Current through Reg. 49, No. 38; September 20, 2024
(a)
Resident bedrooms.
(1) An existing large Type
A assisted living facility must ensure a resident bedroom or living unit is not
located on a floor that is below finished ground level.
(2) An existing large Type A assisted living
facility must ensure bedroom usable floor space is not less than 80 square feet
for a bedroom housing one resident and not less than 60 square feet per
resident for a bedroom housing multiple residents, unless otherwise permitted
by paragraphs (3) and (4) of this subsection. Portions of a bedroom that are
less than eight feet in the smallest dimension cannot be included in the
measurement of bedroom usable floor space, unless approved by the Texas Health
and Human Services Commission (HHSC).
(3) An existing large Type A assisted living
facility containing individual living units that include living space for the
residents, in addition to their bedroom, may reduce the bedroom usable floor
space for a bedroom housing multiple residents within a living unit by up to 10
percent of the required bedroom usable floor space, as long as the minimum
dimensional criteria are maintained. An existing large Type A assisted living
facility must not use this provision in conjunction with the provision
permitting the reduction of common social-diversional areas or common dining
areas found in subsection (g)(6) of this section.
(4) An existing large Type A assisted living
facility must house no more than 50 percent of its licensed resident capacity
in bedrooms housing three or more residents. A bedroom must not house more than
four residents.
(b)
Bedroom windows. An existing large Type A assisted living facility must ensure
each bedroom has at least one operable window with outside exposure and meeting
the following requirements.
(1) The window
sill must be no higher than 44 inches above the floor.
(2) The window must be operable by a resident
occupying the bedroom, from the inside, without the use of tools or special
devices.
(3) The total area of all
windows in a bedroom must not be less than eight percent of the minimum bedroom
usable floor space according to the requirements of subsection (a)(2) of this
section.
(4) An existing bedroom
window not meeting these requirements may be continued in service, subject to
approval by HHSC.
(c)
Bedroom furnishings. When a resident does not provide their own furnishings, an
existing large Type A assisted living facility must provide the following
furnishings for each resident, which must be maintained in good repair:
(1) a bed, including a mattress;
(2) a chair;
(3) a table or dresser; and
(4) private clothes storage space, which must
have closable doors, and drawer space for clothing and personal
belongings.
(d)
Arrangement of resident living units or rooms.
(1) An existing large Type A assisted living
facility must ensure all resident rooms open on an exit, corridor, living area,
or public area.
(2) An existing
large Type A assisted living facility must ensure a resident room is arranged
for convenient resident access to dining and recreation areas.
(e) Staff area. An existing large
Type A assisted living facility must provide a staff area on each floor of an
existing large Type A assisted living facility and in each separate building
containing resident sleeping rooms, except as permitted under paragraph (1) of
this subsection.
(1) An existing large Type A
assisted living facility that is not more than two stories in height and is
composed of separate buildings grouped together and connected by covered walks,
is not required to provide a staff area on each floor or in each building,
provided that a staff area is located not more than 200 feet walking distance
from the farthest resident living unit.
(2) An existing large Type A assisted living
facility must provide the following at each staff area:
(A) a desk or writing surface;
(B) a telephone; and
(C) a fire alarm control unit or a fire alarm
annunciator panel meeting the requirements of §553.135 of this division
(relating to Fire Protection Systems Requirements for an Existing Large Type A
Assisted Living Facility).
(f) Resident toilet and bathing facilities.
An existing large Type A assisted living facility must ensure each resident
bedroom is served by a separate private toilet room, a connecting toilet room,
or a general toilet room.
(1) An existing
large Type A assisted living facility that houses individuals of more than one
gender must provide toilet rooms for each gender, or individual single-occupant
toilet rooms for use by any gender.
(2) An existing large Type A assisted living
facility must ensure a general toilet room or bathing room is accessible from a
corridor or public space.
(3) An
existing large Type A assisted living facility must ensure resident toilet and
bathing facilities comply with the requirements for resident-use plumbing
fixtures according to §553.137 of this division (relating to Mechanical
Requirements for an Existing Large Type A Assisted Living Facility).
(g) Resident living areas.
(1) An existing large Type A assisted living
facility must provide, in a common area of the facility, social-diversional
spaces with appropriate furniture. Examples of social-diversional spaces
include living rooms, day rooms, lounges, dens, game rooms, and sunrooms.
(A) An existing large Type A assisted living
facility must provide a social-diversional space with a minimum area of 120
square feet in at least one space within a common area of the facility,
regardless of the number of residents or other provisions of this section
permitting a reduction in the total minimum social-diversional space.
(B) An existing large Type A assisted living
facility must ensure a social-diversional space has one or more exterior
windows providing a view of the outside.
(C) An existing large Type A assisted living
facility must ensure the total space for social-diversional areas is provided
on a sliding scale according to the following table. No space smaller than 120
square feet in area can be counted toward meeting this requirement.
Attached Graphic
(2) An existing large
Type A assisted living facility must provide a dining area with appropriate
furniture.
(A) An existing large Type A
assisted living facility must provide a dining space with a minimum area of 120
square feet in at least one space within a common area of the facility,
regardless of the number of residents or other provisions of this section
permitting a reduction in the total minimum dining space.
(B) An existing large Type A assisted living
facility must ensure a dining space has one or more exterior windows providing
a view of the outside.
(C) An
existing large Type A assisted living facility must ensure a dining area is
accessible from resident living units or bedrooms via a covered path.
(D) An existing large Type A assisted living
facility must ensure the total space for dining areas is provided on a sliding
scale according to the following table. No space smaller than 120 square feet
in area can be counted toward meeting this requirement.
Attached Graphic
(3) An existing large
Type A assisted living facility may provide a total living and dining area
combined in a single or interconnecting space where the minimum area of the
combined space is at least 240 square feet.
(4) For calculation purposes, where a means
of egress passes through a living or dining area, an existing large Type A
assisted living facility must deduct a pathway, equal to the minimum corridor
width, according to §553.133 of this division (relating to Means of Egress
Requirements for an Existing Large Type A Assisted Living Facility), from the
measured area of the space.
(5) An
existing large Type A assisted living facility must ensure a means of egress
through a resident living or dining area is kept clear of obstructions, except
as permitted by NFPA 101.
(6)
Subject to the limitations of paragraphs (1)(A) and (2)(A) of this subsection
and subparagraphs (A) and (B) of this paragraph, an existing large Type A
assisted living facility containing individual living units may reduce the
minimum square footage required by paragraphs (1)(C) and (2)(D) of this
subsection for total common social-diversional or common dining areas,
respectively, by including up to 10 percent of the individual living unit area
in the calculation of the total social-diversional area or total dining area.
(A) The individual living unit area
contributed toward total social-diversional space or total dining space must
not be counted more than once per living unit but may be split between
social-diversional and dining space calculations.
(B) An existing large Type A assisted living
facility must not utilize both this paragraph and subsection (a)(3) of this
section to reduce both the minimum square footage otherwise required for its
common social-diversional or dining areas and the minimum square footage of
usable floor space otherwise required in bedrooms housing multiple residents
within a living unit.
(h) Storage areas. An existing large Type A
assisted living facility must provide sufficient separate storage spaces or
areas for at least:
(1) administrative
records, office supplies, and other storage needs related to
administration;
(2) medications and
medical supplies;
(3) equipment
supplied by the facility for resident needs, including wheelchairs, walkers,
beds, and mattresses;
(4) cleaning
supplies, including for janitorial needs;
(5) food;
(6) clean linens and towels, if the facility
furnishes linen;
(7) soiled linen,
if the facility furnishes linen; and
(8) lawn and maintenance equipment.
(i) General kitchen.
(1) An existing large Type A assisted living
facility that prepares food off-site or in a separate building must ensure food
is served at the proper temperature and transported in a sanitary
manner.
(2) An existing large Type
A assisted living facility must ensure a kitchen meets the requirements of the
local fire, building, and health codes.
(3) An existing large Type A assisted living
facility that prepares food on-site must provide a kitchen or dietary area to
meet the general food service needs of the residents and must include space
for:
(A) storage, refrigeration, preparation,
and serving food;
(B) dish and
utensil cleaning, which includes:
(i) a
three-compartment sink large enough to immerse pots and pans; and
(ii) a mechanical dishwasher for washing and
sanitizing dishes;
(C) a
food preparation sink;
(D) a
handwashing station in every food preparation area with a supply of hot and
cold water, soap, a towel dispenser and a waste receptacle;
(E) a handwashing lavatory that is readily
accessible to every dish room area;
(F) refuse storage and removal;
(G) floor drains in the kitchen and
dishwashing areas, unless the facility was licensed before January 6, 2014, and
the facility can keep the floor clean; and
(H) a grease trap, if required by local
authorities.
(4) An
existing large Type A assisted living facility must ensure a kitchen is
designed so that room temperature, at peak load or in the summer, does not
exceed 85 degrees Fahrenheit measured throughout the room at five feet above
the floor.
(5) An existing large
Type A assisted living facility must ensure the volume of supply air provided
takes into account the large quantities of air that may be exhausted at the
range hood and dishwashing area.
(6) An existing large Type A assisted living
facility must provide a supply of hot and cold water.
(A) Hot water for sanitizing purposes must be
180 degrees Fahrenheit.
(B) When
chemical sanitizers are used, hot water must meet the manufacturer's suggested
temperature.
(7) An
existing large Type A assisted living facility must maintain a separation
between soiled and clean dish areas.
(8) An existing large Type A assisted living
facility must maintain a separation of air flow between soiled and clean dish
areas.
(j) Kitchen
restrooms.
(1) An existing large Type A
assisted living facility must provide a restroom facility for kitchen staff,
including a lavatory, except as described in paragraph (2) of this subsection.
(A) The restroom facility must be directly
accessible to kitchen staff without traversing resident-use areas.
(B) The restroom must open into a service
corridor or vestibule and not open directly into the kitchen.
(2) An existing large Type A
assisted living facility licensed before January 6, 2014, may provide a staff
restroom that may be located outside the kitchen area.
(k) Kitchen janitorial facility.
(1) An existing large Type A assisted living
facility must provide janitorial facilities exclusively for the kitchen and
located in the kitchen area, except as described in paragraph (2) of this
subsection.
(2) An existing large
Type A assisted living facility licensed before January 6, 2014, must provide a
janitorial facility for the kitchen. The janitorial facility may be located
outside the kitchen if sanitary procedures are used to reduce the possibility
of cross-contamination.
(3) An
existing large Type A assisted living facility must provide a garbage can or
cart washing area with a floor drain and a supply of hot water. The garbage can
or cart washing area may be in the interior or on the exterior of the
facility.
(4) An existing large
Type A assisted living facility must provide floor drains in the kitchen and
dishwashing areas unless the facility was licensed before January 6, 2014, and
the facility can keep the floors clean.
(5) If required by local authorities, an
existing large Type A assisted living facility must provide a grease
trap.
(l) Finishes.
(1) An existing large Type A assisted living
facility must provide non-absorbent, smooth finishes or surfaces on all kitchen
floors, walls and ceilings.
(2) An
existing large Type A assisted living facility must provide non-absorbent,
smooth, cleanable finishes on counter surfaces and all cabinet
surfaces.
(3) An existing large
Type A assisted living facility must ensure surfaces are capable of being
routinely cleaned and sanitized to maintain a healthful environment.
(m) Vision panels in communicating
doors.
(1) An existing large Type A assisted
living facility must ensure a door between a kitchen and a dining area, serving
area, or resident-use area, is provided with a vision panel with fixed safety
glass. Where the door is a required fire door or is located in a fire barrier
or other fire resistance-rated enclosure, the vision panel, including the
glazing and the frame, must meet the requirements of NFPA 101.
(2) Existing doors between kitchens and
adjacent spaces that are not provided with vision panels may be continued in
service, subject to approval by HHSC.
(n) Auxiliary serving kitchens.
(1) An existing large Type A assisted living
facility must ensure an auxiliary serving kitchen is equipped to maintain
required food temperatures.
(2) An
existing large Type A assisted living facility must ensure an auxiliary serving
kitchen is equipped with a handwashing lavatory meeting the requirements of
this section.
(3) An existing large
Type A assisted living facility must ensure all surfaces in an auxiliary
serving kitchen meet the requirements for finishes in this section.
(o) Protection of cooking
operations.
(1) An existing large Type A
assisted living facility must protect cooking facilities using commercial or
residential cooking equipment for meal preparation as commercial cooking
operations, according to the requirements for commercial cooking equipment in
§553.136 of this division (relating to Hazardous Area Requirements for an
Existing Large Type A Assisted Living Facility).
(2) The following commercial or residential
cooking equipment used only for reheating, and not for meal preparation, is not
required to comply with the requirements of §553.136 of this division:
(A) microwave ovens;
(B) hot plates; or
(C) toasters.
(p) Food storage areas.
(1) An existing large Type A assisted living
facility must provide a food storage area large enough to consistently maintain
a four-day minimum supply of non-perishable food. A food storage area may be
located away from the food preparation area as long as there is space adjacent
to the kitchen for necessary daily usage.
(2) An existing large Type A assisted living
facility must provide dollies, racks, pallets, wheeled containers, or shelving,
so that food is not stored on the floor.
(A)
An existing large Type A assisted living facility must ensure shelves are
adjustable wire type shelving.
(B)
An existing large Type A assisted living facility licensed before January 6,
2014, may use wood shelves provided the shelves are sealed and clean.
(3) An existing large Type A
assisted living facility must provide non-absorbent finishes or surfaces on all
floors and walls in food storage areas.
(4) An existing large Type A assisted living
facility must provide effective ventilation in dry food storage areas to ensure
positive air circulation.
(5) An
existing large Type A assisted living facility must ensure the maximum room
temperature in a food storage area does not exceed 85 degrees Fahrenheit at any
time, when measured at the highest food storage level, but not less than five
feet above the floor.
(q)
Laundry and linen services.
(1) An existing
large Type A assisted living facility that co-mingles and processes laundry
on-site in a central location, regardless of the type of laundry equipment
used, must ensure a laundry area:
(A) is
separated from the assisted living building by a fire barrier having a one-hour
fire resistance rating, and this separation must extend from the floor to the
floor or roof above;
(B) is
protected throughout by a fire sprinkler system;
(C) has access doors that open to the
exterior or to an interior non-resident use area, such as a vestibule or
service corridor; and
(D) is
provided with:
(i) a soiled linen receiving,
holding, and sorting room with a floor drain and forced exhaust to the exterior
that;
(I) must always operate when soiled
linen is held in this area; and
(II) may be combined with the washer
section;
(ii) a general
laundry work area that is separated by partitioning a washer section and a
dryer section;
(iii) a storage area
for laundry supplies;
(iv) a
folding area;
(v) an adequate air
supply and ventilation for staff comfort without having to rely on opening a
door that is part of the fire barrier separation required by subparagraph
(1)(A) of this subsection; and
(vi)
provisions to exhaust heat from dryers and to separate dryer make-up air from
the habitable work areas of the laundry.
(2) If linen is processed off site, the
facility must provide:
(A) a soiled linen
holding room with adequate forced exhaust ducted to the exterior; and
(B) a clean linen receiving, holding,
inspection, sorting or folding, and storage room.
(3) An existing large Type A assisted living
facility must ensure a laundry area for resident-use meets the following
requirements.
(A) An existing large Type A
assisted living facility must ensure only residential type washers and dryers
are provided in a laundry area for resident-use.
(B) When more than three washers and three
dryers are provided in one laundry area for resident use, the area must be:
(i) protected throughout by a fire sprinkler
system; or
(ii) separated from the
facility by a fire barrier having a one-hour fire resistance rating.