Section 11-100.1-23 - Physical environment(a) For all ARCHs, suitability of site, quietness, sanitary features of the immediate environment, accessibility,. and proximity to the community to be served shall be considered in licensing a facility.(b) The Type I ARCH shall be free of excessive noise, dust, or odors and shall have good drainage;(c) The Type I ARCH shall be provided with adequate means of sewage, garbage, and other refuse disposal, approved potable water supply, and electricity;(d) The Type I ARCH shall be accessible by emergency medical services and be near a means of public transportation;(e) Resident living areas shall be designed and equipped for the safety, comfort, and privacy of the resident; and(f) Any person regularly utilizing the portions of the home designated for residents including but not limited to day care residents, relatives, and visitors shall be considered as residents for purposes of calculating the space requirements of section 11-100.1-23(1)(2) and section 11-100.1-23(m)(3).(g) Fire prevention protection. (1) All Type I ARCHs licensed under this chapter shall initially comply, and shall be inspected at least annually by appropriate fire authorities for compliance, with state and county codes, ordinances, and laws;(2) Fees for fire inspections shall be the responsibility of the licensee;(3) Type I ARCHs shall be in compliance with, but not limited to, the following provisions: (A) Fire escapes, stairways and other exit equipment shall be maintained operational and in good repair and free of obstruction;(B) There shall be a clear and unobstructed access to a safe area of refuge;(C) Each Type I ARCH shall have a written plan for the safe care and evacuation of residents to areas of refuge in case of emergency. This plan shall be reviewed, and updated as necessary, whenever there is a significant change in the physical or mental condition of a resident or whenever a new resident enters the facility. All personnel shall be instructed in their respective duties in carrying out this plan. The written plan with directional diagrams shall be posted in a conspicuous location within the facility;(D) A drill shall be held to provide training for residents and personnel at various times of the day or night at least four times a year and at least three months from the previous drill, and the record shall contain the date, hour, personnel participating and description of drill, and the time taken to safely evacuate residents from the building. A copy of the fire drill procedure and results shall be submitted to the fire inspector or department upon request;(E) There shall be an adequate system of communication to summon help in case of fire or other emergency. This shall include telephone service. Inside stairways shall be provided for communication between floors within the Type I ARCH. All rooms utilized by the Type I ARCH, under the same roof, shall be connected by interior doors. The communication system shall assure prompt contact with care givers;(F) Smoking shall be permitted only in approved areas where proper equipment and supervision is provided;(G) Smoke detectors shall be provided in accordance with the most current edition of the National Fire Protection Association (NFPA) Standard 101 Life Safety Code, One and Two Family Dwellings. Existing Type I ARCHs may-continue to use battery operated individual smoke detector units, however, upon transfer of ownership or primary care giver, such units shall be replaced with an automatic hard wiring UL approved smoke detector system;(H) Fire extinguishers shall be installed in accordance with NFPA 101 Life Safety Code and have a minimum fire extinguisher classification rating as required by the county fire code;(I) Each resident of a Type I home must be certified by a physician that the resident is ambulatory and capable of following directions and taking appropriate action for self-preservation under emergency conditions, except that a maximum of two residents, not so certified, may reside in the Type I home provided that either: (i) For each such non-certified resident there must be a responsible adult on the premises of the home at all times that the non-certified resident is present in the home, and there must never be a stairway which must be negotiated for emergency exit by such non-certified resident; or(ii) Type I homes having residents not so certified shall have a sprinkler system installed throughout in accordance with the National Fire Protection Association (NFPA) Standard 13-D, Sprinkler Systems, One and Two Family Dwellings.(h) The Type I ARCH shall maintain the entire facility and equipment in a safe and comfortable manner to minimize hazards to residents and care givers. (1) Housekeeping: (A) A plan including but not limited to sweeping, dusting, mopping, vacuuming, waxing, sanitizing, removal of odors and cleaning of windows and screens shall be made and implemented for routine periodic cleaning of the entire Type I ARCH and premises;(B) After discharge of any resident, the bed, bed furnishings, bedside furniture and equipment shall be thoroughly cleansed prior to subsequent resident admission;(C) Floors in resident areas shall be cleaned at least once daily;(D) All walls, ceilings, windows and fixtures shall be kept clean; and toilets and lavatories shall be cleaned and deodorized daily.(2) Temperature control: (A) Temperature and humidity shall be maintained within a practical comfort range by heating, air conditioning, or other means in accordance with residents' needs and desires; and(B) Any heating apparatus or appliances, or open flame in stoves, water heaters and fireplaces shall conform to UL standards as they existed on the date of adoption of this chapter.(3) All Type I ARCHs shall comply with applicable state laws and rules relating to sanitation, health, infection control and environmental safety;(4) Water supply. Hot and cold water shall be readily available to residents for personal washing purposes. Temperature of hot water at plumbing fixtures used by residents shall be regulated and maintained within the range of 100°-120°F.(i) All construction or alterations shall comply with current county building, land use and fire codes and ordinances in the state. The Type I ARCH licensed for wheelchair residents shall be accessible to and functional for the residents at the time of licensure. (1) Windows: (A) A habitable room shall have an aggregate window area of not less than one-tenth of the gross floor area;(B) In bedrooms occupied by residents in wheelchairs, window sills may not be higher than forty four inches, or as stipulated by the current county building codes; and(C) Windows in residents' rooms shall have adequate means of insuring privacy.(2) Windows shall have screens having no less than sixteen meshes per inch.(3) Doors: (A) Two exit doors shall be included which are remote from each other and shall be provided for each floor or separate building where residents reside. For residents with assistive devices, doorways shall be wide enough to allow passage and access;(B) When multiple locking devices are used on exits, a maximum of two locking mechanisms for egress shall be allowed;(C) Sliding doors and folding doors shall not be used as exit doors, but where used in service areas not utilized by residents, shall be of light material and easy to handle;(D) Provision for the free passage of handicapped residents, including wheelchair residents, to rooms, toilets, corridors, and exits shall be maintained at all times; and(E) Each occupied room shall have access to required exits.(4) Lighting: (A) Appropriate lighting fixtures adequate in number shall be provided for the comfort of residents and care givers; and(B) Residents' rooms shall have artificial light adequate for reading at bedside. This lighting shall be at least thirty foot candles at normal reading height;(5) In multi-level homes there shall be an inside enclosed stairway. Ramps shall not exceed a slope of more than one inch per foot and shall be provided with non-slip material. Elevators, stairways and ramps and handrails shall comply with current county building codes;(6) In Type I ARCHs, bedrooms, hallways, and corridors shall be large enough to allow passage, access and be comfortable for residents with assistive devices. Type I ARCHs shall establish a performance criteria for safe evacuation and exit from the facility meeting the standards and requirements as set forth by the Uniform Building Code (UBC) and NFPA 101 (with utilization of the FSES rating).(7) At least one toilet, lavatory and bathtub or shower shall be conveniently located and provided for each floor occupied by residents for sleeping;(8) Toilets, bathtubs and showers shall have provisions for individual privacy;(9) Bathrooms shall have non-slip surfaces in tubs and showers;(10) For Type I ARCHs with wheelchair residents, walk-in showers flush with the floor shall be provided. Showers shall have a minimum floor area of sixteen square feet arranged and located to accommodate both the resident and the care giver providing personal care. The shower entrance shall be at least thirty two inches wide. Adjacent floor areas shall be protected from the water which could constitute an unsafe area;(11) Handrails and grab bars shall be at a height of thirty two to thirty four inches from the floor for residents' use in the hallways and bathrooms.(12) Floors shall be nonabrasive, slip resistant, flush at doorways and be of material which do not retain odors.(j) Waste disposal: (1) Every Type I ARCH shall provide a sufficient number of watertight receptacles, acceptable to the department for rubbish, garbage, refuse, and other matter. These receptacles shall be kept closed by tight fitting covers; and(2) Disposal of infectious waste shall be in compliance with Hawaii Administrative Rules chapter 104, Management and Disposal of Infectious Waste.(k) Storage space for resident's luggage and other bulky items and equipment shall be provided and located in a safe and convenient place.(l) An enclosed dining area within the Type I ARCH shall be provided for residents which shall be apart from sleeping quarters but may be in continuity to the living room area. The following shall prevail: (1) At least one table with twenty nine inches clearance between floor and lower edge shall be provided to allow for those residents using wheelchairs;(2) Dining space allotment shall not be less than twenty square feet per resident capacity;(3) Residents shall be served meals in dining rooms unless they are temporarily confined to their bedrooms; and(4) Safe supportive chairs shall be provided in accord with each resident's need;(m) Family or living room: (1) Provisions shall be made for at least one conveniently located enclosed area for recreational, social and activity needs of the residents within or contiguous to the facility;(2) The family room shall be equipped with reading lamps, tables, chairs and other appropriate furnishings for the use and comfort of the residents but shall not include beds; and(3) The living room space allotment shall not be less than thirty square feet per resident.(n) Outdoor areas accessible to the residents shall be made safe for use by the resident.(o) Bedrooms: (1) General conditions: (A) Bedrooms shall be at or above grade level;(B) There shall be an adequate number of rooms provided for immediate family members as well as residents;(C) Family members shall not sleep in residents' bedrooms;(D) Bedrooms shall not be used for recreation, cooking, dining, storage, bathrooms, laundries, foyers, corridors, lanais, and libraries;(E) Access from each bedroom to a bathroom, toilet, corridor, central utility, or other area shall be arranged to avoid passing through another bedroom;(F) Bedrooms shall be conveniently located near adequate toilet and bathing facilities appropriate in number, size, and design to meet the needs of the residents;(G) All occupants of any bedroom shall be of the same sex except for designated semi-private rooms which may be occupied by a mixed sex couple if the primary care giver and both residents agree to the living arrangements; and(H) Type I ARCH licensed for a person in a wheelchair shall provide an accessible route to and into all sleeping rooms, bathrooms, common areas and exits.(2) Floor space: (A) Minimum usable floor space allowable shall be seventy square feet per bed in a multiple resident bedroom and eighty square feet per bed in a single resident bedroom, excluding toilet, closets, lockers, alcoves, and vestibules. The number of residents shall be limited to a maximum of two;(B) Beds shall be placed at least three feet apart in multiple occupant bedrooms;(C) In all Type I ARCHs and those undergoing construction or renovation, closet space for residents shall be provided within the bedroom, allowing a minimum of thirty inches in width, twenty inches in depth, and five feet in height per person exclusive of bedroom space; and(D) Hanging clothes rods and shelves shall be adjusted as necessary.(3) Bedroom furnishings: (A) Each resident shall be provided for their individual use, a clean bed including spring with mattress, at least thirty six inches wide, of sufficient length and proper height for the resident and to permit an individual in a wheelchair to get in and out of bed unassisted;(B) Each bed shall be supplied with a comfortable mattress cover, a pillow, pliable plastic pillow protector, pillow case, and an upper and lower sheet. A sheet blanket may be substituted for the top sheet when requested by the resident; and(C) A suitable bedspread shall be used on each resident's bed.(p) Miscellaneous: (1) Conveniently located space for personal care items and for equipment, such as crutches and wheelchairs, shall be provided;(2) Walkers, wheelchairs, canes, crutches and bedside rails shall be provided by the resident;(3) Equipment for bedside care shall be stored in resident's bedside stand or other adjacent enclosed space;(4) There shall be adequate provision for privacy when caring for resident or when requested by the resident and an individual bath sheet blanket shall be used when bed baths are given; and(5) Signaling devices approved by the department shall be provided for resident's use at the bedside, in bathrooms, toilet rooms, and other areas where residents may be left alone. In Type I ARCHs where the primary care giver and residents do not reside on the same level or when other signaling mechanisms are deemed inadequate, there shall be an electronic signaling system.(q) All construction, additions, alterations: (1) Drawings and specifications for all new construction or additions, alterations or repairs to existing buildings shall be submitted to the department for review prior to construction;(2) While final authority to approve the construction and fire safety features of such building rests with county agencies and fire marshals, if construction drawings and specifications are submitted to the department, the department shall promptly review such submittals and make every effort to advise the applicant of features which appear nonconforming; and(3) Minor alterations which do not affect structural integrity, fire, safety, or which do not change functional operation, or increase beds or services over that for which the ARCH is licensed may be submitted by freehand drawings or sketches.(r) Facilities shall be maintained in accordance with provisions of state and local zoning, building, fire safety and health codes.Haw. Code R. § 11-100.1-23
[Eff SEP 18 2006] (Auth: HRS §§ 321-9, 321-10, 321-11, 321-15.6) (Imp: HRS §§ 321-10, 321-11, 321-15.6)