Current through Register Vol. 42, No. 5, February 29, 2024
(1)
Buildings and Grounds
(a) The assisted living
facility including site and grounds must be constructed, arranged, and
maintained to ensure the safety of the residents and building
occupants.
(b) Building
Classification.
1. Family assisted living
facilities shall be planned to serve the types of residents to be admitted and
shall comply with the Life Safety Code Chapter for One- and
Two-Family Dwellings, and shall comply with Sections (1), (2), (3), and (4) of
AAC Rule
420-5-4-.12.
2. Group assisted living facilities shall be
planned to serve the residents to be admitted and shall comply with Section
(1), (2), (3), and (5) of AAC Rule
420-5-4-.12.
3. Congregate assisted living facilities
shall be planned to serve the residents to be admitted and shall comply with
Sections (1), (2), (3), (6) of AAC Rule
420-5-4-.12.
4. Renovation within the exterior walls of an
assisted living facility shall in no case be of such nature as to lower the
character of the structure below the applicable building requirements for the
classification of license held by the assisted living facility.
5. Dually Licensed Facility.
(i) For the purposes of meeting physical
facility and building code requirements, a building housing both a regular
assisted living facility and a specialty care assisted living facility shall be
classified as a Group or Congregate facility in accordance with the combined
licensed bed capacities of both facilities. For the purposes of meeting
resident care and administrative requirements, the specialty care assisted
living facility and the regular assisted living facility shall be separately
considered, and each shall be classified as a Congregate facility or a Group
facility in accordance with the licensed bed capacity of each, and the
determination shall not be based on their combined bed capacity. See Rule
420-5-20 for Specialty Care Assisted Living Facilities and
requirements.
(ii) When a facility
has a portion of a building licensed for specialty care residents, instead of
the entire facility, the sleeping, bathing, dining, and activity areas shall be
in a distinct and separate unit within the building, licensed for specialty
care assisted living. Administrative, kitchen, and service areas may be shared
between the two licensed portions.
(c) Location. All assisted living facilities
established or constructed shall be located so that they are free from undue
noises, smoke, dust, or foul odors. New assisted living facilities shall be
located at least 1,000 feet from railroads, freight yards, or disposal plants.
This distance can be reduced to 500 feet when facility is separated by a
boarded fence at least six feet high. This rule shall not prevent enlargement
or expansion of existing assisted living facilities.
(d) Local Restrictions. The location and
construction of all assisted living facilities shall comply with local zoning,
building, and fire ordinances. Evidence to this effect, signed by local fire,
building, or zoning officials, may be required as a condition of licensure. If
a facility is to be located in an area that does not have any zoning, building,
or fire authority review, a letter stating such shall be obtained from the
local county commission through official board action or from the office of the
probate judge.
(e) Assisted living
facilities shall be located on publicly maintained streets or roads, and
connected with driveways which shall be kept passable at all times.
(f) Occupancy. No part of an assisted living
facility may be rented, leased, or used for any commercial purpose not
reasonably necessary for the residents of the facility or the residents of
other licensed facilities on the same campus. A campus consists of the premises
occupied by the licensed facility together with all parcels or property that
the governing authority owns or has the legal right to occupy, and which are
separated from the remainder of the campus only by a public right of way.
Services provided within the facility shall be limited to serving the residents
of facilities on the campus that are licensed by the Department. The Department
shall approve all plans for occupancy.
(g) Basements. The basement shall be
considered as a story if it meets criteria established by the codes for a
story.
(h) The assisted living
facility must maintain adequate furnishings, fixtures, supplies, and equipment
for its services.
(i) Facilities,
supplies, and equipment must be maintained in safe operating
condition.
(j) There must be proper
ventilation, light, and temperature controls in pharmaceutical, food
preparation, and other appropriate areas.
(2)
Submission of Plans and
Specifications.
(a) New Facilities,
Additions, and Alterations. Plans and specifications shall be submitted for
review and approval to the Department, for any building that is intended to
contain an assisted living facility, and for additions and alterations to
existing facilities. Submissions shall be in accordance with Alabama
Administrative Code 420-5-22, "Submission of Plans and Specifications for
Health Care Facilities."
(3)
Inspections. The State Board
of Health and its authorized representatives shall have access to all
facilities for inspection.
(4)
Remodeling.
(a) The remodeled
area of existing facilities shall be upgraded to comply with the current
requirements for new construction.
(b) Any remodeling to existing facilities
shall not diminish the level of safety which existed prior to the start of the
work.
(5)
General
Building Requirements - Family, Group, and Congregate.
(a) Structural Soundness and Repair. The
building shall be structurally sound, free from leaks and excessive moisture,
in good repair, and painted with sufficient frequency to be reasonably
attractive inside and out. The interior and exterior of the building shall be
kept clean and orderly.
(b)
Temperature to be Maintained. The facility shall maintain a comfortable
temperature. A comfortable range is between 71-81 degrees Fahrenheit.
(c) Lighting. Each resident's room shall have
artificial light adequate for reading and other uses as needed. All entrances,
hallways, stairways, inclines, ramps, cellars, attics, storerooms, kitchens,
laundries, and service units shall have sufficient artificial lighting to
prevent accidents and promote efficiency of service. Night lights shall be
provided in all hallways, stairways, and bathrooms.
(d) Screens. All screen doors and operable
windows shall be equipped with tight-fitting, full-length insect screens.
Screen doors shall be equipped with self-closing devices.
(e) Emergency Lighting.
1. All assisted living facilities shall
provide emergency artificial lighting to adequately illuminate halls,
corridors, kitchens, dining areas, and stairwells in case of electrical power
failure. As a minimum, dry cell battery-operated lighting shall be provided to
light such spaces.
2. Emergency
lighting must provide illumination in accordance with the currently adopted
Life Safety Code for at least 90 minutes.
(f) Floors.
1. All floors shall be level, smooth and free
of cracks, and finished so as to be easily kept clean. The basic requirement
for floor finishes shall be wall-to-wall with such finishes as paint, stain,
sealer, carpet, sheet vinyl, vinyl tile, hard tile, or other appropriate floor
finish.
2. Any differences in floor
levels shall not prevent a resident from navigating safely throughout the
facility.
(g) Walls and
Ceilings. All walls and ceilings shall be of sound construction with an
acceptable surface and shall be kept clean and in good repair.
(h) Windows. Operable windows shall be so
constructed and maintained so that they fit snugly, and are capable of being
opened and closed easily.
(i)
Ceiling Height. Each room occupied by residents shall have a ceiling height of
eight feet or more. Existing facilities with ceiling heights less than eight
feet shall be acceptable when the height complies with the codes.
(j) Handrails. If handrails are installed in
halls or corridors, the handrails shall be mounted at 30-36 inches above the
floor and returned to the wall at each end.
(k) Stairways. Stairways shall be well
lighted, kept in good repair, and have handrails. Open space under stairs shall
not be used for storage purpose. All walls and doors under stairs shall meet
the same fire rating as the stairwell.
(1)
Doors.
1. In each new assisted living
facility, doors of resident bathrooms connected to resident bedrooms shall
swing into the bedroom.
2. Bedroom
and bathroom doors may be equipped with hardware that will permit a resident to
lock himself within the room, provided a master key is readily accessible for
the staff at a central location.
3.
Resident bedroom and other exit access doors in each assisted living facility
shall be at least three feet wide. Bedroom doors in Family assisted living
facilities shall not be less than 32 inches wide.
4. Exterior egress doors except the main
entry/exit door, may be equipped with a delayed egress locking system installed
in accordance with NFPA 101. Other special locking
arrangements are permitted only in specialty care assisted living
facilities.
5. Exit doors swinging
outward shall swing out over a landing having a minimum length and width equal
to the door's width at the same level as the floor level, except existing doors
shall not have more than a four inch step down. Exit doors of Family facilities
may swing inward.
(m) Ventilation. The building shall be
well-ventilated at all times to prevent accumulation of objectionable odors.
Kitchens, laundries, service rooms, toilets, and bathrooms shall be ventilated
by windows, gravity vents, or mechanical means as necessary to prevent
offensive odors from entering other parts of the facility.
(n) Fire Extinguishers. Fire extinguishers
shall be provided for each hall, kitchen, and laundry, of type and capacity
appropriate to the need.
1. Each fire
extinguisher shall receive an annual inspection with maintenance, and
recharging when necessary, by a fire equipment servicing representative. An
annual servicing tag shall be attached to the extinguisher reflecting the name
of the servicing company, representative, day, month, and year of
maintenance.
2. A visual inspection
of each fire extinguisher shall be conducted monthly by designated staff of the
facility and documented on the attached extinguisher tag by the designated
staff person.
(o) Call
System. Except in Family facilities, a central electric or electronic call
system shall be conveniently provided for each resident, usable in bedrooms and
bathrooms. The call system shall be certified to meet the applicable
Underwriters Laboratories standard.
(p) Manufactured homes/mobile homes are not
permitted.
(q) Fireplaces and
inserts, shall be inspected and cleaned annually, and shall comply with the
currently adopted building code. Openings shall be protected with screens, or
doors.
(r) Exit marking. In Group
and Congregate facilities, a sign bearing the word "EXIT" in plain legible
block letters shall be placed at each exit. Additional signs shall be placed in
corridors and passageways wherever necessary to indicate the direction of exit.
Letters of signs shall be at least four inches high. All exit and directional
signs shall be kept clearly legible by continuous internal electric
illumination and have battery back-up or emergency power.
(s) Heating, Lighting, and other Service
Equipment.
1. Central or individual room gas
heating systems shall be of the enclosed flame type equipped with automatic
flame shut-off control and shall be vented directly to the outside. Heating
units of any type shall be located to avoid direct contact with any combustible
material and shall be maintained in accordance with manufacturer's
recommendation.
2. Open flame and
portable heaters are prohibited in assisted living facilities. This does not
apply to a fire place with gas logs protected as noted elsewhere in these
rules.
3. Lighting shall be
restricted to electricity. Electric wiring, motors, and other electrical
equipment in all assisted living facilities shall be in accordance with local
electrical codes and the NFPA National Electrical
Code.
(6)
Building Requirements-Family
Assisted Living Facility.
(a) General.
Family assisted living facilities shall comply with the provisions of this
section. Such facilities shall be renovated to comply with the provisions of
the National Fire Protection Association, Life Safety Code
Chapter for One-and Two-Family Dwellings, and other minimum standards of safety
established by the Board.
(b) Fire
Protection.
1. Fire Extinguishers. A
five-pound BC fire extinguisher shall be provided in the kitchen. A five-pound
ABC fire extinguisher shall be provided in the laundry and hall(s) .
2. Smoke Detectors. Smoke detectors tied into
electrical systems are required in all bedrooms, activity rooms, and hallways.
Detectors shall be tested monthly for local alarm activation and documented.
Defective detectors shall be replaced within 24 hours.
(c) Mechanical and electrical systems shall
be inspected by local building, electrical, plumbing officials, or the State
Fire Marshal, or such other person(s) as the State Board of Health may request,
and their recommendations relating to adequacy and safety presented to the
Board.
(7)
Building Requirements - Group Assisted Living Facilities.
(a) General. Group assisted living facilities
licensed, constructed, or renovated after December 25, 1991, shall be limited
to one story buildings and shall comply with the currently adopted building
code and National Fire Protection Association, Life Safety
Code. Facilities, or portions of facilities, built under the currently
adopted codes shall comply with the Life Safety Code Chapter
for New Residential Board and Care Occupancies (excluding NFPA 101A
Alternative Approaches to Life Safety) . Facilities, or portions of
facilities, built under previous adopted editions of the codes shall comply
with the currently adopted Life Safety Code Chapter for
Existing Residential Board and Care Occupancies, Impractical Evacuation
Capability (excluding NFPA 101A Alternative Approaches to Life
Safety) .
(b) Required
Fire Exits.
1. At least two exits, remote
from each other and so located that there will be no dead-end corridors in
excess of 20 feet, shall be provided.
2. Exits shall be so located that the
distance of travel from the corridor door of any occupied room to an exit shall
not exceed 100 feet.
3. Each
bedroom or suite shall have at least one doorway opening directly to the
outside, or to an exit corridor leading directly to the outside.
4. Exit doors shall swing to the
exterior.
5. Panic hardware shall
be installed on all exit doors of facilities submitted for plan review. As a
minimum, single action hardware is required on all exit doors of existing
facilities.
(c)
Corridors and Passageways. Corridors and passageways used as a means of exit,
or part of a means of exit, shall be at least 36 inches wide, shall be
unobstructed, and shall not lead through any room or space used for a purpose
that may obstruct free passage.
(d)
Smoke Barrier Separations.
1. Buildings
exceeding 3,000 square feet in area shall be divided into separate areas by
smoke barriers so located as to provide ample space on each side for
approximately one-half the beds. Smoke barriers shall have a fire-resistive
rating of not less than one hour or minimum one-half hour for existing
sprinkled facilities.
2. Doors
provided in smoke barriers shall be smoke-resistive, so installed that they may
normally be kept in the open position, but will close automatically upon fire
alarm activation.
3. Duct
penetrations in smoke barriers shall be properly protected with smoke
dampers.
4. Penetrations of smoke
barriers with wiring, conduits, pipes, etc., shall be sealed to maintain the
fire and smoke rating.
(8)
Building Requirements - Congregate
Assisted Living Facility.
(a) General.
Congregate assisted living facilities licensed, constructed, or renovated under
the currently adopted codes shall comply with the building code and the
requirements for limited care facilities in the "New Health Care Occupancies"
Chapter of the Life Safety Code (excluding NFPA 101A,
Alternative Approaches to Life Safety). Facilities, or portions of
facilities, built under previously adopted editions of the codes shall comply
with the currently adopted Life Safety Code Chapter for
Existing Residential Board and Care Occupancies, Impractical Evacuation
Capability, thereby requiring compliance with the requirements for limited care
facilities in the "Existing Health Care Occupancies" Chapter for the
Life Safety Code (excluding NFPA 101A Alternative
Approaches to Life Safety).
(b) Exit doors. Panic hardware shall be
installed on all exit doors.
(c)
Corridors and Passageways. Corridors and passageways shall be unobstructed and
shall not lead through any room or space used for a purpose that may obstruct
free passage.
(d) In new
construction, the temperature of hot water accessible to residents shall be
automatically regulated by tempering valves and a circulating pump system,
unless the water heater is dedicated to resident use.
(e) Utility rooms shall be provided for each
floor of Congregate assisted living facilities. The following equipment shall
be provided:
1. Paper towel holder with an
adequate supply of paper towels.
2.
Wall cabinet or shelves.
3. Table
or counter.
4. Soap dispenser with
soap.
5. Sink - counter top, wall
or floor mounted.
6. Space and
facilities for cleaning equipment and supplies.
Previous Chapter 420-5-4 "Domiciliary Care Facilities" filed
September 1, 1982. Repealed: Filed November 20, 1991.
Authors: Victor Hunt, Kelley Mitchell
Statutory Authority:
Code of Ala.
1975, §§
22-21-20,
et
seq.