The standards in this subchapter apply to:
(1) a newly constructed center;
(2) alterations, additions, or renovations to an existing center;
(3) an existing building renovated to create a center; and
(4) a center's maintenance.
(a) Plans for new buildings, additions, conversions of buildings not licensed by DADS, and the remodeling of existing licensed facilities must be submitted to DADS for review. No later than 30 days after receipt of the plans, DADS informs an applicant in writing of the results of the review.
(b) If the submitted plans comply with DADS architectural requirements, DADS may not subsequently change the architectural requirement that applies to the project unless the change is required by federal law or an applicant fails to complete the project no later than two years after submitting the plans to DADS.
(c) DADS may grant a waiver of the two-year period for delays due to unusual circumstances.
(d) DADS may impose a deadline for completing a project using requirements that are revised after the project was reviewed.
(e) Submittal of plans.
(1) One copy of contract documents must be submitted to DADS before construction begins. The documents must:
(A) include working drawing and specifications;
(B) have sufficient detail for DADS to interpret compliance with this chapter and for a general contractor or builder to ensure proper construction; and
(C) be prepared according to accepted architectural practice and include general construction, special conditions, and schedules.
(2) Final copies of plans must be submitted to DADS and include:
(A) a title block that shows the name of the center;
(B) the person or organization preparing the sheet;
(C) sheet numbers;
(D) the center's address; and
(E) the drawing date.
(3) Sheets and sections covering structural, electrical, mechanical, and sanitary engineering final plans, designs, and specifications must bear the seal of a professional engineer licensed by the Texas Board of Professional Engineers.
(4) An architect licensed by the Texas Board of Architectural Examiners must prepare contract documents for additions, remodeling, and construction of a new center. Drawings must bear the seal of the architect.
(5) A final plan for a major addition to a center must be submitted to DADS and include a basic layout to scale of the entire building into which the addition will connect. North direction must be shown. The entire basic layout must be scaled to fit on a single 8 1/2-inch by 11-inch sheet.
(6) Final plans and specifications for conversions or remodeling must be submitted to DADS and include all parts and features involved.
(7) Qualified staff must be employed to prepare the contract documents for construction. If the contract documents have errors or omissions to the extent that compliance with this chapter cannot be reasonably ensured or determined, DADS may request a revised set of documents for review.
(8) DADS review of the plans and specifications is based on general utility and compliance with this chapter and the Life Safety Code. DADS review is not an all-inclusive review of the structural, electrical, or mechanical components of a center. DADS review does not include a review of building plans for compliance with the Texas Accessibility Standards as administered and enforced by the Texas Department of Licensing and Regulation.
(9) Plan review fees must be submitted in accordance with §15.113 of this chapter (relating to Plan Review Fees).
(f) Contract documents.
(1) Site plan documents must be submitted to DADS and include:
(A) grade contours;
(B) streets with names;
(C) north arrow;
(D) fire hydrants;
(E) fire lanes;
(F) public or private utilities;
(G) fences; and
(H) unusual site conditions, including:
(ii) low water levels;
(iii) other buildings on-site; and
(iv) indications of buildings five feet or less beyond site property lines.
(2) Foundation plan documents must be submitted to DADS and include general foundation design and details.
(3) Floor plan documents must be submitted to DADS and include:
(A) room names, numbers, and usages;
(B) numbered doors, including swing;
(D) legend or clarification of wall types that include:
(ii) fixed equipment;
(iii) plumbing fixtures;
(iv) basic layout of the food preparation area; and
(v) identification of all smoke barrier walls from outside wall to outside wall or fire walls.
(4) For both new construction and additions or remodeling to existing buildings, an overall plan of the entire building drawn or reduced to fit on a single 8 1/2-inch by 11-inch sheet must be submitted to DADS.
(5) Schedules must be submitted to DADS and include:
(A) door materials, widths, and types;
(B) window materials, sizes, and types;
(C) room finishes; and
(D) special hardware.
(6) Elevations and roof plans must be submitted to DADS. Plans must include exterior elevations, including:
(A) material note indications;
(B) rooftop equipment;
(C) roof slopes;
(E) gas piping; and
(F) interior elevations where needed for special conditions.
(7) Contract document details must be submitted to DADS and include:
(A) wall sections as needed, especially for special conditions;
(B) cabinet and built-in work, basic design only;
(C) cross sections through buildings as needed; and
(D) miscellaneous details and enlargements as needed.
(8) Building structure documents must be submitted to DADS and include:
(A) structural framing layout and details used primarily for column, beam, joist, and structural building;
(B) roof framing layout if it cannot be adequately shown on a cross section; and
(C) cross sections in quantity and detail to show sufficient structural design and structural details as necessary to ensure adequate structural design and calculated design loads.
(9) Electrical documents must be submitted to DADS and include:
(A) electrical layout, including lights, convenience outlets, equipment outlets, switches, and other electrical outlets and devices;
(B) service, circuiting, distribution, and panel diagrams;
(C) exit light systems with exit signs and emergency egress lighting;
(D) emergency electrical provisions, including generators and panels;
(E) staff communication systems;
(F) fire alarm and similar systems, including control panel, devices, and alarms; and
(G) sizes and details sufficient to ensure safe and properly operating systems.
(10) Plumbing documents must be submitted to DADS and include:
(A) plumbing layout with pipe sizes and details sufficient to ensure safe and properly operating systems;
(B) water systems;
(C) sanitary systems;
(D) gas systems; and
(E) other systems normally considered under the scope of plumbing, fixtures, and provisions for combustion air supply.
(11) Heating, ventilating, and air-conditioning systems (HVAC) documents must be submitted to DADS and include:
(A) sufficient details of HVAC systems and components to ensure a safe and properly operating installation, including heating, ventilating, and air-conditioning layout, ducts, protection of duct inlets and outlets, combustion air, piping, exhausts, and duct smoke and fire dampers; and
(B) equipment types, sizes, and locations.
(12) Sprinkler system documents must be submitted to DADS and include:
(A) plans and details of National Fire Protection Association (NFPA) designed systems to meet the requirements of NFPA 13, Standard for the Installation of Sprinklers;
(B) plans and details of partial systems provided only for hazardous areas; and
(C) electrical devices interconnected to the alarm system.
(13) Specifications must be submitted to DADS that include:
(A) installation techniques;
(B) quality standards and manufacturers;
(C) references to specific codes and standards;
(D) design criteria;
(E) special equipment;
(G) finishes; and
(H) other specifications as needed to amplify drawings and notes.
(14) Other layouts, plans or details must be submitted to DADS as necessary for DADS to obtain a clear understanding of the design and scope of the project. Plans covering private water or sewer systems that have been reviewed by the health or wastewater authority having appropriate jurisdiction must be submitted to DADS.
(g) Construction phase.
(1) DADS Architectural Unit must be notified in writing before beginning construction of a new center or the remodeling of an existing center.
(2) DADS requires additional drawings if construction of the center is not performed in accordance with the completed plans and specifications as submitted to DADS for review or as modified in accordance with DADS review requirements, if the change is significant.
(h) Initial inspection of completed construction.
(1) After completion of construction, including grounds and basic equipment and furnishings, DADS performs an initial architectural inspection of the center before the center admits a minor. DADS schedules an initial architectural inspection after DADS receives a licensure application, required fees, fire marshal approval, approval of local building authority, and a letter from an architect or engineer stating that, to the best of the architect or engineer's knowledge, the center meets the building requirements for licensure.
(2) If DADS Life Safety Code staff inspect the completed construction and find it in compliance with this chapter, the DADS Architectural Unit forwards the information to the DADS Licensing and Credentialing Unit as part of an applicant's license application. For additions to or remodeling of an existing center, DADS may require an applicant to submit a revision or modification to an existing license. The building, including basic furnishings and operational needs, grades, drives, and parking, must be 100 percent complete at the time of DADS initial architectural inspection. A center may admit at least one but no more than three minors after it receives initial approval from DADS but before a license is issued.
(3) An applicant must make the following documents related to the completed building available to DADS architectural inspection surveyor at the time of the inspection:
(A) written approval of the local authorities as required in paragraph (1) of this subsection;
(B) for fire detection and alarm systems:
(i) record drawings of the fire detection and alarm system as installed, signed by an alarm planning superintendent licensed by the State Fire Marshal's Office or sealed by a licensed professional engineer;
(ii) a sequence of operation, the owner's manuals and the manufacturer's published instructions covering all system equipment;
(iii) a signed copy of the State Fire Marshal's Office Fire Alarm Installation Certificate; and
(iv) for software-based systems, a record copy of the site-specific software, excluding the system executive software or external programmer software in non-volatile, non-erasable, non-rewritable memory;
(C) documentation of materials used in the building that are required to have a specific limited fire or flame spread rating, including special wall finishes or floor coverings, flame retardant rated ceilings and curtains, including cubicle curtains.
(D) for carpeting that is required to have a specific limited fire or flame spread rating, a signed letter from the installer verifying that the carpeting installed is named in the laboratory test document;
(E) for fire sprinkler systems:
(i) record drawings of the fire sprinkler system as installed, signed by a responsible managing employee, licensed by the State Fire Marshal's Office or sealed by a licensed professional engineer;
(ii) the hydraulic calculations;
(iii) the alarm configuration;
(iv) above ground and underground Contractor's Material and Test Certificate;
(v) the literature and instructions provided by the manufacturer describing the proper operation and maintenance of all equipment and devices in accordance with NFPA 25, Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems;
(vi) service contracts for maintenance and testing of alarm systems and sprinkler systems;
(vii) a copy of gas test results of the center's gas lines from the meter;
(viii) a written statement from an architect or engineer stating, to the best of the architect or engineer's knowledge, the building was constructed in substantial compliance with the construction documents, the Life Safety Code, this chapter, and local codes; and
(ix) any other such documentation as needed.
(i) Non-approval of new construction.
(1) If, during the initial on-site architectural inspection of completed construction, the DADS Life Safety Code surveyor finds certain basic requirements are not met, the surveyor may recommend that the center not be licensed or approved for occupancy. Items that may result in this recommendation include:
(A) substntial changes made during construction that were not submitted to DADS for review and that may require revised "as-built" drawings to include the changes, including. architectural, structural, mechanical, and electrical items as specified in this section;
(B) construction that does not meet minimum code or licensure standards, including corridors that are less than the required width, ceilings installed at less than the minimum seven-foot, six-inch height, and other features that would disrupt or otherwise adversely affect minors and staff if corrected after occupancy;
(C) lack of written approval by appropriate local authorities;
(D) fire protection systems, including fire alarm systems, emergency power and lighting, and sprinkler systems, that are not completely installed or functioning properly;
(E) required exits that not all usable according to NFPA 101 requirements;
(F) telephones that are not installed or not working properly;
(G) sufficient basic furnishings, essential appliances, and equipment that are not installed or functioning; and
(H) other basic operational or safety feature that would preclude safe and normal occupancy by a minor on that day.
(2) An applicant must submit copies of reduced-size floor plans on an 8 1/2-inch by 11-inch sheet, in duplicate, to DADS for records and for the center's use for an evacuation plan, or fire alarm zone identification. The plan must contain basic legible information including scale, room usage names, actual bedroom numbers, doors, windows, and any other pertinent information.
(a) A center must be designed in accordance with:
(1) the Health Care Occupancy chapter of the 2000 edition of the National Fire Protection Association (NFPA)101 Life Safety Code for newly constructed centers or centers converting an existing unlicensed building to a center; and
(2) the requirements of Limited Care, as defined by NFPA 101.
(b) An applicant for a center license must submit to DADS site approval by the local building department and fire marshal having appropriate jurisdiction.
(c) An applicant for a center license must meet applicable local, state, or national codes and ordinances as determined by the authority having appropriate jurisdiction for those codes and ordinances and by DADS.
(d) A center must meet the requirements of the International Plumbing Code or Uniform Plumbing Code, as adopted by the local municipality.
(e) If conflicting codes apply to the construction of the center, the more stringent codes apply.
(f) A center may not be built in an area designated as a floodplain of 100 years or less.
(g) A center must comply with the accessibility requirements for individuals with disabilities as referenced in the revised regulations for Title II and III (2010 ADA Standards for Accessible Design) of the Americans with Disabilities Act of 1990 at Title 42, United States Code, Chapter 126; federal regulations at Title 28, Code of Federal Regulations, Part 35 and Part 36; Texas Accessibility Standards at Texas Government Code, Chapter 469; and Texas Department of Licensing and Regulation rules at 16 TAC Chapter 68 (relating to Elimination of Architectural Barriers).
(a) A center's construction type is limited to the building construction shown in the minimum construction requirements in the Life Safety Code chapter for New Health Care Occupancies.
(b)A center must have a National Fire Protection Association (NFPA) 72 fire alarm system with initiation, notification, emergency forces notification, annunciation, emergency control and detection in accordance with the Life Safety Code. The center must have a written contract with a fire alarm firm that has been issued an Alarm Certificate of Registration number from the Texas State Fire Marshal's Office to inspect, test and maintain a fire alarm system to meet NFPA 72 requirements, semiannually. Inspections required in the contract must be performed. The person performing the semiannual service must have an individual fire alarm license from the Texas State Fire Marshal's Office.
(c) A center must be protected throughout by an approved, supervised automatic sprinkler system installed in accordance with NFPA 13. The center must ensure that the sprinkler system is inspected, tested, and maintained in accordance with NFPA 25. The center must have a written contract with a fire protection sprinkler firm that has been issued a Sprinkler Certificate of Registration number from the Texas State Fire Marshal's Office to perform the required services, semiannually. The center must document and show to DADS that all the requirements of NFPA 25 are met including the annual inspection, test, and maintenance performed by the registered fire sprinkler firm. The center must retain one set of the fire sprinkler system plans and hydraulic calculations on the property.
(d) A center must distribute portable fire extinguishers throughout the center of size and type in accordance with NFPA 10.
(e) A center must provide emergency power for emergency lighting, exit signs, and the fire alarm by a generator.
(f) A center must ensure that the design, installation, and maintenance of emergency motor generators are in accordance with NFPA 37, NFPA 99, and NFPA 110.
(g) A center must ensure that the generator is of sufficient size to maintain Life Safety Code requirements, medical equipment, and HVAC to operate in designated core areas of the center in the event of power failure.
(h) The center must ensure that emergency powered receptacles are used:
(1) for a patient care-related electrical appliance, including a biological refrigerator;
(2) at a nurse station; and
(3) in a medication room.
(i) The center must store and administer oxygen in accordance with NFPA 99.
(a) A center must be physically and programmatically distinct from any business to which it is attached or of which it is a part.
(b) If more than one business occupies the same building or physical location, the center must have its own entrance.
(c) A center must be separated from other occupancies with construction having a fire resistance rating of not less than 2 hours.
(d) A center's separate entrance must not be accessed solely through another business or health care provider.
(e) A center's separate entrance must have appropriate signage and be clearly identified as belonging to the center.
(f) A licensed center's space must be contiguous.
(g) If a center has more than one building, the center must provide protection from inclement weather to minors, staff, contractors, volunteers and visitors who travel between the buildings.
(a) A center must have separate entrances for guests and minors.
(b) A center must have a covered entry with a covered drop-off for family, emergency medical services (EMS), and the center's vehicles.
(c) A center's roof overhang or canopy must extend as far as practicable to the face of the driveway or curb of the passenger access door of a passenger vehicle.
(d) A center's roof overhang or cover must be of sufficient height to allow entry or departure from EMS vehicles.
(e) A center must provide for an outdoor play space with a direct exit from the center into the outdoor play space. The outdoor play space should at least be 400 square feet in area with at least 20 percent of that area shaded.
(f) A center's play yard must meet the requirements of the Texas Accessibility Standards.
(g) A center must ensure that its structures and the grounds of the center that are used by minors are maintained in good repair and are free from hazards to health and safety.
(h) A center must fence or ensure natural barriers are present to protect a minor from areas determined to be unsafe by DADS, including steep grades, cliffs, open pits, swimming pools, high voltage boosters, high voltage equipment, and high speed roads.
(i) A center must keep fences in good repair.
(j) A center must store garbage, rubbish, and trash securely in outdoor, covered containers.
(k) A center must keep trash collection receptacles and incinerators separated from outdoor recreational spaces and locate the receptacles and incinerators in a place to avoid being a nuisance.
(a) A center must consist of a building suitable for the purpose intended, and have a minimum of 50 square feet of space per minor exclusive of kitchen, toilet facilities, storage areas, hallways, stairways, basements, and attics.
(b) If a center uses a room exclusively for dining or sleeping, the center must not count that space as part of the licensed capacity.
(c) A center must have sufficient rooms to accommodate and segregate the different age groups of minors being served at the center.
(d) A center must provide staff area and staff toilets.
(e) A center must provide a reception area.
(f) A center must provide an administrative office.
(g) A center must provide quiet rooms based on the needs of minors.
(h) A center's quiet room must contain a minimum of 100 square feet.
(i) A center must provide indoor recreational exercise play area.
(j) A center must provide a treatment room with a medication preparation area. The medication preparation area must contain a work counter, refrigerator, sink with hot and cold water, and locked storage for biologicals and drugs.
(k) A center must develop isolation procedures to prevent cross-infection and provide an isolation room with at least one large glass area for observation of a minor in accordance with §15.211 of this chapter (relating to Infection Prevention and Control Program and Vaccination Requirements). The isolation room must contain a minimum of 100 square feet.
(l) The center must make privacy accommodations available to attend to the personal care needs of a minor.
A center must have a food preparation area designated for the preparation of meals, snacks, or prescribed nourishments. The meals, snacks and nourishments must be maintained in accordance with state and local sanitation and safe food handling standards, including the Texas Food Establishment Rules. The center must be in compliance with Department of State Health Services rules in 25 TAC §§229.161-229.171 and §§229.173-229.175 and local health ordinances or requirements in the storage, preparation, and distribution of food; sanitation of dishes, equipment, and work area; and in the storage and disposal of waste.
(a) A center must provide toileting facilities appropriately accessible to persons with disabilities and age appropriate in design with hand-washing stations.
(b) A center must have separate toilet facilities for minors, staff, and visitors.
(c) A center must install a hand-washing station in each play area, classroom, and therapy room or area.
(a) A center must have a secure, individually labeled space available for each minor's personal belongings.
(b) A center must provide locked storage for a minor's personal possessions as needed.
(a) A center must have a mechanical forced air exhaust system to the outside for soiled linen areas in accordance with §15.210 of this chapter (relating to Sanitation, Housekeeping, and Linens).
(b) A center must have separate storage areas for clean and soiled linen in accordance with §15.210 of this chapter.
(a) A center must have a secure room for the safe storage of janitorial supplies and equipment, poisonous materials, and toxic materials.
(b) A center must label and identify poisonous and toxic substances and place them in locked cabinets that are used for no other purpose.
(c) A center must provide a janitor's closet with mechanical forced air exhaust to the outside.
(d) A center must install child proof latches onto closet and cabinet doors that are accessible to a minor.
A center must secure and lock any area the center determines is unsafe for a minor or minor's family. The center's door locking arrangement must meet Life Safety Code egress requirements from inside the room. An unsafe area includes high voltage areas and equipment rooms.
A center must have an area for the safe and secure maintenance and storage of medical records and other center files, records, and manuals. If these areas are deemed hazardous storage in accordance with the Life Safety Code, the center must have rated doors with closers.
(a) A center must store garbage, rubbish, and trash in an area separate from the areas used for the preparation and storage of food. A center must remove garbage, trash, and rubbish from the premises and sanitize the containers regularly.
(b) A center must meet the sanitation requirements in §15.210 of this chapter (relating to Sanitation, Housekeeping, and Linens).
(a) A center must secure clean storage areas for equipment, devices, and supplies including equipment supplied by the center for a minor's needs, including a wheelchair, a bed, and a mattress.
(b) A center must maintain an age appropriate and developmentally appropriate environment in each of the areas where services are provided to a minor.
(a) A center must have a supply of clean linen sufficient to meet the needs of a minor. Clean laundry must be provided by:
(1) an in-house laundry service;
(2) contract with another health care center; or
(3) an outside commercial laundry service.
(b) A center must handle, store, process, and transport laundry in a manner to prevent the spread of infection in accordance with §15.210 of this chapter (relating to Sanitation, Housekeeping, and Linens).
(a) A center must:
(1) maintain a clean and safe environment;
(2) be free of unpleasant odors; and
(3) eliminate odors at the center at their source by prompt and thorough cleaning of commodes, urinals, bedpans, and other sources.
(b) A center must meet the housekeeping requirements in §15.210 of this chapter (relating to Sanitation, Housekeeping, and Linens).
(a) A center must:
(1) ensure that the grounds and the exterior of the building, including the sidewalks, steps, porches, ramps, and fences are in good repair;
(2) keep equipment supplied by the center for a minor's needs in good repair, including wheelchairs, cribs, and mattresses;
(3) keep the interior of the building including walls, ceilings, floors, windows, window coverings, doors, plumbing, and electrical fixtures in good repair; and
(4) use pest control services provided by a licensed structural pest control applicator with a license category for pests.
(b) A center must meet the requirements in §15.210 of this chapter (relating to Sanitation, Housekeeping, and Linens).
(a) A center must use a safe HVAC system that meets the requirements of the National Fire Protection Association (NFPA) 90A and is sufficient to maintain a comfortable temperature, with a minimum of 65 degrees and a maximum of 80 degrees Fahrenheit, in all public and private areas year round.
(b) A center must ensure that during warm weather conditions, the temperature within the center does not exceed 80 degrees Fahrenheit. The center must ensure that the HVAC operates in designated core areas of the center in the event of power failure.
(c) A center must maintain the HVAC system in good repair.
(d) A center must inspect gas-fired heating equipment before the cold weather season to ensure that the equipment operates properly and safely. The center must ensure that gas-fired heating equipment is inspected by a person licensed or approved by the State of Texas to inspect the equipment.
(e) The center must maintain a record of the inspection conducted in accordance with subsection (d) of this section.
(f) A center must correct any unsatisfactory condition or evacuate or relocate the minors.
(g) A center must ensure that a gas heating unit and water heater are vented in accordance with NFPA 54 to carry the products of combustion to the outside atmosphere. The center must ensure that a vent is constructed and maintained to provide a continuous draft to the outside atmosphere in accordance with NFPA 54. The center must ensure that a heating unit is provided with a sufficient supply of outside combustion air in accordance with NFPA 54. A center must not use a portable heater within the center.
(a) A center must maintain an adequate supply of water, under pressure at all times. When a public water system is available, the center must ensure it is connected to the public water system. If the center uses water from a source other than a public water supply, the center must ensure that the water supply meets the rules issued by the Texas Commission on Environmental Quality.
(b) A center must have a plan and policy for an alternative water supply in the event of interruption of water supply and the temporary loss of water to the center.
A center must ensure that sewage is disposed of by a public system or an approved sewage disposal system constructed and operated to conform with the standards established for systems by the Texas Commission on Environmental Quality and in accordance with sanitation requirements in §15.210 of this chapter (relating to Sanitation, Housekeeping, and Linens).
A center's address and name must be displayed so as to be easily visible from the street.
(a)DADS may grant a waiver for certain provisions of the physical plant and environment requirements of DADS licensure standards, which, in DADS opinion, would be impractical for a center to meet. In granting the waiver, DADS, on a case by case basis, determines if:
(1) there are adverse effects on the health and safety of a minor if the center does not meet the licensure requirement; and
(2) the center will experience an unreasonable hardship if the requirement is not waived.
(b) DADS may require a center to offset or comply with an equivalent provision if DADS grants a waiver. A center must demonstrate an equivalent safety feature by utilizing the National Fire Protection Association 101A, Guide on Alternative Approaches to Life Safety, for waivers of the Life Safety Code.
(c) A DADS waiver is not transferable in a change of ownership and is subject to DADS review or revocation upon any change in circumstances at the center.