Designing an Adult Day Center

adult day care

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Adult Day Care is becoming increasingly important as people choose to age in place and age in the community. Yet the industry is not taking off as you would expect. There are many reasons. But you first need to start with a top-notch facility. In our continuing series on adult day services, we examine adult day services design, environment, and safety.

Design Considerations

  • The facility must comply with applicable state and local building regulations, zoning, fire and health codes or ordinances.
  • It must be accessible and functional in accordance with the Americans with Disabilities Act.
  • Each physical location must develop, maintain, update and enforce an emergency plan for the protection of all persons in the event of an emergency.
  • The facility must have a minimum of one toilet per ten participants in an accessible bathroom. Each bathroom must be equipped with a sink, grab bars and call system appropriate to the population served.
  • There must be a minimum of 60 square feet of common floor space per participant. ADS programs serving participants, of which 25 percent or more are cognitively impaired or require the use of adaptive equipment, must provide at least 80 square feet of common floor space per participant.
  • The physical building, premises, and equipment must be maintained in a clean and sanitary condition, free of hazards and in good repair.
  • Outside space that is used for outdoor activities must be safe, accessible to indoor areas and accessible to those with a disability.
  • Heating, cooling, ventilation, and lighting must be appropriate for the age and physical condition of the participants to provide for their health and safety.
  • Flooring must be easily cleaned and made of a non-skid material. Stairways must have handrails and the stairs must be covered with nonskid material.
  • There must be sufficient private space for the provision of confidential staff consultation with the participant, and nursing or therapy services if provided.
  • There must be provisions for the participant to rest.
  • There must be an accessible telephone available for use by participants.
  • Storage space must be provided for files, records, recreational and cleaning supplies.
  • Sufficient furniture for the entire participant population must be of a sturdy construction that will not easily tip over or move when used for seating or support while walking.
  • Safe drinking water must be readily available to participants at all times, as well as a supply of safe drinking water as part of the program’s emergency disaster plan.
  • ADS programs that dispense medications must designate a secured area for storing labeled medication away from the participant activity area. Each ADS program must have a written policy for medication management and must designate which staff are trained and authorized to administer medications.

Safe and Sanitary Environment

With the growing need for these services, it is not uncommon for ADS centers to take care of 50-75 people at a time. All facilities serving 16 or more persons must meet the minimum requirements as outlined in the DHS, Public Health Division’s Food Sanitation Rules. Facilities serving 15 or fewer persons or a facility that purchases meals from an outside meal source or prepare meals must meet the minimum requirements of the Food Sanitation Rules relating to the preparation, storage, and serving of food.

Garbage and refuse containers must be insect-proof, rodent-proof, leak-proof and nonabsorbent.

The facility must be kept clean, safe and in good repair. In facilities serving 16 or more persons, a utility sink must be provided.

Local health department standards must be met regarding communicable diseases.

Written procedures for the safe handling of soiled items minimizing the potential for the spread of communicable diseases must be established.

Emergency Standards

ADS programs must adopt and implement emergency policies and procedures and the plan must be posted and provide the locations of fire extinguishers and exit routes.

Written protocol regarding sick or injured participants must be developed and given to participants, family and care providers upon admission.

Emergency first aid kits must be visible and accessible to staff. Personnel trained in first aid and CPR must be on duty whenever participants are present.

At least two well-identified exits must be available.

State requirements for certification and licensing may vary but these comprehensive standards from Oregon can act as a guide for those considering the development of adult day services.

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Article Sources

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  • DHHS, State of Oregon