1. (1) General Requirements. The facility shall plan and provide an environment that is therapeutic to, and supportive of, all the patients in regard to their disturbances, their healthy development and their changing needs. The therapeutic environment shall take into consideration the architecture of the facility, indoor and outdoor activity areas, furnishings, equipment, decorations and all other factors that involve the interpersonal and physical environment.

2. (2) Facilities shall:

   1. (a) Be designed to meet the needs of the age group of the patients and the objectives of the program;
   2. (b) Provide adequate and appropriate space and equipment for all of the programs of the facility and the various functions within the facility;
   3. (c) Provide sufficient space and equipment to ensure housekeeping and maintenance programs capable of keeping the building and equipment clean and in good repair; and,

   4. (d) Provide buildings and grounds of the special hospital that shall be maintained, repaired and cleaned so that they are not hazardous to the health and safety of the patients and staff.

      1. Floors, walls, ceilings, windows, doors and all appurtenances of the structures shall be of sound construction, properly maintained, easily cleanable and shall be kept clean.

      2. All areas of the facility other than closets or cabinets shall be well lighted. Dormitories, toilets and dayrooms shall have light sources capable of providing adequate illumination to permit observation, cleaning, maintenance and reading. Light fixtures shall be kept clean and maintained.

      3. All housing facilities shall be kept free of offensive odors with adequate ventilation.

      a. If natural ventilation is utilized, the opened window area for ventilation purposes shall be equal to one-tenth of the floor space in the residential area.

      b. When mechanical ventilation or cooling systems are employed, the system shall be kept clean and properly maintained. Intake air ducts shall be designed and installed so that dust or filters can be readily removed. In residence areas and isolation rooms without natural ventilation, mechanical ventilation systems shall provide a minimum of 10 cubic feet of fresh or filtered recirculated air per minute for each patient occupying the area.

      c. All toilet rooms shall be provided with direct openings to the outside or provided with mechanical ventilation to the outside.

      d. Facilities which utilize permanent heating units shall maintain a minimum temperature of 65 degrees F at a point 20 inches above the floor in sleeping areas. Facilities, such as outdoor programs, which cannot provide permanent heating units, shall ensure that patients are provided with items which will provide adequate warmth during sleep. These shall include items such as portable catalytic heaters and sleeping bags, extra blankets and clothing designed to ensure comfortable sleep in cold weather.

   5. (e) Provide both indoor and outdoor areas where patients can gather for appropriate activities. The grounds on which the facility is located shall provide adequate space to carry out the stated goals of the program; for outdoor activity areas that are appropriate for the ages and clinical needs of children; and provide an appropriate transitional area between the facility and the surrounding neighborhood which is consistent with the goals of the facility, and compatible with existing zoning ordinances.

   6. (f) Provide sleeping areas that shall promote comfort and dignity and provide space and privacy for residents.

      1. There shall be no more than eight patients in a sleeping room unless written justification on the basis of the program requirements has been submitted to and approved by the licensing agency.

      2. Beddings, Clothing and Personal Items. Beds and beddings shall be kept in good repair and cleaned regularly. Used mattress and pillow covers shall be laundered before being issued. Sheets and personal clothing shall be washed at least weekly and blankets washed or dry cleaned at least quarterly. Sheets and blankets shall be stored in a clean, dry place between laundering and issue.

      3. Each patient shall have his own bed consisting of a level bedstead and a clean mattress in good condition.

      4. All mattresses shall have fire retardant mattress covers or protectors. Water repellent mattress covers shall be available if needed.

   7. (g) Provide individual and separate accessible storage areas for each resident’s clothing and personal possessions.
   8. (h) Provide laundry and/or dry cleaning facilities. Where laundry facilities are provided, they shall be adequate to ensure an ample quantity of clean clothing, bed linens and towels. Laundry facilities shall be of sound construction and shall be kept clean and in good repair. Laundry rooms shall be well lighted and properly ventilated. Clothes dryers and dry cleaning machines shall be vented to the exterior. If laundry facilities are not available, sheets and blankets shall be sent to commercial laundries.

   9. (i) Provide privacy for personal hygiene.

      1. All toilets shall have secured seats and be kept clean and in good working order, and all toilets shall be partitioned for privacy.

      2. Bathrooms shall be cleaned thoroughly each day.

      3. Bathrooms shall be conveniently located to the sleeping areas.

   10. (j) Provide for the personal hygiene for all patients.

       1. A written policy shall be maintained on file at the facility.

       2. Toothbrushes, toothpaste, soap, and other items of personal hygiene shall be provided by the facility if not provided by the patients.

       3. Shatterproof mirrors shall be furnished in each bathroom.

   11. (k) Maintain food service facilities in accordance with the regulations described in Chapter 64E-11, F.A.C.

3. (3) The facility shall be constructed and maintained in a manner that protects the lives and insures the physical safety of patients, staff and visitors. The center will comply with all relevant federal, state and local building codes, fire, health, safety laws and ordinances and regulations as specified below. Current inspection reports shall be retained in the facility’s files for Agency review.

   1. (a) It is the responsibility of the program to arrange for the necessary inspections and to comply within the time frame with any resulting recommendations noted in the inspection reports.
   2. (b) The grounds and all buildings on the grounds shall be maintained in a safe and sanitary condition, as required in Chapter 386, F.S. (Particular Conditions Affecting Public Health).

   3. (c) Water Supply. Water supplies shall be adequate to serve the demands of the facility and shall be constructed, operated and maintained in accordance with requirements of Chapter 64E-8, F.A.C.

      1. Drinking water shall be accessible to all clients. When drinking fountains are available, the jet of the fountain shall issue from a nozzle of non-oxidizing impervious material set at an angle from the vertical. The nozzle and every other opening in the water pipe or conductor leading to the nozzle shall be above the edge of the bowl so that such nozzle or opening will not be flooded in case a drain from the bowl of the fountain becomes clogged. The end of the nozzle shall be protected by non-oxidizing guards to prevent persons using the fountain from coming into contact with the nozzle. Vertical or bubbler drinking fountains shall be replaced with approved type water fountains or be disconnected. When no approved drinking fountains are available, clients shall be provided with single service cups which shall be stored and dispensed in a manner to prevent contamination. Common drinking cups are prohibited.

      2. Hot and cold running water under pressure and at safe temperatures (not to exceed 120 degrees F for washing and bathing to prevent scalding) shall be provided at regular washing and bathing areas.

   4. (d) Sanitary System, Facilities and Fixtures.

      1. All sewage and liquid waste shall be disposed of in accordance with Chapter 64E-6, F.A.C.

      2. All plumbing shall be in compliance with the requirements of the Florida Building Code, Plumbing as adopted by the Florida Building Commission and described in rule Chapter 61G20-1, F.A.C., or the plumbing code legally applicable to the area where the facility is located.

      3. For facilities with nine or more patients, curbed areas with floor drains shall be available in convenient locations throughout the facility for the proper disposal of cleaning water and to facilitate cleaning.

   5. (e) Garbage and Rubbish. All garbage, trash and rubbish from residential areas shall be collected daily and taken to storage facilities. Garbage shall be removed from storage facilities at least twice per week. Wet garbage shall be collected and stored in impervious, leak proof, fly tight containers pending disposal. All containers, storage areas and surrounding premises shall be kept clean and free of vermin. If public or contract garbage collection service is available, the facility shall subscribe to these services unless the volume makes onsite disposal feasible. If garbage and trash are disposed on premises, the method of disposal shall not create sanitary nuisance conditions and shall comply with provisions of Rule 64E-12.010, F.A.C.
   6. (f) Outdoor Areas. Outdoor areas shall be kept free of litter and trash and be well drained. If swimming pools are available in facilities with nine or more clients, such pools shall comply with requirements of Chapter 64E-9, F.A.C., and shall be supervised at all times when they are in use. Indoor and outdoor recreational areas shall be provided with safeguards designed for the needs of the residents.
   7. (g) Insect and Rodent Control. Facilities shall be kept free of all insects and rodents. All outside openings shall be effectively sealed or screened to prevent entry of insects or rodents. All pesticides used to control insects or rodents shall be applied in accordance with instructions on the registered product label. Persons applying restricted use pesticides shall be certified by the Department of Agriculture. Facilities not having certified pest control operators shall utilize commercial licensed pest control companies.

4. (4) All facilities shall be required to meet the uniform fire safety standards for special hospitals as established by the State Fire Marshal pursuant to Section 633.206, F.S.

   1. (a) All staff shall be instructed in the use of fire extinguishers.
   2. (b) All fire extinguishers shall be inspected as regulated by local requirements and shall be serviced as required.
   3. (c) All fire safety systems shall be kept in good operating condition.
   4. (d) Fire safety systems shall be inspected regularly as regulated by local requirements, and records of such inspections shall be kept on file.

5. (5) The special hospital shall provide for safety inspections by a facility personnel committee.

   1. (a) Personnel responsible for safety evaluation shall receive appropriate training.
   2. (b) Safety inspections shall be done on a monthly basis, shall be made into a written report, and shall be maintained on file at the facility.
   3. (c) Special safety measures shall be provided for areas of the facility that may present an unusual hazard to patients, staff or visitors. Poisonous or toxic compounds are to be stored apart from food and other areas that would constitute a hazard to the residents.
6. (6) Disaster Planning. Programs licensed under Rules 59A-3.300 through 59A-3.312 shall comply with Rule 59A-3.078, F.A.C., in regard to a comprehensive emergency management plan.

Rulemaking Authority 395.1055 FS. Law Implemented 395.1055 FS. History–New 2-15-82, Formerly 10D-28.108, Amended 9-4-95, Formerly 59A-3.108, Amended 5-12-16.