A facility must provide an environment which protects the participants from physical harm but is not so restrictive as to inhibit physical, intellectual, emotional, or social stimulation.
(a) Safety, Health, and Comfort. - (i) No adult day care facility shall be located where conditions exist that would be hazardous to the physical health and safety of participants.
- (ii) Building Construction and Maintenance.
- (A) If space used or planned for use by the facility is renovated or altered, the plans shall be in strict compliance with the Americans with Disabilities Act Accessibility Guidelines (ADAAG) and shall be submitted for review to the State of Wyoming Department of Administration and Information, Central Services Division for review prior to the expected change.
- (B) Prior to becoming a provider and prior to use of newly constructed, renovated, remodeled, or altered buildings or sections of buildings, a facility shall provide written documentation of the following:
- (I) Inspection and approval of the building(s) from the local building official, if applicable, or approval of a plan of correction; OR
- (II) Inspection and approval of the building(s) from the Department of Fire Prevention and Electrical Safety, if applicable, or approval of a plan of correction; AND
- (III) Inspection and approval from the Division, or approval of a plan of correction related to:
- (1.) Sanitation and health;
- (3.) Sewerage system; and
- (IV) Inspection and approval from the local fire department that the facility is free from fire hazards, or approval of a plan of correction.
- (C) The buildings shall be free from safety hazards.
- (iii) Special Requirements for Nonambulatory or Physically Challenged Participants.
- (A) If the facility is providing for nonambulatory participants, at least one (1) entrance shall be readily accessible and useable by nonambulatory participants so that participants can evacuate safely and independently in the event of fire or emergency.
- (B) Before any participant who uses a wheelchair or a walker is accepted for care, doorways and passageways shall be wide enough to accommodate wheelchairs and walkers.
- (C) At least one (1) primary grade-level entrance to the building shall be freely accessible for wheelchairs.
- (iv) Grounds.
- (A) The grounds shall be well maintained and free from safety hazards.
- (B) An area shall be available, accessible, and useable for outdoor activities for all participants.
- (C) A safe area for discharge and pickup shall be available to accommodate daily arrival and departure of participants.
- (v) Sanitation.
- (A) Hot and cold water shall meet the requirements of the Uniform Building Code.
- (B) Private water systems shall be tested and found safe and potable.
- (C) The facility and all of its furnishings and equipment shall be clean and properly maintained.
- (D) The facility shall be free from insects, rodents, and other pests.
- (E) Adequate kitchen facilities and equipment shall be provided for preparation and serving of meals.
- (F) Sufficient working refrigeration shall be available to store perishable food and medicine. All refrigerators and freezers shall have a working thermometer. Freezers will be maintained at zero degrees (0°) Fahrenheit or less. Refrigerator temperature will be maintained at forty degrees (40°) Fahrenheit or less. Freezers and refrigerators shall be maintained, clean, and sanitized.
- (G) Food shall be properly stored, prepared, and served to prevent food-borne illness.
- (H) Drinking water shall be available to participants at all times.
- (I) Drinking fountains, if used, shall be of a type approved by the County Health Department.
- (J) Individual cups shall be provided for drinking water when fountains are not used.
- (K) If disposable dishes, cups, and/or utensils are used, they shall be sturdy enough to prevent them from being a safety hazard. They shall be used once and then discarded.
- (L) The kitchen and dining area shall be kept clean, sanitary, and provided with suitable furniture and adequate space to comfortably seat all residents.
- (M)
- (I) Only dishes and utensils with the original smooth finishes shall be used. Cracked, chipped, scratched, permanently stained dishes, cups or glasses, damaged, corroded utensils, or cookware shall not be used.
- (II) The cleaning and sanitizing of all items used in preparation and service of food shall comply with the State of Wyoming, Wyoming Food Service Regulations. Inspection of all items used for storage, preparation and service of foods may occur.
- (1.) For manual washing, rinsing and sanitizing of utensils and equipment, three compartments or containers shall be used. Each compartment shall be large enough to accommodate the utensils or equipment. The first compartment shall contain a hot detergent that is kept clean. The second compartment shall contain hot, clear rinse water. The third compartment shall contain an approved sanitizing solution. All utensils and equipment shall remain in the final sanitizing rinse for at least one minute. Dishes and equipment shall then be air dried. When chemicals are used for sanitizing, a test kit or other device that accurately measures the parts per million concentration of the sanitizer shall be provided and used.
- (2.) Cleaning and sanitizing of dishes and equipment may also be done by automatic dishwashers.
- (N) Persons handling soiled tableware and/or kitchenware shall wash their hands before handling clean ware.
- (O) No fly strips shall be allowed in the kitchen or dining area.
- (P) Filters, exhaust hoods, ranges, deep fat fryers, ovens and other similar items shall be operable and maintained clean.
- (Q) A fire extinguisher rated 2A-10B:C shall be available in the kitchen area.
- (vi) Lighting.
- (A) All areas of the facility shall be well lighted for the safety and comfort of the participants during all hours of operation according to the nature of activities. NOTE: Special lighting requirements relating to medications are under Section 12(h)(ii)(B) of these rules and regulations.
- (B) Artificial lighting shall be by electricity or battery.
- (C) Additional lighting, as necessary to provide and ensure presence of contrast, shall be available for immediate use in areas that may present safety hazards, such as but not limited to stairways, doorways, passageways, changes in floor level, kitchens, bathrooms, and basements.
- (D) Hallways, stairwells, foyers, doorways, and exits utilized by participants shall be kept well lighted at all times participants are present in the building(s). Whenever natural light is not sufficient, artificial lighting shall be used.
- (E) Glare shall be kept at a minimum in rooms used by participants.
- (I) When necessary to reduce glare, windows shall be equipped with shades, curtains or other coverings.
- (II) All lights, including fluorescent lights, shall be covered with shades or protective fixtures or specially equipped to reduce glare and ensure protection.
- (F) If used, fluorescent lights shall be replaced if they flicker or make noise.
- (G) All sources of light including windows, light fixtures, bulbs, etc., shall be kept clean.
- (vii) Temperature and Ventilation.
- (A) Areas used by participants shall be well ventilated to the outside and dry.
- (B) The temperature of the rooms used by participants shall be maintained at a level safe and suitable for elderly, disabled, and impaired adults:
- (I) The minimum inside temperature shall be sixty-eight degrees (68°) Fahrenheit.
- (II) Fans and/or air conditioners shall be available for use when the inside temperature exceeds eight-four degrees (84°) Fahrenheit.
- (III) Each adult day care facility shall have at least one (1) portable thermometer to assure correct temperature.
- (IV) Fans and air conditioners shall be placed to avoid direct drafts on participants and to avoid safety hazards.
- (viii) Equipment and Materials.
- (A) All furniture and equipment inside and outside the facility shall be maintained in good repair and in safe condition.
- (B) Cleaning products, pesticides, and all poisonous or harmful materials shall be stored separately from food and shall be kept in a locked place when not in use.
- (C) If elevators are used, the following requirements shall be met:
- (I) Elevators shall be kept in safe running condition;
- (II) Elevators shall have sturdy handrails installed;
- (III) Elevators shall be inspected at least annually by the insurance company, the local housing authority, or the elevator company;
- (IV) A copy of the elevator inspection report shall be retained by the facility; and
- (V) An alternative exit shall be accessible for use in case of a fire and/or other emergencies.
- (D) Sturdy handrails shall be installed at all stairs, ramps, and changes in floor levels.
- (E) All interior and exterior stairways and ramps shall have nonslip surfaces or carpet.
- (F) All interior and exterior stairways, changes of floor level, and ramps shall be indicated by a warning strip or contrast in color to aid the participants who have impaired vision.
- (G) Floors shall not be slippery. If rugs or floor coverings are used, they shall be secured to the floor.
- (H) Fireplaces shall be securely screened and glassed in. All fireplaces shall meet the Uniform Mechanical Code.
(b) Space, Furnishings, and Supplies. - (i) Activity Areas.
- (A) In addition to hallways, office space, bathrooms, storage space, or other rooms or areas that are not normally used for program activities, the facility shall provide at least forty (40) square feet of indoor floor space for each participant.
- (B) There shall be sufficient and suitable space that may be interchangeable or adaptable for a variety of planned program activities.
- (I) There shall be enough space for the participants to gather together for group activities.
- (II) There shall be rooms or areas appropriate for small group activities and individual activities.
- (C) Furnishings.
- (I) Furniture shall be sturdy, safe, and appropriate for elderly and impaired adults.
- (II) All facilities shall have:
- (1.) Table and chair space adequate for all participants, excluding people who remain in wheelchairs throughout the day, to take part in activities at the same time; and
- (2.) Recliners, lounge chairs, rockers, or other seating to allow participants to relax and rest.
- (ii) Private Space.
- (A) Space shall be available to allow total privacy for participants during interviews, visits, telephone conversations, counseling, therapy, and other similar activities.
- (iii) Toilet Rooms.
- (A) There shall be a minimum of one (1) toilet available for every eight (8) participants in attendance.
- (B) If eight (8) or fewer participants are in attendance, there shall be at least one toilet or toilet stall large enough to accommodate a participant who needs personal assistance or who uses a walker or wheelchair.
- (C) If more than eight (8) participants are in attendance:
- (I) There shall be separate bathrooms for men and women to allow for privacy; and
- (II) If the facility is providing for nonambulatory participants and the separate bathrooms are not accessible to nonambulatory participants, there shall be one (1) unisex bathroom that provides privacy and shall be on an accessible route and shall meet the lavatory facility requirements of 4.22 of the ADAAG.
- (D) In bathrooms equipped with more than one (1) toilet, each toilet shall be enclosed for privacy.
- (E) Sturdy grab bars or safety frames shall be installed adjacent to all toilets used by participants.
- (F) There shall be a minimum of one (1) sink for every two (2) toilets located close enough together to ensure washing of hands after each toileting procedure.
- (G) There shall be an adequate supply of toilet tissue, soap, and disposable hand towels in each bathroom at all times.
- (H) Housekeeping practices and procedures shall be employed to keep the facility free from offensive odors, accumulations of dirt, and dust.
- (I) Floors shall be maintained clean.
- (iv) Dining Area.
- (A) The dining area shall be large enough to provide sufficient table space and chair access to accommodate the participants.
- (B) If the facility is providing for nonambulatory participants, the dining area shall be large enough to provide sufficient table space and floor space to accommodate participants in wheelchairs.
- (v) Storage.
- (A) Sufficient space shall be provided for coats, sweaters, umbrellas, toilet articles, and similar personal possessions of participants and staff.
- (B) Sufficient space shall be available for equipment, materials, and supplies used in the program.
- (vi) Telephones.
- (A) At least one (1) private, nonpaying, wheelchair-accessible telephone shall be provided in each building.
- (B) If the facility is providing for nonambulatory participants, the telephone shall be easily accessible and shall meet the telephone accessibility requirements of 4.31 of the ADAAG.
- (C) If the facility is providing for hearing impaired participants, at least one hearing aid compatible and volume control telephone shall be provided. Telephones shall comply with telephone-accessibility requirements 4.31 of the ADAAG.
- (vii) Rest Area.
- (A) A rest area shall be available for participants who become ill, need to rest, or need to have privacy.
- (I) The rest area shall be equipped with at least one (1) bed or comfortable cot for every eight (8) participants. EXCEPTION: In facilities that are open for evening care, beds shall be available for participants as necessary.
- (II) Additional beds or comfortable cots shall be available to accommodate all participants who are scheduled for rest periods.
- (III) A minimum of one (1) pillow covered with a pillow case, two (2) sheets, and one (1) blanket, spread, or covering per bed or cot shall be provided.
- (IV) Additional covering or blankets and pillows shall be added as required.
- (V) All sheets and pillow cases shall be laundered before being used by another person.
- (VI) All blankets, spreads, and coverings shall be laundered or dry cleaned, as needed.
048-7 Wyo. Code R. § 7-11