Current through Register Vol. 51, No. 19, September 20, 2024
A. Location.
The premises on which a psychiatric day treatment center is to be located shall
be served by a good road. Accessible public transportation is
desirable.
B. Communication. There
shall be at least one telephone readily available - not a pay station or locked
telephone - in the building and additional telephones or extensions as may be
required to summon help promptly in case of fire or other
emergencies.
C. Buildings.
(1) Any building used for a psychiatric day
treatment center shall be kept in good repair, neat, clean, attractive, and
safe. Housekeeping shall meet the highest possible standards of hygiene and
cleanliness. All floors, walls, ceilings, windows, and fixtures shall be kept
clean. Interior walls and floors shall be of a character to permit frequent and
easy cleaning. The building shall be accessible to the handicapped. The
facility shall be kept free of unnecessary accumulations of unused furniture,
equipment, linen, clothing, and similar items. All paint shall be free from
lead.
(2) The director shall
provide for the safety and protection of all occupants and assure the
elimination of all hazards. Adequate provision and training shall be made for
fire-control equipment, fire escapes, and evacuation of persons in case of fire
or other emergency. Fire drills shall be held on a regular basis.
(3) Any proposed alterations, additions, or
changes shall be submitted to the health authority so that they may be approved
or disapproved with such recommendations as deemed necessary.
D. Sanitation.
(1) Sewage Disposal. The method of sewage
disposal shall conform to COMAR 10.17.03 and be approved by the health
authority.
(2) Water Supply. A safe
drinking-water supply, as determined by COMAR 10.17.02 and approved by the
health authority, shall be provided.
(3) Plumbing. All plumbing and plumbing
fixtures shall be so constructed, installed, and maintained as to prevent
cross-connections or other sanitation hazards, as required by the applicable
State and local plumbing codes.
(4)
Garbage and Refuse Disposal. Garbage and refuse shall be kept in watertight
metal containers with tight-fitting covers and shall be removed from the
premises at frequent intervals.
E. Heating.
(1) The building, whenever possible, shall be
equipped with a heating plant with design capability of maintaining a
temperature of 75°F in mean winter temperatures in patient areas.
(2) Space heaters and portable heaters are
prohibited.
(3) Chimney, flues, and
pipes connected with the heating facility shall be checked and cleaned
annually.
(4) The fuel supply shall
be handled according to the regulations of the State Fire Prevention
Commission. If coal is used, ashes may not be stored in flammable containers
pending disposal.
F.
Insects and Rodents. The premises shall be maintained free of insects and
rodents through an active pest-control program and elimination of
G. Gas and Electric Appliances. All gas
appliances shall be installed and used in accordance with the applicable
codes.
H. Screens.
(1) All outside doors, windows, and other
outside openings shall be screened with wire screen or its equal with not less
than 16 meshes per linear inch.
(2)
All screen doors shall be equipped with self-closing devices and, when closed,
fit tightly enough to prevent entrance of flies, mosquitoes, other insects, and
rodents.
(3) Window screens shall
fit closely enough to keep out insects and be easily removed.
I. Lighting. Each area used for
therapy purposes shall be provided with sufficient artificial lighting so that
the combined natural and artificial lighting shall be capable of providing a
minimum illumination of 100-foot candles at work surfaces at all times when the
psychiatric day treatment center. is in operation and at least 20-foot candles
on all stairways and corridors. Glare shall be kept at a minimum by:
(1) Providing shades or curtains at all
windows exposed to direct sunlight unless seating is arranged so that no person
while at work will be required to face a glaring surface;
(2) Using lighting fixtures designed so that
bare lamps or tubes are shielded at normal viewing angles;
(3) Using light-colored flat paint or other
light finishes on ceilings and upper side walls (semi-gloss finishes may be
used on lower side walls and other wood trim where frequent cleaning is
necessary);
(4) Employing
non-glossy, light-colored finishes on work tables to minimize glare by
reflection.
J. Space and
Ventilation Requirements.
(1) Adequate space
to meet the requirements of program activities shall be available. Space for
individual and group therapy, for occupational and activities therapy, and a
kitchen area for patient use in acquiring and practicing activities of daily
living shall be available.
(2)
Rooms with a total window area of less than 10 percent and an openable window
area of less than 5 percent of the floor area may be used only if there is
provision for air exchange and ventilation according to the standards of the
ASHRAE Code.
(3) Healthful humidity
and comfortable temperatures shall be maintained in patient areas during the
summer months.
K.
Sanitary Facilities.
(1) The drinking-water
supply may not be located in the bathroom. One drinking-water facility shall be
available for every 4o persons or fewer on each floor.
(2) There shall be one toilet and one
lavatory provided for every 10 persons of the same sex or fewer. The lavatory
shall be in close proximity to each toilet. The floor in each toilet room shall
have a waterproof, non-absorbent finish, and the walls shall be smoothly
finished with a hard surface. Grab bars shall be provided in toilets and
bathing areas.
(3) Towels shall be
of the single-service type and shall be provided on single-service towel
dispensers in all toilet rooms. Mechanical hand-drying devices may be used
instead of towel dispensers.
(4)
There shall be hot and cold running water, soap, and toilet paper provided in
the toilet rooms at all times. The temperatures of the hot water may not exceed
125°F in patient areas.
L. Food Facilities. If food is prepared on
the premises, the applicable sections of COMAR 10.15.03 relating to approved
source of food, food temperatures and storage, storage of dangerous chemicals,
handwashing, and dishwashing (sanitizing) shall serve as the
standards.
M. Safety.
(1) Stairways shall be kept free of
obstructions. Fire-exit doors shall be maintained in working order. The
facility shall be free of mechanical and electrical hazards. Non-slip surfaces
and coverings shall be provided in risk areas, such as tubs, showers, and
stairways.
(2) Poisonous and
flammable products are prohibited unless stored in accordance with State Fire
Prevention code requirements.
N. Provisions for Handicapped. Provisions for
the handicapped shall be made according to the American National Standards
Institute (ANSI) A 117.1 to meet the anticipated needs of the population
served.
O. Janitors' Closets and
Slop Sinks.
(1) The facility shall provide
janitors' closets with slop sinks as follows:
(a) At least one per building shall be
provided in non-hospital-based programs;
(b) At least one for every 100 persons, one
per resident building, or one per resident floor, whichever is most stringent,
shall be provided in hospital-based programs.
(2) Mops and supplies may not be stored on
the floor in the closet.
(3) The
closet shall be vented to the outside.
P. Storage. Storage areas shall be provided
and located according to efficiency of scheduling, operation, and patient
needs.
Q. Minimal Equipment.
Minimal equipment for a psychiatric day treatment center shall be adequate to
meet the demands of the program according to the number of clients in
attendance.
