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<regulation prefix="Regulation" num=".57" citation="COMAR 10.07.02.57" title_num="10" subtitle_num="07" chapter_num="02" heading="Housekeeping Services, Pest Control, and Laundry.">
  <paragraph num="A.">
    <text>General Requirements. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Staff. Sufficient housekeeping and maintenance personnel shall be employed to maintain the interior and exterior of the facility in a safe, clean, orderly, and attractive manner.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Cleanliness and Maintenance.</text>
    <paragraph num="(1)">
      <text>The building and all its parts and facilities shall be kept in good repair, neat, and attractive. The safety and comfort of the residents shall be the primary consideration.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>All walls, floors, ceilings, windows, and fixtures shall be kept clean. Interior walls and floors shall be of a type to allow frequent and easy cleaning.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The nursing home shall be kept free of unnecessary accumulations of personal possessions, boxes, trunks, suitcases, papers, unused furniture, bed clothing, linens, bric-a-brac, and similar items.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Storage areas shall be:</text>
      <paragraph num="(a)">
        <text>Kept clean and orderly; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Readily accessible for:</text>
        <paragraph num="(i)">
          <text>Housekeeping;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Maintenance; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Pest control servicing.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>The grounds shall be kept clean, neat, attractive, and free of hazards.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Pest Control. The nursing home shall:</text>
      <paragraph num="(a)">
        <text>Be maintained free of insects and rodents by operation of an active pest-control program, either by use of maintenance personnel or by contract with a pest-control company;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Use and store toxic and flammable insecticides and rodenticides with care;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Ensure that usage of toxic and flammable insecticides and rodenticides conforms to the U.S. Environmental Protection Administration and Maryland Department of Agriculture requirements;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Be protected to prevent the entry and harborage of rodents and insects;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Install and effectively maintain:</text>
        <paragraph num="(i)">
          <text>Screen doors that fit tightly when closed;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Easily adjusted closely fitted window screens;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Rat-proofing devices; or</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Other approved deterrents; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(f)">
        <text>Effectively protect all openings to the outside against the entry of insects by:</text>
        <paragraph num="(i)">
          <text>Closed doors;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Closed windows; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Other means.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>Laundry Services.</text>
      <paragraph num="(a)">
        <text>A nursing home shall provide laundry service, whether on-site or off-site.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Laundry service shall be provided to meet the residents’ needs.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>All laundry shall be processed and handled in a manner that prevents the spread of infections. Staff working in laundry shall be given personal protective equipment, including:</text>
        <paragraph num="(i)">
          <text>Disposable gloves;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Masks; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Body coverings.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>All laundry shall be processed through the use of sufficiently hot water, chemical agents, or a combination of the both, to remove or destroy infectious biological materials.</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Clean and Soiled Areas.</text>
        <paragraph num="(i)">
          <text>There shall be a physical separation between the clean and soiled areas.</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The soiled area shall allow for sorting and washing soiled laundry.</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The clean area shall allow for drying and folding of clean laundry.</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>All soiled areas within a laundry shall be connected to mechanically operated exhaust ventilation.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(f)">
        <text>The system provided in laundries may not allow the spread of airborne contaminants to other parts of the nursing home that are occupied by residents, staff not working in the laundry, and the general public.</text>
      </paragraph>
      <paragraph num="(g)">
        <text>The plumbing fixtures for all water supply connections to washing machines and the plumbing fixtures for all utility sinks shall have an integrated atmospheric vacuum breaker or other approved back-flow prevention devices.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>