final 599

LA 599 GRADUATION PROJECT

ICOI Senior Daycare & assisted living Center

Muhammad Ali Baghchehsarai 0558588

Fall Spring 2010 - 2011

ICOI Senior Daycare & assisted living Research ! 1

TABLE OF CONTENTS

1Purpose of Research! 6

Definitions! 6

Purpose of a daycare! 6

Description! 7

History! 8

A Dummies guild how to start a Day Care! 9

Evaluating Adult Day Care Centers! 10

What Services Are Typica"y Available?! 10

Overview for adult care regulations! 11

Participant thresholds and hourly limits.! 12

Parameters for Who Can Be Served! 12

Required and Optional Services! 13

Provisions Regarding Medications! 14

Staffing Requirements! 14

Staffing for persons with dementia.! 15

Types of staff.! 16

Training Requirements! 16

Monitoring! 17


California Guild Book :-! 17

Operations: Services! 26

Conceptual Plan of services! 33

Planning & Zoning! 35

Design Standards! 49

One bed room! 51

Two bedroom! 52

Special care room! 53

Toilets! 54

Nurses Station! 57

Dinning room! 58

corridor! 59

Elements of Site Selection! 66

Geology :-! 72

Climate :-! 73

Topography :-! 74

Flora & fauna! 75

Base Map! 76

Safety Considerations! 77

EarthQuake Safety :-! 77


Floods:-! 78

WildFires :-! 78

Religious a&ressions:-! 79

Community safety! 79

Medical transportation! 79

General Design Policies :-! 80

Wa"s and Fencing! 80

Noise Attenuation! 80

Building setbacks -! 80

Projections Into Required Setback! 81

Fences, Hedges and Wa"s! 81

Building Height! 81

Lot Coverage -! 81

Between Buildings -! 81

Electricity :-! 82

Natural Gas:-! 82

Telephone & cable :-! 82

Sources! 84

The Beginning! 86

Form Concept! 87


Design program! 88

Master plan! 89

Site plan! 90

Sections! 91

Isometric View! 92

Views! 93

Roof garden :-! 94

Green house! 96

Final sheets! 97


GOALS OF RESEARCH “Copy 'om one, it’s plagiarism; Copy 'om two, it’s research”

Wilson Mizner

1Purpose of Research is to understand Who,are the Users Of the project.What are there needs,Which Facilities

are needed & How to cater to there needs.

Definitions • Senior :- is an individual who is 59 years of age or older.

• Day Care:-

daytime care for the needs of people who cannot be fully independent, such as children or the elderly : family issues such as day care | [as adj. ] a day-care center for employees' children.

• Assisted Living:-

housing for the elderly or disabled that provides nursing care, housekeeping, and prepared meals as needed

Purpose of a daycareThere are two general purposes for adult day-care. The first is to provide an alternative to placement in a residential institution. The second is to create a respite for care-givers, of-ten the children of the persons for whom the care is being provided.


Description

There are two general types of adult day care programs. One is based on a medical model and the other on a social model. The medical model provides comprehensive medical, therapeutic, and rehabilitation day treatment. The social model offers supervised activities, peer support, companionship, and recreation. Both models assist older adults and those with chronic condi-tions to remain as independent as possible, for as long as possible.

Programs organized along the medical model lines are often called adult day health care to dis-tinguish them from social programs. Adult day health care programs offer health services such as physician visits, nursing care, and podiatry, as well as rehabilitation services such as physical, occupational, and speech therapy in a secure environment. This model of adult day care is of-fered to persons with a variety of chronic medical conditions including the following:

% •% adults with Alzheimer's disease, other forms of dementia, or depression

% •% persons recovering from stroke or head or spinal cord injuries

% •% people with chronic conditions such as diabetes or cardiovascular disease

% •% adults with developmental disabilities such as Down syndrome

% •% adults suffering from mental illnesses

% •% weak or frail older adults requiring nursing care or assistance with daily living activities

The social model of adult day care emphasizes supervised group activities such as crafts, gar-dening, music, and exercise . Participants in this model may require some assistance with the activities of daily living (e.g., eating, bathing, dressing) but they generally do not require skilled nursing care. Like adult day health care facilities, these social programs generally provide transportation and a midday meal for participants, as well as caregiver support groups, infor-mation and referral services, and community outreach programs.

In 2009, an estimated 40 million Americans will be aged 65 or older. According to statistics from the U.S. Department of Labor, the fastest growing segment of older adults is the popula-tion aged 85 and older. Historically, approximately 80% of the frail elderly remain in the com-munity and are cared for by relatives, most commonly by adult daughters. Today, however, an increasing number of women aged 35–54 are in the workforce and unable to care for aging par-ents or disabled adult children living at home.


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Although the participants of adult day care are adults who attend the programs daily or several times each week, adult day care also meets the needs of families and other caregivers. Before women entered the workforce, they were available to care for relatives at home. Today, adult day care provides a secure, alternative source of care for women who work outside the home. It also offers respite, or much needed breaks, for caregivers. Older adults caring for spouses, or children caring for aging parents find that adult day care helps ease the burden of caring for ill, confused, or disabled family members.

HistoryThe first adult day care centers opened in England during the 1940s and 1950s. Established by psychiatric hospitals, these centers were designed to reduce the frequency of hospital admis-sions. The first adult day care centers in the United States appeared during the early 1970s. To-day, there are more than 4,000 services and centers. Most centers and programs operate during normal business hours, Monday through Friday, but some offer weekend and evening care.

As of 2003, 34 states offer licensure of adult day care, but only 25 require such licensure. Adult day care services or programs may be affiliated with hospitals, nursing homes , home health agencies, or senior centers, but many are unaffiliated, independent programs. They may be lo-cated in storefronts, senior centers, community health and medical centers, and nursing homes.

Among centers responding to a 1997 National Adult Day Services Association (NADSA) sur-vey, the average number of persons in an adult day care facility was approximately 40 and the average age of persons served was 76. About three out of four persons receiving adult day care services lived with family. Nearly 80% of adult day centers offered nursing services, and ap-proximately 90% were not-for-profit. Fees ranged from $1 to $200 per day, with an average of $28 to $43 dollars per day. As of 2003, Medicare does not pay for any type of adult day care. However, in 35 states, Medicaid can be used to pay for adult day care services.

Though fees for adult day care vary widely, the service is generally considered to be cost effec-tive when compared with the cost of institutional care, such as skilled nursing facilities or even home health care. More importantly, adult day care enables older adults, persons with physical disabilities, and those with cognitive impairments to maintain their independence. Research has demonstrated that adult day care also reduces the risks and frequency of hospitalization for older adults. Adult day care satisfies two requirements of care. It provides a secure, protected environment and is often the least restrictive setting in which care may be delivered.

Quality and standards of care vary from state to state and from one center or program to an-other. NADSA and the National Council on the Aging have developed standards and bench-marks for care, but adherence to these standards is voluntary. NADSA is currently developing a certification program for adult day center administrators and directors. A certification proc-ess for program assistants also exists. Since no uniform national standards exist, it is difficult


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http://www.surgeryencyclopedia.com/La-Pa/Nursing-Homes.html

for consumers to know whether a program or center is staffed by qualified personnel or pro-vides appropriate services.

Generally, quality adult day care centers or programs conduct thorough assessments of each person and develop individualized plans of care and activities to meet the needs of impaired, disabled, or frail older adults. The plans for each individual describe objectives in terms of im-provement or maintenance of health status, functional capabilities, and emotional well being. Centers must have sufficient staff to ensure safety, supervision, and close attention. Further, all personnel and volunteers should be qualified, trained, and sensitive to the special needs of older adults. For example, centers and services for persons with Alzheimer's disease or other dementias must take special precautions to ensure that people do not wander away from the facility.

A Dummies guild how to start a Day Care I. They generally only allowed a certain amount of senior citizens in the adult daycare business

depending upon the size of the Building that you have It is always a good idea to talk to

someone at the city office regarding how to get a business license and any special rules along

with regulations that apply.

II. You can either charge a hourly rate or a weekly rate. Senior Citizens usually have grandchil-

dren or their own kids watch them day after day from time to time, but make sure that you can

keep the senior citizens entertained at a reasonable affordable price each hour.

III. . You want the senior citizens to be entertained while at the adult daycare center. You want them to have the option of playing cards or board games when visiting with other senior citizens. You need to schedule activities such as bowling or even tennis if it is available. Some senior citizens might even enjoy a movie day of a certain selection.

IV. You need to offer healthy foods to the senior citizens. It is important to have meals provided to

them at a regular time. A daycare center is usually required to serve a certain amount of food

each week and different kinds of food too. You will have food regulations and rules to follow

just like a regular daycare center. You will most likely need to get a food handlers permit.


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Evaluating Adult Day Care Centers

• Number of years in operation -- stability.

• State license or certification, if required

• Days and hours of operation

• Financial costs -- be sure to look for any hidden costs (such as extra charges

for transportation or special meals). Do they have any financial assistance

available?

• Meet the staff and ask for credentials -- can your loved one's health needs be

met?

• Is transportation provided?

• Look at the menu -- can special dietary needs be met? It is a good sign if they

ask you to stay for lunch.

• Can they deal with conditions such as incontinence or dementia?

What Services Are Typically Available?

A well-run adult day care center's goals will focus on enriching the participants' lives, building upon their skills, knowledge, and unique abilities and strengths. Below are some of the activi-ties that may be available:

% •% Arts and crafts

% •% Musical entertainment and sing-a-longs

% •% Mental stimulation games such as BINGO

% •% Stretching or other gentle exercise

% •% Discussion groups (books, films, current events)

% •% Holiday and birthday celebrations

% •% Local outings


Adult day care centers have been providing a form of respite for caregivers for more than twenty years. In 1978 there were only 300 centers nationwide. By the 1980s there were 2,100 centers, and today there are about 4,000 centers nationwide, according to the National Adult Day Services Association (NADSA). NADSA reports that the need for such centers has "jumped sharply to keep pace with the mushrooming demand for home and community based services."This growth also is due in part to new funding sources such as Medicaid waiver pro-grams, which support alternatives to institutional long-term care and rehabilitation.

Overview for adult care regulations This section provides a brief overview of states’ approaches to regulating ADS providers in key areas and highlights similarities and differences among them.

Licensing, Certification, and Other Requirements

The majority of states approach ADS regulation by requiring licensure or certification in ac-cordance with state standards. 25 states require licensure, ten states require certification; and four states require both licensure and certification (in these states, Medicaid and non-Medicaid providers have different requirements.) Thirteen states require ADS providers to seek approval from or enter into some type of agreement with a state agency. Exhibit 1 indicates whether a state requires licensure, certification, both, and/or some other arrangement.

Licensure

States vary in their approach to licensure, primarily licensing providers of specific ADS pro-grams or operators of specific types of facilities or centers. Some states license a single pro-gram; others cover two or more program types under a single licensing category; some have separate licenses for specific types of programs in addition to basic licensure.

For example, Maine licenses two types of programs--adult day health services and social ADS programs--as Adult Day Services. Either program may operate a night program that provides services to persons with dementia. However, the ADS provider must have a separate license to operate a night program and must keep record keeping distinct.

States do not generally license by levels of care. Louisiana is an exception. The state licenses both adult day care and adult day health care and has a unique system of licensing with six dis-tinct types of licensed services settings related to the capacities of the clients with develop-mental disabilities whom they serve. Louisiana is the only state that defines adult day care as a


service only for persons with developmental disabilities rather than for “older persons with disabilities” or “adults with disabilities.”

Participant thresholds and hourly limits. States do not vary much with regard to the maximum number of participants that providers may serve before licensure or certification is required. The maximum is generally between three and five individuals who are unrelated to the provider. Tennessee is an exception, setting the threshold at ten individuals.

States vary more with regard to specifying the maximum hours of services that ADS providers may furnish. For example, in Idaho participants may be served during any part of the day but only for less than 14 hours. Iowa’s maximum is 16 hours in a 24- hour period. Some states, such as Kansas, do not specify minimums or maximums but only that facilities must operate fewer than 24 hours a day. On the other hand, Tennessee defines adult day care services as those that are provided for more than 3 hours per day but less than 24 hours per day, implying that pro-viders who furnish services fewer than 3 hours a day do not have to be licensed.

Parameters for Who Can Be ServedThe regulation of a service targeted to frail elders and individuals with disabilities needs to as-sure that providers can meet the needs of their clients. One option for assuring this is through explicit admission/retention/discharge criteria that set the parameters for who can be served.


Many states lack specific provisions regarding the types or level of functional or health needs that should trigger discharge. Most states do have provisions related to involuntary discharge, which generally give providers some discretion to determine

1-8whether or not they can meet an individual’s needs. For example, Vermont’s rules limit in-voluntary discharges to the following situations: (1) the participant’s care needs exceed those an adult day center is certified to provide, (2) an adult day center is unable to meet the partici-pant’s assessed needs, or (3) the participant presents a threat to himself or herself or to other participants or staff. Similarly, Alabama requires that providers discharge participants when the program of care can no longer meet their needs or when their condition presents an immediate and serious risk to the health, safety, or welfare of the participants or others.

In most states, parameters for who can be served are set (although indirectly) through provi-sions regarding mandatory and optional services that indicate a participant’s level of need. For example, Virginia requires adult day health care centers (ADHC) to meet the needs of each participant, but specifies that a minimum range of services must be available to every Medicaid ADHC recipient, including nursing services and rehabilitation services. Virginia further speci-fies that centers can admit recipients who have skilled needs only if there is professional nurs-ing staff immediately available on site to provide the specialized nursing care these recipients require. Provisions such as these indicate that persons with a high level of nursing or medical needs can be served in these centers.

Required and Optional ServicesAll states identify a range of required and optional ADS in their licensing or certification re-quirements or other types of agreements. States list required and optional services for each type of ADS that they license, certify, or otherwise regulate (e.g., for adult day care and adult day health care).

The services we included in our review are:

␣ ADL assistance; ␣ health education; ␣ health monitoring;

␣ medication administration; ␣ skilled nursing services; ␣ nursing services;% ␣ social services; and ␣ physical, occupational,%␣ transportation.

and speech therapy;


We limited our review to these services because the purpose of this study is to better under-stand the role of ADS in addressing elderly persons’ health and functional needs. We did not include services such as emergency services and nutritional services, because they are provided to all residents regardless of residents’ functional or health status. See Section 2 for individual state information about which services are required and optional.

States generally require adult day care providers to furnish ADL assistance and health monitor-ing. Health education; physical, occupational, and speech therapy; and skilled nursing services are less likely to be cited as either required or optional.

States generally require adult day health care or medical adult day care providers to furnish more services than adult day care providers. In addition to ADL assistance, social services, and health monitoring, adult day health care providers are generally required to furnish medication administration; nursing services; physical, occupational, and speech therapy; and skilled nurs-ing services.

Provisions Regarding MedicationsMost states do not specify medication administration as a required service, except for adult day health care providers. The majority of states require licensed personnel to administer medications. States that permit unlicensed staff to administer medications

1-10generally required that they do so under nurse delegation provisions, though a few require only consultation with a physician or pharmacist or specific training.

Most states require providers to have written policies for medication management and admini-stration. For example, Georgia requires adult day care programs to have a written policy for medication management designating specific staff to be authorized and trained to assist with the administration of medications and designating the program’s role in the supervision of self-administered medications and/or staff- administered medications.

Many states also specify requirements related to self-administration of medications. For exam-ple, Texas requires individuals who self-administer their medications to be counseled at least once a month by licensed nursing staff to ascertain if they continue to be capable of self-administering their medications.

Staffing RequirementsStates vary with regard to the number of staff required. Most states specify minimum staff-to-participant ratios. As shown in Exhibit 2, mandatory ratios range between one to four and one to ten. Some states require different ratios for different types of ADS, and some states specify


both a required ratio and a recommended ratio. Some states require lower ratios when serving participants with greater needs, but allow providers to determine what level of need requires the lower ratio.

Several states do not have minimum staff-to-participant ratios and allow providers to deter-mine the number of staff, requiring only that they have “sufficient” staff to meet participants’ needs. For example, Idaho states that staff must be adequate in numbers and skill to provide essential services but does not define essential services. The state further specifies that the number of staff per participant must increase appropriately if the number of participants in day care increases or if the degree of severity of participants’ functional or cognitive impair-ment increases. However, we identified no state guidance to providers for what constitutes an “appropriate” increase.

Idaho’s Medicaid provisions, on the other hand, have more specific requirements. Medicaid providers are required to have a minimum of one staff for every six participants, and a ratio of one-to-four when serving a high percentage of participants who are severely impaired.

Staffing for persons with dementia.Exhibit 3 lists the states that have special provisions for serving individuals with dementia, most of which relate to staffing and training requirements.

Required staffing ratios for persons with dementia are generally one staff to four participants, though Michigan requires Dementia Adult Day Care programs to have a minimum staff/volunteer/student-to-participant ratio of one-to-three. Some states specify lower ratios for people with cognitive impairment who may not have a diagnosis of dementia. For example, Minnesota states that when an adult day care/services center serves both participants who are capable of taking appropriate action for self- preservation under emergency conditions and participants who are not, it is required to maintain a staff-to-participant ratio of one-to-five for


participants who are not capable of self-preservation and one-to-eight for participants who are capable of self-preservation.

Types of staff. In addition to staffing ratios, virtually all states require specific types of staff for ADS pro-grams. The major difference in requirements between adult day care and adult day health care is that states require the latter to have licensed nurses available in some capacity (e.g., as full time or part time employees or as consultants). Because most states require staffing consistent with participants’ needs, licensed nurses are required if adult day health care service centers need skilled nursing services.

Training RequirementsVirtually all states have both orientation and initial and ongoing training requirements, but they are minimal. Some requirements are quite general, while others are specific regarding the type of training and the number of hours required. Most states require at least one staff trained in first aid and CPR on duty at all times. Examples of the wide range of requirements follow:


California requires that adult day health care centers that provide care for adults with de-mentia provide staff training regarding the use and operation of egress control devices (pre-cluding the use of exits) utilized by the center, the protection of participants’ personal rights, wandering behavior and acceptable methods of redirection, and emergency evacuation proce-dures for persons with dementia

MonitoringThe majority of states require inspections--most of them annual inspections that coincide with an initial license application and annual license renewal. Several states also stipulate that unan-nounced visits by state personnel can occur at any time. Only one state does not have external monitoring. Alaska does not license or monitor ADS. The state’s rules require only that an adult day care program conducts an internal evaluation, at least annually, of its operation and services. However, site visit inspections are required for programs receiving state grant funds.1

California Guild Book :-



!"#$%&'($") Overview In California, adult day care services are provided in two types of licensed facilities: adult day programs (ADP) and adult day health care (ADHC) centers. In addition, each local Area Agency on Aging designates at least one Alzheimer’s day care resource center (ADCRC) in its planning and service area to provide specialized Alzheimer’s care and community outreach and education. Adult day program providers are licensed by the State Department of Social Services (DSS) Community Care Licensing Division as community care facilities. The term “adult day program” replaced two earlier program names in legislation (SB 1982, Statutes of 2002): adult day care facility (ADCF) and adult day support center (ADSC). These two programs were licensed by DSS under separate regulations in the California Code of Regulations (CCR) Title 22, based on California Health and Safety Code. Because the regulations have not yet been combined, whenever they differ, they are presented separately in this profile under the heading Adult Day Program. ADP services are not available under the Medicaid State Plan. Adult day health care providers are licensed by the Department of Health Services (DHS) Licensing and Certification Division as health facilities. The California Department of Aging (CDA) administers the program and certifies each center for Medi-Cal (California’s Medicaid State Plan) reimbursement. Licenses are not issued or renewed for an ADHC center that is not certified as a Medi-Cal provider of ADHC services. ADHC providers must meet, at a minimum, the licensing requirements specified in Health and Safety Code, Chapter 3.3; the certification requirements specified in Welfare and Institutions Code, Chapter 8.7; and additional requirements specified in the CCR, Title 22. If an ADHC center licensee also provides adult day care or ADSC services, the ADHC license shall be the only license required to provide these additional services. ADP and ADHC services are also available to clients of the Multipurpose Senior Service Program (MSSP), a case management program targeted to frail elderly clients who are eligible for nursing facility placement. MSSP operates under a Home and Community-Based Services (HCBS) waiver and contracts with appropriately licensed and certified providers for services. In August 2004, a 1-year moratorium on new ADHC centers enrolling in the Medi-Cal program was instituted and will most likely be extended until the state transitions the ADHC program from the Medicaid State Plan to an HCBS waiver program. During the time of the moratorium, ADHC applicants may be licensed to provide services to persons who pay privately or have insurance coverage for the services. ADHC centers may be certified for the Medi-Cal program only if they meet the exemptions to the moratorium as specified in SB 1103. ADCRCs are specialized day care centers that target services to persons with Alzheimer’s disease and other dementias. Until recently, the law permitted ADCRCs to function without a facility license, although the majority of ADCRCs are located in licensed ADP or ADHC centers. Legislation (AB 2127, Statutes of 2004) amended Welfare and Institutions Code 9542 as follows: an Alzheimer’s day care resource center that was not licensed as an adult day program or adult day health care center prior to January 1, 2005, shall be required to be so licensed by January 1, 2008. A direct services program that qualifies to operate as an Alzheimer’s day care resource center after January 1, 2005, shall be required to be licensed as an adult day program or adult day health care center. The ADCRC program is currently authorized by statutes, and specific requirements are specified in a program manual, not in regulation. Regulations that were being developed for the ADCRC program were suspended, effective November 1, 2003. All ADCRCs are funded by grants from CDA. Services are reimbursed by Medi-Cal for eligible participants if the program is housed in an ADHC center.

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Licensure and Certification Requirements Licensure Only

ADP Certification Only

Both Required

ADHC Other

Definitions Adult Day Program Adult day program means any community-based facility or program that provides care to persons 18 years of age or older in need of personal care services, supervision, or assistance essential to sustaining the activities of daily living (ADL) or for the protection of the individual on less than a 24-hour basis. Adult day care facility means any facility of any capacity that provides nonmedical care and supervision to adults on less than a 24-hour per day basis. Adult day support center means a community-based group program designed to meet the needs of functionally impaired adults through an individual plan of care in a structured comprehensive program that provides a variety of social and related support services in a protective setting on less than a 24-hour basis. Adult day support center services means those nonmedical services provided in an ADSC to adults with physical, emotional, or mental impairments and who require assistance and supervision. Adult Day Health Care Adult day health care means an organized day program of therapeutic, social, and health activities and services provided to elderly persons with functional impairments, either physical or mental, for the purpose of restoring or maintaining optimal capacity for self-care. Provided on a short-term basis, ADHC serves as a transition from a health facility or home health program to personal independence. Provided on a long-term basis, it serves as an alternative to institutionalization in a long-term health care facility when 24-hour skilled nursing care is not medically necessary or viewed as desirable by the recipient or their family. Adult day health center or adult day health care center means a licensed and certified facility that provides ADHC, or a distinct portion of a licensed health facility in which such care is provided in a specialized unit under a special permit issued by the department. Parameters for Who Can Be Served Adult Day Program Adult day care facility. Providers determine the parameters for who can be served insofar as they are required to determine whether they can meet prospective clients’ service needs prior to admission. They may serve clients with “obvious symptoms of illness” only if these clients are “separated from other clients.” Adult day support center. Adults with physical, emotional, or mental impairments with nonmedical needs who require assistance and supervision may be served. Such persons include, but are not limited to, the following:

Persons who require assistance with ADL (e.g., bathing, dressing, grooming) and instrumental activities of daily living (IADL) (e.g., laundry, shopping, paying bills). These persons may live independently, at home with a care provider, in a community care facility, or in a health facility, but do not require a medical level of care during the day.

Persons who require assistance and supervision in overcoming the isolation associated with functional limitations or disabilities.

Persons who, without program intervention, are assessed to be at risk of physical deterioration or premature institutionalization due to their psychological condition.

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Providers determine in part the parameters for who can be served insofar as they are required to determine whether they can meet prospective clients’ service needs prior to admission and can discharge those whose needs they can no longer meet or who pose a danger to themselves or others. The regulations also state that participants cannot have specific restricted health conditions as specified in CCR, Title 22, Division 3, Subdivision 1, Chapter 5. (The list of these conditions is too extensive to include here.) Adult Day Health Care ADHC facilities may serve persons 55 years of age or older and other adults who are chronically ill or impaired and would benefit from ADHC. Providers may not admit individuals for whom, in their clinical judgment, they cannot appropriately care. They may serve persons with dementia and other special needs populations, such as persons with developmental disabilities or persons with mental disabilities. Providers may discharge participants if they are unable or unwilling to use the prescribed services and ADHC staff have made every effort to remove possible obstacles. Medicaid provisions for enrollment in ADHC specify that providers may serve individuals: (1) with medical conditions that require treatment or rehabilitative services prescribed by a physician, (2) with mental or physical impairments that handicap ADL but which are not of such a serious nature as to require 24-hour institutional care, and (3) who are at risk for deterioration and probable institutionalization if ADHC services were not available. Inspection and Monitoring

Yes No Adult day program. Within 90 days after the date of issuance of a license or special permit, the department shall conduct an inspection of the facility for which the license or special permit was issued. Any duly authorized officer, employee, or agent of the State Department of Social Services may enter and inspect any place providing personal care, supervision, and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation of, any provision of the General Licensing Requirements, Health and Safety Code. Every licensed community care facility shall be subject to unannounced visits by the department. The department shall visit these facilities as often as necessary to ensure the quality of care provided. The department will conduct random annual unannounced visits to no less than 10 percent of facilities. Under no circumstances shall the department visit a community care facility less often than once every 5 years. Adult day health care. If an ADHC center or an applicant for a license has not been previously licensed, the department may only issue a provisional license to the center. A provisional license to operate an ADHC center shall expire 1 year from the date of issuance, or at an earlier time as determined by the department at the time of issuance. Within 30 days prior to the expiration of a provisional license, the department shall give the ADHC center a full and complete inspection, and, if the ADHC center meets all applicable requirements for licensure, a regular license shall be issued. Annual licenses are required; however, the director has discretion to approve applications for relicensure for a period of up to 24 months.

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Required and Optional Services

Adult Day Program Adult Day Health Care*

Required Optional Required Optional

ADL Assistance X X

Health Education and Counseling ADSC only X

Health Monitoring/Health-Related Services ADSC only X

Medication Administration Medication assistance X

Nursing Services X Physical Therapy, Occupational Therapy, or Speech Therapy X

Skilled Nursing Services X

Social Services ADSC only X

Transportation X

*ADHC centers are also required to provide medical services and psychiatric or psychological services.

Provisions Regarding Medications Adult day program. Clients shall be assisted as needed with self-administration of prescription and nonprescription medications. In ADCFs and ADSCs, staff may be trained by the client’s family or primary caregiver if the licensee obtains written documentation from the client’s family or primary caregiver outlining the procedures and the names of facility staff whom they have trained in those procedures, and the licensee ensures that the client’s family or primary caregiver reviews staff performance as necessary, but at least annually. All staff training shall be documented in the facility personnel files. Facility staff, except those authorized by law, shall not administer injections, but staff designated by the licensee shall be authorized to assist clients with self-administration of injections as needed. For every prescription and nonprescription PRN medication for which the licensee provides assistance, there shall be a signed and dated written order from a physician on a prescription blank maintained in the client’s file and a label on the medication. Adult day health care. Each participant’s health record shall include a drug history that lists all medications currently being taken by the participant and any medications to which the participant is allergic. Medications stored in the center or administered by center personnel shall be labeled in conformance with state and federal laws and regulations. Medications shall be administered only by licensed medical or licensed nursing personnel. Self-administration of medications shall be permitted only under the following conditions: (1) the center shall have approved policies permitting self-administration of medications when approved by the multidisciplinary team; (2) training in self-administration of medications shall be provided to all participants based on the recommendation of the multidisciplinary team; and (3) the health record of each participant who is capable of self-medication shall name all drugs that are to be self-administered. Provisions for Groups with Special Needs Dementia ADHC Mental Retardation/

Developmental Disabilities ADHC Other mental illness,

traumatic brain injury (ADHC)

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Staffing Requirements

Adult Day Program Adult Day Care Facility Type of staff. All ADCFs shall have an administrator. A licensee who is responsible for two or more ADCFs shall be permitted to serve as an administrator of one or more of the facilities. The administrator shall be on the premises the number of hours necessary to manage and administer the facility in compliance with applicable law and regulation. When the administrator is absent from the facility, there shall be coverage by a substitute designated by the licensee who shall be capable of and responsible and accountable for management and administration of the facility in compliance with applicable law and regulation. Facility personnel shall be competent to provide the services necessary to meet individual client needs and shall at all times be employed in numbers necessary to meet such needs. The licensee shall provide for an overlap of staff at each shift change to ensure continuity of care. Care staff shall not be assigned to any of the support staff duties, such as housekeeping, cooking, or office work, unless the care and supervision needs of clients have been met. Staffing ratios. There shall be an overall ratio of not less than one staff member providing care and supervision for each 15 clients present. Whenever a client who relies upon others to perform all ADL is present, the following minimum staffing requirements shall be met:

For Regional Center clients, staffing shall be maintained as specified by the Regional Center. For all other clients, there shall be a staff-client ratio of no less than one direct care staff to four

such clients. Adult Day Support Center Type of staff. All ADSCs shall have an administrator. If an administrator is responsible for two or more ADSCs, there shall be at each site an employee who is responsible for the day-to-day operation of the center and who meets the following qualifications: (1) a baccalaureate degree in psychology, social work, or a related human services field or (2) a minimum of 1 year of experience in a supervisory or management position in the human services delivery system. An administrator shall not be responsible for more than five centers. When the administrator or the employee specified above is absent from the center, there shall be coverage by a substitute designated by the licensee who is on site and who shall be capable of, and responsible and accountable for, the management and administration of the center in compliance with applicable laws and regulations. Support staff and direct care staff are required. Direct care staff provide care and supervision to participants at least 70 percent of the hours of program operation per month. There shall be at least two persons on duty, at least one of whom is a direct care staff member, at all times when there are two or more participants in the center. The licensee shall provide for an overlap of staff at each shift change to ensure continuity of care. The center shall have at least one full-time staff member who has a current certificate in first aid and cardiopulmonary resuscitation present in the facility during operating hours. Staffing ratios. There shall be an overall ratio of not less than one direct care staff member providing care and supervision for each group of eight participants, or fraction thereof, present. For each group of 25 participants, or fraction thereof, there shall be at least one direct care staff person who has a baccalaureate degree in a health, social, or human service field, or 1 year documented full-time experience providing direct services to frail or physically, cognitively, or emotionally impaired adults. Whenever a participant who relies upon others to perform all ADL is present, the following minimum staffing requirements shall be met:

For Regional Center participants, staffing shall be maintained as specified by the Regional Center.

2-21


For all other participants, there shall be a staff-participant ratio of no less than one direct care staff to four such participants. Volunteers may be included in the staff-to-participant ratio if the volunteer meets the requirements for direct care staff.

Adult Day Health Care Type of staff. Each center shall have an administrator. The administrator shall have the responsibility and authority to carry out the policies of the licensee. Each center shall make provision for continuity of operation and assumption of the administrator’s responsibilities during the administrator’s absence. The administrator shall not be responsible for more than three centers without prior written approval by the Department. In this circumstance, there shall be one or more assistant administrators for every three additional centers. Each center shall have a full-time program director. The program director shall be on the premises and available to participants, employees, and relatives. When the program director is temporarily absent, another adult on the staff shall be designated to serve as the acting program director. Centers with a capacity of 50 and over shall provide both an administrator and a full-time program director. The program director of centers whose average daily attendance is 20 or fewer may also serve as the registered nurse, social worker, occupational therapist, physical therapist, speech therapist, or dietitian, provided that the program director meets the professional qualifications for that position and the program director and the administrator are not the same person. Program aides shall be employed in a sufficient number to meet the needs of the participants and the staffing requirements of the Department. The program director, a registered nurse with a public health background, a medical social worker, a program aide, and the activity coordinator shall be on duty during the hours the center offers basic services. Other staff shall be employed in sufficient numbers to provide services as prescribed in the individual plans or care in accordance with minimal requirements determined by each center’s average daily attendance based on the previous quarter experience. Medical services shall be provided to each participant by a personal or a staff physician. Occupational, physical, and speech therapy services staff shall work the hours necessary to meet the needs of each participant as specified in the individual plan of care and in accordance with the staffing requirements of the Department. For the provision of psychiatric or psychological services, the center shall have consultant staff available a minimum of 3 hours per month and consisting of a psychiatrist, clinical psychologist, psychiatric social worker, or psychiatric nurse. Consultant staff shall spend a sufficient number of hours in the center to meet the needs of each participant and the staffing requirements of the Department. Support employees shall include maintenance, food service, and clerical employees sufficient in number to perform the necessary duties. Volunteers may be used in centers but shall not be used to replace required employees. Each volunteer shall receive orientation, training, and supervision. Staffing ratios. There must be one program aide for every 16 participants during the hours of operation. An additional half-time social work assistant and an additional half-time licensed vocational nurse shall be provided for each increment of ten in average daily attendance exceeding 40. Training Requirements Adult Day Program Adult day care facility. All personnel shall be given on-the-job training or shall have related experience that provides knowledge of and skill in the following areas, as appropriate to the job assigned and as evidenced by safe and effective job performance: (1) principles of nutrition, food preparation and storage, and menu planning; (2) housekeeping and sanitation principles; (3) provision of client care and supervision, including communication; (4) assistance with prescribed medications that are self-administered; (5) recognition of early signs of illness and the need for professional assistance;

2-22


(6) availability of community services and resources; and (7) Universal Precautions as defined in Title 22, Section 8001(u)(1). Training in Universal Precautions may be provided in the facility, or staff may attend training provided by a local health facility, county health department, or other local training resources. Adult day support center. The licensee shall develop, maintain, and implement a written plan for the orientation, continuing education, on-the-job training and development, supervision, and evaluation of all direct care staff. (1) The plan shall require direct care staff to receive and document a minimum of 20 hours of continuing education during the first 18 months of employment or within 18 months after the effective date of these regulations and during each 3-year period thereafter. (2) The administrator shall receive and document a minimum of 30 hours of continuing education every 24 months of employment. (3) Continuing education shall include completion of courses related to the principles and practices of care of the functionally impaired adult including, but not limited to, workshops, seminars, and academic classes. The center shall train program staff and participants in emergency procedures. Adult Day Health Care A planned in-service education program, including orientation, skill training, and continuing education, shall be provided for employees. All staff members shall receive in-service training in first aid and cardiopulmonary resuscitation within the first 6 months of employment. An ADHC that provides care for adults with Alzheimer’s disease and other dementias must provide staff training regarding the use and operation of the egress control devices (precluding the use of exits) used by the center, the protection of participants’ personal rights, wandering behavior and acceptable methods of redirection, and emergency evacuation procedures for persons with dementia. Relevant Medicaid Contracting Requirements for Adult Day Services Providers

To obtain certification as a provider of ADHC under the state’s Medicaid program (Medi-Cal), a provider must meet all the requirements of licensure as an ADHC center pursuant to Chapter 3.3 (commencing with Section 1570) of Division 2 of the Health and Safety Code, and Chapter 10, Division 5, Title 22 of CCR. Medi-Cal has additional requirements for providers of ADHC services guided by the Adult Day Health Medi-Cal Law pursuant to Chapter 8.7 of the Welfare and Institutions Code, and Chapter 5, Division 3, Subdivision 1, Title 22 of CCR. CDA may implement a 1-year moratorium on the certification and enrollment into the Medi-Cal program of new ADHC centers. Purpose. The Medi-Cal benefit is intended to establish and continue a community-based system of quality day health services that will: (1) ensure that elderly persons not be institutionalized prematurely and inappropriately; (2) provide appropriate health and social services designed to maintain elderly persons in their own homes; (3) establish adult day health centers in locations easily accessible to the economically disadvantaged elderly person; and (4) encourage the establishment of rural alternative ADHC centers, which are designed to make ADHC accessible to impaired Californians living in rural areas. Discharge. An adult day health center shall not terminate the provision of adult day health services to any participant unless approved by the state department. Optional services. (1) Podiatric services, (2) optometric screening and advice for low-vision cases, (3) dental screening for the purpose of appraising the participant of the necessity of regular or emergency dental care, and (4) such other services within the concept and objectives of ADHC as may be approved by the department. Inspection. Initial Medi-Cal certification for ADHC providers shall expire 12 months from the date of issuance. The director shall specify any date he or she determines is reasonably necessary, but not more than 24 months from the date of issuance, when renewal of the certification shall expire. The certification may be extended for periods of not more than 60 days if the Department determines it to be necessary. Every ADHC center shall be periodically inspected and evaluated for quality of care by a representative or representatives designated by the director, unless otherwise specified in the interagency agreement entered into pursuant to Section 1572 of the Health and Safety Code.

2-23


Inspections shall be conducted prior to the expiration of certification, but at least every 2 years, and as often as necessary to ensure the quality of care being provided. As resources permit, an inspection may be conducted prior to, as well as within, the first 90 days of operation. Staffing. A provider shall employ appropriately licensed personnel for furnishing required services. A provider serving a substantial number of participants of a particular racial or ethnic group, or participants whose primary language is not English, shall employ staff who can meet the cultural and linguistic needs of the participant population. Training. An in-service training plan for each center staff member shall commence within the first 6 months of employment. The training plan shall address, at a minimum, the specific medical, social, and other needs of each participant population the center proposes to serve. Location of Licensing, Certification, or Other Requirements 1. http://www.dss.cahwnet.gov/getinfo/pdf/adcfman.PDF. 2. http://www.dss.cahwnet.gov/getinfo/pdf/adscman.PDF. 3. http://www.dss.cahwnet.gov/getinfo/pdf/genman1.PDF. 4. http://www.leginfo.ca.gov/cgi-bin/calawquery?codesection=hsc&codebody=&hits=20. 5. http://www.leginfo.ca.gov/cgi-bin/calawquery?codesection=wic&codebody=&hits=20. 6. http://files.medi-cal.ca.gov/pubsdoco/Pubsframe.asp?hURL=/pubsdoco/io_search.asp. 7. http://ccr.oal.ca.gov/cgi-bin/om_isapi.dll?clientID=138589&infobase=ccr&softpage=

Browse_Frame_Pg42. Citations 1. Adult Day Care Facilities--Community Care Licensing Division--Manual of Policies and Procedures

(CCR, Title 22, Division 6, Chapter 3). Department of Social Services. [Updated 9/30/02] 2. Adult Day Support Center--Community Care Licensing Division--Manual of Policies and Procedures

(Title 22, Division 6, Chapter 3.5). Department of Social Services. [Updated 3/08/00] 3. General Licensing Requirements. (CCR, Title 22, Division 6, Chapter 1, Article 1) Department of

Social Services. [Updated 12/17/04] 4. California Adult Day Health Care Act--California Health and Safety Code (Chapter 3.3, Section

1570-1596.5). [Effective 1978] 5. Adult Day Health Care Program, California Welfare and Institutions Code (Chapter 8.7, Section

14520-14588). [Effective 1978] 6. Adult Day Health Care Centers, Medi-Cal Inpatient/Outpatient Provider Manual, Department of

Health Services. [Effective August 2000] 7. Adult Day Health Care, California Medical Assistance Program, Health Care Services (CCR, Title

22, Division 3, Subdivision 1, Chapter 5) and Adult Day Health Centers, Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies, (CCR, Title 22, Division 5, Chapter 10). [Effective date unknown]

Additional Information A licensed and certified ADHC center may establish one or more satellites. A satellite may be in the county of the parent or a rural service area. The parent center’s license and certification shall cover ADHC services at one or more satellites. A rural alternative ADHC center shall operate its programs a minimum of 3 days weekly unless the program can justify, to the satisfaction of the department, fewer days of operation due to space, staff, financial, or participant reasons. In December 2003, the Centers for Medicare & Medicaid Services (CMS) notified DHS that the ADHC program should not have been approved as an optional Medi-Cal benefit and directed the state to transition the program into an HCBS waiver. DHS and CDA are currently working on the waiver application, and the administration has introduced legislation that authorizes the state to obtain a waiver to continue ADHC services.

2-24

DESIGN INTRODUCTION:

Operations: ServicesThe nursing home is divided into the following functional areas:-

-Residents care units

-Therapeutic services

- Resident support services

- Administrative services

- Logistical services

- Environmental & maintenance



Space planning & design


Technical considerations

Conceptual Plan of services



Site considerations

Planning & Zoning


Design Standards


One bed room


Two bedroom


Special care room


Toilets


Nurses Station


Dinning room


corridor



Planning & Design Data

BLANK PAGE

SITE SELECTION


Elements of Site Selection

-Distance from the islamic Center.

-Distance From Medical services .

-Function does not Contradicted with City’s Master Plan.

-Quick access from freeway.

-Acceptance of the Surrounding Community

Since the project is Owned By The ICOI the site is better located in the city


Irvine is located in Southern California in Orange County .

From the North it’s Limits are Tustin,Costa messa.

West Newport & laguna beach.

East Lake irvine

South laguna hills, Lake Forest & Aliso vejo .


LOCATION OF IRVINE ,CA

CITY MASTER PLAN


SANTAFWY

ANA

FREEWAY

IRVINE BLVD.

MESA

BRYAN AVE.AVE.

YALE

SANTA

TRABUCO ROAD

COSTA

ANADRIVE

FREEWAY

MAC ARTHUR

ALTON

AVE.

BARRANCAPARKWAY

AVE.

BLVD.

REDHILL

AVE.

IRVINE CENTER DRIVE

YALE

KARMAN AVE.

CULVER

MAIN ROAD

MAC ARTHUR

SAN

HARV

ARD

STREETDIEGOPARKWAY ROAD

VON

FREEWAYMICHELSON

DRIVE

JAMBOREE

ALTON IRVINE

AVE.

CAMPUS

IRVIN

E BLVD

JEFF

REY

CU

LVER

AVE.

SANTA

CENTER

YALE

SANPARKWAY

HAR

VARD

DR.UNIVERSITY ANARIDGE

L INE

LAGU

NA

FRE

EWAY

DR

IVE

BLVD.

DRIVE

FREEWAY

DIEGO PARKWAY

FREEWAYTU RTLE D

R.

(405)RO

C

K

DRIVE

PARKWAY

BAKE

TURTLE

SUNNYHILL

DRIVEROCK

LAGUNAC

ANYO

N

PARKWAY

BARRANCA

MUIRLAND

PORTOLA PKWY

WAR

NE

R A V E.

IRVINE BLVD.

PORTOLA PKWY

PORTOLA PKWY

ROAD

JEFF

REY

AVEN

UE

CANYON

SAND

AVEN

UE

CANYON

SAND

REDHILL A

VE

WALNUT AVE.

EDINGER

JAM

BORE

E R

OAD

MAC ARTHUR

BLV

D.

WALNUT AVE.

DRIVE

SAN JOAQ

UIN HILLS TRANSPORTATION CORRIDOR

SAN JOAQUIN HILLS TRAN

SPORTATIO

N CORRIDOR

EAST

ERN

TRA

NSPO

RTAT

ION

C

OR

RID

OR

W

EST

L

EG

EASTERN TRANSPORTATION

CO

RR

IDO

R EAST LEG

FOOTHILL TRANSPORTATION CORRIDOR

EAST

ERN

TRAN

SPORTA

TION

CORRID

OR E

AST

LE

G

SHADY CANYON DRBONITA CANYON DR

MESA

COSTA

MAC ARTHUR

ALTON

AVE.

BARRANCAPARKWAY

BLVD.

REDHILL

AVE.

KARMAN AVE.

MAIN ROAD

MAC ARTHUR

SAN

HARV

ARD

STREETDIEGO

VON

FREEWAYMICHELSON

DRIVE

JAMBOREE

AVE.

CAMPUS CU

LVER

AVE.

YALE

HAR

VARD

DR.UNIVERSITY

BLVD.

DRIVE

TU RTLE

RO

C

K

WAR

NE

R A V E.

REDHILL A

VE

EDINGER

DRIVE

SAN JOAQUIN HILLS TRAN

SPORTATIO

N CORRIDOR

RATTLESNAKERESERVOIR

1.1

1.2

1.3

1.4

1.5

1.6

Exclusive Agriculture

Development Reserve

Preservation

Recreation

Water Bodies

GEOCODE

Conservation/Open Space Reserve

4.1

4.2

4.3

4.4

4.5

4.6

Neighborhood Commercial

4.8

Community Commercial

Vehicle-Related Commercial

Commercial Recreation

Irvine Center Regional Commercial

Irvine Center Retail Office

Irvine Center Urban Commercial

Irvine Center Garden Commercial

4.7

City Boundary

(1613) WATER BODIES/Conservation & Open Space Reserve

(1113) AGRICULTURE/Conservation & Open Space Reserve(1413) PRESERVATION/Conservation & Open Space Reserve(1513) RECREATION/Conservation & Open Space Reserve

(1111) AGRICULTURE/Exclusive Agriculture

GENERAL PLAN DESIGNATION/ZONING DISTRICT

(1517) RECREATION/Landfill Overlay

(3112) MULTI-USE/Development Reserve

(5412) RESEARCH & INDUSTRIAL/Development Reserve

(2112) ESTATE DENSITY RES/Development Reserve(2212) LOW DENSITY RES/Development Reserve(2412) MEDIUM DENSITY RES/Development Reserve(2512) MEDIUM-HIGH DENSITY RES/Development Reserve(2712) HIGH DENSITY RES/Development Reserve

(6912) INSTITUTIONAL-PUBLIC FACILITIES/Development Reserve

(7112) MILITARY/Development Reserve(7012) INSTITUTIONAL-EDUCATIONAL FAC./Development Reserve(7011) INSTITUTIONAL-EDUCATION FAC./Exclusive Agriculture

(4712) NEIGHBORHOOD COMMERCIAL/Development Reserve(4812) COMMUNITY COMMERCIAL/Development Reserve

6.1 Institutional

5.1

5.2

5.3

5.4

5.5

IBC Multi-Use

IBC Industrial

IBC Residential

General Industrial

Medical and Science

5.6 Business Park

4.9 LPC Regional Commercial2.1

2.2

2.3

2.4

2.5

Estate Density Residential

Low Density Residential

Medium-High Density Residential

High Density Residential

3.1 Multi-Use

Medium Density Residential

1.7 Landfill Overlay

1.8 Golf Course Overlay

7.1 Military

3.2 Transit Oriented Dev.

ORDINANCE # APPROVAL DATE

NOTE: MAP UPDATE 11/11/04 TO INCLUDE

04-04 Feb 24, 2004

04-08

04-11 Sept 14, 2004

04-09 Sept 14, 2004

July 27, 2004

RATTLESNAKERESERVOIR

Frank Bowerman(Bee Canyon)Landfill

SANDCANYONRESERVOIR

LAGUNARESERVOIR

19R

L19

JOHNWAYNE

AIRPORT

3

6

2

51

1

8

4

36

9

28

21

15

5

50

12

11

35

27

22

17

14

10

40

16

20

39

1834

3332

38

31

30

2329

19

1324

25

36

5.1

1.5

2.4

1.22.31.3

2.4 1.2

1.4

4.3

2.3

1.4

2.22.2

1.4

1.4

6.1

2.3 4.32.4

2.2

1.4

6.14.2

2.21.5 5.4

6.1 4.3

1.2

2.4

5.42.22.2 2.2

2.22.2 5.4

1.3

4.3

1.3

5.42.2

1.4

2.3

5.42.22.2 5.42.2

2.2

5.45.4

5.45.4

2.2 2.2 2.2

5.4

2.2 1.6

4.21.4

5.46.1 5.41.5

5.41.5

2.4

1.5

1.5

5.4

1.5

1.5

2.22.32.2

2.2

1.5

5.45.4

2.2

2.2 2.22.25.4

2.2

1.6

6.12.2

2.26.11.5

6.1

4.4

6.16.1

5.4

5.4

2.4

1.5

2.4

1.4

5.4

2.24.1

2.2

1.4

6.1

6.1

6.16.1

2.2

2.2

6.1

1.4

6.1

4.76.1 4.1

3.2

5.41.2

6.1

1.52.32.42.4

2.4 4.7

3.2

1.5

4.55.41.4

3.2

4.6

4.8 5.46.15.4

2.4 1.4 1.14.24.7 4.7

2.36.12.4

4.73.2

6.1

2.4 5.4

4.8

4.8

2.4

1.5

4.7

1.44.2

5.5

2.2

4.86.15.5 1.5

6.1

5.5 4.7

2.2

5.11.5

1.51.5

4.8

1.5

4.7

1.5

1.5

6.12.2

4.85.5

5.45.43.2

4.15.4

5.4

5.54.25.1

2.3 1.5 5.52.3

5.4

1.6 6.14.8

6.1

1.51.5

2.2

4.2

1.3

5.52.4 2.4

6.1 2.46.1

1.5 5.42.4 4.8

2.42.2

6.13.12.2

5.44.1 2.2

4.2

6.11.5

2.4

1.5

2.4

6.11.5

1.24.2

2.4

2.2

1.5

2.21.55.0 4.1 2.5

2.3

2.4

1.4

2.4 1.52.25.1 2.2

2.3

2.2 2.32.4

6.1

1.1

2.3 2.2

1.12.41.52.3

2.32.4 2.2

1.5

2.4 2.56.12.42.3

5.14.1

1.5

1.3

2.2

1.5

2.45.3 1.5

2.2

2.31.52.3 2.21.2

2.32.4

4.2

4.2 1.55.1 2.3

2.25.3

2.2

6.1

2.4

6.1

2.4 2.3 3.15.3 2.4 1.52.45.1

2.35.12.2 1.5

1.5

2.35.1 1.5

2.2

2.4

5.12.2

2.3

1.52.21.5

5.11.6

2.2 1.51.5

3.1

5.3 2.2 2.41.5

2.2

5.1

3.12.2 6.12.32.2

5.13.1

2.35.1

5.1

2.42.3

6.1

1.5

6.12.3

1.5

2.32.25.1 2.3 1.5

5.1 5.1

1.5

3.1 2.4

5.1

2.3 2.41.5 2.2 2.3

2.2

6.1

2.32.3 2.2

2.3

1.5

1.52.2

5.1 6.15.1

2.3 2.25.1 2.45.14.1

5.46.12.2

3.12.42.25.1

1.5

1.56.1

1.5

1.5

6.1

2.22.3

2.4 4.12.31.5

5.1

2.33.1

1.55.05.1 2.25.4

2.35.12.2 2.22.3

1.6

2.43.1 6.1

1.4

2.22.2

5.1

1.5

2.22.36.1 6.1 2.32.41.5 2.3 6.12.2

2.25.1 2.35.1

5.1

5.3

1.42.3

2.2

2.32.22.34.2

5.1

5.1 2.21.4

2.35.1 2.41.5

1.5

2.32.2

5.11.5 2.2

2.2 1.42.4

6.1

5.1

1.5

1.5

2.4

4.1 6.12.42.4

6.1

5.15.15.1

1.4

2.32.22.2

1.4

2.4

5.1

2.4 2.22.21.5

5.12.4

2.2

2.3

2.45.1

1.52.42.3

2.22.4

5.1 5.1

1.5

4.11.55.1

2.2

5.1 2.3

1.55.1

5.11.55.1

5.12.3

5.1

2.2

2.4

5.12.25.1 2.4

2.4

5.1

2.3 4.2

5.1

5.1 2.35.1

2.4

5.15.1

5.1

5.5

1.36.15.1

5.15.1 6.1

3.15.1

5.1

5.1

1.52.3

2.45.1

1.3

5.11.2 6.1

1.21.35.1

5.1

5.15.1

2.25.2

2.3

2.3

2.32.35.15.1

2.2

2.32.3

2.35.1

5.2 1.5

5.2 2.25.2

5.2 4.45.1

2.3

5.11.5

6.1

1.5

5.1 6.15.12.4

2.45.2 2.3

2.3

2.4 2.42.4

5.11.55.2

5.1

1.1

2.25.15.1

2.32.45.1

2.25.12.3

5.1

2.25.1

2.2

1.55.1

1.3

5.12.2

6.1

5.1 1.12.2

5.1 2.4

1.5

2.2 1.16.12.3

2.32.32.3

2.4

2.4

6.14.2

2.21.5

2.2

1.52.2

1.6

2.3

5.4

2.2 1.54.1

2.42.2

2.2 2.42.4

1.4

1.5

1.5

2.3 2.3

1.5

1.5

1.5

5.4

2.3

5.62.2

1.4

2.3

6.16.1

5.6

1.5

1.4

1.52.2

2.22.2

2.4

1.55.62.3

4.9

2.2 2.22.2 2.2

1.5

4.24.9

2.2

1.3

2.31.2

2.32.3

1.4

2.4

2.4

2.2

2.4

1.4

2.3

2.42.4

4.9

2.42.33.1

1.3

1.2

1.2

1.4

1.4

2.4

1.21.2

1.32.4

1.31.2

1.21.2

1.3

5.0A

4.2D 4.2D5.4A

4.2A5.4A

5.4A5.4A4.2A

2.3F

5.4A

5.4A4.2D

5.4A 5.4A

5.4A5.5C

5.4A5.4A

4.2D

5.4A

4.2D

2.1A

5.5C5.5G

3.1A2.4A 5.4B

2.3A4.2M

5.4B

2.3G5.4B

5.4B

1.4A 4.2L2.4A

2.4A

2.3B 2.2B

2.2A2.4B

2.2B

2.2B

2.2B2.2B

2.2B 5.5A 5.5A

2.2B4.4B 5.5D2.4C

5.5A3.1D2.2A2.2B 2.4C

5.5A2.2B 2.2B

2.2A

5.3A 5.5A

2.4D5.5A

2.2B

5.3C 5.5D2.4C

5.3A

5.4B

4.4A4.4A

2.4D2.4D

5.5A

5.5A

4.4A5.3C

3.1D

5.4B2.2C 2.2C 5.5A

5.5D4.2B4.2B2.2C

5.4B

5.5D2.4E 2.2C

2.3C4.2C

2.2C2.3C4.2H

2.3C2.3C 4.3A5.4B

2.3C 2.4D2.4D

2.3C2.4D

2.3C2.4D2.4D

2.4D

5.5D

4.1E2.4D5.3B5.4B

4.2B

4.4B

2.4E2.4D

5.5D

4.2B6.1A2.4E

4.2B6.1A6.1A

2.4E

3.1E1.5A

6.1B1.5A

4.2G

5.5D

2.3K

2.3K

2.4B

2.4C 4.2G4.2A

2.3K

2.4C 3.1E2.4C

3.1E5.5F

2.3H

4.1A

2.4G

4.1B

2.3J

4.1D

4.1B

2.3K

2.3K

5.5E

2.3D2.3D

2.3D2.4F

2.3J

2.3D5.5B

4.2E2.3F

4.2E

2.3I

4.2E

2.3F

2.3F

2.3F

2.3F

2.3F2.3F

2.3F

2.3F

2.3F 2.3F

2.3F 2.3F

2.3F

2.3F

2.3F

2.2/1.8

0 10.5Miles

DATE: November 17, 2004 I:\GIS\GIS_User\Zoning-Map_52X52NEW.mxd

CITY OF IRVINE

ZONING MAPFIGURE 300-1

SITE LOCATION


The Site

TO THE CITY

SITE SURROUNDINGS



ICOI Islamic School

NATURAL STUDIES

This Chapter wi" be Devided in to 5 Di'ent catigores

A- GeologyB- Climate C- Topography D- HydrologyE- Flora & funa

Geology :-


Climate :-


Topography :-The Site Topography almost Flat due to the Function previously Used on the Site Which was farming .


Flora & fauna The Plant list of Irvine will be scanned & attached to this page


Base Map


Safety Considerations We Spoke about the Safety importance for the People in the Homes & now we will speck about the safety Of:-

A- EarthQuake B- FloodsC- Wilde Fires D- Religious aggressions E- Community

EarthQuake Safety :-

From this book wee see that the maximum Magnetite Of a shock in the area is about 6.9 on the Richter scale Thus Design Considerations Of Building Hight & Structure is very impor-tant to take into consideration .


Floods:-The City Has adopted the Zero Run of policy that Drains rain water when Over Flooding into the Ocean Threw an underground system of pipes & channels

Leaving the main agenda to Be the Site have zero run off for the ability to avoid any flood spots or other dilemmas

WildFires :-A - All development in the hillside areas shall be subject to the guidelines established in the September 1976 Fire Protection Planning Task Force Report adopted by the Orange County Board of Supervisors and entitled "Fire Hazard Background Report and Recommendations For The Reduction of Fire Hazard At The Natural Open Space/Urban Development Interface Orange County, California."B- Fire resistant roofing materials must be used on structures occurring within the Hill- side District. Class A minimum os rated .


Religious aggressions:-Due to Current situations it is smart to take into considerations that some people may not ac-cept Muslims in there community .

But in the city of Irvine there is a high muslim population second to Anaheim in the OC & due to the fact that the Islamic center is near to the site & no Major crime has happened it is good to keep a low Key on the Site By Designing it as the Urban plan has Done keeping it in tacked with the community & also by Fencing the community with walls & fences it it a key element in keeping unwanted people out of the Site .

Community safety

By adding a gate to the site entrance & surrounding the site with walls it is a good way in keep-ing people Out also Proper lighting around the fences & & security cameras will increases the safety of the site even though Irvine is the 3rd safest City in the country .

Medical transportation Due to Some Extremes The time From & to the hospital is Crucial From the site to the Medi-cal District in Irvine will take about 4-7 minutes


General Design Policies :-

Walls and Fencing1. Materials. Walls and fencing located adjacent to arterial streets shall be constructed of masonry block with specific finish or detail to match intent of urban design guidelines. Walls and fences dividing common property Jines not adjacent to a public right-of-way may be constructed of any material acceptable to the Planning Commission.2.! Height. Top of walls and fencing along arterial streets shall be a minimum of six feet eight inches in height measured from the finished garde level of the adjoining public sidewalk or top of curb, whichever, is higher. This maximum may be exceeded when higher walls are required as a noise mitigation.Walls and fencing dividing common property Jines not adjacent to a public right-of-way may be constructed at any minimum height, but shall not exceed 7-1/2 feet in height measured from the highest adjacent grade level.

Noise AttenuationPlans for the noise attenuation of units located near arterial highways, freeways, or under the Brown-ing flight corridor which insure that interior and exterior noise levels do not exceed the City of irvine-noise ordinance, shall be submitted for review and approval at the time of builders tentative tract con-sideration for residential development.

Building setbacks -A-Front yard - All structures shall be set bock a minimum of 20 feet from right of way line for either public or private street.B- Side yard - A minimum 5-foot setback for each side yard for main buildings, detached garages, or other accessory structures. Corner lots shall provide a street side yard not less than 10-feet. An overall minimum side yard aggregate of 12-feet shall be required for one story, and on overall minimum of 14 feet for two story.C- Rear yard - The main building shall maintain a minimum setback of 25 feet Detached accessory structures and garages shall maintain a minimum 5-foot setback, subject to the following provisions:1- The structure shall not cover more than 30 percent of the rear yard area.2- Height of the structure shall not exceed 12-feet.3- The structure shall be situated a minimum of 10-feet from the main building.


Projections Into Required Setback

A- Covered patios, trellis, or canopies, unenclosed on at least two sides, shall be setback a minimum of 5-feet from the rear and side yard setback. These uses shall not cover more than 50 percent of the rear yard area.B-Eaves, cornices, chimneys, balconies and other similar architectural features shall not project more than 4-feet into any required front or side or rear yard area.C- Location of swimming pools and/or a spa shall. conform with city regulation 92616.

Fences, Hedges and WallsA- Within front setback area - three feet maximum, except on key lots where the maximum height may be 6-feet within that portion of the front setback area abutting the area where a 6-foot high fence is permitted on the abutting lot and not adjacent to the garage driveway.

b)! Within other setback areas - the minimum height shall be 6-feet, measured from the highest adjacent grade. Fences shall not be constructed in areas reserved as native open space.

c)! For fences adjacent to arterial highways, refer to section 3.5.1

Building Height - 35 feet maximum including any roof mounted equipment.

Lot Coverage - A maximum of 50 percent of the lot area. Covered areas shall include all areas under roof but not including trellis areas, roof overhangs and covered porches outside the exterior wall alignment.

Between Buildings - The minimum horizontal distance between adjacent buildings shall be 10 feet. The minimum distance between buildings may be reduced to 6 feet for no more than a maximum length of 25 feet of a building elevation provided that there are no windows on one elevation for that por-tion of the building elevation with less than a 10 feet setback. If living areas are provided above garages, garage setbacks shall apply.


UTILITIES

Electricity :- Southern California Edison Company provides electrical service to the project area. Existing facilities consist of a substation located at the intersection of Jeffery Rd and Troboulca Avenue, with a 66 Kilovolt (KV) line extending through the project area along Jeffry Rd.

Natural Gas:- The Southern California Gas Company serves the project area through an eight-inch high pressure line

Telephone & cable :- will be provided By AT&T & Cox Communications


BLANK PAGE


Sources BOOKS

Arnold, Dorothy T. Better Elder Care: A Nurse's Guide to Caring for Older Adults. Philadel-phia: Lippincott Williams & Wilkins, 2001.

Beisgen, B. A., M. C. Kraitchman, and A. C. Ellis. Senior Centers: Opportunities for Successful Aging. New York: Springer Publishing Company, 2003.

Clark, Chris L. Adult Day Services and Social Inclusion: Better Days. London: Jessica Kingsley Publishers, 2001.

Harris, Phyllis J. The National Directory of Adult Day Care Centers, 3rd edition. Silver Spring, MD: Health Resources Publisher, 2002.

PERIODICALS

Nieves, E. J. "The Effectiveness of the Assertive Community Treatment Model." Administra-tion and Policy in Mental Health 29, no. 6 (2002): 461–480.


Powell, J., and H. Roberts. "Identifying 'Value' in Day Care Provision for Older People." Jour-nal of the Royal Society of Health 122, no. 3 (2002): 158–164.

Ritchie, L. "Adult Day Care: Northern Perspectives." Public Health Nursing 20, no. 2 (2003): 120–131.

Sanfilippo, J. G., and J. E. Forker. "Creating Family: A Holistic Milieu at a Geriatric Adult Day Center." Holistic Nursing Practice 17, no. 1 (2003): 19–21.

ORGANIZATIONS

Adult Day Care Group. 3 Ramsgate Ct., Blue Bell, PA 19422. Telephone(610) 941-0340, FAX (610) 834-0459. http://www.libertynet.org/adcg .

Alzheimer's Association. 919 North Michigan Avenue, Suite 100, Chicago, IL 60611-1676. 800-272-3900 or 312-375-8700, FAX 312-335-1110. http://www.alz.org .

California Association for Adult Day Services. 921 11th Street Suite 701, Sacramento, CA 95814. (916) 552-7400, Fax: (916) 552-7404. [email protected].

National Adult Day Services Association. 8201 Greensboro Drive, Suite 300, McLean, VA 22102. (866) 890-7357 or (703) 610-9035, Fax: (703) 610-9005. [email protected].

U.S. Administration on Aging. 200 Independence Avenue, SW, Washington, DC 20201. 202-619-0724. AoA [email protected].

OTHER

Administration on Aging. 1998 State Performance Reports. 1998 [cited March 21, 2003]. http://www.aoa.gov/napis/98spr/tables/table4a.html .

"Adult Day Care Checklist." Care Guide. [cited March 21, 2003]. <http://www.careguide.com/Careguide/livingalternatives contentview.jsp?ContentKey=1060> .

"Nursing Homes: Alternatives for Care." Medicare. [cited March 21, 2003]. http://www.medicare.gov/Nursing/Alternatives/Pace.asp .

http://aspe.hhs.gov/daltcp/reports/adultdayCA.pdf

Read more: Adult Day Care - adults, types, children, Definition, Purpose, Description, Results http://www.surgeryencyclopedia.com/A-Ce/Adult-Day-Care.html#ixzz17HIHdU3n


http://www.libertynet.org/adcg

http://www.libertynet.org/adcg

http://www.alz.org/

http://www.alz.org/

mailto:[email protected]






http://www.aoa.gov/napis/98spr/tables/table4a.html

http://www.aoa.gov/napis/98spr/tables/table4a.html

http://www.careguide.com/Careguide/livingalternativescontentview.jsp?ContentKey=1060

http://www.careguide.com/Careguide/livingalternativescontentview.jsp?ContentKey=1060

http://www.medicare.gov/Nursing/Alternatives/Pace.asp

http://www.medicare.gov/Nursing/Alternatives/Pace.asp



http://www.surgeryencyclopedia.com/A-Ce/Adult-Day-Care.html#ixzz17HIHdU3n




LA 599 The Analysis

Under the Supervision of Prof abdual mohsen farahat & Dr mohammad al Shahrani & Dr. Emadi Refat

The Beginning The semester started with a show of all the Studies & its summary

I received a few comments & adjustments on them then began the Analysis stage .

1- a summary of al the natural 7 urban studies

II- Summarizing the human needs By summarizing Maslows Hierarchy


CONCEPTUAL DESIGN

We Came to the conclusion that rather than having a long corridor that is surrounded by rooms divining the rooms in fingers is a much better since it gives us the ability to create small spaces that are like private gardens for the people in the rooms .

& the idea for a roof garden came .

Form Concept Inspired by the name the butterfly form took many forms till I steeled on


Design program


Master plan


Site plan


Sec- tions


Isometric View


Views


SITE DESIGN Before Starting the start Design I had 5 choices in the site design the first option was the

Private gardens I had then the pool area but in the end 2 selected designs where

Roof garden :-


This is one of the designs that really made me feel that I have done something ..


Green house


Final sheets


final 599

Design

adult day care centers

adult care regulations

daytime care

skillednursing care

living research

assisted living

special care room

adult daycare