SOW Attachment 2 - VA Kids Care Space Design Guide.pdf

FINAL DESIGN GUIDE– DATED 11/16/2023 DISTRIBUTION PENDING HEFP DECISION ON LOCATION

VA Drop-In Child Care Design Standard for VA Kids Care A Supplement to PG-18-9 Chapter 420 – Childcare Development Center

Developed in collaboration with the following offices:

• Veterans Child Care Assistance Program Office (VCAP)

• Office of Healthcare Environment and Facilities Programs (HEFP)

• Office of Capital Asset Management (OCAM)

• Office of Security and Law Enforcement (OSLE)

• Office of Healthcare Engineering (19HEFE) / Physical Security and Resiliency Design

Manual (PSRDM)

• National Infectious Diseases Service (NIDS)

1. PURPOSE AND SCOPE:

This document provides space and environment requirements for drop-in child care centers at

VA.

2. DEFINITIONS:

VA Kids Care: A drop-in play area where a contractor provides short-term child care services while Veterans attend qualified VA medical appointments. The space for VA Kids Care centers will be approximately 500 - 1,000 square feet and include appropriate security safeguards and restroom facilities for children. Additional cleaning facilities will be required for proper infection control. Cleaning services may be provided by facility Environmental Management Service (EMS), a contract provider, or other sources. Drop-in/short-term childcare services at these locations will be limited to three hours per child per day which will eliminate classification as a full-time day care center.

PG-18-9: A Department of Veterans Affairs Program Guide for the Space Planning Criteria Standard used to develop space planning guidance for the planning, design, and construction of VA healthcare facilities; a Program Guide (PG) that provides space planning guidance for VA Medical Centers (VAMCs) and VA Clinics (formerly called Community Based Outpatient Clinics, or CBOCs). PG-18-9 is organized by chapters; as of September 2021, there are 56 clinical and non-clinical PG-18-9 chapters. They are implemented and deployed in SEPS for space planners working on VA health care projects to develop baseline space programs.

3. OPERATING RATIONALE AND BASIS OF CRITERIA:

The utilization levels of the proposed drop-in child care space are expected to align with general Medical Center utilization levels, where peak utilization occurs between 9:00 a.m. and 1:00 p.m. Utilization during this time might reach a maximum occupancy level of 12 children.

Typical operational occupancy levels are anticipated to be five to six children, with an overall average of 23 children over an eight-hour period. deviations above these levels will require consultation with OHE and VCAP for additional criteria. This would allow care for approximately 6,000 children yearly. Normal operations are expected to be 7:30 a.m. to 5:00 p.m. Monday through Friday, with flexibility to align with the facility’s extended outpatient appointment schedule. Drop-in child care services typically begin 30 minutes before the first appointment and end 30 minutes after the end of the last appointment each day.

Anticipated utilization rates align with a maximum occupancy level of 17 based on the typical state maximum occupancy levels. These levels vary from state to state and are generally consistent at 35 square feet per child in play areas. Maximum occupancy levels should be set at each facility based on its respective state codes.

This also aligns with maximum occupancy levels based on the National Fire Protection Association (NFPA) Life Safety Code (NFPA 101).

There are no variations for individual space requirements based on the children’s ages.

Regardless of age, all children will be monitored within one large open area due to the short duration of stay and high turn-over rate within the daily operating hours. The average length of stay for a VA Kids Care child care encounter is projected to be 60-90 minutes.

4. INPUT DATA STATEMENTS (IDS):

A: How many VA Kids Care centers are approved to be on-site by the Medical Center Director? (Values: 0 to 1)

B: How many child care encounters per facility are projected annually? (Values: 1 to 12,000)

5. SPACE PLANNING CRITERIA:

A. VA Kids Care Center:

1) Provide one, at least 600 NSF if [annual number of child care encounters] is between 700 and 4,000.

2) Provide one at 800 – 1,200 NSF if [annual number of child care encounters] is between 4,001 and 10,000.

3) Provide one at 1,200 – 1,800 NSF if [annual number of child care encounters] is over 10,001.

B. Minimum Requirements for all VA Kids Care centers:

1) Child Care Center Entry / Secure Vestibule …………………………………….……….80 NSF

(This is the controlled access point for patrons, child registration/check-in, and display and informational boards.)

2) ADA Toilet Room with Changing Table Options (Staff and Children) ……….60 NSF The following functions take place in this space:

a) Toilet and sink serving this area shall accommodate adult staff and potty-trained toddlers/young children.

b) Diapering Area - an area for diaper changing and diaper bag storage with direct access to a toilet.

3) Counter/Sink/Cabinet Area …………………………………………………………………….20 NSF

4) Activity / Play Area …………………………………………………………………………….…450 NSF

The following functions take place in this space:

a) Crawl Area - for crawling and floor play.

b) Play / Activity Area - for floor play, wheel toys, etc., including space for cubbies

(individual storage units that provide from 1-4 cubic ft. (0.03 - 01 cubic meters) of storage.

c) Interest Center - for imaginative play, e.g., blocks/construction, manipulative toys, space for science, music, arts and crafts, quiet activities, gross motor activities, etc.

d) Sleeping Area - to accommodate at least one crib for an infant child, including safety equipment.

e) Storage Area (Secured) - for storing cleaning supplies, crib linens, naptime cots or pads, and general supplies required in everyday caregiving activities.

6. PLANNING AND DESIGN Requirements:

A. Architectural Requirements:

1) Door hardware must meet all NFPA standards.

2) Access control to space must be provided. The door from the entry vestibule from any corridor should be locked at all times with the capability of unlocking from the interior, from a remote location.

3) Privacy lock on the bathroom with emergency release in access in case a child needs assistance.

4) Waiting room style flooring would apply to this type of space. A review of PG18-14 indicates that the luxury vinyl tile would be appropriate for the open child care area.

The toilet room should have either porcelain tile or resin floors with painted walls.

Fold-up mats for play areas have also been found to be effectively cleaned and a softer surface for general activities.

B. Life Safety Requirements:

1) NFPA 101 recognizes that a “Drop-In Center” is a unique occupancy. In Section 16.1.1.7* “Rooms or spaces used for temporary child care, during short term activities of the child’s relative or guardian within the same building, shall not be required to meet the provisions of this chapter.” (A.16.1.1.7(3) further clarifies the requirements for temporary short-term child care for medical appointments.

2) Egress and door-locking provisions from the drop-in center must comply with the requirements of NFPA 101.

C. Electrical Requirements:

1) Lighting should be general office lighting.

2) Electrical outlets should be tamper-resistant.

Reference: NPFA 99, Section 7.3.2.2.1 Types of Receptacles, Paragraph (D) indicates:

Receptacles that are located within patient rooms, playrooms, and activity rooms of pediatric units or spaces with similar risk as determined by the health care facility’s governing body by conducting a risk assessment, other than infant nurseries, shall be listed and identified as “tamper resistant” or shall employ a listed tamper-resistant cover.

D. Heating, Ventilation, and Air Conditioning (HVAC) requirements:

1) There is no room in the VA HVAC Design Manual that is applicable to the child care space. Using the requirements for a “exam room” from the Room Data Sheets is recommended for the activity/play area.

2) Toilet room requirements should apply as currently included in the VA HVAC Design Manual.

E. Plumbing requirements.

1) Toilet room requirements should apply as currently included in the VA Design Manuals.

F. Physical Security Observations:

1) The local Medical Center implementation team must include a Physical Security Specialist. This individual will be able to assist in the development of a risk assessment based on the Modified Infrastructure Security Tool (MIST).

2) Security cameras - The VA Police Department (VAPD) camera monitoring system must cover the following spaces:

a) Entry door from corridor to secure vestibule.

b) Activity / Play area.

3) Facility Security Assessment should identify if Panic Alarms or other alerting mechanisms are required.

4) Reference Chapter 5.3 Childcare/Development Center of the Physical Security and Resiliency Design Manual.

a) Facilities in which VA Kids Care facilities are to be implemented may request deviations from, or interpretations of equivalency to, specific PSRDM requirements as part of the project planning; the submissions should include physical security assessments of the proposed space(s) and indicate how the proposed alternative will meet or exceed the physical security protection of the space if it were compliant with PSRDM requirements. The submissions should also include proposed operational plans for the functionality of the spaces, e.g., how staff will ensure appropriate supervision of children, how the facility will plan for varying populations on different days and at different times, how the staff will respond in emergency situations, and how access control will be maintained.

b) VA Kids Care centers should not have an outdoor play area due to the short length of stay and the impact on staffing requirements. If a facility chooses to include an outdoor play area, paragraph 5.3.3 and any other reference to this type of area apply.

5) The information below is based on Appendix C, “Childcare Center Level of Protection Template.” All locations providing Child Care Services must be designated at a minimum of Facility Security Level (FSL) 2, with a baseline Level of Protection (LOP) 1.

6) Site Security Criteria must comply with PSRDM requirements.

7. GRAPHIC EXAMPLES OF SPACES PROVIDED BY THE VETERANS CHILD CARE ASSISTANCE

PROGRAM OFFICE: