Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 551 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS › Subchapter D - GENERAL REQUIREMENTS FOR FACILITY CONSTRUCTION › Section 551.68 - Architectural Space Planning

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Large facilities.
(1) Ancillary resident
				  space. The minimum total ancillary resident-use space must be not less than 35
				  square feet per resident. Ancillary space includes areas for living, dining,
				  recreation, therapy, training, and other such program areas. It does not
				  include bedrooms, passageways, offices, kitchens, or laundries (more than 35
				  square feet per resident is usually needed in facilities with less than 60
				  residents ). A facility which has large proportions (approximately 65 percent
				  or greater) of nonambulatory or bedfast residents must provide at least 50
				  square feet of ancillary space per resident unless otherwise approved by HHSC.
				  An area providing less space than called for in this paragraph cannot be
				  approved except on an individual basis where clearly justified.
(2) Resident bedrooms.
(A) A bedroom must be arranged and equipped
				  for adequate personal care and for comfort and privacy. A bedroom must have
				  full height walls that extend from floor to ceiling with doors. (Partial
				  partitions or furnishings are not a substitute.) An exception is that an
				  existing facility constructed prior to October 3, 1988, that has partial
				  partitions in lieu of full-height walls, need not install the full-height walls
				  unless there are major renovations or conversions.
(B) A bedroom must provide at least 80 square
				  feet for a single occupancy (one resident ) and 60 square feet per resident for
				  multiple occupancy. (Note: room configuration and usability are taken into
				  consideration and there may be instances where the minimum square footage will
				  not be acceptable.) The minimum room dimension must be at least eight feet for
				  a single resident room and at least ten feet for a multiple-resident room,
				  unless otherwise approved by HHSC. An exception is that a multi-occupancy
				  bedroom for persons in wheelchairs must have 70 square feet per resident
				  .
(C) No more than four residents
				  may be in any one bedroom. An exception is HHSC may grant a variance from the
				  limit of four residents per room only if a physician who is a member of the IDT
				  and who is a qualified intellectual disability professional (QIDP):
(i) certifies that each resident to be placed
				  in a bedroom accommodating more than four residents is so severely medically
				  impaired as to require direct and continuous monitoring during sleeping hours;
				  and
(ii) documents the reasons why
				  accommodating in a room of only four or fewer residents would not be medically
				  feasible.
(D) In the
				  bedroom and for each resident there must be a bed with a comfortable mattress
				  and appropriate bedding, functional furniture appropriate to residents' needs,
				  and closet space providing security and privacy for clothing and personal
				  belongings. Closet space must provide at least 24 inches of lineal hanging
				  space per resident (in certain cases, such as for infants, exceptions may be
				  made). Married couples may share a bed.
(E) Each bedroom must have at least one
				  outside wall with an operable window giving outside exposure. Unless approved
				  otherwise by the HHSC, the window sill of the required window must be no higher
				  than 44 inches from the floor and must be at or above outside grade level.
				  Other window requirements must be as called for in NFPA 101. The window area
				  for a bedroom must be equal to at least 10 percent of the total room floor
				  area.
(F) If a bedroom is below
				  grade level, it must have a window that is usable as a second means of escape
				  by a resident occupying the room. The window must be no more than 44 inches
				  (measured to the window sill) above the floor.
(G) A resident bedroom must open onto an exit
				  corridor, living area, or public area and must be arranged for convenient
				  resident access to dining, living, and bathing areas.
(3) Social-diversional spaces.
(A) A living room, a day room, a lounge, or
				  other social-diversional space, must be provided on a sliding scale as follows
				  (as part of the minimum required ancillary space):
Attached Graphic
(B) Where a required way of exit
				  is through a living area, a pathway equal to the corridor width will normally
				  be deducted from that area. Such exit pathways must be kept clear of
				  obstructions.
(C) Each living room
				  and dining room must have at least one outside window. Normally, a resident
				  classroom and a training area must also have an outside window unless otherwise
				  approved by HHSC.
(4)
				  Dining space. Dining space must provide at least 15 square feet per resident
				  for single-shift feeding. If procedure is approved for feeding in two shifts,
				  at least eight square feet per resident must be provided.
(5) Training spaces including academic,
				  behavioral, occupational, physical, and speech therapy spaces. Classroom type
				  space is anticipated for most training activities. The number and size of such
				  spaces will be evaluated on an individual facility basis and according to
				  program policies and procedures. Generally, a training room must provide at
				  least 20 square feet per resident trainee within the room except that no
				  training room may be less than 80 square feet. For purposes of calculation,
				  space must be provided for at least one-third of the total population at any
				  one time (i.e., plan space for 33 residents in a 100-resident
				  facility).
(6) Kitchens
				  (main/dietary).
(A) A kitchen must be
				  evaluated based on its performance in the sanitary and efficient preparation
				  and serving of meals to residents. Consideration must be given to planning for
				  the type of meals served, the overall building design, the food service
				  equipment, arrangement, and the work flow involved in the preparation and
				  delivery of food. Plans for construction of new facilities must contain a
				  detailed kitchen layout prepared by, or under the direction of, a registered or
				  licensed dietitian.
(B) A kitchen
				  must be designed so that room temperature, at peak load, must not exceed an
				  average temperature of 85 degrees Fahrenheit measured over the room at the
				  five-foot level. The amount of supply air must take into account the large
				  quantities of air exhausted at the range hood and dishwashing area.
(C) A kitchen must be provided with
				  operational equipment as planned and scheduled by the facility's consultants
				  for preparing and serving meals and for refrigerating and freezing perishable
				  foods, as well as equipment in, or adjacent to, the kitchen or dining area for
				  producing ice.
(D) A kitchen must
				  be provided with facilities for washing and sanitizing dishes and cooking
				  utensils. Such facilities will be provided for the number of meals served and
				  the method of serving (permanent or disposable dishes, etc.). The kitchen must
				  contain a compartmented sink large enough to immerse pots and pans. Separation
				  of soiled and clean dish areas must be maintained, including air flow.
(i) A mechanical dishwasher must be used to
				  sanitize dishes and utensils and must meet the requirements specified under 25
				  TAC Chapter 228; or
(ii) Dishes and
				  utensils must be manually sanitized in accordance with 25 TAC Chapter 228 prior
				  to placement in the dishwasher.
(E) A kitchen must be provided with a supply
				  of hot and cold water. Hot water for sanitizing purposes must be 180 degrees
				  Fahrenheit or the manufacturer's suggested temperature for chemical sanitizers,
				  as specified for the system in use. For a mechanical dishwasher, the
				  temperature measurement is at the manifold.
(F) A kitchen must be provided with at least
				  one hand-washing lavatory or hand-sanitizing device. A hand-washing lavatory
				  must be provided with hot and cold running water, soap, and individual towels,
				  preferably paper towels; common use towels must not be used.
(G) In new construction, a staff restroom
				  facility with a lavatory must be accessible to kitchen staff without traversing
				  resident use areas. The restroom door must not open directly into the kitchen,
				  e.g., provide a vestibule.
(H) In
				  new construction, a janitorial facility must be provided exclusively for the
				  kitchen and must be located in and entered from the kitchen.
(I) Nonabsorbent smooth finishes or surfaces
				  must be used on kitchen floors, walls, and ceilings. Such surfaces must be
				  capable of being sanitized to maintain a healthful environment.
(J) All operable window openings must be
				  screened. A door opening to the outside of the building must have self-closing
				  devices.
(7) Food storage
				  areas (main/kitchen).
(A) In new construction,
				  a food storage area must be planned based on the number and type of resident
				  meals to be served. The size and layout of dry foods storage must be prepared
				  by or designed under the direction of a licensed or registered
				  dietitian.
(B) Food storage areas
				  must provide for storage of a four-day minimum supply of nonperishable foods at
				  all times.
(C) Shelves must be
				  movable metal or sealed lumber, and walls must be finished with a nonabsorbent
				  finish to provide a cleanable surface.
(D) Dry food storage must have an approved
				  venting system to provide for positive air circulation.
(E) The maximum room temperature for food
				  storage must not exceed 85 degrees Fahrenheit at all times. The measurement
				  must be taken at the five-foot level.
(F) Food storage areas may be located apart
				  from the food preparation area as long as there is space adjacent to the
				  kitchen for necessary daily stores.
(8) Food services areas.
(A) Where a service area other than the
				  kitchen is used to dispense foods, this must be designated as a food service
				  area and must have equipment for maintaining required food temperatures while
				  serving.
(B) A separate food
				  service area must have hand-washing facilities as a part of the food service
				  area. An employee toilet must be provided.
(C) Finishes of all surfaces except ceilings
				  must be the same as those required for dietary kitchens.
(9) Other spaces.
(A) A bathing unit (tubs or showers) must be
				  provided at a minimum ratio of one per 15 residents. Toilets and sinks must be
				  provided at a minimum ratio of one per eight residents. Bathing and toilet
				  facilities must be of a type appropriate to the resident's varying needs and
				  disabilities and designed for privacy within the bathroom.
(B) Adequate storage space must be provided
				  for equipment, carts, wheelchairs, etc., to eliminate the problem of such items
				  being left or stored in corridors, or overcrowding bedroom space.