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 patients, visitors, and staff.
(1) The licensee must provide and maintain a safe and clean environment. The licensee must maintain the facility consistent with this chapter. Birthing centers built before the adoption of this chapter must be maintained to the standards that were in place at the time the center was originally 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 must provide at least one birthing room. Birthing rooms must have a minimum of 156 square feet, with each dimension having a minimum of 11 feet. The room must be adequate and appropriate to provide for the equipment, staff, supplies, and emergency procedures required for the physical and emotional care of the client, newborn, and their support people during labor, birth, and the immediate postpartum period.
(3) The licensee must locate birthing rooms to provide unimpeded, rapid access to an exit of the building which will accommodate emergency transportation vehicles.
(4) The licensee must provide at least five square feet of fixed or portable work surface areas for use in the birthing room or rooms.
(5) The licensee must provide and maintain bathrooms, handwashing sinks, and bathing facilities.
(a) Bathrooms and handwashing sinks must be located in the vicinity of the birthing room or rooms.
(b) At least one bathroom must be accessible in accordance with the state adopted building code.
(c) A bathing facility must be available for patient use.
(d) The licensee must keep clean and in good repair all floor surfaces, wall surfaces, bathrooms, handwashing sinks, tubs, and showers.
(6) The licensee must provide a space suitable for storage of client and support person's personal belongings.
(7) The licensee must provide visual privacy for each client and their support person or persons.
(8) The licensee must ensure 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.
(9) Water supply. The licensee must ensure an adequate supply of hot and cold running water under pressure consistent with chapter 246-290 WAC, regarding public water supplies. The licensee must provide and maintain equipment required to deliver hot water at point of use as follows: 120°F or less for handwash sinks and bathing fixtures;
(10) The licensee must 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.
(11) The licensee must provide and maintain lighting and power and must provide and maintain:
(a) Emergency lighting throughout the center, which can include plug-in battery pathway lighting;
(b) General lighting throughout the center;
(c) Adequate examination lighting devices with shatterproof bulbs or protective shields, in the birthing room;
(d) Tamper resistant electrical receptacles in birthing rooms, toilets, bathing facilities and family rooms and waiting areas; and
(e) Ground fault circuit interrupter (GFCI) receptacle when located within five feet of water source and above counters that contain sinks.
(12) The licensee must ensure linen and laundry service that provides:
(a) Soiled linen/laundry storage and sorting areas physically separated from clean linen storage and handling areas, kitchen and eating facilities or ensure that any work or function performed in or around a combined linen/laundry area is performed without significant risk of contamination to storing or handling clean linen/laundry;
(b) Laundry services must include a commercial laundry service or the following equipment:
(i) Washing machine(s) must have a designated sanitation cycle or laundry protocols must include chemical sanitation (e.g., bleach);
(ii) Dryer(s);
(iii) Dryer exhaust to the exterior; and
(iv) A handwashing sink for hand sanitation and a utility sink for heavily soiled linens/laundry or a two-compartment sink.
(13) The licensee must provide utility, housekeeping, garbage, and waste services.
(14) Medical gases. If medical gases are stored or used on the premises, the licensee must meet all codes and regulations:
(a) Ensure 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 or open flames where medical gases are being administered.
(15) Food storage and preparation. The licensee must 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 must 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 with a sanitation cycle or cleaning protocols must use chemical sanitation (e.g. bleach).
(16) An applicant or licensee wanting to use an alternative method for the design of new construction including, but not limited to, the Guidelines for Design and Construction of Health Care Facilities, may submit a request following the process in WAC 246-329-025.