2019 California Standards for Accessible Design Guide (effective January 1, 2020 with July 1, 2021 amendments)

11B-604.6 Flush controls.

Flush controls shall be hand operated or automatic. Hand operated flush controls shall comply with Section 11B-309 except they shall be located 44 inches (1118 mm) maximum above the floor. Flush controls shall be located on the open side of the water closet except in ambulatory accessible compartments complying with Section 11B-604.8.2.

[2010 ADA Standards] 604.6 Flush Controls. Flush controls shall be hand operated or automatic. Hand operated flush controls shall comply with 309. Flush controls shall be located on the open side of the water closet except in ambulatory accessible compartments complying with 604.8.2.

Advisory 11B-604.6 Flush controls. If plumbing valves are located directly behind the toilet seat, flush valves and related plumbing can cause injury or imbalance when a person leans back against them. To prevent causing injury or imbalance, the plumbing can be located behind walls or to the side of the toilet; or if approved by the local authority having jurisdiction, provide a toilet seat lid. ◼