Section 1227 [OSHPD 4] Correctional Treatment Centers

The provisions of this section shall apply to correctional treatment centers.

BASIC SERVICES for correctional treatment centers are those services required for licensure as a correctional treatment center, including medical, surgical, psychiatrist, psychologist, nursing, pharmacy and dietary. See "Optional services."

HAND WASHING FIXTURE is a special application sink having a water supply spout mounted so the discharge point is at least 5 inches (127 mm) above the fixture rim and equipped with hot and cold supply controls not requiring direct contact of the hands for operation. The fixture cannot be equipped with an aerator and wrist or elbow blade handles. Gooseneck spouts shall not be used in correctional treatment centers.

LICENSING AGENCY is the California Department of Public Health.

OPTIONAL SERVICES are inpatient or outpatient services which are not required to be provided by law or regulation for licensure. An optional service, when provided, must accommodate the provisions of this section. See "Basic services."

OUTPATIENT SERVICE is an organizational unit of the correctional treatment center which provides nonemergency health care services to patients.

Correctional treatment centers shall comply with this section.

Correctional treatment centers shall comply with the requirements of Section 1224.4.6 wherever applicable.

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 and hazards in patient care areas and bedrooms.

Radiology, laboratory, pharmacy and physical therapy spaces shall not be located in nursing units, surgical units, perinatal units, nursery areas, central sterilization rooms, food service areas, power plants, mechanical equipment rooms, maintenance shops, general storage, laundry, employees' dressing or housekeeping facilities.

If an exam room is provided, it shall have a minimum clear floor area of 80 square feet (7.43 m²), the least dimension of which shall be 8 feet (2438 mm).

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 for writing or electronic documentation.

The minimum width of corridors shall be 8 feet (2438 mm).

Exception: Patient-care corridors in correctional treatment centers for psychiatric care of patients who are not bedridden shall have a minimum clear and unobstructed width of 6 feet (1829 mm). For the purpose of this section, bedridden patients shall be defined as patients confined to beds who would be transported or evacuated in beds or litters.

Service corridors with anticipated light traffic volume for nonpatient use may be reduced to a width of 5 feet (1524 mm) if approved by the enforcing agency.

Exception: Corridors in administrative and business areas may be reduced to a width of 44 inches (1118 mm).

Corridors for patient traffic in areas providing skilled nursing, intermediate, care or rehabilitation services shall be furnished with a handrail on both sides at a height not less than 30 inches (762 mm) or greater than 36 inches (914 mm).

Corridor systems shall connect all patient rooms and essential services.

Doors to toilet rooms shall have an opening of not less than 32 inches (813 mm) clear in width and shall be equipped with hardware which will permit the door to swing outward or in a manner to negate the need to push against a patient who may have collapsed within the toilet room.

Pocket sliding doors are not permitted.

Exception: Doors not serving as exit doors from administration areas.

Doors to patient bedrooms shall be provided with a view window with a minimum area of 288 square inches (0.186 square meters). Window sill height shall not be higher than 42 inches (1067 mm) from the floor.

Rooms approved for the housing of patients shall be provided with natural light by means of glazed openings.

When windows are operable, they 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.

Each patient bedroom shall be provided with viewing windows from the corridor to allow full and unobstructed visual observation of the patient.

The minimum height of ceilings shall be 8 feet (2438 mm).

Exception: Closet, toilet rooms and bathroom minimum ceiling heights shall not be less than 7 feet (2134 mm).

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.

Shall be smooth, waterproof and durable.

Exception: Upon written appropriate documented request, the enforcing agency may grant approval of the installation of carpet. See Table 1224.4.11.

If used in toilet and bathing rooms, shall be continuous and extend upward onto the walls at least 5 inches (127 mm).

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.

Wood bases are prohibited except in administration departments and other offices described in Section 1227.16.

Exceptions: Wall bases in kitchens, operating rooms, delivery rooms, emergency operating rooms, cast rooms, special procedure rooms and other areas which are subject to wet cleaning methods shall be made integral and coved with the floor, and constructed without voids at the intersection of floor and wall surfaces.

Interior wall finishes shall be smooth, washable and durable.

Ceiling finishes shall be in compliance with Table 1224.4.11.

Exceptions: Walls and ceiling finish requirements do not apply to boiler rooms, mechanical equipment rooms, administration departments, other offices, enclosed stairways, maintenance shops and similar spaces.

Patient elevators shall have minimum inside platform dimensions of 5 feet by 8 feet (1524 mm by 2438 mm) and a minimum clear door opening of 4 feet, 0 inches (1118 mm).

Passenger elevators shall have minimum inside platform dimensions of 4 feet, 8 inches by 7 feet, 4 inches (1422 mm by 2236 mm).

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

If bed patients are accommodated on one or more floors, other than the main entrance floor or where operating rooms or delivery rooms are above or below the main entrance floor, at least one patient elevator shall be provided.

At least one patient elevator and one service elevator shall be provided in correctional treatment centers with a capacity of 60 to 149 beds on floors other than the main entrance floor.

At least one patient elevator, one passenger elevator and one service elevator shall be provided in hospitals with a capacity of 150 or more beds on floors other than the main entrance floor.

If elevators in the correctional institution meet the above size requirements and are easily accessible, the elevators need not be duplicated in the correctional treatment centers.

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:

1. A concrete floor with a curb and with a drain connected to the sewer.
2. Steam or hot-water and cold-water supply.
3. A minimum floor area of .5 square feet (0.046 m²) per bed, but not less than 25 square feet (2.32 m²), the least dimension of which shall be 4 feet (1219 mm).
4. A method of limiting access to the material except by authorized persons.

BASIC SERVICES

Patients shall be accommodated only in rooms with the following minimum floor area, exclusive of toilet rooms, wardrobes, entrance vestibules, and fixed furnishings or equipment.

1. Single-patient rooms: 110 square feet (10.22 m²).
2. Multi-patient rooms: 80 square feet (7.43 m²) per bed.

A minimum distance of 3 feet (914 mm) shall be provided between beds and 4 feet (1219 mm) between the foot of beds and walls or fixed objects in multi-patient rooms, and 3 feet (914 mm) in single-patient rooms.

Alternate designs for modifications to isolation rooms in operation prior to the effective date of this section may be utilized when it can be demonstrated that the alternate design meets performance requirements, without compromising any health or life-safety requirement.

Airborne infection isolation room(s) shall have self-closing and latching devices on all anteroom doors.

A separate anteroom shall be provided between the airborne infection isolation room and the corridor, which shall constitute the primary entrance to the negative pressure isolation room. This anteroom shall have a handwashing fixture, work counter at least 3 feet (914 mm) long, cabinets and space to gown and to store clean and soiled materials. There shall be a view window from the anteroom to the isolation room and means to allow for airflow from the anteroom into the negative pressure isolation room. Doors shall be aligned to allow large equipment to be wheeled into the airborne infection isolation room unless a secondary door complying with Section 1227.12.3.4 is provided. One anteroom may serve no more than two airborne infection isolation rooms.

When a secondary entry is provided directly from the corridor to the negative-pressure isolation room, secondary doors shall be provided with locking devices which are readily openable from the room side and which are readily openable by the facility staff on the other side. When key locks are used on isolation rooms, keys shall be located at the nurses' station in a prominent readily accessible location.

Each isolation room shall have its own toilet room facilities with an emergency nurse call system, a lavatory, a shower providing a seat or a space for a shower chair and a toilet equipped with a bedpan flushing attachment with a vacuum breaker.

Airborne infection isolation room perimeter walls, ceiling, floors, doors and penetrations shall be sealed tightly to minimize air infiltration from the outside or from other spaces.

Protective environment rooms for the protection of certain immunosuppressed patients may be provided by the facility. Protective environment rooms shall be labeled "Protective Environment Room" on or adjacent to the anteroom side of the door between the isolation room and the anteroom.

Airborne infection isolation room(s) shall have self-closing and latching devices on all anteroom doors.

A separate anteroom shall be provided between the protective environment room and the corridor or adjoining space which shall constitute the only entrance to the protective environment isolation room. This anteroom shall have a handwashing fixture, work counter at least 3 feet (914 mm) long, cabinets and space to gown and to store clean and soiled materials. There shall be a view window from the anteroom to the positive-pressure isolation room. There shall be means to allow for airflow from the protective environment room into the anteroom. Anteroom doors shall be aligned so that large equipment can be wheeled into the isolation room. One anteroom may serve no more than one protective environment room.

Exception: Alternate designs for protective environment rooms, without individual anterooms, may be approved by the enforcement agency when it can be demonstrated that the alternate design meets the requirements of the California Mechanical Code and does not compromise or alter any health or fire-protection component, assembly or system.

Adjoining toilet room facilities shall meet the requirements of Section 1227.12.3.5.

Protective environment room perimeter walls, ceiling, floors, doors and penetrations shall be sealed tightly to minimize air infiltration from the outside or from other spaces.

Each patient room shall be labeled with an identification number, letter or combination of the two.

Provide for disturbed/special patients at a ratio of one room for each 30 beds and for each major fraction thereof. At least one seclusion room shall be provided in each nursing service unit.

Seclusion rooms shall be provided with viewing windows to allow full and unobstructed visual observation of the patient. They shall be located near the nurses' station and toilet room facilities.