Section 1224 — [OSHPD 1]

The provisions of this section shall apply to general acute-care hospitals and general acute-care hospitals providing only acute medical rehabilitation center services. The provisions of Section 1225 shall apply to distinct part skilled nursing and intermediate-care services on a gen- eral acute-care hospital license provided in a separate unit.

[OSHPD 1R] This section shall apply to buildings removed from acute care service, in compliance with Part 10, Califor- nia Existing Building Code, Chapter 3A, and remain under OSHPD jurisdiction.

New buildings and additions, alterations or repairs to existing buildings subject to licensure shall comply with applicable provisions of the California Electri-

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cal Code, California Mechanical Code, California Plumbing Code, California Energy Code, California Fire Code, Cali- fornia Existing Building Code (Parts 3, 4, 5, 6, 9 and 10 of Title 24) and this section.

Exceptions:

1. Facilities licensed and in operation prior to the effective date of this section shall not be required to institute corrective alterations or construction to comply with any new requirements imposed thereby or subsequently, except where specifically required or where the enforcing agency determines that a definite hazard to health and safety exists. Facilities for which preliminary drawings have been submit- ted to the enforcing agency prior to the effective date of this change shall not be required to comply with such new requirements, provided working drawings are submitted within one year of the effec- tive date of such new requirements.

2. A change in function shall require compliance with all the functional requirements for new construction in this code, including requirements in Sections 1224, 1225, 1226, 1227 and 1228.

3. The provisions of this section do not prohibit the use of alternate space utilization, new concepts of design, treatment techniques, equipment and alter- nate finish materials provided the intent of this sec- tion is accommodated and written approval for such alternative is granted by the enforcing agency. Writ- ten substantiating evidence in support of the alter- nate and a written request for consideration shall be submitted to the enforcing agency.

4. Nothing in this section shall prohibit the provisions of required services from a centralized service facil- ity serving two or more licensed facilities when approved in writing by the licensing agency. Build- ings and required spaces for services provided in a separate centralized services facility shall comply with all applicable provisions of these regulations and applicable local codes and ordinances for the services so provided.

5. Acute psychiatric hospitals and general acute-care hospitals providing only acute medical rehabilitation center services may provide for surgical and anesthe- sia services to be provided by an outside licensed facility when approved by the licensing agency.

6. When the Corrections Standards Authority, the Department of Corrections or the Department of Youth Authority determines that a particular requirement for hospitals located in a correctional facility may compromise the safety, security or pro- tection of staff, inmates or property, the enforcement agency shall consider an alternate design.

1224.2.1 Removed from acute care service [OSHPD 1R]. Hospital buildings removed from acute care service in accordance with Part 10, California Existing Building Code, Section 309A may provide outpatient services and

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other uses. Required Basic or Supplemental Services on the hospital’s license may not be provided.

Exceptions:

1. Duplicative hospital services when permitted by California Department of Public Health.

2. Skilled Nursing Services may be provided in con- formance with Section 1225.

3. Acute Psychiatric Services may be provided in conformance with Section 1228.

Specific terms and definitions are provided to facilitate consistency in the interpretation and application of these requirements. Some of these terms may have a broader definition in other contexts, but the definitions provided here reflect the use of the terms for OSHPD requirements.

AIR CONDITIONING. The process or system by which simultaneously the temperature, humidity, air motion and quality are maintained within required limits.

AIRBORNE INFECTION ISOLATION ROOM. A single- occupancy patient room where environmental factors are controlled in an effort to minimize the transmission of those infectious agents usually spread from person to person by droplet nuclei associated with coughing and inhalation.

AMBULATORY CARE. A defined health care encounter(s) of less than 24 hours in duration that requires direct profes- sional health care support within a specific facility.

AMBULATORY SURGICAL FACILITY. Any surgical facility organized for the purpose of providing procedural, invasive surgical care to patients with the expectation that they will be recovered sufficiently to be discharged in less than a 24-hour period.

ANGIOGRAPHY. The radiographic visualization of blood vessels following introduction of contrast material for pur- poses of diagnosis.

BASIC SERVICES. Those essential services required for licensure as a hospital, including medical, nursing, surgical, anesthesia, laboratory, radiology, pharmacy, dietary services and support services. See “SUPPLEMENTAL SERVICES.”

BIOTERRORISM. The use or threat of use, of biological agents to intimidate a political entity or population group.

CENTRAL AIR-HANDLING SYSTEMS. Any units requir- ing ductwork on the supply or inlet side and serving more than one room.

CHANGE IN FUNCTION. A change in function is a change in activity, service or licensed service provided, within the project limits, that does not necessarily change the use, spe- cific use and/or occupancy. Conversion of a space that results in a change in activity such that the space will be required to satisfy the functional requirements under a differ- ent code sub-section than that of the prior use is considered a change in function.

CLEAR DIMENSION. An unobstructed room dimension exclusive of built-in casework and equipment and available for functional use.

COURT. An open exterior space bounded on three or more sides by the walls of a structure.

ENVIRONMENT OF CARE. Those features in a built health care entity that are created, structured and maintained to support quality health care.

EXAM ROOM. A room with a bed, stretcher or examination table and capability for periodic monitoring (e.g., measure- ment of blood pressure or pulse oximetry) in which proce- dures that do not require a specialized suite can be performed (e.g., pelvic examination, blood transfusion).

FLOOR AREA, CLEAR. The actual occupied area exclusive of fixed or wall-mounted cabinets, fixed beds and furnishings, built-in shelves, toilet rooms, closets, lockers, wardrobes, alcoves, anterooms or vestibules.

GENERAL ACUTE-CARE HOSPITAL. A hospital, licensed by the California Department of Public Health, hav- ing a duly constituted governing body with overall adminis- trative and professional responsibility and an organized medical staff which provides 24-hour inpatient care, includ- ing the basic services.

HANDWASHING STATION. A clinical staff-use area that provides a handwashing fixture, cleansing agents and means for drying hands. Handwashing stations shall be immediately accessible to the patient care area they serve without requir- ing passage through a doorway, unless hands-free door oper- ation of the door is provided. Refer to the California Plumbing Code, Section 210.0 for the definition of hand- washing fixture.

HOSPITAL. A general acute-care hospital, including those providing only acute medical rehabilitation center services and acute psychiatric hospitals.

HOUSEKEEPING. Services anywhere within a health care facility that include general cleaning and tidying and the pro- vision and positioning of identified materials, e.g., soaps, towels, etc. (While routine disinfection protocols can be included in such a definition, the definition is not intended to include complex, nonroutine disinfection procedures nor the nonroutine disposition of hazardous materials such as poten- tially toxic drugs or other chemicals and radioactive wastes.)

INVASIVE PROCEDURE. A procedure that is performed in an aseptic surgical field and penetrates the protective sur- faces of a patient’s body (e.g., subcutaneous tissue, mucous membranes, cornea). An invasive procedure may fall into one or more of the following categories:

1. Requires entry into or opening of a sterile body cavity (i.e., cranium, chest, abdomen, pelvis, joint spaces).

2. Involves insertion of an indwelling foreign body.

3. Includes excision and grafting of burns that cover more than 20 percent of total body area.

4. Does not begin as an open procedure but has a recog- nized measurable risk of requiring conversion to an open procedure.

LDR. Labor, Delivery, Recovery (an unlicensed patient bed)

LDRP. Labor, Delivery, Recovery, Postpartum (a licensed patient bed)

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patient care space shall be provided within the cubicle cur- tain and not overlap with access circulation aisle.

CUBICLE. A space intended for human occupancy that has at least one opening and no door and is enclosed on three sides with full-height or partial-height partitions.

PATIENT CARE STATION. A designated space for a specific patient care function. This term does not imply any structural requirement (e.g., a Post-anesthesia Care Unit (PACU) can have 10 patient care stations of which three are rooms, three are cubicles and four are bays).

PATIENT ROOM. Licensed patient bed rooms. Also referred to as a patient bedroom.

PERIOPERATIVE. Patient care and other related support- ive activities before, during or after the operative event.

PROCEDURE ROOM. A room designated for the perfor- mance of patient care that requires high-level disinfection or sterile instruments and some environmental controls but is not required to be performed with the environmental controls of an operating room.

PROTECTIVE ENVIRONMENT. A bedded unit or patient room where severely immunosuppressed patients are cared for.

RESTRICTED AREA. Applies to a designated space con- tained within the semi-restricted area and accessible only through a semi-restricted area. The restricted area includes operating and other rooms in which operative or other inva- sive procedures are performed. Such space has one or more of the following attributes: specific signage, physical barri- ers, security controls and protocols that delineate require- ments for monitoring, maintenance, attire and use.

ROOM. A space enclosed by hard walls and having a door. Where the word “room” or “office” is used, a separate, enclosed space for the one named function is intended. Other- wise, the described area may be a specific space in another room or common area.

SCRUB SINK. A sink used to wash and scrub the hands and arms during the aseptic preparation for surgery and equipped with a supply spout and controls as required for a handwashing fixture. Refer to the California Plumbing Code Sections 210.0 and 221.0.

SEMI-RESTRICTED AREA. Applies to peripheral areas that support surgical services or intermediate level proce- dures or imaging. These areas may include storage for equip- ment and clean and sterile supplies; work area for processing instruments; sterile processing facilities; hand scrub sta- tions; corridors leading from the unrestricted area to the restricted area of the surgical suite; entrances to staff chang- ing areas; pre- and postoperative patient care areas; and sterile processing facilities. The semi-restricted area of the surgical suite is entered directly from the unrestricted area past a nurse station or from other areas. Public access is controlled.

SERVICE SINK. A sink located in a housekeeping room and designed for the purpose of cleaning mops and the disposal of waste water.

SERVICE SPACE. Service Space refers to the distinct area of a health facility where a licensed Basic Service or Supple-

LICENSING AGENCY. The Department of Public Health, Licensing and Certification.

LOCATION TERMINOLOGY (terms for relationship to an area or room)

ADJACENT. Located next to but not necessarily con- nected to the identified area or room.

DIRECTLY ACCESSIBLE. Connected to the identified area or room through a doorway or other opening without going through an intervening room or public space.

IMMEDIATELY ACCESSIBLE. Available either in the identified area or room, or directly accessible from a room or area located within the same department or service space.

IN. Located within the identified area or room.

READILY ACCESSIBLE. Located within the same department or service space as the identified area or room, located in and shared with an adjacent unit, or within 200 feet (60.96 m) of the department or service space in an accessible corridor.

MONOLITHIC. A surface free of fissures, cracks, perfora- tions and crevices.

MONOLITHIC CEILING. A ceiling constructed with a sur- face free of fissures, cracks and crevices. Any penetrations such as lights, diffusers and access panels shall be sealed or gasketed. Lay-in ceilings are not considered “monolithic.”

NURSING UNIT. A designated patient care area of the hos- pital which is planned organized, operated and maintained to function as a unit. It includes patient rooms with adequate support facilities, services and personnel providing nursing care and necessary management of patients.

OPERATING ROOM. A room specifically designed for the performance of surgical procedures. (In common under- standing, this means most types of surgical procedures, espe- cially those involving the administration of anesthesia, multiple personnel, recovery room access and a fully con- trolled environment.)

HYBRID OPERATING ROOM. A room that meets the definition of an operating room and is also equipped to enable diagnostic imaging before, during and after surgi- cal procedures. Imaging equipment is permanently installed in the room and may include MRI, fixed single- plane and bi-plane tomographic imaging systems and computed tomographic equipment.

Note: Use of portable imaging technology does not make an operating room a hybrid operating room.

OUTPATIENT SERVICE. An organizational unit of the hospital, which provides nonemergency healthcare services to patients.

PATIENT CARE LOCATIONS. Multi-patient treatment rooms, where allowed, may provide patient care stations in bays or cubicles as follows:

BAY (patient). A space for human occupancy with one hard wall at the headwall and up to one hard wall at either side, with two to three soft walls (e.g., cubicle curtains or portable privacy screen). The required area for the specific

Copyright © 2022 by, or licensed to, International Code Council, Inc. (ALL RIGHTS RESERVED); licensed to California Building Standards Commission pursuant to License Agreement. No further reproductions is authorized. Any unauthorized reproduction or distribution is a violation of the federal copyright act and the license agreement, and subject to civil and criminal penalties thereunder.

1224.4.3 Treatment spaces. Radiology, laboratory, phar- macy, physical therapy and service spaces serving only out- patients and similar outpatient service departments shall not be located in nursing units, surgical units, perinatal units, nursery areas, central sterilization rooms, food-ser- vice' areas, power plants, mechanical equipment rooms, maintenance shops, general storage, laundry, employees’ dressing or housekeeping facilities.

Exception: Physical and occupational therapy spaces of a rehabilitation service may serve both outpatients and inpatients.

1224.4.4 Support areas for patient care. Identifiable spaces shall be provided for each function indicated in all Basic and applicable Supplemental Service Space sections with requirements for support areas. The following rooms and spaces are common to most types of health care facil- ities and the requirements associated with each, as listed below, shall be used unless modified under a specific Ser- vice Space section.

1224.4.4.1 Examination, treatment and procedure rooms.

1224.4.4.1.1 Examination room. Unless specified elsewhere, if an exam room is provided, it shall have a minimum clear floor area of 80 square feet (7.4 m ² ), the least dimension of which shall be 8 feet (2438 mm). The room shall contain a handwashing fixture and accommodations for written or elec- tronic documentation shall be provided.

1224.4.4.1.2 Treatment room. Unless specified else- where, 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/gur- ney/table and any wall or other fixed obstruction. The room shall contain an examination light, a work counter for medical equipment, a handwashing fix- ture, cabinets, medication storage and counter space for writing or electronic documentation. If used for exercise stress testing, include space for a crash cart and patient resuscitation and omit the exam light. Multi-bed treatment rooms shall have separate patient cubicles with a minimum clear floor area of 80 square feet (7.4 m ² ) per cubicle. Each cubicle shall contain an examination light, counter and storage facilities. In multi-bed treat- ment rooms, a handwashing fixture shall be pro- vided in the room for each three or fewer cubicles.

itation and omit the_ exam light. Multi-bed treatment rooms shall have separate patient cubicles with a minimum clear floor area of 80 square feet (7.4 m ² ) per cubicle. Each cubicle shall contain an examination light, counter and storage facilities. In multi-bed treat- ment rooms, a handwashing fixture shall be pro- vided in the room for each three or fewer cubicles.

1224.4.4.1.3 Airborne infection isolation exam/treatment room. When provided, the airborne infection isolation room shall be an exam/treatment room, shall be labeled with the words “Airborne Infection Room”, and provide the following:

1. Capacity. Each airborne infection isolation exam/treatment room shall contain only one examination table or recliner.

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mental Service is provided. The Service Space shall include all the functional area requirements required to deliver the specific Service. Basic Service Spaces are identified in Sec- tions 1224.14 through 1224.27. Supplemental Service Spaces are identified in Sections 1224.28 through 1224.41. Similar distinctions are made between Basic and Supplemental or Optional Services in Section 1225 through Section 1228. Required functional areas may be a portion of a larger space, one or more Patient Care Locations, support areas or sepa- rate Rooms as defined in Section 1224.3. See departmental boundary requirements under Section 1224.4.7.6.

SUB-ACUTE CARE. A segment within a continuum of levels of care determined by patient acuity, clinical stability and resource needs.

SUPPLEMENTAL SERVICE. An inpatient or outpatient service which is not required to be provided by law or regula- tion for licensure. A supplemental service, when provided, must accommodate the provisions of this section.

Note: See “BASIC SERVICES.”

SURGICAL SERVICE SPACE. A space that includes the operating room(s) and service areas.

UNRESTRICTED AREA. Applies to any area of the surgery or medical department that is not defined as semi-restricted or restricted. These areas may include a central control point for designated personnel to monitor the entrance of patients, personnel and materials into the semi-restricted areas; staff changing areas; a staff lounge; offices; waiting rooms or area; pre- and postoperative patient care areas; or access to procedure rooms. Public access may be limited.

1224.4.1 Jurisdiction.

1224.4.1.1 Services/systems and utilities.

[OSHPD 1] Services/systems and utilities shall comply with California Existing Building Code Sec- tion 307A.

[OSHPD 1R] Services/systems and utilities shall only originate in, or pass through or under structures which are under the jurisdiction of the Office of State- wide Health Planning and Development (OSHPD).

1224.4.1.2 Means of egress.

[OSHPD 1 ] Means of egress shall comply with Part 10, California Existing Building Code, Section 308A.

[OSHPD 1R] Means of egress shall only pass through structures that are under the jurisdiction of the Office of Statewide Health Planning and Devel- opment (OSHPD).

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, hazards and unsightliness in patient-care areas and bedrooms.

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2. Handwashing station. A handwashing station shall be located in each airborne infection iso- lation exam/treatment room.

3. Gowning and storage area. An area for gown- ing and storage of clean and soiled materials shall be located directly outside or inside the entry door to the airborne infection isolation exam/treatment room.

4. Doors. Room doors shall be self-closing and include latching devices.

5. Sealed-tight room. Room perimeter walls, ceiling, floors, doors and penetration shall be sealed tightly to minimize air infiltration from the outside or from other spaces.

6. Ventilation. The ventilation shall be provided as required by the California Mechanical Code for airborne infection isolation room.

exam/treatment anteroom. An airborne infection isolation anteroom is not required; however, when an anteroom is provided, it shall meet the following requirements:

1. The anteroom shall provide space for persons to don personal protective equipment before entering the patient room.

2. All doors to the anteroom shall have self-clos- ing devices.

3. The anteroom shall provide storage of per- sonal protective equipment (e.g., respirators, gowns, gloves) and clean equipment.

4. Ventilation shall be provided in the anteroom as required by the California Mechanical Code for airborne infection isolation anteroom.

Unless specified else- where, if a procedure room is provided, it shall meet the requirements in this section.

1224.4.4.1.4.1 General.

(1) Application. The governing body shall per-

form a clinical assessment of the procedures to be performed to determine the appropri- ate room type and location for these proce- dures and document this in the Functional Program in compliance with the California Administrative Code, Section 7-119. Where a procedure room is used for multiple proce- dure types, the room shall meet the most stringent requirements for the space.

(2) Location. The procedure room shall meet

the requirements of a semi-restricted area. The procedure room shall be permitted to be accessed from a semi-restricted corridor or from an unrestricted corridor.

(1) Area. Procedure rooms shall have a mini-

mum clear floor area of 130 square feet

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(12.08 m ² ). Procedure rooms where anesthe- sia will be administered using an anesthesia machine and supply carts shall have a mini- mum clear floor area of 160 square feet (14.86 m ² ). Procedure rooms where proce- dures will be performed that require addi- tional personnel and/or large equipment shall be sized to accommodate the personnel and equipment planned to be in the room during procedures, including additional per- sonnel and equipment that will be needed for emergency rescue.

(2) Clearances. Procedure rooms shall have the

following minimum clearances around the table, gurney or procedure chair:

(a) 3 feet 6 inches (1070 mm) on each side. (b) 3 feet (914.4 mm) at the head and foot.

Where an anesthesia machine and associated supply cart is used, the clearance at the head shall be a minimum of 6 feet (1830 mm).

(3) Fixed encroachments into the minimum

clear floor area. Fixed encroachments shall be permitted to be included when determin- ing the minimum clear floor area for a pro- cedure room as long as:

(a) The encroachments do not extend

more than 12 inches (305 mm) into the minimum clear floor area. (b) Where a sterile field is provided, the

encroachment shall not extend into the sterile field. (c) The encroachment width along each wall does not exceed 10 percent of the length of that wall.

(1) Accommodations for written and/or elec-

tronic documentation shall be provided in the procedure room.

(2) Where a built-in feature is provided for doc-

umentation, it shall allow for direct observa- tion of the patient.

1224.4.4.1.4.4 Patient privacy. Provisions shall be made for patient visual and speech privacy.

1224.4.4.1.4.5 Handwashing station. A handwash- ing station shall be provided in the procedure room. Where a hand scrub station is directly acces- sible to the procedure room, omission of the handwashing station is permitted.

Where provided, seclu- sion rooms shall comply with the following require- ments:

1224.4.4.1.5.1 General.

1. Capacity. Each room shall accommodate only one patient.

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2. Layout and access. Seclusion rooms shall be accessed through an anteroom or ves- tibule that also provides access to a toilet room. The door openings to the anteroom and the toilet room shall have a minimum clear width of 3 feet 8 inches (1118 mm).

3. The room(s) shall be located to permit observation from the nurse station.

4. Seclusion rooms shall be permitted to be grouped together and may share a common vestibule/anteroom.

Seclusion rooms shall have a minimum clear floor area of 60 square feet (5.57 m ² ) with a minimum wall length of 7 feet (2134 mm) and a maximum wall length of 11 feet (3353 mm).

Exception: Where a room for restraining patients is authorized by the California Department of Public Health, it shall have a minimum clear floor area of 80 square feet (7.43 m ² ) with a minimum wall length of 7 feet (2134 mm) and a maximum wall length of 11 feet (3353 mm).

Seclu- sion rooms shall be designed and constructed in compliance with the following requirements:

1. The walls, ceiling and floor of the seclu- sion room shall be designed to withstand direct and forceful impact. If padded materials are used inside the room, they shall meet the interior finish requirements in Chapter 8, Interior Finishes, of this code.

2. Minimum ceiling height shall be 9 feet (2743 mm).

3. Doors.

3.1. Door hardware shall be ligature resistant.

3.2. The entrance door to the seclusion room shall swing outward.

3.3. Doors shall permit staff observation of the patient through a view panel while also maintaining provisions for patient privacy. The maximum sill height shall be 36 inches (914 mm) above the finish floor. The view panel shall be fixed glazing with polycarbonate or laminate on the inside of the glazing.

4. Seclusion rooms shall not contain outside corners or edges.

5. All items in the room (e.g., lighting fixtures, sprinkler heads, HVAC grilles and surveil- lance cameras, etc.) shall be tamper resistant.

6. Electrical switches and receptacles are prohibited in the seclusion room.

This area shall have space for counters and storage and at least one hand- washing station shall be located in or directly accessi- ble to the nurse station. It may be combined with or include centers for reception, charting and communi- cation.

1224.4.4.3 Specimen and blood collection facilities.

1224.4.4.3.1 Specimen collection facilities. When provided, specimen collection facilities shall comply with the following requirements:

1. Urine collection rooms shall be equipped with a water closet and handwashing station.

Exception: The handwashing station may be located immediately outside the collection room when the specimen is used for drug testing.

2. Use of the toilet room provided within the examination and treatment room shall be per- mitted for specimen collection.

When pro- vided, blood collection facilities shall comply with the following requirements:

1. Space for a chair and work counter shall be provided.

2. A handwashing station shall be provided.

1224.4.4.4 Medication station. Provision shall be made for distribution of medications. This shall be done from a medication preparation room or from a self-contained dispensing unit.

1224.4.4.4.1 Medication preparation room. If pro- vided, this room shall be lockable. When a medicine preparation room is to be used to store one or more self-contained medicine dispensing units, the room shall be designed with adequate space to prepare medicines with the self-contained medicine dispens- ing unit(s) present. Medicine preparation rooms shall include:

1. Work counter.

2. Handwashing station.

3. Refrigerator.

4. Locked storage for controlled drugs.

unit. If provided, a self-contained medicine dispens- ing unit shall be located at the nurse station, in the clean utility room, or in an area where access to the self-contained medication dispensing unit is under the monitoring and control of nursing staff. Self- contained medication dispensing units shall be pro- vided with essential power and lighting.

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STATION OUTLETS FOR OXYGEN, VACUUM (SUCTION) AND MEDICAL AIR SYSTEMS ^{1, 6}

1. For any area or room not described above, the facility clinical staff shall determine outlet requirements after consultation with the enforcing agency. 2. Four bassinets may share one outlet that is accessible to each bassinet. 3. WAGD stands for “waste anesthesia gas disposal” system. 4. When infant resuscitation takes place in a room such as cesarean section/delivery or LDRP, then the infant resuscitation services shall be provided in that room in addition to the minimum service required for the mother. 5. One outlet for mother and one for each bassinet. 6. Renovation projects of existing spaces where the existing function is not changed, are not required to comply with the requirements of this table. 7. Use of portable equipment shall be permitted. 8. Use of portable equipment is permitted in outpatient observation units provided under Section 1224.39.6.

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[OSHPD 1, 2, 3, 4 & 5] LOCATION OF NURSE CALL DEVICES

Station Types P = Patient Station, B = Bath Station, E = Staff Emergency, C = Code Call, M = Master, D = Duty 1. Not required for Primary Care, Chronic Dialysis, Rehabilitation or Psychology Clinics.

Nourishment areas or rooms required in patient care areas shall include the following:

1. Sink

2. Work counter

3. Refrigerator

4. Storage cabinets

5. Equipment for hot and cold nourishment between scheduled meals.

6. The nourishment shall include space for trays and dishes used for nonscheduled meal service.

7. Provisions and space shall be included for sepa- rate temporary storage of unused and soiled dietary trays not picked up at mealtime.

8. Handwashing stations separate from the nourish- ment sink shall be in the nourishment area or immediately accessible without passing through a door.

The clean work- room or clean supply room shall be separate from and have no connection with the soiled workroom or soiled holding room. If the room is used for preparing patient care items, it shall contain the following:

1. Work counter

2. Handwashing station

3. Storage facilities for clean and sterile supplies

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If the room is used only for storage and holding as part of a system for distribution of clean and sterile materials, the work counter or a handwashing station may be omitted.

1224.4.4.7 Soiled utility/workroom. The soiled work- room or soiled holding room shall be separate from and have no connection with either clean workrooms or clean supply rooms. The soiled utility/workroom shall contain:

1. Clinical sink (or equivalent flushing-rim fixture).

2. Handwashing station

3. Work counter

4. Space for separate covered containers for soiled linen and/or waste

Rooms used only for temporary holding soiled material may omit the clinical sink and work counter. If the flushing-rim clinical sink is eliminated, facilities for cleaning bedpans shall be provided elsewhere.

1224.4.4.8 Toilet rooms. Separate toilet rooms shall be provided for the use of patients, staff and public.

1224.4.4.8.1 Staff toilets. The number of staff toilets provided in a health facility shall comply with the requirements of the California Plumbing Code, Tables 4-2 and 4-3. When staff toilet rooms are required to be dedicated to a specific Service Space, the number of staff toilet rooms provided under the California Plumbing Code shall be based on the number of staff within the specific Service Space served. Satellite service spaces do not require dedi- cated toilet rooms.

When provided, single-user toilets shall include a door-mounted geometric sym- bol, as identified in Section 11B-703.7.2.6.3, Unisex toilet and bathing facilities and wall signage desig- nating use for patients, staff or public. When exist- ing toilet rooms are not compliant with Section 11B- 603, Toilet and bathing rooms, directional signage in compliance with Section 11B-216.8, Toilet rooms and bathing rooms, shall also be provided.

Exception: Patient toilet rooms accessed directly from patient bedrooms are not required to include signage.

Waiting rooms for outpatients shall provide a seating area and space for wheelchairs and have public corridor access. Public toi- lets, drinking fountains and telephones shall be readily accessible.

Note: One waiting area may serve more than one depart- ment or service.

1224.4.5.1 Outpatient access. Outpatient access to ser- vices shall not traverse a nursing unit.

INTERIOR ENVIRONMENT

1224.4.6 Miscellaneous requirements.

Station outlets for oxygen, vacuum and medical air shall comply with Table 1224.4.6.1.

1224.4.6.2 Gas and vacuum systems. The design, installation and testing of medical gas and vacuum sys- tems shall conform to Table 1224.4.6.1 and NFPA 99.

1224.4.6.3 Hyperbaric facilities. The design and con- struction of hyperbaric facilities shall conform to NFPA 99; Health Care Facilities and Section 1224.39.5.

1224.4.6.4 Laboratories. The design and construction of hospital laboratories shall conform to NFPA 99.

The location of nurse call devices shall comply with Table 1224.4.6.5. The design of call systems shall comply with the California Electrical Code, Part 3 of Title 24.

1224.4.7 Corridors.

1224.4.7.1 Width. The minimum width of corridors and hallways shall be 8 feet (2438 mm).

Exception: Patient-care corridors and hallways in hospitals for psychiatric care of patients who are not bedridden shall have a minimum clear and unobstructed width of 6 feet (1829 mm). For the pur- poses of this section, bedridden patients shall be defined as patients confined to beds who would be transported or evacuated in beds or litters.

Service corridors and hall- ways with anticipated light traffic volume for nonpa- tient use may be reduced to a width of 5 feet (1524 mm) if approved by the enforcing agency.

Exception: Corridors and hallways in administra- tive and business areas may be reduced to a width of 44 inches (1118 mm).

1224.4.7.3 Outpatient services. Outpatient clinics or outpatient departments which contain facilities for out- patient use only, such as laboratory, x-ray, physical therapy or occupational therapy, shall have a minimum corridor or hallway width of 5 feet (1524 mm). Corri- dors serving gurney or stretcher traffic shall comply with minimum width requirements of Section 1020.2. Outpatient clinics and outpatient departments consist- ing only of waiting rooms, business offices, doctor’s offices and examining rooms, where there is no traffic through such area to other services or to exits from the building, shall have a minimum corridor or hallway width of 44 inches (1118 mm).

Corridors for patient traffic in areas providing skilled nursing, intermediate care or rehabilitation services shall be furnished with a hand- rail on both sides at a height not less than 30 inches (762 mm) or greater than 36 inches (914 mm).

Copyright © 2022 by, or licensed to, International Code Council, Inc. (ALL RIGHTS RESERVED); licensed to California Building Standards Commission pursuant to License Agreement. No further reproductions is authorized. Any unauthorized reproduction or distribution is a violation of the federal copyright act and the license agreement, and subject to civil and criminal penalties thereunder.

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Corridor systems shall con- nect all patient rooms and basic services.

Exception: Covered pedestrian walkways connect- ing separate buildings are permitted for ambulatory, psychiatric or chemical dependency patients.

1224.4.7.6 Departmental boundaries. Department/ser- vice space areas shall be contiguous and include internal circulation to access each of the rooms/spaces associated with it, as identified under the specific Service Space requirements. Identifiable spaces are required for each of the indicated functions for all service areas, including their support spaces. Where the words “room” or “offices” are used, a separate, enclosed space for the one named function is intended; otherwise, the described area may be specific space in another room or common area.

Exceptions:

1. Satellite radiology, laboratory, pharmacy and physical and occupational therapy space serv- ing inpatients may be located in nursing units and inpatient treatment areas. 2. Rooms and functional areas specifically noted under the Service Space requirements that may be shared with other units and departments.

1224.4.8.1 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 hard- ware 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.

1224.4.8.2 Pocket doors. Pocket sliding doors are not permitted.

Exception: Administration and business areas.

1224.4.9.1 Windows . Rooms approved for the housing of patients shall be provided with natural light by means of exterior glazed openings excluding clerestory windows, obscure glass and skylights, with an area not less than one tenth of the total floor area.

1224.4.9.2 Operation and sills. Patient room windows shall have sills not more than 36 inches (914 mm) above the floor. If operable windows are provided that require the use of tools or keys for operation, the tools or keys shall be located at the nurse station.

Exception: Window sills in intensive-care units may be 60 inches (1524 mm) above the floor.

tive environment rooms. If operable windows are provided in airborne infection isolation or protec- tive environment rooms, they shall only be operable by the use of tools or keys which shall be located at the nurse station.

1224.4.9.3 Psychiatric unit windows. Safety glass or plastic glazing materials shall be used in windows in psychiatric patient areas.

1224.4.9.4 Screens. Windows which may be frequently left in an open position shall be provided with insect screens of 16 meshes to the inch.

All portions of a building used by patients, personnel or other persons shall be provided with artificial light and a mechani- cally operated ventilating system as specified in the California Electrical Code and the California Mechan- ical Code.

1224.4.10 Ceiling heights.

1224.4.10.1 Minimum height. The minimum height of ceilings shall be 8 feet (2438 mm).

Exception: Closet, toilet room and bathroom mini- mum ceiling heights and soffits over fixed cabinets and work surfaces, shall not be less than 7 feet (2134 mm).

ment. Operating rooms, emergency rooms, delivery rooms, radiographic rooms and other rooms contain- ing 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. Suspended tracks, rails and pipes located in the traffic path for patients in beds and/or on stretchers, including those in inpatient ser- vice areas, shall be not less than 7 feet (2134 mm) above the floor.

Exception: Mobile suspended tracks such as tra- verse rails for overhead patient lifts that may be moved out of the traffic path shall provide a clear- ance of not less than 6 feet, 8 inches (2032 mm) above the floor when in use.

For imaging, examina- tion/treatment, procedure and operating rooms, also see Table 1224.4.11.4a.

1224.4.11.1 Floor finishes. Floor finishes shall be smooth, waterproof and durable. Flooring surfaces shall provide smooth transitions between different floor materials. Slip-resistant flooring products shall be used for flooring surfaces in wet areas (e.g., kitchens, shower and bath areas), ramps, stairways, entries from exterior to interior space and other areas as deter- mined by the functional program. Joints for floor open- ings for pipes, ducts and conduits shall be tightly sealed. Joints of structural elements shall be similarly sealed.

Exception: Upon written appropriate docu- mented requests, the licensing agency may grant approval of the installation of carpets. See Table

1224.4.11.1.1 Coved base. Resilient flooring, if used in toilet and bathing rooms, shall be continuous and extend upward onto the wall at least 5 inches (127 mm) to minimize moisture infiltration. Wood bases are prohibited except in waiting areas and adminis- tration departments.

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ACCEPTABLE CEILING AND CARPET LOCATIONS

Ceilings: 1 – Continuous monolithic surface equal in smoothness to enamel plaster. 2 – Smooth and easily cleanable without perforations or fissures. 3 – Pin perforated, fine fissured or lightly textured. 4 – Any finish meeting code requirements. Carpets: Yes = Y No = N

* Upon approval by the licensing agency with adequate maintenance procedure. However, should the carpet not be maintained adequately, the licensing agency has the right to have it removed and replaced with another acceptable material. Footnotes: 1. Carpet permitted in mammography. 2. Except those rooms specified otherwise. 3. For rooms not listed, contact the Office of Statewide Health Planning and Development (OSHPD). 4. Table applies to new construction, additions, remodels and conversions. The patching and replacement of existing materials will be permitted. 5. Lay-in ceiling meeting the requirements of Section 1224.4.11.4.1.7 may be substituted in laundry and kitchens.

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INTERIOR ENVIRONMENT

EXAMINATION/TREATMENT, IMAGING, PROCEDURE AND OPERATING ROOM CLASSIFICATION ^{1, 2}

1. This table includes a brief description of the services performed in these room types and a summary of some applicable requirements that appear elsewhere in the California Building Code. 2. Other requirements that apply to these room types include, but are not limited to, ventilation, lighting and sound transmission requirements. See California Mechanical Code Table 4-A and ASHRAE 170 for ventilation requirements. See California Electrical Code, Article 517 for lighting and power requirements. See California Building Code Table 1224.4.19 for noise transmission requirements. 3. “Invasive procedure” is defined in Section 1224.3 definitions.

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Floors in areas used for food preparation and assembly shall be water-resistant. Floor surfaces, including tile joints, shall be resistant to food acids. Floor con- struction in dietary and food preparation areas shall be free of spaces that can harbor pests.

1224.4.11.1.3 Wet cleaning. In all areas subject to frequent wet-cleaning methods, flooring materials shall not be physically affected by germicidal or other types of cleaning solutions.

borne infection isolation exam/treatment and pro- tective environment rooms. These rooms and anterooms shall have seamless flooring with inte- gral coved base.

1224.4.11.2 Wall bases.

1224.4.11.2.1 Material. The material and textures of bases and the installation thereof shall be such as to minimize dust-catching surfaces, moisture, infiltra- tion and the harboring of vermin.

Exception: In locations where carpet is permit- ted 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.

Floor and wall base assemblies in the following rooms shall be mono- lithic and have an integral coved wall base that is carried up the wall a minimum of 6 inches (150 mm) and is tightly sealed to the wall:

1. Operating rooms

2. Interventional imaging rooms, including car- diac catheterization labs

3. Cesarean delivery rooms

4. Cystoscopy, urology and minor surgical pro- cedure rooms

5. Endoscopy procedure rooms

6. Endoscopy instrument processing rooms

7. IV and chemotherapy preparation rooms

8. Airborne infection isolation (AII) rooms

9. Protective environment (PE) rooms

10. Anterooms to AII and PE rooms, where pro- vided

11. Cast rooms

The floors and wall bases of kitchens, soiled and clean utility rooms, housekeeping rooms with mop sinks, patient, public and staff sanitary facilities and other areas subject to frequent wet cleaning, shall also be homogeneous, nonabsorbent, smooth, easily cleaned and not physically affected by germicidal cleaning solutions, but may have tightly sealed joints and shall be constructed without voids at the intersection of floor and wall surfaces.

INTERIOR ENVIRONMENT

Wall finishes shall comply with the following requirements:

1. Wall finishes shall be washable. In the vicinity of plumbing fixtures, wall finishes shall be smooth, scrubbable and water-resistant.

2. Wall finishes in areas such as operating rooms, delivery rooms and trauma rooms shall be monolithic, scrubbable and able to withstand cleaning with chemicals.

3. Wall finishes in operating rooms, cesarean delivery rooms, isolation rooms and sterile processing rooms shall be free of fissures, open joints or crevices that may retain or per- mit passage of dirt particles.

4. Wall finishes in areas such as clean corridors, central sterile supply spaces, specialized radiographic rooms and minor surgical pro- cedure rooms shall be washable, smooth and able to withstand cleaning with chemicals.

5. Wall areas penetrated by pipes, ducts and conduits shall be tightly sealed to minimize entry of rodents and insects. Joints of struc- tural elements shall be similarly sealed.

6. Wall finish requirements of Section

mechanical equipment rooms, administration departments, other offices, enclosed stair- ways, maintenance shops and similar spaces.

1224.4.11.3.1 Dietary and food preparation areas. Dietary and food preparation areas shall comply with the following requirements:

1. In dietary and food preparation areas, wall construction, finish and trim, including the joints between the walls and the floors, shall be free of spaces that can harbor insects and rodents.

2. Wall surfaces in wet areas (e.g., kitchens, environmental services closets) shall be monolithic and all seams shall be covered and/or sealed.

Ceilings in areas occupied by patients and the public shall be cleanable with the use of routine housekeeping equipment. Acoustic and lay-in ceiling, where used, shall not create ledges or crevices.

1224.4.11.4.1 Ceiling finishes. Ceiling finishes shall comply with Table 1224.4.11, Table 1224.4.11.4.1a and the following requirements:

Semirestricted areas:

1. Ceiling finishes in semirestricted areas such as airborne infection isolation exam/treat- ment rooms, surgical corridors, central sterile supply spaces and minor surgical procedure rooms, shall be nonabsorptive, nonperforated, capable of withstanding cleaning with chemicals, and without crev-

Copyright © 2022 by, or licensed to, International Code Council, Inc. (ALL RIGHTS RESERVED); licensed to California Building Standards Commission pursuant to License Agreement. No further reproductions is authorized. Any unauthorized reproduction or distribution is a violation of the federal copyright act and the license agreement, and subject to civil and criminal penalties thereunder.

INTERIOR ENVIRONMENT

ices that can harbor mold and bacterial growth.

2. If a lay-in ceiling is provided in semi- restricted areas, it shall be gasketed or each ceiling tile shall weigh at least one pound per square foot to prevent the pas- sage of particles from the cavity above the ceiling plane into the semirestricted envi- ronment. Perforated, tegular, serrated cut or highly textured tiles are not acceptable.

Restricted areas:

3. Ceilings in restricted areas shall be mono- lithic with no cracks or perforations.

4. Ceilings in restricted areas shall be scrub- bable and able to withstand cleaning and/or disinfecting chemicals.

5. All access openings in restricted area ceil- ings shall be gasketed.

Dietary and laundry areas:

6. Provide either a sealed monolithic and scrubbable gypsum board ceiling or a lay- in ceiling.

7. If a lay-in ceiling is provided, it shall include the following:

a) A rust-free grid.

b) Ceiling tiles that weigh at least one

pound per square foot and are smooth, scrubbable, nonabsorptive, nonperfo- rated and able to withstand cleaning with chemicals.

8. Ceiling finish requirements of Section

mechanical equipment rooms, administra- tion departments, other offices, enclosed stairways, maintenance shops and similar spaces.

1224.4.12 Courts. Where one or more walls of a court contain a door or window of one or more patients’ bed- rooms, the least dimension of the court shall be 20 feet (6096 mm) between facing structures.

1224.4.13 Elevators.

1224.4.13.1 Patient. Patient elevators shall have mini- mum inside platform dimensions of 5 feet by 8 feet (1524 mm by 2438 mm), and a minimum clear door opening of 4 feet 0 inches (1219 mm).

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

1224.4.13.3 Patient services. Buildings over one story in height with accommodations or services for patients on floors without grade-level entrance shall provide at least one patient elevator.

1224.4.13.4 Low patient capacity. If bed patients are accommodated on one or more floors, other than the

main entrance floor or where operating rooms or deliv- ery rooms are above or below the main entrance floor, at least one patient elevator shall be provided.

At least one patient elevator and one service elevator shall be pro- vided in hospitals with a capacity of from 60 to 149 beds on floors other than the main entrance floor.

1224.4.13.6 High patient capacity. At least one patient elevator, one passenger elevator and one service eleva- tor shall be provided in hospitals with a capacity of 150 or more beds on floors other than the main entrance floor.

1224.4.14 Garbage, solid waste and trash storage. 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 con- nected to the sewer.

2. Steam or hot-water and cold-water supply.

3. A minimum floor area of ¹ /2 square foot (0.046 m ² ) per bed, but not less than 25 square feet (2.3 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.

This room shall be a min- imum floor area of 15 square feet (1.4 m ² ). It shall contain a service sink or floor receptor and provisions for storage of supplies and housekeeping equipment.

1224.4.16 Laundry and trash chutes. Gravity-type laun- dry and trash chutes shall have a minimum diameter of 2 feet (610 mm) and shall be designed to prevent distribu- tion of airborne contaminating elements to all floors served.

1224.4.17 Telephone. Each floor accommodating patients shall have a telephone installed for patient use. Such tele- phones shall be readily accessible to patients who are lim- ited to wheel chairs and stretchers. This may not be required in separate buildings having six or fewer beds which are restricted to occupancy by ambulatory patients.

Each toilet, bathtub and shower serving patients in rooms not required to provide mobility features, shall have conveniently placed grab bars that shall comply with Chapter 11B, Sections 11B-609.2, 11B- 609.3, 11B-609.5, 11B-609.6 and 11B-609.8.

Exception: Excluding facilities designed for use by persons with disabilities, grab bars may be deleted from those facilities serving chemical dependency recovery and psychiatric patients.

1224.4.19 Noise control.

1224.19.1 Impact noises. Recreation rooms, exercise rooms, equipment rooms and similar spaces where impact noises may be generated, shall not be located directly over patient bed areas or delivery and operat-

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ing suites, unless special provisions are made to mini- mize such noise.

1224.19.2 Noise reduction. The noise reduction crite- ria shown in Table 1224.4.19 shall apply to partitions, floors and ceiling construction in patient areas.

SOUND TRANSMISSION LIMITATIONS IN HOSPITALS

INTERIOR ENVIRONMENT

the point at which outside carrier data and voice cir- cuits and services enter the facility and outdoor cabling interfaces with the building’s internal cabling infra- structure. Each hospital facility shall have at least one telecommunications service entrance room, and each room that is provided shall be dedicated to the telecom- munications function with related support facilities and meet the requirements of this section.

1224.5.2 Technology equipment center.

1224.5.2.1 Number. Each hospital shall have at least one technology equipment center space that is not used for any purpose other than electronic data storage, processing and networking.

1224.5.2.2 Size. The technology equipment center shall be sized to provide space to meet the service require- ments for the required equipment.

1224.5.2.3 Location. The technology equipment center shall be located to minimize the risk of water damage, both from internal and external sources. The technol- ogy equipment center shall be located above any flood- ways or flood hazard areas as described in the National Flood Insurance Program.

1224.5.3 Technology distribution room.

1224.5.3.1 Number. There shall be a minimum of one technology distribution room on each floor of the facil- ity.

Exception: For existing facilities not undergoing major renovation, a technology distribution room may serve adjacent floors.

1224.5.3.2 Size.

1. Technology distribution rooms shall be sized based on the area of the floor being served, with minimum clear dimensions as follows:

1. Sound Transmission Class (STC) shall be determined by tests in accordance with methods set forth in ASTM 90 and ASTM 413. Where partitions do not extend to the structure above, sound transmission through ceilings and composite STC performance shall be considered. 2. Treatment rooms shall be treated the same as patient rooms. STC rating may be reduced to 40 dBA for rooms with electronic masking. Electronic masking shall provide a maximum background level of 48 dBA. 3. Public space includes corridors (except patient room access corridors), lobbies, dining rooms, recreation rooms and similar space. 4. Service areas for the purposes of this table include kitchens, elevators, elevator machine rooms, laundries, garages, maintenance rooms, boiler and mechanical equipment rooms and similar spaces of high noise. Mechanical equipment located on the same floor or above patient rooms, offices, nurse stations and similar occupied space shall be effectively isolated from the floor. 5. Patient room access corridors contain composite walls with doors/windows and have direct access to patient rooms. 6. Renovation projects of existing spaces where the existing function is not changed, are not required to comply with the requirements of Table

Technology and medical communication rooms shall comply with the California Elec- trical Code, California Mechanical Code, California Plumb- ing Code and the requirements of this section.

1224.5.1 Telecommunications service entrance room. The telecommunications service entrance room houses

2. Where ceilings are provided, the minimum clear height shall be 9 feet (2.75 m).

Exception: Existing buildings shall be permit- ted to have a minimum clear height of 8 feet (2.44 m).

1224.5.3.3 Location. Technology distribution rooms shall be provided throughout the facility as necessary to meet the maximum cable distance requirement for the cabling system specified.

1224.5.4 SPC/NPC compliance. The location of spaces required by this section shall meet the requirements of

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INTERIOR ENVIRONMENT

California Existing Building Code, Section 310A, Compli- ance Alternatives for Services/Systems and Utilities.

1224.5.5 Access. Access to the spaces required by this sec- tion shall be controlled and not require passage through patient-care or sterile space.

1224.5.6 Combining spaces. The combining of the tele- communications service entrance room, technology equip- ment center and technology distribution room shall be permitted, provided that the requirements for each of the individual spaces are met.

BASIC SERVICES

1224.14.1 Patient rooms.

1224.14.1.1 Capacity. No patient room shall be designed to accommodate more than four beds.

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

1224.14.1.2 Space requirements. In new construction, patient rooms shall have a minimum of 100 square feet (9.29 m ² ) of clear floor area per bed in multiple-bed rooms and 120 square feet (11.15 m ² ) of clear floor area for single-bed rooms. The dimensions and arrangement of rooms shall be such that there is a min- imum of 3 feet (914 mm) between the sides and foot of the bed and any wall or any other fixed obstruction. In multiple-bed rooms, a minimum clearance of 3 feet (914 mm) shall be provided between beds and a clear- ance of 4 feet (1219 mm) shall be available at the foot of each bed to permit the passage of equipment and beds.

Exception: Where renovation of existing patient rooms is undertaken in facilities built under the 2001 or prior California Building Code, patient rooms shall have no less than 80 square feet (7.43 m ² ) of clear floor area per bed in multiple-bed rooms and 110 square feet. (10.22 m ² ) of clear floor area in single-bed rooms.

1224.14.1.3 Windows. Each patient room shall have a window in accordance with Section 1224.4.9.

1224.14.1.4 Arrangement. Patient rooms shall not be designed to permit the placement of beds more than three deep from the exterior window, but shall be of such shape and dimensions to allow for the perfor- mance of routine functions, including the easy transfer of patients to and from bed to wheelchair or wheeled gurney.

1224.14.1.5 Outside exposure. All patient bedrooms shall have an outside exposure and shall not be below ground level.

1224.14.1.6 Handwashing stations. A handwashing station shall be provided in the patient room. This handwashing station shall be located at or adjacent to the entrance to the patient room with unobstructed access for use by health care personnel and others entering and leaving the room. Water spouts used shall have clearances adequate to avoid contaminating uten- sils and the contents of carafes, etc. In multiple-bed rooms the handwashing station shall be located outside of the patient’s cubicle curtain so that it is immediately accessible to staff. Where renovation of patient rooms is undertaken a handwashing station shall be located in the patient toilet room or patient room.

used shall_ have clearances adequate to avoid contaminating uten- sils and the contents of carafes, etc. In multiple-bed rooms the handwashing station shall be located outside of the patient’s cubicle curtain so that it is immediately accessible to staff. Where renovation of patient rooms is undertaken a handwashing station shall be located in the patient toilet room or patient room.

1224.14.1.7 Toilet room. Each patient shall have access to a toilet room without having to enter the gen- eral corridor area. One toilet room shall serve no more than four beds and no more than two patient rooms. The toilet room shall contain a water closet and a lava- tory and the door shall swing outward or be double act- ing. Unless located in a toilet room, bedpan-washing fixtures shall be installed in dedicated rooms, separate from patient care areas.

1224.14.1.8 Patient storage. Each patient shall have within his or her room a separate wardrobe, locker or closet suitable for hanging full-length garments and for storing personal effects.

1224.14.1.9 Privacy. A method of assuring visual pri- vacy for each patient shall be maintained in patient rooms and in tub, shower and toilet rooms. Windows or doors within a normal sightline that would permit observation into the room shall be arranged or cur- tained as necessary for patient privacy. In multiple-bed rooms, visual privacy from casual observation by other patients and visitors shall be provided for each patient. The design for privacy shall not restrict patient access to the entrance, lavatory or toilet room.

1224.14.1.10 Grab bars. Grab bars shall be installed in accordance with Section 1224.4.18.

1224.14.1.11 Room identification. Each patient room shall be labeled with an identification number, letter or combination of the two.

1224.14.2 Support areas. The size and location of each support area will depend upon the numbers and types of beds served. If it has direct access to the unit, some sup- port areas may be arranged and located to serve more than one nursing unit as indicated below, but, unless noted

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tub for each 12 beds without such facilities. Each bath- tub or shower shall be in an individual room or enclosure that provides privacy for bathing, drying and dressing. Each centralized bathing facility shall have direct access to a patient toilet and handwashing fix- ture.

1224.14.2.15 Special bathing facilities. If provided, special bathing facilities for patients on gurneys, carts and wheelchairs shall include space for an attendant.

1224.14.2.16 Patient toilet room(s). Common patient toilet room(s), in addition to those serving bed areas, shall be located adjacent to multipurpose room(s) and within, or directly accessible to each central bathing facility.

1224.14.2.17 Emergency equipment storage. Space shall be provided for emergency equipment that is under direct control of the nursing staff, such as a car- diopulmonary resuscitation (CPR) cart. This space shall be directly accessible from the nursing station, but out of normal traffic.

1224.14.2.18 Housekeeping room. Housekeeping rooms may be shared between adjacent compatible nursing units.

1224.14.2.19 Grab bars. Grab bars shall be installed in accordance with Section 1224.4.18.

1224.14.3 Airborne infection isolation rooms.

1224.14.3.1 General. Single rooms shall be provided for the isolation of patients with airborne communica- ble disease at a ratio of one room for each 35 licensed 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 adja- cent to the anteroom side of the door between the isola- tion room and the anteroom.

Exceptions:

1. Acute psychiatric hospitals shall provide air- borne infection isolation rooms at the ratio of one room for each 50 beds, or major fraction thereof.

2. Airborne infection isolation rooms are not required for chemical dependency recovery ser- vices.

1224.14.3.2 Anteroom doors. Airborne infection isola- tion room(s) shall have self-closing and latching devices on all anteroom doors.

1224.14.3.3 Anteroom. A separate anteroom shall be provided between the airborne infection isolation room and the corridor, which shall constitute the primary entrance to the airborne infection 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 airborne infection isolation room. Doors shall be aligned to allow large equipment to be

otherwise, at least one such support area shall be pro- vided on each nursing floor.

1224.14.2.1 Nurse station(s). Nurse station(s) shall be provided in each nursing unit and shall comply with Section 1224.4.4.2.

1224.14.2.2 Nurse or supervisor office. A nurse or supervisor office shall be provided and may be shared between adjacent nursing units on the same floor.

1224.14.2.3 Toilet room(s) for staff use. Staff toilet rooms may be shared between adjacent nursing units on the same floor.

1224.14.2.4 Multipurpose room(s) Multipurpose rooms shall be provided for staff, patients, patients’ families for patient conferences, reports, education, training sessions and consultation. These rooms must be readily accessible to each nursing unit. One such room may serve several nursing units and/or depart- ments.

1224.14.2.5 Examination or treatment room(s). Exam- ination or treatment rooms are optional. If provided, provision shall be made to preserve patient privacy from observation from outside the exam room though an open door.

1224.14.2.6 Clean utility/workroom. Clean util- ity/workroom shall be provided and shall comply with Section 1224.4.4.6.

1224.14.2.7 Soiled workroom or soiled holding room. A soiled workroom or soiled holding room shall be pro- vided and shall comply with Section 1224.4.4.7.

1224.14.2.8 Medication station. A medication station shall be provided in each nursing unit and shall comply with Section 1224.4.4.4.

1224.14.2.9 Clean linen storage. Each nursing unit shall contain a designated area for clean linen storage. This may be within the clean utility room or a separate closet.

1224.14.2.10 Nourishment area. A nourishment area or room shall be provided for each nursing unit and shall comply with Section 1224.4.4.5.

1224.14.2.11 Ice machine. Each nursing unit shall have equipment to provide ice for treatments and nour- ishment. Ice making equipment may be in the clean util- ity room/holding room or at the nourishment station. Ice intended for human consumption shall be from self- dispensing icemakers.

1224.14.2.12 Equipment storage room. Appropriate room(s) shall be provided for storage of equipment necessary for patient care with not less than 10 square feet (0.93 m ² ) per patient bed.

1224.14.2.13 Gurneys and wheelchairs. Provide a storage room or alcove for gurneys and wheelchairs which shall be a minimum of 15 square feet (1.39 m ² ).

1224.14.2.14 Centralized bathing facilities. When indi- vidual bathing facilities are not provided in patient rooms, there shall be at least one shower and/or bath-

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wheeled into the airborne infection isolation room unless a secondary door complying with Section 1224.14.3.2 is provided. One anteroom may serve no more than two airborne infection isolation rooms.

1224.14.3.4 Secondary entry. When a secondary entry is provided, the secondary doors shall be provided with locking devices which are readily operable from the room side and which are readily operable by the facil- ity staff on the other side. When key locks are used on isolation rooms, keys shall be located at the nurse sta- tion in a prominent readily accessible location.

1224.14.3.5 Sealed-tight room. Airborne infection iso- lation room perimeter walls, ceilings, floors, doors and penetrations shall be sealed tightly to minimize air infiltration from the outside or from other spaces.

1224.14.3.6 Adjoining toilet room. Each isolation room shall have its own directly accessible toilet room 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.

1224.14.4 Protective environment room(s).

1224.14.4.1 General. Protective environment rooms for the protection of certain immunosuppressed patients may be provided by the facility. Protective environment rooms shall be labeled “Protective Envi- ronment Room” on or adjacent to the anteroom side of the door between the isolation room and the anteroom. Protective environment rooms shall contain only one bed.

1224.14.4.2 Anteroom doors. Protective environment room (s) shall have self-closing and latching devices on all anteroom doors.

1224.14.4.3 Anteroom. A separate anteroom shall be provided between the protective environment room and the corridor, hallway or adjoining space which shall constitute the only entrance to the protective environ- ment 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 protective environment room. There shall be means to allow for airflow from the pro- tective environment room into the anteroom. Anteroom doors shall be aligned so that large equipment can be wheeled into the protective environment room. One anteroom may serve no more than one protective envi- ronment room.

Exception: Alternate designs for protective environ- ment rooms, without individual anterooms, may be approved by the enforcement 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.

1224.14.4.4 Adjoining toilet room. Room shall meet the requirements of Section 1224.14.3.6.

1224.14.4.5 Sealed-tight room. Protective environment room perimeter walls, ceiling, floors, doors and pene- trations shall be sealed tightly to minimize air infiltra- tion from the outside or from other spaces.

1224.14.5 Seclusion room(s). If provided, the hospital shall provide one or more single bedrooms for patients needing close supervision for medical and/or psychiat- ric care. This may be part of the psychiatric unit described in Section 1224.31. If the single bedroom(s) is part of the acute-care nursing unit, the provisions of Section 1224.14.1 shall apply, with the following exceptions: each room shall be for single occupancy; each shall be located to permit staff observation of the entrance, preferably adjacent to the nurse station; and each shall be designed to minimize the potential for escape, hiding, injury or suicide. If vision panels are used for observation of patients, the arrangement shall insure patient privacy and prevent casual observation by visitors and other patients.

1224.15.1 General. The surgical service space shall be divided into two designated areas: 1) semi-restricted areas (e.g., storage areas for clean and sterile supplies, sterile processing rooms, scrub stations and corridors leading to restricted areas of the surgical suite, etc.); and 2) restricted areas (e.g., operating rooms, hybrid operat- ing rooms, sterile procedure rooms, cardiac catheteriza- tion labs, sterile cores, etc.) that can be reached only through a semi-restricted area. The surgical service space shall be located and arranged to provide direct support from the anesthesia/recovery service space with a common door to prevent nonrelated traffic through the surgical service space.

An operating room suite design with a sterile core shall provide for no cross traffic of staff and supplies from the decontaminated/soiled areas to the sterile/clean areas. The use of facilities outside the operating room for soiled/decontaminated processing and clean assembly and sterile processing shall be designed to move the flow of goods and personnel from dirty to clean/sterile without compromising universal precautions or aseptic techniques in either department.

The number of operating rooms and recovery beds, and the sizes of the support areas, shall be based on the expected surgical workload. Hospitals shall maintain at least the number of operating rooms in ratio to licensed bed capacity as follows:

For each additional 100 beds, and for each major fraction thereof, at least one additional operating room shall be maintained, unless approved to the contrary by the Department of Public Health. Required operating rooms are in addition to special operating rooms, cys-

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toscopy rooms and fracture rooms which are provided by the hospital. Beds in a distinct-part skilled nursing service, intermediate care service or psychiatric unit shall be excluded from calculating the number of oper- ating rooms required.

Exception: Surgical service space is not required in a rural general acute care hospital, if the hospital main- tains written transfer agreements with one or more general acute care hospitals that provide surgical and anesthesia services. Written transfer agreements shall be approved by the Department of Public Health, Licensing and Certification.

1224.15.2 Surgery.

1224.15.2.1 General operating room(s). Each room shall have a minimum clear floor area of 400 square feet (37.16 m ² ) with a minimum of 20 feet (6096 mm) clear dimension between fixed cabinets and built-in shelves; and a system for emergency communication with the surgical service space control station. X-ray or imaging viewing capabilities shall be provided.

Exception: Where renovation of existing operating rooms is undertaken in facilities built under the 2001 or prior California Building Code, each oper- ating room shall have a minimum clear floor area of 324 square feet (30.10 m ² ) with a minimum of 18 feet (5486 mm) clear dimension between fixed cabi- nets and built-in shelves.

1224.15.2.2 Procedure room(s). Where a procedure room is provided, it shall comply with Section 1224.4.4.1.4 unless specified elsewhere.

1224.15.2.2.1 Surgical cystoscopic and other endo- urologic procedures. Each room shall have a mini- mum clear floor area of 250 square feet (23.23 m ² ) with a minimum of 15 feet (4572 mm) clear dimen- sion between fixed cabinets and built-in shelves. X- ray viewing and/or other imaging modality capabili- ties shall be provided

Exception: Where renovation of operating rooms is undertaken in facilities built under the 2001 or prior California Building Code rooms for surgi- cal cystoscopy shall have a minimum clear floor area of 180 square feet (16.72 m ² ). Cast rooms for open reductions, if provided, shall have a minimum clear floor area of 180 square feet (16.72 m ² ), no dimension of which shall be less than 11 feet (3353 mm).

1224.15.3 Service areas. Services, except for the enclosed soiled workroom referenced in Section 1224.15.3.7 and the housekeeping room referenced in Section 1224.15.3.12, may be shared with the obstetrical facilities. Service areas, when shared with delivery rooms, shall be designed to avoid the passing of patients or staff between the operating room and the delivery room areas. The following shall be provided in support of the surgical service space:

1224.15.3.1 Control station. Control stations shall be located to permit visual observation of all traffic into the surgical service space.

INTERIOR ENVIRONMENT

1224.15.3.2 Supervisor’s office or station.

1224.15.3.3 Sub-sterile areas. If provided within the surgery suite, a sub-sterile area(s) shall be equipped with a flash sterilizer, warming cabinet, countertop and handwashing station. If a sterilizing facility(ies) with high-speed sterilizer(s) or other sterilizing equipment for immediate or emergency use are provided, they shall be directly accessible from the operating room(s) it serves or shall be located inside the clean core if the clean core is directly accessible from the operating room(s). This room shall be accessible without travel- ing through any operating room. Other facilities for processing and sterilizing reusable instruments, etc., may be located in another hospital department such as central sterile supply.

1224.15.3.4 Medication station. A medication station shall be provided in accordance with Section 1224.4.4.4.

1224.15.3.5 Scrub facilities. Scrub sinks shall be located outside of sterile areas. A minimum of two scrub sinks shall be provided in a surgical unit contain- ing one operating room. Four scrub sinks shall be pro- vided in surgical units containing two operating rooms. One additional scrub sink shall be provided for each additional operating room. Scrub sinks shall have water supply controls not requiring direct contact of the hands for operation.

1224.15.3.6 Clock. A direct-wired or battery-operated clock or other equivalent timing device shall be visible from the scrub-up sinks.

1224.15.3.7 Soiled workroom. An enclosed soiled workroom (or soiled holding room that is part of a sys- tem for the collection and disposal of soiled material) for the exclusive use of the surgical service space shall be provided. The soiled workroom shall contain a flushing-rim clinical sink or equivalent flushing-rim fixture, a handwashing station, a work counter and space for waste receptacles and soiled linen recepta- cles. Rooms used only for temporary holding of soiled material may omit the flushing-rim clinical sink and work counters. However, if the flushing-rim clinical sink is omitted, other provisions for disposal of liquid waste shall be provided. The room shall not have direct connection with operating rooms. Soiled and clean util- ity room or holding rooms shall be separated. The soiled workroom shall provide 24 square feet (2.23 m ² ) per operating room up to eight operating rooms and shall have a minimum area of 48 square feet (4.46 m ² ), with no dimension less than 6 feet (1829 mm).

1224.15.3.8 Clean utility room. This room shall not be used for food preparation.

A clean utility room is required when clean materials are assembled within the surgical service space prior to use or following the decontamination cycle. It shall contain a work counter, a handwashing station, storage facilities for clean supplies and a space to package reusable items. The storage for sterile supplies must be separated from this space. If the room is used only for storage and holding as part of a system for distribution

are assembled within the surgical service space prior_ to use or following the decontamination cycle. It shall contain a work counter, a handwashing station, storage facilities for clean supplies and a space to package reusable items. The storage for sterile supplies must be separated from this space. If the room is used only for storage and holding as part of a system for distribution

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INTERIOR ENVIRONMENT

of clean supply materials, the work counter and hand- washing station may be omitted. Soiled and clean util- ity rooms or holding rooms shall be separated.

1224.15.3.9 Anesthesia workroom. Provide an anes- thesia workroom for cleaning, testing and storing anes- thesia equipment. This room shall contain work counter(s) and sink(s) and racks for cylinders.

1224.15.3.10 Equipment storage room(s) for equip- ment and supplies used in surgical service space. Each surgical service space shall provide sufficient storage area to keep its required corridor width free of equipment and supplies, but not less than 150 square feet (13.94 m ² ) or 50 square feet (4.65 m ² ) per operat- ing room, whichever is greater.

1224.15.3.11 Staff clothing change areas. Appropriate areas shall be provided for male and female staff work- ing within the surgical service space. The areas shall contain lockers, showers, toilets, handwashing stations and space for donning surgical attire. These areas shall be arranged to ensure a traffic pattern so that personnel entering from unrestricted area outside the surgical service space enter, change their clothing and move directly into the surgical service space semi- restricted corridor.

1224.15.3.12 Housekeeping room. Shall be provided for the exclusive use of the surgical service space. It shall be directly accessible from the service space.

1224.16.1 General . The anesthesia/recovery service space shall provide perioperative support services to the surgi- cal service space as required under this section. Perioper- ative services shall include preoperative patient care and post-operative recovery with a Post-Anesthesia Care Unit (PACU). The anesthesia/recovery service space shall be located adjacent to the surgical service space with direct access to the surgical suite’s semi-restricted corridor.

Exception: In a rural general acute care hospital, when the surgical service space is not provided, the anesthesia service space is not required. The hospital must maintain written transfer agreements with one or more general acute care hospitals that provide surgical and anesthesia services. Written transfer agreements shall be approved by the Department of Public Health, Licensing and Certification.

1224.16.2 Preoperative patient holding area(s). In facili- ties with two or more operating rooms, area(s) with patient care stations shall be provided to accommodate gurney patients or sitting space for ambulatory patients not requiring gurneys. The preoperative area is an unre- stricted area and shall be under the direct visual control of the nursing staff and may be part of the recovery space. If the preoperative patient care area will serve other pur- poses, such as overflow PACU or holding area, applicable requirements in Section 1224.16.3 PACU shall be met.

1224.16.2.1 Space requirements. Each station shall have a minimum clear floor area of 80 square feet (7.43 m ² ) and a minimum clearance of 3 feet (914 mm) shall be provided between the sides and foot of patient

lounge chairs/gurneys and adjacent walls, partitions or fixed elements.

1224.16.2.2 Patient privacy. Provisions for patient pri- vacy such as cubicle curtains shall be made.

1224.16.2.3 Handwashing stations. Handwashing sta- tion(s) shall be provided in the preoperative service area at a ratio of one for each 4 stations, and for each major fraction thereof, in open bay areas. A handwash- ing station shall be provided in each single care station room.

1224.16.3 Recovery and Post-Anesthesia Care Unit (PACU). The recovery area and Post-Anesthesia Care Unit is an unrestricted area and located such that at least one door to the recovery room shall provide access directly from the surgical service space without crossing unrestricted corridors. A minimum of 1.5, or major frac- tion thereof, post-anesthesia care stations per operating room shall be provided. If pediatric surgery is provided, pediatric recovery stations shall be provided. They shall be separate from adult stations, and shall include space for family or visitors and be visible from the nurse station.

rgical service space without crossing_ unrestricted corridors. A minimum of 1.5, or major frac- tion thereof, post-anesthesia care stations per operating room shall be provided. If pediatric surgery is provided, pediatric recovery stations shall be provided. They shall be separate from adult stations, and shall include space for family or visitors and be visible from the nurse station.

1224.16.3.1 Space requirements. A minimum of 4 feet (1218 mm) clearance shall be provided between the sides and the foot of patient gurneys or beds and adja- cent walls or other fixed elements. A minimum clear floor area of 80 square feet (7.43 m ² ) shall be provided for each station in an open-bay plan. A minimum clear- ance of 5 feet (1524 mm) shall be provided between sides of gurneys or beds, and a minimum of 3 feet (914 mm) clearance shall be provided between the foot of the gurney or bed, to a closed cubicle curtain. A mini- mum width of 6 feet (1829 mm) of access/circulation outside the curtain shall be provided. See Patient Bay under Patient Care Locations in Section 1224.3.

1224.16.3.2 Patient privacy. Provisions for patient pri- vacy such as cubicle curtains shall be made.

1224.16.3.3 Handwashing stations. Handwashing sta- tions shall be provided in the post-anesthesia care unit with at least one for every four patient positions, and for each major fraction thereof, uniformly distributed to provide equal access from each patient station. A handwashing station shall be provided in each single care station room.

1224.16.4 Reserved.

1224.16.5 Support areas for patient care.

1224.16.5.1 Nurse station. A nurse station shall be provided in postoperative patient care areas, and shall allow direct observation of the patients and charting facilities. The nurse station shall comply with the requirements of Section 1224.4.4.2.

1224.16.5.2 Clinical sink. A clinical sink shall be pro- vided in postoperative patient care areas with provi- sions for bedpan cleaning.

1224.16.5.3 Medication station. Each Post-Anesthesia Care Unit shall contain a medication station. The med-

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ication station shall comply with the requirements of Section 1224.4.4.4.

1224.16.5.4 Ice-making. Ice-making equipment shall be provided in the perioperative service space. Ice- making equipment is permitted to be located in preop- erative or postoperative patient care areas, however, it shall not be located in semi-restricted areas.

1224.16.5.5 Storage. Storage shall be provided for gur- neys, supplies and equipment.

1224.16.6 Support areas for staff . Staff toilet rooms shall be immediately accessible to the postoperative patient care area(s) to maintain staff availability to patients.

1224.16.7 Support areas for patients, families and visi- tors.

1224.16.7.1 Waiting area. A waiting area, in compli- ance with Section 1224.4.5, shall be provided.

1224.16.7.2 Patient change area. A changing area shall be provided for outpatient use in perioperative areas in support of surgical suites that provide outpa- tient procedures. The changing area shall include space for changing or gowning, provisions for storing patients’ belongings during the procedure, and access to patient toilet(s).

1224.17.1 General requirements. All hospitals shall pro- vide space and equipment to perform urinalysis, complete blood counts, hemoglobin blood typing and cross match- ing. If laboratory facilities for bacteriological, serologi- cal, pathological and additional hematological procedures are not available in the community, then space, equipment and supplies for such procedures shall be provided. 1224.17.2 Laboratory work areas. The following labora- tory work areas shall be provided:

1224.17.2.1 Laboratory workstation(s). Space shall be provided to accommodate equipment used and, at mini- mum, shall include a laboratory work counter and a sink. All work counter(s) in areas used for specimen handling, preparation of specimens or reagents, and laboratory testing shall be constructed of nonporous materials. Access to the following shall be provided as required:

1. Tele/data service.

2. Electrical service.

3. Computer/printer.

1224.17.2.2 Handwashing station(s).

1224.17.2.2.1. If there is one work station, a hand- washing station shall be provided at the worksta- tion.

1224.17.2.2.2. If more than one work station is pro- vided, a handwashing station shall be provided within 25 feet (762 mm) of all testing and specimen- handling areas.

INTERIOR ENVIRONMENT

1224.17.2.2.3. A handwashing station shall be pro- vided in each enclosed room where bio-hazardous specimens and/or hazardous chemicals are handled.

1224.17.2.3 Refrigerated storage facilities. Refriger- ated blood storage facilities for transfusions shall be provided. Blood storage refrigerators shall be equipped with temperature-monitoring and alarm sig- nals that are monitored continuously.

1224.17.2.4 Storage facilities.

1. Storage for reagents, specimens, flammable materials, acids, bases and other supplies shall be provided as necessary.

2. Separate facilities shall be provided for such incompatible materials as acids and bases.

3. Vented storage shall be provided for volatile sol- vents.

1224.17.2.5 Terminal sterilization. Facilities and equipment may be provided for terminal sterilization of bio-hazardous waste before transport (autoclave or electric oven).

Notes:

1. Terminal sterilization is not required for waste that is incinerated on-site.

2. Terminal sterilization is subject to other state and federal regulatory requirements.

Exception: Terminal sterilization facilities are not required when it can be demonstrated to the licens- ing agency that transport and terminal sterilization can be effectively contracted to an independent med- ical waste treatment facility.

1224.17.2.6 Radioactive material handling. If radioac- tive materials are employed, facilities for long-term storage and disposal of these materials shall be pro- vided.

1224.17.3 Specimen collection facilities. 1224.17.3.1 General. Space shall be provided for spec- imen collection. Facilities for this function shall be located outside the laboratory work area.

1224.17.3.2 Facility requirements. At a minimum, specimen collection facilities shall have the following:

1. A blood collection area with a work counter, space for patient seating, handwashing station(s) and supply storage.

2. A urine and feces collection facility equipped with a toilet and a handwashing station.

3. Storage spaces for specimen collection supplies.

4. Work counters for labeling and computerized data entry.

5. Storage for specimens awaiting pickup.

1224.17.4 Administrative areas. Office(s) and space for clerical work, filing and record maintenance and storage shall be provided.

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INTERIOR ENVIRONMENT

VICE SPACE. Space and equipment shall be provided to accommodate all required elements, and any additional imag- ing modalities included in the service space, as required in this section. To differentiate the design and construction require- ments needed to achieve the environmental controls and other requirements that support the amount of intervention to be pro- vided, imaging rooms shall be classified as described in Table 1224.4.11.4a (Examination/Treatment, Imaging, Procedure and Operating Room Classification). Where an imaging room will be used for Class 1 and Class 2 procedures, the more stringent requirements for the higher class room shall apply. Where imaging procedures meeting Class 3 criteria are per- formed, rooms that meet the requirements for the applicable imaging suite and for an operating room per Section 1224.15.2.1 or hybrid operating room per Section 1224.28.5 shall be provided. If Class 3 interventional or image-guided procedures are performed in the imaging services area, addi- tional provisions shall be as described in Section 1224.28 Sup- plemental Surgery and other Special Procedure Services. If nuclear medicine is provided in the imaging services area, spaces shall also comply with the requirements described in Section 1224.34 Nuclear Medicine.

1224.18.1 Minimum requirements. Hospital shall provide a minimum of:

1. One fluoroscopy room or CT room on approval of Licensing Agency, which can also provide x-ray examination services.

2. Space for processing or viewing images.

3. A toilet room shall adjoin and be directly accessible to each fluoroscopy room. In addition to the fluoros- copy toilet rooms, common patient toilet room facil- ities shall be located in the radiological/diagnostic imaging service space.

4. An office or other suitable area for viewing and reporting radiographic examination.

5. Storage spaces for all image equipment, supplies and copies of reports.

6. Handwashing stations located within the unit.

a) Handwashing station(s) shall be provided within

the unit to serve imaging spaces not served by a dedicated handwashing station within the imag- ing room or scrub facility located directly outside the imaging/procedure room.

b) A handwashing station shall be provided in Class

1 imaging rooms, unless specified otherwise for a specific imaging modality.

c) A handwashing station or hand scrub facility

shall be provided for Class 2 imaging rooms. If a handwashing station is provided, it shall be directly accessible to the imaging room. If a hand scrub facility is provided, it shall be directly out- side the entrance to the imaging room.

d) Hand scrub facilities shall be provided directly

outside the entrance to a Class 3 imaging room.

7. Dressing room facilities.

1224.18.1.1 Radiation protection. A certified physicist or other qualified expert shall specify the type, location and amount of radiation protection to be installed in accordance with the final approved department layout and equipment selections. Where protected alcoves with view windows are required, a minimum of 1'-6" (0.45 meter) between the view window and the outside partition edge shall be provided. Radiation protection requirements shall be incorporated into the construc- tion documents and comply with Chapter 31C and the requirements of California Radiation Control Regula- tions, California Code of Regulations, Title 17, Divi- sion 1, Chapter 5 and Subchapter 4.

1. The control alcove or room shall be, at minimum, sized and configured in compliance with the man- ufacturer’s recommendations for installation, service and maintenance.

2. A control alcove or room shall be permitted to serve more than one imaging room, provided the manufacturer’s recommendations for installa- tion, service and maintenance are accommodated for all rooms served.

3. The control alcove or room shall include a shielded view window, as specified in the physi- cist’s report, designed to provide a full view of the examination/procedure table and the patient at all times, including a full view of the patient during imaging activities (e.g., when the table is tilted or the chest x-ray is in use).

4. The control room shall be physically separated from a Class 2 or Class 3 imaging room with walls and a door.

5. Where an imaging room requires positive (or negative) pressure, a door shall be provided between the control room and the imaging room.

1224.18.1.2 Multiple-modality devices. Where two or more individual imaging or therapy modalities are integrated into one imaging device (e.g., PET/CT, SPECT/CT or PET/MRI), the minimum requirements for that room shall include the criteria for each individ- ual contributing modality. Refer to Section 1224.34 for modalities not included under Section 1224.18.

1224.18.2 Angiography. If provided, diagnostic angiogra- phy space shall accommodate the following:

1. A control room with a view window to permit full view of the patient.

2. A scrub sink located outside the staff entry to the procedure room.

3. Patient holding area shall accommodate at least one patient gurney with a minimum of 3-foot (914 mm) clearance on the long side.

4. Storage for portable equipment and catheters shall be provided.

1224.18.2.1 Interventional angiography procedures. If interventional angiography procedures are to be per- formed in the angiography room, the suite shall comply

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with interventional imaging requirements in Section 1224.28.4. If cardiac catheterization procedures are performed refer to Section 1224.28.2.

1224.18.3 Computerized tomography (CT) scanning. If provided, CT space shall accommodate the following:

1224.18.3.1 Spaces required. If provided, CT scan spaces shall accommodate the equipment with a mini- mum of 3 feet (914 mm) on all sides of the equipment, together with the following:

1. A control room or alcove shall be provided that is designed to accommodate the computer and other controls for the equipment. A view window shall be provided to permit view of the patient.

2. A patient toilet room readily accessible to the procedure room.

1224.18.3.2 Intraoperative computerized tomogra- phy. If provided, intraoperative CT scanning spaces shall comply with Section 1224.28.5.

1224.18.4 Magnetic resonance imaging (MRI). If pro- vided, the MRI room shall accommodate the equipment with a minimum of 3 feet (914 mm) on all sides of the equipment, together with the following:

1. A control room shall be provided with full view of the patient in the MRI scanner. The control console shall be positioned so the operator has a full view of the approach and entrance to the MRI scanner room.

2. An anteroom or area visible from the control room shall be located outside the MRI scanner room so that patients, health care personnel and other employees must pass through it before entering the scanning area and control room. The room or area shall be outside the restricted areas of the MRI’s magnetic field.

3. Safety Zones One through Four shall be identified.

a) Zone One consists of all areas freely accessible

to the general public. This zone includes the entrance to the MR facility.

b) Zone Two acts as a buffer between Zone One and

the more restrictive Zone Three. Patients are under the general supervision of MR personnel. Zone Two may include the reception area, dress- ing room and interview room.

c) Zone Three should be restricted by a physical

barrier. The MR control room and/or computer room are located within Zone Three.

d) Zone Four is strictly the area within the walls of

the MR scanner room. Access into the MR scan- ner room should only be available by passing through Zone Three.

4. An imaging equipment room shall be provided if needed for the operation of the MRI.

INTERIOR ENVIRONMENT

1224.18.4.1 Handwashing station. Handwashing sta- tion(s) shall be immediately accessible to the MRI scanner room.

1224.18.4.2 Wall, floor and ceiling assemblies. Wall, floor and ceiling assemblies shall accommodate the installation of required radio frequency (RF)-shielded assemblies. All doors, windows and penetrations into the RF-shielded enclosure shall be RF-shielded. As well as RF shielding, individual sites may also require magnetic shielding on some or all surfaces to contain portions of the magnetic field not contained by the RF shield.

1224.18.4.3 Lighted sign. MRI rooms shall be clearly marked with a red light and lighted sign stating, “The Magnet Is On”. This light and sign are to be lighted at all times and have a backup energy source to remain illuminated for at least 24 hours in the event of a loss of power.

1224.18.4.4 Magnetic field strength identification. Facilities shall use finishes or markings to identify the critical values of the magnetic field surrounding the MRI scanner, including the 5-gauss exclusion zone or other magnetic field strength values that may impair the operation of equipment.

1224.18.4.5 Special ventilation requirements. Where superconducting MRI scanners are installed, an insu- lated cryogen quench exhaust pipe as well as room exhaust and pressure equalization shall be provided to protect occupants in the event of a cryogen breach.

1224.18.4.6 Intraoperative magnetic resonance imag- ing. If provided, the intraoperative magnetic resonance imaging (iMRI) suite shall comply with Section 1224.28.5.

1224.18.5 Ultrasound. When provided, the ultrasound room shall comply with the following:

1224.18.5.1 Space requirements.

1. Area. Rooms used for ultrasound examina- tion/treatment shall have a minimum clear floor area of 120 square feet (11.15 m ² ).

2. Clearances. A minimum clear dimension of 3 feet (914 mm) shall be provided on three sides of the table/stretcher.

1224.18.5.2 Handwashing station. A handwashing sta- tion shall be provided within the exam room.

1224.18.5.3 Patient toilet(s). A patient toilet shall be directly accessible to the ultrasound exam room. The patient toilet may be permitted to serve more than one ultrasound exam room. If exams performed are limited to cardiology, vascular, breast ultrasound or used only for image guided procedures, then the toilet is not required to have direct access.

1224.18.5.4 Processing room. If provided, a process- ing room shall contain distinct areas for cleaning and decontaminating instruments. The cleaning area shall

Copyright © 2022 by, or licensed to, International Code Council, Inc. (ALL RIGHTS RESERVED); licensed to California Building Standards Commission pursuant to License Agreement. No further reproductions is authorized. Any unauthorized reproduction or distribution is a violation of the federal copyright act and the license agreement, and subject to civil and criminal penalties thereunder.

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provide for flow of instruments from the contaminated area to the clean area and then to storage.

1224.18.5.4.1 The decontamination area shall be equipped with the following:

1. One freestanding handwashing station.

2. Work counter space(s).

3. Separate storage room or cabinets for HLD probes.

1224.18.6 Mammography. When provided, the mammog- raphy room shall comply with the following:

1224.18.6.1 Space requirements.

1. Area. Mammography rooms shall be a minimum of 100 square feet (9.3 m ² ).

2. Shielded alcove. Each x-ray room shall include a shielded control alcove. For mammography machines with built-in shielding for the operator, omission of the alcove shall be permitted when approved by the certified physicist.

1224.18.6.2 Handwashing station . A handwashing sta- tion shall be provided within the procedure room.

1224.18.7 Support spaces. The following spaces are com- mon to the imaging service area and are minimum requirements unless stated otherwise:

1224.18.7.1 Patient’s toilet room(s). In service spaces with procedure rooms that do not have dedicated patient toilets, provide a minimum of one patient toilet room within the service space.

1224.18.7.2 Patient dressing areas. Dressing areas shall be provided adjacent to the imaging rooms.

1224.18.7.3 Staff facilities. In service space of three or more procedure rooms, staff toilet room(s) internal to the service space shall be provided.

1224.18.7.4 Film storage (active). If film systems are used, provide the following:

1. A room with cabinet or shelves for filing patient film for immediate retrieval shall be provided.

2. Storage facilities for unexposed film which shall include protection of film against exposure or damage.

1224.18.7.5 Locked storage. Provision shall be made for locked storage of medications and drugs.

1224.19.1 General. Facilities shall be provided to accom- modate services and equipment associated with the drug distribution system used, the number of patients to be served, and the extent of shared or purchased services as licensed by the California Board of Pharmacy. Hospital pharmacies shall comply with the requirements of Section 1250 and include the functional spaces under Sections 1224.19.2 through 1224.19.7. Exempt hospitals shall pro- vide a drug room and the supporting spaces, in compli- ance with Section 1224.19.1.2.

1224.19.1.1 Licensed pharmacy. All hospitals having a licensed capacity of 100 or more beds shall have a pharmacy on the premises licensed by the California Board of Pharmacy.

Note: See General Acute Care Hospitals §70263(a), Article 3, Chapter 1, Division 5, Title 22, California Code of Regulations, for requirements concerning hospitals with fewer than 100 beds. The pharmacy room or service space shall conform to the require- ments of § 1751, Article 7, Division 17, Title 16, California Code of Regulations as enforced by the California Board of Pharmacy.

1224.19.1.2 Less than 100-bed exemption. Hospitals under a Hospital Pharmacy Permit Exemption issued by the Board of Pharmacy, associated with Business and Professions Code Section 4056, shall provide all basic pharmaceutical services in compliance with Sec- tion 1224.19.1.2.

1224.19.1.2.1 Drug room. Licensed pharmaceutical space with drug distribution shall be under the supervision of a physician and be monitored by a pharmacist consultant. The drug room shall include the following:

1224.19.1.2.1.1. A room or area for receiving, breakout and inventory control of drugs used in the hospital.

1224.19.1.2.1.2. Cleanable work counters and space for automated and/or manual dispensing activities.

1224.19.1.2.1.3. Reserved.

1224.19.1.2.1.4. An area for reviewing and recording.

1224.19.1.2.1.5. An area for storage, exchange and restocking of carts.

1224.19.1.2.1.6. Security provisions for drugs and personnel in the dispensing counter area.

1224.19.1.2.2 Handwashing station. A hand-wash- ing station shall be provided in the area where med- ication(s) are handled or be immediately accessible, without going through a door unless the door is equipped with hands-free operation.

1224.19.1.2.3 Storage. Cabinets, shelves and/or separate rooms or closets shall be provided for the following:

1224.19.1.2.3.1. Bulk storage.

1224.19.1.2.3.2. Active storage.

1224.19.1.2.3.3. Refrigerated storage.

1224.19.1.2.3.4. Storage for volatile fluids and alcohol in accordance with applicable fire safety codes for the substances involved.

1224.19.1.2.3.5. Secured lockable storage for controlled drugs.

1224.19.1.2.3.6. Equipment and supply storage for general supplies and equipment not in use.

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1224.19.2 Pharmacy areas.

1224.19.2.1 Dispensing facilities. Hospital pharmacies shall provide the following areas for patient-specific compounding and dose repackaging of non-sterile preparations.

1224.19.2.1.1 Receiving. A room or area for receiv- ing, breakout and inventory control of materials used in the pharmacy.

1224.19.2.1.1.1 Size. A minimum of 120 square feet (11.15 m ² ) shall be provided.

1224.19.2.1.2 Dispensing. Work counters and space for automated and/or manual dispensing activities shall be provided to serve the volume of doses per day for in-patient and out-patient needs.

1224.19.2.1.3 Non-sterile compounding areas. An extemporaneous compounding/dose repackaging area shall be located next to bulk storage and include the following:

1224.19.2.1.3.1 Size. Work stations shall have sufficient counter space for drug preparation, with a minimum area of 120 square feet (11.15 m ² ) per station.

1224.19.2.1.3.2 Handwashing station. Hand- washing station(s) shall be in or immediately accessible to all areas where pharmaceuticals are handled without going through a door unless the door is equipped with hands-free operation.

1224.19.2.1.3.3 Utility sink. A utility sink shall be provided.

1224.19.2.1.3.4. If carousel or analogous robotic technologies are used, the area shall respond to the special system requirements.

1224.19.2.1.4 Recording. An area for reviewing and recording shall be provided. The area shall include counter space and electronic workstation(s).

1224.19.2.1.5 Temporary storage. An area for temporary storage, exchange and restocking of carts.

1224.19.2.1.6 Security. Security provisions shall be provided for drugs and personnel in the dispensing counter area.

1224.19.2.3 Storage. The following storage facilities shall be provided in the pharmaceutical service area.

1224.19.2.3.1 Bulk storage. A separate bulk storage area, or room, may be provided.

1224.19.2.3.2 Active storage. Active storage in sup- port of repackaging and dispensing activities shall be provided.

1224.19.2.3.3 Refrigerated storage. Refrigera- tion/freezer area shall be provided.

1224.19.2.3.4 Hazardous materials. Storage for volatile fluids and alcohol shall comply with Section 307.

INTERIOR ENVIRONMENT

1224.19.2.3.5 Secured storage. Secured lockable storage shall be provided for narcotics and con- trolled drugs.

1224.19.2.3.6 Equipment and supplies. Equipment and supply storage for general supplies and equip- ment not in use.

1224.19.3 Sterile compounding areas.

1224.19.3.1 General. If sterile compounding areas are provided, the requirements in this section shall be met. Buffer rooms (also known as clean rooms) and their anterooms, and Segregated Compounding Areas (SCA) are classified as semi-restricted areas. The pharmacy shall be laid out to preclude unrelated traffic to hazard- ous and nonhazardous preparation rooms. The buffer room, anteroom and SCA must be separated from areas not directly related to compounding and must be appropriately controlled to achieve and maintain required air quality classifications. A monitoring sys- tem shall be used in a cleanroom suite to continuously monitor the pressure differential between the ante- room(s) and buffer room(s) and between the ante-room and the general pharmacy area. Sterile compounding areas in hospitals shall comply with Sections 1735 and 1751 in Article 4.5 of Division 17 of Title 16 of the Cal- ifornia Code of Regulations and US Pharmacopeia (USP) Chapters 797 and 800, and the requirements in this section.

Note: Where robotic systems are used in the prepa- ration of IV solutions in either the positive pressure nonhazardous preparation room or the negative pressure hazardous prep room, the robotics shall be separate systems and not pass through from one area to the other.

1224.19.3.2 Nonhazardous sterile preparation area. If IV solutions are prepared in the pharmacy, a sterile compounding work area with a laminar airflow work- station designed for product protection shall be pro- vided in accordance with Title 16, Section 1735, and USP Chapter 797 and include the following.

1224.19.3.2.1 Workstation. The Primary Engineer- ing Control (PEC) shall be a laminar airflow work bench or isolator (CAI) as required. The worksta- tion shall have a visible pressure gauge for detec- tion of filter leaks or defects. All exposed sides of the workstation shall be accessible for cleaning and allow for reach behind the unit if not built against a wall. If built against a wall, the space behind the unit shall be sealed to prevent intrusion of moisture, contaminants and bacteria growth.

1224.19.3.2.2 Buffer room. Workstations shall be located in a Secondary Engineering Control (SEC) room. The SEC shall be a buffer/clean room, with the following requirements:

1224.19.3.2.2.1 Size. The minimum size for a non- hazardous buffer room is 120 square feet (11.15 m ² ) for a single workstation, and 75 square feet (6.97 m ² ) for each additional workstation.

Copyright © 2022 by, or licensed to, International Code Council, Inc. (ALL RIGHTS RESERVED); licensed to California Building Standards Commission pursuant to License Agreement. No further reproductions is authorized. Any unauthorized reproduction or distribution is a violation of the federal copyright act and the license agreement, and subject to civil and criminal penalties thereunder.

INTERIOR ENVIRONMENT

1224.19.3.2.2.2 Air quality. Nonhazardous buffer rooms shall be sealed tight, and be under positive pressure relative to the anteroom. Air supply shall be laminar airflow with a low-level return. Refer to California Mechanical Code Table 4A, Title 16 Section 1735 and USP Chapter 797 for additional requirements.

1224.19.3.2.2.3 Finishes. The buffer room is considered a semi-restricted area with non- porous and cleanable surfaces, ceilings, walls and floors subject to wet cleaning. The surfaces of ceilings, walls, floors, fixtures, shelving, counters and cabinets shall be smooth, seamless, impervious, free from cracks and crevices and be non-shedding. Ceilings shall be monolithic or utilize cleanroom style scrubbable and gasketed panels, able to withstand cleaning with chemi- cals. Junctures of ceilings to walls shall be coved or caulked to avoid cracks and crevices where dirt can accumulate. Sprinkler systems shall be recessed, covered, easily cleanable and of a type suitable for a cleanroom environment. Wall fin- ishes shall be 2-coat epoxy-covered gypsum board, seamless vinyl or other impervious cover- ing. Work surfaces, shelving and cabinets shall be constructed of smooth, impervious materials, such as stainless steel or molded plastic, so that they are easily cleaned and disinfected. Plastic laminate finish over a pervious substrate is not permitted.

1224.19.3.2.2.4 Eyewash station. If provided in the buffer room, the eyewash station shall be located just inside the door from the anteroom, and must be dry, unless in use. Drains are not permitted in the buffer room.

1224.19.3.2.2.5 Sealed tight room. Room perim- eter walls, ceiling, floors, doors and penetrations shall be sealed tightly to minimize air infiltration from the outside or from other rooms. Buffer room doors shall be glass, metal or other pheno- lic material, self-closing and with hands-free door operation. Normal operation may include automatic door controls sequencing such that only the buffer room door or the anteroom door is open at one time. Egress provisions shall not be impeded.

1224.19.3.2.2.6. If a pass-through is used, both doors shall not be capable of being open at the same time, and the doors should be interlocking.

1224.19.3.2.3 Anteroom. Nonhazardous buffer rooms shall be accessed through an anteroom with the following requirements:

1224.19.3.2.3.1 Size. The anteroom shall be of adequate size to accommodate a demarked area for donning and doffing, and anticipated staging of carts and supplies. The minimum size for the anteroom is 120 square feet (11.15 m ² ).

Note: A common anteroom may be shared between hazardous and nonhazardous buffer rooms. The anteroom must comply with both 1224.19.3.2.3 and 1224.19.3.3.3, provide a minimum of 5 feet (1524 mm) between the buf- fer room doors, and provide automatic door controls sequencing such that only one of the buffer room doors may be open at one time. Egress provisions shall not be impeded.

te:_** A common anteroom may be shared between hazardous and nonhazardous buffer rooms. The anteroom must comply with both 1224.19.3.2.3 and 1224.19.3.3.3, provide a minimum of 5 feet (1524 mm) between the buf- fer room doors, and provide automatic door controls sequencing such that only one of the buffer room doors may be open at one time. Egress provisions shall not be impeded.

1224.19.3.2.3.2 Air quality. Nonhazardous ante- rooms shall be under negative pressure relative to the buffer room and positive pressure relative to nonrestricted areas. Refer to California Mechanical Code Table 4A, Title 16 Section 1735 and USP Chapter 797 for additional requirements.

1224.19.3.2.3.3 Handwashing station. A hand- washing station, with hands-free controls and nonrefillable closed soap dispensing system, pro- viding support for scrubbing up to the elbows, shall be located in the anteroom.

1224.19.3.2.3.4 Eyewash station. An eyewash station shall be provided in the anteroom if one is not provided in the buffer room.

1224.19.3.2.3.5 Housekeeping. Dedicated envi- ronmental services, materials and supplies for the buffer room and the anteroom shall be located in the anteroom.

1224.19.3.2.3.6 Finishes. The anteroom room is considered a semi-restricted area with non- porous and cleanable surfaces, ceilings, walls and floors subject to wet cleaning. The surfaces of ceilings, walls, floors, fixtures, shelving, counters and cabinets shall be smooth, seamless, impervious, free from cracks and crevices and be non-shedding. Ceilings shall be monolithic or utilize cleanroom style scrubbable and gasketed panels, able to withstand cleaning with chemi- cals. Junctures of ceilings to walls shall be coved or caulked to avoid cracks and crevices where dirt can accumulate. Sprinkler systems shall be recessed, covered, easily cleanable and of a type suitable for a cleanroom environment. Wall fin- ishes shall be 2-coat epoxy-covered gypsum board, seamless vinyl or other impervious cover- ing. Work surfaces, shelving and cabinets shall be constructed of smooth, impervious materials, such as stainless steel or molded plastic so that they are easily cleaned and disinfected. Plastic laminate finish over a pervious substrate is not permitted.

1224.19.3.2.3.7 Sealed tight room. Room perim- eter walls, ceiling, floors, doors and penetrations shall be sealed tightly to minimize air infiltration from the outside or from other rooms. Buffer room doors shall be glass, metal or other pheno- lic material, self-closing and with hands-free door operation.

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Copyright © 2022 by, or licensed to, International Code Council, Inc. (ALL RIGHTS RESERVED); licensed to California Building Standards Commission pursuant to License Agreement. No further reproductions is authorized. Any unauthorized reproduction or distribution is a violation of the federal copyright act and the license agreement, and subject to civil and criminal penalties thereunder.

1224.19.3.2.4 Segregated Compounding Area (SCA). When provided in lieu of a buffer/clean room and anteroom, a segregated compounding area, with a limitation on permitted compounded sterile preparations and allowable time of use, shall com- ply with the requirements of Title 16, Section 1735 and USP Chapter 797. The SCA shall include the PEC and extend to a line of demarcation between the PEC and other surrounding areas with a mini- mum clearance of 3.281 feet (1 meter) between the PEC and the line of demarcation.

1224.19.3.2.4.1 Air quality. Nonhazardous Seg- regated Compounding Areas shall provide air- flow from clean to less clean areas. Refer to California Mechanical Code Table 4A, Title 16 Section 1735 and USP Chapter 797 for addi- tional requirements.

1224.19.3.2.4.2 Handwashing station. A hand- washing station, with hands-free controls and nonrefillable closed soap dispensing system, pro- viding support for scrubbing up to the elbows, shall be located in the SCA with a minimum clearance of 3.281 feet (1 meter) between the rim of the sink and the PEC.

1224.19.3.2.4.3 Finishes. The segregated com- pounding area is considered a semi-restricted area with nonporous and cleanable surfaces, ceilings, walls and floors subject to wet cleaning. The surfaces of ceilings, walls, floors, fixtures, shelving, counters and cabinets shall be smooth, seamless, impervious, free from cracks and crev- ices and be non-shedding. Ceilings shall be monolithic or utilize cleanroom style scrubbable and gasketed panels, able to withstand cleaning with chemicals. Junctures of ceilings to walls shall be coved or caulked to avoid cracks and crevices where dirt can accumulate. Sprinkler systems shall be recessed, covered and easily cleanable. Wall finishes shall be 2-coat epoxy- covered gypsum board, seamless vinyl or other impervious covering. Work surfaces, shelving and cabinets shall be constructed of smooth, impervious materials, such as stainless steel or molded plastic so that they are easily cleaned and disinfected. Plastic laminate finish over a pervi- ous substrate is not permitted.

1224.19.3.3 Hazardous sterile preparation room. If hazardous drugs are used in compounding activities, a separate room shall be provided for preparation of hazardous admixtures in accordance with Title 16, Sec- tions 1735 and 1751 and USP Chapters 797 and 800.

1224.19.3.3.1 Workstation. The Primary Engineer- ing Control (PEC) shall be a negative pressure bio- logical safety cabinet or isolator (CACI) as required. The workstation shall have an exhaust to the outside with a visible pressure gauge for detec- tion of filter leaks or defects. All exposed sides of the workstation shall be accessible for cleaning and

INTERIOR ENVIRONMENT

allow for reach behind the unit if not built against a wall. If built against a wall, the space behind the unit shall be sealed to prevent intrusion of moisture, contaminants and bacteria growth.

1224.19.3.3.2 Buffer room. Workstations shall be located in a Secondary Engineering Control (SEC) room. The SEC shall be a buffer/clean room, with the following requirements:

1224.19.3.3.2.1 Size. The minimum size for a non-hazardous buffer room is 130 square feet (12.08 m ² ) for a single workstation, and a mini- mum of 75 square feet (6.97 m ² ) for each addi- tional workstation.

1224.19.3.3.2.2 Air quality. Hazardous buffer rooms shall be sealed tight and be under negative pressure relative to the anteroom. Air supply shall be laminar airflow with a low-level return. Refer to California Mechanical Code Table 4A, Title 16 Section 1751 and USP Chapter 800 for additional requirements.

1224.19.3.3.2.3 Finishes. The buffer room is considered a semirestricted area with nonporous and cleanable surfaces, ceilings, walls and floors subject to wet cleaning. The surfaces of ceilings, walls, floors, fixtures, shelving, counters and cabinets shall be smooth, seamless and impervi- ous, free from cracks and crevices and be non- shedding. Ceilings shall be monolithic or utilize cleanroom style scrubbable and gasketed panels, able to withstand cleaning with chemicals. Junc- ture of ceilings to wall shall be coved or caulked to avoid cracks and crevices where dirt can accu- mulate. Sprinkler systems shall be recessed, cov- ered, easily cleanable and of a type suitable for a cleanroom environment. Wall finishes shall be 2- coat epoxy covered gypsum board, seamless vinyl or other impervious covering. Work surfaces, shelving and cabinets shall be constructed of smooth, impervious materials, such as stainless steel or molded plastic so that they are easily cleaned and disinfected. Plastic laminate finish over a pervious substrate is not permitted.

1224.19.3.3.2.4 Eyewash station. If provided in the buffer room, the eyewash station shall be located just inside the door from the anteroom, a minimum clearance of 3.281 feet (1 meter) from the PEC, and must be dry, unless in use. Drains are not permitted in the buffer room.

1224.19.3.3.2.5 Refrigerator. Refrigerated stor- age may be provided in the negative pressure buffer room. Clearance around the refrigerator shall be accessible for cleaning.

1224.19.3.3.2.6 Doffing area. An area for doff- ing with a hamper shall be demarked inside the buffer/clean room at the door to the anteroom.

1224.19.3.3.2.7 Sealed tight room. Room perim- eter walls, ceiling, floors, doors and penetrations

Copyright © 2022 by, or licensed to, International Code Council, Inc. (ALL RIGHTS RESERVED); licensed to California Building Standards Commission pursuant to License Agreement. No further reproductions is authorized. Any unauthorized reproduction or distribution is a violation of the federal copyright act and the license agreement, and subject to civil and criminal penalties thereunder.

INTERIOR ENVIRONMENT

shall be sealed tightly to minimize air infiltration from the outside or from other rooms. Buffer room doors shall be glass, metal or other pheno- lic material, self-closing and with hands-free door operation. Normal operation may include automatic door controls sequencing such that only the buffer room door or the anteroom door is open at one time. Egress provisions shall not be impeded.

1224.19.3.3.2.8 Pass-throughs. If a pass-through is used between the buffer and anteroom, both doors should not be capable of being open at the same time, and the doors should be interlocking. A pass-through is not permitted between the haz- ardous drug buffer room and any unclassified area.

1224.19.3.3.2.9 Housekeeping. Dedicated envi- ronmental services, materials and supplies shall be located in the buffer room.

1224.19.3.3.3 Anteroom. Hazardous buffer rooms shall be accessed through an anteroom with the fol- lowing requirements:

1224.19.3.3.3.1 Size. The anteroom shall be of adequate size to accommodate a demarked area for donning and doffing, and anticipated staging of carts and supplies. The minimum size for the anteroom is 120 square feet (11.15 m ² ).

Note: A common anteroom may be shared between hazardous and nonhazardous buffer rooms. Refer to note under Section 1224.19.3.2.3.1.

1224.19.3.3.3.2 Air quality. Hazardous ante- rooms shall be under positive pressure relative to the buffer room and positive pressure relative to nonrestricted areas. Refer to California Mechan- ical Code Table 4A, Title 16 Section 1751 and USP Chapter 800 for additional requirements.

1224.19.3.3.3.3 Handwashing station. A hand- washing station with hands-free controls and nonrefillable closed soap dispensing system, pro- viding support for scrubbing up to the elbows, shall be located in the anteroom, with a minimum clearance of 3.281 feet (1 meter) between the rim of the sink and the door opening to the buffer room.

1224.19.3.3.3.4 Eyewash station. An eyewash station shall be provided in the anteroom if one is not provided in the buffer room.

1224.19.3.3.3.5 Housekeeping. Dedicated envi- ronmental services, materials and supplies shall be located in the anteroom.

1224.19.3.3.3.6 Finishes. The anteroom is con- sidered a semi-restricted area with nonporous and cleanable surfaces, ceilings, walls and floors subject to wet cleaning. The surfaces of ceilings, walls, floors, fixtures, shelving, counters and cabinets shall be smooth, seamless and impervi-

ous, free from cracks and crevices and be non- shedding. Ceilings shall be monolithic or utilize cleanroom style scrubbable and gasketed panels, able to withstand cleaning with chemicals. Junc- ture of ceilings to wall shall be coved or caulked to avoid cracks and crevices where dirt can accu- mulate. Sprinkler systems shall be recessed, cov- ered, easily cleanable and of a type suitable for a cleanroom environment. Wall finishes shall be 2- coat epoxy-covered gypsum board, seamless vinyl or other impervious covering. Work sur- faces, shelving and cabinets shall be constructed of smooth, impervious materials, such as stain- less steel or molded plastic so that they are easily cleaned and disinfected. Plastic laminate finish over a pervious substrate is not permitted.

1224.19.3.3.3.7 Sealed tight room. Room perim- eter walls, ceiling, floors, doors and penetrations shall be sealed tightly to minimize air infiltration from the outside or from other rooms. Buffer room doors shall be glass, metal or other pheno- lic material, self-closing and with hands-free door operation.

1224.19.3.3.4 Segregated Compounding Area (SCA). When provided in lieu of a buffer/clean room and anteroom, a segregated compounding area, with a limitation on permitted compounded sterile preparations and allowable time of use, shall com- ply with the requirements of Title 16 Section 1751 and USP Chapter 800. The SCA shall include the PEC and be located in a negative pressure room dedicated to this use.

1224.19.3.3.4.1 Air quality. Hazardous Segre- gated Compounding Areas shall be under nega- tive pressure and provide airflow from clean to less clean areas. Refer to California Mechanical Code Table 4A, Title 16 Section 1735 and USP Chapter 797 for additional requirements.

1224.19.3.3.4.2 Handwashing station. A hand- washing station, with hands-free controls and nonrefillable closed soap dispensing system, pro- viding support for scrubbing up to the elbows, shall be located in the SCA with a minimum clearance of 3.281 feet (1 meter) between the rim of the sink and the PEC.

1224.19.3.3.4.3 Finishes. The segregated com- pounding area is considered a semi-restricted area with nonporous and cleanable surfaces, ceilings, walls and floors subject to wet cleaning. The surfaces of ceilings, walls, floors, fixtures, shelving, counters and cabinets shall be smooth, seamless, impervious, free from cracks and crev- ices and be nonshedding. Ceilings shall be mono- lithic or utilize cleanroom style scrubbable and gasketed panels, able to withstand cleaning with chemicals. Juncture of ceilings to wall shall be coved or caulked to avoid cracks and crevices where dirt can accumulate. Sprinkler systems

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shall be recessed, covered and easily cleanable. Wall finishes shall be 2-coat epoxy-covered gyp- sum board, seamless vinyl or other impervious covering. Work surfaces shall be constructed of smooth, impervious materials, such as stainless steel or molded plastic so that they are easily cleaned and disinfected. Plastic laminate finish over a pervious substrate is not permitted.

1224.19.4 – 1224.19.5. Reserved.

1224.19.6 Support areas for the pharmacy.

1224.19.6.1 Access to information.

1224.19.6.1.1 Patient information. Provisions shall be made for cross-checking medication and drug profiles of individual patients.

1224.19.6.1.2 Pharmacological information. Provi- sions shall be made for access to poison control, reaction data and drug information.

1224.19.6.2 Office. A separate room shall be provided for the Chief Pharmacist’s office.

1224.19.6.3 Education and training. A multipurpose room shared with other departments shall be permitted to serve this purpose.

1224.19.6.4 Outpatient medication consultation. If medication is dispensed to outpatients from the hospital pharmacy, an area for consultation and patient educa- tion shall be provided.

1224.19.6.5 Additional equipment and supply storage. If a dose procedure is used, additional space and equipment shall be provided to accommodate supplies, packaging, labeling and storage, including space for carts.

1224.19.7 Support areas for staff.

1224.19.7.1 Lounge, locker and toilet facilities. Pro- vide pharmacy staff lounge, toilet rooms and lockers that are readily accessible.

1224.20.1 General. Food and nutrition facilities shall be provided to support food services provided for staff, visi- tors and patients. Adequate space for the preparation and serving of food shall be provided. Equipment shall be placed so as to provide aisles of sufficient width to permit easy movement of personnel, mobile equipment and sup- plies. Food service facilities and equipment shall conform to these standards, the standards of the National Sanita- tion Foundation and the requirements of the local public health agency.

1224.20.2 Functional elements. On-site conventional food service preparation shall be provided as follows in the size and number appropriate for the type of food ser- vice selected:

1224.20.2.1 Location. Patient food preparation areas shall be directly accessible to the entry for food supply

INTERIOR ENVIRONMENT

deliveries and for the removal of kitchen wastes, inte- rior transportation, storage, etc., without traversing patient or public circulation. Food preparation, service and storage shall be inaccessible to nondietetic service staff.

1224.20.2.2 Receiving/control stations. Provide an area for the receiving and control of incoming dietary supplies. Space shall be provided for the delivery and transport equipment used, such as receiving carts/jacks, transport carts and returnables. The exte- rior door into the receiving area shall have a minimum clear width of 4 feet (1.22 m) and a minimum clear height of 7 feet (2.14 m).

1224.20.2.3 Storage.

1. Food storage space shall be readily accessible to the receiving area and shall be located to exclude traffic through the food preparation area to reach them. Storage spaces for bulk, refrigerated and frozen foods shall be provided. At least one week’s (7 days) supply of staple foods and at least two (2) days’ supply of frozen and two (2) days’ supply of perishable foods shall be main- tained on the premises. Food storage components shall be grouped for convenient access from receiving and to the food preparation areas. All food shall be stored clear of the floor. Lowest shelf shall be not less than 12 inches (305 mm) above the floor or shall be closed in and sealed tight for ease of cleaning.

As a minimum, dietary storage space shall be

Space to allow refrigeration for the storage of frozen and chilled foods shall be provided at a minimum of 2 cubic feet (0.057 m ³ ) of usable space per bed.

2. Additional storage space for dietetic service sup- plies, such as paper products, equipment, tray delivery carts, etc., shall be provided.

Copyright © 2022 by, or licensed to, International Code Council, Inc. (ALL RIGHTS RESERVED); licensed to California Building Standards Commission pursuant to License Agreement. No further reproductions is authorized. Any unauthorized reproduction or distribution is a violation of the federal copyright act and the license agreement, and subject to civil and criminal penalties thereunder.

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3. Storage areas and sanitizing facilities for cans, carts and mobile-tray conveyors shall be pro- vided.

4. Waste storage and recycling facilities (per local requirements) shall be located in a separate room immediately accessible to the outside for direct pickup or disposal.

1224.20.2.4 Cleaning supplies storage. Provide a sep- arate storage room for the storage of nonfood items such as cleaning supplies that might contaminate edi- bles.

1224.20.2.5 Food preparation workspaces. Provide workspaces for food preparation, cooking and baking. These areas shall be as close as possible to the user (i.e., tray assembly and dining). Provide additional spaces for thawing and portioning.

1224.20.2.6 Assembly and distribution. The patient tray assembly area shall be immediately accessible to the food preparation and distribution areas.

1224.20.2.7 Food service carts. A cart distribution sys- tem shall be provided with spaces for storage, loading, distribution, receiving and sanitizing of the food ser- vice carts. The cart traffic shall be designed to elimi- nate any danger of cross-circulation between outgoing food carts and incoming soiled carts and the cleaning and sanitizing process. Cart circulation shall not be through food preparation areas.

1224.20.2.8 Dining area. Provide dining space(s) for patients, staf and visitors. These spaces shall be sepa- rate from the food preparation and distribution areas.

1224.20.2.8.1 Employee dining. Where separate employee dining space is provided, a minimum of 15 square feet (1.4 m ² ) of floor area per person served, including serving area, shall be maintained.

1224.20.2.9 Vending services. If vending devices are used for unscheduled meals, provide a separate room that can be accessed without having to enter the main dining area.

1224.20.2.10 Ware-washing facilities. Ware-wash- ing space shall be provided in a room separate from food preparation and serving areas. It shall be designed to prevent contamination of clean wares with soiled wares through cross-traffic. The clean wares shall be transferred for storage or use in the dining room area without having to pass through food preparation areas.

1. Commercial-type ware-washing equipment shall be provided.

2. Space shall be provided for receiving, scraping, sorting and stacking soiled tableware separate from food preparation areas.

3. Handwashing stations shall be provided in the ware-washing space.

1224.20.2.11 Pot washing facilities. Pot washing shall include multi-compartmented sinks.

1224.20.2.12 Waste storage room. A food waste stor- age room shall be readily accessible to the food prepa- ration and ware washing areas but not within the food preparation area. It shall have direct access to the hos- pital’s waste collection and disposal facilities.

1224.20.2.13 Handwashing stations. Handwashing stations shall be provided within 20 feet (6096 mm) of each food preparation or serving area.

1224.20.2.14 Office and administrative space. An office shall be provided for the dietician or dietetic ser- vice supervisor. Dietetic service administrative staff shall have offices or other suitable space necessary to conduct business related to the dietetic service. Such office and administrative space shall:

1. Provide privacy and accommodate the prepara- tion and maintenance of menus, reports and records.

2. Be located to provide an unobstructed view of the food preparation area.

Note: This location requirement applies to all new dietetic service space.

1224.20.2.15 Toilet room(s) and locker spaces. Toilet rooms shall be provided for the exclusive use of the dietary staff. They shall not open directly into the food preparation areas, but shall be readily accessible to them. An enclosed, separate locker area shall be pro- vided for dietetic service employee’s clothing and per- sonal belongings.

1224.20.2.16 Housekeeping room. A housekeeping room, meeting the requirements of Section 1224.4.15, shall be provided within the dietary department for the exclusive use of the dietary department.

1224.20.3 Outside service. On approval of the Licensing Agency, when food is provided by an outside food service, all applicable licensing and certification requirements shall be met. The facility shall maintain adequate space, equipment and food supplies to accommodate required functional elements listed in Section 1224.20.2, as required to provide patient food service in the event that outside food service is interrupted. A temporary mobile kitchen approved by the licensing agency can be used to meet the requirements of Section 1224.20.2 during con- struction. SUPPORT SERVICES

1224.21.1 Administration. An administration area shall be provided which shall provide for the following func- tions:

1. A lobby with reception and information counter or desk, waiting space, men’s and women’s public toi- let room facilities, telephones and drinking fountain.

2. Offices for administrator and admitting.

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1224.21.2 Records. Hospitals shall provide a health record service which shall accommodate the following functions:

1. Work area for sorting and recording records for either paper or electronic media.

2. Storage area for records for either paper or elec- tronic media.

1224.22.1 Minimum requirements. A central supply and sterilizing area shall be provided. Rooms and distinct spaces shall accommodate the following services and equipment:

1. Soiled work area. A receiving and gross cleaning area which shall contain work space 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.

4. Storage. Provide storage space for sterile supplies and unsterile supplies.

Exception: Section 1224.22.1 does not apply to hos- pitals which serve psychiatric or alcoholism patients exclusively.

1224.22.2 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.

1224.23.1 General storage. Hospitals shall provide gen- eral storage space of at least 20 square feet (1.86 m ² ) per bed in addition to specialized storage spaces. All storage spaces shall be located within a conforming hospital building and readily accessible to the connecting corridor required under Section 1224.4.7.5. Required storage, including but not limited to patient, dietary, etc., shall accommodate at least 72 hours of storage capacity in a conforming building. Storage beyond this requirement may be in a non-hospital or nonconforming building.

1224.23.2 Specialized storage. Specialized storage spaces shall include the following:

1224.23.2.1 Linen. Provide separate and enclosed facilities for clean and soiled linen in each nursing unit. The clean linen storage space shall have a mini- mum area of 10 square feet (0.93 m ² ) and may be within the clean utility room. The soiled linen collec- tion 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.

1224.23.2.2 Supply. One supply storage space having a minimum area of 15 square feet (1.39 m ² ) shall be pro- vided in each nursing unit. Supply storage may be

INTERIOR ENVIRONMENT

within the clean utility room used only as part of a sys- tem for distributing clean and sterile supplies.

1224.23.2.3 Wheelchairs. A room or space shall be provided in each nursing unit for wheelchairs and gur- neys. The wheelchair and gurney space shall have a minimum area of 15 square feet (1.39 m ² ).

1224.23.2.4 Sterile and unsterile supplies shall be stored separately.

1224.23.2.5 Food storage shall be as described in Sec- tion 1224.20.

1224.24.1 General acute-care hospitals with a licensed bed capacity of 50 or more beds 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.

1224.24.2 Minimum requirements. The morgue and autopsy space shall have a minimum of 250 square feet (23.23 m ² ) of floor area, no dimension of which shall be less than 10 feet (3048 mm), and provide for:

1. Handwashing station.

2. Space for refrigerated compartments if human remains are held unembalmed. Refrigerated rooms and prefabricated body refrigerator temperatures shall not be higher than 45°F (25°C).

ERS.

1224.25.1 Minimum facilities. Hospitals shall provide the following:

1. Separate dressing rooms for male and female per- sonnel with lockers and a toilet room.

2. Additional dressing rooms for the surgical service and as required within any of the supplemental ser- vices.

Shall be provided to serve each department and nursing unit, and may be shared by compatible departments, except when specifically required by other sections.

1224.27.1 If a laundry is to be provided, the following is required in addition to the laundry room:

1. A separate soiled linen receiving, holding and sort- ing room with handwashing fixture.

2. A separate clean linen storage, issuing and holding room.

3. Storage for laundry supplies.

1224.27.2 Outside service. If linen is processed off site, the following shall be provided within the hospital:

1. Soiled linen holding room.

2. Clean linen receiving room.

3. Clean linen storage room.

Copyright © 2022 by, or licensed to, International Code Council, Inc. (ALL RIGHTS RESERVED); licensed to California Building Standards Commission pursuant to License Agreement. No further reproductions is authorized. Any unauthorized reproduction or distribution is a violation of the federal copyright act and the license agreement, and subject to civil and criminal penalties thereunder.

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SUPPLEMENTAL SERVICES

PROCEDURE SERVICES. When provided, the following supplemental surgery and special procedure services shall meet the requirements below:

1224.28.1 Cardiovascular and other special procedures. When provided, the cardiovascular room shall have a minimum clear floor area of 650 square feet (60.39 m ² ), with a minimum of 20 feet (6096 mm) clear dimension. Orthopedic surgical and other special procedure rooms shall have a minimum clear floor area of 600 square feet (55.74 m ² ), with a minimum of 20 feet (6096 mm) clear dimension. When open-heart surgery is performed, an additional room in the restricted area of the surgical ser- vice space, that is directly accessible to this operating room, shall be designated as a pump room where extra corporeal pump(s), supplies and accessories are stored and serviced. Appropriate plumbing and electrical con- nections shall be provided in the cardiovascular, pump and storage rooms.

1224.28.1.1 Service areas. Shall be provided in accor- dance with Section 1224.15.3.

Exception: Where renovation work is undertaken in facilities built under the 2001 or prior California Building Code, existing rooms for cardiovascular, and other special procedures may have a minimum clear floor area of 500 square feet (46.45 m ² ). Orthopedic surgical rooms shall have a minimum clear floor area of 360 square feet (33.44 m ² ) and a minimum dimension of 18 feet (5486 mm).

1224.28.2 Cardiac catheterization.

1224.28.2.1 Procedure room. A procedure room with a minimum clear floor area of 400 square feet (37.16 m ² ) for the procedure room in addition to spaces for con- trol, monitoring and recording equipment and imaging equipment power and controls and a minimum of one scrub sink for each catheterization laboratory. This space does not include the control room.

1224.28.2.1.1 Emergency response space. Where electrophysiology studies are performed, dedicated space and equipment for emergency resuscitation and stabilization shall be immediately accessible to the procedure room.

1224.28.2.2 Control room. A control room or area shall be provided. A view window permitting full view of the patient from the control console shall be pro- vided.

1224.28.2.3 Equipment space. An equipment space or enclosure large enough to contain imaging equipment transformers, power modules and associated electron- ics and electrical gear shall be provided.

1224.28.2.4 Scrub facilities. Scrub facilities with hands-free operable controls shall be provided adja- cent to the entrance of procedure rooms.

1224.28.2.5 Staff clothing change areas. Appropriate areas shall be provided for male and female staff work-

ing within the surgical service space. The areas shall contain lockers, showers, toilets, handwashing stations and space for donning surgical attire. These areas shall be arranged to ensure a traffic pattern so that personnel entering from outside the service space can enter, change their clothing and move directly into the cardiac catheterization service space. The staff change area may be combined with the surgical staff change area.

1224.28.2.6 Patient holding. A patient preparation, holding, and recovery area or room shall be provided and arranged to provide visual observation before and after the procedure. This may occur in a unit outside of the catheterization service space.

1224.28.2.7 Clean utility room. A clean utility room shall be provided. If the room is used for preparing patient care items, it shall contain a work counter and handwashing station. If the room is used only for stor- age and holding of clean and sterile supply materials, the work counter and handwashing station shall be per- mitted to be omitted. The clean utility room may be shared with an adjacent surgical unit.

1224.28.2.8 Soiled utility room. A soiled utility room shall be provided which shall contain a handwashing station and a clinical sink (or equivalent flushing rim fixtures). When the room is used for temporary holding or soiled materials, the clinical sink and handwashing station shall be permitted to be omitted. The soiled util- ity may be shared with an adjacent surgical unit.

1224.28.2.9 Housekeeping room. Shall be a minimum floor area of 15 square feet (1.4 m ² ). It shall contain a service sink or floor receptor and provisions for stor- age of supplies and housekeeping equipment. This may be shared with an adjacent surgical unit.

1224.28.3 Freestanding cardiac catheterization labora- tory service space. A general acute care hospital refer- enced in Health and Safety Code Section 1255 (d)(3)(E) may provide cardiac catheterization laboratory service in a freestanding nonhospital building in conformance with this section and Section 1226.2.2. In addition, the service space shall comply with Section 1224.28.2 and applicable requirements in Section 1224.15.3 that are not covered by this section.

1224.28.3.1 Outpatient support areas. Outpatient sup- port areas shall include outpatient waiting rooms in compliance with Section 1224.4.5. A separate space shall be provided where outpatients change from street clothing and are prepared for a procedure. This space shall include provisions for clothing storage, toilet room(s), sink and an area for clothing change and gowning.

1224.28.3.2 Connection to hospital. The freestanding cardiac catheterization laboratory service space shall be located in the nonhospital building such that the ser- vice space has a direct connection to the general acute care hospital providing cardiac surgery by a patient corridor link in compliance with Section 1224.4.7. The corridor link shall have a minimum width of 8 feet

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Copyright © 2022 by, or licensed to, International Code Council, Inc. (ALL RIGHTS RESERVED); licensed to California Building Standards Commission pursuant to License Agreement. No further reproductions is authorized. Any unauthorized reproduction or distribution is a violation of the federal copyright act and the license agreement, and subject to civil and criminal penalties thereunder.

(2438 mm) as required under Section 1224.4.7.1. The corridor link shall connect to the hospital corridor sys- tem with access to all basic services as required under Section 1224.4.7.5.

1224.28.3.3 Control station. Control station(s) shall be located to permit visual observation of all traffic into the semi-restricted service space from unrestricted cor- ridors and/or passageways.

1224.28.3.4 Essential electrical system. Cardiac cathe- terization laboratories shall meet the provisions for ambulatory surgical clinics required in the California Electrical Code including the requirements of Article 517.45 for an essential electrical system.

1224.28.3.5 Services/systems and utilities. Ser- vices/systems and utilities that support the catheteriza- tion laboratory space include, but are not limited to: normal power; emergency power; nurse call; commu- nication and data systems; space heating systems; cooling systems; domestic hot and cold water systems; building drain and sewer systems; and medical gas sys- tems. When these systems serve other portions of the building, any alteration to the system shall be subject to review by the Office of Statewide Health Planning and Development.

1224.28.4 Interventional imaging. Image-guided inter- ventional procedures shall be performed in procedure rooms in compliance with this section. Cardiac catheter- ization operating rooms shall be in compliance with Sec- tion 1224.28.2, and hybrid operating rooms shall be in compliance with Section 1224.28.5.

1224.28.4.1 Space requirements. The procedure room shall meet the space, clearance and storage require- ments for the imaging equipment contained in the room and the following:

1. A minimum clear dimension of 18 feet (5486 mm).

2. The procedure room shall also be sized to allow a minimum clearance of 4 feet (1219 mm) on all sides of the procedure table.

1224.28.4.2 Pre-procedure and recovery. Pre-proce- dure and recovery areas shall be immediately accessi- ble to procedure rooms and separate from corridors. The pre-procedure and recovery areas shall comply with the requirements of Section 1224.16 Anesthe- sia/recovery Service Space.

1224.28.4.3 Interventional MRI facilities. Interven- tional and intraoperative magnetic resonance imaging (I-MRI) procedure rooms shall comply with Section 1224.28.5 Hybrid Operating Rooms.

1224.28.4.4 Control room or area. A control room or area shall be provided.

1. The control room or area shall be sized to accommodate the image-recording and viewing equipment.

2. A shielded view window permitting direct obser- vation of the patient from the control console shall be provided.

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3. The shielded control room shall be configured to prevent radiation exposure into occupied areas of the control room when ionizing radiation modalities are used.

4. Where the procedure room requires positive (or negative) pressure, a door shall be provided between the control room and the procedure room or between the combined control room/pro- cedure room and other adjacent space.

5. Where control functions for ionizing radiation exposures take place in the procedure room, stor- age for personal radiation protection devices shall be provided.

1224.28.4.5 Scrub facilities. Scrub sinks shall be located outside of sterile areas. A minimum of one scrub sink station shall be provided for each interven- tional imaging procedure room. Scrub sinks shall have water supply controls not requiring direct contact of the hands for operation.

1224.28.4.6 Medication station. A medication station shall be provided in compliance with the requirements in Section 1224.4.4.4.

1224.28.4.7 Reading room. A reading room for review- ing images shall be available for use by the interven- tional imaging suite.

1224.28.4.8 Imaging equipment room. Imaging equip- ment room or enclosures large enough to contain x-ray transformers, power modules and associated electron- ics and electrical gear shall be provided. Sharing of imaging equipment rooms by multiple procedure rooms is permitted.

1224.28.4.9 Clean utility room. A clean utility room shall be provided in accordance with the requirements in Section 1224.4.4.6.

1224.28.4.10 Soiled workroom. A soiled workroom shall be provided in accordance with Section 1224.4.4.7.

1224.28.4.11 Housekeeping room. A housekeeping room shall be provided in accordance with the require- ments of Section 1224.4.15.

1224.28.4.12 Staff changing areas. Male and female staff changing areas shall be provided and arranged to ensure a traffic pattern so that personnel can enter from an unrestricted area, change their clothing and move directly into the interventional imaging suite.

1224.28.5 Hybrid operating room(s). Hybrid operating rooms shall comply with the requirements of Section 1224.15 and comply with the requirements in this section.

1224.28.5.1 Space requirements. Each hybrid operat- ing room shall meet the space, clearance and storage requirements for the imaging equipment contained in the room and the following:

1. A minimum clear floor area of 650 square feet (60.39 m ² ) is required for a hybrid operating room unless the imaging equipment requires a larger area.

Copyright © 2022 by, or licensed to, International Code Council, Inc. (ALL RIGHTS RESERVED); licensed to California Building Standards Commission pursuant to License Agreement. No further reproductions is authorized. Any unauthorized reproduction or distribution is a violation of the federal copyright act and the license agreement, and subject to civil and criminal penalties thereunder.

with the requirements of Section 1224.16 (Anesthe- sia/recovery Service Space).

1224.28.6 Electroconvulsive Therapy. If electroconvul- sive therapy (ECT) is provided, the requirements of this section shall be met. Where a psychiatric unit is part of a general acute care hospital (Section 1224.31 Psychiatric Nursing Unit), all the requirements in this section shall be permitted to be accommodated in a procedure suite that complies with the requirements in this section or in an operating room in a surgical suite that meets the require- ments in Section 1224.15.

1224.28.6.1 General. The ECT procedure area may be a single procedure room or a suite of procedure rooms.

1224.28.6.2 ECT procedure room.

1. Space requirements. Each ECT procedure room shall have a minimum clear floor area of 200 square feet (18.6 m ² ) with a minimum clear dimension of 14 feet (4267 mm).

2. Handwashing station. A handwashing station shall be provided.

3. Documentation area. Accommodation for written or electronic documentation shall be provided.

1224.28.6.3 Pre-procedure and recovery area. When ECT services have a low-volume of procedures, the ECT procedure room may be used for pre-procedure patient care and recovery. If a pre-procedure and recovery areas are provided they shall comply with the requirements of Section 1224.16.

1224.28.6.4 Emergency equipment storage. Space shall be provided in the procedure room(s) for storage of emergency equipment such as a CPR cart. A sepa- rate emergency equipment storage is permitted to serve more than one ECT procedure room.

1224.28.6.5 Patient support areas. A waiting area and changing area shall be provided for outpatient use in perioperative areas in support ECT suites that provide outpatient procedures. The waiting room shall comply with Section 1224.4.5. The changing area shall include space for changing or gowning, provisions for storing patients’ belongings during the procedure and access to patient toilet(s).