Environmental Standards for All Site Based Services

(1) All sites where residential supports, 24 hour site based respite supports, employment supports and day supports are provided must meet all applicable building, sanitary, health, safety, and zoning requirements. (2) The environmental requirements 115 CMR of 7.07(3) through (8) shall apply to sites where residential supports, 24 hour site based respite supports, employment supports and day supports are provided, unless supports and services are provided in the home of the family of the individual. (3) All providers must assure that the sites where supports and services are provided are clean, environmentally safe, free of vermin and obvious fire and chemical hazards, maintained in accordance with common fire safety practices, and of sufficient size to accommodate comfortably the number of individuals and staff it serves. Any objects or conditions that represent a fire hazard greater than that which could be expected of ordinary household furnishings shall not be permitted. (4) All providers must assure that the sites used by persons with substantial mobility impairment are barrier-free to the extent necessary to permit access to the supports, services, personal, and common areas. A location shall be deemed to be barrier-free, in whole or part, if it meets the applicable standards of 521 CMR: Architectural Access Board as adopted by 780 CMR: Board of Building Regulations and Standards. (5) The following environmental requirements shall apply to sites owned or leased by providers of residential supports, individualized home supports and 24 hour site based respite supports, and the homes of care providers. (a) The site shall include complete living accommodations, including its own kitchen, living room, dining area, bedrooms, and bathrooms of typical residential design. The site shall provide for group and individual needs, including opportunities for privacyin clearly defined living, sleeping, and personal care spaces and areas that are accessible and available according to individual needs to enable personal development, the development of personal relationships, and engagement in leisure activities. (b) The site shall provide physical comfort as well as a pleasing style of decor and an external appearance that is typical of other homes in the vicinity, except for accommodations that enhance accessibility for individuals. (c) The layout of rooms shall permit ready access to common areas, with no intrusion into private bedroom areas. (d) The site shall provide conveniently located common storage adequate for a reasonable amount of individual and group possessions. (e) Major environmental controls, including those for lighting, appliances, plumbing, windows, and shades shall be operable by and accessible to individuals. (f) Heating and plumbing systems shall be installed and maintained for safe, healthy, and comfortable use by the individuals supported by the provider. (g) Heating and ventilation systems shall be adequate to maintain comfortable levels throughout the year. (h) All substances that are potentially dangerous in nature shall be stored separately from food and in containers which are accurately labeled. No flammable liquids, such as gasoline, shall be stored in the site or in spaces attached to the site. (i) Lighting shall be adequate to meet the individual and group needs of the residents and shall be provided in all major interior spaces, including walk-in closets and mechanical and storage rooms. (j) Each individual shall be provided with bedroom space adequate for sleeping, dressing, attending to personal appearance and needs, and caring for his or her personal possessions. The bedroom shall be of sufficient size to comfortably accommodate a bed, dresser, closet space, and adaptive equipment if required, and to allow for an individual's privacy and activities. (6) The following environmental requirements shall apply to sites owned, rented or leased by providers of residential supports, care providers, and providers of 24 hour site based respite support: (a) The bedroom size shall be no less than 90 to 100 square feet for a single bedroom and 130 to 144 square feet for a double bedroom. (b) The bedroom shall be occupied by one individual; provided, however, two individuals may share one bedroom if the two individuals, or their guardians if applicable, consent to the sharing of the bedroom. (c) Existing sites serving five individuals as of July 15, 2016 must have at least 1½ bathrooms. Any newly developed sites serving five individuals must have two bathrooms. (7) The following environmental requirements shall apply to sites owned or leased by providers of residential supports, care providers, providers of employment supports, day supports, and providers of 24 hour site based respite supports. (a) All sites shall have two means of egress from floors at grade level; all other floors above grade level shall have one means of egress and one escape route serving each floor and leading to grade. This requirement shall not apply to employment supports or day supports when the second floor is used on an intermittent basis only. Any proven usable path to the open air outside at grade shall be deemed acceptable as an escape route, including but not limited to connecting doors, porches, windows within six feet of grade, ramps, fire escapes, and balcony evacuation systems. Double cylinder dead bolt locks that require key operation from within are prohibited on egress doors. (b) All sites providing residential supports shall have a fire extinguisher that is operable and that is located in the kitchen. (c) All sites shall have smoke detectors as required by 780 CMR: Board of Building Regulations and Standards. If more than one detector is required per site, each detector shall be interconnected so as to activate all other detectors. (d) All sites shall have carbon monoxide detectors as required by 780 CMR: Board of Building Regulations and Standards. (e) All vertical chutes (e.g., laundry chutes, dumbwaiters, heating plenums) shall be sealed with gypsum board or some other fire retardant material. (f) Bedroom doors are lockable unless clinically contraindicated or unless an individual, or his or her guardian, if applicable, chooses a bedroom with access to egress and consents to the bedroom door not having any lock. (g) Locks on bedroom doors which do not provide access to an egress shall be permitted only in accordance with the following: 1. The head of the provider has documentation that the lock may be easily opened from the inside without a key and that the individual is able to unlock the door from the inside; and 2. At all times staff carry a key or have immediate access to a key to open the door in the event of an emergency. (h) Bedrooms of individuals requiring hands-on physical assistance to evacuate or who have a mobility impairment, including individuals who use a wheelchair, shall be on a floor at grade or on a floor with a "horizontal exit," in accordance with 780 CMR: Board of State Building Regulations and Standards. (i) Smoking shall be permitted only under the following conditions: 1. Staff may not smoke in the homes of individuals. 2. Smoking shall be prohibited in bedrooms and at sites where employment supports or day supports are provided. 3. Ashtrays of non-combustible material and safe design shall be provided in all areas where smoking is permitted. (8) A provider shall not deviate in any respect from the foregoing environmental requirements of 115 CMR 7.07(7) as they apply to that provider, unless the provider demonstrates that the safety needs of individuals are otherwise adequately addressed and has received approval from the area director within its safety plan as required by 115 CMR 7.06. However, providers of 24 hour site-based respite may not deviate from any of the environmental requirements of 115 CMR 7.07(7) under any circumstances.