(a) A center shall conduct

1. (1) daily environment-of-care rounds to assess the physical environment to ensure the safety and well-being of each patient admitted to the center; and
2. (2) an annual ligature risk assessment to mitigate ligature risk.

(c) A center's interior

1. (1) must have an environment that protects the health, safety, and security of each patient that includes

   1. (A) routinely cleaning the entire center;
   2. (B) adequate lighting;
   3. (C) performing routine facility maintenance to keep the center in good and safe order according to applicable manufacturer recommendations, including equipment, fixtures, plumbing, electrical, and furnishings;
   4. (D) adequate heating, ventilation, and cooling systems that operate safely and ensure a comfortable environment; and
   5. (E) electric receptacles in patient care areas that are tamper-resistant or equipped with ground fault circuit interrupters;

2. (2) must have a sufficient number of bathrooms to meet the needs of the center's patients and allow for a patient's individual privacy in accordance with the patient's plan of care; each bathroom must contain

   1. (A) a wash basin with hot and cold running water, a soap dispenser, and paper towels or an automatic dryer;
   2. (B) a toilet with a toilet seat and an adequate toilet paper supply;

   3. (C) plumbing, piping, and ductwork that is

      1. (i) recessed or enclosed; and
      2. (ii) inaccessible to patients;
   4. (D) a shatterproof mirror that is secured to the walls at a convenient height; and
   5. (E) other amenities necessary to meet each patient's basic hygienic needs;
3. (3) must have a sufficient number of bathtubs or showers, but not less than one bathtub or shower, to meet each patient's bathing needs, with hot and cold water and slip-proof surfaces;

4. (4) must have separate and secure storage areas that are inaccessible to patients and for

   1. (A) patient possessions that may not be accessed during a patient's stay;
   2. (B) records and other confidential information; and
   3. (C) hazardous, flammable, or combustible materials;
5. (5) must have designated space for administrative functions that is separate from patient common areas;

6. (6) must have designated space that allows clinical staff to

   1. (A) complete tasks while remaining accessible to patients; and
   2. (B) observe and monitor patient activity within the unit;

7. (7) must have designated private space that is exclusive of patient common areas, for

   1. (A) physical examinations;
   2. (B) counseling sessions; and
   3. (C) other staff and patient discussions;

8. (8) must have at least one designated space with reduced visual and auditory stimulus that

   1. (A) is used for de-escalation;
   2. (B) is used for not more than one patient at a time; and
   3. (C) allows for continual visual observation and monitoring of the patient either directly or by video and audio;

9. (9) may have a seclusion room if the seclusion room

   1. (A) is used for not more than one patient at a time;
   2. (B) allows for continual visual observation and monitoring of the patient either directly or by video and audio;
   3. (C) has a monolithic ceiling;
   4. (D) has flat walls that are free of protrusions and angles;
   5. (E) does not contain electrical receptacles; and
   6. (F) is a dedicated space;
10. (10) must have windows that are fabricated with laminated safety glass or protected by polycarbonate, laminate, or safety screens;
11. (11) must have door hinges that are designed to minimize ligature risk;
12. (12) must have door handles that point downward in the latched or unlatched position, except for specifically designed anti-ligature hardware;
13. (13) must have tamper-resistant fasteners on windows and doors; and

14. (14) must have visual and complete physical separation between adult and pediatric patient care areas, sleeping areas, and patient common areas, if the center provides services to both populations; if temporary partitions are used, the partitions must

    1. (A) extend from floor to wall;
    2. (B) be sound dampening;
    3. (C) be lockable; and
    4. (D) be consistent with exit egress requirements.

(e) A crisis stabilization center shall have a space for chairs or recliners in an observation area. The space may be a permanent configuration or rearranged based on the needs of the patients in the center. The observation area

1. (1) must have at least three feet of space between each chair or recliner;
2. (2) must have at least six feet of clearance at the foot of each chair or recliner; and
3. (3) may position the head of each chair or recliner at a wall.

(f) A crisis residential center shall

1. (1) have sleeping areas that are exclusive of observation rooms, examination rooms, meeting rooms, and other common areas;
2. (2) have a designated space that is exclusive of sleeping areas and common space to allow private and small group discussions and counseling sessions between individual patients and staff;
3. (3) ensure that each patient closet, bedroom, or bathroom that is equipped with a door has a lock that can be readily opened by staff from both sides;
4. (4) have a designated space for dining, visitation, leisure, and recreational activities;
5. (5) have access to laundry facilities or contract with a laundry service to launder a patient's clothing;
6. (6) have access to laundry facilities or contract with a laundry service to launder linens; and
7. (7) have a clean linen storage area and a separate area to store soiled linen until the linen may be laundered.

(g) A center's exterior space, including any exterior structure, must

1. (1) have adequate lighting;
2. (2) be maintained to prevent elopement, injury, suicide, or the introduction of contraband;
3. (3) be in good repair and free from any reasonably foreseeable hazard to health or safety;
4. (4) include a perimeter security system designed to monitor and control visitor access and patient egress; and
5. (5) keep trash collection receptacles and incinerators in an area that is not accessible to patients.

(h) A center shall ensure that an unsafe area is adequately separated from a patient area by a barrier such as a fence, wall, or natural barrier. An "unsafe area" includes

1. (1) a steep grade;
2. (2) an open pit;
3. (3) a high voltage booster; or
4. (4) a high-speed road.

(i) If a center has an outdoor area for patient use, the center shall secure the area to prevent

1. (1) unauthorized patient access to the outdoor area; and
2. (2) patient elopement.

(j) A center shall have appropriate exterior signage that is visible to the public and clearly

1. (1) indicates that the center provides only behavioral health services;
2. (2) indicates that the center is not a hospital or emergency department; and
3. (3) identifies the center's legal or operational name.