Surgeries, day clinics <strong>and</strong> other medical complexes must comply with the following requirements:3.1 Physical <strong>and</strong> structural facilitiesa) Surfaces of walls, floors, ceilings, doors <strong>and</strong> equipment must be of a smooth finish that facilitatescleaning <strong>and</strong> disinfecting as is required in a facility providing medical care.b) Adequate floor space must be provided <strong>to</strong> allow unobstructed movement of patients, mobileequipment, <strong>and</strong> staff <strong>and</strong> <strong>to</strong> ensure that the hospital adheres <strong>to</strong> an acceptable level of occupationdensity in consulting rooms <strong>and</strong> related facilities.c) The locality of all facilities, including lifts, fire escapes <strong>and</strong> general exits must be clearly indicated forconvenience of patients, staff <strong>and</strong> visi<strong>to</strong>rs.d) Facilities for patients <strong>and</strong> other visi<strong>to</strong>rs must be adapted <strong>to</strong> accommodate physically disabledpersons.e) Consultation rooms should be provided separate from waiting rooms <strong>to</strong> facilitate privacy forconsultation purposes.3.2 Water supply <strong>and</strong> ablution facilitiesa) Potable running water in compliance with the SANS 241, with regards <strong>to</strong> its bacteriological, chemical<strong>and</strong> physical quality must be available on the premises.b) Taps <strong>and</strong> pipes must be maintained in good working order <strong>and</strong> in good repair, rust free.c) Water must be continuously available for 24 hours a day on the premises <strong>and</strong> <strong>to</strong> accommodate otheruses e.g. fire fighting.d) An adequate supply of running hot <strong>and</strong> cold water must be provided on all h<strong>and</strong> wash basins <strong>and</strong>sinks on the premises.e) Adequate ablution <strong>and</strong> <strong>to</strong>ilet facilities must be provided for use by patients <strong>and</strong> staff. 1 (one) <strong>to</strong>iletfacility <strong>and</strong> 1 (one) h<strong>and</strong>wash basin must be available for every 12 (twelve) staff members, <strong>and</strong> 1(one) <strong>to</strong>ilet facility <strong>and</strong> 1 (one) h<strong>and</strong>wash basin must be available for every 20 (twenty)patients/visi<strong>to</strong>rs, <strong>and</strong> located in close proximity <strong>to</strong> the waiting rooms.f) Doors of ablution <strong>and</strong> <strong>to</strong>ilet facilities for patients must be un-lockable from the outside.g) The <strong>to</strong>ilets must be kept clean <strong>and</strong> sanitary, with an adequate amount of <strong>to</strong>ilet paper, soap <strong>and</strong> drying<strong>to</strong>wels available at all times.h) Floors of <strong>to</strong>ilet facilities must be constructed of a smooth <strong>and</strong> easily cleanable material.i) Walls must be of a smooth finish <strong>and</strong> painted with a light coloured, washable paint or tiled.3.3 <strong>Health</strong> care risk waste managementApproved methods of waste collection, s<strong>to</strong>rage, transportation <strong>and</strong> disposal must be adopted <strong>and</strong>must be in line with SANS 10248.a) The collection, s<strong>to</strong>rage <strong>and</strong> disposal of waste, including health care risk waste must be managed inaccordance with the requirements as specified in the SANS Code 10248 <strong>and</strong> Section 9-10 of the<strong>Norms</strong> <strong>and</strong> St<strong>and</strong>ards for Waste Management;b) A waste management plan concurrent <strong>to</strong> the st<strong>and</strong>ards as set out in the Core St<strong>and</strong>ards for healthEstablishments in South Africa must be in place <strong>and</strong> updated every two years.c) A designated staff member responsible <strong>to</strong> ensure that the collection, h<strong>and</strong>ling, s<strong>to</strong>rage <strong>and</strong> disposalof waste on the premises is in compliance <strong>to</strong> relevant legislation <strong>and</strong> st<strong>and</strong>ards must be available.d) The facility must have a documented waste management policy <strong>and</strong> procedures that is followed forthe collection, h<strong>and</strong>ling, segregation, s<strong>to</strong>rage <strong>and</strong> disposal of waste (incl health care risk waste, suchas infectious ana<strong>to</strong>mical <strong>and</strong> pathological, sharps, pharmaceutical, chemical <strong>and</strong> radiation hazardwaste).e) If the facility makes use of the services of a private contrac<strong>to</strong>r for managing of waste, the contrac<strong>to</strong>rmust be an approved <strong>and</strong> legally compliant waste removal service provider <strong>and</strong> a service levelagreement in place.f) An adequate number of containers for the disposal of health care risk waste <strong>and</strong> general waste mustbe available <strong>and</strong> accessible <strong>to</strong> h<strong>and</strong>le the volume of waste generated on the premises.g) Appropriate bags <strong>and</strong> containers must be available <strong>and</strong> used for the type of waste collected.DOH. <strong>Norms</strong> <strong>and</strong> st<strong>and</strong>ards for environmental health in South Africa Feb 2013 46
h) An adequate number of purpose-manufactured, leak-proof, sealable containers must be available forthe s<strong>to</strong>rage of health care risk waste. Such containers <strong>to</strong> be designed as <strong>to</strong> not allow the exposure ofneedles, cuts <strong>and</strong> other substances that may cause harm <strong>to</strong> service users or staff members;i) Containers used for the s<strong>to</strong>rage of health care risk waste must be clearly labeled in large, legiblelettering;j) Employees must be adequately trained in the identification, separation, h<strong>and</strong>ling <strong>and</strong> s<strong>to</strong>ring of healthcare risk waste;k) Containers used for the s<strong>to</strong>rage of health care risk waste must be clearly labeled in large, legiblelettering;l) Employees must be adequately trained in the identification, separation, h<strong>and</strong>ling <strong>and</strong> s<strong>to</strong>ring of healthcare risk waste;m) <strong>Health</strong> care risk waste may only be removed/ collected, transported, treated <strong>and</strong> dispose by aregistered service provider from the premises.3.4 Infection prevention <strong>and</strong> controla) Infection control <strong>and</strong> prevention st<strong>and</strong>ards concurrent with the st<strong>and</strong>ards as set out in the CoreSt<strong>and</strong>ards for <strong>Health</strong> Establishments in South Africa, published by the <strong>National</strong> Department of <strong>Health</strong>,Office of the <strong>Health</strong> St<strong>and</strong>ards Compliance.3.5 S<strong>to</strong>rage facilitiesa) If five or more persons are employed, separate change-rooms must be provided for male <strong>and</strong> femalestaff members, equipped with s<strong>to</strong>rage facilities or lockers for personal belongings of each worker.b) Food <strong>and</strong> non-food items must be s<strong>to</strong>red separately; refrigera<strong>to</strong>rs used for s<strong>to</strong>rage of medicines mustnot at any time be used for s<strong>to</strong>rage of any foodstuffs.c) Separate s<strong>to</strong>rage facilities for dirty <strong>and</strong> clean linen <strong>and</strong> equipment, including sluice facilities forcleaning of soiled linen <strong>and</strong> equipment must be provided.d) Separate s<strong>to</strong>rage facilities must be provided for s<strong>to</strong>rage of cleaning equipment <strong>and</strong> medicines.3.6 Rodent proofing <strong>and</strong> pest controla) The construction of rodent proofing must be done on the internal <strong>and</strong> external areas of the facility <strong>to</strong>minimize the risk of rodents <strong>and</strong> pests.a) Rodent proofing in must be maintained in good order or repair so as <strong>to</strong> be impervious <strong>to</strong> rodents.b) To prevent the wide-spreading of rodents or pests, rodents must be eliminated before demolition ofany building or structure likely <strong>to</strong> be infested with rodents.c) A rodent management program must be in place in line with the requirements as set out inSection……….of this norms <strong>and</strong> st<strong>and</strong>ards.3.7 General requirementsa) The s<strong>to</strong>rage <strong>and</strong> dispensing of medicines must comply with the Pharmacy Act, Medicines <strong>and</strong>Related Substances Act <strong>and</strong> the relevant regulations.b) The building structure must be maintained in good repair <strong>to</strong> provide the safety of clients/patients.c) The premises must comply <strong>to</strong> the Local Fire Authority’s, fire safety regulations <strong>and</strong> requirements.d) All areas of the facility must be kept clean, free from offensive odours, debris, litter <strong>and</strong> othermiscellaneous waste at all times.e) Appropriate cleaning material <strong>and</strong> equipment must be available <strong>and</strong> properly used <strong>and</strong> s<strong>to</strong>red.f) Infection control procedures <strong>relating</strong> <strong>to</strong> cleaning must be followed in all areas of the facility.SECTION 12: HEALTH ESTABLISHMENTS<strong>Health</strong> establishments shall refer <strong>to</strong> public <strong>and</strong> private hospitals <strong>and</strong> includes, district, regional <strong>and</strong> tertiaryhospitals.1. NORMSDOH. <strong>Norms</strong> <strong>and</strong> st<strong>and</strong>ards for environmental health in South Africa Feb 2013 47
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water world etc)1. In the event of
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SECTION 14:MONITORING OF DRINKING W
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DEFINITION OF APPLICABLE TERMSThe f
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Sharps container 90 days Cool room
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Bacterial infectionsCholeraCampylob
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