Office of Statewide Health and Planning Department Requirements (OSHPD 3)

Office of Statewide Health and Planning Department Requirements (OSHPD 3) INFORMATION GUIDELINE 27 February 2010 CITY OF ESCONDIDO BUILDING DIVISION 201 N. BROADWAY, ESCONDIDO, CA 92025 (760) 839-4647 FREQUENTLY ASKED QUESTIONS Regarding Office of Statewide Health and Planning Department Requirements (OSHPD 3) 1. How do I know if my building, building space or unit, under construction as a clinic, will require plan review and inspection for OSHPD 3 Requirements? A 'clinic' is one that is licensed by the California Department of Health Services. Generally a doctor's, or dentist's office operates under the doctor's license and is not a clinic, under OSHPD 3 requirements. For example, a dialysis facility is usually licensed. A surgical facility (laser eye surgery, dental surgery, etc.) may be a licensed clinic. Licensure is regulated by the State of California, Department of Health Services. 2. Isn't OSHPD supposed to provide plan review and provide inspections for clinics? The building Official's responsibility for clinics was clarified with the passage of Senate Bill (SB) 1419 in 1996. The subsequent language in the 1995 California Code of Regulations was effective on January, 1, 1997. 3. What does certification mean and when does a jurisdiction provide certification? (A notice, letter or a signed form.) The building official is required under SB 1419 to provide certification that a clinic facility, which is to be licensed, meets the requirements of the California Code provisions as they relate to OSHPD 3 requirements. This certification is used by the Applicant to receive a license for a clinic. The Department of Health Services has specific forms or the Jurisdiction may prepare its own form (on letterhead). 4. Will the plan review and inspection of OSHPD 3 requirements impact the plan review and inspection? Plans will be checked and inspections will be conducted under a jurisdiction's plan review, and inspection process. However, additional requirements, as required by OSHPD 3, will be reviewed. 5. Are OSHPD 3 requirements more restrictive than other Building Code requirements? Some provisions may be more restrictive. 6. If I have additional questions who should I contact? Your local Building Department or the Office of Statewide Health and Planning Department, or your local department of health services. Many jurisdictions keep a list of current telephone numbers for these two agencies. Guideline 27_OSPHD3(2-10).doc Page 1 of 18

Minimum Plan Submittal Requirements: BUILDING CODE CORRECTION LIST Permit No.: OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT OSHPD 3 REQUIREMENTS Job Address: Date: Job Name: Contact person/firm: Plan Reviewer: Phone. No. I. California Building Code 2007. SECTION 1226 [FOR OSHPD 3]-CLINICS Scope. The provisions of this chapter shall apply to primary-care clinics, specialty clinics and psychology clinics. Primary-care clinics include free clinics, community clinics, employee clinics and optometric clinics. Specialty clinics include surgical clinics, alternative birth clinics (ABC s), chronic end-stage renal dialysis clinics and rehabilitation clinics. (1226.1) Application. All new buildings and additions, alterations or repairs to existing buildings subject to licensure shall comply with applicable provisions of the 2007 California Electrical Code, 2007 California Mechanical Code, 2007 California Plumbing Code (Parts 3, 4 and 5 of Title 24) and this chapter. (1226.2) EXCEPTION: See Section 1224.2. GENERAL CONSTRUCTION II. General Construction. Clinics shall comply with Sections 1224.4.2-1224.4.5 (hospitals) wherever possible. (1226.4) A. Corridor/hallway systems shall connect all essential services. (1226.5.1) B. Rehabilitation clinics shall have corridors and hallways of at least 5 feet in width, with handrails on both sides. NOTE: See Chapter 10 for corridor, hallway, stair, exit and occupancy requirements. C. Doors. Doors for patient use shall have an opening of not less than 3 feet in width. Where patients are transported by wheeled stretchers, doors shall provide a minimum opening of 44 inches. (1226.6.1) D. Pocket Doors. Except for administrative areas, pocket sliding doors are not permitted. (1226.6.2) E. Windows and Screens. Where necessary to protect against entrance of insects, screens of 16 meshes per inch shall be installed on windows which may be left in an open position. (1226.7) F. Minimum height. The minimum height of ceilings shall be 8 feet, except in closets, toilet rooms and bathrooms, where the minimum ceiling height shall not be less than 7 feet. (1226.8.1) Guideline 27_OSPHD3(2-10).doc Page 2 of 18

G. Minimum height with fixed ceiling equipment. Operating rooms, radiographic rooms and other rooms containing ceiling-mounted major fixed equipment or ceiling-mounted surgical light fixtures shall have ceiling heights to accommodate the equipment or fixtures and their normal movement. (1226.8.2) H. Floor finishes shall be smooth, water resistant and durable. Upon written, appropriately documented requests, the enforcing agency may grant approval of the installation of carpet. (1226.9.1) I. The materials and textures of bases and the installation thereof shall be so as to minimize moisture infiltration. Wood bases are prohibited except in waiting areas and administration departments. (1226.9.2). See also 1224.4.11 Table 1224.1. J. Wall bases in operating rooms, cast rooms and other areas which are frequently subject to wet-cleaning methods shall be made integral and caved with the floor. Construction shall be without voids at the intersection of the floor and wall surfaces. (1226.9.3) K. Buildings Over one story in height with accommodations or services for patients on floors without grade-level entrance shall provide at least one elevator sized in compliance with Section 3002.4. (1226.ll.1) L. Elevators used for the routing transport of wheeled stretchers shall have minimum inside platform dimensions of 5 feet by 8 feet and a minimum clear door opening of 3 feet 8 inches. (1226.11.2) M. A lockable room or screened enclosure of at least 25 square feet shall be provided for the washing and cleaning of garbage containers and for the storage of garbage, trash and other solid wastes. Such room or screened enclosure shall include the following: 1. A concrete floor with a curb with a drain connected to the sewer. 2. Steam or hot water and cold water supplies in accordance with the California Plumbing Code. 3. A minimum floor area of not less than 25 square feet, the least dimension of which shall be 4 feet. This amount of space may not be required by the enforcing agency if there is proposed a method of handling, storage, or cleaning of containers which requires a lesser amount of space. Additional space may be required by the enforcing agency when special operations or col1ection and disposal methods results in greater than usual accumulation of solid wastes. (1226.12.1.3) N. Trash compactor systems shall meet the drainage and wash-down requirements under Section 1226.12.1, Items I and 2. EXCEPTION: If a dumpster system is proposed, operational Procedures for handling and storage must be specifically approved by the local health officials. (1226.12.2) O. Laundry and Trash Chutes. Gravity-type laundry and trash chutes shall conform with Section 1224.4.16. (1226.13) PRIMARY CARE CLINICS (1226.14) III. Abortion Services. Clinics with abortion services shall provide, in addition to the basic clinic facilities: A. Post-abortion recovery area with a minimum area of 60 square feet per recovery bed, with cubical curtains for patient privacy. B. Space for the storage of patient clothing and personal items. Guideline 27_OSPHD3(2-10).doc Page 3 of 18

IV. C. A room or private area of at least 60 square feet for pre-abortion and post-abortion counseling. (1226.14.3) Clinical Facilities. Clinical facilities shall include the following: A. Examination rooms shall have a minimum area of 70 square feet, the least dimension of which shall be 7 feet, excluding such spaces as vestibule, toilet closet and work counter. B. Treatment rooms for minor surgical procedures and cast procedures, if provided, shall have a minimum area of 120 square feet, the least dimension of which shall be 10 feet, excluding such spaces as vestibules and work counters. EXCEPTION: Treatment rooms used for aspiration may be, as a minimum, sized as examination rooms. C. Examination and treatment rooms, including those used for abortion, shall be equipped with hand-washing fixtures. EXCEPTION: Examination and treatment rooms used for routine examinations or where surgical procedures are not performed may be equipped with fixtures having wrist or elbow controls. D. Space shall be designed for charting and storage of clinical records. E. A lockable drug distribution station with space for a refrigerator. F. A utility room which contains storage, sinks, work counter and separate clean and soiled linen hampers. The room shall be designed for the separation of clean and dirty work areas. Separate clean and soiled utility rooms may be designated. (1226.15.6) BIRTHING CLINICS 1226.16 V. Birthing Clinics. Birthing clinics shall accommodate the provisions of Sections 1226.17.4, 1226.17.5 and 1226.17.6, as well as the following: A. A birthing room shall provide not less than 156 square feet, with a minimum dimension of 12 feet of usable floor space. B. An adjoining toilet room with a nurses' call system and a lavatory. C. Direct access to a patient shower. D. A hand-washing fixture located within or directly outside the room. When located within the room, the fixture may be screened or within openable casework. E. A nurses' call system which will alert the nearest continually staffed nurses' station. F. Lighting capable of lo76 lux (100 footcandles) at working surfaces. Dimmer switches may be used. G. Oxygen and suction capabilities, portable or piped. H. Space for a crash cart. I. Space for supplies and equipment, as well as separate spaces for clean and soiled linen. (1226.16) SPECIALITY CLINICS VI. Surgical Clinics. (1226.17) A. Operating rooms shall have a minimum floor dimension of 15 feet and shall contain not less than 270 square feet of floor area and have provisions for the following: Guideline 27_OSPHD3(2-10).doc Page 4 of 18

1. Clock and elapsed timer. 2. X-ray film illuminator. (1226.17.1) B. Cast rooms, fracture rooms and cystoscopic rooms, if provided, shall have minimum floor area of 180 square feet, no dimension of which shall be less than 11 feet (1226.17.2) C. Scrub sinks. A minimum of two scrub sinks shall be provided in a surgical unit containing one operating room. Four scrub sinks shall be provided in surgical units containing two operating rooms. One additional scrub sink shall be provided for each additional operating room. (1226.17.3) D. Clock. A direct-wired or battery-operated clock or other equivalent timing device shall be visible from the scrub-up sinks. (1226.17.3.1) E. Clean-up room. Each surgical unit shall provide a clean-up room with a handwashing fixture and work space which is separate from any surgical sterilizing facilities. The cleanup room shall provide 24 square feet per operating room up to eight operating rooms, with no dimensions less than 6 feet. The clean-up room may be the soiled work area of the central sterile supply. (1226.17.4) F. Cart storage. Space for clean and soiled cart storage shall be provided if a case cart supply system is proposed. (1226.17.5) G. Housekeeping Room (Refer to 1224.4.15). The housekeeping room shall have a minimum floor area of 15 square feet, contain a service sink or floor receptor, shall include provisions for storage of supplies and housekeeping equipment provided for the surgery suite. The housekeeping room shall serve no other areas. (1226.17.6) H. Lockers. Separate dressing rooms with lockers, showers, lavatories and toilet(s) shall be provided for male and female staff. (1226.17.7) I. Support spaces. A surgical supervisor's station, a sterile supply storage facility stretcher space and instrument storage facilities shall be provided. (1226.17.8) J. Outpatient change area. A separate space shall be provided where outpatients change from street clothing and are prepared for surgery. This would include provisions for clothing storage, toilet(s), sink space for clothing change and gowning area. (1226.17.9) K. Post-anesthesia recovery (1226.17.10). The post-anesthesia recovery unit shall be provided and contain the following spaces: 1. Size. Floor area of at least 70 square feet per bed, exclusive of the spaces listed below in Items 2 and 3. 2. Nurses' control area. Provide spaces for the following: a nurse s control desk, signal system annunciator, charting space, lockable medicine cabinet, refrigerator and hand-washing fixture. 3. Storage. Separate storage spaces of at least 10 square feet for clean and soiled linen, supplies and equipment. 4. Provisions for piped or portable oxygen and suction systems at each bed location. (1226.17.10) L. Central sterile supply (1226.17.11). A central supply and sterilizing area shall be provided. Rooms and spaces to provide for the following services and equipment: 1. Soiled work area. A receiving and gross cleaning area of at least 50 square feet which shall contain work space and equipment for cleaning medical and surgical Guideline 27_OSPHD3(2-10).doc Page 5 of 18

equipment and for disposal of or processing unclean material. 2. A Clean work area of at least 50 square feet which shall contain space and equipment for sterilizing medical and surgical equipment and supplies. 3. Separation. There shall be separation of soiled or contaminated supplies and equipment and clean work areas. 4. Space for sterilizing equipment. 5. Separate storage space for sterile supplies and unsterile supplies. 6. All sterilizers and autoclaves, except small instrument sterilizers which emit steam exhaust, shall be vented to the outside of the building. Such vents shall be independent from the plumbing vent system. VII. Chronic Dialysis Clinics (1226.18). A chronic dialysis clinic shall provide the following: A. A minimum of 100 square feet of floor space, inclusive of aisles, per bed or station. B. Nurses' station equipped with a cabinet, a desk, space for records, a telephone, and a specifically designated and well-illuminated medicine storage compartment with a lockable door. C. Utility room which shall provide for the separation of clean and dirty work areas and shall include work counters and cabinets. D. If an isolation room is provided, the room shall have a minimum of 100 square feet of usable floor space. E. A waiting area. F. A private room or office near or contiguous with the unit for conference space for patients and staff. G. Storage space for supplies and equipment. H. Separate secure storage for all contaminated materials. I. An equipment room sized to accommodate the pumps, central distribution equipment and any other necessary equipment. J. Patient toilet(s) shall be directly accessible and shall be equipped with bedpan flushing attachment(s). K. Staff lockers and change areas with toilet(s). L. Housekeeping Room of at least 15 square feet with service sink and storage space. M. Separate clean and soiled linen storage. N. Space for admitting, business and administration areas. O. Home training, if provided within the unit, shall contain 110 square feet of usable enclosed floor space. P. Bloodborne Infection Isolation Room if provided shall have a minimum of 100 square feet of clear floor space. Q. At least one handwashing fixture shall be provided for each of the following areas: 1. Nurses' station which may also serve up to eight patient beds or stations. 2. Bloodborne Infection Isolation room. Guideline 27_OSPHD3(2-10).doc Page 6 of 18

3. Home training room. 4. Utility room. 5. One additional handwashing fixture for every eight patients, or fraction thereof, not served by the nurses' station fixture. VIII. Rehabilitation Clinics (1226.19). Rehabilitation clinics shall meet the general requirements of Sections 1226.4 through 1226.13, as well as the following sections. A. Occupational therapy service space, if provided, shall include the following: 1. A minimum floor area of 300 square feet, no dimension of which shall be less than 12 feet. 2. An office space separate from the treatment area. 3. Storage space for equipment and supplies, as well as separate spaces for clean and soiled linen. 4. Hand-washing sink. IX. Physical therapy service space (1226.19.2). A physical therapy service space shall be provided to accommodate the following: A. A physical therapy treatment space of at least 300 square feet, with no dimension of which shall be less than 12 feet. B. An office space, separate from the treatment area. C. A minimum of one handwashing sink in the treatment area. D. Storage space for equipment and supplies, as well as separate spaces for clean and soiled linen. X. Audiology service space (1226.19.3). If an audiology service is provided, the following shall be provided: XI. A. A minimum of one two-room testing suite that meets Standards S-3.1, 1960 (R-1971), Criteria for Background Noise in Audiometer Rooms, of the American National Standards Institute, Inc., 1430 Broadway, New York, NY 10018. B. Space for tables and chairs to conduct interviews, consultations and treatment. C. Storage space for equipment and supplies. D. Hand-washing sink in each treatment area. Speech pathology (1226.19.4). If a speech pathology service is provided, there shall be: A. Space for tables and chairs to conduct interviews, consultations and treatment. B. Storage space for equipment and supplies. C. Hand-washing sink in each treatment room. PSYCHOLOGY CLINICS XII. Psychology Clinics (1226.20). Psychology clinics shall provide at least an interview room, consulting room and group therapy room, in addition to meeting the general requirements of Sections 1226.4 through 1226.13: Guideline 27_OSPHD3(2-10).doc Page 7 of 18

HEALTH FACILITY SYSTEMS [FOR OSHPD 1, 2, 3, & 4] REFERENCES to the California Mechanical Code, U.O.N. I. Gas and Vacuum Systems. The design, installation and testing of medical gas and vacuum systems shall be in accordance with NFPA 99-1999, Standard for Health Care Facilities. (1224.4.6.2 CBC) II. Hyperbaric Facilities. The design and construction of hyperbaric facilities shall conform to NFPA 99, Standard for Health Care Facilities. (1224.4.6.3 CBC) III. Laboratories. The design and construction of hospital laboratories shall conform to NFPA 99, Standard for Health Care Facilities. (1224.4.6.4 CBC), (410). IV. Design Requirements for Ethylene Oxide (ETO) Sterilization Areas. The design requirements for ethylene oxide (ETO) sterilization areas shall be as follows: (418) A. Air changes. For required air changes, see the California Mechanical Code. (Table 4-A) B. Exhaust requirements. For exhaust requirements, see the California Mechanical Code. (418A.2.1, 418.2.2) C. Discharge point. For discharge point requirements, see the California Mechanical Code. (418.2.3) D. Emergency power. When the ETO sterilizers are on emergency power during periods of power outage, the exhaust system shall be on emergency power. (See 316.0) E. Alarm system. An audible and visual alarm system shall be installed to alert sterilizer operating personnel if the airflow falls below design cubic feet per minute (L/s.) (418.5) V. Ventilation requirements. A. Ventilation of sterilizer door area. The system shall be designed to capture the ETO when the door is opened following the completion of the sterilization process. A hood or canopy closed on each end should be installed over the sterilization door. A hood or canopy shall be connected to a dedicated exhaust ventilation system. (418.3.5) B. Aeration units. For ventilation requirements involving aeration units, see the California Mechanical Code. (418.3.1) C. Capture box. For ventilation requirements requiring a capture box, see the California Mechanical Code. (418.3.2) D. Cylinder change. For ventilation requirements during cylinder change, see the California Mechanical Code. (418.3.3) E. Sterilizer relief valve. For sterilizer relief valve ventilation requirements, see the California Mechanical Code. F. Gas Valves. Installation of gas line hand valves at the connection to the supply cylinders are required to minimize leakage during cylinder change. (418.4) G. Water Installations. Prior to utilization of newly constructed or altered domestic water piping systems, all affected domestic water piping shall be sterilized using procedures prescribed in AWWA C651-92. Guideline 27_OSPHD3(2-10).doc Page 8 of 18

Minimum Mechanical Plan Submittal Requirements: MECHANICAL CODE CORRECTION LIST OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT OSHPD 3 REQUIREMENTS Job Name: Date: Job Address: Plan Reviewer: Contact person/firm: Tel. No. I. CALIFORNIA BUILDING CODE (CBC) 2007 SECTION 1226 [FOR OSHPD 3] -- CLINICS Scope. The provisions of this chapter shall apply to primary-care clinics, specialty clinics and psychology clinics. Primary-care clinics include free clinics, community clinics, employee clinics and optometric clinics. Specialty clinics include surgical clinics, chronic end-stage renal dialysis clinics and rehabilitation clinics. (1226.l) Application. All new buildings and additions, alterations or repairs to existing buildings subject to licensure shall comply with applicable provisions of the California Electrical Code, California Mechanical Code, California Plumbing Code (Parts 3, 4 and 5 of Title 24) and Building Code. (1226.2) EXCEPTION: See Section 1224.2. II. The above building was reviewed for compliance with the 2006 Uniform Mechanical Code with the 2007 California Amendments (the California Mechanical Code "CMC"). The following items are CMC requirements for the State Licensed Medical Clinics (OSHPD-3). Please read all provisions of The California Mechanical Code which apply to OSHPD 3 clinics prior to your plan submittal. As the result of new information, additional corrections may follow. To facilitate the recheck review, following each item, describe in writing the corrective action taken. As the result of new information, additional corrections may follow. OSHPD 3 requirements are in addition to all other CMC provisions. A. Area Designation describing room function shall be indicated on the Mechanical drawings. Please submit calculation for each area designation to show compliance with Table 4-A for pressure relationship and ventilation requirements. (407.1.1) (407.3.1) B. Fans serving exhaust systems shall be located at the discharge end of the system. (407.1.2) C. Corridors shall not be used to convey supply, return air to or exhaust air to or from any room except to ventilate small rooms (30 square feet maximum) which are mechanically exhausted, such as bathrooms, toilet rooms and janitor's closets. (407.4.1.3). (See also 407.4.1.4 and 602.1) D. Air distribution system: 1. Sensitive areas (including operating rooms, delivery rooms, and nurseries) - supply air Guideline 27_OSPHD3(2-10).doc Page 9 of 18

outlets shall be located at or near the ceiling. At least two exhaust or recirculation air inlets shall be located between 3 to 8 inches above the finished floor. (407.4.1.1) 2. Negative pressure isolation rooms - supply air outlets shall be located at or near the ceiling and at the end of the room which is opposite the head of the bed. Exhaust registers shall be located on the wall behind the patient's head between 3 to 24 inches above the finished floor. (414.2) 3. Positive pressure isolation rooms - supply air shall be delivered at or near the ceiling and near the patient's bed. All exhaust or return registers shall be located near the entrance to the room between 3 to 8 inches above the finished floor. (415.1) E. Variable Air Volume systems are not permitted for negative or positive pressure isolation rooms or other sensitive areas listed in Table 315 of the CMC. (407.5.1) F. Variable Air Volume (V A V) systems through the full range of operation for nonsensitive areas shall comply with the following criteria: l. The central return fan shall be interlocked with and track the central supply fan. (407.5.1.2) 2. VAV for return air shall be accomplished by utilizing an automatic modulating damper in the return-air duct for each room. The damper will modulate from full open to minimum position in conjunction with the V A V terminal box. (407.5.1.3) 3. The outside air shall be a minimum of 2 air changes per hour for V A V system. (407.5.1.4) 4. The minimum ventilation rate shall not drop below 4 air changes per hour for each space. (407.5.1.4) G. No space above a ceiling may be utilized as an outside-air, supply-air, exhaust-air or return-air plenum. (407.4.1.4) H. Ducts which penetrate construction, intended for X-ray or other radiation protection, shall not impair the effectiveness of the protection. Submit manufacturer's data sheet for penetration requirements and show detail on the plans. (409.1) I. A dedicated exhaust system shall be provided for negative pressure isolation rooms. Please show compliance with Section 414 of the CMC in detail. (414) J. A dedicated exhaust system shall be provided for Ethylene Oxide sterilizer equipment room. Please show compliance with Section 417 of the CMC in the detail (418) K. Direct evaporative cooling systems shall be limited in health facilities to non-patient areas such as laundry rooms, food preparation areas and boiler or machinery rooms. (405.4) L. Please indicate the following notes on the drawings: 1. All filters shall be certified by the manufacturer and installed in compliance with Sections 408.1 and 411 of the CMC. (408.1 and 411) 2. Outdoor air intakes shall be located at least 25 feet from exhaust outlets of ventilating systems, combustion equipment stacks, medical-surgical vacuum systems, cooling towers and areas that may collect vehicular exhaust or other noxious fumes. The bottom of outdoor air intakes shall be located not less than 10 feet above ground level or 18 inches above roof level. (407.2.1) 3. Exhaust outlets shall be located a minimum of 10 feet above adjoining grade and 10 feet from doors, occupied areas and operable windows. (407.2.2) Guideline 27_OSPHD3(2-10).doc Page 10 of 18

4. Cold air ducts shall be insulated to prevent condensation problems. (409.3) 5. Laboratory fume hood systems shall comply with Section 409 of the CMC. (410) 6. The exhaust ducts serving negative pressure isolation rooms shall be installed, labeled, and tested in compliance with Sections 413 and 416 of the CMC. (414 and 417) 7. An alarm system shall be installed in compliance with Section 416 of the CMC for negative and positive pressure isolation rooms. (416) 8. Flexible ducts of not more than 10 feet in length may be used to connect supply, return or exhaust air terminal devices to rigid duct systems. (602.3.1 and 605.0) 9. Thermal or acoustical lining materials shall not be installed within ducts, terminal boxes, sound traps and other in-duct systems serving areas such as operating, delivery and recovery rooms, nurseries, intensive care units and negative pressure isolation rooms unless terminal filters with 90 percent efficiency are installed downstream of the duct lining. (604.0, 605.1 and 605.3) 10. All medical gas piping and systems shall be in accordance with NFPA 99 and the general provisions of Chapter 30, CFC. (3006.4 CFC) Applicant Signature Date Plan Reviewer Date Te1ephone No. Telephone No. Rechecked & Approved Date Guideline 27_OSPHD3(2-10).doc Page 11 of 18

Minimum Electrical Plan Submittal Requirements: ELECTRICAL CODE CORRECTION LIST OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT OSHPD 3 REQUIREMENTS Job Address: Date: Job Name: Plan Reviewer: Contact person/firm: Tel. No. I. CALIFORNIA BUILDING CODE (CBC) 2007 SECTION 1224 [FOR OSHPD 3] - CLINICS Scope. The provisions of this chapter shall apply to primary-care clinics, specialty clinics and psychology clinics. Primary-care clinics include free clinics, community clinics, employee clinics and optometric clinics. Specialty clinics include surgical clinics, chronic end-stage renal dialysis clinics and rehabilitation clinics. (1226.l) Application. All new buildings and additions, alterations or repairs to existing buildings subject to licensure shall comply with applicable provisions of the California Electrical Code, California Mechanical Code, California Plumbing Code (Parts 3, 4 and 5 of Title 24) and Building Code. (1226.2) EXCEPTION: See Section 1224.2. II. The above building was reviewed for compliance with the 2007 California Electrical Code based on the 2005 National Electrical Code. The following items are CEC requirements for the State Licensed Medical Clinics (OSHPD-3). Please read all provisions of the California Electrical Code which apply to OSHPD 3 requirements for clinics prior to your plan submittal. To facilitate the recheck process, following each item describe in writing the corrective action taken. OSHPD 3 requirements are in addition to other CEC provisions. ELECTRICAL CORRECTION LIST OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT OSHPD 3 REQUIREMENTS A. Nonmetallic Multi-outlet Assemblies shall not be used in Clinics. (Section 380.2 (B) (7)) B. In clinic patient care areas, the grounding terminals of all receptacles and all noncurrentcarrying conductive surfaces of fixed electric equipment subject to personal contact, operating over 100 volts, shall be grounded by an insulated copper conductor. The grounding conductor shall be sized per Table 250.122 and installed with the branch circuit conductors in metal raceways per Section 517.13(A). Branch circuits on the plans shall identify this insulated grounding conductor. Guideline 27_OSPHD3(2-10).doc Page 12 of 18

C. The wiring method in Clinic patient care areas shall be in metal raceways or cable assemblies per Section 517.13(B). Metallic raceways and cable sheath assemblies shall be approved as a ground path as defined in Section 250.118. Note on the plans the type of wiring method. The following wiring methods are not allowed in Clinic patient care areas: I. Nonmetallic Cable Trays Section 392.4 2. Electrical Nonmetallic Tubing ENT Section 362.12(11) 3. Nonmetallic Extensions Section 382.12(5) 4. Rigid Nonmetallic Conduit RNC Section 352.12(G) 5. Surface Nonmetallic Raceways, Section 388.12(8) Except low voltage applications D. Panelboards serving normal and essential branch circuits in clinics shall have their equipment grounding terminal busses bonded together with a minimum # 10 insulated copper conductor. Identify equipment grounding conductor on the plans. Section 517.14 E. Provide a note on the plans stating that any receptacles with insulated grounding terminals in Clinic patient care areas shall have identifiable means visible after installation. Section 517.16 F. Provide ground fault protection for feeder disconnecting means supplying power to Clinics if there is ground fault protection for the service disconnecting means as required in Sections 230.95 or 215.10. The ground fault protection for such feeders shall be selectively coordinated as required by Section 517.17(B). G. All receptacle outlets and fixed equipment within wet location in Clinics shall have GFCI protection. Section 517.20(A) H. Fixed equipment installed in wet locations where an isolated power system is utilized, shall be listed for the purpose and installed in accordance with the provisions of Section 517.160 for Isolated Power Systems. Section 517.20(B) I. Lighting fixtures in each room and passageway and shall be equipped with a protective lens or diffuser per Section 517.22(C). J. Switches controlling lighting fixtures and receptacle outlets powered by an emergency source shall a distinctive color or marking on cover plates and/or colored devices as to be readily identifiable. Section 517.45 (E) K. Feeders for Mobile Medical Facilities shall be sized in accordance with Article 220. Section 517.24(A). L. Provide a disconnecting means listed and rated for its use for Mobile Medical Facilities. Disconnect shall be located adjacent to and within sight of the service receptacle, and shall be capable of simultaneously disconnecting the ungrounded conductors which supply the service receptacle. Section 517.24(C) M. Provide a generator with on-site fuel with a minimum capacity of 4 hours in locations with ambulatory surgical clinics. Note on the plans that power shall be restored by the generator within 10 seconds after loss of normal power. Section 517.45(D.1) and 700.12 (B) (2), Exception 3 Guideline 27_OSPHD3(2-10).doc Page 13 of 18

N. Illumination of means of egress, exit lights, alarms and alerting systems, nurses' call system and central suction system in ambulatory surgical clinic locations shall be supplied by an emergency generator. Section 517.45(F), 517.30-517.35. O. Task illumination and selected receptacle outlets in operating rooms, recovery rooms, nurse's stations, electrical and mechanical rooms and telephone equipment rooms in ambulatory surgical clinic locations shall be supplied by an emergency generator with onsite fuel. Section 517.45(D.1) P. Illumination for means of egress and exit lights in Hemodialysis Clinics shall be provided using battery-operated equipment with a minimum 1 1/2 hour capacity after loss of the normal source. Section 517.45(G)(1) Q. Provide signal systems with provisions for visual and audible communications between patients and nursing personnel and between health care facility staff. Section 517.123 Guideline 27_OSPHD3(2-10).doc Page 14 of 18

Minimum Plumbing Plan Submittal Requirements: PLUMBING CODE CORRECTION LIST OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT OSHPD 3 REQUIREMENTS Job Address: Job Name: Contact person/firm: Plan Reviewer: Tel. No. Date: I. CALIFORNIA BUILDING CODE (CBC) 2007 SECTION 1224 [FOR OSHPD 3] - CLINICS Scope. The provisions of this chapter shall apply to primary-care clinics, specialty clinics and psychology clinics. Primary-care clinics include free clinics, community clinics, employee clinics and optometric clinics. Specialty clinics include surgical clinics, chronic end-stage renal dialysis clinics and rehabilitation clinics. (1226.l) Application. All new buildings and additions, alterations or repairs to existing buildings subject to licensure shall comply with applicable provisions of the California Electrical Code, California Mechanical Code, California Plumbing Code (parts 3, 4 and 5 of Title 24) and Building Code( 1226.2) EXCEPTION: See Section 1224.2. II. The above building was reviewed for compliance with the 2006 Uniform Plumbing Code with the 2007 California Amendments (the California Plumbing Code "CPC"). The following items are CPC requirements for the State Licensed Medical Clinics (OSHPD-3). Please read all provisions of the California Plumbing Code which apply to OSHPD 3 requirements for clinics prior to your plan submittal. To facilitate the recheck process, following each item describe in writing the corrective action taken. OSHPD 3 requirements are in addition to other CPC provisions. A. Area designation describing room function shall be indicated on the plumbing drawings. Please show compliance with Tables 4-1 and 4-2 for minimum number of required fixtures. As the result of new information, additional corrections may follow. (413, Table 4-1, Table 4-2) B. Floor drains shall not be installed in operating and delivery rooms. (311.10) C. Each department shall be served by a service sink. Compatible listed departments may share service sinks. (Table 4-2 Footnote 1) D. At least two pieces of hot water-heating equipment shall be provided to supply hot water for dishwashing (180 o F) and minimum patient services such as hand washing and bathing (120 o F). Guideline 27_OSPHD3(2-10).doc Page 15 of 18

(612.2) E. Temperature control valves shall be provided to automatically regulate the temperature of hot water delivered to plumbing fixtures used by patients to a range of 105 o - 120 F. (612.5) F. Grease traps shall not be installed in food preparation areas of kitchens. (1014.1B) G. Please indicate the following notes on the drawings: 1. Drainage piping over operating and delivery rooms, nurseries, food preparation, serving, and storage areas shall be kept to a minimum and shall not be exposed. Special precautions shall be taken to protect these areas from possible leakage. (311.9) 2. Faucets for lavatories and kitchen sinks shall not be equipped with aerators. (402.7) 3. Drinking fountains shall have a jet of water extending at least two inches from the water orifice. The orifice shall not be accessible to the mouth of the drinker nor subject to immersion. (406.5.1) 4. High temperature alarms set at 125 F shall be provided down stream of temperature control valves, where hot water is originally generated at temperatures exceeding 125 F. (612.5) 5. Scrub sinks/handwashing fixture: Fixtures shall not be equipped with aerators. The water discharge point shall be five inches above fixture rim. Fixtures shall be equipped with hot and cold water supplies not requiring direct contact of the hands for operation (wrist or elbow blades are not acceptable). (210), (Table 4-2 Footnotes) 6. Water storage tanks shall be fabricated of corrosion-resistant materials or lined with corrosion resistant materials. (612.4) 7. At fixtures where water exceeding 125 of is accessible to patients or personnel, warning signs in letters at least two inches high shall be posted above fixtures. (612.7) 8. Dialysis water distribution systems shall comply with the requirements of Section 613.0 of the CPC. (613) 9. Identification of potable and non-potable water pipes and outlets shall comply with Section 614.0 of the CPC. (614.0) (603.4.11) Applicant Signature Date Plan Reviewer Date Contact Person/Firm Telephone No. Rechecked & Approved Date Guideline 27_OSPHD3(2-10).doc Page 16 of 18

Community Development Department Building Division Declaration of Request for Plan Review, Inspection and Certification of OSHPD 3 Requirements Please check all boxes that apply to your project. 1. My Clinic will be a State Licensed Clinic. 2. My Clinic will not be a State Licensed Clinic. I certify under penalty of perjury: Hospital Governing Authority Signature Building Owner Signature I am requesting the City of Escondido to: Provide plan review and certify Inspect construction and certify the clinic located at: Hospital Governing Authority Signature under OSHPD 3 requirements. or Building Owner Signature Note: Persons designated by the building owner, as agents, for the owner and the board Member for the Hospital Governing Authority shall have a notarized letter of authorization accompanying this Certification notice. Guideline 27_OSPHD3(2-10).doc Page 17 of 18

Community Development Department Building Division Notice of Certification of Completion of Plan Review and Inspection for Office of Statewide Health and Planning Department OSHPD 3 Requirements The City of Escondido has provided plan review and verification under OSHPD 3 requirements, for the clinic located at. Signature of Plan Reviewer. Title Date The City of Escondido has provided inspection verification under OSHPD 3 requirements, for the clinic located at. Signature of Inspector Title Date Guideline 27_OSPHD3(2-10).doc Page 18 of 18