Section 1227 — [OSHPD 4]-CORRECTIONAL TREATMENT CENTERS

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

New buildings and additions, alterations or repairs to existing buildings subject to licensure shall comply with appli- cable provisions of the California Electrical Code, California Mechanical Code, California Plumbing Code and California Fire Code (Parts 3, 4, 5 and 9 of Title 24) and this section.

Note: Refer to Section 1224.2, Exception 6.

BASIC SERVICES for correctional treatment centers are those services required for licensure as a correctional treatment center, includ- ing medical, surgical, psychiatrist, psychologist, nursing, pharmacy and dietary. See “Optional services.”

HANDWASHING STATION. An area that provides a handwashing fixture, cleaning agents and means for drying hands. Refer to the Cali- fornia Plumbing Code, Section 210.0 for the definition of handwashing fixture as amended in this section. The water supply spout discharge point may be less than 5 inches (127 mm) above the fixture rim. Fixtures shall be equipped with hot and cold supply controls not requiring direct contact of the hands for operation. The fixture cannot be equipped with an aerator or wrist or elbow blade handles.

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.

1227.4.1 Services/systems and utilities. Correctional treatment centers shall comply with this section.

1227.4.1.1 Oxygen, vacuum and medical air. Correctional treatment centers shall comply with the requirements of Section 1224.4.6 wherever applicable.

1227.4.2 Service spaces. 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.

1227.4.3 Treatment spaces. 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.

1227.4.4 Exam room. Unless specified elsewhere, if an exam room is provided, it shall have a minimum clear floor area of 80 square feet (7.43 m [2] ), the least dimension of which shall be 8 feet (2438 mm) and contain a handwashing station.

1227.4.5 Treatment room. Unless specified elsewhere, if a treatment room is provided, it shall have a minimum clear floor area of 120 square feet (11.15 m [2] ), 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 station, cabinets, medication storage and counter for writing or electronic documentation.

1227.5.1 Width. 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.

1227.5.2 Service corridors width. 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).

1227.5.3 Handrails. 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).

1227.5.4 Connections. Corridor systems shall connect all patient rooms and essential services.

1227.6.1 Toilet room doors. 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.

1227.6.2 Pocket doors. Pocket sliding doors are not permitted.

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

1227.6.3 Door view windows. Doors to patient bedrooms shall be provided with a view window with a minimum area of 288 square inches (0.186 m [2] ). Window sill height shall not be higher than 42 inches (1067 mm) from the floor.

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1227.7.1 Natural light. Rooms approved for the housing of patients shall be provided with natural light by means of glazed openings.

1227.7.2 Screens. When windows are operable, they shall be provided with insect screens of 16 meshes to the inch.

1227.7.3 Light and ventilation. All portions of a building used by patients, personnel or other persons shall be provided with artifi- cial light and a mechanically operated ventilating system as specified in the California Electrical Code and the California Mechanical Code.

1227.7.4 Patient viewing windows. Each patient bedroom shall be provided with viewing windows from the corridor to allow full and unobstructed visual observation of the patient.

1227.8.1 Minimum height. 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).

1227.8.2 Minimum height with fixed ceiling equipment. 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.

1227.9.1 Floor finishes.

1227.9.1.1 Floor finishes. 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.

1227.9.1.2 Resilient flooring. If used in toilet and bathing rooms, shall be continuous and extend upward onto the walls at least 5 inches (127 mm).

1227.9.2 Wall bases.

1227.9.2.1 Materials and installation. The material and textures of bases and the installation thereof shall be such as to mini- mize 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.

1227.9.2.2 Wood bases. 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 proce- dure 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.

1227.9.3 Walls. Interior wall finishes shall be smooth, washable and durable.

1227.9.4 Ceilings. 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.

1227.10.1 Patient elevators shall have minimum inside platform dimensions of 5 feet by 8 feet (1524 mm by 2438 mm) and a mini- mum clear door opening of 4 feet, 0 inches (1118 mm).

1227.10.2 Passenger elevators shall have minimum inside platform dimensions of 4 feet, 8 inches by 7 feet, 4 inches (1422 mm by 2236 mm).

1227.10.3 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.

1227.10.4 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.

1227.10.5 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.

1227.10.6 At least one patient elevator, one passenger elevator and one service elevator shall be provided in hospitals with a capac- ity of 150 or more beds on floors other than the main entrance floor.

1227.10.7 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.

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3. A minimum floor area of .5 square feet (0.046 m [2] ) per bed, but not less than 25 square feet (2.32 m [2] ), 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.

1227.12.1 Patient bedrooms. 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 m [2] ). 2. Multi-patient rooms: 80 square feet (7.43 m [2] ) per bed.

1227.12.2 Distance. 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 multipatient rooms, and 3 feet (914 mm) in single-patient rooms.

1227.12.3 Airborne infection isolation rooms. Single rooms shall be provided for the isolation of patients with airborne communica- ble disease at a ratio of one room for each 35 beds, and for each major fraction thereof. At least one airborne infection isolation room shall be provided. Airborne infection isolation rooms shall be labeled with the words “Airborne Infection Room” on or adjacent to the anteroom side of the door between the isolation room and the anteroom.

1227.12.3.1 Alternates. 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 compro- mising any health or life-safety requirement.

1227.12.3.2 Anteroom doors. Airborne infection isolation room(s) shall have self-closing and latching devices on all anteroom doors.

1227.12.3.3 Anteroom. 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 station, 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 nega- tive 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.

1227.12.3.4 Secondary entry. 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 read- ily openable by the facility staff on the other side. When key locks are used on isolation rooms, keys shall be located at the nurse station in a prominent readily accessible location.

1227.12.3.5 Adjoining toilet facilities. 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 attach- ment with a vacuum breaker.

1227.12.3.6 Sealed-tight room. 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.

1227.12.4 Protective environment rooms. 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.

1227.12.4.1 Anteroom doors. Airborne infection isolation room(s) shall have self-closing and latching devices on all anteroom doors.

1227.12.4.2 Anteroom. 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 station, work counter at least 3 feet (914 mm) long, cabinets and space to gown and to store clean and soiled mate- rials. 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 enforce- ment 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.

1227.12.4.3 Toilet room(s). Adjoining toilet room facilities shall meet the requirements of Section 1227.12.3.5.

1227.12.4.4 Sealed-tight room. 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.

1227.12.5 Identification. Each patient room shall be labeled with an identification number, letter or combination of the two.

1227.12.6 Seclusion rooms. Seclusion rooms shall comply with the requirements of Section 1224.4.4.1 and the following:

1227.12.6.1 Seclusion rooms. 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.

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1227.12.6.2 Viewing windows. Seclusion rooms shall be provided with viewing windows to allow full and unobstructed visual observation of the patient. They shall be located near the nurse station and toilet room facilities.

1227.12.6.3 Appendages and equipment. Rooms shall be free of appendages and equipment which could facilitate suicide or self-mutilation.

1227.12.7 Nurse station. A nurse station shall be provided within each nursing unit.

1227.12.7.1 Components. Nurse stations shall be provided with a cabinet, a desk, space for records, a bulletin board, a tele- phone, and a specifically designated and lockable and illuminated medicine storage compartment and a handwashing fixture. If a separate medicine room is provided, it shall have a lockable door and a medicine sink. This sink cannot replace the required nurse station handwashing station. 1227.12.7.2 Size. Nurse stations serving 25 or less beds shall have a minimum floor area of 100 square feet (9.29 mm [2] ). Nurse stations servicing more than 25 beds shall have a minimum floor area of 125 square feet (11.6 m [2] ). The minimum dimension of any nurse station shall not be less than 8 feet (2438 mm).

1227.12.7.3 Distance. The distance between the nurse station entrance and the center of the doorway of the most remote patient bedroom shall not exceed 90 linear feet (27432 mm).

Exception: This section does not preclude designs based on primary nursing concepts incorporating more than one single nursing station of less than 100 square feet (9.29 m [2] ) each and an additional work space or station for unit clerk/receptionist junctions.

1227.12.7.4 Correctional officer. A separate space for the correctional officer may adjoin the nurse station but shall not be included in the minimum square footage requirement for a nurse station.

1227.12.8 Utility rooms. Utility rooms shall be provided in each nursing unit. Soiled and clean utility or holding rooms shall be sepa- rated and have no direct connection.

1227.12.8.1 Clean utility room. Clean utility rooms shall contain a work counter, handwashing station and storage facilities unless the room is used only for storage and holding as part of a system for distribution of clean and sterile supplies, in which case the work counter and handwashing fixture may be omitted.

1227.12.8.2 Soiled workroom or soiled holding room. Soiled utility rooms shall contain a flushing-rim clinical sink or equivalent flushing-rim device, handwashing station, work counter, waste receptacles and linen hampers unless the room is used only for the temporary holding of soiled materials, in which case the flushing-rim clinical sink, handwashing station and work counter may be omitted. However, if the flushing-rim clinical sink is omitted, other provisions for disposal of liquid waste shall be provided.

1227.12.9 Treatment and exam rooms. If treatment rooms or exam rooms are provided, they shall comply with Sections 1227.4.4 and 1227.4.5.

1227.12.10 Toilet and bath facilities. Separate toilet room facilities shall be provided for the use of patients and personnel.

1227.12.10.1 Bathroom facilities. Provide for patients in the nursing unit in at least the following ratios:

Bathtubs or showers 1:12 patients

Lavatories 1:8 patients

(Fixtures shall be equipped without aerators and may have conventional controls. Gooseneck spouts shall not be used.)

Toilets 1:6 patients

Fixtures serving individual patient rooms shall not be considered as meeting the required ratios for bedrooms not served by individual adjoining toilet rooms or bathrooms.

Changes in these ratios for wards or units in which bed patients only are to be cared for may be permitted by the enforcing

agency.

1227.12.11 Patient/nurse call system. A patient/nurse call system shall be provided in compliance with Table 1224.4.6.5 and the provisions of Section 517.123 of the California Electrical Code.

1227.13.1 Licensed pharmacy. A licensed pharmacy shall be provided and shall comply with the provisions of Section 1250.

1227.13.1.1 Entrance and waiting. If the pharmacy dispenses directly to inmates from the correctional institution, an entrance and a waiting area separate from the inpatient areas shall be provided.

1227.14.1 Dietetic service space. The dietetic service space shall accommodate the provisions of Section 1225.4.2.

Exceptions: 1. Unless the dietetic service in the correctional institution is found acceptable to the licensing agency. 2. A contractual arrangement for dietetic services with another health facility is acceptable to the licensing agency.

Office spaces shall be provided for the provisions of nursing, physician, psychiatric and psychological services.

1227.15.1 Consultation/interviews. Consultation/interview rooms shall be provided.

1227.15.2 Conference/group activities. Separate rooms or spaces shall be provided for conferences and group activities.

Exception: If conference room or space is available to the correctional treatment facility staff in the correctional institution, this room or space need not be duplicated.

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1227.16.1 Administration. An administration area shall be provided which shall provide for the following functions: 1. Waiting area. 2. Offices for the administrator and clerical personnel.

1227.16.2 Records. Spaces shall be provided which accommodate the following functions: 1. Work area for sorting and recording records, for either paper or electronic media. 2. Secure storage area for medical records, for either paper or electronic media.

1227.17.1 Minimum requirements. A central supply and sterilizing area shall be provided. Rooms and spaces shall accommodate the following services and equipment: 1. Soiled work area. A receiving and gross cleaning area which shall contain workspace and equipment for cleaning medical and surgical equipment and for disposal of or processing of soiled material. 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 space. Exception: Items 1 through 3 do not apply to facilities with contractual arrangements for outside autoclaving and sterilizing services.

4. Storage. Space for sterile supplies and unsterile supplies.

1227.17.2 Sterilizers and autoclaves. All sterilizers and autoclaves which emit 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.

1227.18.1 General storage. Correctional treatment centers shall provide combined general and specialized storage space in accor- dance with the following: 1 to 10 beds 120 square feet (11.15 m [2] ) minimum 11 to 100 beds 12 square feet (1.11 m [2] ) per bed Over 100 beds 1,200 square feet (111.48 m [2] ) plus 5 square feet (0.46 m [2] ) per bed for each bed over 100

1227.18.2 Specialized storage. Specialized storage spaces shall include the following: 1. Linen. Separate and enclosed facilities for clean and soiled linen in each nursing unit. The clean linen storage space shall have a minimum area of 10 square feet (0.93 m [2] ) and may be within the clean utility room. The soiled linen collection space shall have an area of no less than 10 square feet (0.93 m [2] ), and may be within the soiled utility room. 2. Supply. One supply storage space having a minimum area of 15 square feet (1.39 m [2] ) shall be provided in each nursing unit. Supply storage may be within the clean utility room used only as part of a system for distributing clean and sterile supplies. 3. Wheelchairs. A room or space shall be provided in each nursing unit for wheelchairs and stretchers. The wheelchair and stretcher space shall have a minimum area of 15 square feet (1.39 m [2] ). 4. Storage. Sterile and unsterile supplies shall be stored separately.

1227.19.1 Minimum facilities. Correctional treatment centers shall provide the following: 1. Dressing rooms. Separate dressing rooms for male and female personnel with lockers, lavatory and toilet(s).

Exception: If provided for the correctional treatment center staff in adjacent correctional institutions, dressing rooms and lockers need not be duplicated.

1227.20.1 A securely lockable housekeeping room with service sink and supply storage spaces shall be provided in each nursing unit.

OPTIONAL SERVICES.

Service spaces, such as laboratory, radiology and any other services approved by the licensing agency, shall comply with the applicable space requirements of Sections 1224 and 1225. Service spaces shall also comply with applicable provisions of the California Building Standards Administrative Code (Part 1).

The following shall be provided or made available to an outpatient service space.

1227.22.1 Waiting. Waiting area(s) shall be provided with access to toilet room facilities and a drinking fountain both meeting the requirements of Sections 1231.3.1, 1231.3.2 and 1231.3.3.

1227.22.1.1 Holding cell. If a temporary holding cell or room is used for this purpose, it shall comply with Section 1231.2.2. Exception: The minimum floor area shall be 80 square feet (7.43 m [2] ).

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1227.23.1 Program/dining space. Provide within the Correctional Treatment Center for use by mental health treatment program patients, as is consistent with security requirements. Program/dining space shall be provided with a minimum floor area of 30 square feet (2.79 m [2] ) per patient served at a given time.

1227.23.2 Mental health treatment. Correctional treatment centers providing a mental health treatment program shall include one seclusion room providing direct observation of every portion of the room for every 15 mental health beds and for each major fraction thereof. At least one seclusion room shall be provided.