Section 1226 [OSHPD 3] Clinics

The provisions of this section shall apply to outpatient clinical services of a hospital when provided in a freestanding building, primary care clinics, specialty clinics, and psychology clinics. Primary care clinics include free clinics, community clinics, employee clinics and optometric clinics. Specialty clinics include surgical clinics, chronic dialysis clinics, rehabilitation clinics and alternative birth centers (ABC).

All new buildings and additions, alterations or repairs to existing buildings, and conversion of space to a clinic use within existing buildings, subject to licensure by Licensing and Certification, California Department of Public Health, shall comply with applicable provisions of the California Electrical Code, California Mechanical Code, California Plumbing Code, California Fire Code, (Parts 3, 4, 5, and 9 of Title 24) and this section. OSHPD requirements apply to all facilities described above and are not dependent upon Occupancy Group designations.

Exception: See Section 1224.2.

Hospitals providing outpatient clinical services and clinics licensed under Health and Safety Code Section 1200 providing services that are not covered by this section shall meet the applicable requirements in Section 1224.

A general acute care hospital referenced in Health and Safety Code Section 1255 (d) (3) (E), that provides special services in conformance with Health and Safety Code Section 1255, shall meet all the provisions of Section 1224.28.3 in addition to Section 1226.2. The Office of Statewide Health Planning and Development (OSHPD) shall review any proposed construction or alteration for OSHPD compliance.

Refer to Section 1224.3.

Clinics and outpatient clinical services under a hospital license shall comply with the following provisions wherever applicable.

Refer to Section 1224.4.2.

Refer to Section 1224.4.3.

Refer to Section 1224.4.4.1.

Refer to Section 1224.4.4.1.3.

When provided, refer to Section 1224.4.6.1.

When provided refer to Section 1224.4.6.2.

When provided, refer to Section 1224.4.6.3.

Refer to Section 1224.4.6.4.

Refer to Section 1224.4.6.5.

Refer to Section 1224.4.7.3

For clinics with bed/gurney patient(s) refer to Section 1224.4.7.1.

Refer Section 1224.4.7.2.

For rehabilitation services space, refer to Section 1224.4.7.4.

Refer to Section 1224.4.7.5.

Refer to Section 1224.4.8.1.

Refer to Section 1224.4.8.2.

Refer to Section 1224.4.9.4.

Refer to Section 1224.4.9.5.

For minimum ceiling height requirements, refer to Section 1224.4.10.1.

Refer to Section 1224.4.10.2.

Refer to Section 1224.4.11.1 and Table 1224.4.11.

Refer to Section 1224.4.11.1.1.

Refer to Section 1224.4.11.1.3.

Refer to Section 1224.11.1.4.

Refer to Section 1224.4.11.2.1.

Refer to Section 1224.4.11.2.2.

Refer to Section 1224.4.11.3.

Ceiling finishes shall comply with Section 1224.4.11.4 and Table 1224.4.11.

Buildings over one story in height with accommodations or services for patients on floors without grade-level entrance shall provide at least one elevator in compliance with Section 3002.4.

Elevators used for the routine transport of wheeled stretchers shall have minimum inside platform dimensions of 5 feet by 8 feet (1524 mm by 2438 mm) and a minimum clear door opening of 3 feet 8 inches (1118 mm).

These facilities shall comply with the appropriate local health and environmental authorities’ requirements, California Department of Public Health requirements for medical waste management, and comply with the following minimum requirements:

A location shall be provided for waste collection and storage with sufficient space based upon the volume of projected waste and length of anticipated storage. The location of compactors, balers, sharps containers, and recycling container staging at docks or other waste removal areas shall comply with Section 1224.4.2.

A lockable room or screened enclosure of at least 25 square feet (2.32 m²) shall be provided for the washing and cleaning of garbage containers and for the storage of garbage, trash and other solid wastes.

Exception: This amount of space may not be required by the enforcing agency if there is a proposed method of handling and storage which requires a lesser amount of space. Additional space may be required by the enforcing agency when special operations or collection and disposal methods result in greater than usual accumulation of solid wastes.

The room or screened enclosure shall include the following:

1. Floor and curb. A concrete floor with a curb and with a drain connected to the sewer.
2. Water. Steam or hot water and cold water supplies in accordance with the California Plumbing Code.
3. Size. A minimum floor area of not less than 25 square feet (2.32 m²), the least dimension of which shall be 4 feet (1219 mm). This amount of space may not be required by the enforcing agency if there is proposed a method of handling, storage, or cleaning of containers which requires a lesser amount of space. Additional space may be required by the enforcing agency when special operations or collection and disposal methods result in greater than usual accumulation of solid wastes.

As an alternative to the requirements in Section 1226.4.9.2, a holding room for medical waste and garbage may be provided.

Exception: This amount of space may not be required by the enforcing agency if there is a proposed method of handling and storage which requires a lesser amount of space. Additional space may be required by the enforcing agency when special operations or collection and disposal methods result in greater than usual accumulation of solid wastes.

The waste holding room shall comply with the following:

1. The waste holding room shall be a minimum of 25 square feet, with the least dimension of which is 4 feet.
2. The waste holding room shall have 100 percent exhaust ventilation.
3. All finishes in the waste holding room shall comply with the requirements in Section 1224.4.11.
4. The waste holding room shall be immediately accessible to an exterior door.

Trash compactor systems shall meet the drainage and wash-down requirements under Section 1226.4.9.2, Items 1 and 2.

Exception: If a dumpster system is proposed, operational procedures for handling and storage must be specifically approved by the local health officials.

Refer to Section 1224.4.15.

Gravity-type laundry and trash chutes shall comply with Section 1224.4.16.

This area shall have space for counters and storage and shall have direct access to a handwashing stations (refer to Section 1224.3 for definition of handwashing station). It may be combined with or include centers for reception, charting and communication.

Provision shall be made for distribution of medications. This shall be done from a medicine preparation room or a self-contained medicine dispensing unit.

When provided, the entry of the medicine preparation room or area shall be under the visual control of the staff. This may be a part of the administrative center or nurse station and shall include all of the following:

1. Work counter
2. Sink
3. Lockable refrigerator
4. Immediate access to handwashing station
5. Locked storage for biologicals and drugs

When a medicine preparation room or area is to be used to store self-contained medicine dispensing units, the room shall be designed with adequate space to prepare medicines with the self-contained medicine-dispensing units present.

When provided, the location of a self-contained medicine-dispensing unit shall be permitted in the clean workroom or at the administrative center or nurses’ station, provided there is adequate security for medications and adequate lighting to easily identify drugs. Immediate access to a handwashing station shall be provided.

A clean utility room shall be provided. If the room is used for preparing patient care items, it shall contain:

1. Work counter
2. Handwashing fixture
3. 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 and handwashing fixture may be omitted. Soiled and clean utility rooms or holding rooms shall be separated and have no direct connection.

Soiled workroom or soiled holding room shall be provided and contain:

1. Clinic sink

   Exception: For primary care clinics, a utility sink or patient toilet room equipped with a bedpan flushing device may be provided in lieu of a clinic sink. A utility sink may be used for soaking or rinsing and shall be provided as appropriate to the method of decontamination used.

2. Handwashing fixture
3. Work counter
4. Storage cabinets
5. A designated area for waste receptacle(s)
6. A designated area for soiled linen receptacle(s)

If the clinic includes a central sterile supply that complies with Section 1224.22 and the soiled holding room is used only for temporary holding of soiled materials, the clinic sink and work counter may be omitted. Where rooms are used for temporary holding of materials, provisions shall be made for separate collection, storage, and disposal of soiled materials. Soiled and clean utility rooms or holding rooms shall be separated and have no direct connection.

Separate storage for sterile supplies and pharmaceutical supplies shall be provided.

When provided, a sterilization facility shall meet the following applicable requirements:

Each facility shall provide space for the storage of disposable sterile supplies or provide space for sterilization and disinfection equipment.

Exception: Facilities with contractual arrangements for outside autoclaving and sterilizing services.

When provided, rooms and spaces of the central supply and sterilizing area shall comply with the following:

1. Soiled work area. A receiving and gross cleaning area which shall contain work space and equipment for cleaning medical and surgical equipment and for disposal of or processing of soiled materials.
2. Clean work area. A clean work area which shall contain work space and equipment for sterilizing medical and surgical equipment and supplies.
3. Sterilizing and equipment disinfection space.
4. Storage. Space for sterile supplies and unsterile supplies.

When provided, all sterilizers and autoclaves which emit system steam exhaust shall be vented to the outside of the building. Such vents shall be independent from the plumbing vent system.

Exception: Small instrument sterilizers.

When provided, the nourishment room or area shall have all of the following:

1. Sink
2. Work counter
3. Refrigerator
4. Storage cabinets
5. Equipment for serving nourishment
6. A handwashing fixture, as defined in Section 1224.3, shall be located in the nourishment room or adjacent to the nourishment area.

Toilet room(s) with a lavatory shall be provided separate from public use toilet(s) and shall be located to permit access from patient care areas without passing through publicly accessible areas.

Exception: For primary care clinics where the facility contains no more than three examination and/or treatment rooms, the patient toilet room shall be permitted to serve outpatient waiting room(s).

When provided, refer to Section 1224.4.4.2. Use of patient toilet room(s) shall be permitted for specimen collection.

If linen is to be processed off site, the following shall be provided:

1. Soiled linen holding area or designated and dedicated area for soiled laundry cart.
2. Clean linen storage area that protects linen from soil or damage.

A reception and information counter or desk shall be provided.

Refer to Section 1224.4.5.

Outpatient clinics shall provide a health record service which shall comply with the following:

1. Work area for sorting and recording records for either paper or electronic media.
2. Storage area for records for either paper or electronic media.

General storage facilities for office supplies and equipment shall be provided.

Provide staff toilet(s) in addition to and separate from, public and patient facilities. The areas shall contain toilet(s) and handwashing fixtures pursuant to the California Plumbing Code, Table 4-2.

Provide storage for staff personal effects with locking drawers or cabinets (may be individual desks or cabinets). Such storage shall be readily accessible to individual workstations and shall be staff controlled.

When provided, the lounge shall have adequate space to accommodate staff.

A licensed hospital may elect to locate certain outpatient services in a freestanding outpatient clinical services building(s). To be considered a freestanding outpatient clinical services building the building must not be physically attached to a building in which inpatient services are provided. No more than 25 percent of the services provided in an outpatient clinical services building may be rendered to inpatients. Services that duplicate the basic services may be provided in freestanding building(s). These services, defined in Subsection (a) of the Health and Safety Code Section 1250, must be in excess of the basic services, necessary for hospital licensure, required to be located in a hospital building under OSHPD jurisdiction.

Outpatient clinical services of a hospital in a freestanding outpatient clinical services building shall comply with Sections 1226.4.2 through 1226.4.8 and the provisions of this section. Outpatient clinical services of a hospital that are not addressed in the provisions of Section 1226 shall comply with applicable provisions of Section 1224.

GENERAL SUPPORT AREAS FOR OUTPATIENT CLINICAL SERVICES - Requirements for all service types.

Refer to Section 1226.4.14.1.

When provided, refer to Section 1224.4.4.2.

Refer to Section 1226.4.9.

Refer to Section 1224.4.15.

Refer to Section 1226.4.16.1.1.

Refer to Section 1224.4.5.

Refer to Section 1224.4.5.

Refer to Section 1224.4.5.

Refer to Section 1224.4.5.

Refer to Section 1226.4.16.2.1.

Refer to Section 1226.4.16.2.2.

Refer to Section 1226.4.17.1.

Refer to Section 1226.4.17.2.

When x-ray examination services, computerized tomography scanning, magnetic resonance imaging, ultrasound, and/or mammography services are provided, the radiological/imaging services space shall comply with the provisions of this section.

The following spaces are common to the imaging service area and are minimum requirements:

In service spaces with procedure rooms that do not require dedicated patient toilets, provide a minimum of one patient toilet room within the service space, refer to Section 1226.4.14.1.

A separate space shall be provided where outpatients change from street clothing. This shall include provisions for clothing storage, space for clothing change and gowning area. Dressing rooms shall be readily accessible to the imaging rooms.

In service space of three or more procedure rooms, staff toilet room(s) internal to the service space.

Handwashing fixtures shall be located within the unit.

If imaging storage systems are used, provide a means of sorting and filing patient film or electronic media for immediate retrieval shall be provided.

Provision shall be made for locked storage of medications and drugs. Refer to Section 1226.4.13.2.

Refer to Section 1226.4.15.1.

Radiation protection requirements for equipment refer to Section 1224.18.1.1.

When provided, x-ray examination services space shall comply with the following:

1. X-ray room.
2. When shielded control alcove with protective view windows is provided, refer to Section 1224.18.1.1.
3. Fluoroscopy room, when provided, shall have a toilet room directly accessible to the fluoroscopy room. This toilet room is in addition to common patient toilet room facilities located in the radiological/imaging service space.
4. Space for processing images.
5. An office or other suitable area for viewing and reporting radiographic examination.

When provided, CT services space shall comply with the requirements of Section 1224.18.3.

When provided, MRI services space shall comply with the requirements of Section 1224.18.4.

When ultrasound is provided, refer to Section 1224.18.5.

When mammography is provided, refer to Section 1224.18.6.

When provided, gastrointestinal endoscopy services space shall comply with Section 1224.39.3 and the provisions of this section:

Refer to Section 1224.39.3.1.1.

Refer to Section 1224.39.3.1.2.

Refer to Section 1224.39.3.2.

Refer to Section 1224.15.2.

Refer to Section 1224.16.

Refer to Section 1224.39.3.5.

Refer to Section 1224.15.3.1.

Refer to Section 1226.4.13.2.

Refer to Section 1224.15.3.7.

Refer to Section 1224.15.3.8.

Refer to Section 1224.15.3.9.

Refer to Section 1224.15.3.10.

Refer to Section 1224.15.3.11.

Refer to Section 1224.39.2, Item 7.

Refer to Section 1224.39.2, Item 4.

Refer to Section 1226.4.13.5.

A separate space shall be provided where patients change out of their street clothing and are prepared for the procedure. This space shall include provisions for clothing storage, toilet room(s), sink, space for clothing change and gowning area.

When provided, nuclear medicine services space shall comply with Section 1224.34 and the provisions of this section:

When provided, refer to Section 1224.34.1.1.

Refer to Section 1224.34.1.2.

When provided, refer to Section 1224.34.1.3.

Refer to Section 1224.34.2.2.

Refer to Section 1224.34.2.5.

Refer to Section 1224.34.2.6.

Refer to Section 1224.34.2.7.

Refer to Section 1224.34.2.8.

Refer to Section 1224.34.2.9.

Refer to Section 1224.34.2.10.

Refer to Section 1226.5.3.

A storage area for clean linen shall be provided.

Refer to Section 1224.34.2.13.

When provided, radiotherapy service space shall comply with the following provisions of this section:

Refer to Section 1224.34.3.2.

Refer to Section 1224.34.3.3.

Refer to Section 1224.34.3.4.

Refer to Section 1224.34.4.1.

Refer to Section 1224.34.4.2.

When provided, cancer treatment/infusion therapy service space shall comply with the provisions of this section:

Refer to Section 1224.39.4.2.1.

Refer to Section 1224.39.4.2.2.

Refer to Section 1224.39.4.2.3.

Refer to Section 1224.39.4.2.4.

Refer to Section 1224.39.4.2.5.

Refer to Section 1224.39.4.2.6.

Refer to Section 1224.39.4.2.7.

Refer to Section 1224.39.4.2.8.

Refer to Section 1224.39.4.2.9.

Refer to Section 1224.39.4.2.10.

Refer to Section 1224.39.4.2.11.

Refer to Section 1224.39.4.2.12.

Refer to Section 1224.39.4.2.13.

Refer to Section 1224.39.4.2.14.

Refer to Section 1224.39.4.3.2.

When provided, hyperbaric therapy service space shall comply with Section 1224.39.5 and the provisions of this section:

Refer to Section 1224.39.5.1.

Refer to Section 1224.39.5.2.

Refer to Section 1224.39.5.3.

Refer to Section 1224.39.5.4.

Refer to Section 1224.39.5.5.1.

Refer to Section 1224.39.5.5.2.

Refer to Section 1224.39.5.5.3.

Refer to Section 1224.39.5.5.4.

Refer to Section 1224.39.5.5.5

Refer to Section 1224.39.5.5.6.

Refer to Section 1224.39.5.5.7.

Refer to Section 1224.39.5.5.8.

Refer to Section 1224.39.5.6.

Refer to Section 1224.39.5.7.1.

Refer to Section 1224.39.5.7.2.

Refer to Section 1224.39.5.7.3.

Primary care clinics and outpatient clinical services of a hospital providing services equivalent to a primary care clinic shall comply with Sections 1226.4.3 through 1226.4.8 and the provisions of this section.

Refer to Section 1224.4.4.1.

Treatment room(s) for minor procedures (e.g. minor surgical procedures, casting), if provided, shall have a minimum area of 120 square feet (11.15 m²), the least dimension of which shall be a minimum of 10 feet (3048 mm), excluding such spaces as vestibules and work counters, and shall meet the requirements in Section 1224.4.4.1.

When provided, the examination and treatment space shall be permitted to be a room or a patient care station in an open treatment area.

The treatment space shall have a minimum clear floor area of 80 square feet (7.4 m²).

This space is required for each station in an open operatory or treatment area. A minimum of 3 feet (915 mm) clearance shall be provided along the full length of one side of the chair, the head of the chair, and between the cuspidor and the head of the chair on the other side for assisting dental staff.

At least one private consultation/treatment room shall be provided when pediatric patients are treated in a facility.

Each treatment room shall include a handwashing station. If treatment is provided at stations in an open operatory, a handwashing station may be permitted to serve two treatment stations.

If provided, space for a dental panographic x-ray system and printer shall also comply with shielding requirements in Section 1226.5.5.2 and alcove requirements in Section 1224.18.1.1.

When provided, treatment areas for procedures for which general anesthesia is used, shall comply with the requirements in Section 1226.8.

Refer to Section 1226.4.13.1.

Refer to Section 1226.4.13.2.

Refer to Section 1226.4.13.3.

Refer to Section 1226.4.13.4.

Dental facilities must provide a consultation room for private conferences with patients.

If sterile processing and/or high level disinfection is provided, the sterile processing room shall consist of a decontamination area and a clean work area. The sterile processing/high level disinfection room shall be designed to provide one-way flow of contaminated materials/instruments to the sterilizer/high level disinfection equipment. Sterile/high level disinfected instruments should be distributed from the area in such a manner that processed items do not pass through the decontamination area.

The decontamination area shall be equipped with the following:

1. Countertop, separated from clean countertop by 4 feet minimum distance.
2. Handwashing station separate from the instrument washing sink.
3. Sink for washing instruments. To avoid splash, the decontamination sink shall be separated from the clean work area by either a 4-foot distance from the edge of the sink or a separating wall or screen. If a screen is used, it shall extend a minimum of 4 feet (1220 mm) above the sink rim.
4. Storage for supplies.

The clean work area shall be equipped with the following:

1. Countertop, separated from decontamination countertop by 4 feet minimum distance.
2. Sterilizer/high level disinfection equipment, as required for the services provided.
3. Handwashing station, may share with decontamination area handwashing station.
4. Built-in storage for supplies.

Facilities for laboratory services shall be provided in dental facilities or through a contract arrangement with a laboratory service.

Refer to Section 1226.4.14.1.

When provided, refer to Section 1224.4.4.2.

Refer to Section 1226.4.9.

Refer to Section 1224.4.15.

Refer to Section 1226.4.16.1.1.

Refer to Section 1224.4.5.

Refer to Section 1224.4.5.

Refer to Section 1224.4.5.

Refer to Section 1224.4.5.

Refer to Section 1226.4.16.2.1.

Refer to Section 1226.4.16.2.2.

Refer to Section 1226.4.17.1.

Refer to Section 1226.4.17.2.

Outpatient surgical clinics, and outpatient clinical services of a hospital providing services equivalent to a surgical clinic, shall comply with Sections 1226.4.2 through 1226.4.8 and the provisions of this section.

Refer to Section 1224.39.2, Item 1.

Provide preoperative patient holding and post-anesthesia recovery area. Refer to Section 1224.16.

Refer to Section 1224.15.3.1.

Refer to Section 1224.15.3.2.

When provided, refer to Section 1224.15.3.3.

Refer to Section 1226.4.13.2.

Refer to Section 1224.15.3.5.

Refer to Section 1224.15.3.6.

Refer to Section 1224.15.3.7.

Refer to Section 1224.15.3.8.

Refer to Section 1224.15.3.9.

Refer to Section 1224.15.3.10.

Refer to Section 1224.15.3.11.

Refer to Section 1224.39.2, Item 7.

Refer to Section 1224.39.2, Item 4.

Refer to Section 1226.4.13.5.

Refer to Section 1226.4.13.6.

Refer to Section 1226.4.14.1.

A separate space shall be provided where patients change out of their street clothing and are prepared for the procedure. This space shall include provisions for clothing storage, toilet room(s), sink, space for clothing change and gowning area.

Refer to Section 1226.4.9.

Refer to Section 1226.4.15.1.

Refer to Section 1226.4.16.1.1.

Refer to Section 1224.4.5.

Refer to Section 1224.4.5.

Refer to Section 1224.4.5.

Refer to Section 1224.4.5.

Refer to Section 1226.4.16.2.1.

Refer to Section 1226.4.17.1.

Refer to Section 1226.4.17.2.

Chronic dialysis clinics and outpatient clinical services of a hospital providing services equivalent to a chronic dialysis clinic shall comply with Sections 1226.4.3 through 1226.4.8 and the provisions of this section.

An examination room with a handwashing fixture shall be provided with a minimum clear floor area of 100 square feet (9.29 m²).

When provided, refer to Section 1224.4.4.1.

Individual patient treatment areas shall contain at least 80 square feet (7.44 m²). There shall be at least a 4-foot (1219 mm) space around and between beds and/or lounge chairs. In addition, the following shall be provided:

1. Location. The treatment area may be an open area and shall be separate from administrative area and outpatient waiting room.
2. Privacy. An open unit shall be designed to provide visual privacy for each patient.

Refer to Section 1226.4.16.1.1.

Refer to Section 1224.4.5.

A minimum of one bloodborne infection isolation room of at least 120 square feet (11.15 m²) of clear floor space shall be provided for patients. This room shall contain a counter and handwashing fixture.

When provided, refer to Section 1224.4.4.1.3.

When provided in the unit, a private treatment area of at least 120 square feet (11.15 m²) shall be provided for patients who are being trained to use dialysis equipment at home. This room shall contain counter, handwashing fixture(s), and a separate drain for fluid disposal.

Administrative center or nurse station shall be located within the dialysis treatment area and designed to provide visual observation of all patient stations. In addition, refer to Section 1226.4.13.1 for nurses’ station(s) requirements.

Handwashing stations shall be directly accessible to the administrative center or nurses' station and to patient treatment areas. Handwashing stations shall be provided for each four patient stations and for each major fraction thereof. These shall be uniformly distributed to provide equal access from each patient station. Refer to Section 1224.3 for the definition of a handwashing station.

Refer to Section 1226.4.13.2.

Refer to Section 1226.4.13.3.

Refer to Section 1226.4.13.4.

Provide a housekeeping room that is immediately accessible to, and for the exclusive use of, the unit. This room shall have a minimum floor area of 15 square feet (1.4 m²) and shall include the following:

1. Service sink or floor receptor
2. Supply storage
3. Housekeeping equipment storage

When provided, refer to Section 1226.4.13.7.

When provided, refer to Section 1226.4.13.6.

Provide office and clinical work space including the following:

Refer to Section 1226.4.16.2.1.

Refer to Section 1226.4.16.2.2.

Provide patient toilet room(s) directly accessible from treatment area. The toilet shall be equipped with bedpan flushing attachment(s). Refer to Section 1226.4.14.1.

Provide space for storage of patient clothing and personal items.

When provided, refer to Section 1224.4.4.2.

Refer to Section 1226.4.9.

Refer to Section 1226.4.15.1.

When dialyzers are reused, a reprocessing room is required and sized to perform the functions required and include one-way flow of materials from soiled to clean with provisions for a refrigerator for temporary storage of dialyzer, decontamination/cleaning areas, sinks, processors, computer processors and label printers, packaging area, dialyzer storage and disinfectants storage.

When required, an equipment repair and breakdown room shall be equipped with a handwashing fixture, deep service sink, work counter and storage cabinet. Provide water supply and drain connection for testing machines.

Each facility using a central batch delivery system shall provide, either on the premises or through written arrangements, individual delivery systems for the treatment of any patient requiring special dialysis solutions. The mixing room shall also include a sink, storage space and holding tanks.

The water treatment equipment shall be located in an enclosed room.

Refer to Section 1226.4.17.1.

Refer to 1226.4.17.2.

Rehabilitation clinics and outpatient clinical services of a hospital providing services equivalent to a rehabilitation clinic shall comply with Sections 1226.4.3 through 1226.4.8 and the provisions of this section.

Refer to Section 1226.4.14.1.

Refer to Section 1226.4.9.

Refer to Section 1224.4.15.

Refer to Section 1226.4.15.1.

Refer to Section 1226.4.16.1.1.

Refer to Section 1224.4.5.

Refer to Section 1224.4.5.

Refer to Section 1224.4.5.

Refer to Section 1224.4.5.

Provide office and clinical work space including the following:

Refer to Section 1226.4.16.2.1.

Refer to Section 1226.4.16.2.2.

Refer to Section 1226.4.17.1.

Refer to Section 1226.4.17.2.

A physical therapy service space shall be provided. The service space shall comply with the following provisions:

1. Individual treatment area(s). Refer to Section 1224.35.2, Item 1.
2. Handwashing fixture(s). Refer to Section 1224.35.2, Item 2.
3. Exercise area. Refer to Section 1224.35.2, Item 3.
4. Clean linen and towel storage. Refer to Section 1224.35.2, Item 4.
5. Storage for equipment and supplies. Refer to Section 1224.35.2, Item 5
6. Separate storage for soiled linen, towels and supplies. Refer to Section 1224.35.2, Item 6.

When an occupational therapy service is provided, the service space shall comply with following provisions:

1. Work areas and counters. Refer to Section 1224.35.3, Item 1.
2. Handwashing fixture(s). Refer to Section 1224.35.3, Item 2.
3. Storage for supplies and equipment. Refer to Section 1224.35.3, Item 3.
4. Area for teaching daily living activities. Refer to Section 1224.35.3, Item 4.

When speech pathology and/ or audiology service(s) is provided, the service space shall comply with the following provisions:

1. Interview, consultation and treatment space. Refer to Section 1224.35.4, Item 1.
2. Waiting area. Refer to Section 1224.35.4, Item 2.
3. Handwashing fixture. Refer to Section 1224.35.4, Item 3.
4. Testing unit. If an audiology service is provided. Refer to Section 1224.35.4, Item 4.

Alternative birthing clinics and outpatient clinical services of a hospital providing services equivalent to alternative birthing clinics shall comply with Sections 1226.4.3 through 1226.4.8 and the provisions of this section:

A birthing room shall have a minimum clear floor area of 200 square feet (18.58 square meters), including the newborn care area. A birthing room shall have a minimum clear dimension of 12 feet (3658 mm). The maximum number of beds per room shall be one.

Birthing rooms shall be located out of the path of unrelated traffic and under direct supervision of the facility staff.