CHAPTER 44:78:02
PHYSICAL ENVIRONMENT AND SAFETY
Section
44:78:02:01 Sanitation.
44:78:02:02 Cleaning procedures.
44:78:02:03 Patient rooms.
44:78:02:04 Patient room furnishings.
44:78:02:05 Care units.
44:78:02:06 Food service.
44:78:02:07 Laundry.
44:78:02:08 Storage.
44:78:02:09 Outside yard storage.
44:78:02:10 Flooring.
44:78:02:11 Handwashing fixtures.
44:78:02:12 Exhaust ventilation.
44:78:02:13 Waste disposal.
44:78:02:14 Ventilation.
44:78:02:15 Heating and cooling.
44:78:02:16 Hot water systems.
44:78:02:17 Potable water.
44:78:02:18 Water supply.
44:78:02:19 Plumbing.
44:78:02:20 Lighting.
44:78:02:21 Electrical convenience outlets.
44:78:02:22 Infection control.
44:78:02:23 Occupant protection.
44:78:02:24 Physical plant changes.
44:78:02:25 Insect and rodent control.
44:78:02:26 Location.
44:78:02:27 Preventative maintenance.
44:78:02:28 Other hazardous conditions.
44:78:02:29 Personnel training.
44:78:02:01. Sanitation. The facility shall be kept clean, neat, and free of litter and rubbish. Hazardous cleaning solutions, chemicals, and poisons shall be labeled, stored in a safe place, and kept in an enclosed cabinet. Garbage and refuse shall be kept in durable, easily cleanable containers that do not leak and do not absorb liquids. Garbage and refuse shall be disposed of often enough to prevent the development of odor and the attraction of insects and rodents. Sewage shall be disposed of by means of a public sewage disposal system or a septic system, and may not constitute a source of contamination of food, equipment, or utensils or otherwise create an unsanitary condition or nuisance.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
44:78:02:02. Cleaning procedures. The facility shall develop written procedures for cleaning all areas of the building. The building shall be maintained clean. Equipment and supplies shall be available for proper cleaning and disinfecting and shall be stored safely to protect the building occupants. Dustless methods shall be used for cleaning.
Written procedures shall be developed for the cleaning and sanitizing of food service equipment, countertops in the food production area, and dining room tables in accordance with the registered product label.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.
44:78:02:03. Patient rooms. A patient room shall meet the following requirements:
(1) The maximum room capacity is two patients. Patient rooms approved prior to January 1, 2001, are acceptable as approved;
(2) The minimum clear floor area required is, exclusive of toilet rooms, closets, wardrobes, and vestibules, 100 square feet in single occupancy and 160 square feet in double occupancy;
(3) The floor of the patient room shall be above grade at the building site;
(4) A separate closet space of five square feet shall be provided for each patient; and
(5) Toilet rooms shall be available to the patient room. If the toilet room is not attached to the patient room, the distance to the toilet room from the door to the patient room may not exceed 50 feet. The toilet room shall be accessible and shall contain a handwashing fixture and stool with at least a side grab bar and toilet paper dispenser.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:78:02:04. Patient room furnishings. The facility shall provide the following furnishings for the patient rooms:
(1) A sturdy, comfortable bed with an impervious cover on the mattress;
(2) A pillow, two sheets, blanket, and bath towel;
(3) A dresser, drawers, or shelves for each patient;
(4) A chair, table or desk, reading lamp, and mirror for each patient; and
(5) Window coverings for privacy.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3) and (4).
Law Implemented: SDCL 34-12-13(3) and (4).
44:78:02:05. Care units. The care unit shall contain the following features:
(1) Staff work area with handwashing fixture, charting space, communication and security equipment, supply storage, and locked medication storage, including refrigerated storage and dispensing area;
(2) Staff toilet room convenient to work area. The toilet room shall be accessible and shall contain a handwashing fixture and stool with at least a side grab bar and toilet paper dispenser;
(3) Clean linen storage or linen cart storage room;
(4) A housekeeping room for supply and housekeeping equipment storage. A floor receptor or service sink shall be provided and the adjacent wall surfaces shall be protected from water damage;
(5) A bathing room for each gender served with bath fixtures in accordance with SDCL 36-25-15 and 36-25-15.1;
(6) Lounge space with a minimum area of 20 square feet for each patient;
(7) Dining space with a minimum of 20 square feet for each patient;
(8) A group room with a minimum of 150 square feet for each six patients; and
(9) A counselor office with a minimum of 100 square feet for each six patients.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), (4), and (14).
Law Implemented: SDCL 34-12-13(1), (3), (4), and (14).
44:78:02:06. Food service. In-house dietary department areas and equipment shall meet sanitary storage, processing, and handling requirements of the Food Service Code. If a facility's food service is contracted out, the contractor shall be a licensed food service establishment that is inspected by a local, state, or federal agency. If the facility has an in-house dietary department the dietary manager or at least one cook must successfully complete and possess a current certificate from a ServSafe Food Protection Program offered by various retailers or the Certified Food Protection Professional's Sanitation Course offered by the Dietary Managers Association, or successfully completed equivalent training as determined by the Health Department. If the facility contracts out food services at least one staff person serving meals shall successfully complete and possess a current certificate from a ServSafe Food Protection Program or equivalent as noted in this section. The following equipment and space shall be provided in the dietary area:
(1) A receiving area for incoming food supplies;
(2) A vegetable preparation two compartment sink with a garbage disposal. This fixture requires an indirect connection to the waste line;
(3) A dry food storage area;
(4) A floor receptor with moisture resistant protection for the adjacent wall surfaces;
(5) Refrigerated storage space with 15 cubic foot refrigerator capacity and four cubic foot freezer capacity for each 12 persons served by the dietary area. Refrigerated storage for milk, eggs, and butter shall be located within six feet of the food preparation areas;
(6) Food production equipment designed to produce a complete meal three times daily for each person served;
(7) Food holding and transport equipment capable of protecting food from contamination and maintaining safe temperatures during the meal serving time;
(8) A hood and ventilation equipment for cooking equipment to remove heat, moisture, cooking odors, and grease to the exterior of the building. Continuous mechanical exhaust ventilation at the commercial dishwasher location to remove heat and moisture;
(9) A handwashing fixture convenient to food preparation areas and dishwashing. No mirror is allowed at these sink locations;
(10) Aisles of 36 inches clear width;
(11) If a grease trap is required by local ordinance, it shall be located in a room adjacent to the dietary area;
(12) A dishwasher with a sanitizing cycle. A commercial dishwasher supplied with 180 degree Fahrenheit rinse water or a chemical sanitizing cycle is required when more than 20 meals are served;
(13) Dietary manager work space with desk and chair; and
(14) A self-dispensing ice machine. Ice from a bin type ice machine may be used for cooling food containers, but not for consumption.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5) and (8).
Law Implemented: SDCL 34-12-13(5) and (8).
Note: Article 44:02, Lodging and Food Service, Administrative Rules of South Dakota, contains the Food Service Code and may be obtained from Legislative Mail, 1320 East Sioux Avenue, Pierre, South Dakota 57501, telephone (605) 773-4935, for $4.14.
44:78:02:07. Laundry. Personal clothing shall be transported to the laundry equipment in a closed container.
The facility shall process laundry following the laundry equipment and cleaning agent recommendations. If hot water is used for disinfection, all common use linens and combined patients' personal clothing shall be processed for disinfection using either hot water at 160 degrees Fahrenheit (71 degrees centigrade) or chlorine bleach shall be introduced to the process to provide 100 parts per million free chlorine with the water temperature reduced to 120 degrees Fahrenheit or department approved laundry disinfectant. Air flow in the linen processing shall be from clean processing areas toward the soiled holding and sorting area. Clean linens shall be covered during transport to storage areas. Laundry services shall have adequate space and equipment for the safe and effective operation of the laundry service.
The facility may choose to wash commingled patients' personal clothing, common-use linen, and any isolation clothing in water temperatures less than 120 º F. if the following conditions are met:
(1) The supplier of the chemical specifies low-temperature wash formulas in writing for the machines used in the facility;
(2) Charts providing specific information concerning the formulas to be used for each machine are posted in an area accessible to staff;
(3) The facility ensures that laundry staff receives in-service training by the chemical supplier on a routine basis, regarding chemical usage and monitoring of wash operations; and
(4) The facility ensures that staff monitors chemical usage and wash water temperatures at least monthly to ensure conformance with the chemical supplier's instructions.
Any resident's personal clothing that is not commingled may be processed according to manufacturer's recommendations using water temperatures and detergent in quantity as recommended by the garment or detergent manufacturer. The facility shall have distinct areas for the storage and handling of clean and soiled linens. Those areas used for the storage and handling of soiled linens shall be negatively pressurized. The facility shall establish special procedures for the handling and processing of contaminated linens. Soiled linen shall be placed in closed containers prior to transportation. To safeguard clean linens from cross contamination, the linens shall be transported in containers used exclusively for clean linens, shall be kept covered with dust covers at all times while in transit or in hallways, and shall be stored in areas designated exclusively for this purpose. A written request for any modification of the requirements of this section shall be received and approved by the department before any changes are made.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (4).
Law Implemented: SDCL 34-12-13(1) and (4).
44:78:02:08. Storage. A minimum of the 200 square feet of general supply storage shall be provided in a single room. If the patient capacity exceeds 25, an additional 200 square feet of storage shall be provided for each multiple of 25 patients.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:78:02:09. Outside yard storage. The facility shall provide storage space for yard equipment with an exterior building access or separate storage shed.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:78:02:10. Flooring. Flooring materials that are slip resistant shall be installed at the building main entry, dishwashing, and bathing areas.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
44:78:02:11. Handwashing fixtures. Hot and cold water shall be supplied through a mixing faucet controlled by a "hands free" operator. Each handwashing fixture shall be provided with a soap dispenser, hand dryers or protected single use towel dispensers, and waste receptacle.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3) and (4).
Law Implemented: SDCL 34-12-13(3) and (4).
44:78:02:12. Exhaust ventilation. Electrically powered continuous exhaust ventilation shall be provided for soiled areas, wet areas, and toilet rooms at ten air changes each hour and shall be provided for storage rooms at two air changes each hour.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:78:02:13. Waste disposal. Garbage, refuse, and waste shall be handled and disposed of in a safe and sanitary manner. Final disposal of all refuse and waste shall comply with articles 74:27 and 74:28. Putrescible garbage shall be removed at a frequency to contain or prevent odors, insects, and vermin.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
44:78:02:14. Ventilation. The facility shall have general ventilation of two air changes each hour. The outside air supply shall be tempered to eliminate cold air from being introduced into occupied space. The supply air unit shall be equipped with one inch furnace filter media installed in the ductwork ahead of the unit. The filter media shall be changed at least every three months.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
44:78:02:15. Heating and cooling. The facility heating system shall be capable of maintaining a minimum temperature of 75 degrees Fahrenheit at winter design conditions. The building cooling system shall be capable of maintaining room temperatures in occupied spaces at 75 degrees Fahrenheit or less.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:78:02:16. Hot water systems. The facility shall install a recirculating system to provide hot water to all fixtures. Equipment shall be installed to provide hot water at a temperature of 100 (38 degrees centigrade) to 125 degrees Fahrenheit (52 degrees centigrade) to all handwashing sinks. Maximum hot water temperatures at plumbing fixtures used by patients may not exceed 125 degrees Fahrenheit (52 degrees centigrade).
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
44:78:02:17. Potable water. All plumbing used for distribution of potable water shall be maintained to minimize dead-end runs of piping. Before placing a potable water system into use and after repairs or modifications, the system shall be disinfected in accordance with the 2009 Uniform Plumbing Code, Section 609.9.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
44:78:02:18. Water supply. The facility's water supply shall be obtained from a public water system or, in its absence, from a supply approved by the Department of Agriculture and Natural Resources. Any private water supply shall have a water sample bacteriologically tested at least monthly. The volume of water shall be sufficient for the needs of the facility. The hot water system shall be capable of supplying the work and resident areas with water at the required temperatures.
Source: 42 SDR 51, effective October 13, 2015; SL 2021, ch 1, §§ 8, 19, effective April 19, 2021.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:78:02:19. Plumbing. A facility's plumbing system shall be designed and installed in accordance with SDCL 36-25-15 and 36-25-15.1. Plumbing shall be sized, installed, and maintained to carry required quantities of water to required locations throughout the facility.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:78:02:20. Lighting. All building spaces, parking lots, and exit discharge routes shall be illuminated for general safety. Specific required lighting levels shall be provided for the following spaces:
(1) Ten footcandles for general illumination;
(2) Thirty footcandles for dining rooms, bathing areas, food preparation areas, laundry, staff work area, and areas where persons are involved in reading or other close work tasks;
(3) Fifty footcandles shall be provided on the work surface of the medication set up and distribution area; and
(4) Portable halogen lamps may not be used due to extremely high surface temperatures.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
44:78:02:21. Electrical convenience outlets. Electrical extension cords may not be used as a substitute for properly installed electrical receptacles. Power strips in business office areas and for entertainment centers may be used.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:78:02:22. Infection control. The facility shall develop policies to address cleaning of environmental surfaces, standard precautions, employee illness, and patient transfer to another health care facility.
Chemicals used to sanitize, disinfect, or sterilize shall be labeled to show registration with the United States Environmental Protection Agency as being safe and effective for use in accordance with the procedures used by the facility.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (2).
Law Implemented: SDCL 34-12-13(1) and (2).
44:78:02:23. Occupant protection. Each facility shall be constructed, arranged, equipped, maintained, and operated to avoid injury or danger to the occupants. The extent and complexity of occupant protection precautions is determined by the services offered and the physical needs of the patients admitted to the facility. The facility shall take at least the following precautions:
(1) Provide securely constructed and conveniently located grab bars in all toilet rooms and bathing areas used by patients;
(2) Provide grounded or double-insulated electrical equipment or protect the equipment with ground fault circuit interrupters. Ground fault circuit interrupters shall be provided in wet areas and for outlets within six feet of sinks;
(3) A portable space heater, portable halogen lamp, household-type electric blanket or household-type heating pad may not be used in a facility;
(4) Any clothes dryer shall have a galvanized metal vent pipe for exhaust; and
(5) The storage and transfilling of oxygen cylinders or containers shall meet the requirements of the NFPA 99 Standard for Health Care Occupancies, 2012 Edition.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
Reference: NFPA 99 Health Care Facilities, 2012 edition, National Fire Protection Association. Copies may be obtained from the National Fire Protection Association, P.O. Box 9101, Quincy, MA 02269-9101. Phone: 1-800-344-3555. Cost: $93.00.
44:78:02:24. Physical plant changes. A facility shall submit any proposed change by new construction, remodeling, or change of use of an area to the department. Any change shall have the approval of the department before it is made. A written narrative describing the intended use of the proposed construction shall accompany the plans and specifications.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
44:78:02:25. Insect and rodent control. The facility shall take measures to effectively control the entry, presence, and breeding of vermin. All openings around pipe, conduit, and wiring or similar penetrations of the exterior wall shall be caulked to prevent vermin entry. Any poisons used shall be stored safely to avoid contamination of food and properly labeled and applied to protect the building occupants.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
44:78:02:26. Location. The location of the facility shall promote the health, treatment, comfort, safety, and well-being of persons accepted and retained for care. The facility shall be served by good, passable roads. Easy accessibility for caregivers, visitors, and fire-fighting services shall be maintained.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (14).
Law Implemented: SDCL 34-12-13(1), (3), and (14).
44:78:02:27. Preventative maintenance. The facility shall develop and implement a written system of scheduled maintenance for building equipment, mechanical, and electrical systems.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
44:78:02:28. Other hazardous conditions. A facility may be directed to remove or correct other hazardous conditions not covered in this chapter if the department considers the conditions to have the potential to cause injury or illness to any resident or staff.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (14).
Law Implemented: SDCL 34-12-13(1) and (14).
44:78:02:29. Personnel training. The facility shall have a formal orientation program and an ongoing education program for all personnel. Ongoing education programs shall cover the required subjects annually. These programs shall include the following subjects:
(1) Fire prevention and response. The facility shall conduct fire drills quarterly for each shift. If the facility is not operating with three shifts, monthly fire drills shall be conducted to provide training for all staff;
(2) Emergency procedures and preparedness;
(3) Infection control and prevention;
(4) Accident prevention and safety procedures; and
(5) Incidents and diseases subject to mandatory reporting and the facility's reporting mechanisms;
Additional personnel education shall be based on facility identified needs.
Current professional and technical reference books and periodicals shall be made available for personnel.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).
