Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 30 - Division of Regulation and Licensure › Chapter 90 - Adult Day Care Program Licensure › Section 19 CSR 30-90.070 - Fire Safety and Facility Physical Requirements

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the minimum physical
				  and maintenance requirements for facilities in which adult day care programs
				  are operated.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. This material as incorporated by reference in this rule shall be
				  maintained by the agency at its headquarters and shall be made available to the
				  public for inspection and copying at no more than the actual cost of
				  reproduction. This note applies only to the reference material. The entire text
				  of the rule is printed here.
(1) Facility Physical Requirements.
(A) The adult day care program building shall
				be safe and suitable for participants. The building in which the program is
				located shall be clean, of sound construction and maintained in good
				repair.
(B) Minimum space
				requirements shall be eighty (80) square feet per participant, for up to twenty
				(20) participants and an additional fifty (50) square feet per each additional
				participant. Space requirements do not include office space, bathrooms,
				storage, examining rooms or dining rooms, unless the latter is also used for
				activities. For associated adult day care programs, the required space shall be
				designated and in excess of the particular facility's required licensed space
				for providing long-term care or medical care. For adult day health care
				programs, the required space, regardless of the number of participants, shall
				not be less than three hundred twenty (320) square feet of space.
(C) The facility shall have a room of
				sufficient size to meet the needs of the participants based on minimum
				standards where all of the participants can gather as well as rooms or divided
				areas for small group activities, including a quiet area for rest, which
				contains at least one (1) bed for temporary use by participants when
				needed.
(D) Furniture shall be of a
				size and design so that it is easily used by persons with limited agility. It
				shall be sturdy and secure so that it cannot easily tip when used for support
				while walking or sitting. At a minimum, the following shall be provided:
1. One (1) chair for each participant and
				staff person;
2. Table space
				adequate for all participants to be served a meal at a table at the same
				time;
3. Reclining lounge chairs or
				other sturdy comfortable furniture, the number to be determined by the needs of
				the participants; and
4. At least
				one (1) bed with adequate privacy in a quiet area to be available for temporary
				use by participants as needed.
(E) Equipment and supplies shall be adequate
				to meet the needs of participants including items necessary for personal care
				and materials to encourage activities among participants. The activity
				materials shall be geared to the interests and backgrounds of the
				participants.
(F) Ventilation by
				natural or mechanical means shall be provided. All screen doors shall be
				equipped with self-closing devices and shall fit tightly. Doors and windows and
				other openings to the outside shall be screened when necessary to prevent
				entrance of insects and vermin.
(G)
				The heating system for adult day care facilities initially licensed prior to
				December 1, 2004 shall be in compliance with the applicable provisions of the
				2000
Life Safety Code
for existing occupancies (NFPA 101),
				incorporated by reference in this rule, as published by the National Fire
				Protection Agency, 1 Batterymarch Park, PO Box 9101, Quincy, MA 02269-9101 and
				all state and local codes. This rule does not incorporate any subsequent
				amendments or additions. Heating systems for adult day care facilities
				initially licensed on or after December 1, 2004 shall be in compliance with the
				applicable provisions of the 2000
Life Safety Code
for New Day
				Care Occupancies, incorporated by reference in this rule, as published by the
				National Fire Protection Agency, 1 Battery-march Park, PO Box 9101, Quincy, MA
				02269-9101 and all state and local codes. This rule does not incorporate any
				subsequent amendments or additions. Exposed heating pipes, hot water pipes or
				radiators in rooms and areas used by participants shall be covered or
				protected, and insulated when appropriate. Portable space heaters shall not be
				used. Room temperatures shall be maintained between sixty-eight degrees
				Fahrenheit (68oF) and eighty-five degrees Fahrenheit
				(85oF) in all seasons. The reasonable comfort needs
				of individual participants shall be met.
(H) Illumination shall be adequate in all
				areas and commensurate with the type of activity. Glare shall be kept at a
				minimum by providing window coverings at all windows exposed to direct sunlight
				and using shaded light fixtures.
(I) All plumbing and plumbing fixtures shall
				conform to applicable local codes. There shall be no cross-connection between
				the potable water supply and any source of pollution through which the potable
				water supply might become contaminated.
(J) An adequate supply of water, the source
				of which is approved by the state water control authority, under sufficient
				pressure to properly serve the facility shall be provided. The potable water
				system shall be installed to preclude the possibility of backflow.
(K) Drinking water shall be easily accessible
				to the participants and provided by either an angle jet drinking fountain with
				mouth guard or by a running water supply with individual service drinking cups.
				Drinking facilities shall not be located in a toilet room.
(L) At least one (1) toilet and handwashing
				sink shall be provided for each ten (10) participants or any additional
				fraction thereof. The handwashing sink shall be in close proximity to each
				toilet and shall have hot and cold running water. The water temperature shall
				be maintained between one hundred degrees Fahrenheit
				(100oF) and one hundred fifteen degrees Fahrenheit
				(115oF). The toilet room shall be within easy access
				of the activity areas and afford the participants privacy. Each toilet room
				shall be equipped with approved natural or mechanical ventilation. All toilets
				shall have grab-rails. Individual paper towels, a trash receptacle, soap and
				toilet paper shall be provided at all times and shall be within reach of the
				participants.
(M) If persons using
				wheelchairs or persons with other physical disabilities are accepted, or the
				building in which the facility is located is otherwise required to comply with
				the Americans with Disabilities Act (ADA), the facility shall have ramps or
				other means of accessibility to the adult day care facility for persons with
				disabilities, and shall meet the standards of the
ADA Standards for
				Accessible Design
which are available at
www.usdoj.gov/crt/ada/adastd94.pdf
.
(N) Stairways and hallways shall be kept free
				of obstructions and shall be well lighted. All stairways and ramps shall have
				nonslip surface or treads. All inside and outside stairs and ramps shall have
				handrails.
(O) All rugs and floor
				coverings shall be secured to the floor. Throw rugs shall not be used. All
				equipment and furnishings shall be safe and maintained in good
				condition.
(P) The adult day care
				program shall provide necessary services to maintain the building or portion of
				the building in which the adult day care program is located in good repair and
				in a safe, clean, orderly and sanitary manner.
(Q) Drugs, cleaning agents, pesticides and
				poisonous products shall be stored apart from food, out of the reach of the
				participants, and shall be used in a manner which assures the safety of
				participants and staff.
(R)
				Wastebaskets and trash containers shall be made of noncombustible or
				fire-resistant material. Garbage and other waste shall be stored and disposed
				of in an appropriate manner.
(S)
				The facility shall be maintained free of insects and rodents. Control measures
				shall be implemented to prevent rodent and insect infestation.