Section 1240-07-10-.10 - PHYSICAL FACILITY(1) New construction, major renovations and/or additions to existing facilities shall be constructed and maintained according to the standards of the Fire Prevention Division of the Tennessee Department of Commerce and Insurance and/or of the Division of General and Environmental Health of the Tennessee Department of Health.(2) Any new construction, major renovations, and/or additions to existing facilities that are located on the premises of a licensed nursing home, a licensed hospital, a licensed assisted-care living facility, a licensed home for the aged or a licensed residential hospice must have been inspected and approved for fire and environmental safety standards using the Life Safety Code by the Tennessee Department of Health's Division of Health Care Facilities prior to use as an adult day services center.(3) Fire Safety Requirements.(a) Prior to issuance of a temporary license and each annual license thereafter, an adult day services center shall receive an approved fire safety inspection by an appropriate fire inspection official as directed by the State Fire Marshal's office of Tennessee Department of Commerce and Insurance.(b) A separate fire safety inspection as specified in subparagraph (a) above is not required for centers that: 1. Receive approval in compliance with the law as a licensed nursing home, a licensed hospital, a licensed assisted-care living facility, a licensed home for the aged or a licensed residential hospice by the Tennessee Department of Health's Division of Health Care Facilities.2. Are located on the premises of a licensed nursing home, a licensed hospital, a licensed assisted-care living facility, a licensed home for the aged or a licensed residential hospice and provide evidence that the "adult day services center" area of the facility has been inspected and approved for fire safety standards using the Life Safety Code by the Tennessee Department of Health's Division of Health Care Facilities.(4) Environmental Safety Requirements. (a) Prior to issuance of a temporary license and each annual license thereafter, an adult day services center shall receive an approved environmental inspection by an appropriate health inspection official as directed by the Tennessee Department of Health.(b) A separate environmental inspection as specified in subparagraph (a) above is not required for centers that: 1. Receive approval in compliance with the law as a licensed nursing home, a licensed hospital, a licensed assisted-care living facility, a licensed home for the aged or licensed residential hospice by the Tennessee Department of Health's Division of Health Care Facilities.2. Are located on the premises of a licensed nursing home, a licensed hospital, a licensed assisted-living facility, a licensed home for the aged or a licensed residential hospice and provides evidence that the "adult day services center" area of the facility has been inspected and approved for environmental standards using the Life Safety Code by the Tennessee Department of Health's Division of Health Care Facilities.(c) The director of the adult day services center shall immediately alert the Department of any deficiency identified by the Tennessee Department of Health during the course of an inspection.(d) No license for an adult day services center located on the premises of, and operated by, a licensed nursing home, a licensed hospital, a licensed assisted-care living facility, a licensed home for the aged, or a licensed residential hospice may be issued without the written approval of the Tennessee Department of Health and the Department of Human Services that an adult day services program may be operated at the same time.(5) The director of the adult day services center is responsible for supplying documentation of compliance with the fire and environmental inspections required in paragraphs (3) and (4) above to the Department upon request.(6) The center shall have space on the ground level floor, or that is accessible by elevator or wheelchair ramps or other assistive devices, to accommodate a full range of program activities and services, which shall include, but are not limited to:(a) Space for individual and group activities;(b) Private office space to permit staff to work effectively;(c) Storage space for program and operating supplies; and(d) Space for special therapies, a rest area, and a designated area to isolate the ill, which includes comfortable resting furniture that would allow participants to recline or lie down. This may be in one room or in more than one room.(7) At least forty (40) square feet of indoor activity space per participant shall be provided, excluding floor space for bathrooms, storage areas, and rooms designated for staff use only.(8) Adult day services centers located on the premises of, on the grounds of, or adjacent to other operations such as licensed nursing homes, licensed hospitals, licensed assisted-care living facilities, licensed residential homes for the aged, or licensed residential hospices may utilize, on a staggered or shared basis, the same facilities such as dining rooms, recreation rooms, or physical therapy rooms, provided that:(a) Overcrowding does not occur;(b) The staff participant ratio set forth in 1240-07-10-.12 is maintained; and(c) The space in these other facilities shall not count toward the space requirements necessary for the conduct of the adult day services center as specified in paragraph (6) above.(9) Programs that are located on the premises of a licensed nursing home, a licensed hospital, an assisted-care living facility, a licensed home for the aged or a licensed residential hospice or other programs in a multi-use facility shall have dedicated space that provides at least forty (40) square feet of indoor activity space per participant separate from other programs and activities in the building.(10) Involvement of adult day services center participants in other activities in the building with participants from other programs shall be on a planned basis, as a part of the adult day services program, and supervised by adult day services staff.(11) The center and any designated outdoor space shall be kept clean, safe and free from hazards and offensive odors.(12) Program Equipment. (a) Sufficient and appropriate seating space for all participants shall be provided.(b) Sufficient table or tray space for dining and activities shall be provided.(c) All equipment shall be safe and well maintained.(d) Space and equipment shall be arranged for ease of use, accessibility, and to minimize noise and distractions.(13) Safety Equipment. The following safety equipment shall be kept on site:
(a) A first aid kit that contains at least the following: sterile and adhesive bandages, antiseptics, sterile compresses, scissors, an oral or topical thermometer and adhesive tape;(g) Locked storage space for drugs. 1. If medicine requiring refrigeration is kept in a refrigerator used for food storage, the medicine shall be put in a leak proof locked container and be properly labeled.2. Keys for these storage containers shall be inaccessible to participants.(14) Toilet Facilities. (a) For the first fifteen (15) participants in the adult day services center, there shall be a minimum of two (2) toilets in the adult day services center, one (1) of which shall be wheelchair accessible. An additional toilet shall be available for each additional ten (10) participants.(b) Fifty percent (50%) of the toilets in the adult day services center shall be wheelchair accessible.(15) The heating/cooling system shall operate adequately to assure the comfort and safety of the participants.(16) The center shall have a working land line telephone.Tenn. Comp. R. & Regs. 1240-07-10-.10
Original rule filed December 14, 1999; effective 2/27/2000. Repeal and new rule filed February 23, 2018; effective 5/24/2018. Amendments filed October 25, 2022; effective 1/23/2023.Authority: T.C.A. §§ 4-5-201, et seq.; and 71-2-401, et seq.