University of California Davis 48X Complex

“These tasks are usually labor-intensive; for example, just floating the floor would require someone mixing mud in the hallway for days,” Bartley said. “In this case, it’s already done. That means fewer disruptions and a more streamlined process. You’re getting a high-quality product without the usual workmanship issues that come from constantly rotating crews in the field. Since the pods are built in a controlled environment, the result is a better product and a more efficient production process. That’s exactly the direction we want to go.”

NAVIGATING CODE AND COMPLIANCE

Delivering prefabricated bathrooms in a healthcare setting required more than design innovation; it demanded deep coordination with regulatory authorities and a clear understanding of California’s stringent building codes. As an HCAI 3 project, the 48X Outpatient Surgery Center had to meet the California Building Code and specific healthcare-related provisions, all while working with UC Davis Health’s building official and fire marshal. This classification allowed for a faster review process than traditional HCAI 1 hospital projects, but still required careful planning around ADA compliance, fire ratings, acoustics, and structural anchorage. UCDH and SmithGroup’s proactive engagement with authorities and early coordination ensured that each unit arrived fully code-compliant, streamlining inspections and reinforcing trust in the prefab approach.

SurePods worked closely with HCAI over six to eight months to develop a standardized inspection process for prefabricated modular bathrooms. This includes material ID inspections at the manufacturing facility, first article inspections for each unique design, and periodic inspections during full production, such as one inspection per 100 pods for a 500-pod project. Final inspections occur onsite to verify mechanical anchorage to the subfloor. Additionally, it’s critical to consider how the pod integrates with the rest of the building, especially transitions in flooring and alignment of wall trims. Details like flush floor transitions using stainless steel strips and matching wainscot trim heights ensure a seamless, code-compliant installation that meets healthcare facility standards.

WHY EARLY DESIGN DECISIONS IS THE KEY TO PREFAB SUCCESS

The shift in mindset required from UCDH and SmithGroup was a major success factor in the project. Unlike traditional construction, where design decisions can evolve over time, the use of SurePods demanded early decisions on finishes, fixture selections, and structural coordination.

“It’s changing the way you think in terms of the stereotypical design process,” said Jackie Lee, lead architect at SmithGroup, highlighting how elements like slab depressions, plumbing rough-ins, and ADA compliance had to be meticulously planned far in advance.

The team worked closely with UCDH and SmithGroup to secure early buy-in on design standards and approvals, ensuring that every prefabricated bathroom unit arrived fully code-compliant and installation-ready. This proactive approach not only streamlined construction but also reinforced the importance of collaborative, front-loaded design in achieving both aesthetic and functional success.

“In terms of a progressive design-build job, which this is, we as architects understood that if the design team took more time designing this and coordinating it during our design phase, it would save time in the field,” Lee said. “And in my understanding, if our job takes a little bit longer or a little more time, but it even saves craft a week or 10 people's time, it is worth it, especially for a project of this size and scale and the schedule in which we had to accomplish it.”

QUALITY WITHOUT COMPROMISE

The PCS certification for SurePods also played a critical role in streamlining approvals and building confidence with HCAI and other authorities.

“We’re being approved with version one, and we’ve expanded upon it into version two,” said Jake Meyer, SurePods project manager. “Now we don’t just have a structurally preapproved pod, we have preapproval for structural, mechanical, electrical, plumbing and fire life safety. Everything except for picking your interior finishes and your fixture specs is fully preapproved by HCAI.”

Traditionally, tasks like tile work would require a worker mixing mud onsite for days, disrupting workflow and compromising quality. With pods, that labor is shifted offsite, plumbing and electrical work are completed in advance, eliminating the need to crowd multiple trades into a small space and reducing construction congestion. This streamlined approach not only improves efficiency but also delivers a higher-quality result. Additionally, prefabrication supports cost and time savings by increasing productivity through a well-organized supply line. The controlled factory environment offers a safer, more focused workspace compared to the unpredictable conditions of a construction site. SurePods, for example, are evolving to meet diverse needs such as angled doors for better nurse visibility thanks to a collaborative design process. The team’s proactive engagement with HCAI staff has accelerated development, moving from initial application to multiple iterations with impressive speed. 

“Having that PCS approval, just the applications, you can discuss this early on with your project teams 'cause you already have those details at your hand that says this is what the sizes can be. This is what my limitations are,” said Cody Bartley. “But the whole PCS program is very new to HCAI in general. There are only five products, so they're still trying to figure out what prefabrication offsite looks like. And I think that's one of the things that they've kind of relied on SurePods to some extent to help figure that out.”

LESSONS LEARNED: ADVICE FOR FUTURE PREFAB PROJECTS

Early alignment and proactive coordination are the most valuable concepts to consider when incorporating prefabrication assemblies. Prefabrication fundamentally reshapes the design process, requiring architects to make critical decisions such as finish selections, fixture placements, and structural accommodations much earlier than in traditional builds. This shift demands a new level of collaboration between the design team, construction partners, and the client.

“Knowing what I know now about SurePods, we could get the team on board much earlier, which would help streamline coordination and reduce rework,” Lee said. “The advice for future projects is clear: if prefabrication is even a possibility, bring it into the conversation during programming. Early commitment enables the design team to plan around prefab constraints and unlocks the full benefits of speed, quality, and efficiency that modular systems offer.”

One of the most important recommendations is to begin pod design as early as possible, with a strong emphasis on standardization. Standardization minimizes the number of unique designs requiring approval from jurisdictions like HCAI, reducing both design and inspection time.

The 48X project proved that prefabrication isn’t just viable, it’s a strategic advantage when executed with foresight and collaboration.