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Document Citation: 59A-11.023, F.A.C.
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FLORIDA ADMINISTRATIVE CODE
TITLE 59 AGENCY FOR HEALTH CARE ADMINISTRATION
59A HEALTH FACILITY AND AGENCY LICENSING
CHAPTER 59A-11 BIRTH CENTER STANDARDS AND LICENSURE
Date:
08/31/2009
Document:
59A-11.023 Physical Environment, Water Supply and Fire Safety.
(1) At least one birthing room shall be maintained which is adequate and appropriate to provide for the equipment, staff, supplies and emergency procedures required for the physical and emotional care of a maternal client, her support person and the newborn during labor, birth, and the recovery period.
(2) The birth center shall be designed to provide adequate space for the following:
(a) Birth rooms shall be located to provide unimpeded, rapid access to an exit of the building which will accommodate emergency transportation vehicles;
(b) Adequate fixed or portable work surface areas shall be maintained for use in the birth room;
(c) A separate space for a clean area and a contaminated area; if it is not feasible to provide such separate areas, special procedures shall be established for the disposal of infectious waste. Sanitary waste containers, soiled linen containers, storage cabinets, and an autoclave, pressure cooker, or other effective sterilization equipment shall be available;
(d) Prenatal and postpartum examinations which will provide privacy for the patient, hand washing facilities and the appropriate equipment for staff; and
(e) Medical record storage, client interviews, instruction, and waiting rooms.
(3) Toilet and bathing facilities.
(a) A toilet and lavatory shall be maintained in the vicinity of the birth room.
(b) Hand washing facilities shall be in or immediately adjacent to the birth room.
(c) A bathtub or shower shall be available for client use.
(d) All floor surfaces, wall surfaces, water closets, lavatories, tubs, showers, shall be kept clean, and all appurtenances of the structures shall be of sound construction, properly maintained, in good repair, and free from safety hazards.
(4) There shall be provisions and facilities for secure storage of personal belongings and valuables of clients.
(5) There shall be provisions for visual privacy for each maternal client and her support person.
(6) Hallways and doors providing access and entry into the birth center and birth room shall be of adequate width and conformation to accommodate maneuvering of ambulance stretchers and wheelchairs.
(7) All areas of the facility shall be well lighted and shall have light fixtures capable of providing at least 20 footcandles of illumination at 30 inches from the floor to permit observation, cleaning and maintenance. Light fixtures shall be properly maintained and kept clean.
(8) All housing facilities shall have adequate ventilation and be kept free of offensive odors.
(a) If natural ventilation is utilized, the opened window area for ventilation purposes shall be equal to one-tenth of the floor space in the residential area.
(b) When mechanical ventilation or cooling systems are employed, the system shall be properly maintained and kept clean. Intake air ducts shall be designed and installed so that dust or filters can be readily removed. In residence areas and segregation rooms with solid doors, mechanical ventilation systems shall provide a minimum of ten cubic feet of fresh or filtered recirculated air per minute for each client occupying the area.
(c) All toilet rooms shall be provided with direct openings to the outside or provided with mechanical ventilation to the outside.
(9) Adequate heating and cooling facilities shall be provided to maintain a minimum temperature of 68 degrees Fahrenheit and maximum temperature of 78 degrees Fahrenheit at a point 20 inches above the floor.
(10) All heating devices shall comply with fire prevention provisions found in Chapter 4A-3, F.A.C., April 8, 1990, promulgated pursuant to Chapter 633, F.S.
(11) Laundry.
(a) Where laundry facilities are provided, clean clothing, bed linens, and towels shall be available for the patients. Laundry facilities shall be of sound construction and shall be in good repair and clean. Adequate space shall be provided and areas shall be designated for the separation of clean and soiled clothing, linen and towels.
(b) Laundry rooms shall be well lighted and properly ventilated. Clothes dryers shall be vented to the exterior. Carts used for transporting dirty clothes, linens, and towels shall not be used for transporting clean articles unless they have been thoroughly cleaned.
(c) If laundry facilities are not available, sheets and blankets shall be cleaned by commercial laundries.
(12) Bedding. Beds and beddings shall be kept in good repair, cleaned and sanitized whenever soiled. Mattresses and pillows shall have cleanable covers which shall be cleaned and sanitized between use by different clients. Clean sheets shall be used for each client. Blankets shall be washed or dry cleaned whenever soiled. Sheets, blankets, and clean clothing shall be stored in a clean, dry place between laundering and use.
(13) The grounds and all buildings on the grounds shall be maintained in a safe and sanitary condition.
(14) Insect and Rodent Control. Facilities shall be kept free of all insects and rodents. All outside openings shall be effectively sealed or screened with sixteen mesh screening or equivalent to prevent entry of insects or rodents. All pesticides used to control insects or rodents shall be applied in accordance with instructions on the registered product label. Persons applying restricted use pesticides shall be certified by the department. Facilities not having certified pest control operators shall utilize commercial licensed pest control companies when using restricted use pesticides.
(15) Outdoor Areas. Outdoor areas shall be well drained and kept free of litter and trash. Indoor and outdoor recreational areas shall be provided with safeguards designed for the needs of the residents.
(16) Poisonous or Toxic Substances. Poisonous or toxic compounds are to be stored apart from food and other areas that would constitute a hazard to the residents.
(17) Water Supply.
(a) Water supplies shall be adequate to serve the demands of the facility and shall be constructed, operated and maintained in accordance with requirements of Chapter 62-555 or 10D-4, F.A.C.
(b) Drinking water shall be accessible to all clients. When drinking fountains are available, the jet of the fountain shall issue from a nozzle of non-oxidizing impervious material set at an angle from the vertical. The nozzle and every other opening in the water pipe or conductor leading to the nozzle shall be above the edge of the bowl so that such nozzle or opening will not be flooded in case a drain from the bowl of the fountain becomes clogged. The end of the nozzle shall be protected by non-oxidizing guards to prevent persons using the fountain from coming into contact with the nozzle. Vertical or bubbler drinking fountains shall be replaced with approved type water fountains or be disconnected. When no approved drinking fountains are available, clients shall be provided with single service cups which shall be stored and dispensed in a manner to prevent contamination. Common drinking cups are prohibited.
(c) Hot and cold running water under pressure and at safe temperature, not to exceed 110 degrees Fahrenheit to prevent scalding, shall be provided to all restrooms, lavatories and bathing areas.
(18) Sewage Disposal.
(a) All sewage and liquid waste shall be disposed of in accordance with Chapter 62-600 or 10D-6, F.A.C.
(b) All sanitary facilities shall comply with the requirements of Chapter 10D-10, F.A.C.
(c) All plumbing shall comply with the requirements of Chapter 10D-9, F.A.C., or the plumbing code legally applicable to the area where the facility is located.
(d) For facilities with nine or more birth rooms, mop sinks or curbed areas with floor drains shall be available in convenient locations throughout the facility to facilitate cleaning and for the proper disposal of cleaning water.
(19) Waste Disposal.
(a) All garbage, trash and rubbish from residential areas shall be collected daily and taken to storage facilities. Garbage shall be removed from storage frequently enough to prevent a potential hazard or at least twice per week. Wet garbage shall be collected and stored in impervious, leak proof, fly tight containers pending disposal. All containers, storage areas and surrounding premises shall be kept clean and free of vermin.
(b) If public or contract garbage collection service is available, the facility shall subscribe to these services unless the volume makes on-site disposal feasible. If garbage and trash are disposed of on premises, the method of disposal shall not create sanitary nuisance conditions and shall comply with provisions of Chapters 62-701 and 10D-6, F.A.C.
(20) Fire Control. Each birth center shall provide fire protection through the elimination of fire hazards, the installation of necessary safeguards such as extinguishers and smoke alarms to insure rapid and effective fire control, and the adoption of written fire control plans rehearsed four times a year by all personnel.
(a) To safeguard all clients, the birth center shall have:
1. Written evidence of regular inspection by local fire control agencies;
2. Annual check of fire extinguishers for type, replacement, and renewal dates;
3. "No Smoking" signs prominently displayed in those areas where smoking is not permitted; and
4. Fire regulations and evacuation route prominently posted.
(b) The written fire control plan approved by the appropriate local fire authority shall contain provisions for prompt reporting of all fires, extinguishing fires, protection of personnel and guests, evacuation, and cooperation with fire fighting authorities.
(c) New centers' carpeting must comply with the maximum flame-spread rating of seventy-five in accordance with American Society for Testing Material (ASTM) E-84-68 test as required under Title Chapter 4A, F.A.C. Those existing centers not having affirmative evidence of complying with such flame-spread rating shall establish fire control measures including the prohibition of smoking in carpeted areas. Such procedures shall be approved by the appropriate local fire authority.
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