PURPOSE: This rule establishes the minimum physical and maintenance requirements forfacilities in which adult day care programs are operated. Editor’s Note: The secretary of state has determined that the publication of this rule in its entirety would be unduly cumbersome OT expensiue. The entire text of the material referenced has been filed with the secretary of state. This material may befound at the Office ofthe SecretaryofStateorat the headquarters ofthe agency and is available to any interested person at a cost established by state law.

1. (1) The adult day care program facility shall he safe and suitable for participants.
2. (2) Minimum space requirements shall be eighty (80) square feet per participant, for up to twenty (20) participants and an additional fifty (50) square feet per each additional participant. Space requirements do not include office space, bathrooms, storage, examining rooms or dining rooms, unless the latter is also used for activities. For associated adult day care programs, the required space shall be designated and in excess of the particular facility’s required licensed space for providing long-term care or medical care. 13) The facility shall have a room where all of the participants can gather as well as rooms or divided areas for small group activities, including a quiet area for rest.

3. (4) Furniture shall be of a size and design so that it is easily used by persons with limited which is approved by the state water control agility. It shall be sturdy and secure so that it cannot easily tip when used for support while walking or sitting. At a minimum, the fol. lowing shall be provided:

   1. (A) One (1) chair for each participant and staff person;
   2. (B) Tablespaceadequateforallparticipants to be served a meal at a table at the same time;
   3. (C) Reclining lounge chairs or other sturdy comfortable furniture, the number to be determined by the needs of the participants; and
   4. (0) One (1) bed with adequate privacy and quiet to be available for temporary use of participants as needed.
4. (5) Equipment and supplies shall be adequate to meet the needs of participants including items necessary for direct care and items to encourage active participation and group interaction.
5. (6) The building in which the program is located shall be of sound construction and maintained in good repair.
6. (7) Ventilation, by natural or mechanical means, shall be provided. All screen doors shall be equipped with self-closing devices and shall fit tightly. Doors and windows and other openings to the outside shall be screened when necessary, to prevent entrance of insects and vermin.
7. (8) The heating system shall be in compliance with the National Fire Protection Code, published by the National Fire Protection Association (NFPA) and all state and local codes. Exposed heating pipes, hot water pipes or radiators in rooms and areas used by participants shall be covered or protected, and insulated when appropriate. Portable space heaters shall not be used. Room temperatures shall be maintained between sixty-eight degrees Fahrenheit (68°F) and eighty-five degrees Fahrenheit (85’F) in all seasons and the reasonable comfort needs of individual participants shall be met.
8. (9) Illumination shall be adequate in all areas and commensurate with the type of activity. Glare shall be kept at a minimum by providing shades at all windows exposed to direct sunlight and light fixtures shall have shades.
9. (10) All plumbing and plumbing fixtures shall conform to applicable local codes. There shall be no cross-connection between the potable water supply and any source of pollution through which the potable water supply might become contaminated.
10. (11) An adequate supply of water, the source of

authority, under sufficient pressure to properly servethefacilityshall beprovided.Thepotable water system shall be installed to preclude the possibility of backflow.

1. (12) Drinking water shall be easily accessible to the participants and provided by either an angle jet drinking fountain with mouth guard or by a running water supply with individual service drinking cups. Drinking facilities may not be located in a toilet room.
2. (13) At least one (1) toilet and washbowl shall be provided for each ten (10) participants or any additional fraction. The washbowl shall be in proximity to each toilet and shall have hot and cold running water. Hot water shall not exceed one hundred ten degrees Fahrenheit (1103F). The toilet room shall be within easy access of the activity areas and the participants shall have the right to privacy. Each toilet room shall be equipped with approved natural or mechanical ventilation. All toilets shall have grab-rails. Individual paper towels, a trash receptacle, soap and toilet paper shall be provided at all times and shall be within reach of the participants.
3. (14) If wheelchair-bound or other physically handicapped persons are accepted, the facility shall have ramps or other means of accessibility for handicapped persons, and shall meet the standards of the American National Standards Institute publication (ANSI), A117.1 Making Buildings and Facilities Accessible to, and Usable by, the Physically Handicapped.
4. (15) Stairways and hallways shall be kept free of obstructions and shall be well lighted. All stairways and ramps shall have nonslip surface or treads. All inside and outside stairs and ramps shall have handrails.
5. (16) All rugs and floor coverings shall be secured to the floor. Throw rugs shall not be used. All equipment and furnishings shall be safe and in good condition.
6. (17) Sufficient housekeeping and maintenanceserviceshall beprovided tomaintain the facility in good repair and in a safe, clean, orderly, attractive and sanitary manner.
7. (18) Drugs, cleaning agents, pesticides and poisonous products shall be stored apart from food, out of the reach of the participants and shall be used in a manner which assures the safety of participants and staff.

8. (19) Garbage shall be stored and disposed of in an approved manner.

   Judith K. Moriarty secreranj Of Stafa

9. (20) The facility shall be maintained free of insects and rodents. Control measures shall be provided to prevent rodent and insect infestation.

   Auth: sections 660.050, RSMo (Cum. Supp. 1992) and 660.418, RSMo (1986).* original de filed Oct. 15, 1984, effective Jan. 11, 1985. ‘Original authority: 660.050, RSMo (19841, amended 1988,1992 and 660.418, RSMo 11984).