(a) A center must ensure a sanitary environment by following accepted standards of practice and maintain a safe physical environment free of hazards for minors, staff, and visitors.
(b) A center must ensure that the following conditions are met.
  (1) Wastewater and sewage must be discharged into a state-approved municipal sewage system. An on-site sewage facility must be approved by the Texas Commission on Environmental Quality (TCEQ) or authorized agent.
  (2) The water supply must be from a system approved by the Public Drinking Water Section of the TCEQ, or from a system regulated by an entity responsible for water quality in the jurisdiction where the center is located as approved by the Public Drinking Water Section of the TCEQ.
  (3) Waste, trash, and garbage must be disposed of from the premises at regular intervals in accordance with state and local practices. Excessive accumulations are not permitted. Outside containers must have tight-fitting lids left in closed position. Containers must be maintained in a clean and serviceable condition.
  (4) Center grounds must be well kept and the exterior of the building, including sidewalks, steps, porches, ramps, and fences, must be in good repair.
  (5) The interior of the center's buildings including walls, ceilings, floors, windows, window coverings, doors, plumbing and electrical fixtures must be in good repair.
  (6) Pest control must be provided by a licensed structural pest control applicator with a license category for pests. The center must maintain documented evidence of routine efforts to remove rodents and insects.
  (7) The center must be kept free of offensive odors, accumulations of dirt, rubbish, dust, and hazards. Storage areas, attics, and cellars must be free of refuse and extraneous materials.
(c) A center must adopt and enforce a written work plan for housekeeping operations, with categorization of cleaning assignments as daily, weekly, monthly, or annually within each area of the center.
(d) A center must ensure the provision of housekeeping and maintenance of the interior, exterior and grounds of the center in a safe, clean, orderly and attractive manner. The center must provide housekeeping and maintenance staff with equipment and supplies if needed. A center must designate staff to be responsible for overseeing the housekeeping services.
(e) A center must develop procedures for the selection, use, and disposal of housekeeping and cleaning products and equipment. The center must ensure:
  (1) the use of EPA approved cleaning products appropriate for the application and materials to be sanitized;
  (2) the following of manufacturer instructions for use and disposal of cleaning products;
  (3) all bleaches, detergents, disinfectants, insecticides, and other poisonous substances are kept in a safe place accessible only to staff; and
  (4) all products are labeled.
(f) A center must ensure a sufficient supply of clean linens is available to meet the needs of minors. Clean laundry must be provided in-house by the center, through a contract with another health care center, or with an outside commercial laundry service.
(g) A center must ensure:
  (1) linens are handled, stored, and processed so as to control the spread of infection;
  (2) linens are maintained in good repair;
  (3) linens are washed, dried, stored, and transported in a manner which will produce hygienically clean linen;
  (4) the washing process has a mechanism for removing soil and killing bacteria;
  (5) clean linens are stored in a clean linen area easily accessible to the staff;
  (6) soiled linens and clothing are stored separately from clean linen and clothing;
  (7) soiled linens and clothing are stored in well ventilated areas, and are not permitted to accumulate at the center;
  (8) soiled linens and clothing are transported in accordance with procedures consistent with universal precautions;
  (9) soiled linens are not sorted, laundered, rinsed, or stored in bathrooms, corridors, food preparation area, or food storage areas;
  (10) a minor's clothing stored at the center is cleaned after each use; and
  (11) staff wash their hands both after handling soiled linen and before handling clean linen.

Source Note: The provisions of this §550.210 adopted to be effective September 1, 2014, 39 TexReg 6569; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1875