WAC 246-329-160   Birth center -- Physical environment.  The purpose of this section is to reduce and control environmental hazards and risks, prevent accidents and injuries, and maintain safe conditions and equipment for clients, visitors, and staff.

     (1) The licensee shall provide and maintain a safe and clean environment. The licensee shall maintain the facility consistent with this chapter. Birthing centers built before the adoption of this chapter shall be maintained to the standards that were in place at the time the facility was licensed. If the licensee modifies or alters the facility, the altered areas must meet and be maintained consistent with this chapter and in accordance with the approved plans.

     (2) The licensee shall provide at least one birthing room that is a minimum of three hundred square feet and has a minimum dimension of fifteen feet. The room shall be adequate and appropriate to provide for the equipment, staff, supplies, and emergency procedures required for the physical and emotional care of a maternal client, her support person or persons, and the newborn during birth, labor, and the recovery period.

     (a) Additional birthing rooms shall have a gross floor space of one hundred fifty-six square feet or fourteen and one-half square meters and a minimum room dimension of eleven feet.

     (b) The licensee shall locate birthing rooms to provide unimpeded, rapid access to an exit of the building which will accommodate emergency transportation vehicles.

     (3) The licensee shall provide at least five square feet of fixed or portable work surface areas for use in the birthing room or rooms.

     (4) The licensee shall provide and maintain toilet and bathing facilities.

     (a) Toilet and lavatory shall be located in the vicinity of the birthing room or rooms.

     (b) A bathing facility must be available for client use.

     (c) The licensee shall keep clean and in good repair all floor surfaces, wall surfaces, water closets, lavatories, tubs, and showers.

     (5) The licensee shall provide a space suitable for hanging full length garments and secure storage of clients' personal belongings and valuables.

     (6) The licensee shall provide visual privacy for each maternal client and her support person or persons.

     (7) The licensee shall assure hallways and doors providing access and entry into the birth center and birthing room or rooms are adequate width and conformation to accommodate maneuvering of ambulance stretchers and wheelchairs.

     (8) Water supply. The licensee shall assure an adequate supply of hot and cold running water under pressure consistent with chapter 246-290 WAC, regarding public water supplies. The licensee shall provide and maintain equipment required to deliver hot water at point of use as follows:

     (a) 120°F or less for handwash sinks and bathing fixtures;

     (b) 160°F or more for laundry washers;

     (c) 120°F or more for laundry washers using chemical sanitation;

     (d) 120°F or more for mechanical dishwashers using chemical sanitation;

     (e) 140°F or more for mechanical dishwashers using high temperature sanitation; and

     (f) 180°F or more for sanitation cycle in high temperature mechanical dishwashers.

     (9) The licensee shall provide heating and ventilation that:

     (a) Provides a safe and adequate source of heat capable of maintaining a room temperature of at least 72°F.

     (b) Provides ventilation sufficient to remove odors, excessive heat, and condensation.

     (10) The licensee shall provide and maintain lighting and power and shall provide and maintain:

     (a) Emergency lighting;

     (b) General lighting and adequate examination lighting devices with shatterproof bulbs or protective shields, in the birthing room;

     (c) Tamperproof electrical receptacles in birthing rooms, toilets, bathing facilities and family rooms and waiting areas; and

     (d) Ground fault circuit interrupter (GFCI) receptacle when located within five feet of water source and above counters that contain sinks.

     (11) The licensee shall assure linen and laundry service, and shall provide:

     (a) Soiled linen/laundry storage and sorting areas physically separated from clean linen storage and handling areas, kitchen and eating facilities;

     (b) Laundry services and shall include a commercial laundry service or the following equipment:

     (i) Washing machine(s) providing hot water at a temperature of 160°F or 120°F for laundry washers using chemical sanitation;

     (ii) Floor drains as required for equipment;

     (iii) Dryer(s);

     (iv) Dryer exhaust to the exterior; and

     (v) A handwash sink.

     (12) The licensee shall provide utility, housekeeping, garbage, and waste services and:

     (a) Provide and maintain utility and storage facilities designed and equipped for washing, disinfecting, storing, and other handling of equipment and medical supplies in a manner which ensures physical segregation of clean and sterile supplies and equipment from those that are soiled and/or contaminated; and

     (b) Assure all sewage, garbage, refuse, biomedical waste, human tissue, needles and sharps and liquid waste are collected and disposed of in a manner to prevent the creation of an unsafe or unsanitary condition.

     (13) Medical gases. If oxygen is stored or used on the premises, the licensee shall, in addition to meeting other codes and regulations:

     (a) Assure electrical equipment used in oxygen-enriched environments is designed for use with oxygen and is labeled for use with oxygen; and

     (b) Post "no smoking" signs where oxygen is being administered.

     (14) Food storage and/or preparation. The licensee shall not provide food preparation and service except when the birth center policy allows the preparation or storage of personal food brought in by the client or families of clients for consumption by that family. In this case, the licensee shall provide an electric or gas refrigerator capable of maintaining a temperature of 45°F or lower and if furnishing reusable utensils and dishes for client use, provide dishwashing facilities assuring hot water at a temperature of not less than 140°F or 120°F or more for mechanical dishwashers using chemical sanitation.

     (15) The applicant may, as an alternate method for the design of new construction, use the 2006 edition of the Guidelines for Design and Construction of Health Care Facilities for the physical environment standards.



[Statutory Authority: Chapter 18.46 RCW and RCW 43.70.040. 07-07-075, § 246-329-160, filed 3/16/07, effective 4/16/07.]