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Site Safety Sanitation and Maintenance



Original effective date: 10/99                                                    Operating Procedure
Revised:                                                                            Risk Management
Approved:                                                           Service Site Safety, Sanitation and



The service site shall be located so as to promote at all times the health, comfort, safety, and well-
being of the individuals served.

The service site shall conform to all applicable state laws and local codes and ordinances. When
such laws, codes, and ordinances are more stringent than these standards for personal care homes, the
more stringent requirements shall govern. Should state laws or local codes or ordinances be in
conflict with the requirements of these standards, the Licensing Agency shall be informed so these
conflicts may be legally resolved.

In the case of a fire the service site shall be serviced by a paid or volunteer fire fighting unit as
approved by the Licensing Agency. Water supply for fire fighting purposes shall be as required or
approved by the fire fighting unit. Sites are provided Annual Fire Safety Inspections by Fire
Marshals or the BTCMHMR Safety Officer.

Each service site is provided on annual safety inspection by the BTCMHMR Safety Offer.

Floor, ceilings, and wall finish materials shall be complete and substantially held in place.

Existing small one story building housing individuals served will not be required to have a time rated
structure. Walls and ceilings shall be sheathed with at least 3/16" thick plywood (flame spread of
200 or less) or equivalent. In existing facilities, bedroom doors can be 1 2/8" hollow core with tight
fit and latching hardware.

Electrical and mechanical systems shall be safe and in working order. The Licensing Agency may
require the facility sponsor or licensee to submit evidence to this effect, consisting of a report of the
fire marshal or city/county building official having jurisdiction or a report of a registered professional

Independent self-contained smoke detectors located in bedrooms, hallways, and living/dining areas
may be installed in existing small one-story buildings.

Detectors must be heard throughout the building with the doors closed. Smoke detectors shall be
inspected monthly and maintained by facility personnel. Batteries will be replaced at least one time
per year in battery powered smoke detectors. General fire safety shall be observed at all times.

Original effective date: 10/99                                                  Operating Procedure
Revised:                                                                          Risk Management
Approved:                                                         Service Site Safety, Sanitation and

Storage items shall be neatly arranged and placed to minimize fire hazard. Gasoline, volatile
materials, paint, and similar products shall not be stored in the building housing individuals served
except as may be approved by the local fire marshal.

Accumulations of extraneous material and refuse shall not be permitted.

The building shall be in good repair; electrical, heating and cooling systems shall be maintained in a
safe manner. Use of electrical appliances, devices, and lamps shall be such as not to overload
circuits or cause excessive lengths of extension cords. All extension cords must be UL approved.

All fires shall be reported to the BTCMHMR Safety Officer, who will notify to the Licensing
Agency within seventy-two hours; however, any fire causing injury or death to an individual served
resident shall be reported immediately.

Fire drills shall be conducted and recorded at least quarterly on each shift. Alternate means of exit
shall be practiced. Fire/safety inspection reports will be done by each residence manager on a
monthly basis, other program sites quarterly.

Waste and storage containers.

Metal wastebaskets of substantial gauge or approved plastic trash containers must be provided for
bedrooms, offices, attendance areas, lounges, handicraft rooms, and similar locations. Containers at
these locations are emptied at least daily.

Garbage, waste, or trash containers provided for kitchens, janitor closets, laundries, general storage,
and similar places must be made of substantial material having a close fitting cover, and have at least
a half-inch air space between floor and bottom of container.

Disposable plastic liners may be used in these containers for sanitation.

Plastic containers with lids are acceptable for storage of staple foods in the pantry. Dish washing
chemicals used in the kitchen may be stored in plastic containers if they are the original in which the
manufacturer packaged the chemicals.

Other requirements of safety and comfort.

The physical plant shall be designed for handicapped use and must comply with applicable federal,

Original effective date: 10/99                                                    Operating Procedure
Revised:                                                                            Risk Management
Approved:                                                           Service Site Safety, Sanitation and

state, and local requirements.

All draperies and other window coverings shall be flame retardant in a manner satisfactory to the
Licensing Agency.

Open flame heating devices are prohibited. All fuel burning heating devices shall be vented.
Working fireplaces are acceptable if of safe design and construction and if screened or otherwise

Smoking is not permitted in BTCMHMRC service sites.

All exterior site conditions shall be designed, constructed, and maintained in the interest of safety.
Newly constructed ramps shall not exceed 1:12 slope. Ramps, walks, and steps shall be of slip-
resistive texture and be smooth and uniform, without irregularities. Guard rails, fences, and hand
rails shall be provided where needed.

Grounds, grass, shrubbery, trees and other site features shall be maintained in a neat and attractive
manner in the interest of health and safety.

All stairways shall have substantial hand rails.

Tubs and showers shall have non-slip bottoms or floor surfaces either built-in or applied to the

All lavatories and bathing units shall be supplied with hot water in quantities to meet the needs of the
residents. Hot water temperature will be kept at safe levels at all times. The BTCMHMR Safety
Officer will provide annual inspections. Residential managers will inspect periodically.

Cooling and heating shall be provided for occupant comfort ranges of heating and cooling (60-80

The facility shall be well ventilated through the use of windows, mechanical ventilation, or a
combination of both.

Illumination, either natural or artificial, shall be provided to supply the needs of the individual served
and staff without eye strain or glare.

Original effective date: 10/99                                                     Operating Procedure
Revised:                                                                             Risk Management
Approved:                                                            Service Site Safety, Sanitation and

There shall be at least one telephone in the facility available to both staff and resident's use in case of
emergency. Emergency telephone numbers shall be posted conspicuously at or near the telephone.

Storage of hazardous items such as janitor supplies and equipment shall be provided in closets or
spaces separate from resident-use areas. Closets or spaces shall be maintained in a safe and sanitary
condition and ventilated in a manner commensurate with the sue of the closet or space.

Sanitary Environment

Waste water and sewage shall be discharged into a state approved municipal sewer system; any
exception shall be as approved by the Teas Department of Health.

Water supply shall be approved by the Texas Department of Health. Quantity and pressure shall be
as necessary to serve the needs of the facility.

Waste, trash, and garbage shall be disposed from the premises at regular intervals in accordance with
state and local practices. Excessive accumulations are not permitted.

Outside containers shall have tight fitting lids left in closed position. Containers shall be cleaned

The building and groups shall be kept neat and free of refuse, litter, extraneous materials, and
unsightly or injurious accumulations.

The service site will make every effort possible to guard against insects, rodents, rainwater, and other
conditions adversely affecting a sanitary environment or the well-being of the individuals served.

Operable windows shall be insect screened.
A pest control program shall be provided by qualified facility staff or by contract with a licensed pest
control company. The least toxic and least flammable effective chemicals shall be used.

All floors, walls, and ceiling surfaces must be cleanable.

All bathroom, toilet rooms, and other odor-producing rooms and areas for soiled and unsanitary
operations shall be ventilated with operable windows or powered exhaust to the exterior for odor

In kitchens and laundries, there shall be adequate procedure to avoid cross contamination between

Original effective date: 10/99                                                  Operating Procedure
Revised:                                                                          Risk Management
Approved:                                                         Service Site Safety, Sanitation and

clean and soiled utensils and linens.

The service site shall be kept free of offensive odors, accumulations of dirt, rubbish, dust, and
hazards. Floors shall be maintained in good conditions and cleaned regularly; walls and ceiling shall
be structurally maintained, repaired, and repainted or cleaned as needed.

Storage areas, attics and cellars shall be free of refuse and extraneous materials.

The quantity of available linen shall meet shall meet the sanitary and cleanliness needs of the
residents. Clean linens shall be stored in clean linen storage areas.

As directed by the nursing staff and Director of Nursing, after assessment individuals served who
have communicable disease or transmittable infections, shall immediately be transferred to a hospital
or other health care facility equipped to isolate or treat the condition.


       Resident Bedrooms:
       Bedrooms shall be arranged and equipped for adequate personal care and for comfort and

       Bedroom usable floor space shall be not less than eighty square feet for one-bed room and
       not less than sixty square feet per bed for a multiple bedroom. A bedroom shall be less than
       eight feet in the smallest dimension, unless specifically approved otherwise by the Licensing

       In the bedrooms and for each individual served there shall be a bed, comfortable chair, table
       or dresser, and closet space providing security and privacy for clothing and personal
       belongings. Married couples may share a bed.

       Each bedroom shall have at least one operable window giving outside exposure. Unless
       approved otherwise by the Licensing Agency, the window sill of the required window shall
       be no higher than forty four inches from the floor and shall be at or above outside grade level.

       The window will be readily operable from the inside and provide a clear opening of at least
       5.7 square feet (minimum width of 20 inches; minimum height of 24 inches). Windows
       required for evacuation will not be blocked by bars, shrubs, or any obstacle that would

Original effective date: 10/99                                                  Operating Procedure
Revised:                                                                          Risk Management
Approved:                                                         Service Site Safety, Sanitation and

       impede evacuation.

       All resident rooms shall open upon an exit or service corridor, living area, or public area and
       shall be arranged for convenient resident access to dining and recreation areas.

Resident toilet and bathing facilities

General toilet room or bathing room shall be provided. A lavatory shall be readily accessible to each
water closet. At least one water closet, lavatory, and bathing unit shall be provided.

One water closet and one lavatory for each six occupants or fraction thereof are required. Shower for
each ten occupants or fraction thereof is required.

Towels, soap, and toilet tissue shall be provided at all times.

Recreation, living, and day room

Recreation, living and day room space and furniture shall be provided to allow seating of not less
than fifty percent of the residents at one time.

Some of the recreation, living and day room areas shall have exterior windows providing a view of
the outside.

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