Key Concepts: Physical Environment

21 key concepts from Title 22, Division 6, Chapter 8, Article 5: Physical Environment, for the RCFE Administrator exam. For the searchable, bookmarkable version, use the interactive Study Guide.

Basic Maintenance & Cleanliness Duties
87303 p. 73
The facility has to be clean, safe, sanitary, and in good repair at all times, with maintenance services/procedures in place for the safety and well-being of residents, employees, and visitors. Floor surfaces in bath, laundry, and kitchen areas specifically have to stay clean, sanitary, and odorless.
Show Title 22 source text
(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.Part 1, Page 73
(1) Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition.Part 1, Page 73
Temperature Control, Beyond the Minimums
87303 p. 73
A comfortable temperature has to be maintained at all times; the specific heating/cooling minimums are covered in the Numbers & Deadlines "Room Temperature Standards" card. One thing not in that card: nothing in this section stops residents from adjusting their own individual thermostat controls.
Show Title 22 source text
(b) A comfortable temperature for residents shall be maintained at all times.Part 1, Page 73
(1) The facility shall heat rooms that residents occupy to a minimum of 68 degree F, (20 degrees C).Part 1, Page 73
(2) The facility shall cool rooms to a comfortable range, between 78 degrees F (26 degrees C) and 85 degrees F (30 degrees C), or in areas of extreme heat to 30 degrees F less than the outside temperature.Part 1, Page 73
(3) Nothing in this section shall prohibit residents from adjusting individual thermostatic controls.Part 1, Page 73
Screens & Lighting
87303 p. 73
Window screens have to be kept clean and in good repair. And every room needs lamps or lighting appropriate to its use, and sufficient for the comfort and safety of everyone in the facility.
Show Title 22 source text
(c) All window screens shall be clean and maintained in good repair.Part 1, Page 73
(d) There shall be lamps or light appropriate for the use of each room and sufficient to ensure the comfort and safety of all persons in the facility.Part 1, Page 73
Private Water Source: Initial Safety Testing
87303 p. 73
For facilities on a private water source, before initial licensure the facility has to provide evidence of an on-site inspection of the water source and a bacteriological analysis (from a local/state health department or a qualified public/private lab) confirming the water is safe. (The ongoing testing schedule after that initial test is covered in the next card.)
Show Title 22 source text
(e) Water supplies and plumbing fixtures shall be maintained as follows:Part 1, Page 73
(1) All residential care facilities for the elderly where water for human consumption is from a private source shall:Part 1, Page 73
(A) As a condition of initial licensure, provide evidence of an on-site inspection of the source of the water and a bacteriological analysis by a local or state health department or other qualified public or private laboratory which establishes the safety of the water.Part 1, Page 73
Private Water Source: Ongoing Testing Schedule
87303 p. 73-74
After that initial test, the facility has to keep testing the private water supply as often as needed to protect residents, but no less often than this schedule (facilities with 6 or fewer residents don't need a follow-up test unless there's a specific reason to think one's needed):
Licensed CapacityTesting Schedule
Under 6Initial test, then only if there's reason to suspect a problem
7-15Initial test, then annually
16-24Initial test, then every 6 months
25+Follow county health department rules (Safe Drinking Water Act)
Show Title 22 source text
(B) Following licensure, provide a bacteriological analysis of the private water supply as frequently as is necessary to assure the safety of the residents, but no less frequently than the time intervals shown in the table below. However, facilities licensed for six or fewer residents shall be required to have a bacteriological analysis subsequent to initial licensure only if evidence supports the need for such an analysis to protect residents.Part 1, Page 73
Under 6 -- Initial Licensing -- Upon evidence of need / 7 through 15 -- Initial Licensing -- Annually / 16 through 24 -- Initial Licensing -- Every six months / 25 or more -- Refer to the county health department for compliance with the California Safe Drinking Water Act, Health and Safety Code, Division 5, Part 1, Chapter 7, Water and Water Systems.Part 1, Page 74
Hot Water Temperature Rules
87303 p. 74
Faucets residents use for personal care (shaving, grooming) have to deliver hot water, automatically regulated to stay between 105°F and 120°F. Any tap that can reach 125°F or hotter has to have a warning sign posted.
Show Title 22 source text
(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C).Part 1, Page 74
(3) Taps delivering water at 125 degree F (52 degree C) or above shall be prominently identified by warning signs.Part 1, Page 74
Bathroom Safety Features
87303 p. 74
Beyond water temperature, bathroom fixtures need specific safety features: grab bars at every toilet, bathtub, and shower used by residents; slip-resistant mats/strips/flooring in every bathtub and shower (kept in good repair and actually slip-resistant); and toilets, sinks, and bathing facilities kept in working order, with additional equipment provided as needed for physically handicapped or nonambulatory residents.
Show Title 22 source text
(4) Grab bars shall be maintained for each toilet; bathtub and shower used by residents.Part 1, Page 74
(5) Slip-resistant mats, strips, or flooring shall be used in all bathtub and shower floors. (A) All slip-resistant mats, strips, or flooring shall be in good repair and maintain slip-resistant properties.Part 1, Page 74
(6) Toilet, handwashing and bathing facilities shall be maintained in operating condition. Additional equipment shall be provided in facilities accommodating physically handicapped and/or nonambulatory residents, based on the residents' needs.Part 1, Page 74
Waste Disposal & Sharps Handling
87303 p. 74
Waste has to be located, stored, and disposed of in a way that won't spread disease or odors, create a health/safety risk, or attract insects/rodents. Specifically: waste containers have to stay in good repair, leak-free, and get emptied promptly, and syringes/needles have to be disposed of under Cal/OSHA's bloodborne-pathogens standard (Title 8, 5193).
Show Title 22 source text
(f) All waste shall be located, stored, and disposed of in a manner that will not transmit communicable diseases or odors, pose a risk to health and safety, or provide a breeding place or food source for insects or rodents.Part 1, Page 74
(1) All containers storing waste shall be in good repair, free of leaks, and emptied in a timely manner.Part 1, Page 74
(2) Syringes and needles are disposed of in accordance with the California Code of Regulations, Title 8, Section 5193 concerning blood borne pathogens.Part 1, Page 74
Outdoor Waste Container Access
87303 p. 75
Outdoor waste containers (garbage receptacles, dumpsters) have to provide enough access and drainage to allow the storage area to be completely cleaned.
Show Title 22 source text
(3) All outdoor containers, such as garbage receptacles or dumpsters, shall provide suitable access and drainage to allow complete cleaning at the storage area.Part 1, Page 75
In-House Laundry Requirements
87303 p. 75
Facilities that do their own laundry (with machines on-site) have specific requirements:
  • Adequate supplies and well-maintained equipment; a separate space for sorting soiled linen from clean linen storage/handling. Facilities over 15 residents can't use the laundry space for anything besides laundry-related storage. Steam, odors, lint, and laundry noise can't reach resident or employee areas.
  • At least one machine available for residents who are able and want to do their own personal laundry (kept in good repair) plus ironing equipment for residents who want to iron their own clothes.
Show Title 22 source text
(g) Facilities which have machines and do their own laundry shall: (1) Have adequate supplies available and equipment maintained in good repair. Space used to sort soiled linen shall be separate from the clean linen storage and handling area. Except for facilities licensed for fifteen (15) residents or less, the space used to do laundry shall not be part of an area used for storage of anything other than clean linens and/or other supplies normally associated with laundry activities. Steam, odors, lint and objectionable laundry noises shall not reach resident or employee areas.Part 1, Page 75
(2) Make at least one machine available for use by residents who are able and who desire to do their own personal laundry. This machine shall be maintained in good repair. Equipment in good repair shall be provided to residents who are capable and desire to iron their own clothes.Part 1, Page 75
Emergency Lighting & Signal Systems
87303 p. 76
Every facility needs working emergency lighting: at minimum, flashlights or other battery-powered lighting readily available where residents and staff can reach them. Open-flame lighting isn't allowed.

Facilities licensed for 16+ residents (and any facility with separate floors/buildings) also need a signal system that: works from each resident's living unit, sends a visual/auditory alert to a staffed central location (or is loud enough at the unit itself to summon staff), and identifies which specific unit triggered it. Facilities with multiple wings/floors/buildings can use a separate system in each, as long as each one meets those same requirements.
Show Title 22 source text
(h) Emergency lighting shall be maintained. At a minimum this shall include flashlights, or other battery powered lighting, readily available in appropriate areas accessible to residents and staff. Open-flame lights shall not be used.Part 1, Page 76
(i) Facilities shall have signal systems which shall meet the following criteria: (1) All facilities licensed for 16 or more and all residential facilities having separate floors or buildings shall have a signal system which shall: (A) Operate from each resident's living unit. (B) Transmit a visual and/or auditory signal to a central staffed location or produce an auditory signal at the living unit loud enough to summon staff. (C) Identify the specific resident living unit.Part 1, Page 76
(2) Facilities having more than one wing, floor or building shall be permitted to have a separate system in each, provided each meets the above criteria.Part 1, Page 76
Building Permits for Construction or Alterations
87305 p. 76
Before any construction or alterations, a facility has to get a building permit. And separately, if the licensing agency suspects a health/safety hazard, it can require the facility to get a local building inspection.
Show Title 22 source text
(a) Prior to construction or alterations, all facilities shall obtain a building permit.Part 1, Page 76
(b) The licensing agency may require the facility to acquire a local building inspection where the agency determines that a suspected hazard to health and safety exists.Part 1, Page 76
Common Rooms & Bedroom Basics
87307 p. 77
Living accommodations and grounds have to match the facility's function, big enough for comfortable living and privacy for everyone who lives or works there. That includes:
  • Common rooms (living room, dining room, den, or other recreation/activity rooms) big enough (or separated enough) to support the activity program without interfering with other facility functions.
  • Bedrooms that are large enough for residents to move comfortably between beds/furniture/mobility devices; that were never intended for another use (no halls, stairways, unfinished attics, garages, sheds, or similar); that aren't used as a passageway to another room/bath/toilet; and that house no more than 2 residents each.
Show Title 22 source text
(a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply:Part 1, Page 77
(1) There shall be common rooms such as living rooms, dining rooms, dens or other recreation/activity rooms. They shall be of sufficient space and/or separation to promote and facilitate the program of activities and to prevent such activities from interfering with other functions.Part 1, Page 77
(2) Resident bedrooms shall be provided which meet, at a minimum, the following requirements: (A) Bedrooms shall be large enough to allow for easy passage between and comfortable usage of beds and other required items of furniture specified below, and any resident assistant devices such as wheelchairs or walkers. (B) No room commonly used for other purposes shall be used as a sleeping room for any resident. This includes any hall, stairway, unfinished attic, garage storage area, shed or similar detached building. (C) No bedroom of a resident shall be used as a passageway to another room, bath or toilet. (D) Not more than two residents shall sleep in a bedroom.Part 1, Page 77
What Every Resident's Room Needs
87307 p. 77-78
Each resident needs certain basic equipment/supplies for personal care and hygiene; the resident can provide these themselves, but if they can't or don't, the licensee has to make sure they're available:
  • A bed (married couples can share one appropriately sized bed) with good springs, a clean/comfortable mattress, pillow(s), and lightweight warm bedding, with flame-retardant mattress/pillow fillings and covers, and rubber sheeting when needed.
  • Bedroom furniture: a chair, night stand, a lamp or sufficient reading light, and a chest of drawers.
  • Clean linens (blankets, bedspreads, sheets, pillowcases, mattress pads, towels, washcloths), changed at least weekly (more often if needed), kept in good repair, with shared washcloths/towels prohibited.
  • General hygiene items like soap and toilet paper.
  • Closet and drawer space for clothing/belongings: at least 8 cubic feet of drawer space per resident.
  • Basic laundry service: washing, drying, and ironing of personal clothing.
Show Title 22 source text
(3) Equipment and supplies necessary for personal care and maintenance of adequate hygiene practice shall be readily available to each resident. The resident may provide the following items; however, if the resident is unable or chooses not to provide them, the licensee shall assure provision of: (A) A bed for each resident, except that married couples may be provided with one appropriate sized bed. Each bed shall be equipped with good springs, a clean and comfortable mattress, available pillow(s) and lightweight warm bedding. Fillings and covers for mattresses and pillows shall be flame retardant. Rubber sheeting shall be provided when necessary.Part 1, Page 77
(B) Bedroom furniture, which shall include, for each resident, a chair, night stand, a lamp, or lights sufficient for reading, and a chest of drawers.Part 1, Page 77
(C) Clean linen, including blankets, bedspreads, top bed sheets, bottom bed sheets, pillow cases, mattress pads, bath towels, hand towels and wash cloths. The quantity shall be sufficient to permit changing at least once per week or more often when indicated to ensure that clean linen is in use by residents at all times. The linen shall be in good repair. The use of common wash cloths and towels shall be prohibited.Part 1, Page 77
(D) Hygiene items of general use such as soap and toilet paper.Part 1, Page 78
(E) Portable or permanent closets and drawer space in the bedrooms for clothing and personal belongings. A minimum of eight (8) cubic feet (.743 cubic meters) of drawer space per resident shall be provided.Part 1, Page 78
(F) Basic laundry service (washing, drying, and ironing of personal clothing).Part 1, Page 78
Toilet & Bathing Ratios, and Privacy
87307 p. 78
Toilets and bathrooms have to be conveniently located, with licensed capacity tying into these ratios: at least 1 toilet/washbasin per 6 people (residents+family+staff), and at least 1 bathtub/shower per 10 people (residents+family+live-in staff). Whatever the ratio, every toilet/bath/shower area has to provide individual privacy.
Show Title 22 source text
(b) Toilets and bathrooms shall be conveniently located. The licensed capacity shall be established based on Section 87158, Capacity, and the following: (1) At least one toilet and washbasin for each six (6) persons, which include residents, family and personnel. (2) At least one bathtub or shower for each ten (10) persons, which includes residents, family and live-in personnel.Part 1, Page 78
(c) Individual privacy shall be provided in all toilet, bath and shower areas.Part 1, Page 78
General Space & Hazard-Prevention Rules
87307 p. 78
A handful of baseline space and safety provisions apply to every facility:
  • Enough room for residents to be accommodated in comfort and safety.
  • The premises kept in good repair, providing a safe and healthful environment.
  • Hazard protection (like nonslip material on rugs) plus information/instruction on life protection and related safety topics.
  • Stairways, inclines, ramps, and open porches (hazard areas for residents with poor balance or eyesight) made inaccessible unless they have sturdy handrails and good lighting.
  • Night lights kept on in hallways and passages leading to nonprivate bathrooms.
  • All indoor and outdoor passageways and stairways kept free of obstructions.
Show Title 22 source text
(d) The following space and safety provisions shall apply to all facilities: (1) Sufficient room shall be available to accommodate persons served in comfort and safety. (2) The premises shall be maintained in a state of good repair and shall provide a safe and healthful environment.Part 1, Page 78
(3) All persons shall be protected against hazards within the facility through provision of the following: (A) Protective devices such as nonslip material on rugs. (B) Information and instruction regarding life protection and other appropriate subjects.Part 1, Page 78
(4) Stairways, inclines, ramps and open porches and areas of potential hazard to residents with poor balance or eyesight shall be made inaccessible to residents unless equipped with sturdy hand railings and unless well-lighted.Part 1, Page 78
(5) Night lights shall be maintained in hallways and passages to nonprivate bathrooms.Part 1, Page 78
(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction.Part 1, Page 78
Supervision Near Hazards: Heat Sources & Water Features
87307 p. 79
The licensee has to supervise residents around certain hazards, based on what the resident's pre-admission appraisal or reappraisal says they need:
  • Heating devices (ranges, ovens, heaters, fireplaces, wood stoves, etc.), which need protective mechanisms or other measures to prevent access, or to make them inoperable when not in use, to reduce burn/fire risk.
  • Larger bodies of water (fishponds, wading pools, hot tubs, swimming pools), which have to be made inaccessible (fencing, covering, etc.) when not actively in use by residents.
  • Smaller decorative water features too, like birdbaths and fountains; supervision here is also based on the resident's appraisal.
Show Title 22 source text
(e) The licensee shall supervise residents as needed and as determined by the resident's appraisal pursuant to Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, when residents are in proximity to or when there is use of the following items: (1) Ranges, ovens, heaters, fireplaces, wood stoves, inserts, and other heating devices. (A) Heating devices shall have protective mechanisms or other measures to prevent access to the device, or to make it inoperable when not in use, in order to reduce the risk of burns or fire.Part 1, Page 79
(2) Fishponds, wading pools, hot tubs, swimming pools, or similar larger bodies of water. (A) The licensee shall ensure that the bodies of water specified above are inaccessible through fencing, covering, or other means when not in active use by residents.Part 1, Page 79
(f) The licensee shall supervise residents as needed and as determined by the resident's appraisal, pursuant to Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, when residents are in proximity to birdbaths, fountains, or similar smaller decorative water features.Part 1, Page 79
Administrative Office Requirement
87308 p. 79
Facilities licensed for 16 or more residents have to maintain an administrative office/area (covering business, administration, and admission activities) plus a reception area and restroom facilities visitors can use. Appropriate equipment (including a phone) has to be available, and a private office has to be maintained for the administrator or other professional staff as appropriate.
Show Title 22 source text
(b) Administrative offices or area shall be maintained in facilities having a capacity of sixteen (16) persons or more, which includes space for business, administration and admission activities, a reception area and restroom facilities which may be used by visitors. Appropriate equipment shall be available, including a telephone. A private office shall be maintained for the administrator or other professional staff as appropriate.Part 1, Page 79
Locked Storage for Dangerous Items
87309 p. 80
Certain dangerous items (disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and similar hazards) have to be kept in locked storage and never left unattended outside that storage. Disinfectants/cleaning solutions/poisons specifically have to be stored separate from food supplies. And if any of these items get moved to a different container, that container needs a legible label showing the product name and any warnings from the original label.

Residents can still have personal access to these items, unless documentation (from their appraisal/reappraisal) shows that access would put their safety, or another resident's safety, at risk. Even when access is allowed, the licensee still has to take reasonable steps to make sure that access doesn't create a hazard for other residents.
Show Title 22 source text
(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. (1) Disinfectants, cleaning solutions, and poisonous substances shall be stored in areas separate from food supplies as specified in Section 87555, General Food Service Requirements. (2) Any items in subsection (a)(1) that are transferred from their original container to another container shall have a legible label that indicates: (A) Name of product on the original container, and (B) Any product warnings indicated on the original label.Part 1, Page 80
(b) Residents may have access to items specified in subsection (a) for personal use unless there is documentation, as specified in Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, that indicates the resident's or other residents' safety would be at risk if allowed access. (1) The licensee shall implement reasonable interventions in order to ensure that access to the items specified in subsection (a) does not pose a hazard to other residents.Part 1, Page 80
Storing Other Potentially Toxic Items
87309 p. 80
A parallel rule applies to a broader category: nutritional supplements, vitamins, alcohol, cigarettes, and other potentially toxic substances (like certain plants, gardening supplies, and auto supplies), the licensee has to take reasonable steps to store these so they don't pose a hazard to residents.

Same access exception applies: residents can access these for personal use unless documentation shows a safety risk, with the same duty to prevent hazards to other residents.

Two more notes: centrally-stored medications follow the separate storage rules in 87465, and depending on the facility's physical layout or other residents' conditions/habits, the licensee can require the items covered by (a) and (c) to be centrally stored to avoid creating a hazard for others.
Show Title 22 source text
(c) Except as specified in subsection (d), the licensee shall implement reasonable interventions in order to ensure that nutritional supplements, vitamins, alcohol, cigarettes and other potentially toxic substances, such as certain plants, gardening supplies, and auto supplies, are stored so as not to pose a hazard to residents.Part 1, Page 80
(d) Residents may have access to items specified in subsection (c) for personal use unless there is documentation as specified in Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, that indicates the resident's or other residents' safety would be at risk if allowed access. (1) The licensee shall implement reasonable interventions in order to ensure that access to the items specified in subsection (c) does not pose a hazard to other residents.Part 1, Page 80
(e) Medications that are centrally stored shall be stored as specified in Section 87465, Incidental Medical and Dental Care Services.Part 1, Page 80
(f) Due to the physical arrangements in the facility, or the condition or the habits of other residents in the facility, or both, the licensee may require the items specified in subsections (a) and (c) to be centrally stored so as not to pose a safety hazard to others.Part 1, Page 80
Phones & Vehicles
87311 / 87312 p. 80.1
Every facility needs phone service on the premises (facilities with 16+ residents also have to be listed in the phone directory under the facility's name, same as the Numbers & Deadlines "Phone Directory Listing" card).

Separately, if the facility transports residents: only drivers licensed for that type of vehicle can do it, the vehicle's rated seating capacity can't be exceeded, and any vehicle used has to be kept in safe operating condition.
Show Title 22 source text
All facilities shall have telephone service on the premises. Facilities with a capacity of sixteen (16) or more persons shall be listed in the telephone directory under the name of the facility.Part 1, Page 80.1
Only drivers licensed for the type of vehicle operated shall be permitted to transport residents. The rated seating capacity of the vehicles shall not be exceeded. Any vehicle used by the facility to transport residents shall be maintained in a safe operating condition.Part 1, Page 80.1