05A - Appendix D.1 ASR.pdf

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COMMUNITY BASED OUTPATIENT CLINICS

Rolla, Missouri

Appendix D.1 Architectural Narrative & Code

RLP No. 36C10F22R0047

Contract No. 36C10F21N0051

October 19, 2022

This appendix contains Agency Specific Requirements that must be included in the construction and operation of the leased premises. Refer to the Lease Design Narrative (LDN) for additional information.

I. Healthcare Requirements

The lease is for a federal healthcare facility and, as such, local building codes do not capture all requirements needed for the facility to be accredited by The Joint Commission for operation after acceptance. Appendix D contains the additional standards and codes that must be met to ensure accreditation. Several standards and codes depend on the types and quantities of services provided to determine requirements.

The VA intends to treat “zero” patients at any given time who are incapable of self-preservation. This facility will fall into a Business Occupancy.

The Lessor shall follow the most current codes applicable at the time the project is awarded.

NFPA 99

For NFPA 99, Chapter 5, the VA has determined that there will be no medical gases such as air vacuum systems.

1. Only portable cylinders will be used.

For NFPA 99, Chapter 6 and Chapter 7, the VA has determined the following spaces are Category 3 spaces requiring appropriate Essential Emergency Systems. There will be no Category 1 or 2 spaces requiring Essential Emergency Systems.

2. Clinical Neighborhoods/PACT:

a. Medication/Omni – most robust UPS’s and a minimum of 2hrs.

NFPA 101 and IBC

For the Developer to properly determine occupancy type, the VA intends to simultaneously treat “zero” patients at any given time who are incapable of self-preservation.

Occupancy type IBC: Business Occupancy.

The Joint Commission (TJC)

The Joint Commission (TJC) requirements apply to this facility due to it being occupied by the VA under a medical center license, including testing of any generator, exit lights, and emergency lights.

Additional considerations are when conflicts occur between TJC, Facilities Guide Institute (FGI) Standards, Facility

Security Level (FSL) II, and VA Design Guides.

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• No cork boards shall be installed per the VA’s infection control requirement.

Infection Control Risk Assessment for isolation/decontamination rooms:

• For infection control, at least one exam room shall be negative pressure.

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II. General Site Requirements

1. General Parking

a. The design shall not exceed 400 parking spaces unless the city requires, or allows, additional spaces.

b. Offeror shall follow ABAAS requirements for accessible patient/staff parking.

c. Design shall include separate staff parking and staff entry.

d. If it is a shared parking lot, the VA shall use the 400 spaces for VA employees and patients.

e. Motorcycle parking shall include a minimum of six (6) spaces.

f. Parking lot to have future area for drive through immunization complete with power.

2. Electric Vehicle Space and Charging Stations:

a. Provide five (5) electric vehicle (EV) spaces for patients/visitors and five (5) government vehicle spaces, for a total of ten (10) spaces, respectively. The stalls shall be 9' x 20', or 180 sq. ft.

i. Patient/Visitor spaces shall be located in the patient/visitor lot, and GOV spaces in the staff/employee parking area.

ii. Install charging station signs for each EV space.

b. Charging stations shall be managed, operated, and maintained by the Lessor.

c. Patient/Visitor charging stations shall be pay-by-use. GOV shall be metered separately and paid as part of the facility utilities. Lessor can incorporate solar systems into the charging station if it is cost feasible.

d. Charging stations shall be Level 2 capable; 240 V power.

e. Charging Stations shall have appropriate protection and space from vehicles (i.e., parking bollards).

3. Mobile Radiology equipment pad shall be installed for potential future.

a. Confirm there is adequate turning radius and access for size of vehicles.

b. Concrete pad is on grade.

c. Concrete pad is structurally sound for vehicle expected to be placed there.

4. Building Entrances:

a. The main entrance shall have a covered entry for vehicle and patient drop-off.

b. Staff entry to have larger covered entry with awning and dedicated walkways into the building. On the plans, the staff entrance shall be shown located at the opposite side of the Main Entry where staff parking is located.

c. There shall be an ambulance drive entry. If a separate entry cannot be achieved, the ambulance drive can share the same entry as the VA staff. The ambulance drop-off shall be at the staff corridor and have a drop-off area large enough to allow cars to pass. The required awning shall be large enough to cover the rear of the ambulance but should not be as significant as the Main Entry.

d. Logistics docks to have awning.

5. Automatic Door Opener Locations:

a. Main Lobby.

b. All patient toilets.

c. Doors leading from patient corridor to Lobby.

6. Green Space - The VA desires a healing environment for healthcare and patient areas.

a. Maximize green spaces and benches within the parking areas and around the building. Provide concrete pads for VA furnished benches in green spaces. The benches shall be anchored to the concrete pads.

b. Do not include smoking shelters; the CBOC shall be a smoke-free facility.

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c. Provide direct access from Physical Medicine & Rehabilitation (PM&R) to an outside secure courtyard for gait training.

d. Provide direct access to an outside secure courtyard for the Café area.

e. Provide buffers of either greenery and/or barriers (i.e., fencing) along adjacent property lines.

7. Driveway Entry:

a. Driveway shall be off a two directional entry (i.e., Do not locate on a one-way street or boulevard).

b. Provide a secondary staff/service/ambulance entrance.

8. The site shall meet the minimum planning & zoning requirements.

9. Dumpsters are to be placed on a concrete pad and shall not be visible to patients. Enclosure materials shall meet

AHJ standards and complement the building architecture.

10. Marque Sign: The VA shall maintain the VA branding which will be governed by the VA sign design guide and funding shall come from the tenant improvements.

11. Bike Rack: The Lessor shall furnish and install a minimum of one back rack for a minimum of five (5) bicycles.

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III. Building Features

1. Maximize daylight where possible.

a. Maximize glass and exterior views in waiting areas/lobby,

b. Utilize light from outside walls into open workspaces.

2. Provide operable partitions where indicated on plans.

a. Acoustical folding walls in Group rooms and Shared Appointment rooms, STC min 45

3. Slab depression for audiology booths shall maintain fire ratings and acoustical STC ratings

4. Install Eye Wash stations at the following locations:

See Room Contents List for locations, coordinate and confirm with VA Safety personnel.

5. Drinking Fountains

a. Drinking fountains shall include bottle fillers.

6. Safety

a. Combustibles in volume shall have flammable cabinets and are stored in Logistics.

i. Hand Sanitizer Storage (logistics)

ii. O2 portables (logistics)

iii. Sani-wipes and Microkill wipes (logistics)

7. All non-bariatric Toilet Rooms shall have wall mounted non-bariatric toilets and non-bariatric sinks.

IV. Security Requirements

Refer and coordinate with Standard FSL Level II requirements.

1. Overhead Paging: There will be a limited paging system for building emergencies only. This shall be controlled from the Police Operations Room. The paging system shall allow a VA announcement to be heard throughout the facility.

2. Cameras: This facility shall conform to the FSL Level II requirements.

a. Locations – Developer to coordinate and confirm quantities and locations with the VA Police

b. Monitoring

i. All cameras routed to main medical center and in the clinic Police Operations Room via Lenel S2 or RS2 furnished by VA

3. Duress System: The Lynx System shall be used. These are keyboard-based panic alarms that run through the network and shall communicate via Lenel S2 or RS2.

4. All Servers to be on Uninterrupted Power Supply (UPS) – see Appendix E for additional requirements.

5. Emergency and Back Up Power

a. All servers on UPS and emergency power.

b. All emergency exit lighting and exit systems.

c. All medication refrigerators.

d. Any alarms in critical areas.

i. Police Suite

ii. Logistics Warehouse

iii. Exterior Door Entries.

e. Automated medication dispensing system (ex. Pyxis System)

f. Radiology CT Scanners.

g. PM&R large MAT table.

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h. Any Cameras in critical areas

i. Police Operations

ii. Police Suite

iii. Exterior Door Entries

6. Locking System/Doors:

a. VA will use a combination of PIV card readers and 7-pin cylindrical core locks throughout the facility.

b. Single factor key system locations.

i. Medication rooms.

ii. Staff secure corridors.

iii. Patient to staff separation “Intention is to secure staff corridors from patient side” refer to drawings in Appendix B for examples. Locations and counts may vary based on actual site selection and building design

iv. Exam room doors into PACT staff area.

c. Two factor key system locations.

i. Police Suite.

ii. Police Operations.

iii. VA OIT Rooms.

iv. Special Systems.

v. Mechanical and Electrical Rooms.

vi. Armory.

vii. Main Server Computer Room.

viii. Pharmacy.

ix. Other locations as determined during design.

d. Door Alarms will be local to the doors and not to a central system.

7. Motion intrusion detector locations below.

a. Window breaks and doorway required per FSL II

b. Police Suite and Police Operations

c. Logistics Warehouse

d. Medication Alcoves

8. Specialty Area Security

a. Police department:

i. Glazing by VA Design Guide shall be Ballistic glass around operations; however, Blast film is also an option per the VA Police

ii. Walls built to underside of deck with mesh.

iii. Camera in Secure Storage and Armory.

iv. Secure storage needs to be construction with hardened walls and a non-accessible ceiling.

v. Ballistic glazing around operations.

vi. Need a two-factor security key system to the Police Operations and the Suite Entry.

vii. Ability to operate 800mHz radio system within the facility and back to main medical center.

viii. Mental Health Clinic

1. Mental Health Acute Clinic (MAC) Exam rooms shall have anti-ligature measures and viewing windows.

V. Special Space Requirements

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1. Departmental Specific Space Narratives

a. PACT/Clinical Neighborhoods:

i. Consult rooms should be flexible and be plumbed behind the wall for location of a sink where standard Exam room would have one located.

ii. Exam Rooms will have two doors: one for the patient from public access and one from the PACT teamlet area.

iii. Team work areas shall be open areas; maximize daylighting.

1. Utilize light from outside walls into open work spaces. Provide full height interior and exterior store front glazing in conference rooms and break rooms to provide daylighting to team work spaces.

iv. Procedure and Women’s Health Exam Rooms to have lockable cabinets.

v. Storage equipment closets will have locks, power and data jacks for charging and ventilation to release the heat from the equipment.

vi. All Exam, Consult, Shared Group Spaces shall have at least one quad outlet on each wall and data jacks on 2 opposite walls.

vii. Storage, Shared Medical Appointments: provide one quad outlet for refrigeration storage.

viii. Provide ceiling mounted lifts in Procedure rooms.

ix. Conference Rooms: provide HDMI extensions from flat panel display to location on the wall.

x. Tele-health shall meet a minimum STC of 45.

xi. Provide operable room dividing partitions between Shared Medical Appointment rooms to allow for larger spaces. Min STC of 45.

b. Mental Health:

i. Provide operable room dividing partitions between group rooms to allow for larger spaces. Min

STC of 45.

c. Radiology:

i. Provide direct access to toilet from ultrasound rooms.

ii. Plan should allow for movement of a stretcher to the general radiology room. Plan should allow for storage of a single stretcher in an alcove in staff corridor near a covered entry.

iii. Provide dimmable Lights.

d. Eye Clinic:

i. Dispensing & fitting: should be adjacent to the lobby area (retail) and will have store front to waiting area.

ii. Locate Sub-wait area within Eye Clinic where staff can monitor patients.

iii. Eye Clinic patient areas require dimmable lighting options.

iv. Need additional outlets in each room one quad per wall plus 2 additional quads on the non-door walls.

v. Eye Exam Rooms are preferred to be located on interior walls. Eye Exam Rooms on exterior walls shall have no windows.

vi. Install dome mirrors at hallway corners and use reflectors.

vii. Lighting or notification system needed on doors to show when a patient is ready or needs help.

e. Dental

i. All the mobile equipment needs additional power outlets.

f. Pathology & Lab:

i. Specimen toilets have a direct pass-thru cabinet to the Lab and or alcove with counter.

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ii. Specimen toilets to have a nurse call light which connects within the suite only in the need the patient requires help.

iii. One toilet shall be designed so that a staff member shall observe patient in private without any view to the patient corridor. *IS THIS A REQUIREMENT?*

iv. Millwork in the lab will be “built-in” with no vibration.

g. Audiology:

i. Separate the reception/check-in area on a side corridor and not open directly to main waiting area.

ii. Verify booth sizes with VA during Design Development phase.

h. PM&R:

i. Provide direct access to outside or have exterior access nearby.

ii. Maximize daylight.

iii. Install non-slip flooring; for example, a gymnasium grade rubber. Flooring selection shall be appropriate for gait training.

iv. Ceiling height shall accommodate exercise, stair-stepping equipment.

v. Install automatic doors in high traffic or transfer areas.

vi. Provide temporary storage space for wheelchairs and scooters.

vii. Provide space and adequate air exchanges/HVAC for lymphedema.

i. Prosthetics:

i. Provide space parallel bars in Gait Training Room. Configure room to accommodate mirror installation on walls opposite each entrance/exit end of parallel bar.

ii. Install noise attenuation measures in fabrication rooms; STC 55.

iii. Provide space to maneuver wheelchairs and patients with prosthetics. The clinic has special tables and equipment for amputees and patients with mobility challenges.

iv. Install multiple hand cleaning stations, sinks for washing and dumping fluids.

v. Install railings throughout exam rooms and gait room.

vi. Install parabolic mirrors for ingress/egress for those in power mobility, artificial limbs, and gait devices.

j. Police:

i. Ensure masonry wall extend to underside of deck and have a solid ceiling for secure storage, holding rooms and armory. 8” block core walls surround the police suite. Secure lockers will be implemented for evidence storage.

ii. Configure Operations Room at front entry to maximize visibility to the front entry, vestibule, waiting room and reception.

k. Lobby/Reception:

i. Provide centralized Welcome Desk.

ii. Provide check-In at specific Clinical Neighborhoods. Provide enough queuing space.

l. Canteen: *WILL A GATE OF SOME SORT BE REQUIRED TO LOCK OFF THE CANTEEN WHEN IT’S CLOSED?*

i. Will have a small marketplace with limited option purchased from coolers via self check-out.

1. Provide small café area semi-enclosed with partial solid wall height and glazing above.

2. Coordinate location of plumbing and exhaust with VA.

ii. Vending

1. Provide necessary utilities; i.e., water and drain lines a vending facility to be operated under the provisions of the Randolph-Sheppard Act (20 USC 107 et. Seq.).

m. Engineering:

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i. BioMed.

1. Install power strips at 40” on center along counter.

2. Provide additional open data ports – 2 at 40” along counter/workbench.

3. Install double doors for pallet passage.

ii. General Engineering.

1. Install double doors for pallet passage.

2. Install power strips at 40” along counter.

n. Environmental Management System:

i. Install double 180-degree outswing doors in HAC Equipment Room.

1. Provide water source for floor scrubbers and mop sinks in this room.

ii. Install hand sink in recycle area.

iii. Provide storage space by main restrooms.

o. Information Technology – Refer to Appendix E.

p. Logistics:

i. Install sloped-down ramp (semi-truck access)

ii. Install level ramp with lift capability.

iii. Provide space for truck turn-around and back up (semi-truck access).

iv. Install roll up and overhead doors with 10-foot-high clear opening.

v. Install double doors with a total width and height of 6 ft x 8 ft.

vi. Outlets for recharging the forklifts – VA to confirm power requirements.

q. Physical Medicine & Rehabilitation:

i. Provide direct access to outside or have exterior access nearby.

ii. Maximize daylight.

iii. Install non-slip flooring; for example, a gymnasium grade rubber. Flooring selection shall be appropriate for gait training.

iv. Ceiling height shall accommodate exercise, stair-stepping equipment.

v. Maximize day lighting where possible

vi. Ceiling height shall accommodate exercise, stair-stepping equipment.

vii. Install automatic doors in high traffic or transfer areas.

viii. Provide temporary storage space for wheelchairs and scooters.

ix. Provide space and adequate air flow/HVAC for lymphedema.

VI. Commissioning Requirements

In addition to system commissioning requirements called out in FGI, the developer will also test and commission all sound rated walls required by FGI.

1. Minimum STC requirement of 45 for all rooms where patient care is provided.

2. Eyewashes are required to be commissioned with other mechanical equipment.

3. Test and balance reports and corrections need to be provided a minimum of once per five years from date of occupancy.

VII. Maintenance Requirements

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Lessor will maintain utilities and equipment as prescribed by local codes and references listed in Appendix D. Lessor will provide records of the maintenance in the format and frequency required by the VAMC to ensure compliance with TJC.

VIII. Environmental Management Plan

Lessor to provide full service lease, with cleaning and cleaning spaces by Lessor primarily after hours. It is expected that environmental staff be present on-site during business hours for urgent needs and maintenance at restrooms. House

Keeping Aids closets are provided as well as a larger equipment space to house a floor scrubber.

JANITORIAL SERVICES

1. Description of Services.

The contractor shall furnish all personnel, equipment and materials necessary to perform the janitorial services.

Emergencies, unusual and out-of-line situations shall promptly be reported to the contracting officer or his/her designee. Standard cleaning procedures provides the first level of sanitation by routinely cleaning all surfaces which decrease and eliminates the harborage of organisms. Routine and frequent cleaning prevents build-up and accumulation of sites which might enhance micro-organism growth. The frequency of cleaning and cleaning standards will be enhanced by the utilization of disinfectant detergents and sanitizers to continually reduce the level of micro-organisms on all surfaces and to promote and provide the lowest possible infections risk for all patients, employees, and visitors to the Clinic. Standard cleaning procedures is one of the most important aspects of infection control.

1.1. BASIC CLEANING SERVICES. The contractor shall maintain the facility in a state of physical and biological cleanliness on a daily basis. The facility's appearance must fully meet the sanitary and aesthetic requirements for beneficiary healthcare. This includes but not limited to exam rooms, bathrooms, staff break rooms, kitchenettes, lobby and offices.

1.1.1. Maintain Floors. All floors, shall be swept, dust mopped, damp mopped, wet mopped, dry buffed, and spray buffed, as needed, to ensure they have a uniform, glossy appearance and freedom from dirt, debris, dust, scuff marks, heel marks, other stains and discoloration, and other foreign matter. Baseboards, corners, and wall/floor edges shall also be clean. "Wet Floor" signs shall be posted in all areas having received service in order to avoid mishaps. Easily movable items shall be relocated to maintain floors beneath them and returned to their original position once service has been completed.

1.1.2. Vacuum Walk-Off Mats. High Efficiency Particulate Air (HEPA) Filter type vacuum cleaners shall be used to thoroughly clean and restore the resilience of walk-off mats. After vacuuming, walk-off mats shall be free of all visible dirt, debris, and other foreign matter. Walk off mats shall be maintained in good repair.

1.1.3. Waste Collection and Removal. All refuse, trash and garbage containers shall be emptied and returned to their initial location. Any obviously soiled or torn plastic trash receptacle liners shall be replaced. Trash receptacles shall be left clean, free of foreign matter, and free of odors.

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1.1.4. Clean Interior Glass/Mirrors. Clean all interior glass, including glass in doors, partitions, walls, display cases, directory boards, etc. After glass cleaning, there shall be no traces of film, dirt, smudges, water, or other foreign matter.

1.1.5. Clean Drinking Fountains, Ice Machines and Sinks. Contractor shall clean and sanitize all surfaces of drinking fountains, ice machines/ sinks to include the orifice, cofferdam and drain. Surfaces shall be free of streaks, smudges, fingerprints, marks film/residue, stains, spots, scale, soil, and other foreign matter once service has been completed. All metal surfaces shall be cleaned and polished and have a uniform appearance. All cofferdams surrounding ice machines shall be cleaned and free of standing water. Paper towel/soap dispensers associated with sinks/kitchens shall be cleaned, sanitized, and restocked.

1.1.6. Spot Cleaning. Perform spot cleaning on a continual basis. Spot cleaning includes, but is not limited to removing, or cleaning cobwebs, smudges, fingerprints, marks, streaks, spills, etc., from washable surfaces of all walls, partitions, vents, grillwork, doors, door guards, wall guards, door handles, push bars, kick plates, light switches, and fixtures. After spot cleaning, the surface shall have a clean, uniform appearance, free of streaks, spots, and other evidence of soil.

1.1.7. General Dusting. All horizontal surfaces must be dusted or cleaned as necessary to eliminate dust collection.

1.1.8. Exam Table Cleaning. Completely clean and disinfect all surfaces of the exam tables using a germicidal detergent. Exam tables shall be left clean and free of foreign matter.

1.2. BASIC RESTROOMS/ LOCKER ROOM CLEANING SERVICES. The contractor shall accomplish all cleaning tasks to meet requirements for clean restrooms daily.

1.3. Clean and Disinfect. Completely clean and disinfect all surfaces of sinks, toilet bowls, urinals, lavatories, showers, shower mats, dispensers, plumbing fixtures, partitions, dispensers, doors, walls, and other such surfaces, using a germicidal detergent to include de-scaling as needed. After cleaning, receptacles will be free of deposits, dirt, streaks, and odors. Disinfect all surfaces of partitions, stalls, stall doors, entry doors, (including handles, kick plates, ventilation grates, metal guards, etc.), and wall areas adjacent to wall mounted lavatories, urinals, and toilets.

1.4. Sweep and Mop Floor. After sweeping and mopping, the entire floor surface, including grout, shall be free from litter, dirt, dust and debris. Grout on wall and floor tiles shall be free of dirt, mildew, residue, etc. Floors shall have a uniform appearance without streaks, swirl marks, detergent residue, or any evidence of soil, stain, film or standing water. Moveable items shall be tilted or moved to sweep and damp mop underneath. Floors shall be stripped, scrubbed, waxed, etc., as necessary to maintain sanitary conditions and a clean, uniform appearance.

1.5. Restock Restroom Supplies. Contractor shall ensure restrooms are stocked sufficiently so that supplies, including soap for the soap dispensers, do not run out. Supplies shall be stored in designated areas. No overstocking shall be allowed. If supplies run out prior to the next service date, contractor shall refill within one hour of notification.

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1.6. Glass and Mirror Cleaning. All glass/mirrors shall be cleaned in such a manner that all trace of film/residue, dirt, dust, smudges/fingerprints, streak, watermark, and other foreign matter are eliminated.

1.3. PERIODIC CLEANING SERVICES.

1.3.1. Clean Interior Windows. Clean all interior glass window surfaces quarterly. After surfaces have been cleaned, all traces of film, dirt, smudges, water and other foreign matter shall be removed from frames, casings, sills, and glass.

1.3.2. Floor Cleaning. Vinyl no-wax flooring shall be swept, mopped and scrubbed to remove debris only. There shall be no wax type floors of any kind. Clean floors according to flooring manufacturer warranty and recommendation regarding scrubbing. There shall be no damage to the floors. Any damage incurred is of the responsibility of the Lessor to replace.

1.3.3. Wall Cleaning. Wall cleaning to remove routine spills, stains, splatters, marks, etc. shall be provided by the contractor as a part of routine space cleaning. Walls shall be thoroughly and completely cleaned and sanitized with an approved solution to eliminate the hazardous conditions.

1.3.4. Light Fixture Cleaning. Light fixtures shall be cleaned, when ordered by the Government or as needed, to achieve a "free of soil" state. The light cover shall be removed, and the light fixtures shall be cleaned of debris inside and out.

1.4. SPECIAL REQUIREMENTS

1.4.1. Equipment Operation. All housekeepers shall adhere to the manufacturers or established operating procedures when operating battery-powered or electrical floor machines, wet/dry vacuums, scrubbers, etc. All equipment will be cleaned as specified by the manufacturer to ensure operation safety and to eliminate the spread of micro bacteria, nosocomial infection, etc. Battery and electrical equipment will be properly maintained, stored, and charged after each use, if necessary.

1.4.2. Equipment Cleaning. Wheelchairs, stretchers, and Hoyer lifts in storage for patient escort use shall all be cleaned with a germicidal once a week or as needed.

1.4.3. Emergency or Special Event Cleaning Services. Upon notification, the contractor shall perform emergency or special event cleaning required in any area or room covered under this contract. The contracting officer shall order cleaning services through issuance of a delivery order for the appropriate and required work task(s). Contractor shall begin emergency work, as determined by the contracting officer, within one hour of notification, which may be verbal. The contracting officer or designated representative will notify the contractor as soon as a special event requirement is known, but not less than 24 hours prior to the event. Completion schedule shall be determined for each delivery order.

1.4.4. Exterior Window Cleaning. Exterior windows shall be cleaned semi-annually, to achieve a "free of soil" state. This includes cleaning of the frame, the areas immediately adjacent to the frame, ledges, and removing, cleaning, and replacing window screens.

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1.4.5. Curtains and Blinds Cleaning. Blinds shall be removed and cleaned inside and out as needed, to achieve a "free of soil" state. Privacy curtains in examination rooms shall be the responsibility of the government.

2. Personnel Management.

2.1.1 Employee Roster. The Contractor shall establish a roster of Contractor employees within 30 calendar days after the start of this contract. The roster shall list the name and job title of each Contractor employee. The Contractor shall provide a copy of the personnel roster and changes thereto to the COR.

Non-Government contract employees shall be subject to a thorough security screening for issuance of a

Government employee badge.

2.1.2 Employee Discipline. The Contractor shall take prompt, appropriate action in all instances of employee misbehavior that may reflect adversely upon the Government. The Contractor shall furnish to the CO or

COR, for review, a written report of disciplinary action taken in those instances where an infraction of a

Government regulation has been reported and substantiated.

2.1.3 Employee Schedules. The Contractor shall prepare and maintain employee schedules for all Contractor employees to ensure that VA internal security is maintained (i.e., determine if personnel are scheduled to work). Schedules shall be provided as requested by COR. If overall time of performance changes, COR is to be notified.

2.1.4 Communication. All Contractor employees, who must communicate with the COR, must be able to read, write, speak, and understand the English language to ensure the effective administration of this contract and accurate ordering of work.

2.1.5 Standards of Conduct. While on duty and executing the specifications of this contract, Contractor employees are prohibited from using and/or possessing alcohol, non-prescription drugs, and firearms.

Non-compliance with this requirement, confirmed by the COR, shall be grounds for immediate removal of the Contractor employee from the VA and baring the individual from performing further work under this contract. All contractor employees will be required to provide customer service consistent with that of the VA’s mission.

2.1.6 Training. The Contractor shall develop an employee-training plan and be responsible for the cost and provision of initial and developmental training programs for Contractor employees. The Contractor shall maintain and update the plan throughout the life of this contract and shall submit the plan to the COR for review when requested.

Initial Intensive Training. All employees shall receive initial, intensive training in health care facility housekeeping. Employees, who have never received initial intensive training in health care facility housekeeping, including infection control, shall not be assigned to work until this training requirement is completed. Training shall include, at a minimum, the following topics:

• Familiarization with all written Contractor technical and quality control procedures and instructions

• Basic bacteriological concepts, including how disease is caused, transmitted, and prevented, reduced, or contained through proper housekeeping methods

• Infection control & blood borne pathogen standards relating to duty functions to all requirements of this contract. (OSHA, TJC, etc)

• Proper use and handling of germicidal detergents, supplies, and equipment

• Care and maintenance of Contractor- and Government-furnished property

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• Procedures for replenishing cleaning supplies and obtaining equipment repairs

• Familiarization with the Government's fire prevention, safety, and security procedures and current disaster plans

• Role of housekeeping in the health care facility and its effect on the health and wellbeing of patients

• Sexual harassment training and VHA Privacy Policy training is required within the first 30 days and annually thereafter.

Training Records. Records of all employee training, including attendance rosters, shall be maintained by the Contractor and shall be furnished upon request to the CO or COR for review.

2.2.1 Uniforms.

2.2.1.1 Type of Uniform. All employees shall wear Contractor provided standard uniforms which are clearly distinguishable from other VA uniforms currently in use. The uniforms shall be worn as designed by the uniform manufacturer. Sandals or other open toed shoes shall not be worn. All personnel shall display identification badges, except for protective clothing, which shall include the employee's full name and Contractor's full name.

2.2.1.2 Protective Clothing. When required the Contractor personnel shall wear special protective clothing and shoe covers while working in designated areas. They shall be used as specified and then destroyed, as directed by the COR.

2.2.1.3 Personal Hygiene. Contractor personnel shall be clean and wear a clean uniform at all times when in patient care and public areas. Fingernails shall be clean and free of dirt, and hair shall be neatly trimmed and combed.

2.3 Health Requirements.

2.3.1. Infection Control. The contractor shall comply with Standard Precautions as defined by the

Centers for Disease Control and Prevention in the performance of this contract. The contractor must have orientation on all applicable policies and procedures specified by Veteran Health

Indiana that deal with infection control. The Contractor must have documented proof of training in infection control. A copy of the documented proof will be made available to the CO or COR upon request. The infection control training and associated cost is the responsibility of the

Contractor. The Contractor employees and subcontractors must follow TJC approved policies regarding infection surveillance, prevention, and control.

2.3.2. Reporting Requirements. The Contractor shall report to the COR all-occupational health and preventive medicine information required by the Government and for complying with current TJC health records documentation requirements.

2.3.3 Health Maintenance. The Contractor shall employ personnel who are medically fit. The

Contractor shall refer all employees alleging health problems to a qualified health care provider for diagnosis and treatment. If such an employee is absent for three working days or more due to illness, the Contractor shall require the employee to furnish written certification from a qualified health care provider that the employee is free from all communicable disease(s) and is fit to return to work in a health care facility. The Government reserves the right to examine or re-examine any Contractor employee who meets these criteria.

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2.4 Eating and Smoking.

2.4.1 Eating by Contractor personnel is permitted only in designated areas.

2.4.2 Smoking is not permitted on site.

3.0. GOVERNMENT FURNISHED PROPERTY, SERVICES, UTILITIES, SUPPLIES, AND PHYSICAL SECURITY.

3.1. Supplies, Materials, and Equipment. The government will provide hand sanitizer for distribution throughout the clinic.

3.2. Physical Security. All government facilities, equipment, and materials shall be safeguarded by the

Contractor. At the end of each work period, government facilities, equipment, and materials shall be secured. The Contractor shall provide protection to government facilities, equipment, and materials to prevent damage during the period the property is under control of, or in the possession of, the contractor.

The Contractor shall record all available facts related to each instance of damage to government facilities, equipment, or materials and report it to the CO or the COR within 24 hours of occurrence. The Contractor shall be responsible for any damage caused by contract personnel to government facilities, equipment, or materials and shall repair, clean, replace, or restore damaged items to the condition existing immediately prior to the item being damaged, as directed by the CO.

3.2.1 Contractor employees shall not allow anyone use of any key in their possession. They shall not open locked rooms or areas to permit entrance by persons other than Contractor employees performing assigned duties. All rooms/areas unlocked for cleaning shall not be left unattended during the cleaning process and shall be locked by Contractor personnel after completion of cleaning duties.

3.2.2 Contractor employees will be responsible for ensuring any installed alarms are activated at the end of cleaning

4.0 CONTRACTOR FURNISHED ITEMS. The Contractor shall furnish and maintain all equipment and supplies, other than those specified as Government furnished in clause 3 of this Section, necessary to perform all services required in this contract.

4.1.1. Specifications. Contractor supplies and equipment shall meet the specifications listed below, and shall comply with the occupational safety and health standards (OSHA) and fire regulations.

4.1.2. Approval of Supplies and Equipment. All Contractor proposed supplies and equipment must conform to applicable technical provisions and specifications contained herein. Materials shall comply with

Government fire and safety regulations. No materials bearing an Interstate Commerce Commission (ICC) red label shall be used. Proposed supplies and equipment for which specifications are not provided herein must be of the highest commercial quality and must be of a suitable type or grade for the required housekeeping task. This list shall be a part of the Contractor's instructions and procedures manual. Any new item of material, supplies, or equipment shall be submitted to the CO or COR for review prior to use in the VA.

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4.1.3. Abrasives. Steel wool, abrasive metal cleaners, or any other cleaning supplies or equipment, which could cause damage to Government property, shall not be used.

4.2. Equipment and Cleaning Material Standards

4.2.1. Sanitation. All original and replacement equipment introduced shall be in proper working order, as specified by the equipment manufacturer, and shall be cleaned with a disinfectant detergent free of soil prior to introduction into the VA. All equipment removed from a designated use area shall be cleaned with a disinfectant detergent prior to its removal from and reintroduction into the area. Equipment must be kept clean and in good working order throughout the term of the contract.

4.2.2. Electrical Equipment. All electrically operated equipment shall be equipped with hospital quiet-type motors, be third-wire grounded, and be equipped with an appropriate length of Underwriters

Laboratories (UL) approved three conductor cord. The cord shall be permanently attached to the machine. The Contractor's equipment shall be in good repair and shall comply with all Government safety standards and all TJC standards for no clinical electrical equipment. Any equipment, which the COR considers in disrepair or unsafe shall be removed from the VA and replaced with equivalent equipment that is in good repair and meets the specifications contained herein.

4.2.3. Bumper Guards. All wheeled and movable equipment shall be equipped with protective, non-marking wheels and rubber bumpers or guards around the entire perimeter, except for fiberglass trash receptacles. No part of the equipment, except handles, shall protrude beyond the rubber bumpers.

Bumpers and guards shall be maintained in good repair at all times. Equipment with improper bumpers or guards shall be removed from service immediately and shall not be used until repaired. Any repairs to

Government property required as a result of improperly protected equipment shall be made at the

Contractor's expense.

4.2.4. Disinfectant and Detergent. Disinfectant and detergents used shall be currently registered with the Environmental Protection Agency (EPA) as a pseudomonicidal, fungicidal, and viricidal at the manufacturer's recommended use dilution and shall be UL approved. The detergent shall be a quaternary ammonium germicidal detergent, Hypochlorite, ethyl or Isopropyl alcohol, or phenolic germicidal detergent.

4.2.6. Liquid Floor Finish. Liquid floor finish shall be a synthetic copolymer plastic (not a wax), water emulsion with solid content of at least 16 percent, removable by detergent scrubbing, and safe for use on all synthetic floors, such as rubber, asphalt, vinyl, and linoleum. It shall dry to a high gloss shine, be slip resistant, and resist scuffing and water penetration. The Government may accept alternate floor finishes if the Contractor demonstrates to the CO or COR in a designated test area that the alternate floor finish is superior to the above specifications.

4.2.7. Stripping Compound. – Non-Applicable - There shall be no wax used on any flooring.

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4.2.8. Mop Heads. Non-disposable mop heads shall be neutral-colored rayon or cotton yarn. Disposable mop heads shall be made of non-woven fabric, a lintless fabric consisting of textile fibers, or a combination of fibers and yarn, and shall be clear or neutral in color. Both disposable and non-disposable mop heads shall be changed when they become saturated with dirt or dust. Oil-based treatments are not allowed.

Chemical treatments shall not have a "flash point" of less than 330°F, and shall be free of saponifiable matter. Chemical treatments shall not heat spontaneously under service conditions. Total treatment residue in mop heads shall not exceed 28 percent by weight and shall contain no carbon residue.

4.2.9. Cloths Impregnated Dusting and Sweeping. Dusting and sweeping cloths shall be tubular cotton with 18 percent to 22 percent by weight, and shall be non-oil impregnated. The impregnation compound shall meet UL specifications and requirements relative to safety from combustibility, shall have an affinity for dust, and shall be registered with the EPA.

4.2.10. Bowl Cleaner Liquid-Type, Triple Action. The bowl cleaner shall clean, deodorize, disinfect, not be noxious or cause irritating fumes in use as determined by the Food and Drug Administration, of S

Typhosa, and be suitable for use in toilet bowls and urinals only. It shall be fully inhibited to protect pipes and metal against corrosion. Products requiring a "Poison" label, as defined in CFR, Title 49, shall not be permitted.

4.2.11. Floor Polishers. Floor polishers shall have a non-porous scrubbing surface to inhibit bacterial growth. Rotary floor polishing, buffing, and scrubbing machines shall be equipped with new brush or pad drive assemblies made of non-porous materials when introduced into the VA.

4.2.12. Combination Scrubber-Vacuum Machines. Combination scrubber-vacuum machines shall be battery powered, motorized units designed for use in large public areas.

4.2.13. Housekeeper’s Carts. Housekeeping carts shall have a low platform for mop buckets, mop wringer, and other gear, with locking compartments for tools and cleaning supplies, trash collection device and lockable. Mops shall fit on the cart so that mop heads do not protrude above the top of the cart.

Carts shall fit in assigned storage closets.

4.2.14. Trash Collection Containers. Collection containers shall be rigid with a smooth interior finish and shall be equipped with a snug fitting cover and hard rubber, non-marking, silent-running casters. All trash containers shall meet Government fire regulations. Trash carts shall be of such size that they do not block passageways or prevent building evacuation.

4.2.15. Mop Buckets. Mop buckets may be either single or double compartmented and shall be constructed of a non-porous, acid resistant, seamless material.

4.2.16. Tool Handles. All mops, brooms, and sweeping tools, which are equipped with handles of over 48 inches in length, shall be capped with non-marking rubber, vinyl, or plastic tips to prevent the marking or scarring of walls or other surfaces in the VA.

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4.2.17. Signs. All signs shall contain easily understood directions and guidance in both English and

Spanish.

4.3. Supplies and Equipment. Specific routine infection control requirements are as follows:

4.3.1. All containers of cleaning chemicals and similar products shall be marked with a factory label, to identify contents, and all other labels shall be removed or defaced. Materials bearing Department of

Transportation red labels shall not be used.

4.3.2. Contractor furnished supplies and equipment not in immediate use shall be stored in designated storage areas provided by the Government. Towels, mops, brushes, and other supplies, which contain an oil residue and are subject to spontaneous combustion, shall be disposed of or stored outside of the VA in tightly covered metal containers. Storage shall be in accordance with applicable Federal, state, and local regulations. Cleaning supplies that are subject to combustion may be temporarily stored and transported in tight fitting metal containers while in use inside of the VA.

4.3.3 Supplies shall be transported in carts designed for supply movement (e.g., housekeeping carts), not in trash barrels, nor mop buckets. All materials not immediately in use shall be properly stored in designated storage spaces provided by the Government. The following supplies shall be furnished by the contractor to fit existing infrastructure:

• Paper towel

• Toilet paper

• Toilet seat covers

• Medicated lotion soap

• Clear plastic trash can liners (large 40x48 and small 24x36)

• Red medical waste receptacle liners

4.3.4. Material Safety Data Sheets (MSDS). The contractor will be required to furnish the VA with MSDS sheets for all chemicals that are used in the clinic. This list will be kept current at all times. This information is required by the VA for emergency treatment in the event of ingestion of and/or contact with the material by humans, and is required by OSHA regulations. Contractor must maintain a binder of all MSDS sheets on site for use and inspection at all times.

5. WORK HOURS:

The services covered by this contract shall be furnished by the contractor as defined herein. The contractor will be required to furnish such services five (5) days a week excluding weekends and federal holidays. The clinic’s daily normal hours of operation are from 7:00a.m. to 5:00 p.m. Shift hours may change based on the needs of the facility.

The Contracting Officer or designee, reserves the right to change/adjust/establish any hours of performance.

5.1. Work Hours: Contractor work hours shall be during non-operating hours and of sufficient time to complete assigned tasks as outlined.

5.2. Federal Holidays: The ten holidays observed by the Federal Government, i.e., New Year's Day, Martin Luther

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King Jr.'s Birthday, President's Day, Memorial Day, Juneteenth National Independence Day, Independence Day, Labor Day, Columbus Day, Veterans' Day, Thanksgiving Day, and Christmas Day and any other day specifically declared by the President of the United States to be a federal holiday.

6. SERVICE DELIVERY SUMMARY

The Contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

Performance Objective SOW

Para

Performance Threshold

Basic Cleaning Services.

Floors, baseboards, corners, and wall edges are free of dirt, dust, and debris.

Trash is empty. Plastic liners are replaced.

Trash containers are free of odors and visible dirt. Trash is emptied into outdoor trash collection container. Glass and mirrors have no traces of film, dirt, smudges, or water. Drinking fountains are disinfected and free of streaks, stains, spots, smudges, scale, and other deposits.

Stairwells are free of dirt, debris, litter, and other foreign matter. Dust is not visible. Exam tables are completely clean and free of foreign matter.

1.1. Not to exceed 5 customer

complaints per month.

Basic Restroom/Locker Rooms Cleaning

Services. Restrooms and locker rooms are disinfected and free of dirt, deposits, streaks, and odors. Showers are disinfected and free of soap film, scum, and other deposits. Toilets and urinals are disinfected and free of scale, stains, scum, and other deposits. Floors are free of litter, dirt, dust, and debris. Supplies are adequate until next service.

1.2. Not to exceed 5 customer

complaints per month.

Periodic Cleaning Services. Floors have a glossy uniform appearance free of scuffmarks, heel marks, wax build-up, and other stains and discoloration. Windows are free of film, dirt, smudges, water, and other foreign matter.

1.3. Not to exceed 5 customer

complaints for the reporting period.

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Surveillance: The COR or clinic manager will receive complaints from hospital personnel and pass them to the contractor for correction.

Standard: Not to exceed 5 customer complaints for the month or reporting period. The COR shall notify the contracting officer for appropriate action in accordance with FAR 52.212.4, Contract Terms and Conditions-

Commercial Items (May 1997) or appropriate Inspection of Services clause, if any of the above service areas exceed five customer complaints.

Procedures. Any patient, employee, or visitor that observes unacceptable services, either incomplete or not performed, for any of the above performance objectives should immediately contact the clinic manager or COR who will complete appropriate documentation to record the complaint. The VA staff will consider the customer complaint valid upon receipt from the customer. The VA staff shall verbally notify the assigned contractor contact of the complaint. The contractor will be expected to resolve the complaint during the next work shift. If the contractor staff disagrees with the complaint, he/she will notify the COR. The COR will investigate to determine the validity of the complaint. If the COR determines the complaint as invalid, he will document the written complaint of the findings and notify clinic manager. The COR will retain the annotated copy of the written complaint for his/her files. If after the investigation the COR determines the complaint as valid, the COR will inform the contract and the contractor will be expected to correct the defect within one hour. A defect will not be recorded if proper and timely correction of the unacceptable condition(s) is accomplished. Recurring customer complaints are not permitted for any of the above service items. If a repeat customer complaint is received indicating the same deficiency during the service period

(month, quarter, etc.), the COR should contact the Contracting Officer for appropriate action. The VA staff will verify the issue is resolved.