5122-33-22 Space, equipment, safety, and sanitation.

(A) Each adult care facility shall provide a living area where residents may engage in social, recreational, and leisure activities on a daily basis. The living area shall be well-lighted and adequately heated and ventilated. It shall contain sufficient comfortable, safe, and functional furniture to ensure a seating place for at least fifty per cent of the total number of residents. The living area shall not be used as a bedroom by anyone.

(B) To foster a home-like environment, residents shall be permitted to bring personal items to the facility, so long as the personal items do not create a safety hazard or infringe upon the rights of other residents.

(C) The facility shall provide a dining area where meals are served to residents. The dining area, table, and seating places shall be of sufficient size and number to allow at least fifty per cent of all residents to eat comfortably together at one time. All furniture shall be comfortable, safe, and functional.

(D) Each facility shall provide, for each resident, bedroom space separate and distinct from that of the owner, operator, manager, or live-in staff which meets all of the following criteria:

(1) The location of forced air furnaces is prohibited on sleeping floors unless fire and smoke protection separations are in place. Fire and smoke protection separations must be maintained by the facility;

(2) A single-occupancy room shall have a minimum of eighty square feet and a multiple-occupancy room shall have a minimum of sixty square feet per occupant of wall-to-wall floor space, exclusive of closets and adjoining bathrooms.

(3) No facilities licensed on or before December 31, 2006 shall provide sleeping space for more than three residents in a bedroom. Facilities licensed after December 31, 2006 shall provide sleeping space for no more than two residents per bedroom;

(4) There shall be at least three feet between beds. No furniture shall block any doorway;

(5) Bedrooms shall be separated from halls, corridors, and other rooms by permanent floor-to-ceiling walls. Rooms shall not be divided into sleeping areas or bedrooms by use of temporary partitions.

(6) A bedroom shall not be used as a passageway to other rooms. Any room utilized as a resident room must be accessible by a door opening into a hallway or common use area;

(7) A bedroom shall not be located in any room that contains a furnace;

(8) A bedroom shall not be more than fifty per cent below average grade level in an adult family home. A bedroom shall not be in a basement of an adult group home unless the basement meets the applicable requirements of Chapters 3781. and 3791. of the Revised Code and the rules adopted under them;

(9) When assigning bedrooms, the facility shall take into account the mobility of residents and their ability to evacuate the facility readily and easily in case of emergency and shall ensure compliance with paragraph (C)(6) of rule 5122-33-09 of the Administrative Code, if applicable;

(10) The facility shall provide a bed for each resident consisting of springs and a clean, comfortable mattress. The bed shall be sturdy, safe, and in good condition. Rollaway beds, cots, double-deck beds, stacked bunk beds, hide-a-bed couches, and studio couches shall not be provided as beds for residents by the facility. Residents may bring their own beds and furnishings of any type they choose, if the beds and furnishings are safe, sturdy, and functional and there is sufficient space in the facility;

(11) The facility shall provide bed linen for each resident, which shall include at least two sheets, a pillow and pillow case, a bedspread, and one blanket. All bed linen must be free of tears, holes, and excessive fraying or wear. Additional blankets and pillows shall be provided to each resident upon request. A minimum of two sets of linen shall be available for each bed at all times. Bed linen shall be changed at least weekly and more often if soiled. Residents may provide and maintain their own bed linen;

(12) The facility shall provide each resident with closet or wardrobe space in his or her bedroom for storage of his or her personal clothing and other items. Each resident also shall have adequate bureau, dresser, or equivalent space, and a mirror appropriate for grooming;

(13) Each resident bedroom shall have a minimum of one window capable of being easily opened and remaining open without the use of egress-restricting props. Each window shall be equipped with a screen and a curtain, shade, or other appropriate covering to assure privacy; and

(14) All bedrooms shall be well-lighted and dry; and

(15) All bedrooms shall have doors that are capable of being closed and latched.

(E) As used in this paragraph, "bathroom" means a room or rooms including at least one toilet, one shower or bathtub, and one sink. The facility shall provide at least one bathroom for each eight individuals living in the facility, including both residents and other individuals. The bathroom facilities shall meet the following requirements:

(1) The bathroom facilities shall be kept clean, sanitary, and in good repair and shall be accessible to residents at all times;

(2) There shall be nonskid surfacing and handrails or grab bars in each bathtub or shower for the safety of the residents;

(3) There shall be a sufficient supply of soap and toilet paper in each bathroom to meet the needs of the residents;

(4) Clean bath towels and washcloths shall be provided to each resident. Bath towels and wash cloths shall be free of tears, holes, and excessive fraying or wear. The towels and washcloths shall be changed at least twice weekly and more often if soiled;

(5) Each bathtub, shower, and sink shall have hot and cold running water. The hot water shall have a temperature of at least one hundred five degrees Fahrenheit but no more than one hundred twenty degrees Fahrenheit at the point of use;

(6) The bathroom shall be accessible to all users from a corridor, hallway, or common area; and

(7) Residents may provide and maintain their own bath and shower supplies.

(F) Each facility shall provide at least one non-pay telephone to which residents shall have reasonable access at all times for making local calls and is immediately available to any resident of the facility for use in case of an emergency. The telephone shall be provided in a location or manner which affords privacy. The facility also shall arrange for a method by which residents can make long-distance calls from the facility at the residents' expense. The facility shall maintain a record of billing, charging, and collecting the costs of long distance calls made by individual residents to ensure that residents are charged for only the actual costs of calls made.

(G) Each facility shall assure a safe clean, healthy environment by doing at least the following:

(1) Eliminating any existing insects and rodents and taking effective measures to prevent the presence of insects and rodents in and around the facility;

(2) Avoiding temperature extremes within the facility which may be a health hazard to the residents;

(3) Providing durable garbage and refuse receptacles to accommodate wastes. Outdoor garbage and refuse receptacles shall be kept covered with tight-fitting lids at all times;

(4) Promptly and thoroughly cleaning toilets, bathrooms, and other obvious sources of odors;

(5) Establishing and implementing housekeeping and maintenance procedures to assure a clean, safe, sanitary environment and a home-like appearance to the facility; and

(6) Protecting the drinking water supply against contaminating sources.

(H) Each facility shall develop and implement appropriate procedures to prevent and control the development and transmission of infections and disease which, at minimum, shall provide for the following:

(1) Individuals working in the facility shall wash their hands before beginning work and upon completing work, before and after eating, after using the bathroom, after covering their mouth when sneezing and coughing, before and after providing personal care for a resident when there has been physical contact, after contact with contaminated materials, before handling food, and at other appropriate times;

(2) The facility shall keep clean and soiled linen separate. Individuals handling linen shall hold both dirty and clean linen away from the body to avoid contamination to the linen or the individual handling the linen. Soiled laundry shall be handled as little as possible and with minimum agitation. The facility shall use normal laundry cycles according to the washer and detergent manufacturers' recommendations; and

(3) Individuals providing personal care services that may result in exposure to blood, body fluids, or feces, shall wear disposable gloves made of latex or other impervious material as a protective barrier and shall change gloves and dispose of the used gloves and wash hands before contact with another resident. If exposed to blood, another body fluid, or feces, the individual who has been exposed shall wash his or her hands and other exposed skin surfaces immediately and thoroughly with soap and hot water. The facility shall provide follow-up consistent with the guidelines issued by the U.S. centers for disease control and prevention for the prevention of transmission of human immunodeficiency virus and hepatitis B virus to health-care and public-safety workers in effect at the time. Individuals providing personal care services shall wash their hands before and after providing the services even if they used gloves.

(I) Each facility shall meet the following safety and maintenance requirements:

(1) The facility shall provide sturdy and securely fastened handrails for exterior and interior stairways;

(2) The facility shall provide railings on the open sides of any porch and on the open sides of interior and exterior stairways;

(3) The facility shall keep floors in good repair. Any rugs used in the home shall be securely fastened to the floor, or shall have non-skid padding, and otherwise shall be used in a manner that does not create a safety hazard;

(4) The facility shall keep corridors, entrances, exits, and outside pathways free of obstacles and in good repair;

(5) The facility shall keep sidewalks, escape routes, and entrances free of ice and snow;

(6) The facility shall maintain all wiring, electrical outlets, permanent fixtures and electrical systems including appliances, cords, switches, lighting fixtures, and lamps in good, safe operating condition. Extension cords, where appropriate for use, shall be underwriter's laboratories (UL) approved, of the appropriate load carrying capacity, and placed so as not to create a hazard for tripping and falling. Extension cords shall not be run under rugs or carpeting;

(7) The facility shall have its central heating system checked annually no later than the first day of the fall season, september twenty-second, by a qualified heating contractor. If the primary heating source is electric baseboard heating, the system shall be checked by a qualified electrical contractor or electrician. If applicable, the facility boilers shall be inspected by a qualified, contracted boiler inspector. The facility shall maintain the heating system in safe operating condition;

(8) The facility may use fireplaces and firestoves only in areas other than resident bedrooms in accordance with the requirements of this paragraph.

(a) The facility shall ensure that fireplaces and firestoves are used safely. Use of fireplaces with exposed gas flames is prohibited. The facility shall equip fireplaces with fireplace enclosures.

(b) The facility shall ensure that fireplaces and firestoves are installed properly in accordance with the manufacturer's instructions and are cleaned and inspected every two years by a qualified independent fireplace or firestove cleaning company unless the qualified heating contractor, when performing the inspection required by paragraph (I)(7) of this rule, indicates in writing that the fireplace or firestove does not need to be checked or cleaned until a later date.

(c) A staff member shall supervise the use of a firestove.

(d) In deciding whether or not to maintain an operable fireplace or firestove, the facility shall consider the capabilities and needs of its residents, the likelihood of resident accidents, and the need for safety precautions or guards in addition to the requirements of this paragraph.

(9) The facility shall establish and enforce an appropriate smoking policy. If smoking is permitted, the policy, at minimum, shall address smoking hours, smoking areas, and requirements for supervision, if any;

(10) The facility shall assure that common areas and exits are well-lighted;

(11) The facility shall store poisonous and hazardous materials in clearly labeled containers and away from foodstuffs and medication. The facility shall store gasoline, kerosene, lighter fluid, paints, thinners, and all other flammable materials and liquids in a safe manner. Combustible materials shall be stored in accordance with the manufacturer's label and not within two feet of any heater;

(12) Any locks on bedroom doors shall meet both of the following requirements:

(a) All locks to residents' bedroom entrance doors shall be capable of being opened from the inside without the use of a key, such as by pushing a panic bar, releasing a deadbolt, or using similar means. The locks also shall be capable of being opened by a key from the outside. The facility shall provide each resident with a key to his or her bedroom if it has a lock. Bedroom closet doors shall be equipped with an appropriate closet door knob set and be capable of locking when shut; and

(b) If resident bedrooms have locks, the facility shall have duplicate keys or a master key available and accessible to the staff members on duty at all times for use in cases of emergency;

(13) If the facility has an unoccupied basement, it shall install and maintain a lock on the basement door which can be opened easily from the upstairs, such as a safety chain or deadbolt. For adult group homes, a lock on the basement door shall be installed when approved by the appropriate building department and shall be maintained in accordance with the applicable rules adopted by the state fire marshal under section 3737.83 of the Revised Code. The facility shall determine when the basement door must be locked to prevent resident accidents. In making this determination, the facility shall take into consideration all residents' conditions and habits and the residents' need to have access to the basement;

(14) The facility shall maintain first-aid supplies in a closed but unlocked container which is easily accessible to the manager, staff, and residents; and

(15) The facility shall prominently display the telephone numbers of the fire and police departments, crisis center and other emergency numbers at each telephone in the home. The home shall not require residents or staff members to obtain approval from the manager or owner prior to telephoning for assistance in the event of an emergency.

(16) Each home shall maintain all interior and exterior doors in safe operating condition and shall ensure that they are capable of latching securely when closed.

Effective: 02/17/2012
R.C. 119.032 review dates: 11/30/2011 and 02/17/2017
Promulgated Under: 119.03
Statutory Authority: 5119.79
Rule Amplifies: 5119.73
Prior Effective Dates: 5-6-1991 (Emer.), 8-4-1991, 12-16-1993, 2-25-1994, 9-5-1997, 6-17-2001, 6-1-2006, 10-1-2010