Vigor / JRA Medical Clinic by Jessica Tangeman

Vigor / JRA Medical Clinic Vigor / JRA Medical Clinic Architectural Thesis by Jessica Tangeman

Architectural Thesis by

Jessica Tangeman, M Arch

Vigor / JRA Medical Clinic Architectural Thesis by Jessica Tangeman

This is an analysis of the environment as it relates to spaces based on the various users’ physiological conditions within medical clinics.

A / School Identification Number 02819521

B / School and Department Academy of Art University Graduate School of Architecture

C / Units M Arch 87 Units

D / Thesis Presentation May 2016

E / Graduation Date May 2016

JES SICA TA NGEMAN // M ARCH

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Table of Contents / 01 - 09 01 / Background Project Abstract Page 006

04 / Proposed Design Concepts and Plans Page 106

07 / Timeline of Study Courses Page 172

02 / Research Topic and Project Analysis Page 010

05 / Bibliography Research and Images Page 160

08 / Colophon Publisher’s Emblem Page 177

03 / Preliminary Design Design Process Page 076

06 / Index Project Resource Page 166

09 / Acknowledgements Thank Yous Page 179

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Background / Project Abstract

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BACKGROUND

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PROJECT AB STR ACT

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Architects have sterilized medical facilities and have used that as an excuse to not add anything else to make hospitals feel more inviting. There has been progress made towards this goal but it is not at the level that it should be. There is a certain level of sterilization that Doctors and medical facilities must adhere to such as the extreme level of sterilization for that of surgeries. There is also a level of extreme non-sterilization that

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Doctors are aware of such as anything in the outdoors. It is said that children contain the most germs since their bodies are leaning how to create a better and stronger immune system. Since children do tend to carry this high level of germs, the facility itself then tends to contradict its ideal level of pristine sterilization. There is an imaginary harsh wall that one must walk through when entering typical medical facilities. Hallways and

waiting rooms try to act as a barriers between the lowest area of sterilization and the highest level of sterilization. Distractions occur along the way to help separate the reality from the fantasy. The reality is that everyone has problems, health problems. The fantasy is that every’s problems are not as important as they should be. How can architecture blend the levels of sterilization and humanize the facility into one cohesive environment?

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Research / Topic and Project Analysis

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Introduction Concept Statement Friendly and healthy spaces are vital especially when children are the main users. This study helps define what it means to be a healthy environment, what it means to have a playful and friendly atmosphere and how the user’s experience define architecture. Architecture not only brings anticipated users but also unanticipated users under one umbrella. Although this project primarily focuses on the children’s health and their families and even more specifically, children with Juvenile Rheumatoid Arthritis, the project also focuses on bringing the community together in an active, healthy space. It also focuses on enhancing the well being of other neighboring communities.

User Group Narrative The project is inspired by the needs of the patients and users for medical facilities. Arthritis is a disease that is not only a universal link to other disabilities but is also a way of life. With this being said, this project revolves around creating a healthy life style through various programs and spatial conditions. Although the users are primarily children with rheumatoid arthritis and their parents / guardians, the users also extend to the community. The idea of the project is to integrate a landscape that contains different levels of activities to help stimulate a healthy life style. Through expanding the programmatic area needs while integrating landscape, this project can then tap into they psychological needs patients need to help recooperate from medical exams, surgeries, and more.

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Sustainability Narrative Sustainability is more than dealing with the environment, or using new technology to update the building.

This thesis addresses sustainability as a wholistic idea that involves the users and the architecture. The project views the users and the environment as a blended form where public and private spaces can be overlapped and connected. As or the architecture, sustainable architecture is shown in the orientation of the building, materials and their color that reflect the most sun, using the environment to create a natural cooling system and more. Through architecture, this idea of activating the senses can be seen in the various materials and permiable enclosures that not just the staff but everyone can enjoy. Being sustainable is a way of life and not just elements that make up a building. Being sustainable is living a healthy lifestyle where the user and the building become one with the environment.

In terms of what sustainable architecture means for this project, material choices, controlling temperature, and air flow are vital. The site is a desert climate and limits what material to use as well as where to place them. Steel should not be used unless it has a thick coating that helps cool the building down. However, instead of using a steel that absorbs heat, concrete or wood becomes a better choice. What also helps is using reflective materials that bounce the sun off the building. One solution to this can be a green roof system.

Such a system would absorb the heat but would allow for the building to cool down since the plants are taking the heat and not the building. Pushing back entrances so that there is an overhang on the East, South and West facing facades also helps with the cooling along with adding in appropriate louvers on these facades.

This project also relies on an understanding of how heat flows through the building. Although material choices will cut down the amount of heat trapped, heat will still be in the building. Therefore, creating skylights that not only allow for light to penetrate into the spaces but that are operable to allow for the heat to rise up and out of the building is a crucial element.

Cuts

By combining an idea of a healthy lifestyle along with establishing a sustainable building that reflects an understanding of its environment, the project is able to show varying degrees of what sustainable means.

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01 / Sustainable Diagram Site Cuts and Fills

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02 / Sustainable Diagram Green Roof Habitable v. Non Habitable

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Precedent Summary Throughout each of the studies, there is one common goal that each building is trying to achieve, this goal is the healing process for patients should be a better experience. What began as an open yet isolated experience has transformed to an enclosed and non isolated experience. The buildings have become too industrialized and therefore have neglected the atmosphere of the facilities. However, more recently, environmental based design has started to question the negative and positive impacts of such design.

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Instead of designing for the client, Evidence Based Design analyzes sustainable structure, psychological effects on various users and how one heals better in medical clinics. Although Evidence Based Design can be applied to any type of design, for the purpose of this thesis, selected studies related to health care environments will be used to further persuade any design decisions. These can include color selections, room size, furniture placement, physical access or visual access to the environment, number of vehicles on site, material of building and furniture, and pathways. Through these studies, these thesis is a look into what could be rather than what already exists. Although Evidence Based Design has not yet been proven but rather theorized, these levels of analysis will be taken into consideration throughout the entire project.

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Research Summary

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Arthritis may just be one disease, but it can used to help shape architecture to help make other lives better who have different and similar disabilities. Looking at precedents that not only reflect good design but also bad design is what helps a project progress. Trends like Evidence Based Design and incorporating sustainable architecture allows for the designer to be more environmentally and culturally aware. This project will be analyizing experiences from not only on a personal standpoint but on a communal standpoint. The project will be influenced mostly from heaving and in-depth research stemmed from Evidence Based Design. The parts that do not come from the research will be shown in the process of analyzing site conditions and any research that takes place. As a result, the project should reveal an understanding of how the building was created holistically and spatially.

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03 / User Group Patients Age 5 - 17

04 / User Group Family Members and Community

05 / User Group Doctors and Staff

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Medical Research Knowing the Facts About Arthritis

Understanding the Disease

- 50 million adults have doctor diagnosed arthritis - 1 in 5 children over the age of 18 have arthritis - Almost 300,000 babies and children have arthritis or a rheumatic condition. That is 1 in 250 children.

- In the year 2030, it is predicted that 67 million people will be doctor diagnosed with arthritis.

- Carpal tunnel is not the same as arthritis. Carpal tunnel concerns the nerves and is preventable through ergonomic design. Arthritis is an autoimmune disease and the cause is unknown.

- Rheumatology “is the study of rheumatism, arthritis, and other disorders of the joints, muscles and ligaments.”

- Rheumatoid Arthritis is not the same as rheumatology.

Rheumatology is the umbrella that covers all types of arthritis or other such diseases that involve disorders of the joints. Rheumatoid is a specific type of arthritis and is commonly known as Idiopathic Arthritis. The juvenile form is the most common type for children to have and causes persistent joint pain, swelling and stiffness.

- A 2015 CDC shows over 300,000 US children under the age of 16 have juvenile arthritis

Q / What is Arthritis?

A / Painful inflammation and stiffness of the joints Q / Is there a difference between adult and juvenile arthritis?

A / Yes there is a difference. Certain types of children’s arthritis can be outgrown were as adult arthritis cannot.

Q / Why do an architectural thesis project for this disease?

Q / Arthritis is the leading cause of disabilities in America. Arthritis also leads to a variety of disabilities depending on what joint is being affected and how that joint affects surrounding nerves and muscles. Architects have to abide by ADA codes. Designing for arthritic patients is a great way to understand those with different disabilities through the study of the disease.

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01 / Research on Arthritis US Statistic of every age who has arthritis versus those who do not

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02 / Research on Arthritis Common form of Arthritis in the US in all age groups

03 / Research on Arthritis Faces of Arthritis

04 / Bibliography Sources 12, 13, 16, 50

Psoriatic PMR

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Gout

Osteo

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Classifications

Differences

- Clinical Classifications: JRA (Juvenile Rheumatoid Arthritis) , JCA (Juvenile Chronic Arthritis) , JIA (Juvenile Idiopathic Arthritis

- Degenerative Arthritis [Osteoarthritis] Cartilage wears away, bone rubs against bone, causing pain, swelling and stiffness. Risk factors include the following: excess weight, family history, age and previous injury. Balance activities with rest. Use hot and cold therapies. Regular physical activity is important. Maintain a healthy weight. Strengthen muscles around joint for added support. Use assistive devices. Take pain relievers or anti-inflammatory medicines. Avoid excessive repetitive movement.

- Most Common Form Classified in US: JRA - Three Types of JRA: Systemic 10% of total US JRA patients, Polyarticular 40% of total US JRA patients, Particular 50% of total US JRA Patients (% Presentation, clinical course and immunogenic association - What Classifies a Child with Arthritis: A child having 6 persistent weeks of arthritis in a child younger than 16. After a close watch of 6 months by the Doctor, the patient will then be classified with a specific type of arthritis.

- Inflammatory Arthritis [Rheumatoid and Psoriatic] Immune system goes away and causes joint inflammation, joint erosion, damages internal organs, eyes and other parts of the body. Risk factors can include genetics, environment and smoking.

Remission is the goal for this type. Early diagnosis and treatment is crucial. Reduce pain, improve functions to prevent further joint damage.

- Infectious Arthritis A bacterium, virus or fungus that grows on the joint causing inflammation. Organs can be effected. Timely treatment with antibiotics may clear the infection.

- Metabolic Arthritis Uric acid won’t break down as easily as it should in other people. This acid causes a build-up forming crystals around the joint resulting in extreme pain or gout attack. Uric acid levels need to be reduced, if not this can lead to series of other disabilities.

04 / Bibliography Sources 12, 13, 50

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Evidence Based Design Research

01 / Bibliography Sources 14, 15, 22 - 24, 26, 29 - 31, 33, 34, 37, 38, 43, 47

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Various Studies of EBD Evidence based design, or EBD, is design based on research. This research ranges from physiological effects to environmental impact. This thesis is primarily focused on the physiological effects of the patient, family of the patient, doctor and staff in medical clinics, more specifically, juvenile rheumatoid arthritis medical clinic. This project is analyzing ceiling heights, colors, paths, sound, site, touch and total experience in relationship to the various users.

There are studies showing that certain ceiling heights can make a user react in a certain way for the given space. According to the article, “The Influence of Ceiling Height: The Effect of Priming on the Type of Processing That People Use” by Joan Meyers-Levy and Rui [Juliet] Zhu, studies revealed that department stores’ ceiling heights can influence how much people buy and whether or not those purchases ever get returned. Studies show that ceiling heights above the 15 foot height make people want to buy the object because the space is able to illuminate the object. However, these stores above the 15 foot height typically have a high return rate for the item. Whereas stores with a ceiling height ranging from 8 - 10 feet high have less purchases than the higher ceiling heights but have fewer returns. This is because when the object is in a lower ceiling store, the store better shows what the product would look like in the consumer’s home. In a larger ceiling height store, the product may look better in the taller ceiling store than in the actual consumer’s home therefore the consumer ends up returning the product. This explains the number of returns for the varying stores. The reason why more products are being sold in the larger ceiling spaces compared to the lower ones is because the product is essentially

highlighted in the larger space and hidden in the smaller one. But on the contrary, the consumers in the large space often buy based on impulse since the eye can see so far into the space scanning the objects. In a smaller space, the consumer has to look at each individual object one at a time and therefore shops at a slower pace. Imagine applying this research to a clinic.

If consumers end up staying longer in a smaller ceiling height space than a larger one because it best represents the home feel, then one may think that creating a medical clinic that is not just inviting but comforting should be said in the same way. This could apply to that of the exam rooms, bathrooms, office spaces and other heavily used spaces.

Color can play an important role in how people react in spaces. According to the article, “The Physiology of Architecture” by John Leher from WIRED discusses a study done on the effects of a blue room, red room and a white room. The white room ended up being a neutral room where no significant statistics were created. As for the other two rooms, these spaces created spikes in the studies done. The study discusses simulated rooms set up where people were given tasks that ranged from creative thinking to tedious thinking. The study revealed that the red room made people think quickly while working with tedious tasks. The blue room showed that the people did better with more creative tasks. The study said that the reason for this is because the color red provokes a high alert space and high levels of stress.

When someone is actually in danger, quick thinking and problem solving is a must therefore our natural instincts kick in when being placed in a red room. As for the blue room, the color blue reminds people of the sky

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and ocean and therefore the mind can relax and begin to day dream. Relaxing the mind helps the creative juices flow. The best color of blue is one that matches the sky to allow for a more open mind.

This can be useful information since medical clinics have a range of tasks based on the user and the program. Although it might seem strange, painting the walls red in a high task related space can help the users of the space. For example, painting the walls red in surgical room can help the surgeons concentrate on the provided task. The idea for this room is that the patient would require to be asleep before entering the room so that the patient is as calm as possible the before ready, mentally and physically, for the surgery.

However, the exam room, waiting room or other publicly open spaces should painted blue to allow for the patient family and community to feel relaxed in the space.

There are many articles in the Health Design Magazine that discuss the importance of the provoking the senses of the users. This can be easily done through the incorporations of nature into the design of the building. Nature provides ranges of natural and vibrant colors, various scents that depend on the plant and a view that is often taken as relaxing and almost vacation-like. There are various hospitals that include pictures of scenic places as well as fake, or sometimes real, plants that are placed through out the building.

Although this is just one level of providing more nature into buildings as a form of distractions, this project is meant to reveal more options. One idea is to provide exam rooms levels of access to real nature either visually, physically or somewhere inbetween. Another 01 / Bibliography Sources 14, 15, 22 - 24, 26, 29 - 31, 33, 34, 37, 38, 43, 47

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idea is to provide paths, both indoors and outdoors, that act as a form of meditation. This idea stems from the studies of labyrinths and their purpose, the purpose of gardens, and the need for more inspirational outdoor spaces that can activate the surrounding community.

Also in Health Design Magazine, there are many articles discussing the importance of allowing the patient and their family more control in the spaces. This means that the spaces should be user friendly and more inviting. This can be done in various ways like hiding the medical equipment behind a wall so that if only the patient and/or family wants to see it / use it, they can just pull it out. Another way is by providing various activities to do while the patient and family are waiting.

These activities can be reading, walking, listening or smelling. Such waiting areas can be, therefore, placed next to a kitchen (where cookies can be made to remind people of home) , or next to an accessible garden or pool, or next to a library, or even next to a playground where one can hear children playing.

Evidence Based Design should be used in a lot, if not all projects. At the end of the day, its the user who decides whether or not the spaces are deemed beautiful, inviting and comforting. If architects continue to design spaces that neglect the user’s needs, then the final design of the building was not the best designed space. There are needs that the user desires, like their wish list, but there are also mental and physical needs that must be met in order for the user to continue to want to use the space. Medical clinics are just one example of architectural spaces that need to tend to the users’ mental conditions.

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Commercial buildings should also apply EBD to their layout and design to help better sell their products as well as keep those returns practically to a minimum.

Imagine if homes used EBD. Homes are supposed to be the most welcoming spaces but sometimes the homes are often designed based on the latest trend but not the practicality of the space. Based on my personal experience while working for an Interior Design custom cabinet firm, called Kitchen Matrix, the most request from clients in their home is more storage especially the kitchen. The kitchen is the space where people eat and gather. It is the common space in a house that needs to be open, yet have appliances close enough for ease of access. If storage and its evolving uses are taken more into account in homes then this need would be less evident. Same applies for medical clinics.

Medical clinics are in need of EBD since the purpose of medical clinics is to heal the patient. EBD can help provide designers such as architects, interior designers, engineers, landscape architects, doctors, teachers, artists and other related careers, create spaces and environments that help the users mentally and physically. Although EBD is relatively new for designers, it is an ever-evolving field of study that can help better the world.

Evidence Based Design should be used in a lot, if not all projects. At the end of the day, its the user who decides whether or not the spaces are deemed beautiful, inviting and comforting. If architects continue to design spaces that neglect the user’s needs, then the final design of the building was not the best designed space. There are needs that the user

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desires, like their wish list, but there are also mental and physical needs that must be met in order for the user to continue to want to use the space. Medical clinics are just one example of architectural spaces that need to tend to the users’ mental conditions.

Commercial buildings should also apply EBD to their layout and design to help better sell their products as well as keep those returns practically to a minimum.

Imagine if homes used EBD. Homes are supposed to be the most welcoming spaces but sometimes the homes are often designed based on the latest trend but not the practicality of the space. Based on my personal experience while working for an Interior Design custom cabinet firm, called Kitchen Matrix, the most request from clients in their home is more storage especially the kitchen. The kitchen is the space where people eat and gather. It is the common space in a house that needs to be open, yet have appliances close enough for ease of access. If storage and its evolving uses are taken more into account in homes then this need would be less evident. Same applies for medical clinics.

Medical clinics are in need of EBD since the purpose of medical clinics is to heal the patient. EBD can help provide designers such as architects, interior designers, engineers, landscape architects, doctors, teachers, artists and other related careers, create spaces and environments that help the users mentally and physically. Although EBD is relatively new for designers, it is an ever-evolving field of study that can help better the world.

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Medical Typology - Necessities for the Sick Shelter, improvement of one’s health through structure, levels of care and institution of communication - Problems with Hospitals Too many sick people in one room, defining the quality of space, lack of ventilation and lack of sunlight.

01 / 430 BC Temple of Ascelope Derived from the Greek God Asclepios. The section shows a courtyard in the center. [19]

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02 / 400 BC Hotel in Epidauros House built for guests providing shelter. This is a two story building with 20 quadrants and 160 rooms.

[41]

03 / 140AD Sanctuary of Asclepios Soter Two story building with 20 quadrants and 160 rooms. [42]

04 / 1522 The Hospital Real in Spain The crucifix form was common to show a sign of religious healing. [25]

05 / 1743 Mole Vanitelliana in Italy Designed to protect military authorities from diseases therefore it stretches over 20,000 sm. [35]

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06 / 1754 Frederik’s Hospital, Germany Size of the rooms were determined by the size of the beds. Each bed was 6’x3’ with 6’ spacing between beds [18]

07 / 1774 Hotel-Dieu in France A circular building with radial corridors that allows each corridor to have access to a courtyard. [27]

08 / 1865 Royal Herbert Hospital, London Designed by Captain Douglas Galton, the hospital tries to allow for more ventilation, sunlight and bed space.

[45]

09 / 1935 Beaujon Hospital, Paris France Designed by J. Walter, is a 13 story building with view and ventilation but no access to courtyards [07]

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10 / Bibliography Sources 07, 18, 19, 25, 27, 35, 41, 42, 45

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Precedent Studies Texas Medical Center MD Anderson Cancer Center Alkek Tower Expansion - Date of Completion 1990 (Original Building’s Completion: 1945) - Architect HKS (Orginal Building’s Architect: HKS) - Location Houston, Texas, USA - Construction Material Glass fiber reinforced concrete for exterior facade - Main Materials Glass Fiber Reinforced Concrete (GFRC) a precast system, created a 1 to 1 1/2 inch thick facade (traditionally 7-9 inch precast concrete system is used) . Existing building used precast concrete.

- Building’s Relevance Created a distraction for the patients and doctors during construction by adding in the buffer zone with the use of the mechanical floor.

- Concept To foster the ideas of the MD Anderson culture of collaboration, coordination of many facilities and focus on patients and their families by creating a warm and inviting environment.

- Type of Treatment Outpatient care, parking and offices - Total Square Feet 500,000 sq ft of new construction and 25,000 sq ft of renovation and total of 192 added bed space.

- Special Features Improved staff and patient circulation, way finding and added 8,000 sq ft of enclosed observation deck.

Mechanical floor was created in between the existing an addition to create a buff during the construction.

This facilitated building systems and operations. Using GFRC helped create a lighter attachment to the vertical facade.

01 / Precedent Study Exterior Perspective

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02 / Precedent Study Interior Perspective

03 / Precedent Study Concept Sketch

04 / Precedent Study Concept Sketch

05 / Bibliography Sources 01, 02

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08 / Precedent Study Mapping One’s Experience

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Bumrungrad International Hospital - Date of Completion Original Building in 1980, Expanded Facility in 1997 and Added Outpatient Clinic Building in 2008 - Architect JWT - Location Bangkok, Thailand - Construction Material Steel and Reinforced Concrete - Main Materials Steel and Reinforced Concrete - Buildingâ&#x20AC;&#x2122;s Relevance One of the worldâ&#x20AC;&#x2122;s largest private sector outpatient clinic - Concept A world of care - Type of Treatment Outpatient clinic facility - Total Square Feet 1997 Building has 230,518 sq ft 2008 Building has 187,683 sq ft - Special Features One-stop convenience with cashier and pharmacy stations on each clinic floor, and the 10th floor has a Sky Lobby for premium member lounge and first time registration services.

- Number of Patients per Year 1.1 million patients (outpatient and inpatient) , out of the 1.1 million over 520,000 are international patients from over 190 different countries, 5,500 Outpatients are treated per day - Total Number of Beds 580 Inpatient Beds for medical / surgical / OB / Pediatrics, Adult Intensive Care, Cardiac Care (CCU) , Pediatric Intensive Care, Level III Neonatal Intensive and 275 Outpatient Examination Suites.

01 / Precedent Study Exterior Perspective

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02 / Precedent Study Interior Exam Room Perspective

03 / Precedent Study Interior Lobby Perspective

04 / Precedent Study Site Plan

05 / Bibliography Sources 09

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Boston Children’s Hospital - Date of Completion 1965 (Original Building 1869 - 1945) - Architect TK&A - Location Boston, Massachusetts, USA - Construction Material Reinforced concrete and steel - Main Materials Steel, glass and concrete - Building’s Relevance Known for its intensive research facility that is linked to Harvard Medical School Teaching Hospital and many discoveries like the cure for mumps and measles. It’s the world’s largest research enterprise at a pediatric medical center.

- Concept To train pediatricians so that the facility can serve as a national model for pediatric training and comprehensive care for children - Type of Treatment Laboratory, inpatient and outpatient facilities, research facility, nursing room, dental facility and housing.

- Total Square Feet 600,080 sq ft of state-of-the art laboratory space - Special Features Large research lab and children’s hospital garden for the children and their families - Number of Patients per Year 25,000 inpatient admissions each year, 200+ specialized clinical programs schedule, 26,500 surgical procedures, 158,00 radiological examinations - Total Number of Beds 20 beds in 1869 and is now at 395 beds

01 / Precedent Study Exterior Perspective

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02 / Precedent Study Interior Exam Room Perspective

03 / Precedent Study Interior Perspective

04 / Precedent Study MRI Room Perspective

05 / Bibliography Sources 28

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ASU Health Service - Date of Completion 212 - Architect Lake Flato Architects - Location Tempe, Arizona, USA - Construction Material Wood, glass and steel - Main Materials Wood and glass - Concept To define a healthful, non-clinical, welcoming identity - Type of Treatment ASU campus student and faculty health center with outpatient treatment - Total Square Feet 113,189 sq ft - Special Features Gardens engage with historic neighboring buildings

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02 / Precedent Study Interior Reception Perspective

03 / Precedent Study Site Plan

04 / Precedent Study Floor Plan

05 / Bibliography Sources 04

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06 / Precedent Study Community Connections

07 / Precedent Study Sustainable Detail

08 / Precedent Study Levels of Experience

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Bubup Nairm Children’s Centre - Date of Completion Original Building 1938, Remodel No. 1 1971, Remodel No. 2 2013 - Architect GHD Woodhead - Location Australia - Construction Material Concrete and steel - Main Materials Wood and concrete - Building’s Relevance The original building was a children’s care center.

Although it was demolished, the architects decided to keep the site’s original intent and rebuilt a children’s center that better served the community’s children and facility.

- Concept To stimulate all senses therefore encouraging the community to activate, inspire, teach and explore the building’s many layers.

- Type of Program Offered Meeting room, parking, planning room, kitchen, 3 years or less play room, covered courtyard, older than 3 years play room, outdoor activity yard, family room, administration, consultant room, new parent room, 8 years and older play room and terrace - Total Square Feet 113,189 sq ft - Architect Focused on Sensory and sustainable materials, multi-function adaptability for users and community and sanctuary place.

01 / Precedent Study Exterior Perspective

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02 / Precedent Study Exterior Playground Perspective

03 / Precedent Study Interior Play Area Perspective

04 / Precedent Study Site Plan

05 / Bibliography Sources 10

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06 /

07 /

08 /

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08 / Precedent Study Levels of Experience in Elevation

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Muzeiko Children’s Science Discovery Center - Date of Completion 2015 - Architect Lee H. Skolnick Architecture + Design Partnership - Location Sofia, Bulgaria - Construction Material Concrete and steel - Main Materials Concrete - Building’s Relevance Bulgaria’s first children’s museum built in post-Soviet Easter Europe. The project is the merging of American culture with Bulgaria’s culture.

- Concept To stimulate all senses therefore encouraging the community to activate, inspire, teach and explore the building’s many layers.

- Type of Program Offered Archaeology room, geology room, paleontology room, green roof top, climbing wall, rain garden, amphitheater and outdoor activity space - Total Square Feet 35,000 sq ft - Architect Focused on Open space and layers of transparency

01 / Precedent Study Exterior Perspective

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02 / Precedent Study Exterior Perspective

03 / Precedent Study Interior Play Area Perspective

04 / Precedent Study Site Plan

05 / Bibliography Sources 39

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01 /

02 /

03 /

04 /

06 /

07 /

08 /

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06 / Precedent Study Floor Plan Ground Level

07 / Precedent Study Floor Plan First Level

08 / Precedent Study Levels of Experience in Elevation

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JES SICA TA NGEMAN // M ARCH

Fuji Kindergarten - Date of Completion 2007 - Architect Tezzuka Architects - Location Tokyo, Japan - Construction Material Concrete and steel - Main Materials Wood and Concrete - Buildingâ&#x20AC;&#x2122;s Relevance Interior Spaces are created through furniture placement - Concept Single village - Type of Program Offered Kindergarten School for 500 children - Size 600 ft perimeter, 82 ft tall, 4,278 sq ft - Architect Focused on Opening the space and allowing for children to be outdoors at all times.

- Special Features Roof is a playground for the children, trees are used to separate the classrooms but can also be climbed on from the roof. It is low enough for parents to keep an eye on the children - Benefits of the Design Children are rated the most athletic in the community, children have the highest attention span in the community, children want to stay in the classroom

01 / Precedent Study Exterior Perspective

02 / Precedent Study Exterior Roof Perspective 03 / Precedent Study Interior Classroom Perspective

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04 / Precedent Study Exterior Roof Skylight Perspective

05 / Bibliography Sources 03, 08, 20, 46

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06 / Precedent Study Floor Plan

07 / Precedent Study Roof Plan

08 / Precedent Study Concept Sketch

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Site Analysis California Oregon 25(*21

Key for California Site Border County Border Kern County Border Population Density per sq mile >500 Residents

0217(5(< 7

JA Clinics 50 Mile Radius 100 Mile Radius

1(9$'$ Nevada

Major Intersections, Fwys and Hwys 7.0 to 8.9% Children with Disabilities 5.0 to 6.9% Children with Disabilities 3.5 to 4.9% Children with Disabilities

6$1 /8,6 2%,632

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Kern County Border Bakersfield Border

Hospitals 5 Mile Radius 10 Mile Radius

3$&,),& Pacific 2&($1 Ocean

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Mexico 0(;,&2 01 / Bibliography for California Sources 11 -HVVLFD 7DQJHPDQ

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02 / Bibliography for Kern County Sources 32

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Kern County

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.,1*6 Kings

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6$17$ %$5%$5$ Santa Barbara

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6$1 San Bernardino %(51$5',12

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JES SICA TA NGEMAN // M ARCH

Bakersfield

Shafter 6+$)7(5

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01 / Bibliography for Bakersfield Sources 05, 17

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/$0217 Lamont

Childrenâ&#x20AC;&#x2122;s Clinics 5 Mile Radius 10 Mile Radius Hospitals 5 Mile Radius 10 Mile Radius Physical Therapy 5 Mile Radius 10 Mile Radius Recreational Parks 5 Mile Radius 10 Mile Radius Preferred Site 5 Mile Radius 10 Mile Radius Major Intersections, Fwys and Hwys

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CHAPTER 02

About Bakersfield Region Incorporated Named for Area / City Land 1 Water Urban Metro Elevation Population / City Density Urban Density Metro Density

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Bakersfield Climate San Joaquin Valley 1873-1898 Thomas Baker 143 sq mile 42 sq mile 1.45 sq mile (1.01%) 1.38 sq mile 8.161 sq mile 404 ft 347,483 2,400 ssq mile 3,800 sq mile 100 sq mile

Issues Annual High Temperature Annual Low Temperature Average Temperature Average Precipitation Annual Low Temperature

76.8F 53.4F 65.1F 6.45F 53.4F

This climate may have decent average temperatures, but the temperatures can reach temperatures into the 100s F and can go as low as the 30s F. It does not snow often but does about every 20 years. These extremes pose for heat problems such as extreme electricity bills and tule fog.

and pollutions. Tule fog comes around during the late fall and winter seasons. Tule fog is a problem for many reasons. Typically, one can not see no more than a foot in front of oneâ&#x20AC;&#x2122;s face when it arrives. Tule fog also is a problem because of the pollutions coming from the LA area as well as the dairy farms that are located on the outskirts and in the city of Bakersfield.

Tule fog is a fog mixture composed of water

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JES SICA TA NGEMAN // M ARCH 01 /

Bakersfield Typology Issues Oil Derricks There are an excessive amounts of oil derricks scattered and grouped together throughout the city. Many are still in use but there are many that are no longer in use. This creates excessive waste in construction material. The problem with creating the oil derricks is the fact that once they are created, they cannot be torn down since it creates small gas leaks and becomes toxic to the environment. These are built in the first place because Bakersfield has an abundance amount of oil.

02 /

Commercial Buildings Many commercial buildings are located in the middle of a large parking lot appearing more like an island than a building that interacts with the site and users.

Most people in Bakersfield use cars as means of transportation. Although public transportation, such as the GET bus, is available, people still rely on their own personal cars. This makes many buildings have to support a massive amount of parking spaces.

It is common to see oil derricks scattered in commercial parking lots as well as in residential backyards. When these conditions happen, fences and / or plants often act as the barrier between the machine and the public spaces.

03 /

It is also common to see plants that are nonnative to the area to be planted in both commercial and residential spaces like grass, flowers and any non-desert-like plant. Not only does this consume water but the plants often die and are continuously replaced.

Many major public spaces have fountains in front of the buildingâ&#x20AC;&#x2122;s entrance to create an oasis feel.

01 / City Analysis Oil Fields

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02 / City Analysis Stockdale Tower

03 / City Analysis Padre Hotel

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Suburban There are many different suburban areas in Bakersfield. Many of the homes are built by contractors and are the typical American cookie cutter houses. Each suburban area has itâ&#x20AC;&#x2122;s own way of designating what area was built by what contractor. Walls are often created around each of these different areas labeling them as the area to which they will be known. For example, the most expensive area to live in is the Hagen Oaks and Seven Oaks area. These areas are a mixture of non-gated communities and gated-communities. Each area contains public parks that are primarily used by the residents and public schools.

These suburban areas that are being built today are sprawling out of the cityâ&#x20AC;&#x2122;s boundaries consuming the land designated for farming.

04 / City Analysis Suburban Condition

05 / City Analysis Hot Summer Roads

06 / Bibliography Sources 05, 17

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JES SICA TA NGEMAN // M ARCH 01 /

Site Options

Criteria Location / Near a major Fwy or Hwy / Near a recreational park (preferably near a bike path) or a physical therapy facility / Near a hospital, surgical facility or lab / Near hotels / Near restaurants / Near dentistry clinics

02 /

Lot Size / Between 30,000 sf to 80,000 sf / If lot is smaller than 50,000 sf, then the lot must be large enough to accommodate the building massing and height restriction Urban Condition / Must be currently undeveloped / Must be in the center of the city so as not to contribute to urban sprawl Site 1 Area 78,000 sf and located near [1] hospital, [2] pharmacy, [3] dentist, [4] bike path, [5] OBG/YN, [6] surgical facility, [7] pediatrician, [8] medical center, [9] radiology, [10] ball park, [11] elementary, [12] Hwy 99

03 /

Site 2 Area 54,680 sf and located near [1] hospital, [2] pharmacy, [3] Orthodontist, [4] park, [5] Amtrak train station, [6] elementary, [7] high school, [8] medical facility, [9] hotel, [10] Hwy 99 Site 3 Area 43,170 sq ft and located near [1] hospital, [2] pharmacy, [3] pediatrician, [4] medical center, [5] radiology, [6] surgical facility, [6] park, [8] university [9] bike path, [10] ball park, [11] main road (Stockdale hwy)

01 / Possible Site Selections Site 1

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02 / Possible Site Selections Site 2

03 / Possible Site Selections Site 3

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Site Selection

Site 1 Site 1 contains a mix between residential, commercial and medical. Although the site, itself is not connected to a near Fwy, it is close enough where driving would not be that bad. Site 1 also shows changes in topography allowing for more freedom and flexibility.

There are some negative aspects to site 1.

The site does have existing buildings but that are all medically related. There are four existing buildings which all share similar char-

acteristics but change in scale and square footage. The existing programs consist of an optometrist, surgical center, cardiologist and a family practitioner. The family practitioner deals with a variety of medical practices including an OBG/YN center but also deals with general family doctors. Although having these programs on the site may match to that of my criteria, it does create design challenge where my proposed design must take into account these existing conditions.

proposed building. Within the master plan will be close ups of the proposed building thus providing architectural information that can then be applied to the remainder of the site.

The architectural drawings provided further in the research will show the changes made to the master plan as well as the proposed section of the master plan. These drawings will have to reflect an understanding of the pre-existing conditions as well as the research that has been done for the project.

The positive aspects of the site is that with the variety of building types, the project can encompass a variety of programs and becoming a response to the site. The design will now have to have a master plan showing the evolution of the existing buildings with the

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JJES ES SICA SIC A TANG TTA ANGEMA NGEMAN EMA N // // M A ARCH RC H

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04/ CARDIOLOGIST

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09 /

03 /FAMILY PRACTITIONER

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0’

30’

90’

01 /

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01 / Site Plan Current Condition 06 / Site Photo Optometrist 11 / Site Photo Canal

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02 / Site Photo Entrance 07 / Site Photo Round About

03 / Site Photo Family Practitioner 08 / Site Photo Trailer Home Entrance

04 / Site Photo Cardiologist 09 / Site Photo Apartments

05 / Site Photo Surgery Center 10 / Site Photo Apartments

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01 /

01 / Site Model Existing Condition

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VIGOR

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Program Analysis Program Options Aquatic Therapy

Dental

Operating Room

Things to Consider 2 tank pool with dressing rooms can be designed in 2,000 sf. The supporting rooms and exercise area can be designed in 3,500 sf. The aquatic exercise “continuum area” can be designed in 6,000 sf. An additional 4,000 sf can be added for meeting rooms, hallways, concession areas, public areas, storage, offices, cleaning and laundry. Total square footage required for entire facility is approximately 15,500 sf.

Things to Consider Multiply total square footage by 1.3 to allow for wall and hallway space. Space needs to include staff lockers, staff toilets and employee lounge. If this is a stand-alone clinic, there needs to be a staff lounge of a minimum of 120 sf. Coats, hats, purses or other personal items that go into lockers can be placed in staff lounge or a separate room. There should be restrooms only for staff . Clinics with 6 or fewer members can save funds by providing a unisex staff restroom. Restrooms are approximately 50 sf.

Things to Consider Minimum operating room square footage was determined by combining square footage of minimum amount of equipment required, square footage for minimum number of people required and space of approximately 4’ - 0” for a minimum safe traffic pathway on all four sides of the sterile field.

Sterile field includes: OR table (1.75’ plus 2’) on each side to accommodate for outstretched patient armrests.

Safe traffic path of 4’ includes space for 2 people to meet and pass each other without touching wearing sterile attire standing at the sterile field or sterile surfaces.

Minimum equipment for surgical procedure: anesthesia machine, anesthesia supply cart, anesthesia professional chair, back instrument table, ring stand, 2 trash containers, soiled linen container, hazardous waste receptacle, mayo stand, kick bucket, surgical field suction attached to a wall, image viewers and sharps disposal receptacle.

Required personnel: surgeon, scrub nurse / technician, circulating nurse and anesthesia care provider 9 sq ft rectangle is required for clear door swing when a stretcher is in the room .

01 / Bibliography Sources 40

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Pilates

Rheumatology

Parking

Pilates for Rehab Good for back injuries, cancer, knee injuries, Parkinsonâ&#x20AC;&#x2122;s Disease and trauma

Things to Consider This adds about 35% to the total square footage to account for any common areas, loss factor, or consultation needs (walls, doorways, etc.) .

Bakersfield, CA Municipal Code Title 17.58.110 Medical 1 space for 200 sf of floor area Physical Therapy 1 space for 300 sf of floor area Laboratories 1 space for 250 sf of floor area Park 1 space per 6 people building accommodates

Pilates for Athletes and Trainers Good for athletes to hit the ball farther, run faster, jump higher all with no injuries.

Works trunk, pelvis, shoulder gridle, proper breathing, correct spinal and pelvic alignment and smooth flowing movement.

Pilates for Specific Joints spine, shoulders, wrists, ankles, knees, hips, hands and feet Pilates for Arthritis Works inside out. Starts with deep stabilization muscles that create inner warmth and then moves towards more superficial and distal muscles with few repetitions. Ensures an equal balance of strength. Movements are not quick or high impact but are controlled and smooth. Helps those with arthritis for muscular endurance, cardiovascular endurance, range of motion / flexibility work, posture / body mechanics, balance, coordination, body awareness training, breathing techniques and relaxation techniques.

Equipment used Springs, Tye4, Magic Circle, Bands, Weights, Barrel or Mat Also good for patients with arthritis Bicycle

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Program Options Aquatic Therapy Room Sizes

Dental Room Sizes

Operating Room Sizes

Pool 10’x15’x4’ deep, Temperature: 88F 10’x15’x4’ deep, Temperature: 92F

Fixed Operations 110 sf per Operatory (OC)

Procedure Room Outpatient 150 sf clear space, Inpatient 600 sf

Pool Versitle 75’x45’x4’ to 6’ deep, Temperature: 83-86F Minimum Pool Size 25’x45’x4’ to 6’ deep, Temperature: 83-86F Specialty Pool (Needs Ladders at Entry) 50mx7’ deep, Temperature: 81F Unisex Assisted Care-Giver Dressing Rooms and Showers N/A Examining and Treatment Rooms for Therapist to Evaluate Patients N/A Land Based Exercise Equipment N/A Waiting Areas and Other Amenities N/A

Panoramic X-Ray 30 sf Clean-Up Alcove 2-3 OC 90 sf, 4-8 OC 100 sf, 9-12 OC 150 sf Laboratory 2-3 OC 60 sf, 4-8 OC 80 sf, 9-12 OC 120 sf

Unit Supply Area 2-3 OC 40 sf, 4-8 OC 80sf, 9-12 OC 120 sf

Patient Care Station N/A

Reception 1-4 OC 100 sf, 5-8 OC 120 sf, 9-16 OC 240 sf

Bay Area N/A

Director’s Office 120 sf

Cubicle N/A

Manager’s Office 100 sf

Waiting Area 1-4 OC 120 sf, 5-7 OC 180 sf, 8-13 OC 240 sf Janitorial Closet 40 sf

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Restricted Area N/A Semi-Restricted Area N/A

Restroom 50 sf

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Hybrid Operating Room Inpatient Minimum 24’ Room Dimension

Darkroom 2-8 OC (2 Automatic Developer) 60 sf, 9-16 OC (2 Automatic Developer) 90 sf

Non-Supervisor’s Office 80 sf

01 / Bibliography Sources 40

Operating Room Outpatient 250 sf, Inpatient 400 sf

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Pilates Equipment and Room Sizes

Rheumatology Room Sizes

Equipment Allegro Reformer 8’-9” x 3’-0” Allegro Tower of Power Reformer 9’-7” x 3’-0” Chair 2’-4” x 2’-5” Wood Reformer 2’-3” x 7’-9” Allegro 2 Reformer 2’-2” x 7’-10” Stretch Reformer 2’-1” x 9’-3” Sport Reformer 2’-0” x 8’-1” Wood Reformer with Tower 2’-3” x 7’-9” Allegro 2 Reformer with Tower 2’-2” x 7’-10” Allegro Reformer with Tower 1’-11” x 7’-9” Trapeze Table (Cadillac) 2’-5” x 7’-2” Chair Storage 2’-5” x 2’-4” Ladder Barrel 2’-1” x 4’-0” Step Barrel 2’-5” x 1’-5” Chair-In Use 2’-6” x 2’-0” Avalon Box 2’-7” x 1’-8” Sitting Box 2’-10” x 1’-11” Springboard with Mat 6’-0” x 1’-8” Wall Tower 9’-2” x 3’-5” Mat 1’-11” x 6’-0” Foam Roller 3’-0” x 0’-6” Ped-O-Pull 1’-11” x 2’-1” Baby Arc 1’-11” x 1’-9” Exercise Ball 2’-6” x 2’-6” CoreAlign 2’-0” x 5’-1” CoreAlign with Ladder 3’-6” x 5’-9”

Office Small 12’ x 10’, Large 15’ x 15’

Other Room Furnishings Water Cooler 2’-7” x 2’-10” Water Cooler 1-10” x 1’-10” Shoe Rack 0’-6” x 5’-0” Desk 5’-9” x 2’-8” Typical Room Size (fits 8 equipment) 24’-0” x 16’-0”

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Consultation Room Small 10’ x 10’, Large 10’ x 20’ Exam Room Small 8’ x 10’, Medium 10’ x 10’, Large 12’ x 10’ Reception Small (1 Person) 8’ x 10’, Large (3 Person) 10’ x 14’ Waiting Area Small (6-8 Person) 10’ x 11’, Medium (12 Person) 10’ x 20’, Large (22 Person) 20’ x 20’ X-Ray Small 10’ x x11’, Large 10’ x 17’ Lab Small 5’ x 10’, Large 10’ x 10’ Kitchen Small 8’ x 10’, Large 15’ x 20’ Server Room Small / Closet 4’ x 6’, Large / Closet 10’ x 12’ Work Room Small 10’ x 12’, Large 15’ x 20’ Bathroom Small 7’ x 8’

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JES SICA TA NGEMAN // M ARCH

Program Table Program Proposals

AQUATIC AND PILATES THERAPY

RHEUMATOLOGY

PARKING

Reception Waiting Lockers Restroom Gym Pool Restroom with Shower Storage Exam

240 sf 1,320 sf 210 sf 360 sf 2,640 sf 3,375 sf 620 sf 100 sf 540 sf

Exam Lab

Aquatic Rheumatology Pilates

51 spaces 36 spaces 6 spaces

93 -10 83

TOTAL GROSS SF: TOTAL SF WITH HALLWAY

9,405 sf 15,925 sf

Total Gross sf Total sf with Hallway

Total Spaces Public Transit -10% Required Spaces Motorcycle 5% Handicapped 2% Regular

2,415 sf 915 sf Lab Restroom 210 Lab Workstation 705 Kitchen 1,540 sf Office 1,270 sf Office Workstation 520 Office Conference 750 Reception 240 sf Waiting 990 sf 7,370 sf 14,285 sf

sf sf sf sf

5 2 76

Total Building sf

Parking

Total Proposed sf 30,210 sf Total Proposed Gross sf 16,775 sf Total Existing sf 82,275 sf Total Proposed Gross sf 45,035 sf

Total Proposed Spaces Total Existing Spaces

93 195

Total Spaces Public Transit -10% Required Spaces Motorcycle 5% Handicapped 2% Regular

288 -29 259

Total Gross sf Total sf with Hallway 01 / Bibliography Sources 06, 40

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61,810 sf 112,485 sf

15 6 238

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Existing Program Changes

CARDIOLOGIST Reception Exam Storage Gym Waiting Service Restroom Kitchen Office x 3 Office Conference Office Workstation Total Gross sf Total sf with Hallway

240 sf 3,255 sf 220 sf 3,290 sf 330 sf 1,365 sf 445 sf 1,075 sf 2,170 sf 1,115 sf 1,055 sf 12,390 sf 23,260 sf

FAMILY PRACTITION

OPTOMETRIST

Reception 240 sf Waiting 990 sf Exam 3,285 sf Office 3,715 sf Office Conference 1,020 sf Office Workstation 2,695 sf Kitchen 1,760 sf Storage 415 sf Restroom 600 sf Service 585 sf

Exam Service Restroom Reception Waiting Storage Glasses Retail Office

3,165 sf 795 sf 380 sf 240 sf 1,320 sf 580 sf 1,695 sf 2,460 sf

Total Gross sf Total sf with Hallway

Total Gross sf Total sf with Hallway

10,635 sf 18,285 sf

11,590 sf 17,950 sf

PARKING

SURGICAL Reception Waiting Office Restroom Storage Service Exam Room

Total Gross sf Total sf with Hallway

240 sf 2,310 sf 1,250 sf 780 sf 400 sf 400 sf 5,040 sf

10,420 sf 22,780 sf

Cardiologist Family Practitioner Optometrist Surgical

54 42 42 57

spaces spaces spaces spaces

Total Spaces Public Transit -10% Required Spaces Motorcycle 5% Handicapped 2% Regular

195 -20 175 10 4 161

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Furniture Analysis

What makes a room is not the walls but the experience. People socialize in areas that are comfortable and safe. They congregate in such areas. It is these social areas that define furniture placement. People are not stagnate but rather move around and evolve over time. As people evolve over time, so should the spaces and everything that goes into those spaces.

This is an analysis on what it means today to have furniture. This analysis is based on personal and observational experience. By selecting furniture that is typically used to establish these spaces, one can then analyze who uses what and by how much.

This study is taking a closer look at doctors, staff, parents of the patients, the patients themselves, and the community and how they often they used the furniture. Some pieces get repeated in various spaces allowing for the piece to be moved around to those locations or can be duplicated so as to not have to move the piece. Some pieces are specific to the program in which it sits. This analysis is not taking into account the changes in technology that may alter what furniture may be needed.

With this in mind, the study will need to evolve and become flexible just as peopleâ&#x20AC;&#x2122;s gatherings have evolved.

The color represents the various users and how often they will use them. If the furniture

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is ranked at the highest percentage for either user, then the furniture corresponding to the correct userâ&#x20AC;&#x2122;s color gets placed on the list.

Some users will use the same furniture therefore making the furniture placed on the list get stacked with multiple colors.

The second part of the analysis shows how the furniture has evolved in the proposed project. What changes in this analysis is the furniture that was once an industrial like, typical piece has now evolved into a more homey look thus referencing the EBD research as expressed previously in this book.

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Furniture Analysis Current Condition Aquatic Therapy Waiting Area

Chair F 100% P 100% D 0%

Patient Care Station

Storage F 100% P 50% D 50%

Storage F 100% P 50% D 50%

Water Cooler F 100% P 100% D 100%

Water Cooler F 100% P 100% D 100%

Shoe Rack F 0% P 100% D 50%

Treatment Table F 50% P 100% D 50%

Guest Chair F 100% P 50% D 0%

Bay Area

Storage F 0% P 0% D 100%

Bathroom

Nurseâ&#x20AC;&#x2122;s Station F 0% P 50% D 100%

Doctor Chair F 0% P 0% D 100%

Sink F 50% P 50% D 100%

Computer Chair F 0% P 0% D 100%

Wall Mounted Toilet F 50% P 50% D 100%

Wall Mounted Urinal F 50% P 50% D 100%

Physical Therapy Equipment

Allegro Reformer F 0% P 100% D 50%

Chair F 0% P 100% D 50%

Wood Reformer F 0% P 100% D 50%

Stretch Reformer F 0% P 100% D 50%

Allegro 2 Reformer F 0% P 100% D 50%

Sport Reformer F 0% P 100% D 50%

Allegro Tower of Power Reformer Allegro 2 Reformer with Tower F 0% F 0% P 100% P 100% D 50% D 50%

Wood Reformer with Tower F 0% P 100% D 50%

A l Arm A Chair Ch i Avalon F 0% P 100% D 50%

P d O P ll Ped-O-Pull F 0% P 100% D 50%

C Ali CoreAlign F 0% P 100% D 50%

C Ali with ith L dd CoreAlign Ladder F 0% P 100% D 50%

MatM t F 0% P 100% D 50%

F Roller R ll Exercise E i BallB ll Foam F 0% F 0% P 100% P 100% D 50% D 50%

B bArcA Baby F 0% P 100% D 50%

Office

Office

OFFICE SPACE / 12 x 10 / 15 x 15

EXAM ROOM / 8 x 10 / 10 x 10 / 12 x 10

Chair F 100% P 100% D 0%

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Storage F 0% P 0% D 100%

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Office Chair F 0% P 0% D 100%

058

Desk F 10% P 0% D 100%

Chair F 100% P 50% D 0%

Storage F 25% P 25% D 100%

Sink F 10% P 10% D 100%

Treatment Table F 50% P 100% D 100%

Nurses Station F 50% P 25% D 100%

Doctor Chair F 0% P 0% D 100%

Chair - StorageAllegro Reformer with Tower F 0% F 0% P 100% P 100% D 50% D 50%

Bathroom

Reception

Ch - iIn -I Use U Chair F 0% P 100% D 50%

Ladder Barrel F 0% P 100% D 50%

Computer Chair F 0% P 0% D 100%

Storage F 0% P 0% D 100%

Sink F 50% P 50% D 100%

Wall Mounted Wall Mounted Toilet Urinal F 50% F 50% P 50% P 50% D 100% D 100%

Trapeze Table (Cadillac) F 0% P 100% D 50%

Wall Tower F 0% P 100% D 50%

Couch F 100% Guest Sofa P 100% D 0%

Step Barrel F 0% P 100% D 50%

Sitting Box F 0% P 100% D 50%

Shared Equipment

Waiting Area

Chair F 100% P 100% D 0%

Springboard with Mat F 0% P 100% D 50%

Coffee Table F 100% Coffee Table P 100% D 0%

Storage F 100% Buffet Storage P 50% D 50%

Water Cooler F 100% P 100% D 100%

Water Cooler F 100% P 100% D 100%

Shoe Rack F 0% P 100% D 50%

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Operating Room Procedure Inpatient

Stretcher F 25% P 100% D 50%

Procedure Outpatient

Sink F 10% P 15% D 100%

Doctor Chair F 0% P 0% D 100%

Chair F 100% P 25% D 0%

Storage F 0% P 0% D 100%

Waiting

Sink F 10% P 15% D 100%

Stretcher F 25% P 100% D 50%

Hybrid

Doctor Chair F 0% P 0% D 100%

Chair F 100% P 100% D 0%

F 0% P 0% D 100%

Cubicle

Fixed C - Arm F 10% P 15% D 100%

MRI Scanner F 0% P 100% D 50%

Storage F 0% P 0% D 100%

Couch F 100% Guest Sofa P 100% D 0%

Coffee Table F 100% Coffee Table P 100% D 0%

Storage F 100% Buffet Storage P 50% D 50%

Sink F 50% P 50% D 100%

Patient Care Area

Office Chair F 0% P 0% D 100%

Storage F 0% P 0% D 100%

Office Desk F 0% P 0% D 100%

Desk F 0% P 0% D 100%

Desk F 0% P 0% D 100%

Bathroom

Guest Chair F 50% P 50% D 0%

Wall Mounted Urinal F 50% P 50% D 100%

Bay

Guest Chair F 100% P 50% D 0%

Treatment Table F 50% P 100% D 50%

Wall Mounted Toilet F 50% P 50% D 100%

Nurseâ&#x20AC;&#x2122;s Station F 0% P 50% D 100%

Doctor Chair F 0% P 0% D 100%

Storage F 0% P 0% D 100%

Computer Chair F 0% P 0% D 100%

Rheumatology Office

Chair F 100% P 100% D 0%

Consultation

Storage F 0% P 0% D 100%

Office Chair F 0% P 0% D 100%

Desk F 10% P 0% D 100%

Chair F 50% P 50% D 100%

Waiting Area

Chair F 100% P 100% D 0%

Couch F 100% Guest Sofa P 100% D 0%

Exam Room

Conference Table F 50% P 50% D 100%

TV Cart F 0% P 0% D 100%

Lectern F 0% P 0% D 100%

Buffet Storage F 50% P 50% D 50%

Chair F 100% P 50% D 0%

Storage F 25% P 25% D 100%

Sink F 10% P 10% D 100%

Treatment Table F 50% P 100% D 100%

Nurses Station F 50% P 25% D 100%

Doctor Chair F 0% P 0% D 100%

Coffee Table F 100% Coffee Table P 100% D 0%

Storage F 100% Buffet Storage P 50% D 50%

Computer Chair F 0% P 0% D 100%

Workspace

Table Top Cassette Holder F 0% P 0% D 100%

DR Plate Holder F 0% P 0% D 100%

Standard Tilt + Rotate F 0% P 0% D 100%

Mobile Cassette Holder F 0% P 0% D 100%

Wall Cassett Holder F 0% P 0% D 100%

DCRAD 1200 DR F 0% P 75% D 50%

Cassett Holder with Extension Arm F 0% P 0% D 100%

Tall Cassette Holder F 0% P 0% D 100%

Kitchen

LAB / 5 x 10 or 10 x 10

Guest Chair F 100% P 50% D 0%

Storage F 0% P 25% D 100%

Sink F 25% P 25% D 100%

Doctor Chair F 0% P 0% D 100%

Storage F 0% P 0% D 100%

Computer Chair F 0% P 0% D 100%

X-Ray

Lab

Treatment Table F 25% P 100% D 100%

Reception

Desk F 25% P 25% D 100%

Office Chair F 0% P 0% D 100%

Sink F 100% P 100% D 0%

Wall Mounted Toilet F 100% P 100% D 0%

Lab Chair F 10% P 100% D 10%

Break Room Table F 0% P 0% D 100%

Desk F 0% P 0% D 100%

Storage F 0% P 0% D 100%

Office Chair F 0% P 0% D 100%

Desk F 0% P 0% D 100%

Bathroom

Refrigerator F 0% P 0% D 100%

Dishwasher F 0% P 0% D 100%

Sink F 0% P 0% D 100%

Chair F 0% P 0% D 100%

Sink F 0% P 0% D 100%

Wall Mounted Toilet F 0% P 0% D 100%

Wall Mounted Urinal F 0% P 0% D 100%

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Labyrinth Studies

Labyrinths are typically used as a form of meditation. These meditations can be in the form of religion or reflection. Labyrinths have been around since man has made baskets.

The original labyrinths were a visual form of meditation seen on woven baskets and painted pottery. Today, labyrinths can be seen in gardens, posters and even coloring books. For the reasons of meditation purposes, a series of studies were done on the typology of labyrinths. These studies not only include the overall shape of the labyrinths but the structural components, number of exits and entrances and number of open areas.

These studies also include how long it can take someone to get through each type of labyrinth by measuring how many turns and to what degree they turn.

01 / Bibliography Sources 48

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Labyrinths are not the same as mazes. They share similar characteristics but they can still be distinguished from the other. Mazes are designed to test memory and wayfinding skills. They are meant to get lost and refound again multiple times throughout the experience. Although a labyrinth can appear to be confusing when looking at the overall scheme, labyrinths are meant to have 1-2 paths that will lead you straight to the end with no traps or dead ends. Labyrinths typically have 1-2 end points. Each end point represents where youâ&#x20AC;&#x2122;re mind has started and where it has ended. Mazes can have noise whereas those doing a labyrinth usually follow the path in silence.

Like mazes, labyrinths can be elaborate too.

During the Renaissance period, labyrinths hac up to 15 end points where each end point either had a bench or statue. These were typically placed near medical facilities so that when the person got to a statue, they could say a prayer for those who are sick.

Today, labyrinths are still used for praying and reflecting purposes but have also evolved into a more artistic form. Labyrinths now have moved from what was a more geometric pattern to a more organic shape mimicking cartoon characters and other such pop culture icons. On a larger scale, they can be seen in fields. On a smaller scale they can be seen in books. This study is designed to help influence the circulation in the final project.

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Classical Labyrinths Classic Type 1 Structural Analysis - 2 lines intersecting - 1 area of overlapping / intersecting Path Analysis - 1 entry - goes to center, outside, core - 10 rotations 01 /

Classic Type 2 Structural Analysis - 3 line coming to a point but not intersecting - 2 lines are reflected - 1 line is a scaled down of other 2 lines Path Analysis - 1 entry - goes to center, outside, core, outside, core - 37 rotations

Classic Type 3 Structural Analysis - 2 lines intersecting - 1 area of overlapping / intersecting - lines are reflected - similar to classical type 1 - has end points for start and finish of each line

02 /

Path Analysis - has endpoints non accessible - goes to center outside, outside, center outside, outside, center inside, center, center inside, center - has 1 entry - 33 rotations

03 /

01 / Classical Type 1

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02 / Classical Type 2

03 / Classical Type 3

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Roman Labyrinths Roman Type 1 Structural Analysis - 15 lines - no overlapping - 13 perpendicular lines - 2 sides diagonal / mirrored Path Analysis - 108 rotations - move through segments inside, outside, then next segment - 1 entry

04 /

Roman Type 2 Structural Analysis - 30 intersections - 31 lines - 4 mirrored sides Path Analysis - move inside, outside, inside then next segment - 108 rotations - 1 entry 05 /

Roman Type 3 Structural Analysis - 6 lines - 6 intersections - 4 rotations Path Analysis - move outside, inside, outside and then next segment - 109 rotations

06 /

04 / Roman Type 1

05 / Roman Type 2

06 / Roman Type 3

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Medieval Labyrinths Medieval Type 1 Structural Analysis - 12 lines - 2 intersections - 2 mirrored sides Path Analysis - 1 entry - 29 rotations - move outside left to right, then inside right to left

01 /

Medieval Type 2 Structural Analysis - 27 lines - 25 intersections - 4 segments rotated Path Analysis - 60 rotations - 1 entry

Medieval 3 Structural Analysis - 33 lines - 27 intersections - symmetrical sides

02 /

Path Analysis - 128 rotations - 1 entry - moves zig-zag in one segment halfway, then switches to another segment zig-zagging back

03 /

01 / Medieval Type 1

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02 / Medieval Type 2

03 / Medieval Type 3

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Contemporary Labyrinths Contemporary Type 1 Structural Analysis - 5 lines - 4 intersections - 2 zones non-occupiable - 1 possible intersection Path Analysis - 1 entry - 1 fork with opposite exits - forms relatable shape / form

04 /

Contemporary 2 Structural Analysis - 4 lines - 2 intersections - random design - integrated with landscape Path Analysis - 1 entry - organic form with no pattern

05 /

Contemporary Type 3 Structural Analysis - 8 lines - 14 intersections - 1 area in center with 12 intersections - 2 non occupiable sections Path Analysis - 1 entry - 1 fork with opposite exits - integrated into landscape - organic form with pattern

06 /

04 / Contemporary Type 1

05 / Contemporary Type 2

06 / Contemporary Type 3

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Bakersfield Planning Code Occupancy and Construction Type

Property Information Parcel

120-221-07

Address

547 W. Columbus St Bakersfield, CA 93301

Lot Area

279,457 sf (City) 6.42 acres (County)

Occupancy Group

Sect. 308 (I) Industrial Group Sect. 308.3 (I-2) Child Care Facility / Hospitals / Mental Hospitals

Type of Construction

Type 1 UL

Full Sprinklered

Yes, Connected Above to Nurse’s Station / Connected to Automatic Sprinkler System to Domestic Water Service

Siting / Separation

Greater than 10’-0” No-Fire-Rating for both sides 10’-0” or Less Fire Rated on both sides Sect. 705.5 Fire-Resistant Rating

Zoning Information Zoning District

C-2 Commercial

Height / Bulk District

103-18-19

Height Limit

90’-0” Commercial

Setbacks Front

10’-0”

Setbacks Side with Street Facing Corner 10’-0” Setbacks Rear

None

Lot Coverage

None

Floor Area Ratio

?

Building Area Number of Stories

UL

At = Tabular Area per Story

Type I

F = Building Perimeter with > 20 ft open

840 7965

Special Use District

?

Special Sign District

?

P = Total Building Perimeter

Legislative Setbacks

None

W = Width of Public Way 36

Coastal Zone

None

Portal Authority

None

If = Increase Factor for Sprinkler {F/P-0.25} W/30=

0.13

Nonconforming Uses

?

Is = Increase Factor for Sprinkler

N/A

Neighborhood-Specific Area

?

Redevelopment Area

None

01 / Bibliography Sources 06

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Aa = Allowable Building Area per Story {At+{At+If}+{AtxIf]}= UL

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Egress Program Building Rheumatology

Program Exam Labs Kitchen Office Reception Waiting Total

Area 804 304 512 423 80 330

Load Factor 100 100 200 100 15 15

Occupant Load 8.04 3.04 2.56 4.23 5.33 22 45.20

Number of Exits 1 1 1 1 1 1 1

Corridor Width 44 44 44 44 44 44 44

Door Width 36 36 36 36 36 36 36

Stair Width 44 44 44 44 44 44 44

Aquatic and Physical Therapy

Reception Waiting Lockers Gym Pool Showers Storage Exam Total

80 440 70 880 1125 206 32 180

15 15 50 50 50 50 300 100

5.3 29.3 1.4 17.6 22.5 4.12 0.12 1.8 82.19

1 1 1 1 1 1 1 1 2

44 44 44 44 44 44 44 44 44

36 36 36 36 36 36 36 36 36

44 44 44 44 44 44 44 44 44

Cardiology

Reception Exam Storage Gym Waiting Service Conference Kitchen Office Total

80 1085 72 1096 440 455 200 200 100 512

15 100 300 50 15 300 100 200 100

5.33 10.85 0.24 21.92 29.33 1.56 2 1.79 80.23

1 1 1 1 1 1 1 1 1 2

44 44 44 44 44 44 44 44 44 44

36 36 36 36 36 36 36 36 36 36

44 44 44 44 44 44 44 44 44 44

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Egress Continued Program Building Optometry

Program Exam Service Reception Waiting Storage Workstation Total

Area 1055 132 80 440 192 565 820

Load Factor 100 300 15 15 300 50 100

Occupant Load 10.55 0.44 5.33 29.33 0.64 11.3 8.2 67.79

Number of Exits 1 1 1 1 1 1 1 2

Corridor Width 44 44 44 44 44 44 44 44

Door Width 36 36 36 36 36 36 36 36

Stair Width 44 44 44 44 44 44 44 44

Family Practitioner

Reception Waiting Exam Office Kitchen Storage Service Total

80 330 1095 1238 587 138 194

15 15 100 100 200 300 300

5.33 22 10.95 12.38 2.935 0.46 0.64 54.71

1 1 1 1 1 1 1 2

44 44 44 44 44 44 44 44

36 36 36 36 36 36 36 36

44 44 44 44 44 44 44 44

Surgical

Reception Waiting Office Storage Service Exam Total

80 770 416 132 132 1680

15 15 100 300 300 100

5.33 51.33 4.16 0.44 0.44 16.8 78.51

1 2 1 1 1 1 2

44 44 44 44 44 44 44

36 36 36 36 36 36 36

44 44 44 44 44 44 44

01 / Bibliography Sources 06

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Plumbing Fixtures Program Building Rheumatology

Aquatic and Physical Therapy

Cardiology

Program Exam Labs Kitchen Office Reception Waiting Total

Area 804 304 512 423 80 330

Load Factor 100 100 200 100 15 15

Occupant Load 8.04 3.04 2.56 4.23 5.33 22 45.20

Water Closet M 1 per room N/A N/A 1 per 25 N/A N/A 15

Water Closet F 1 per room N/A N/A 1 per 25 N/A N/A 15

Urinals M 1 per room N/A N/A 1 per 25 N/A N/A 15

Lavatories 1 per room N/A N/A 1 per 40 N/A N/A 12

Reception Waiting Lockers Gym Pool Showers Storage Exam Total

80 440 70 880 1125 206 32 180

15 15 50 50 50 50 300 100

5.3 29.3 1.4 17.6 22.5 4.12 0.12 1.8 82.19

N/A N/A N/A 1 per 125

N/A N/A N/A 1 per 1 per N/A 1 per 1 per 12

N/A N/A N/A 1 per 1 per N/A 1 per 1 per 12

N/A N/A N/A 1 per 1 per N/A 1 per 1 per 12

Reception Exam Storage Gym Waiting Service Conference Kitchen Office Total

80 1085 72 1096 440 455 200 200 100 512

15 100 300 50 15 300 100 200 100

5.33 10.85 0.24 21.92 29.33 1.56 2 1.79 80.23

N/A 1 per 1 per 1 per N/A N/A N/A N/A 1 per 22

1 per 125 N/A 1 per 100 1 per room 12 room 100 125

25

N/A 1 per 1 per 1 per N/A N/A N/A N/A 1 per 22

125 125 100 room

room 100 125

25

N/A 1 per 1 per 1 per N/A N/A N/A N/A 1 per 22

125 125 100 room

room 100 125

25

N/A 1 per 1 per 1 per N/A N/A N/A N/A 1 per 22

200 200 100 room

room 100 125

25

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Plumbing Fixtures Continued Program Building Optometry

Program Exam Service Reception Waiting Storage Workstation Total

Area 1055 132 80 440 192 565 820

Load Factor 100 300 15 15 300 50 100

Occupant Load 10.55 0.44 5.33 29.33 0.64 11.3 67.79

Water Closet M 1 per room N/A N/A N/A 1 per 100 1 per 25 30

Water Closet W 1 per room N/A N/A N/A 1 per 100 1 per 25 30

Urinals M 1 per room N/A N/A N/A 1 per 100 1 per 25 30

Lavatories 1 per room N/A N/A N/A 1 per 100 1 per 25 30

Family Practitioner

Reception Waiting Exam Office Kitchen Storage Service Total

80 330 1095 1238 587 138 194

15 15 100 100 200 300 300

5.33 22 10.95 12.38 2.935 0.46 0.64 54.71

N/A N/A 1 per room 1 per 25 N/A 1 per 100 N/A 22

N/A N/A 1 per room 1 per 25 N/A 1 per 100 N/A 22

N/A N/A 1 per room 1 per room N/A 1 per 100 N/A 22

N/A N/A 1 per room 1 per room N/A 1 per 100 N/A 22

Surgical

Reception Waiting Office Storage Service Exam Total

80 770 416 132 132 1680

15 15 100 300 300 100

5.33 51.33 4.16 0.44 0.44 16.8 78.51

N/A N/A 1 per 25 1 per 100 N/A 1 per room 31

N/A N/A 1 per 25 1 per 100 N/A 1 per room 31

N/A N/A 1 per 25 1 per 100 N/A 1 per room 31

N/A N/A 1 per 25 1 per 100 N/A 1 per room 31

01 / Bibliography Sources 06

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Sustainability

Sustainable architecture plays especially an important role in the design of the project.

Sustainable architecture is in essence a healthy building. Just like the program chosen for the project promotes a healthy lifestyle, so does the building promote a healthy building. So what does this actually mean? Projects, like the Oakland Museum of Art, are just one of many that promote a healthy building.

These architectural buildings show a full understanding of the building mass orientation, site conditions, site climate, use of material and how much energy it takes for the program within the building to function.

For this particular project, a desert climate requires a green roof system as well as cool to the touch materials. This project also calls 01 / Bibliography Sources 17, 36, 44, 49

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02 / Heat island Heat gain from buildings in Bakersfield, California

for an understanding of the East to West sun conditions especially in the Summer months.

There are different ways to understand how these affect the project. A study done of Bakersfield shows how the sun can heat up the buildings thus the need for air conditioning and other mechanical, electrical products that consume energy.

This study, as seen on page 072 of chapter 02, shows how much heat the building is gaining. Although buildings do want to create an environment that is comfortable to people the building also needs to create an environment that does not contribute to global warming or other such environmental issues. Anything shown in red is a building that is absorbing heat thus has the higher need for air condi-

tioning. Anything shown in blue is a building that has the lowest need for air conditioning thus reflecting the heat. As you can see, there is not much blue for Bakersfield. Some reasons why this is such is because Bakersfield uses a lot of asphalt and dark materials like steel. Concrete or wood would be better material choices for the city to help reduce this.

Flat surfaces that are not angled properly also contribute to the heat factor. Either a green roof that has the plants gaining the heat and the soil creating the barrier or by slanting the roof could also help the problem.

These are all things this project must consider throughout the design of the project especially if the project is promoting a healthy lifestyle.

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SITE

FLAT ROOFS WITH ASPHALT

Roof Albedo 0

0.05

0.10

0.15

0.20

0.25

0.35

0.40

0.45

0.50

0.55

0.60

0.30

1.00

Data Source: Berkeley Lab Heat Island Group 02 / Heat island

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JES SICA TA NGEMAN // M ARCH 01 /

Ground Fill (without green roof)

Cut

01 / Cut and Fill Strategic cut and fill placement along site for master plan

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02 / Sun Path Summer and Winter Sun Path for Site

03 / Habitable and Non Habitable Roof Green Roof System with Walkable Areas and Skylight Placed Based on Programmatic Needs

04 / MEP System Green Roof, Concrete Walls on South Facing Facades, Fans at Ceiling with Open Skylight and Cooling Floor System

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Winter Sun Summer Sun Green Roof to Help Block Sun

02 /

Green Roof System

Walkable Areas

Skylight

03 /

Materials like concrete and a green roof system help lower the Southern sun from heating the building thus minimizing the heat gain on the inside of the building. To help further the needed cooling on the building, the project needs to have additional cooling systems built into it. One solution is to have radiant cooling and heating on the floor.

With just this, the project will still need to have built in cooling system into the building. Another solution is to provide fans at the center of each building pod that directs the heat from inside to the outside passing through the sun roof. The building is too low to have the natural heat pressure push it up and out thus the need for the fan.

Heat Rising and Green Roof Cooling Down Heat

Radiant Heating and Cooling System

Concrete Facade Cooling Down Southern Sun

04 /

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Preliminary Design / Design Process

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Sketches Spatial and Conceptual Analysis

01 /

01 / Sketchbook Current and Proposed Condition of Sterilization

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02 / Sketchbook Environmental and Enclosed Condition

03 / Sketchbook Current Condition of Experiences

04 / Sketchbook Current Condition of Experiences

05 / Sketchbook Crop Circle Conditions

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03 /

04 /

05 /

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VIGOR

01 /

01 / Sketchbook NY Store by Yohi Analysis of Existing and New Conditions Merging

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01 /

02 /

03 /

04 /

01 / Sketchbook Case study on Furniture Defining Space

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02 / Sketchbook Patient Experience

03 / Sketchbook Patient Experience

04 / Sketchbook Patient Experience

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05 /

06 /

07 /

08 /

05 / Sketchbook Patient Experience

06 / Sketchbook Structure versus Space

07 / Sketchbook Vertical Massing Orientation

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08 / Sketchbook Vertical Massing Orientation

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Sketches Spatial and Conceptual Analysis

01 /

01 / Drawing Master Plan Process Trace Single Line Drawing

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02 / Drawing Master Plan Process Trace Two Line Drawing

03 / Drawing Master Plan Process Trace Islands

04 / Drawing Master Plan Process Trace Single Line Drawing with Islands

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03 /

04 /

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Sketches Spatial and Conceptual Analysis

01 /

01 / Drawing Master Plan Process Trace Program Placement

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02 / Drawing Master Plan Process Trace Penetrations

03 / Drawing Master Plan Process Trace Parking

04 / Drawing Master Plan Process Trace Massing with Square Footage

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02 /

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03 /

04 /

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VIGOR

01 / 01 / Drawing Master Plan Process Trace Userâ&#x20AC;&#x2122;s Experience

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Experiences / Self Analysis Surgery / Current Condition Once in the building, there is not a physical connection to the environment. There is no easy transition from one space to another.

Solution Utilizing the outdoor (non-sterile) condition to create a psychological sense of calmness. Using the waiting areas as buffer zones between the extremely sterile environment (operating room) to the extremely non-sterile environment (outdoor) .

Exam / Current Condition The waiting room becomes the transition zone between meeting with the doctor and the pre-exam process. The spaces do not accommodate for family members nor a large age group.

Solution Provide a variety of exam room sizes for the different age ranges. Provide a more linear and clear path between the different pre-exam process and meeting with the doctor.

01 / Surgery Type 1 Current Knee Injection, Not Overnight

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02 / Surgery Type 1 Solution Using Waiting and Exam as Buffer Zones

03 / Surgery Type 2 Current Typical Surgery, Multiple Joint Injections, Can be Overnight, Not Open Wound

04 / Surgery Type 2 Solution Using Visual Connections to Outdoors and Waiting as Buffer Zone

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Key

surg exam wait out Types of Spaces

Levels of Sterile

100%

75%

25%

0%

Visual Connection

Physical Connection

05 / Exam Type 1 Current Small Scale Surgeries (injections) , Check-Ups, Typically for Large Scaled Hospital-like Clinics

01 /

02 /

03 /

04 /

05 /

06 /

07 /

08 /

06 / Exam Type 1 Solution Using Waiting Rooms that are Spread Out Amongst Exams for Clarity

07 / Exam Type 2 Current Quick Check-ups, Small Scale Surgeries (Injections) , Typically Private Practice with Emphasis on JRA

08 / Exam Type 2 Solution Allowing for Non-Sterile Environment to Bleed into Interiors

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Experiences / Self Analysis Continued Physical Therapy / Current Condition Typically not integrated with the JRA clinics but requires constant verbal connection with the JRA doctor.

Is a space that a patient may not go to but if they do, the space becomes utilized on a multiple times a week basis.

Solution Merge the program that is just as important as the check-up with the spaces that the JRA doctor oversees.

Put the idea of a healthy lifestyle into the routines of the typical JRA doctor appointments.

01 / Physical Therapy Type 1 Current No Aquatic Space, More Common Experience of PT, Takes Place After 1st Visit

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02 / Physical Therapy Type 1 Solution Wrap and Private Examination with Psychological Healing Space (Outdoors)

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JES SICA TA NGEMAN // M ARCH The structure is made of reinforced concrete. The structure consists primarily of 18” concrete walls that act as retaining walls when needed, 1’ x 5’ concrete beams that are placed as an irregular waffle slab holding up an extensive green roof system that is habitable, 18” concrete columns supporting main corridor spaces, 18” concrete interior walls that also define the private programmatic spaces.

The concrete for the facade is used for various things like to hold back the earth as well as provide shading from the Souther sun. The walls do get covered on the inside with a wood finish. All exterior concrete is made from wood formed reinforced concrete to thus reference the need for texture that looks like nature. The concrete is stained in hues of red to show the various stages of the pouring techniques that would be used to build the building. By creating a natural looking texture and choosing the color of the stages, the architecture begins to educated the users on how the building was created as well as show the concept of creating a healing space.

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The main circulation (shown in blue drawn arrows in circles) represent the idea of an open floor plan where the social activities and programmatic furniture define the spaces. This circulation is loose and fluid. It is as flexible as the open spaces are flexible. The design allows for easy access to the outdoors. It is because of this ease of direct access that the structure does not have main exit points since there about 1 on each facade. The solid blue boxes shows exits that take slightly longer to exit since it leads directly to the roof garden but if one walks 10’-0” away from these exits, they can walk directly to ground level. The blue dashed lines are the exits that lead directly to the outdoors. The entire structure is made of 18” 2 hour fire proof concrete. Although this is excess for a building this size to have that amount of fire proof membranes, the concept of the design needs to have such thick walls in order to create a harsh boundary between the public (street sides) and the private (buildings on the inside of the property line) . The benefit of this is that since medical clinics have a high demand for fire proofing, the design allows for the code to not only be achieved by the minimum standard, but goes above the minimum to provide for a healthier environment.

Exits to Roof Then to Ground 0

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01 / “About.” Chd. Web. 24 Apr. 2016. [page 024 - 025] 02 / “About MD Anderson.” MD Anderson. Web. 24 Apr. 2016. [page 024 - 025] 03 / “ArchDaily | Broadcasting Architecture Worldwide.” Tezuka Architects. Web. 24 Apr. 2016. [page 036 - 037] 04 / “ASU Health Service / Lake Flato Architects.” ArchDaily. 2013. Web. 24 Apr. 2016. [page 030 - 031] 05 / “Bakersfield Geographic Document Search.” Bakersfield Geographic Document Search. Web. 28 Apr. 2016. [page 40] 06 / “Bakersfield Municipal Code (Bakersfield, California) .” Bakersfield Municipal Code (Bakersfield, California) . Web. 24 Apr. 2016.- Bradshaw, Vaughn. Building Control Systems. New York: Wiley, 1993. Print. [page 054, 055, 066 - 070] 07 / “Beaujon Hospital.” Wikipedia. Wikimedia Foundation. Web. 24 Apr. 2016. [page 023] 08 / “The Best Kindergarten You’ve Ever Seen.” Takaharu Tezuka:. Web. 24 Apr. 2016. [page 036 - 037] 09 / “Bumrungrad International Hospital | Bangkok Thailand.” Bumrungrad Interna tional Hospital | Bangkok Thailand. Web. 24 Apr. 2016. [page 026 - 027] 10 / “Bubup Nairm Children’s Centre / GHD Woodhead.” ArchDaily. 2015. Web. 24 Apr. 2016. [page 032 - 033] 11 / “California Map Collection.” Map of California. Web. 28 Apr. 2016. [page 038] 12 / “The Definition of Arthritis.” Dictionary.com. Web. 13 Mar. 2016. [page 014] 13 / “The Definition of Carpal Tunnel Syndrome.” Dictionary.com. Web. 13 Mar.2016. [page 014]

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14 / “Evidence-based Design.” Evidence-based Design. Web. 24 Apr. 2016. [page 019 - 021] 15 / “EBD.” Evidence Based Design Journal. Web. 24 Apr. 2016. [page 019 - 021] 16 / “Faces of Arthritis.” Faces of Arthritis. Web. 24 Apr. 2016. [page 015] 17 / “FEATURED ITEMS.” San Joaquin Valley APCD Home Page. Web. 24 Apr. 2016. [page 040 - 043, 072 - 073] 18 / “Frederick V of Denmark.” Wikipedia. Wikimedia Foundation. Web. 24 Apr. 2016. [page 023] 19 / “The First Hospital - Asclepius and the Temples of Healing.” The First Hospital Asclepius and the Temples of Healing. Web. 24 Apr. 2016. [page 022, 23] 20 / “Fuji Kindergarten by Tezuka Architects | Architonic.” Architonic. Web. 24 Apr. 2016. [page 036 - 037] 21 / Gerlach-Spriggs N, Kaufmann RE, Warner SB. Restorative Gardens The Healing Landscape. Yale University Press; New Haven, CT, USA: 1998. [page 023] 22 / Grinde, Bjørn, and Grete Grindal Patil. “Biophilia: Does Visual Contact with Nature Impact on Health and Well-Being?” International Journal of Environmen tal Research and Public Health. Molecular Diversity Preservation International (MDPI) . Web. 24 Apr. 2016. [page 019 - 021] 23 / Hamilton, D. Kirk., and David H. Watkins. Evidence-based Design for Multiple Building Types. Hoboken, NJ: John Wiley & Sons, 2009. Print. [page 019 - 021] 24 / “Healthcare Design Magazine: Architecture and Interior Design Trends for Health care Facilities.” Healthcare Design Magazine: Architecture and Interior Design Trends for Healthcare Facilities. Web. 14 Mar. 2016. [page 019 - 021] 25 / “Hospital Real De Granada.” - Wikipedia, La Enciclopedia Libre. Web. 24 Apr. 2016. [page 022, 023]

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26 / “Home / Klassen.” Home / Klassen. Web. 24 Apr. 2016. [page 019 - 021] 27 / “Hôtel-Dieu De Paris.” Wikipedia. Wikimedia Foundation. Web. 24 Apr. 2016. [page 023] 28 / “How Can We Help You?” Boston Children’s Hospital. Web. 24 Apr. 2016. [page 028 - 029] 29 / “Http://www.ijalel.org/pdf/573.pdf.” IJALEL International Journal of Applied Linguistics & English Literature 4.1 (2014) . Web. [page 019 - 021] 30 / “Human Spaces.” Human Spaces Home Comments. Web. 24 Apr. 2016. [page 019 - 021] 31 / Kellert, Stephen. “Biophilia and Biomimicry: Evolutionary Adaptation of Human versus Nonhuman Nature.” Intelligent Buildings International 8.2 (2014): 5156. Web. [page 020] 32 / “Kern County Map.” , Map of Kern County. Web. 28 Apr. 2016. [page 019 - 021] 33 / Kellert SR, Willson EO. The Biophilia Hypothesis. Island Press; Washington DC, USA: 1993. [page 019 - 021] 34 / Kellert SR. Building for Life: Designing and Understanding the Human-Nature Connection. Island Press; Washington, DC, USA: 2005. [page 019 - 021] 35 / “Lazzaretto of Ancona.” Wikipedia. Wikimedia Foundation. Web. 24 Apr. 2016. [page 022, 023] 36 / Loftness, Vivian. “Sustainable Built Environment Sustainability/sustainable Built Environment , Introduction.” Sustainable Built Environments (2013): 62033. Web. [page 072, 073] 37 / Manaker GH. Interior Plantscapes: Installation, Maintenance, and Management.

3rd ed. Prentice-Hall; Upper Saddle River, NJ, USA: 1996. [page 019 - 021]

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38 / Meyers-Levy, Joan, and Rui Zhu. “The Influence of Ceiling Height: The Effect of Priming on the Type of Processing That People Use.” J Consum Res Journal of Consumer Research 34.2 (2007): 174-86. Web. [page 019 - 021] 39 / “Muzeiko Children’s Science Discovery Center / Lee H. Skolnick Architecture Design Partnership.” ArchDaily. 2015. Web. 24 Apr. 2016. [page 034 - 035] 40 / “Outpatient Clinic.” WBDG. Web. 25 Apr. 2016. [page 050 - 055] 41 / “Pergamon.” Wikipedia. Wikimedia Foundation. Web. 24 Apr. 2016. [page 022, 023] 42 / “Permalik.” Epidauros Site. Tufts.edu. Web. 24 Apr. 2016. [page 022, 023] 43 / “The Psychology of Architecture.” Wired.com. Conde Nast Digital. Web. 14 Mar. 2016. [page 019 - 021] 44 / Radford, Warren, Andre Ptaszynski, Suzanne Riess, Gene Tanke, Kevin Roche, and Mark Cavagnero. The Oakland Museum of California: A Gift of Architecture.

Print. [page 072, 073] 45 / “Royal Herbert Pavilions.” Royal Herbert Pavilions. Web. 24 Apr. 2016. [page 023] 46 / “TEZUKA ARCHITECTS.” TEZUKA ARCHITECTS. Web. 24 Apr. 2016. [page 036 - 037] 47 / Wilson EO. Biophilia. Harvard University Press; Cambridge, MA, USA: 1984. [page 019 - 021] 48 / “Welcome to the Labyrinthos Homepage.” Welcome to the Labyrinthos Homep age. Web. 24 Apr. 2016. [page 060] 49 / Weston, Richard. Alvar Aalto. London: Phaidon, 2004. Print. [page 072, 073] 50 / “What Is Arthritis?” What Is Arthritis? Web. 13 Mar. 2016. [page 014]

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0.00 Cover

0.01 Cover Page 0.02 Table of Contents and Index Introduction, Chapter 06 Page 005, 168, 169 0.03 Project Abstract Chapter 01 Page 006 0.04 Timeline of Study Chapter 07 Page 172, 173

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1.00 Thesis Research and Preliminary Design 1.01 Concept Statement Chapter 02 Page 012 1.02 User Group Narrative Chapter 02 Page 012, 013 1.03 Precedent Studies Chapter 02 Page 022 - 037

1.08 Area Master Plan Chapter 03, Chapter 04 Page 084 - 089, 108 - 114, 116, 117, 138 - 143 1.09 Spatial and Functional Program Chapter 02 Page 050 - 055 1.10 Spatial Analysis Chapter 03 Page 078 - 083, 090 - 093

1.04 Research Chapter 02 Page 012 - 021, 056 - 065, 072 - 075

1.11 Building Code Analysis Chapter 02 Page 066 - 071

1.05 Research Summary Chapter 02 Page 013

1.12 Site Model Chapter 02 Page 048, 049

1.06 Site and Context Analysis Chapter 02 Page 038 - 049

1.13 Conceptual Studies Chapter 03 Page 083 - 089, 098 - 101

1.07 Existing Site Condition Site Plan Chapter 02 Page 046

1.14 Bibliography Chapter 05 Page 162 - 165

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CHAPTER 06

2.00 Thesis Project

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3.00 Thesis Presentation Deliverables

2.01 Study, Process and Massing Models Chapter 03 Page 083, 094 - 105

2.08 Four Building Details Chapter 04 Page 128, 129, 157, 166, 167

3.01 One Complete Presentation Model Chapter 04 Page 119, 120, 125 - 127

2.02 Site Plan Chapter 04 Page 108, 118

2.09 Sustainability Strategy Chapter 02 Page 012, 072 - 075

3.02 Two Exterior Perspectives Chapter 04 Page 130, 131, 134, 135

2.03 Floor Plans Chapter 04 Page 111 - 114, 121 - 124

2.10 Egress Diagram Chapter 04 Page 152 - 153

3.03 Two Interior Perspectives Chapter 04 Page 132, 133, 136, 137

2.04 Building Sections Chapter 04 Page 154 - 157

2.11 Structural Diagrams Chapter 04 Page 144 - 145

2.05 Elevations Chapter 04 Page 138 - 143, 146 - 151

2.12 Mechanical Diagrams Chapter 02 Page 075

3.04 Photos of Physical Models Chapter 02 - Chapter 04 Page 048, 049, 074, 075, 094 105, 109, 110, 116, 117, 119, 120, 125 - 127

2.06 Wall Section Chapter 04 Page 129

2.13 Building Section of Importance Chapter 04 Page 158 - 159

2.07 Partial Elevation Chapter 04 Page 129

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Timeline of Study / Courses

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TIMELINE OF STUDY

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Fall / 2012 ARH 621 - Architectural History 1 Antiquity to da Vinci Instructor - Heuy Ying Hsu Units - 3 ARH 650 - Introductory Design Studio 1 Instructors - Alberto Bertoli, Ethen Wood and Karen Seong Units - 3 ARH 651 - Design Process and 2D Media Instructor - Samuel Mathau Units - 3 GLA 752 - ARH 650 Required Lab Instructor - Brian Lamprell Units - 0

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Spring / 2013 ARH 631 - Architectural History 2 Ascendancy of the Renaissance Instructor - Sean McPherson Units - 3

Fall / 2013 ARH 602 - Graduate Design Technology 1 - Structures Instructor - Francisco Castillo Units - 3

ARH 653 - Introductory Design Studio 2 Instructor - Keith Plymale Units - 3

ARH 635 - Contemporary Urban Theory Instructor - Alexandra Neyman Units - 3

ARH 654 - Design Process and 3D Media Instructor - Doron Serban Units - 3

ARH 641 - Architectural History 3 - Modernism and its Global Impact Instructor - Ethen Wood Units - 3 ARH 656 - Introductory Design Studio 3 Instructor - Jiane Du and Ron Kappe Units - 3

Spring / 2014 ARH 601 - Spatial Composition Instructor - Alvaro Bonfiglio Bardier Units - 3 ARH 609 - Intermediate Design Studio 1 Instructor - Monica Tiulescu Units - 6 ARH 620 - Digitally Generated Morphology Instructor - Benjamin Rice Units - 3

Fall / 2014 ARH 605 - Graduate Design Technology 2- Environmental Controls Instructor - Nathan Ogle Units - 3 ARH 604 - Material and Methods of Construction - Building Detailing Instructor - David Gill Units - 3 GLA 754 - ARH 608 Required Writing Lab Instructor - Alexandra Lacey Units - 0

JR A MEDICAL CLINIC

Spring / 2015 ARH 608 - Advanced Design Studio 1 Concept, Context and Typology Instructors - Nicole Lambrou and Mark Mueckenheim Units - 6 ARH 657 - Design Media - Perspective Instructor - Mark Cruz Units - 3 ARH 658 - Introduction to Computer Aided Drafting and Modeling Instructor - Mark Cruz Units - 3

CHAPTER 07

Summer / 2015 ARH 606 - Construction Documents and Building Code Instructor - Fumio Suda Units - 3 ARH 614 - Architectural Professional Practices Instructor - Elizabeth Tippin Units - 3

Fall / 2015 ARH 619 - Advanced Design Studio 2 Concept and Comprehensiveness Instructors - Benjamin Corotis and David Gill Units - 6 ARH 652 - Architectural Tectonics Instructor - Benjamin Corotis Units - 3 ARH 690 - Thesis Preparation and Development Instructor - David Gill Units - 3

Spring / 2016 ARH 801 - Group Directed Study - Thesis Refinement - Part A Instructor - David Gill Units - 3 ARH 801 - Group Directed Study - Thesis Refinement - Part B Instructor - David Gill Units - 3

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Total Units 87 Units

Graduation Date Spring 2016

ARH 800-5 / GR 460 - Senior Portfolio Instructor - Mary Scott Units - 3

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CHAPTER 08

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C O LOPH O N

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PU B L I S H E R ’ S E M B L E M

Colophon / Publisher’s Emblem A / School Academy of Art University, Graduate School of Architecture

D / Book Binder Blurb

H / Fonts Franklin Gothic URW: book and demi

B / Course Thesis Preparation, David Gill

E / Photographer Jessica Tangeman, Kevin Beer, Sandra Beer and Suzie Durst

I / Software InDesign, Photoshop, Illustrator, AutoCAD, Rhino, Maxwell and Revit

C / Student Jessica Tangeman tangemanjessicab@gmail.com issuu.com/jessicatangeman jessicatangeman.com 661 333 8105

F / Cover Stock Imagewrap, matte finish

J / Copyright © 2016 all rights reserved. No parts of this publication can be reproduced without express permission from Jessica Tangeman.

G / Text Stock Mohawk superfine eggshell, ultra white 100 lbs, 148 gsm

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CHAPTER 09

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AC KNOWLEDGEMENTS

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THANK YO US

Acknowledgements / Thank Yous 01 /

02 /

04 /

Mom, Dad, Ashley Martin, Freddy Martin, Kevin Beer, Stoyan Gaydarov and Suzie Durst thanks for your countless support and love you have given me too many times to count.

Alberto Bertoli, Alexandra Lacey, Alexandra Neyman, Alvaro Bonfiglio Bardier, Benjamin Corotis, Benjamin Rice, Brian Lamprell, Doron Serban, Elizabeth Tippin, Ethen Wood, Francisco Castillo, Fumio Suda, Heuy Ying Hsu, Jaine Du, Karen Seong, Keith Plymale, Mark Cruz, Mark Mueckenheim, Monica Tiulescu, Nathan Ogle, Nicole Lambrou, Ron Kappe, Samuel Mathau, Sean McPherson and Yim Lim Jew, thank you for support and eductaion you have provided in the architectural community.

Deema Zahra, Leslie Breibart, Nicole Tannous, Jamie Joyce, Catherine Owens, Yiyue Chen, Jennifer Gingras, Kristen Gingras, and to Nicole Miletti, thank you for being my family away from home.

03 /

David Gill, thank you for the much needed advice and support in creating this thesis.

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