Minnesota Department of Health N U R S I N G H O M E C H E C K L I S T 04/07 PHYSICAL PLANT - New Construction FACILITY NAME: LOCATION: MORATORIUM
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1 Minnesota Department of Health *Revised N U R S I N G H O M E C H E C K L I S T 04/07 PHYSICAL PLANT - New Construction RCS FACILITY NAME: _ LOCATION: MORATORIUM LIMIT: $_ COST OF PROJECT: $ REQUIREMENTS: _ Reference in MN Rules OK Remarks _ Architectural: Site Requirements (if new facility) Bedrooms: 5% of total bedrooms are "single" remaining are "double" above grade rooms , 7 floor area- 120 SF sgl, 100 SF/bed bed clearances, doors 44" W /.4110 Dining/Dayroom/Activ.: 40 SF/bed Windows: dayroom/dining /4210 Nurse Station: 140 ft from bedrms , 8 provides superv'n of corridors , 2 nurses' toilet nearby , 3 Handwashing lav. in station , 2 Cln Utility (CU): , 4 cabinets, shelves , 4 sink w/ inst'l fttgs, towel disp. (same) Medic'n Room: (same as CU +refrig.) , 2 double lock for narcotics , 1 Soiled Utility: in resid. wings (recomm.) clinical sink, sink w/ inst'l fttgs , 5 cabinets & shelves, towel disp. (same) bedpan washer/sanitizer (same) Corridors: 8 ft. wide , 2 handrails each side: 1 " to 2" (same), 1 diam., 32-34" to top of rail Bedroom Windows: 30"H sills , 6 clear space deg. angle (same) window area is 1/8 bedroom area (same) Central Bathing: 1 tub & 1 shr min; 1 per 20 beds direct access to WC and lavatory , 2D clearances (same), 4A if shower, splash wall (same), 3A Toilet Rooms: direct access from bedrms doors 32" clear & swinging out , A WC and lavatory in room, mounting ft. 6 in. min. width, clearances , B private for single bedrooms special toilet rms. 6 x 5-1/2 ft , C toilet paper holder E/4150F
2 Page 2 of 5 Storage Space: 15 SF per bed Janitor's Closet (floor sink, shlvs) Entrance: canopy to curb (HC access) Public Toilets/Lobby near main entry PT Area (if provided): special toilet room in area cubicle curtains (same) supervisor space, storage space (same) lav/sink w/ inst'l fttgs, towl. dsp. (same) Activity Area: toilet room nearby (recommended) HC accessible sink, counter storage space, display space (same) Barber/Beauty Shop: stor. space shampoo sink (same) Kitchen: dishes flow , 1 food storage (deliv. access) , 1 sep. jan. closet & toilet rm , 5&7 cart washing area can washing area (outside kitchen) partition (dishwashing area) B 4 ft. aisles throughout , 1 lavatories (food prep./dishwashing) , 6 Laundry Room/Area: work flow cart storage soiled linen room laundry processing room (washers, dryers, 2-comp. sink, lav., tbls.) clean linen room (sep. & enclosed) Nourishment Area: counter & sink cabinets, refrig. (same) Ref. Drinking Fountains (HC access) for resident areas, activ, dining Elevator: 5 ft. W x 7 ft. D door opening 44" wide (same) Ceiling Heights: 8 ft. living areas ft., 6 in. corridors, other rooms (same) 9 ft. min. boiler rooms (same) Lever Type Door Handles Cubicle Curtains 2-bed rooms, cent. bathing, PT Grab Bars: showers and tubs , 3C&4D all toilets (except staff) F/4150G&H Plumbing Fixture Mntg.: lav's H/4150J water closets B&C/4150C&D Sterilizer (if provided) in CU room
3 Page 3 of 5 Mechanical: Heating System: Maintain F indirect fired (including range m.up) , , 1 Humidity: Maintain 25-50% , 1 Hot Water: F with recirculation , 4 180/160 F at dish/clothes washers (same) Dishwasher: pressure gauge , 5 press. reducing vlv., vac. brkr. (same) floor drn. w/o backwater vlv. (same) Food Storage Areas no floor drains , 6 Waste Line Interceptors: recomm.@ washers/activ. sinks Bedpan Cleaning Device (SU sinks) , 2 Washer/Sanitizer indirect waste MN. Plmg. Code Sterilizer indirect waste, , 3 independently vented (same) Valves/Controls easy access , 3 Ventilation meets Table exhaust to outside from all ranges (same) Air Cond'ing: after 6/30/88 (Statute 144A, Subd.1b) Fresh Air Intake: 25 ft. from exhaust, parking height above grade or above roof Exhaust or Waste Chute Vent: 25 ft. from openable windows (same) Filtered Outside Air 25% efficient Filtered Kitchen Exhaust Hoods Institutional Fittings (lav's, sinks) Radiation Elements 4" above floor Air Registers 4" above floor Medical Gas System (if any) Electrical: Light/Power Panels typed index Corridor Receptacles 50 ft spacing Four-plex Receptacles on headwall on each side of each bed Night Light each bedroom Nurse Call System registers at central annunciator (same) registers at bedroom door (same) duty Med. Rm., CU/SU Rms., (same) and Nourishment Stations (same) , 2& , , , (certification) , emergency calls at resident toilets and (same) bathing fixtures, and in dayrooms, therapy and activity areas nurse call each bed (same) zone lights where required (same) Door Alarms at exits Emergency Power (4 hrs. minimum) emergency corridors, (same) exits, nurse sta., mech'l room telephone switchboard (+ light) (same) fire alarm system (+ panel) (same)
4 Page 4 of 5 emergency generator (+ light) (same) Keyed Power Switch with indicator light at the electric range *No lamps exposed to incidental damage (safety) REQUIREMENTS: LIFE SAFETY CODE (LSC) CHECKLIST NFPA Standard 101, 2000 Edition, Chapter 18 New Construction Standards Building Construction (type & ht.) 2-hour Sep. (Betw. occupcy s/const n types) Interior Finish: -walls & ceilings Corridor Walls & Doors: -sep. by part'ns from all areas -smoke-tight walls/doors -hold-open devices on rated doors -exit signs Smoke Compartmentation: -2 compartments min. per floor -size limitation/travel distance -smoke barriers (1-hour wall) -smoke doors:-self closing -solid-core wood doors -double egress, 44" ea. Leaf -vision panels -rabbets, bevels, or astragals -filling penetrations thru smoke barriers REFERENCE OK Remarks in LSC (Bold=chapter) / & (1) (3,4) (same) using dampers & approved/appropriate sealing materials -smoke dampers Protection from Hazardous Areas Protection of Vertical Openings Exit Enclosures to outside & / hour & 2-hour enclosures Means of Egress: -exit discharges paved to public way & at least 2 exits from all areas /4.2 -max. travel distances max. dead ends stair details exit access /2.5.1 & 7.5 -exit capacity (exit width) corridor width 8-0 clear (to wall finish) exit access doors 44" wide stair doors 36" wide (upper floors) (same) -sleeping rooms/suites over 1000 SF other rooms/suites over 2,500 SF door/panic hardware, locks -horizontal exits (if used) & /2.1.6, /
5 Page 5 of 5 Illumination & Emergency Power: -*continuous emergency lighting 7.8/7.9 & exit signs (2 directions) & life support systems (where provided): Life Safety Branch (F.A. system) NFPA 70/99 -exterior exits (2 bulbs) Electric generators that include: 1999 NFPA 110 remote monitoring (3-5.6), a radiator-type cooling system (3-5.7), remote shut-off ( ); on-site fuel system (recommended) Fire Alarm and Detection System: -electrically supervised, activated by water-flow alarms, detectors -transmission of FA to Fire Dept & corridor smoke detectors spaced 30 max NFPA manual FA pull ea. Exit Bedroom Windows (or doors) to outside Sprinkler System with QRS heads(all new construction): -provides complete coverage /9.7.1 Meets NFPA 13: including overhangs, canopies (5-13.8); closets (CMS Bull. 5-38) -Quick Response Sprinkler (QRS) Heads flow alarm (transmitted to F.D.) local trouble alarm on valves adequate/reliable water supply NFPA 13 Portable Fire Extinguishers NFPA AC & Ventilation Equipment-NFPA 90A: & corridors not used as air plenums NFPA 90A -duct detectors (over 2,000 CFM) NFPA 90A -kitchen: hood extinguishment - NFPA / no portable space heaters Laundry/Rubbish Chutes: -protected 9.5 & vented thru roof 3 ft. min NFPA 82: Furnishings, curtains, drapes /3.5.5 & 10.3 Enclosed Courtyards used as exits: signage, lighting, complying egress to public way MN State Fire Code: Room smoke detectors (IFC) _ with corridor lights & annunciation at the nurse station (amend.) _
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