(a) An adult care home shall provide living arrangements for the residents, the live-in staff, and other live-in persons.

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

(1) a living room and recreational area shall be located off a lobby or corridor. For the purpose of this Rule, a "living room" is a space enclosed by walls used for social activities, such as reading, talking or watching television. For the purpose of this Rule, a "recreational area" is a space within the facility that may be opened to adjacent spaces and is designated to be used for social activities, such as reading, talking or watching television;

(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) a required living room and recreational area shall have windows with views to the outside. The total gross window area shall not be less than eight percent of the gross floor area of the room. The window shall be openable from the inside and shall have insect-proof screens.

(1) the dining room shall be located off a lobby or corridor. For the purposes of this Rule, a "dining room" is a space enclosed by walls used for eating meals;

(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 required dining room shall have windows with views to the outside. The total gross window area shall not be less than eight percent of the gross floor area of the room. The window shall be openable from the inside and shall have insect-proof screens.

(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) live-in staff shall be permitted in facilities with a capacity of 7 to 12 residents provided all of the requirements of Section .0600 of these Rules are met;

(3) there shall be separate bedrooms for any live-in staff and other persons living in the facility. Residents shall not share bedrooms with live-in staff and other live-in non-residents;

(4) live-in staff shall not occupy a licensed bed or live in a licensed bed;

(5) residents shall reside in bedrooms with residents of the same sex unless other arrangements are made with each resident's consent;

(6) only rooms authorized by the Division of Health Service Regulation as bedrooms shall be used for bedrooms;

(7) 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 as a resident's bedroom;

(8) private resident bedrooms shall have not less than 100 square feet of occupiable floor area excluding accessory areas such as vestibules, closets, or wardrobes. For the purpose of this Rule, "private resident bedroom" is a resident bedroom occupied by one resident;

(9) semi-private resident bedrooms shall have not less than 80 square feet of occupiable floor area per bed excluding accessory areas such as vestibules, closets, or wardrobes. For the purpose of this Rule, "semi-private resident bedroom" is a resident bedroom occupied by two residents;

(10) the total number of residents assigned to a bedroom shall not exceed the number authorized by the Division of Health Service Regulation for that particular bedroom;

(11) a bedroom may not be occupied by more than two residents;

(12) resident bedrooms shall be designed to accommodate all required furnishings;

(13) resident bedrooms shall be ventilated with one or more windows which are maintained operable. The window area shall not be less than eight percent of the floor space and be equipped with insect-proof 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

(14) Residents' bedrooms shall have one closet or wardrobe per resident. A closet or wardrobe shall have clothing storage space of not less than 48 cubic feet per bed, approximately two feet deep by three feet wide by eight feet high, of which one-half of this space shall be for hanging with an adjustable height hanging bar.

(e) The requirements for bathrooms, toilet rooms, bathtubs, showers, a manufactured walk-in tub, or a similar manufactured bathtub, and central bathing rooms are:

(1) minimum bathroom and toilet rooms shall include a toilet and a hand lavatory for each 5 residents, and a bathtub, shower, a manufactured walk-in tub, or a similar manufactured bathtub for each 10 residents or portion thereof. The hand lavatory shall be trimmed with valves that can be operated without hands. If the hand lavatory is equipped with blade handles, the blade handles shall not be less than four and one half inches in length. If the hand lavatory faucet depends on the building electrical service for operation, the faucet must have an emergency power source or battery backup capability. If the faucet has battery operated sensors, the facility shall have a maintenance policy to keep extra rechargeable or non-rechargeable batteries on premises for the faucets;

(2) entrance to bathrooms and toilet rooms shall not be through a kitchen, another person's bedroom, or another bathroom;

(3) toilet rooms and bathrooms for staff and visitors shall be in accordance with the North Carolina State Building Code: Plumbing Code;

(4) bathrooms and toilet rooms accessible to the physically handicapped shall be provided as required by the North Carolina State Building Codes;

(5) bathrooms and toilet rooms shall be designed to provide privacy. Bathrooms and toilet rooms with two or more toilets shall have privacy partitions or curtains for each toilet. Each bathtub, shower, a manufactured walk-in tub, or a similar manufactured bathtub shall have privacy partitions or curtains. Notwithstanding the requirements of Rule .0301 of this Section, the requirements of this Paragraph shall apply to new and existing facilities;

(6) hand grips shall be installed at all toilets, bathtubs, showers, a manufactured walk-in tub, and similar manufactured bathtubs;

(7) there shall be one central bathing room opening off the corridor in a facility. In multi-level facilities, each resident floor shall contain a minimum of one central bathing room opening off the corridor. Central bathing room(s) shall have the following:

(A) a door of three feet minimum width;

(B) a roll-in shower designed to allow the staff to help a resident in taking a shower without the staff getting wet. The roll-in shower shall be designed and equipped for unobstructed ease of shower chair entry and use. If a bathroom with a roll-in shower designed and equipped for unobstructed ease of shower chair entry adjoins each resident bedroom in the facility, the central bathing area is not required to have a roll-in shower;

(C) a bathtub, a manufactured walk-in tub, or a similar manufactured bathtub designed for easy transfer of residents into the tub. Bathtubs shall be accessible on three sides. Manufactured walk-in tubs or a similar manufactured bathtub shall be accessible on at least two sides. Staff shall not be required to reach over or through the tub faucets and other fixture fittings to assist the resident in the tub;

(D) a toilet and a lavatory trimmed with valves that can be operated without hands. If the lavatory is equipped with blade handles, the blade handles shall not be less than four and one half inches in length. If the lavatory faucet depends on the building electrical service for operation, the faucet shall have an emergency power source or battery backup capability. If the faucet has battery operated sensors, the facility shall have a maintenance policy to keep extra rechargeable or non-rechargeable batteries on premises for the faucets; and

(E) individual cubicle curtain enclosing each toilet, bathtub, shower, manufactured walk-in tub, or a similar manufactured bathtub and shower. A closed cubicle curtain at one of these plumbing fixtures shall not restrict access to the other plumbing fixtures.

(8) where the tub and shower are in separate rooms, each room shall have a lavatory and a toilet. The lavatory shall be trimmed with valves that can be operated without hands. If the lavatory is equipped with blade handles, the blade handles shall not be less than four and one half inches in length. If the lavatory faucet depends on the building electrical service for operation, the faucet must have an emergency power source or battery backup capability. If the faucet has battery operated sensors, the facility shall have a maintenance policy to keep extra rechargeable or non-rechargeable batteries on premises for the faucets;

(9) in facilities where resident bedrooms do not have direct access to a bathroom or toilet room, bathrooms and toilet rooms shall be evenly distributed throughout the facility for residents' use;

(10) resident toilet rooms and bathrooms shall not be used for storage or other purposes;

(11) toilet rooms and bathrooms shall be well lighted;

(12) toilet rooms and bathrooms shall have an exhaust system per the North Carolina State Building Codes. Exhaust vents shall be vented directly to the outdoors;

(13) nonskid surfacing or strips shall be installed in showers, bath areas, and bathtubs; and

(14) the floors of the bathrooms and toilet rooms shall be water-resistant and slip-resistant.

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

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

(2) separate storage room or area shall provide for the storage of clean linens. Clean linens shall not be stored in the same room or area as soiled linens;

(3) separate storage room shall provide for the storage of soiled linens. Access to soiled linen storage shall be from a corridor or laundry room. If space for the storage of soiled linen is provided in the soiled utility room, a separate soiled linen room is not required;

(4) there shall be space for the storage of dry, refrigerated, and frozen food items, and shall comply with Rules Governing the Sanitation of Hospitals, Nursing Homes, Adult Care Homes and Other Institutions set forth in 15A NCAC 18A .1300, which is incorporated by reference including subsequent amendments and editions, for facilities with a licensed capacity of 13 or more residents, and Rules Governing the Sanitation of Residential Care Facilities set forth in 15A NCAC 18A .1600, which is incorporated by reference including subsequent amendments and editions, for facilities with a licensed capacity of 7 to 12 residents;

(5) the requirements for housekeeping storage 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. In multi-level facilities, each resident floor shall have a housekeeping closet; 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;

(6) there shall be a sink which can be operated without the use of hands located adjacent to the drug storage area. If the sink is equipped with blade handles, the blade handles shall not be less than four and one half inches in length. If the sink faucet depends on the building electrical service for operation, the faucet must have battery backup capability or an emergency power source. If the faucet has battery operated sensors, the facility shall have a maintenance policy to keep extra rechargeable or non-rechargeable batteries on premises for the faucets;

(7) the facility shall have locked storage for residents' personal articles within the facility; and

(8) the facility shall have some means for staff to lock personal articles within the facility.

(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 have handrails and guards. Handrails shall be on both sides of steps and ramps including sides bordered by the facility wall. Handrails shall extend the full length of steps and ramps. Guards shall be on all open sides of steps, porches, stoops, and ramps. For the purposes of this Rule, "guards" are rails or barriers located at or near the open side of elevated walking surfaces that minimizes the possibility of a fall from a walking surface to any adjacent change in elevation;

(3) all exit door locks shall operate from the inside at all times by a single hand motion without keys, tools or special knowledge; and

(4) in facilities with at least one resident who is determined by a physician or is otherwise observed by staff to be disoriented or exhibits wandering behavior, a continuously sounding device that is activated when the door is opened shall be located on each exit door that opens to the outside. The sound shall be audible in the facility. If a central system of remote sounding devices is provided, the control panel shall be powered by the facility's electrical system, and be in a location accessible by staff to operate the control panel. Notwithstanding the requirements of Rule .0301, the requirements of this Paragraph shall apply to new and existing facilities.

(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) The requirements for soiled utility rooms are:

(1) for facilities with a licensed capacity of 13 or more residents, a separate soiled utility room shall be provided and equipped for the cleaning and sanitizing of bed pans as required by 15A NCAC 18A .1312, which is incorporated by reference including subsequent amendments and editions. The soiled utility room shall have a sink trimmed with valves that can be operated without hands. If the sink is equipped with blade handles, the blade handles shall not be less than four and one half inches in length. If the sink faucet depends on the building electrical service for operation, the faucet must have battery backup capability or an emergency power source. If the faucet has battery operated sensors, the facility shall have a maintenance policy to keep extra rechargeable or non-rechargeable batteries on premises for the faucets; and

(2) for facilities with a licensed capacity of 7 to 12 residents, a separate soiled utility room shall be provided and equipped for the cleaning and sanitizing of bed pans. The soiled utility room shall have a sink trimmed with valves that can be operated without hands. If the sink is equipped with blade handles, the blade handles shall not be less than four and one half inches in length. If the sink faucet depends on the building electrical service for operation, the faucet must have battery backup capability or an emergency power source. If the faucet has battery operated sensors, the facility shall have a maintenance policy to keep extra rechargeable or non-rechargeable batteries on premises for the faucets.

(k) The facility shall have an area within the facility 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 that is accessible by staff, residents, and family, even if all laundry services are contracted. In multi-level facilities, each resident floor shall have a minimum of one residential type washer and dryer each in a separate room which is accessible by staff, residents, and family.

(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. For the purpose of this Rule, "clean and safe condition" means free from debris, trash, uneven surfaces, and similar conditions as not to attract rodents and vermin and provide for safe movement throughout facility grounds. Creeks, ravines, ponds, pools, and other similar areas shall have safety protection. For the purpose of this Rule, "safety protection" means preventive measures, such as barriers, to block access to such areas;

(2) if the facility has a fence around the premises, the fence shall not prevent residents from exiting or entering freely or have sharp edges, rusting posts, or other similar conditions that may cause injury; and

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

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 10A NCAC 13F .0303 Eff. July 1, 2004;

Temporary Amendment Eff. July 1, 2004;

Amended Eff. July 1, 2005;

Readopted Eff. April 1, 2025.