Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 175 - HEALTH CARE FACILITIES AND SERVICES LICENSURE
Chapter 3 - REGULATIONS GOVERNING CENTERS FOR THE DEVELOPMENTALLY DISABLED
Section 175-3-006 - PHYSICAL PLANT STANDARDS

Universal Citation: 175 NE Admin Rules and Regs ch 3 ยง 006

Current through September 17, 2024

Each building where services are provided must be maintained by licensee in a manner that is safe, clean and functional for the clients who reside there.

006.01 CLIENT BEDROOMS. Single bedrooms for ambulatory clients must provide at least 80 square feet of usable floor area with a side dimension of not less than 7 feet - 0 inches. All client bedrooms must have windows which provide an unobstructed view of not less than 15 feet - 0 inches in at least 1 horizontal direction.

006.02 MULTI-BEDROOMS. Ambulatory clients must be provide d at least 60 square feet of usable floor space for each client. There must be at least 3 feet - 0 inches between beds placed side-to-side and not less than 3 feet - 0 inches between the heads of the beds. The amount of usable floor space in a client bedroom is determined after taking adjustments into account as stated in this chapter. A bedroom must have no more than 4 beds.

006.03 WINDOWS. Bedrooms must be exterior rooms with at least 1 window which is easily opened to the outside. The minimum total area of the window or windows measured between stops -- clear width when opened, must be at least 10 percent of the usable floor area. All windows must be provided with screens which are maintained in good repair. Combination storm window screens are acceptable. Full length storm windows may be used during the winter months. Window sills must not be more than 36 inches above the finished floor. All exterior windows and doors must have serviceable screens except for doors with panic hardware.

006.04 CLOSETS. There must be accessible private and adequate storage space for clothing and personal belongings in the bedroom area for each client. Built-in closets or wardrobes with doors or curtains are acceptable.

006.05 CEILING HEIGHTS. Level ceilings in sleeping rooms must not be less than 7 feet - 0 inches high. In sleeping rooms with sloped ceilings, only the areas with vertical wall heights of 5 feet or more must be included in the required usable floor area. At least half of the usable floor space must have a ceiling not less than 7 feet - 0 inches.

006.06 PARTITIONS. Partitions defining each bedroom must run from floor to ceiling.

006.07 CLIENT BEDROOMS. All client bedrooms must be located at or above natural grade level. Non-ambulatory clients must not be housed in bedrooms located above the first floor level.

006.08 DOORS. Doors in a building may be lockable by the occupant if they can be unlocked by a master key from the opposite side. Master keys are to be carried by staff at all times.

006.08(A) INTERIOR DOORS. Excluding time out room doors, interior doors must not have vision panels.

006.08(B) DOOR LOCKS. Door locks installed on sleeping room doors must be lockable from the corridor side only, except where such doors open directly to the outside of the building. Sleeping room doors leading directly to the outside of the building may be lockable on the room side. All locks must permit exit from a room by a simple operation without the use of a key.

006.08(C) DOOR WIDTHS. Door widths must not be less than 3 feet wide to allow a minimum clear opening of 32 inches in the fully opened position.

006.08(D) DOOR ALARMS. Door alarms must be provided for exterior doors when clients requiring such supervision is established by the Individual Program Plan.

006.09 CORRIDORS. Corridor widths must not be less than 3 feet - 0 inches.

006.10 BEDS. Each client must have an individual bed. Adult beds must be at least 36 inches wide. Adult size beds must be provided for individuals 14 years of age and older. Each bed must have a clean, firm, comfortable mattress. Beds must be of suitable construction and dimensions to accommodate persons using them. Bunk beds, roll-aways and trundles are not permitted.

006.10(A) BEDDING. All beds provided for clients must be supplied with suitable pillowcases and bottom and top sheets. All bedding, including mattresses, mattress pads, quilts, blankets, pillows, sheets, spreads, and all bath linen must be kept clean. Bedding, including mattresses, mattress pads, quilts, blankets, pillows, and bed and bath linen which is worn out or unfit for further use must not be used. Bedding must be appropriate to the season. Pillowcases, sheets, and bath linen, after being used by one client, must be washed before they are used by other clients.

006.10(B) BED LINEN. Clean bed linen must be furnished at least once each week, or more frequently, to maintain cleanliness and a clean washcloth, towel or appropriate paper service must be available to each client.

006.11 ROOM FURNISHINGS. All equipment, fixtures, furniture and furnishings, including windows, draperies, curtains, and carpets must be kept clean and free of dust, dirt, vermin, and other contaminants and must be maintained in good order and repair. Each client must be provided with appropriate individual furniture, including at a minimum a chest of drawers, an individual wardrobe with clothes racks and shelves unless built-in closet space is provided, and a mirror, and at least one chair per bedroom will be provided. Tilted mirrors or mirrors located at a height for wheelchair use must be provided for clients where appropriate. There must be accessible private storage space for clothing in the bedroom area for each client. Each client must have individual racks or other drying space for washcloths and towels.

006.12 TOILETS AND BATHING FACILITIES. Toilet and bathing areas and fixtures must approximate normal patterns found in residential construction and must meet the following requirements:

(A) If there are wheelchair clients in the home, the toilet and bath areas must be large enough for wheelchair use and also to include appropriate fixtures and appurtenances for the wheelchair clients' use;

(B) Shower curbs must be omitted to permit access by wheelchairs. An accessible restroom shall provide at least the following fixtures and appurtenances for the wheelchair clients' use:

(C) No bathroom must open directly into a food preparation area;

(D) Toilets must provide bar soap or a soap dispenser to be located no higher than 48 inches from the floor;

(E) All toilet and bathing area facilities and fixtures must be kept clean and in good repair;

(F) Each bathroom and toilet area must be well-lighted with a mirror over each lavatory; and

(G) Wherever there is a bathroom, there must be an easily accessible toilet.

006.13 BATHROOMS. Client bathrooms must be provided as follows:

(A) One sink and one toilet for each 6 clients;

(B) One sink when mounted, allows 29 inches clearance from the floor to the bottom of the apron and a maximum rim height of 34 inches;

(C) One toilet with the seat 15 inches to 20 inches from the floor, or 13 inches to 15 inches for children;

(D) Grab bars near each side or one side attached and the back of the toilet stool securely attached 32 inches to 34 inches above the parallel to the floor. Grab bars at the side must not be less than 24 inches in front of the toilet. Grab bars must have an outside diameter of not less than 1 1/2 inches and must provide a clearance of 1 1/2 inches between grab bars and adjacent surface. For children's restrooms grab bars must be securely attached 15 inches above the floor and be positioned to extend 16 inches beyond the toilet seat; and

(E) Toilet tissue must be provided within reach of the toilet seat and at a height of no more than 48 inches from the floor.

006.14 BATHING FACILITIES. Bathing facilities must be provided as follows:

(A) One bathing facility (tub or shower) for each eight clients;

(B) Bathtubs and showers must be provided with stable grab bars to assist clients; and

(C) Towels or warm air hand dryers must be provided with the operating mechanism no higher than 48 inches from the floor and not mounted directly above the sinks.

006.15 DINING AND RECREATION. All facilities must have minimum areas for clients' dining and recreation which must be at least 10 and 20 square feet respectively per client, or 30 square feet total per client when the area is used for a combination thereof. Space for non-ambulatory mobile clients must be increased by 50 percent. Under no circumstances must the combined recreation and dining space be less than 150 square feet. In residential units that have 8 beds or less, space in the kitchen may be used for dining if the kitchen was laid out to accommodate table space for eating purposes; the space must be located apart from the food preparation area, and 10 square feet per client must be allocated for dining purposes. Furnishings in the dining recreation room must include a couch, chair(s), end tables, dining table and chairs or similar furniture to provide a comfortable setting.

006.16 FOOD SERVICE. The kitchen may be residential in nature in both layout and equipment.

006.17 DISHWASHING. Utilizing an automatic dishwasher or a three compartment sink is adequate if it meets the following requirements:

(A) When automatic dishwashers are used, the final rinse cycle temperature must not be less than 150 degrees Fahrenheit; and

(B) For chemical sanitization of dishes in a three compartment sink, the following procedure is followed:
(i) Immersion for a minimum of one minute in sanitizing solution containing: at least 50 parts per million of available chlorine in water at a temperature not less than 75 degrees Fahrenheit (one-half tablespoon of laundry bleach or similar product containing 5 1/4 percent of available chlorine to each gallon of water provides minimum concentration;

(ii) Use another commercial chemical sanitizer which has the equivalent bacterial effect at this level of chlorine. The quantity required will need to be determined on an individual basis. For some, quantity will depend on the hardness or mineral content of the local water supply; or

(iii) At least a 2-compartment sink must be available in each kitchen. It is recommended that, when made up, the strength of sanitizing solutions be at least twice the minimum strength required for the particular sanitizing solution used. One tablespoon of laundry bleach or other solution containing 5 1/4 percent available chlorine to each gallon of water provides 100 parts per million.

006.18 FOOD STORAGE. Dry or staple foods must be stored at least 4-6 inches above the floor in a ventilated room not subject to sewage or waste water backflow, contamination leakage, water overflow, rodents, or vermin. This requirement does not preclude the use of dry or staple food stored in cabinets in the kitchen if these requirements are met.

006.19 HANDWASHING. There must be a conveniently located handwashing facility in the kitchen.

006.20 COUNTER SPACE. There is cleanable work counter space for the preparation of meals. Formica, vinyl, or resilient type work counter coverings which are free of crevices or cracks are permitted.

006.21 REFRIGERATION. Refrigerators are provided for perishable foods and are kept clean and in good working order, and maintain refrigerated foods at from 33 degrees Fahrenheit to 45 degrees Fahrenheit.

006.22 ADMINISTRATION. A room must be provided for the house manager or house parents. If the house manager or family live in the facility, their numbers must be counted in determining the number of toilets and baths, and space allocated for dining and recreation, unless a separate apartment is provided.

006.23 OUTSIDE RECREATION AREA. The lot must be large enough for an outside recreation area commensurable with the number and type of clients in order to effectively promote normalization. In areas where public recreation is not available within one city block of the block where the facility is located, at least 25 square feet of outdoor recreation area per client must be provided.

006.24 GENERAL STORAGE. General storage in addition to linen closets and clients' room closets must be provided at the ratio of 60 cubic feet per bed.

006.25 VENTILATION. If areas used as kitchens, bathrooms, toilet areas, or laundries are located in rooms without windows, or widows that cannot be opened to the outside air, these areas must be provided with mechanical ventilation with vents leading directly to the outside. If these areas have windows that can be opened to the outside air, mechanical ventilation is not required.

006.26 PLUMBING. Hot and cold water must be piped to all fixtures in the building except cold water shall be piped to the toilet. Hot water at fixtures used by clients for bathing and sinks must at a minimum be 110 degrees Fahrenheit and must not exceed 115 degrees Fahrenheit. In order to prevent a hazard to the clients, mixing valves must be utilized in cases where a client's Individual Program Plan specifies training in temperature adjustment. Water temperature may not exceed 115 degrees Fahrenheit.

006.27 HEATING AND COOLING. The building must be equipped with a heating system and have a radiator, convertor, or register in each room used by clients that does not constitute a burn hazard. The heating system must be capable of maintaining a temperature of 70-75 degrees Fahrenheit during severe cold weather conditions at an elevation of 30 inches above the floor in all areas used by clients. For all facilities a cooling system is required which is capable of maintaining an indoor temperature of a range from 68 degrees Fahrenheit to 78 degrees Fahrenheit during hot weather conditions at an elevation of 30 inches above the floor in all areas used by clients. Indoor relative humidity must be maintained within the 30-70% range throughout the year. If hot water or steam radiators are used, they must be provided with covers to prevent inadvertent burns.

006.27(A) MECHANICAL ROOMS. Mechanical equipment rooms housing gas-fired heating and hot water equipment must have positive outside combustion air supplied for the equipment.

006.27(B) HEATING APPLIANCES. Every gas-fired or oil-fired heating appliance and hot water and other heating appliance must be vented to the outside air.

006.28 ARTIFICIAL LIGHTING. Each room or area, including store rooms must be provided with light fixtures to provide the following minimum foot candles or lumen per square foot rating at an elevation of 30 inches above the floor. Extension cords and temporary outlets are prohibited. Bare, incandescent bulbs are prohibited in client areas.

006.29 LAUNDRY. Laundry services or facilities for clients must be provided in accordance with the developmental needs of the clients. Separate storage space for soiled and clean laundry must be located in the residence. All damp soiled linen such as bed linen, towels, and washcloths must be maintained in covered waterproof containers.

006.29(A) LAUNDRY EQUIPMENT. Domestic type equipment must be provided for the laundry. Laundry equipment must not be located in the kitchen.

006.30 ELEVATORS. All elevators in a Center for the Developmentally Disabled must be inspected for safety at least once a year by the Nebraska State Department of Labor.

006.31 FLOORS, WALLS, AND CEILINGS.

The floors of all rooms, hallways, bathrooms, storerooms, and all other spaces used or traversed by clients and staff must be of such construction as to be easily cleaned, shall be smooth, and shall be kept clean and in good repair. Cleaning of floors must be so done as to minimize the raising of dust and exposure of clients thereto. Ceilings in areas where food is stored or prepared and in which dishes and utensils are washed must be of such construction as to be easily cleaned, must be smooth, and must be kept clean and in good repair. The safe use of rugs, carpets, or natural stone which can be kept clean is permitted. Abrasive strips to reduce or prevent slipping shall be used where slippery surfaces present a hazard.

006.31(A) DIRT FLOORS. Dirt floors in a basement area are prohibited. Basement floors must be concrete with proper drainage.

006.31(B) WALLS. Walls must be free from spaces which may harbor vermin. Walls in other areas of the facility must have a cleanable finish. Lead based paints are not permitted in any area of the facility.

006.31(C) CEILINGS. Enamel-painted plaster, gypsum board, concrete and vinyl-coated suspended ceiling panels, or equally washable surfaces are adequate.

006.32. FOOD SERVICE. Each licensee must comply with the provisions of the Nebraska Food Code.

006.33 MENU PLANNING. Menus must be planned at least a week in advance. and must be reviewed and approved by a dietician before service.

006.33(A) MEAL SUBSTITUTIONS. Records of substitutions of planned food items must be made and must be of equal nutritional value.

006.33(B) DOCUMENTATION OF MENUS. Records of menus must be filed for 6 months in the facility.

006.34 DINING ROOMS. All clients, including the mobile non-ambulatory must eat or be fed in dining areas except where contraindicated for health reasons. Table service must be provided for all who can and will eat at a table.

006.34(A) DINING EQUIPMENT. Dining areas must be equipped with tables, chairs, eating utensils and dishes to meet the developmental needs of the clients.

006.34(B) DINING SUPERVISION. Dining areas must be adequately supervised and staffed for the direction of self-help eating procedures and to assure that each client receive an adequate amount and variety of food.

006.35 WATER AND SEWER SYSTEMS. Each building must have and maintain an accessible and safe supply of potable water. Where an authorized public water supply of satisfactory quality, quantity and pressure is available, the building must be connected to it and must use it exclusively. All water distribution systems must be protected with anti-siphon devices and air-gaps to prevent contamination.

006.35(A) PRIVATE WELLS. The licensee must ensure that any building with a private well or wells as the source of the water supply must have this water supply tested quarterly for coliform bacteria and a chemical analysis every 3 years by the Department or a laboratory approved by the same.

006.36 CLOTHING. Each client must have an adequate allowance of neat, clean, fashionable and seasonable clothing.

006.36(A) CLOTHING IDENTIFICATION. Each client must have her or his own clothing which is properly marked with her or his name, and he or she shall use this clothing.

006.36(B) APPROPRIATE CLOTHING. Such clothing must make it possible for clients to go out of doors in inclement weather, to go on trips or visits appropriately dressed and to make a normal appearance in the community.

006.36(C) NON-AMBULATORY CLIENTS. Non-ambulatory clients must be dressed daily in their own clothing, including shoes, unless contraindicated in a written, medical order which is reviewed periodically.

006.36(D) CLOTHING MAINTENANCE. An ongoing wardrobe check should be kept on each client's personal and clothing items to assure proper maintenance.

Disclaimer: These regulations may not be the most recent version. Nebraska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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