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11B-805 Medical care and long-term care facilities 

ETA Editor's Note

The numbering of subsections within Section 11B-805 is not aligned between 2013 CBC and 2010 ADAS.  The 2013 CBC requirements are considerably more extensive, as indicated by the italicized requirements below.

11B-805.1 General.

Medical care facilities and long-term care facilities shall comply with Section 11B-805. All common use spaces and public use spaces in medical care facilities and long-term care facilities shall comply with this chapter.

[2010 ADAS] 805.1 General.  Medical care facility and long-term care facility patient or resident sleeping rooms required to provide mobility features shall comply with 805.

11B-805.2 Patient bedrooms and resident sleeping rooms.

Patient bedrooms and resident sleeping rooms required to provide mobility features shall comply with Section 11B-805.2.

ETA Editor's Note

According to the Office of Statewide Health Planning and Development (OSHPD), "resident sleeping rooms," not defined in 2013 CBC Chapter 2, refers to the bedrooms of long-term care occupants.  The scoping for accessibility of On-Call Rooms for physicians and other staff is addressed at Subsection 11B-223.2.3, and these are treated as Transient Lodging components.

11B-805.2.1 Hand washing fixtures.

Hand washing fixtures shall comply with Section 11B-606.

11B-805.2.2 Beds.

A 36 inch (914 mm) minimum wide clear space shall be provided along the full length of each side of the beds.

[2010 ADAS] 805.3 Clear Floor or Ground Space.  A clear floor space complying with 305 shall be provided on each side of the bed. The clear floor space shall be positioned for parallel approach to the side of the bed.

11B-805.2.3 Turning space.

Turning space complying with Section 11B-304 shall be provided within the room.

11B-805.2.4 Toilet and bathing rooms.

Toilet and bathing rooms that are provided as part of patient bedrooms and resident sleeping rooms complying with Section 11B-223.2 or 11B-223.3 shall comply with Section 11B-603. Where provided, one water closet, one lavatory, and one bathtub or shower shall comply with the applicable requirements of Sections 11B-603 through 11B-610.

[2010 ADAS] 805.4 Toilet and Bathing Rooms.  Toilet and bathing rooms that are provided as part of a patient or resident sleeping room shall comply with 603. Where provided, no fewer than one water closet, one lavatory, and one bathtub or shower shall comply with the applicable requirements of 603 through 610.

11B-805.3 Waiting rooms.

Waiting rooms shall comply with Section 11B-805.3.

11B-805.3.1 Wheelchair spaces.

Where seating is provided in waiting rooms, at least 5 percent of the seating shall be wheelchair spaces complying with Section 11B-802.1.

Exception: In waiting rooms serving facilities specializing in treating conditions that affect mobility, 10 percent of the seating shall be wheelchair spaces complying with Section 11B-802.1.

11B-805.4 Examination, diagnostic and treatment rooms.

Examination, diagnostic and treatment rooms shall comply with Section 11B-805.4.

ETA Editor's Note

The Office of Statewide Health Planning and Development (OSHPD), which has jurisdiction over hospitals and long-term care facilities in California, has issued Code Application Notice CAN 2-11B, dated 9/9/14, which includes the following interpretation of Section 11B-805.4:

Examination, diagnostic and treatment rooms refer to all patient care areas and include but are not limited to:  exam rooms, treatment rooms, imaging rooms, operating rooms, emergency rooms, post anesthesia recovery rooms/units, dialysis rooms/units, infusion rooms/units, labor/delivery/recovery rooms and observation rooms/units.  All examination, diagnostic and treatment rooms shall be accessible.  Toilet rooms that are accessed from an examination, diagnostic or treatment room shall also be accessible.  Note that all patient toilet rooms, other than those specifically exempted (i.e. non-accessible patient rooms and ICU patient rooms), must comply with Section 11B-603.

This is a scoping requirement, apparently misplaced outside Division 2.

11B-805.4.1 Beds, exam tables, procedure tables, gurneys and lounge chairs.

A 36 inch (914 mm) minimum wide clear space shall be provided along the full length of each side of beds, exam tables, procedure tables, gurneys and lounge chairs.

Exception:  General exam rooms in non-emergency settings may provide clear space on only one side of beds, gurneys and exam tables.

11B-805.4.2 Equipment.

Clear space complying with Section 11B-305.2 shall be provided as required for specific equipment.

11B-805.4.3 Turning space.

Turning space complying with Section 11B-304 shall be provided within the room.

ETA Editor's Note

The Office of Statewide Health Planning and Development (OSHPD), which has jurisdiction over hospitals and long-term care facilities in California, has issued Code Application Notice CAN 2-11B, dated 9/9/14, which includes the following interpretation of Subsections 11B-805.4.1, 11B-805.4.2 and 11B-805.4.3:

All patient care areas must provide access to the area and to the bed, exam table, procedure table, gurney, lounge chair and/or equipment/apparatus associated with the delivery of care, exam, diagnosis or treatment performed in the space.  Access includes compliance with Division 4 of Chapter 11B for travel to, and circulation within, the patient care area;  and turning space in compliance with Section 11B-304.  A minimum of a 36-inch wide access shall be provided to and along each side of the bed, exam table, procedure table, gurney, lounge chair and/or equipment/apparatus.  "Each side" includes both sides and the foot, but does not include the head unless the provision of care requires it.  Refer to the following examples:

         Exam room - Exam rooms are required to provide a turning space, accessible handwashing fixture, and 36-inch wide access along the full length of each side and the foot of the exam table.  The exception is in reference to general exam rooms only.  These are restricted to those meeting the definition of exam room in CBC Section 1224.3.  Specific exam rooms required to be larger than 80 square feet are not considered "general exam rooms" and are not eligible for the exception.

         Treatment room - Treatment rooms are required to provide a turning space, accessible handwashing fixture, accessible counter and writing surface, and 36-inch wide access along the full length of each side and foot of the treatment table.  If the treatment room is intended to accommodate procedures requiring access to the head (e.g. minor surgery, etc.), all four sides of the table require 36-inch wide access.

         Equipment - Exam or treatment rooms with equipment such as imaging must provide a turning space, accessible handwashing fixture if required, and 36-inch wide access to both sides and the foot of the table.  The head of the equipment does not require 36-inch access if only used for servicing.

OSHPD has not yet made it clear which, if any, movable items are allowed within the required 36-inch wide access.

11B-805.5 Patient Change Areas.

Areas where patients change or are prepared for a procedure shall comply with Section 11B-222.

11B-805.6 Hand washing fixtures, lavatories and sinks.

All hand washing fixtures, lavatories and sinks shall comply with Section 11B-606.

Exception: Scrub sinks,  as defined in California Plumbing Code Section 221.0, shall not be required to comply with Section 11B-606.

ETA Editor's Note

The Office of Statewide Health Planning and Development (OSHPD), which has jurisdiction over hospitals and long-term care facilities in California, has issued Code Application Notice CAN 2-11B, dated 9/9/14, which includes the following interpretation of Section 11B-805.6:

The requirements of Section 11B-606 apply to all lavatories, sinks, and handwashing fixtures for public use, patient use, and employee use, unless otherwise specifically exempted by the code.  Lavatories, sinks, and handwashing fixtures are common use areas and therefore, require accessibility.

Exceptions:

         •        Scrub sinks (due to impracticality)

         •        Specific workstations (see Section 11B-203.9).  This applies only where the sink is the actual workstation.

         Example:  A sink used exclusively for cleaning endoscopes.  The sink is the actual area where work is performed as opposed to a place where the employee cleans up before and after performing work elsewhere in the room.

Knee clearance requirement - All accessibility requirements of Section 11B-606 apply to lavatories, sinks and handwashing fixtures required to be accessible.  Lavatories are subject to Section 11B-306.3.3, Exception 1 which states:  "At lavatories required to be accessible by Section 11B-213.3.4, the knee clearance shall be 27 inches (686 mm) high minimum above the finish floor or ground at a depth of 8 inches (203 mm) minimum increasing to 29 inches (737 mm) high minimum above the finish floor or ground at the front edge of a counter with a built-in lavatory or at the front edge of a wall-mounted lavatory fixture."

This requirement applies to all lavatories.  "Handwashing fixtures" are special application "sinks" and not subject to the exception.  Handwashing fixtures, as sinks, are subject to Section 11B-306.2.3, Exception 1 which states"  "The toe clearance shall extend 19 inches minimum under sinks required to be accessible by Section 11B-212.3."

Consequently, handwashing fixtures must have a minimum depth of 19 inches in order to comply with the minimum toe clearance.  They shall also have a minimum knee clearance of 27 inches at the depth and reduction described in Sections 11B-306.3.3 and 11B-306.3.4.

The implications of this interpretation are that a wall-mounted china fixture of the most common size, nominally 20 inches wide x 18 inch projection, cannot serve as a handwashing fixture.  See also the ETA Editor's Note at 11B-212.3.

11B-805.7 Built-in cabinets and work surfaces.

Built-in cabinets, counters and work surfaces shall be accessible, including: patient wardrobes, nurse’s stations, administrative centers, reception desks, medicine preparation areas, laboratory work stations, equipment consoles, clean and soiled utility cabinets, and storage areas; and shall comply with Sections 11B-225 _|Storage|_ and 11B-902 _|Dining Surfaces and Work Surfaces|_.

ETA Editor's Note

The Office of Statewide Health Planning and Development (OSHPD), which has jurisdiction over hospitals and long-term care facilities in California, has issued Code Application Notice CAN 2-11B, dated 9/9/14, which includes the following interpretation of Section 11B-805.7:

Built-in equipment consoles include recessed or wall mounted Electronic Medical Record (EMR) systems.  These units must also comply with US Access Board Section 508 Standards for Electronic and Information Technology.  A 30-inch by 48-inch clear floor space, in compliance with Section 11B-305, shall be centered in front of the display screen.  Wall-mounted units shall comply with protrusion limits prescribed in Section 11B-307.2.  Touch screen units shall be allowed to be vertically mounted with the centerline of the display screen no more than 52 inches above the floor in compliance with Section 11B-707.7.1.1.  These units will need the capability of an alternate input method such as a wireless keyboard made available to those who would need it.

Exceptions:

1.      Built-in wardrobes in patient bedrooms and resident sleeping rooms not required to be accessible are not required to comply with the provisions of this chapter.

2.      Clinical laboratory work stations provided in a laboratory area that are in addition to the minimum number required to be accessible (5 percent of the work stations provided, but no fewer than one), are not required to comply with the provisions of Section 11B-902.

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