WAC 248-29-001 - PURPOSE.

Regulations relating to childbirth centers are hereby adopted pursuant to chapter 18.46 RCW. The purpose of these regulations is to provide health and safety standards for the organization, maintenance and operation of childbirth centers and to set forth procedures for the issuance, denial, suspension and/or revocation of licenses for facilities maintained and operated to provide birth services: PROVIDED, That birth takes place within the birth center.

WAC 248-29-010 - DEFINITIONS.

(1) "Administration of drugs" means an act in which a single dose of a prescribed drug or biological is given to a client by an authorized person in accordance with all laws and regulations governing such acts. The complete act of administration entails removing an individual dose from a previously dispensed, properly labeled container (including a unit dose container) verifying it with the orders of a practitioner who is legally authorized to prescribe, giving the individual dose to the proper client and properly recording the time and dose given.

(2) "Authenticated or authentication" means authorization of a written entry in a record by means of a signature which shall include, minimally, first initial, last name, and title.

(3) "Bathing facility" means a bathtub or shower.

(4) "Birth center or childbirth center" means a type of maternity home which is a house, building, or equivalent, organized to provide facilities and staff to support a birth service provided that the birth service includes or is limited to low risk maternal clients during the intrapartum period.

(5) "Birthing room" means a room designed, equipped, and arranged to provide for the care of a woman and newborn and to accommodate her support person(s) during the process of vaginal childbirth, (the three stages of labor and recovery of a woman and newborn).

(6) "Birth service" means the prenatal, intrapartum, and postpartum care provided for individuals with uncomplicated pregnancy, labor, and vaginal birth, to include the newborn care during the recovery period.

(7) "Board" means the Washington state board of health.

(8) "Client" means a woman, fetus, and/or newborn receiving care and services provided by a birth center during pregnancy and/or childbirth and recovery.

(9) "Clinical staff" means physicians and midwives appointed by the governing body authority to practice within the birth center and governed by rules approved by the governing body.

(10) "Department" means the Washington state department. of social and, health services.

(11) "Governing body" means the individual or group which is legally responsible for the operation and maintenance of the childbirth center.

(12) "Hospital" means any institution, place, building, or agency which provides accommodations, facilities, and services over a continuous period of twenty-four hours or more, for observation, diagnosis, or care, of two or more individuals not related to the operator or suffering from any other condition which obstetrical, medical, or surgical services would be appropriate for care or diagnosis. "Hospital" as used in this definition does not include hotels, or similar places furnishing only food and lodging, or simply, domiciliary care; nor does it include clinics, physicians' offices where patients are not regularly kept as bed patients for twenty-four hours or more; nor does it include nursing homes, as defined and which comes under the scope of chapter 18.51 RCW; nor does it include maternity homes, which come within the scope of chapter 18.46 RCW; nor does it include psychiatric hospitals, which come under the scope of chapter 71.12 RCW; nor any other hospital or institution specifically intended for use and the diagnosis and care of those suffering from mental illness, metal retardation, convulsive disorders, or other abnormal mental conditions. Furthermore, nothing in this definition shall be construed as authorizing the supervision, regulation, or control of the remedial care or treatment of residents or patients in any hospital conducted for those who rely primarily upon treatment by prayer or spiritual means in accordance with creed or tenets of any well recognized church or religious denomination.

(13) "Lavatory" means a plumbing fixture designed and equipped for handwashing purposes.

(14) "Low-risk maternal client" means an individual who:

(a) Is in general good health with uncomplicated prenatal course, and participating in ongoing prenatal care;

(b) Is participating in an appropriate education program;

(c) Has no major medical problems;

(d) Has no previous significant obstetrical complications likely to recur, nor previous uterine wall surgery or Cesarean section;

(e) Has parity under six unless a justification for a variation is documented by clinical staff;

(f) Is not a nullipara of greater than thirty-six years of age;

(g) Is not less than sixteen years of age;

(h) Has no significant signs or symptoms of hypertension, toxemia, hydramnios, abruptio placenta, chorioamnionitis, malformed fetus, multiple gestation, intrauterine growth retardation, fetal meconium, fetal distress, alcoholism or drug addiction;

(i) While in active labor, demonstrates no significant signs or symptoms of anemia, active herpes genitalis, significant hypertension, placenta praevia, malpositioned fetus, breech;

(j) Is in labor, progressing normally;

(k) Is without prolonged ruptured membranes;

(l) Is not in premature labor nor postmature gestation;

(m) Is appropriate for a setting where anesthesia is limited to local infiltration of the perineum, or a pudendal block, and analgesia is limited.

(15) "Maternity home" means any home, place, hospital, or institution in which facilities are maintained for the care of four or more women not related by blood or marriage to the operator during pregnancy or during or within ten days after delivery: PROVIDED, HOWEVER, That this chapter shall not apply to any hospital licensed under chapter 70.41 RCW, "Hospital Licensing Rules and Regulations."

(16) "Midwife" means an individual recognized by the Washington state board of nursing as a certified nurse midwife as provided in chapter 18.88 RCW, WAC 308-120-310 or an individual possessing a valid, current license to practice midwifery in the state of Washington as provided in chapter 18.50 RCW.

(17) "New construction" means any of the following started after promulgation of these rules and regulations:

(a) New buildings to be used as a birth center;

(b) Addition(s) to an existing building(s) to be used as a birth center;

(c) Alteration(s) or modification(s) other than minor alterations to a birth center or to a building or place that is intending to be licensed as a birth center. "Minor alterations" means any structural or functional modification within an existing birth center which does not change the approved use of a room or an area. Minor alterations performed under this definition do not require prior approval of the department.

(18) "Personnel" means individual(s) employed by the birth center.

(19) "Physician" means a doctor of medicine or a doctor of osteopathy duly licensed in the state of Washington.

(20) "Registered nurse" means a person licensed under the provision of the law regulating the practice of registered nursing in the state of Washington, chapter 18.88 RCW, who is practicing in accordance with the rules and regulations promulgated there under.

(21) "Recovery" means that period or duration of time starting at birth and ending with discharge of a client from the birth center or the period of time between the birth and the time a client leaves the premises of the birth center.

(22) "Shall" means compliance is mandatory.

(23) "Should" means a suggestion or recommendation, but not a requirement.

(24) "Support person" means the individual(s) selected or chosen by a maternal client to provide emotional support and to assist her during the process of labor and childbirth.

(25) "Toilet" means a room containing at least one water closet.

(26) "Volunteer" means an individual who is an unpaid worker in the birth center, other than a support person.

(27) "Water closet" means a plumbing fixture for defecation fitted with a seat and a device for flushing the bowl of the fixture with water.

WAC 248-29-020 - LICENSURE.

(1) Application for license - Fee.

(a) An application for a childbirth center license shall be submitted on forms furnished by the department. The application shall be signed by the legal representative of the governing body.

(b) The applicant shall furnish to the department full and complete information and promptly report any changes which would affect the current accuracy of such information as to the identity of each officer and director of the corporation, if the birth center is operated by a legally incorporated entity, profit or nonprofit, and of each partner if the birth center is operated through a legal partnership.

(c) Each application for license shall be accompanied by a license fee of fifteen dollars plus one dollar per birthing room. No fee shall be required of charitable or nonprofit or government operated birth centers. Upon receipt of the license fee, when required, the department shall issue a child birth center license, if the applicant and the birth center facilities meet the requirements of this chapter.

(2) License renewal - Limitations - Display.

(a) A license, unless suspended or revoked, shall be renewed annually.

(i) Licenses shall expire on the first day of July next succeeding the date of issuance.

(ii) Applications for renewal shall be on forms provided by the department and shall be filed by the department not less than ten days prior to expiration.

(iii) Each application for renewal shall be accompanied by a license fee of twenty-five dollars. No fee shall be required of charitable, nonprofit, or government operated facilities.

(iv) The department shall inspect and investigate each childbirth center as needed and at least annually to determine compliance with standards herein (chapter 249-29 WAC) and applicable standards of chapter 18.46 RCW.

(b) Each license shall be issued only for the premises and persons named. Licenses shall be transferable or assignable only with written approval by the department.

(c) Licenses shall be posted in a conspicuous place, on the licensed premises.

(3) License -- Denial, suspension, revocation. The department may, if the interests of the clients so demand, deny, suspend, or revoke a license when there has been failure or refusal to comply with the requirements established in chapter 248-29 WAC or applicable sections of chapter 18.46 RCW, in accordance with RCW 18.46.050 and chapter 248-08 WAC.

(4) New construction -- Major alterations.

(a) When new construction or major alteration is contemplated, the following shall be submitted to the department for review:

(i) A written program containing, at a minimum, information concerning services to be provided and operational methods to be used which will affect the extent of facilities required by these regulations;

(ii) Duplicate sets of preliminary plans which are drawn to scale and include: A plot plan showing streets, driveways, water, and sewage disposal systems, grade and location of building(s) on the site; the plans for each floor of the building(s), existing and proposed, which designate the functions of each room and show all fixed equipment. The preliminary plans shall be accompanied by a statement as to the source of water supply and the method of sewage and garbage disposal and a general description of construction and materials, including interior finishes.

(b) Construction shall not be started until duplicate sets of final plans (drawn to scale) and specifications have been submitted to, and approved by the department. Final plans and specifications shall show complete details to be furnished to contractors for construction of buildings or major alterations in existing buildings. These shall include:

(i) Plot plans;

(ii) Plans for each floor of the building(s) which designate -the function of each room and show all fixed equipment and the planned location of beds and other furniture in patient sleeping rooms;

(iii) Interior and exterior elevations, building sections, and construction details;

(iv) Schedule of floors, wall, and ceiling finishes, and the types and sizes of doors and windows; plumbing, heating, ventilation, and electrical systems; and

(v) Specifications which fully describe workmanship and finishes.

(c) Adequate provisions shall be made for the safety and comfort of clients as construction work takes place in or near an occupied area.

(d) Construction shall take place in accordance with approved final plans and specifications. Only those changes which have been approved by the department may be incorporated into the construction project. Modified plans, additions, or changes incorporated into the construction project shall be submitted to the department for the department file on the project.

(5) Compliance with other regulations.

(a) Applicable rules and regulations adopted by the Washington state fire marshal.

(b) If there is no local plumbing code, the Uniform Plumbing Code of the National Association of Plumbing and Mechanical Officials shall be followed.

(c) Compliance with these regulations does not exempt birth centers from compliance with the local and state electrical codes or local fire, zoning, building, and plumbing codes.

WAC 248-29-030 - GOVERNING BODY AND ADMINISTRATION

(1) The birth center shall have a governing body which is responsible for overall operation and maintenance of the center.

(2) The governing body shall be responsible for provision of personnel, facilities, equipment, supplies and special services needed to meet the needs of the clients.

(3) The governing body shall adopt policies for the care of clients within or on the premises of the birth center.

(4) The governing body shall appoint an administrator or director who shall be responsible for implementing the policies adopted by the governing body.

(5) The governing body shall establish and maintain a current written organizational plan which includes all positions and delineates responsibilities, authority, and relationship of positions within the birth center.

(6) The governing body shall have the authority and responsibility for appointments and reappointments of clinical staff and ensure that only members of the clinical staff shall admit clients to the birth center.

(a) Each birth center shall have designated physician participation in clinical services.

(b) Each birth center shall have a written policy and program which shall stipulate the extent of physician participation in the services offered.

(c) Each physician and midwife appointed to the clinical staff shall provide evidence of current licensure in the state of Washington.

(d) The clinical staff shall develop and adopt bylaws, rules, and regulations subject to the approval of the governing body, which shall include requirements for clinical staff membership; delineation of clinical privileges and the organization of clinical staff.

(7) The governing body shall be responsible for documenting and implementing a program to review the care of patients within the center.

WAC 248-29-040 - PERSONNEL, CLINICAL STAFF AND VOLUNTEERS WHO WORK DIRECTLY WITH PATIENTS.

(1) There shall be sufficient, qualified personnel and clinical staff to provide the services needed by client(s) and for safe maintenance and operation of the birth center.

(2) A physician certified by the American Board of Obstetrics and Gynecology or a physician who is otherwise qualified, authorized by training and recognized by peers in the community as an experienced, competent practitioner in obstetrics and gynecology shall be immediately available by phone twenty-four hours a day. A written agreement is recommended.

(3) Appropriate personnel and clinical staff of the birth center shall be trained in infant and adult resuscitation. Clinical staff or personnel who have demonstrated ability to perform neonatal resuscitation procedures shall be present during each birth.

(4) A physician or midwife shall be present at each birth. A second person, who is an employee or member of the clinical staff with resuscitation skills shall be immediately available during each birth.

(5) Appropriate, qualified personnel and/or clinical staff shall be present in the birth center at all times when clients are present.

WAC 248-29-050 - BIRTH CENTER POLICIES AND PROCEDURES.

Written policies and procedures shall include, but not be limited to:

(1) Definition of a low-risk maternal client who shall be eligible for birth services offered by the birth center.

(2) Definition of a client who shall be ineligible for birth services at the birth center.

(3) Identification and transfer of clients who, during the course of pregnancy, are determined to be ineligible.

(4) Identification and transfer of clients who, during the course of labor or recovery, are determined to be ineligible for continued care in the birth center.

(5) Written plans for consultation, backup services, transfer and transport of a newborn and/or maternal client to a hospital where appropriate care is available.

(6) Written informed consent which shall be obtained prior to the onset of labor and shall include evidence of an explanation by personnel of the birth services offered and potential risks.

(7) Provision for the education of clients, family, and support persons in childbirth and newborn care.

(8) Plans for immediate and long term follow-up of clients after discharge from the birth center.

(9) Registration of birth and reporting of complications and anomalies.

(10) Prophylactic treatment of the eyes of the newborn in accordance with RCW 70.24.040, WAC 248-100-295 as now, or as hereafter, amended.

(11) Metabolic screening of newborns.

(a) Educational materials shall be provided to each client relative to metabolic screening and informed consent for metabolic screening. These materials shall be obtained from the genetics program of the department.

(b) There shall be a mechanism for weekly reporting of all live births to the genetics program of the department on forms provided by the genetics program.

(c) The birth center shall provide each client with instructions and a metabolic screening collection kit, (obtained from the genetics program of the department). There shall be a procedure and/or evidence of a plan for follow-up so that blood samples are collected between the eighth and twelfth day of life.

(d) When parents refuse metabolic screening, there shall be provisions for a signed refusal statement which shall be sent to the genetics program of the department in lieu of the blood sample.

(12) Infection control to include consideration of housekeeping; cleaning, sterilization, sanitization, and storage of supplies and equipment, and health of personnel. Health records for personnel shall include documented evidence of a tuberculin skin test by the Mantoux method upon employment and annually unless medically contraindicated. When this skin test is negative, (less than 10mm induration read at 48 to 72 hours) no further tuberculin skin test shall be required. A positive skin test shall consist of 10mm of induration, or greater, read at 48 to 72 hours. Positive reactors shall have chest X-ray within ninety days of the first day of employment. Exceptions and specifics are as follows:

(a) Those with positive skin tests, (as defined above) shall have an annual screening in the form of a chest X-ray.

(b) Those with positive skin tests those chest X-rays show no sign of active disease at least two years after the first documented, positive skin test shall be exempted from further annual testing and chest X-rays.

(c) Those with positive skin tests who have completed the recommended course of preventive or curative treatment, as determined by the local health officer, shall be exempted from further testing.

(d) A record of test results, X-rays, or exemptions to such, shall be kept by the facility.

(e) Employees with any communicable disease in an infectious stage shall not be on duty.

WAC 248-29-060 - BIRTH CENTER EQUIPMENT AND SUPPLIES.

(1) There shall be adequate and appropriate size and type equipment and supplies maintained for the maternal client and the newborn to include:

(a) A bed suitable for labor, birth, and recovery;

(b) Separate oxygen with flow meters and masks or equivalent;

(c) Mechanical suction and bulb suction (immediately available);

(d) Resuscitation equipment to include resuscitation bags and oral airways; laryngoscopes and endotracheal tubes appropriate for the newborn;

(e) Firm surfaces suitable for resuscitation;

(f) Emergency medications and intravenous fluids with supplies and equipment appropriate for administration;

(g) Fetal monitoring equipment, minimally to include a fetoscope;

(h) Equipment for monitoring and maintaining the optimum body temperature of the newborn. A radiant heat source appropriate for use in warming newborns shall be available. An appropriate newborn incubator should be available;

(i) A clock with a sweep second hand;

(j) Sterile suturing equipment and supplies;

(k) Adjustable examination light;

(l) Containers for soiled linen and waste materials which shall be closed or covered.

(2) There shall be a telephone, or equivalent communication device.

WAC 248-29-070 - RECORDS.

(1) The birth center shall have a defined client record system, policies and procedures which provide for identification, security, confidentiality, control, retrieval, and preservation of client care data and information.

(2) There shall be a health record maintained for each maternal and newborn client to include:

(a) Adequate notes describing the newborn and maternal status during prenatal, labor, birth, and recovery.

(b) Documentation that metabolic screening instructions and specimen collection kits were provided or that the specimen was obtained and forwarded to the genetics program of the department.

(c) Documentation and authentication by clinical staff and birth center personnel who administer drugs and treatments or make observations and assessments.

(3) Entries in the client record shall be typewritten or written legibly in ink.

(4) Documentation and record keeping shall include:

(a) Completion of a birth certificate.

(b) Documentation of orders for medical treatment and/or medication.

WAC -248-29-080 - PHARMACEUTICALS.

(1) There shall be written prescriptions or orders signed by a practitioner legally authorized to prescribe for all drugs administered to clients within the birth center.

(2) There shall be policies and procedures addressing the receiving, transcribing, and implementing of orders for administration of drugs.

(3) Written policies shall be established addressing the type, and intended use of any drug to be used by patients within the facility.

(4) Anesthetic agents other than local anesthetics and pudendal blocks shall not be used.

(5) Drugs shall be administered by personnel or clinical staff licensed to administer drugs.

(6) Drugs, medications, and chemicals kept anywhere in the center shall be clearly labeled with drug name, strength, and expiration date.

(7) Drugs, chemicals, and medications shall be stored and secured in specifically designated cabinets, closets, drawers, or storerooms and made accessible only to authorized persons.

(8) Poisonous chemicals, caustic materials, or drugs shall show appropriate warning or poison labels and shall be stored separately from other drugs. Drugs for external use shall be separated from drugs for internal use.

WAC 248-29-090 - BIRTH CENTER-PHYSICAL ENVIRONMENT.

(1) The birth center shall be maintained to provide a safe and clean environment.

(2) At least one birthing room shall be maintained which is adequate and appropriate to provide for the equipment, staff, supplies, and emergency procedures required for the physical and emotional care of a maternal client, her support person(s), and the newborn during birth, labor, and the recovery period.

(a) Birthing rooms built, modified or altered after July 31, 1980, shall have a gross floor space of 156 square feet or 14.5 square meters and a minimum room dimension of 11 feet.

(b) Birthing rooms shall be located to provide unimpeded, rapid access to an exit of the building which will accommodate emergency transportation vehicles.

(3) Adequate fixed or portable work surface areas shall be maintained for use in the birthing rooms(s).

(4) Toilet and bathing facilities.

(a) A toilet and lavatory shall be maintained in the vicinity of birthing room.

(b) A bathing facility should be available for client use.

(c) All floor surfaces, wall surfaces, water closets, lavatories, tubs, and showers shall be kept clean and in good repair.

(5) There shall be provisions and facilities for secure storage of personal belongings and valuables of clients.

(6) There shall be provisions for visual privacy for each maternal client and her support person(s).

(7) Hallways and doors providing access and entry into the birth center and birthing room(s) shall be of adequate width and conformation to accommodate maneuvering of ambulance stretchers and wheelchairs.

(8) Water supply. There shall be an adequate supply of hot and cold running water under pressure for human consumption and other purposes which shall comply with WAC 248-54-701 and 248-54-740, rules and requlations of the state board of health regarding public water supplies.

(9) Heating and ventilation.

(a) A safe and adequate source of heat capable of maintaining a room temperature of at least 72 degrees Fahrenheit shall be provided and maintained.

(b) Ventilation shall be sufficient to remove objectionable odors, excessive beat, and condensation.

(10) Lighting and power.

(a) There shall be provisions for emergency lighting.

(b) There shall be general lighting and provision for adequate examination lights in the birthing room.

(11) Linen and laundry.

(a) Soiled linen/laundry storage and sorting areas shall be physically separated from clean linen storage and handling areas, kitchen and eating facilities.

(b) Laundry equipment shall provide hot water at a temperature of 160 degrees Fahrenheit.

(12) Utility, housekeeping, garbage, and waste.

(a) There shall be utility and storage facilities designed and equipped for washing, disinfecting, storing, and other handling of equipment and medical supplies in a manner which ensures segregation of clean and sterile supplies and equipment from those that are soiled and/or contaminated.

(b) All sewage, garbage, refuse and liquid waste shall be collected and disposed of in a manner to prevent the creation of an unsafe or unsanitary condition.

(13) Food storage and/or preparation.

(a) Food service and catering of food shall not be provided by the facility.

(b) When birth center policy provides for allowing the preparation and/or storage of personal food brought in by the client or families of clients for consumption by that family, there shall be an adequate electric or gas refrigerator capable of maintaining a temperature of 45 degrees Fahrenheit or lower and dishwashing facilities which provide hot water at a temperature of not less than 140 degrees Fahrenheit.

Chapter 212-44 WAC:CENTERS - STANDARDS FOR FIRE PROTECTION

WAC

212-44-001 Purpose.

212-44-005 Definitions.

212-44-010 Applicability.

212-44-015 Compliance.

212-44-020 Inspection.

212-44-025 Approval.

212-44-030 Right of appeal.

212-44-035 Local codes.

212-44-040 Standards.

212-44-045 Construction requirements.

212-44-050 Modernization or renovation.

212-44-055 Additions.

212-44-065 Design operation.

212-44-067 Exiting.

212-44-069 Vertical openings.

212-44-072 Fire extinguishers.

212-44-073 Lighting.

212-44-077 Protection from hazards.

212-44-080 Fire alarm.

212-44-090 Fire and evacuation plan.

212-44-100 Equipment maintenance.

212-44-105 Severability

DISPOSITION OF SECTIONS FORMERLY CODIFIED IN THIS CHAPTER

212-44-060occupancies. [Order FM-77-3, œ 212-44-060, filed 12/8/77.] Repealed by 80-15-077 (Order FM 80-1). filed 10/10/80. Statutory Authority: RCW 18.46.110.

212-44-070. [Order FM 77-3, œ 212-44 070, filed 12/8/77.] Repealed by 80-15-077 (Order FM 80 1), filed 10/20/80. Statutory Authority: RCW 18.46.110.

212-44-075detection [Order FM-77- 3, œ 212-44-075. filed 12/8/77.] Repealed by 80-15-077 (Order FM 80-1), filed 10/20/80. Statutory Authority RCW 18.46.110

212-44-085protection. [Order FM 77-3, œ 212-44-085, filed 12/8/77.] Repealed by 80-15-077 (Order FM 80 1), filed 10/20/80. Statutory Authority: RCW 18.46.110.

212-44-095drills. [Order FM 77 3, œ 212-44-095, filed 12/8/77.] Repealed by 80-15-077 (Order FM 80 1), filed 10/20/80. Statutory Authority: RCW 18-46-110.

WAC 212-44-001 - Purpose.

The purpose of this regulation is to adopt recognized standards for the protection of life against the cause and spread of fire and fire hazards pursuant to RCW 18.46.110, with respect to all facilities to be licensed by the department of social and health services and maintained and operated to provide birth services. [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80-1), œ 212-44- 001, filed 10/20/80: Order FM-77-3, œ 212-44-001, filed 12/8/77.]

WAC 212-44-005 - Definitions.

The following definitions shall apply to this regulation:

(1) "Maternity home means any home, place, hospital or institution in which facilities are maintained for the care of four or more women, not related by blood or marriage to the operator, during pregnancy or during or within ten days after delivery: Provided, however. That this regulation shall not apply to any hospital approved by the American College of Surgeons, American Osteopathic Association or its successor.

(2) "Licensing agency" means the Washington state department of social and health services.

(3) "Building official" means the person or agency appointed by the governing body of each city, town or county for the administration and enforcement of the Uniform Building Code, adopted by reference by the State Building Code Act.

(4) "Fire official" means the person or agency appointed by the governing body of each city, town or county for the administration and enforcement of the Uniform Fire Code, adopted by reference by the State Building Code Act.

(5) "Fire chief" means the chief of the fire department providing fire protection services to the child birth centers.

(6) "State Building Code Act" means chapter 19.27 RCW, effective January 1, 1975, which establishes state-wide building and fire prevention codes and mandates enforcement by each city, town and county.

(7) "Ambulatory" means physically and mentally capable of walking a normal path to safety, including the ascent and descent of stairs.

(8) "Birth center" or "child birth center." means a type of maternity home which is a house, building, or equivalent, organized to provide facilities and staff to support a birth service: Provided, That the birth service includes or is limited to low risk maternal clients during the intrapartum period.

(9) "Birthing room" means a room designed, equipped and arranged to provide for the care of a woman and newborn and to accommodate her support person(s) during the process of vaginal birth (the three stages of labor and recovery of a women and newborn).

(10) "Birth service" means the prenatal, intrapartum, and postpartum care provided for individuals with uncomplicated pregnancy, labor, and vaginal birth, to include the newborn care during the recovery period. [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80-1), œ 212-44-005, filed 10/20/80; Order FM-77-3, œ 212-44-005, filed 12/8/77.]

WAC 212-44-010 - Applicability.

This regulation applies to all facilities licensed or subject to licensure as child birth centers by the department of social and health services [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80-1), œ 212-44-010. filed 10/20/80; Order FM-77-3. œ 212-44-010, filed 12/8/77.]

WAC 212-44-015 - Compliance.

All facilities licensed as child birth centers shall comply with the provisions of this regulation [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80 1), œ 212-44-015, filed 10/20/80: Order FM-77-3, œ 212-44-015, filed 12/8/77.]

WAC 212-44-020 - Inspection.

The licensing agency, upon receipt of an application for a license or at least thirty days before the expiration date of an existing license shall submit to the state fire marshal in writing, a request for an inspection. The state fire marshal or his authorized representative shall make an inspection of the facility. and if it is found that the facility does not comply with the standards contained in this regulation, a written report shall be made to the facility listing the violations found, corrective actions necessary and time allowed for correction. As soon as practicable after the expiration date of the time allowed to effect the corrective measures a reinspection shall be made to determine compliance. [Order FM 77-3, œ 212-44-020, filed 12/8/77.]

WAC 212-44-025 - Approval.

Upon the completion of the inspection, if the facility is in reasonable compliance with the applicable standards, a notice of approval for licensing shall be forwarded to the licensing agency. [Order FM-77-3 œ 212-44-025, filed 12/8/77.]

WAC 212-44-030 - Right of appeal.

A facility aggrieved by the corrective orders of the state fire marshal or his authorized representative may appeal to the state fire marshal within five days of the order. If the state fire marshal confirms the order, it shall remain in force [Order FM-77-3, œ 212-44-030, filed 12/8/77.]

WAC 212-44-035 - Local codes.

Approvals are issued or denied on the basis of the applicant's compliance with the state fire marshal's minimum fire and life safety standards. The enforcement of local fire and building codes is the responsibility of the respective fire and building officials. [Statutory Authority: RCW 18-46.110. 80-15 077 (Order FM 80-1), œ 212-44-035, filed 10/20/80: Order FM-77-3, œ 212-44-035, filed 12/8/77.]

WAC 212-44-040 - Standards.

The following standards shall be applicable to all child birth centers built or licensed after the effective date of this regulation. [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80-1), œ 212-44-040, filed 10/20/80; Order FM 77-3, œ 212-44-040, filed 12/8/77.]

WAC 212-44-045 - Construction requirements.

(1) New construction or major remodeling shall comply with the Group B, Division 2 requirements of the 1976 Uniform Building Code This classification is advisory, but not binding on local building officials charged with the administration and enforcement of the State Building Code Act.

(2) New and existing buildings not over two stories in height, to be occupied as a child birth center, may be of any recognized construction type: Provided, That the building has been maintained to the extent that the fire and life safety features have not been reduced.

(3) Buildings three stories in height shall be of at least one hour fire resistive construction. [Statutory Authority RCW 18.46.110. 80-15-077 (Order FM 80-1), œ 212-44-045, filed 10/20/80; Order FM-77-3, œ 212-44-045, filed 12/8/77.]

WAC 212-44-050 - Modernization or renovation.

No construction in either modernization or renovation projects shall diminish the fire safety features of the facility below the level of new construction, as required elsewhere in this regulation. Alterations or installations of new building services equipment shall be accomplished as near as possible in conformance with the requirements for new construction [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80 1), œ 212-44-050. filed 10/20/80; Order FM 77-3, 212-44-050. filed 12/8/77.]

WAC 212-44-055 - Additions.

Any addition shall be separated from any existing nonconforming structure as required in Table 5B of the Uniform Building Code. [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80-1), œ 212-44-055, filed 10/20/80; Order FM-77-3, œ 212-44-055, filed 12/8/77.]

WAC 212-44-065 - Design, operation.

All child birth centers shall be so designed, constructed, maintained and operated as to minimize the possibility of a fire emergency endangering the residents or patients. The protection of residents or patients from fire shall be provided by appropriate arrangement of facilities, adequate staffing and careful development of operating and maintenance procedures composed of the following (1) Proper design, construction and separation; (2) provision for detection, alarm and evacuation; and (3) fire prevention and the planning, training and drilling in programs for the notification of fire and the safe evacuation of residents or patients from the building or affected fire area [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80-1), œ 212-44-065, filed 10/20/80; Order FM-77-3, œ 212-44-065, filed 12/8/77.]

WAC 212-44-067 - Exiting.

(1) Not less than two exits shall be accessible from every part of each floor being used for birth services or uses incidental thereto, including floor levels below the street floor.

(2) Exits shall be remote from each other and shall be arranged to minimize the possibility that both may be blocked by any emergency. [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80-1), œ 212-44-067, filed 10/20/80.]

WAC 212-44-069 - Vertical openings.

Every stairway, elevator shaft, light and ventilation shaft, chute, and other opening between stories shall be enclosed or protected to prevent the spread of fire or smoke from one floor to another. [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80-1), œ 212-44-069, filed 10/20/80 ]

WAC 212-44-072 - Fire extinguishers.

At least one approved fire extinguisher suitable for use on fires in ordinary combustibles shall be provided on each floor level. Additional fire extinguishers may also be required due to area, travel distance or special hazards. [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80-1). 212-44-072 filed 10/20/80.]

WAC 212-44-073 - Lighting.

(1) Illumination of the means of egress shall be continuous during the time that conditions of occupancy require that the means of egress be available for use.

(2) Automatic emergency lighting shall be provided and so arranged as to provide the required illumination automatically in the event of any interruption of normal lighting, such as the failure of public utility or other outside electrical power supply, opening of a circuit breaker or fuse, or any manual act(s) including accidental opening of a switch controlling normal lighting facilities.

(3) Electric battery operated emergency lights shall use only reliable types of storage batteries, provided with suitable facilities for maintenance in properly charged condition. Electric storage batteries used in such lights or units shall be approved for their intended use and shall comply with the National Electrical Code. NFPA 70. [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80-1). œ 212-44-073, filed 10/20/80.]

WAC 212-44-077 - Protection from hazards.

Any area used for general storage, and boiler or furnace rooms shall be separated from other parts of the building by construction having a fire-resistance rating conforming to the general construction requirements of the building type.

Central heating plants and other fuel burning appliances shall be properly maintained and cleaned at frequent intervals. The surrounding area shall be kept free of rubbish and combustible storage. [Statutory Authority RCW 18.46.110. 80 15-077 (Order FM 80-1). 212-44-077 filed 10/20/80.]

WAC 212-44-080 Fire alarm.

Every child birth center shall have an electrically supervised manual fire alarm system. Operation of any fire alarm activating device shall automatically, without delay, accomplish general alarm indication and sound an audible alarm throughout the building or affected portion thereof. [Statutory Authority: RCW 18 46.110. 80.15.077 (Order FM 80-1), œ 212-44-080, filed 10/20/80; Order FM 77-3, œ 212-44-080, filed 12/8/77.]

WAC 212-44-090 - Fire and evacuation plan.

The administration of every child birth center shall have in effect and available to all supervisory personnel written copies of a plan for the protection of all persons in the event of fire and for their evacuation to areas of refuge and from the building when necessary. All employees shall be instructed and kept informed respecting their duties under the plan. [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80-1). œ 212-44-090, filed 10/20/80; Order FM-77-3, œ 212-44-090, filed 12/8/77.]

WAC 212-44-100 - Equipment maintenance.

Every required automatic sprinkler system, fire detection and alarm system, exit lighting. fire door and other item of equipment required by this regulation or the applicable building and/or fire code shall be continuously maintained in proper operating condition. Equipment shall be tested or operated in accordance with manufacturer's recommendation and/or at sufficient intervals to assure reliability. Records of all tests and inspections shall be maintained for review. Tests and inspections shall be under the supervision of a responsible person. [Order-FM-77-3, œ 212-44-100, filed 12/8/77.]

WAC 212-44-105 - Severability.

If any provision of this regulation or its application to any person is held invalid, the remainder of the regulation or the application of the provision to other persons or circumstances is not affected. [Statutory Authority: RCW 18.46.110. 80-15-077 (Order FM 80-1). œ 212-44-105, filed 10/20/80; Order FM-77-3, œ 212-44-105, filed 12/8/77.]