10A NCAC 13F .0305       PHYSICAL ENVIRONMENT

(a)  An adult care home shall provide living arrangements to meet the individual needs of the residents, the live-in staff and other live-in persons.

(b)  The requirements for each living room and recreational area are:

(1)           Each living room and recreational area shall be located off a lobby or corridor.  At least 50 percent of required living and recreational areas shall be enclosed with walls and doors;

(2)           In buildings with a licensed capacity of 15 or less, there shall be a minimum area of 250 square feet;

(3)           In buildings with a licensed capacity of 16 or more, there shall be a minimum of 16 square feet per resident; and

(4)           Each living room and recreational area shall have windows.

(c)  The requirements for the dining room are:

(1)           The dining room shall be located off a lobby or corridor and enclosed with walls and doors;

(2)           In buildings with a licensed capacity of 15 or less, there shall be a minimum of 200 square feet;

(3)           In building with a licensed capacity of 16 or more, there shall be a minimum of 14 square feet per resident; and

(4)           The dining room shall have windows.

(d)  The requirements for the bedroom are:

(1)           The number of resident beds set up shall not exceed the licensed capacity of the facility;

(2)           There shall be bedrooms sufficient in number and size to meet the individual needs according to age and sex of the residents, any live-in staff and other persons living in the home.  Residents shall not share bedrooms with staff or other live-in non-residents;

(3)           Only rooms authorized as bedrooms shall be used for residents' bedrooms;

(4)           Bedrooms shall be located on an outside wall and off a corridor.  A room where access is through a bathroom, kitchen, or another bedroom shall not be approved for a resident's bedroom;

(5)           There shall be a minimum area of 100 square feet excluding vestibule, closet or wardrobe space in rooms occupied by one person and a minimum area of 80 square feet per bed, excluding vestibule, closet or wardrobe space, in rooms occupied by two people;

(6)           The total number of residents assigned to a bedroom shall not exceed the number authorized for that particular bedroom;

(7)           A bedroom may not be occupied by more than two residents.

(8)           Resident bedrooms shall be designed to accommodate all required furnishings;

(9)           Each resident bedroom shall be ventilated with one or more windows which are maintained operable and well lighted.  The window area shall be equivalent to at least eight percent of the floor space and be provided with insect screens. The window opening may be restricted to a six-inch opening to inhibit resident elopement or suicide.  The windows shall be low enough to see outdoors from the bed and chair, with a maximum 36 inch sill height; and

(10)         Bedroom closets or wardrobes shall be large enough to provide each resident with a minimum of 48 cubic feet of clothing storage space (approximately two feet deep by three feet wide by eight feet high) of which at least one-half shall be for hanging clothes with an adjustable height hanging bar.

(e)  The requirements for bathrooms and toilet rooms are:

(1)           Minimum bathroom and toilet facilities shall include a toilet and a hand lavatory for each 5 residents and a tub or shower for each 10 residents or portion thereof;

(2)           Entrance to the bathroom shall not be through a kitchen, another person's bedroom, or another bathroom;

(3)           Toilets and baths for staff and visitors shall be in accordance with the North Carolina State Building Code, Plumbing Code;

(4)           Bathrooms and toilets accessible to the physically handicapped shall be provided as required by Volume I-C, North Carolina State Building Code, Accessibility Code;

(5)           The bathrooms and toilet rooms shall be designed to provide privacy. Bathrooms and toilet rooms with two or more water closets (commodes) shall have privacy partitions or curtains for each water closet.  Each tub or shower shall have privacy partitions or curtains;

(6)           Hand grips shall be installed at all commodes, tubs and showers used by or accessible to residents;

(7)           Each home shall have at least one bathroom opening off the corridor with:

(A)          a door of three feet minimum width;

(B)          a three feet by three feet roll‑in shower designed to allow the staff to assist a resident in taking a shower without the staff getting wet;

(C)          a bathtub accessible on at least two sides;

(D)          a lavatory; and

(E)           a toilet.

(8)           If the tub and shower are in separate rooms, each room shall have a lavatory and a toilet;

(9)           Bathrooms and toilet rooms shall be located as conveniently as possible to the residents' bedrooms;

(10)         Resident toilet rooms and bathrooms shall not be utilized for storage or purposes other than those indicated in Item (4) of this Rule;

(11)         Toilets and baths shall be well lighted and mechanically ventilated at two cubic feet per minute.  The mechanical ventilation requirement does not apply to facilities licensed before April 1, 1984, with natural ventilation;

(12)         Nonskid surfacing or strips shall be installed in showers and bath areas; and

(13)         The floors of the bathrooms and toilet rooms shall have water-resistant covering.

(f)  The requirements for storage rooms and closets are:

(1)           General Storage for the Home.  A minimum area of five square feet (40 cubic feet) per licensed capacity shall be provided.  This storage space shall be either in the facility or within 500 feet of the facility on the same site;

(2)           Linen Storage.  Storage areas shall be adequate in size and number for separate storage of clean linens and separate storage of soiled linens.  Access to soiled linen storage shall be from a corridor or laundry room;

(3)           Food Storage.  Space shall be provided for dry, refrigerated and frozen food items to comply with sanitation rules;

(4)           Housekeeping storage requirements are:

(A)          A housekeeping closet, with mop sink or mop floor receptor, shall be provided at the rate of one per 60 residents or portion thereof; and

(B)          There shall be separate locked areas for storing cleaning agents, bleaches, pesticides, and other substances which may be hazardous if ingested, inhaled or handled.  Cleaning supplies shall be monitored while in use;

(5)           Handwashing facilities with wrist type lever handles shall be provided immediately adjacent to the drug storage area;

(6)           Storage for Resident's Articles.  Some means for residents to lock personal articles within the home shall be provided; and

(7)           Staff Facilities.  Some means for staff to lock personal articles within the home shall be provided.

(g)  The requirements for corridors are:

(1)           Doors to spaces other than reach-in closets shall not swing into the corridor;

(2)           Handrails shall be provided on both sides of corridors at 36 inches above the floor and be capable of supporting a 250 pound concentrated load;

(3)           Corridors shall be lighted with night lights providing 1 foot-candle power at the floor; and

(4)           Corridors shall be free of all equipment and other obstructions.

(h)  The requirements for outside entrances and exits are:

(1)           Service entrances shall not be through resident use areas;

(2)           All steps, porches, stoops and ramps shall be provided with handrails and guardrails;

(3)           All exit door locks shall be easily operable, by a single hand motion, from the inside at all times without keys; and

(4)           In homes with at least one resident who is determined by a physician or is otherwise known to be disoriented or a wanderer, each exit door accessible by residents shall be equipped with a sounding device that is activated when the door is opened.  The sound shall be of sufficient volume that it can be heard by staff.  If a central system of remote sounding devices is provided, the control panel for the system shall be located in the office of the administrator or in a location accessible only to staff authorized by the administrator to operate the control panel.

(i)  The requirements for floors are:

(1)           All floors shall be of smooth, non‑skid material and so constructed as to be easily cleanable;

(2)           Scatter or throw rugs shall not be used; and

(3)           All floors shall be kept in good repair.

(j)  Soil Utility Room.  A separate room shall be provided and equipped for the cleaning and sanitizing of bed pans and shall have handwashing facilities.

(k)  Office.  There shall be an area within the home large enough to accommodate normal administrative functions.

(l)  The requirements for laundry facilities are:

(1)           Laundry facilities shall be large enough to accommodate washers, dryers, and ironing equipment or work tables;

(2)           These facilities shall be located where soiled linens will not be carried through the kitchen, dining, clean linen storage, living rooms or recreational areas; and

(3)           A minimum of one residential type washer and dryer each shall be provided in a separate room which is accessible by staff, residents and family, even if all laundry services are contracted.

(m)  The requirements for outside premises are:

(1)           The outside grounds of new and existing facilities shall be maintained in a clean and safe condition;

(2)           If the home has a fence around the premises, the fence shall not prevent residents from exiting or entering freely or be hazardous; and

(3)           Outdoor walkways and drives shall be illuminated by no less than five foot-candles of light at ground level.

(n)  Alternate methods, procedures, design criteria and functional variations from the physical environment requirements, because of extraordinary circumstances, new programs or unusual conditions, shall be approved by the Division when the facility can effectively demonstrate to the Division's satisfaction that the intent of the physical environment requirements are met and the variation does not reduce the safety or operational effectiveness of the facility.

History Note:        Authority G.S. 131D-2.16; 143B-165;

Eff. January 1, 1977;

Readopted Eff. October 31, 1977;

Amended Eff. July 1, 1990; April 1, 1987; July 1, 1984; April 1, 1984;

Temporary Amendment Eff. December 1, 1999;

Amended Eff. July 1, 2000;

Recodified from Rule .0303 Eff. July 1, 2004;

Temporary Amendment Eff. July 1, 2004;

Amended Eff. July 1, 2005.