonable control over both access and egress.
Waiting rooms shall have an adjacent restroom which is designed to accommodate persons with physical disabilities in accordance with the Florida Building Code, Accessibility.
The entrance shall be grade level, sheltered from inclement weather and accessible to persons with physical disabilities in accordance with the Florida Building Code, Accessibility.
The lobby shall include a drinking fountain and space for clerical personnel. Private interview space for emergency screening of voluntary persons shall be adjacent to the lobby.
This shall be a locked area in which law enforcement admissions may be received. This area shall not be wholly isolated visually from the CSU to provide safety for emergency screening personnel who may become isolated in this area. This area shall provide for medical clearance, emergency screening, bathroom facilities, and other activities which may be necessary.
A separate entrance shall be provided directly to emergency screening areas and examination rooms for law enforcement personnel. It shall have a driveway where a law enforcement vehicle can pull immediately adjacent to the building before transferring a person through the separate entrance to the emergency screening area. The law enforcement entrance shall also have a lock box where the law enforcement officer can lock his weapons during such time as he or she is in the facility.
A separate bathroom with supervised shower area shall be located so that all persons being admitted may be showered before being admitted to the residential section of the unit.
Each CSU shall have a minimum of two seclusion rooms that shall share a common vestibule with a bathroom off the vestibule area. Each SRT shall have at least one seclusion room. Seclusion rooms shall be free of sharp edges or corners and be strongly constructed to withstand repeated physical assaults. Walls shall be either concrete block or double layered to provide resistance and be smooth. The ceilings shall be 9 feet (2743 mm) in clear height, hard-coated, and lighting fixtures recessed and tamperproof. Lighting fixtures shall be nonbreakable, preferably Lexan, and shall be installed with tamperproof screws, as shall any other items in the seclusion rooms. The seclusion room door shall be heavy wood or metal at least 36 inches (914 mm) in width and shall open outward. The door frame shall be heavy steel and shall be thoroughly bolted into the wall and cemented in.
At least one seclusion room in the CSU shall have a sturdily constructed bed, without sharp edges and bolted to the floor. A bed in the SRT seclusion room is optional; however, if present, the bed shall meet the same requirements as specified for the CSU. Its placement in the room shall provide adequate space for staff to apply restraints and not assist individuals in tampering with the lights, smoke detectors, cameras, or other items that may be in the ceiling of the room. There shall be a rheostat control mechanism outside the room to adjust the illumination of the light in the seclusion room.
The floor and walls, up to a height of 3 feet (914 mm), shall be coated with an impermeable finish to resist penetration of body fluids. One seclusion room shall have a floor drain. A hose bibb shall be in a readily adjacent area such as a bathroom.
There shall be a vision panel in the door of the seclusion room, no larger than 8 inches by 8 inches (203 mm by 203 mm), which provides a view of the entire room. This vision panel shall be Lexan or other suitably strong material and it shall be securely mounted in the door. Provisions shall be made to ensure privacy from the public and other persons receiving services while providing easy access for staff observation.
Seclusion rooms shall be a minimum of 70 square feet (7 m2) and a minimum room dimension of 9 feet (2743 mm).
Fire sprinkler heads shall be ceiling mounted and either recessed or flush-mounted type without a looped spray dispersal head.
A voice-activated and switchable emergency calling system for monitoring persons receiving services shall be provided in each seclusion room.
Each seclusion room shall have an electronic visual monitoring system capable of viewing the entire room and be monitored from the nurses’ station.
A janitor's closet shall be on the unit. It shall contain a floor receptor for mop water and provide space for mop bucket, brooms, and other minimal items. Caustic and other dangerous chemicals shall not be stored in this closet.