457.1.4.2 Overall Functional Design

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 a 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 (0.009 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 (0.02 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.