Chapter 12 Interior Environment

California Energy Commission

User Note

Modified to properly reference the California Energy Code.

1202.3.1 California Energy Code and International Energy Conservation Code (IECC) Climate Zones and Table 1202.3.1 IECC vs California Energy Code Climate Zone Comparison

Added section and table to prevent confusion between climate zones identified in ICC model codes and climate zones identified in the California Energy Code by explaining the relationship between the two codes and adding Table 1202.3.1 to represent these differences.

Department of Housing and Community Development

1202.2.1 Ventilated attics and rafter spaces and 1202.3 Unvented attic and unvented enclosed rafter assemblies

Repealed reference to Climate Zones 14 and 16 and California Energy Code Figure 100.1-A since the California Energy Commission adopted a new Table 1202.3.1 from the International Energy Conservation Code.

Table 1202.3 Insulation for condensation control

Repealed reference to specific climate zones from the table since the California Energy Commission adopted a new Table 1202.3.1 from the International Energy Conservation Code.

Office of Statewide Health Planning and Development

1224.3 Definitions

HANDWASHING STATION
Amended existing language to clarify that hands-free operation is required at the door and not at the handwashing fixture.

INVASIVE PROCEDURE
New definition to be used to determine the classification of the imaging room or procedure room required.

LOCATION TERMINOLOGY
Terms for relationship to an area or room.

READILY ACCESSIBLE
Amended existing language to avoid ambiguity by removing the requirement that the area or room also be “directly accessible.” New language added to include option for locating readily accessible areas or rooms to within 200 feet of department or space served to accommodate space orientation or security concerns.

PROCEDURE ROOM
New definition specifically designates the procedure room as the intermediate level room for procedures that do not require a full surgical environment.

RESTRICTED AREA
Amended existing language to better align with Facilities Guidelines Institute (FGI), which stipulates that a restricted area is a designated space contained within the semi-restricted area and accessible only through a semi-restricted area. This definition is required to determine the level of procedure room to be used and the requirements therein.

SEMI-RESTRICTED AREA
New defined term per request of CDPH. This area applies to intermediate level procedures and imaging as well as peripheral areas that support surgical services.

START OF CONSTRUCTION
OSHPD added the definition to Part 1, California Administrative Code. The banner note added to this definition avoids ambiguity and clarifies that the term is not adopted by OSHPD.

UNRESTRICTED AREA
New defined term per CDPH request. This area applies to any area of the department that is not defined as semi-restricted or restricted. This definition is required to determine the level of control outside a surgical area or within a medical department.

1224.4.4.1 Examination, treatment, and procedure rooms

Amended existing language to add “procedure room” to the heading.

1224.4.4.1.2 Treatment room

OSHPD has coordinated with CDPH to add a requirement for providing a new service space for exercise stress testing. This space can be in several locations within a hospital and not assigned to any one service. Amended language allows for exercise stress testing in a treatment room due to the need for space for a crash cart and possible resuscitation.

1224.4.4.1.4 Procedure room

Added new language to align with Facilities Guidelines Institute (FGI) requirements and renumbered following sections.

1224.4.4.4.1 Medication preparation room

Per CDPH request, amended existing language to remove the requirement that a medication preparation room be directly accessible from the nursing station.

Table 1224.4.6.1

Line 6 has been identified specifically for “Intensive Care” to avoid confusion with the similarly named room on Line 3.

Table 1224.4.6.5

Added Note 1 to the line for Patient Toilet Room under column 1226. Current language is confusing and is often misinterpreted that a nurse call station is required in all clinic patient toilets under column 1226. The note clarifies that a nurse call station is not required for Primary Care, Chronic Dialysis or Psychology Clinic patient toilet rooms.

1224.4.11 and 1224.4.11.4.1 Interior Finishes

Added a pointer to the new table for different levels of procedure and imaging rooms. Includes new Table 1224.4.11.4a which identifies the different levels of exam/procedure rooms as well as the different classes of imaging rooms, including the room type, the uses in each type of room, if the room is unrestricted, semi-restricted or restricted, how it is accessed, and the level of finishes required.

1224.14.2 Support areas

Amended existing language to allow for support areas that service nursing units to be shared if there is direct access, including nurses’ office, a clean utility/workroom, soiled workroom or soiled holding room, nourishment area and equipment storage room.

1224.14.2.15 Special bathing facilities

Amended existing language for special bathing facilities to be optional. Per review with CDPH, special bathing facilities for roll-in gurneys should not be a requirement as there are several other methods of bathing or cleaning bedridden patients.

1224.15.1 General

Amended existing language to clarify that a sterile core where clean equipment is stored prior to bringing into an operating room is required to be in a restricted area.

1224.15.2.2 Procedure room(s)

Added a pointer to the requirements for a procedure room. The following section 1224.15.2.2.1 was renumbered.

1224.16.3 Recovery and Post-Anesthesia Care Unit (PACU)

Amended existing language to clarify the clearances required between beds and the access aisle at the foot of a bed.

1224.18 Radiological/diagnostic imaging service space

Amended existing language to provide direction for applying the new classes of imaging rooms. To alleviate confusion, pointers are provided to Table 1224.4.11.4a and to address more acute-level procedures using imaging systems in hybrid operating rooms.

1224.18.1 Minimum requirements

Amended existing language to allow a CT scanner to be used as the primary imaging modality once Title 22 is revised. Existing language was also amended to allow the space used for processing images to also be used exclusively for viewing, as processing technology is no longer required on newer equipment. Requirements for handwashing stations were added to provide direction for applying the new classes of imaging rooms.

1224.18.1.1 Radiation protection

Added requirements for radiation protection in the new classes of imaging rooms.

1224.18.1.2 Multiple-modality devices

Added new language to clarify that when two or more modalities are integrated into one device, the requirements of both must be met. This would apply to space requirements, radiation protection and any differences in the requirements.

1224.18.4 Magnetic resonance imaging (MRI)

Added new language to provide safety zones for MRIs. Existing language for the imaging equipment room was amended to align with other imaging equipment room annotation.

1224.18.5 Ultrasound

Amended existing language to properly identify an ultrasound exam room. An exception is added to not require a directly accessible toilet if only specific exams are conducted. Language is added for the requirements of a processing room if it is to be provided as a support service.

1224.19.7 Support areas for staff

Amended existing language to align with Title 22 and Board of Pharmacy regulations that pharmacy staff lounge, lockers and toilet may be readily accessible in lieu of immediately accessible.

1224.20.3 Outside service

Amended existing language to clarify that if a temporary mobile kitchen is approved by CDPH for use during construction, a separate warming kitchen is not needed internally.

1224.22 Central sterile supply

Per a request from CDPH, amended existing language to clarify that a central sterile supply process includes distinct spaces within one or more rooms.

1224.25 Employee dressing rooms and lockers

Amended existing language to clarify that the lockers must be separate from the toilet room and not within it.

1224.28.2.1 Procedure room and 1224.28.2.3 Equipment space

Amended existing language to update “x-ray” to “imaging” equipment.

1224.28.4.8 Imaging equipment room

Amended existing language for the imaging equipment room to align with other imaging equipment room annotations.

1224.28.4.12 Staff changing areas

Amended existing language to clarify that both male and female staff changing areas are required as interventional procedures are equivalent to surgery and have the same changing requirements.

1224.28.5.2 Control room

Added new language to allow cameras to be used for patient observation in hybrid operating rooms as the configuration of the rooms may prevent full patient visibility within the equipment bore from within the control room.

1224.28.5.5.2 iMRI

Corrected reference pointer in Item 3 of 1224.28.5.5.2 to indicate that the anteroom must comply with Section 1224.18.4.2, Item 2.

1224.28.5.5.3 Vascular imaging

Corrected reference pointer to indicate that hybrid operating rooms with vascular imaging systems must comply with Section 1224.18.4.

1224.29.1.12 Medication station

Added to existing language to clarify that refrigerated storage is required for the medication station in an ICU.

1224.29.1.13 Airborne infection isolation room

Amended existing language to clarify that ICU units that are protected environments do not require airborne infection isolation rooms as all rooms are already negative pressure.

1224.29.2 Newborn intensive care units (NICU)

Amended existing language to clarify that the headwall in a NICU does not need to be 13 feet long as in an ICU. This would force the NICU bed spaces to be much larger than needed.

1224.30 Pediatric and Adolescent Unit

Amended existing language to align with Title 22 language for pediatric and adolescent units, and clarified that both an exam room and a treatment room are required in or adjacent to the pediatric unit.

1224.31.1.1 General

Amended existing language to clarify that the requirements for a psychiatric nursing unit in Section 1224 is for a psychiatric medical unit and Section 1228 is for a psychiatric ambulatory unit.

1224.31.1.10 Occupational therapy

Amended existing language to remove the requirement for an area for teaching daily living activities.

1224.31.1.17 Administrative center(s) or nurse stations(s)

Added new language to state that a nurse station can be no further than 90 linear feet from the furthest patient room doorway. This is a Title 22 requirement for a medical psychiatric unit which was not currently in the building code.