Section 1228 — [OSHPD 5]—ACUTE PSYCHIATRIC HOSPITALS

An acute psychiatric hospital shall meet the requirements of Section 1228 for a non-medical unit based on the func- tional program. Specific application shall respond to the patient injury and suicide prevention component of the Patient Safety Risk Assessment prepared under California Administrative Code (Part 1 of Title 24) Section 7-119. If a psychiatric facility or unit provides acute medical care, it shall comply with Section 1224.31. New buildings and additions, alterations or repairs to existing buildings subject to licensure shall comply with applicable provisions of the California Electrical Code, California Mechanical Code, California Plumbing Code, California Energy Code, California Fire Code (Parts 3, 4, 5, 6 and 9 of Title 24) and this section.

Note: Refer to the applicable exceptions under Section 1224.2.

1228.2.1 Functional program. Refer to California Administrative Code (Part 1 of Title 24), Section 7-119, Functional Program, for requirements. Projects associated with acute psychiatric hospitals and with psychiatric nursing units in general acute-care hospitals shall include a Patient Safety Risk Assessment.

The definitions provided under Section 1224.3 apply to this section except as modified below:

ACUTE PSYCHIATRIC HOSPITAL. Acute psychiatric hospital means a hospital having a duly constituted governing body with overall administrative and professional responsibility and an organized medical staff which provides 24-hour inpatient care for mentally disor- dered, incompetent or other patients referred to in Division 5 (commencing with Section 5000) or Division 6 (commencing with Section 6000) of the Welfare and Institutions Code, including the following basic services: medical, nursing, rehabilitative, pharmacy and dietary services.

BASIC SERVICES. Basic services mean those essential services required by law for licensure as an acute psychiatric hospital including medical, nursing, rehabilitative, pharmaceutical, dietary and support services.

HOSPITAL. Hospital, where used in this section, means an acute psychiatric hospital.

SALLY PORT. A compartment provided with two or more doors where the intended purpose is to prevent continuous and unobstructed passage by allowing the release of only one door at a time.

TAMPER RESISTANT means designed to prevent damage, destruction or interference or indicates the product is designed to withstand dismantling, removal of the product, or interference with the operation of the product.

Acute psychiatric hospitals shall comply with the provisions under Section 1224.4, General Construc- tion, where applicable, except as supplemented, amended or modified below. Specific application shall respond to the patient injury and suicide prevention component of the Patient Safety Risk Assessment prepared under California Administrative Code (Part 1 of Title 24), Section 7-119.

1228.4.1 Jurisdiction.

1228.4.1.1 Services/systems and utilities. Services/systems and utilities shall only originate in, pass through or under structures which are under the jurisdiction of the Office of Statewide Hospital Planning and Development (OSHPD).

1228.4.1.2 Means of egress. Means of egress shall only pass through structures that are under the jurisdiction of the Office of Statewide Hospital Planning and Development (OSHPD).

1228.4.2 Reserved.

1228.4.3 Reserved.

1228.4.4 Support areas for patients.

1228.4.4.1 Examination and treatment rooms.

1228.4.4.1.1 Examination room. Examination rooms in acute psychiatric hospitals shall meet the requirements of Section 1224.4.4.1.1 as amended below:

1228.4.4.1.1.1 Location. Examination rooms shall be permitted to serve several nursing units and shall be permitted to be on a different floor, unless prohibited by specific sections of this code or by the Patient Safety Risk Assessment. 1228.4.4.1.1.2 Space requirements. Examination rooms shall have a minimum clear floor area of 120 square feet (11.15 m [2] ).

1228.4.4.1.2 Treatment room. Where provided, refer to Section 1224.4.4.1.2.

1228.4.4.1.3 Airborne infection isolation exam/treatment room. Where provided, refer to Section 1224.4.4.1.3.

1228.4.4.1.4 Seclusion room. Refer to Section 1224.4.4.1.5.

1228.4.4.1.5 Quiet room . Where provided, a quiet room for a single patient who requires a period of solitude but does not require a seclusion room, shall have a minimum clear floor area of 80 square feet (7.43 m [2] ).

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1228.4.4.2 Reserved.

1228.4.4.3 Specimen and blood collection facilities. Where provided, refer to Section 1224.4.4.3.

1228.4.4.4 Medication station. Refer to Section 1224.4.4.4.

1228.4.4.5 Nourishment area or room. Refer to Section 1224.4.4.5.

1228.4.4.6 Clean utility/work room. Refer to Section 1224.4.4.6.

1228.4.4.7 Soiled utility/work room. Refer to Section 1224.4.4.7.

1228.4.5 Outpatient waiting rooms. Where provided, refer to Section 1224.4.5.

1228.4.6 Miscellaneous requirements. Refer to Section 1224.4.6 for requirements regarding station outlets, gas and vacuum systems, hyperbaric facilities, laboratories and nurse call systems.

1228.4.7 Corridors. Refer to Section 1224.4.7.

1228.4.8 Doors and door openings. Refer to Section 1224.4.8 with the following modifications and amendments: 1. Where indicated by the Patient Safety Risk Assessment, toilet room doors shall be equipped with keyed locks that allow staff to control access to the toilet room.

2. Use of door closers is to be avoided unless required by other sections of this code. 3. Door hinges shall be designed to minimize accessible anchor points (e.g., cut hinge type, piano hinge, concealed hinge, etc.). 4. Except for specifically designed ligature-resistant hardware, door lever handles shall point downward when in the latched and in the unlatched position. 5. All hardware shall have tamper-resistant fasteners. 6. Soft doors may be used for patient room toilets where indicated in the Patient Safety Risk Assessment.

1228.4.9 Windows and screens.

1. Windows located in patient care areas or areas used by patients, shall limit the opportunities for patients to inflict harm to themselves or others.

1.1. All glazing (interior and exterior) shall be fabricated with polycarbonate or laminate on the inside of the glazing or with any glazing that meets or exceeds the requirements for Class 1.4 per ASTM F1233-08 (2013), Standard Test Method for Security Glazing Material and Systems. Translucent film may be used up to 60 inches (1524 mm) for privacy. Exception: Use of tempered glass for interior borrowed lights shall be permitted where allowed by the Patient Safety Risk Assessment. 1.2. Where window treatments are provided, they shall be designed without accessible anchor points. 1.3. Where operable windows are provided in patient rooms or suites, openings shall be limited to prevent the passage of a 4-inch (102 mm) sphere. 2. Anchorage for windows and window assemblies (including frames, hinges and locking devices) shall be designed to resist impact loads applied from the inside and shall be tested in accordance with ANSI Z97.1, Safety Glazing Materials Used in Buildings. 3. A minimum net glazed area of not less than 8 percent of the floor area of each indoor activity space and dining space shall be provided for observation from nurse station.

1228.4.10 Ceiling heights. Refer to Section 1224.4.10 unless noted otherwise.

1228.4.11 Interior finishes. Interior finishes shall comply with Section 1224.4.11 as amended in this section. Special design consider- ation shall be given to injury and suicide prevention in the context of the Patient Safety Risk Assessment.

1228.4.11.1 Reserved.

1228.4.11.2 Reserved.

1228.4.11.3 Reserved.

1228.4.11.4 Ceilings. Refer to Section 1224.4.11.4 with the following modifications and amendments:

Ceilings shall be monolithic in seclusion rooms, exam/treatment rooms, patient bedrooms, patient toilet rooms or patient bathing facilities. 1. In these rooms, the ceiling shall be secured from patient access. 2. Mechanical, electrical and plumbing systems, other than terminal elements serving the room (e.g., diffusers, registers, luminaires, etc.), shall be concealed above the ceiling.

ilings shall be monolithic in seclusion rooms, exam/treatment rooms, patient bedrooms, patient toilet rooms or patient_ bathing facilities. 1. In these rooms, the ceiling shall be secured from patient access. 2. Mechanical, electrical and plumbing systems, other than terminal elements serving the room (e.g., diffusers, registers, luminaires, etc.), shall be concealed above the ceiling.

1228.4.12 Courts. Refer to Section 1224.4.12.

1228.4.13 Elevators. Refer to Section 1224.4.13.

1228.4.14 Garbage, solid waste and trash storage. Refer to Section 1224.4.14.

1228.4.15 Housekeeping room. Refer to Section 1224.4.15.

1228.4.16 Laundry and trash chutes. Refer to Section 1224.4.16.

1228.4.17 Telephones. Refer to Section 1224.4.17.

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1228.4.18 Grab bars. Refer to Section 1224.4.18 with the following modifications and amendments: 1. Grab bars, including those that are part of fixtures such as soap dishes, shall be sufficiently anchored to sustain a concen- trated load of 250 pounds (113.4 kg). 2. Grab bars shall be graspable and shall be ligature resistant.

1228.4.19 Noise control. Refer to Section 1224.4.19.

1228.4.20 Built-in furnishings. Built-in furnishings in areas accessible to patients shall comply with the following requirements: 1. Built-in furnishings with doors or drawers shall not be provided. 2. Open shelves shall be fixed with tamper-resistant hardware. 3. When provided, clothing rods or hooks shall be ligature resistant. 4. The following are not permitted:

4.1. Towel bars.

4.2. Shower curtain rods.

4.3. Lever handles, except where a specifically designed ligature-resistant lever handle is used.

1228.4.21 Building systems.

1228.4.21.1 Lighting. Lighting in areas identified in the Patient Safety Risk Assessment as high- and medium-risk areas shall be tamper resistant. Refer to California Electrical Code.

1228.4.21.2 Receptacles. When electrical receptacles are provided in a patient bedroom, the receptacles shall be in compliance with California Electrical Code.

1228.4.22 Handwashing stations. All handwashing fixtures that are accessible to patients, including those located in patient rooms and patient toilet rooms, shall include ligature-resistant features that do not compromise compliance with the hot and cold water supply controls, laminar flow and sink requirements of the California Plumbing Code. Handwashing fixtures within patient rooms and patient toilet rooms in psychiatric nursing units are not required to be equipped with gooseneck spouts and the discharge point may be less than 5 inches (127 mm) above the fixture rim.

BASIC SERVICES.

The psychiatric rehabilitation activities service space may be centralized for common use or may be located in each nursing unit in response to the Patient Safety Risk Assessment. The following areas are required in the psychiatric rehabilitation activities service space:

1228.13.1 Patient care areas.

1228.13.1.1 Indoor activity rooms. 1. At least two separate activity rooms, one appropriate for group recreation and one for quiet activities to serve as a patient lounge, shall be provided. 2. Space requirements. The combined area of these rooms shall have a minimum of 25 square feet (2.32 m [2] ) per patient bed, with at least 120 square feet (11.15 m [2] ) of clear floor area for each of the two spaces.

1228.13.1.2 Outdoor activity area. An outdoor activity area shall be provided. Outdoor areas shall meet the following requirements: 1. Fences and walls shall be designed to: 1.1. Be installed with tamper-resistant hardware. 1.2. Have a minimum height of 10 feet (3048 mm) above the outdoor area elevation. 1.3. Be anchored and constructed to withstand the body force of a 350-pound (158-kg) person. 2. If provided, gates or doors in the fence or wall shall: 2.1. Swing away from the outdoor activity area. 2.2. Have the hinge installed on the outside of the outdoor activity area. 2.3. Be provided with a locking mechanism that has been coordinated with egress requirements of Section 1004.5, Outdoor areas.

3. Lights shall not be accessible to patients. Lighting in the outdoor activity area shall not be pole mounted. 4. If provided, security cameras shall not be accessible to patients and cameras shall view the entire outdoor activity area.

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5. If provided, furniture shall be secured from movement. Furniture shall not be placed in locations where it can be used to climb the fence or wall.

1228.13.1.3 General support areas. 1. Space for staff conferences, patient evaluation and progress reports. 1.1. Staff conference room. A conference and treatment planning room shall be provided. 1.2. Office space separate from the activities area. 2. Where outpatients are treated, there shall be a waiting area compliant with the requirements of Section 1228.4.5.

1228.13.2 Physical therapy service space. Where provided, the physical therapy service space shall comply with Section 1224.35.2.

1228.13.3 Occupational therapy service space. Where provided, the occupational therapy service space shall comply with Section 1224.35.3, Items 1, 2 and 3.

1228.13.4 Speech pathology and/or audiology service space. Where provided, the speech pathology service space shall comply with Section 1224.35.4.

Psychiatric nursing units shall comply with the requirements of this section. If the nursing unit is a locked unit, the primary access point to the unit shall be through a sally port. For “secure treatment facilities,” alternate designs for locked unit access without individual sally ports may be approved by the enforcement agency when it can be demonstrated that the alternate design meets performance requirements without compromising any health or life-safety requirement.

1228.14.1 Patient rooms. Each patient bedroom shall meet the following standards:

1228.14.1.1 Capacity. Maximum room capacity shall be two patients.

Exception: Where renovation of existing individual acute psychiatric hospital patient rooms is undertaken in facilities built under the 2013, or prior, California Building Code, maximum room capacity shall be no more than the present capacity, to a maximum of eight patients per patient room. Placement of beds shall not be more than three deep from the exterior window.

1228.14.1.2 Space requirements. Patient bedrooms shall have a minimum clear floor area inclusive of beds of 110 square feet (10.2 m [2] ) for single-bed rooms and 80 square feet (7.43 m [2] ) per bed for multiple-bed rooms.

1228.14.1.3 Windows. Each patient bedroom shall have a window in accordance with Section 1228.4.9.

1228.14.1.4 Reserved.

1228.14.1.5 Outside exposure. Refer to Section 1224.14.1.5.

1228.14.1.6 Handwashing stations. Handwashing stations shall comply with Section 1228.4.22. Handwashing stations are required in patient toilet rooms. Handwashing stations are not required in patient bedrooms.

1228.14.1.7 Patient toilet room.

1. Each patient shall have access to a toilet room without having to enter a corridor. Exception: Corridor access to the patient toilet room shall be permitted at pediatric or adolescent patient bedrooms and in specific patient bedrooms where the use of corridor access is part of the hospital’s written Patient Safety Risk Assess- ment and management program. 2. One toilet room shall serve no more than two patient bedrooms and no more than four patients. 3. The toilet room shall contain a toilet and a handwashing station.

1228.14.1.8 Patient storage. Each patient room shall include a separate wardrobe, locker or closet for storing clothing and personal effects for each patient. Shelves for folded garments shall be used instead of arrangements for hanging garments.

1228.14.1.9 Privacy. Visual privacy in multibed rooms (e.g., cubicle curtains) is not required in psychiatric nursing units.

1228.14.1.10 Grab bars . Grab bars provided in accessible patient toilet rooms shall comply with Section 1228.4.18.

1228.14.1.11 Room identification. Each patient room shall be labeled with an identification number, letter or combination of the

two.

1228.14.2 Service areas. Provision for the services listed below shall be in or immediately accessible to each psychiatric nursing unit. The size and location of each service area will depend upon the numbers and types of beds served. Identifiable spaces are required for each of the indicated functions. If a service area is specifically permitted to serve more than one nursing unit, there shall be at least one such service area located on each nursing unit floor.

1228.14.2.1 Administrative center(s) or nurse station(s). Refer to Section 1224.4.4.2.

1228.14.2.1.1 Documentation area. A separate charting area with provisions for acoustic and patient file privacy shall be provided.

1228.14.2.1.2 Handwashing station(s). Refer to Section 1228.4.22 for the definition of handwashing station. Handwashing stations in high- or medium-patient-risk areas shall be ligature resistant.

1228.14.2.2 Office(s) for staff. Office(s) for staff shall be provided.

1228.14.2.3 Support areas for staff. 1. Staff lounge facilities. Staff lounge facilities may be combined between units.

2. Staff toilet rooms.

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3. Staff storage locations. Securable closets or cabinet compartments for the personal effects of nursing personnel shall be immediately accessible to the administrative center or nurse station.

1228.14.2.4 Multipurpose room(s). Multipurpose rooms shall be provided for staff, patients, patients’ families for patient visits, conferences, reports, education, training sessions and consultation. These rooms shall be readily accessible to each nursing unit. One such room may serve several psychiatric nursing units.

1228.14.2.5 Examination and treatment room . Refer to Sections 1228.4.4.1.1 and 1228.4.4.1.2.

1228.14.2.6 Clean utility/workroom. Refer to Section 1228.4.4.6.

1228.14.2.7 Soiled utility/workroom. Refer to Section 1228.4.4.7.

1228.14.2.8 Medication station. Refer to Section 1228.4.4.4.

1228.14.2.9 Clean linen storage. Each psychiatric nursing unit shall contain a designated area for clean linen storage. This may be within the clean utility room or a separate closet.

1228.14.2.10 Nourishment area . Refer to Section 1228.4.4.5.

1228.14.2.11 Ice-making equipment. Each nursing unit shall have equipment to provide ice for treatments and nourishment. Ice- making equipment may be in the clean utility/workroom or at the nourishment station. Ice intended for human consumption shall be from self-dispensing icemakers.

1228.14.2.12 Equipment and supply storage. Appropriate room(s) shall be provided for storage of equipment necessary for patient care. Each unit shall provide not less than 15 square feet (1.39 m [2] ). Location of the storage areas shall not present a risk to the patient population as indicated in the functional program.

1228.14.2.13 Reserved.

1228.14.2.14 Patient bathing facilities. A bathtub or shower shall be provided for each six patient beds not otherwise served by bathing facilities at patient bedrooms.

1228.14.2.15 Common patient toilet room(s). In addition to the toilet rooms serving bed areas, common patient toilet rooms shall be located adjacent to multipurpose room(s) and within or directly accessible to each common patient bathing facility.

1228.14.2.16 Emergency equipment storage. Emergency equipment storage shall be provided at each nursing unit that is under visual observation of staff.

1228.14.2.17 Housekeeping room. One housekeeping room shall be permitted to serve more than one nursing unit on a floor. Refer to Section 1228.4.15.

1228.14.2.18 Grab bars. Grab bars in common patient toilets and bathing facilities shall be installed in accordance with Section 1228.4.18.

SPECIAL PATIENT CARE ROOMS.

1228.14.3 Airborne Infection Isolation (AII) room(s). There shall be at least one airborne infection isolation (AII) room provided for each 50 beds, and for each major fraction thereof. Airborne infection isolation rooms for pediatric/adolescent and forensic supple- mental service nursing units shall be calculated independently from, and shall not be shared with each other or any other psychiatric nursing unit. Refer to Section 1224.14.3 and the general construction requirements of Section 1228.4. A bedpan flushing attachment is not required.

1228.14.4 Protective environment room(s). If provided, refer to Section 1224.14.4 and the general construction requirements of Section 1228.4.

1228.14.5 Seclusion room(s). There shall be at least one seclusion room provided for each 24 licensed beds, and for each major frac- tion thereof. At least one seclusion room shall be provided. A seclusion room may be shared by psychiatric nursing units. Seclusion rooms for pediatric/adolescent and forensic supplemental service nursing units shall be calculated independently from, and shall not be shared with each other or any other psychiatric nursing unit. Refer to the general construction requirements of Section 1228.4.

1228.14.6 Quiet room. A quiet room shall be provided in each psychiatric nursing unit for a patient who needs to be alone for a short period of time but does not require a seclusion room. Refer to Section 1228.4.4.1.5.

1228.14.7 Visitor/consultation room(s ). Visitor/consultation rooms shall be provided at a room-to-bed ratio of one consultation room for each 12 psychiatric beds, or major fraction thereof with a minimum of one, in each psychiatric nursing unit. Additionally, the following requirements shall be met: 1. Visitor/consultation room(s) shall have a minimum clear floor area of 100 square feet (9.29 m [2] ). 2. The room(s) shall be designed for acoustical and visual privacy. Refer to Table 1224.4.19, Sound Transmission Limitations in Hospitals.

s, or major fraction thereof with a minimum of one, in each psychiatric nursing unit. Additionally, the_ following requirements shall be met: 1. Visitor/consultation room(s) shall have a minimum clear floor area of 100 square feet (9.29 m [2] ). 2. The room(s) shall be designed for acoustical and visual privacy. Refer to Table 1224.4.19, Sound Transmission Limitations in Hospitals.

1228.14.8 Conference room. A conference and treatment planning room shall be provided for use by the psychiatric nursing unit. 1228.14.9 Space for group therapy. An enclosed private space with a minimum clear floor area of at least 225 square feet (20.90 m [2] ) shall be available for group therapy activities.

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Pharmaceutical service space shall comply with the provisions of Section 1224.19.

Refer to Section 1224.20, Dietetic Service Space for requirements, as modified below:

1228.20.1 Dining area. Provide dining space(s) for ambulatory patients, staff and visitors. Provide patient dining room(s) of 20 square feet (1.86 m [2] ) per patient bed separate from staff dining. These spaces shall be separate from the food preparation and distri- bution areas.

SUPPORT SERVICES.

1228.23.1 General storage. Psychiatric hospitals shall provide general storage space of at least 10 square feet (0.93 m [2] ) per bed in addition to specialized storage spaces. All storage spaces shall be located within the hospital building and shall be readily accessible to the connecting corridor required under Section 1224.4.7.5.

1228.23.2 Specialized storage. Specialized storage spaces shall include the following:

1228.23.2.1 Linen. Provide 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] ), except where linen chutes are provided, and may be within the soiled utility room. 1228.23.2.2 Supply. One supply storage space having a minimum area of 15 square feet (1.39 m [2] ) shall be provided in each nurs- ing unit. Supply storage may be within the clean utility room used only as part of a system for distributing clean and sterile supplies.

1228.23.2.3 Wheelchairs. A room or space shall be provided in each nursing unit for wheelchairs. Wheelchair storage areas may be located within the nursing unit or outside but readily accessible to the unit. The wheelchair space shall have a minimum area of 15 square feet (1.39 m [2] ).

1228.23.2.4 Sterile and unsterile supplies shall be stored separately.

1228.23.2.5 Food storage shall be as described in Section 1224.20.

1228.23.3 Patient storage facilities. A staff-controlled secured storage area shall be provided for patient’s effects that are deter- mined to be potentially harmful (e.g., razors, nail files, cigarette lighters).

1228.24.1 Acute-care Psychiatric Hospitals with a licensed bed capacity of 50 to 199 shall provide a morgue with autopsy facilities.

Exception: This may not be required if it can be demonstrated to the licensing agency that morgue and autopsy facilities are available locally.

1228.24.2 Acute-care Psychiatric Hospitals with a licensed bed capacity of 200 or more shall provide a morgue with autopsy facilities.

1228.24.3 Minimum requirements. Refer to Section 1224.24.3.

SUPPLEMENTAL SERVICES.

If electroconvulsive therapy (ECT) is provided in the facility, the require- ments in Section 1224.28.6 shall be met.

Pediatric and adolescent psychiatric service space patient areas shall be separate from each other and shall be separate from adult psychiatric service space patient areas. Common areas including activity areas, dining area, outdoor area and space for an educational program may be shared and used by pediatric and adolescent patients at different times. The requirements of Section 1228.14, Psychiatric Nursing Service Space shall apply to pediatric and adoles- cent units as amended below:

1228.30.1 Patient bedroom.

1228.30.1.1 Capacity. Maximum bedroom capacity shall be four patients.

1228.30.1.2 Space requirements. Patient bedroom areas (with beds or cribs) shall meet the following requirements: 1. For single-bed rooms, a minimum clear floor area of 100 square feet (9.29 m [2] ). 2. For multiple-bed rooms, a minimum clear floor area of 80 square feet (7.43 m [2] ) per bed and 60 square feet (5.57 m [2] ) mini- mum clear floor area per crib.

1228.30.2 Patient toilet room.

1. Each patient shall have access to a toilet room, either from the patient room or from the corridor outside the patient room.

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2. Where access is provided via a corridor, the following requirements shall be met: 2.1. The toilet room shall be located in the nursing unit. 2.2. The toilet room shall be located no more than 150 feet (45.72 m) from the bedroom.

1228.30.3 Activity areas. The pediatric and adolescent activities space may be centralized for common use by multiple pediatric and adolescent psychiatric units or may be located in each individual unit, in response to the Patient Safety Risk Assessment. Centralized activity areas shall be readily accessible without traversing adult patient areas.

1228.30.3.1 Space requirements. 1. The combined area for activity space shall have 35 square feet (3.25 m [2] ) of clear floor area per patient bed. 2. A separate dining space shall be provided and shall have a minimum of 15 square feet (1.39 m [2] ) of clear floor area per patient bed.

1228.30.3.2 Outdoor areas. Pediatric and adolescent outdoor areas shall be separate from adult outdoor areas. Refer to Section 1228.13.1.2.

1228.30.4 Support areas for the pediatric and adolescent psychiatric unit. Storage space shall be provided for toys, equipment, extra cribs and beds and cots or recliners for parents who may stay overnight.

1228.30.5 Education. If a unit treats children of school age over a period of one month or more, it shall provide physical facilities for an educational program, such as classrooms and an office for the teacher.

Where provided, a forensic psychiatric unit shall be separate and distinct from other patient areas. The requirements of Section 1228.14, Psychiatric Nursing Service Space shall apply to forensic units as amended below:

1228.31.1 Sally port. Forensic units shall have security vestibules or sally ports at the unit entrance. For “secure treatment facilities,” alternate designs for locked unit access without individual sally ports, may be approved by the enforcement agency when it can be demonstrated that the alternate design meets performance requirements, without compromising any health or life-safety requirement.

1228.31.2 Pediatrics and adolescents. Forensic unit areas for pediatrics and adolescents shall be separated from adult areas. Refer to Section 1228.30.

1228.31.3 Space requirements. Specialized program requirements may result in additional treatment areas, police and courtroom space, and security considerations. When a forensic unit is provided, the needs of the patient population and special requirements shall be specifically addressed in the Patient Safety Risk Assessment.

Where provided, an intermediate-care service unit shall be housed in a separate and distinct nursing unit and shall comply with the applicable requirements of Section 1225 and the general construction provisions of Section 1228.4.

Where provided, outpatient service space shall comply with the applicable requirements of Section 1224.39 and the general construction provisions of Section 1228.4.

Where provided, the skilled nursing service unit shall be housed in a separate and distinct nursing unit and shall comply with the applicable requirements of Section 1225 and the general construction provisions of Section 1228.4.

Where provided, clinical laboratory service space shall comply with the requirements of Section 1224.17, Clinical Laboratory Service Space.

Where provided, Radiology/Imaging Service Space shall comply with the requirements of Section 1224.18, Radiological/Imaging Service Space and the general construction provisions of Section 1228.4.

Pursuant to Health and Safety Code Section 1250.3, acute psychiatric hospi- tals may provide chemical dependency recovery services in a distinct part. If provided, the chemical dependency recovery hospital, unit or services shall comply with Section 1229.