B01_Attachment_J-07_Combined_PCRA-ICRA-ILSM_-_2016.docx

Construction and Renovation Preconstruction Risk Assessment (PCRA), Infection Control Risk Assessment (ICRA), and Interim Life Safety Measures (ILSM) Procedures

1. Purpose: To describe procedures for identification and protection of patients, control of exposure and prevention of the spread of infection during construction, demolition, renovation, and repair projects at this IHS facility.

2. Policy: It is the policy of the FORT PECK SERVICE UNIT to proactively reduce the potential for exposure to infection during construction, renovation, demolition, or repair, using current technology to protect patients, visitors, and staff. The appropriate staff is involved in all stages including planning, design, procurement of construction, and construction phases.

3. Definitions: Construction and remodeling are defined as activities that disturb the environment where settled dust or dirt is found and which may cause spores to become airborne. This includes: demolition of existing ceilings or walls; exposure of ceiling spaces by removal of all or part of ceiling; breaching of walls, ceilings, or floors; removal of uncovered debris from construction areas; and major disturbance of soil in which dust or dirt becomes airborne.

4. Procedures:

a. Introduction

i. Engineering provides project management services for renovation and construction projects.

ii. Project Engineer work in conjunction with services, architectural / engineering firms and contractors to guide a project from initial planning through occupancy of the space. The project team also includes Administration, Information Systems, Engineering, Environmental Services, Infection Control, and Occupational Safety and Health.

Other departments are included as appropriate.

iii. All renovation or new construction must meet criteria outlined by AAAHC and the authorities having jurisdiction. The 2010 Edition of the Guidelines for Design and Construction of Health Care Facilities and The Joint Commission Standards and Elements of Performance are used as a basis for design for clinical programs falling under the purview of AAAHC.

Attachment J-07

iv. Responsibility for ensuring that renovation and construction projects meet the aforementioned requirements lies with the project engineers, design professionals, contractors, infection control preventionist, safety officer and administrators. The project engineer will take the lead in including the appropriate stakeholders throughout the process.

b. Forms and Uses

i. This facility has an PCRA- ICRA- ILSM Multidisciplinary Construction Safety Inspection Team that reviews construction projects. The team is responsible for completing the PRCA- ICRA-ILSM process.

ii. The Construction Safety Inspection team utilizes the following forms:

1) PCRA-ICRA. The PCRA-ICRA form is completed during the construction documentation phase. The Project Engineer completes the top portion of the form and checks the appropriate boxes and elaborates on items as needed. The Infection Control part of the form serves two functions: a) determines the Infection Control Risk Level, and b) serves as a “permit” for construction. The form is reviewed and signed by the Multidisciplinary Construction Inspection team as designated by the Construction Safety Policy. The original form is maintained as part of the Safety Committee file. The form may need to be reviewed and changed for projects with multiple design phases and changes. Project Engineer Prior to construction, the Project Engineer convenes a preconstruction meeting that includes the design team, contractor, Engineering, infection control preventionist, and safety officer. The Project Engineer brings the original PCRA-ICRA form to the meeting. The ICRA level and precautions are reviewed with the contractor, who signs off on the form. A copy of the form is maintained on the construction site; the original is returned to the Safety file.

2) ILSM. The Interim Life Safety Measures (ILSM) Assessment Form is completed during the construction documentation phase. It identifies deficiencies in building systems or safety risks that will be present during the construction period. The project engineer completes the top section of the form and completes the pre-assessment by indicating (yes or no) whether conditions of a deficiency or impairment exist. The safety officer then confirms whether the deficiencies or impairments are significant, and if so, checks the appropriate measures. If, in the professional opinion of the Safety Officer, any identified deficiencies or impairments are deemed to be significant, ILSM’s will be identified by checking the appropriate cell(s) on the grid in the assessment portion of the ILSM Assessment Form. The ILSM Assessment Form indicates when and to what extent measures are typically required. However, mitigating conditions may allow the professional discretion of the Safety Officer to reasonably and safely not select or implement some typical measures which may be deemed unnecessary on a case by case basis. Mitigating conditions may include, but are not limited to: trained staff in the area; small size of the deficiency; area with lower impact to patient population; short duration of the deficiency; and other means of fire suppression, or fire alarm, or exit in the area. The original form is maintained as part of the Safety file.

iii. Prior to construction, the project engineer convenes a pre-construction meeting that includes the design team, contractor, Engineering, infection control preventionist, and safety officer. The Project Engineer brings the original ILSM form to the meeting. The ILSMs are reviewed with the contractor, who signs off on the form. A copy of the form is maintained on the construction site; the original is returned to the Safety file.

iv. Circumstances and conditions on job sites will change as work progresses. Project requirements will be re-evaluated, and the infection control preventionist and safety officer will modify the PCRA-ICRA and ILSM as appropriate. Changes will be maintained as part of the Safety file.

v. When planning projects, project engineers must take into account construction activities that will take place outside of the main job site. It is necessary that PCRA-ICRA and ILSMs are completed for areas adjacent to, above, below or remote from the site. A separate set of forms will be required, as the PCRA-ICRA level and safety measures may be different from the main job site.

c. Compliance

i. The Project Engineer is responsible for notifying Infection Control and Safety prior to the start of work, when activity levels or circumstances change, and when work has been completed.

ii. Any significant breach in the PCRA- ICRA enclosure or other non-compliant condition must be reported to Infection Control, Safety Officer and the Project Engineer immediately. Corrective action must be taken and the area re-inspected.

iii. Any significant deficiencies in the ILSM must be reported to Safety and the Project Engineer immediately. Corrective action must be taken and the area re-inspected.

iv. The contractor is responsible for maintaining the construction site according to the PCRA-ICRA and ILSM. The contractor will maintain a log with Daily Construction Checklist form, which is completed twice per shift worked and signed off by the superintendent. The log, along with the PCRA-ICRA permit, ILSM form and applicable HEPA log must be available on site at all times.

v. As part of the monitoring process, the Project Engineer will complete a Daily Construction Checklist. Deficiencies are noted; appropriate services notified; corrective action is taken. If deficiencies or corrective actions are noted, the Project Engineer reviews the form with and obtains sign-off from the contractor’s superintendent. The original form is maintained in the Engineering file.

d. Project Flow for Renovation or New Construction

i. Renovation or new construction projects can have up to four distinct phases. Once a project area and program have been defined, the project proceeds through schematic design, design development, construction documentation, and construction administration.

ii. The project team will address infection control and risk assessment throughout design to ensure that all Guideline requirements are satisfied. This applies to the main construction area and any adjacent or remote areas directly affected by the project.

iii. Because projects vary in size and complexity, not every project will require all three design phases. The Project Engineer should use his or her best judgment to ensure that the documentation described below has been completed and presented to the Multidisciplinary Construction Safety Inspection Team.

e. Schematic Design

i. The purpose of this project phase is to determine that all program elements fit within the space allotted and all general elements of design are included. For projects involving patient care, all facility/department requirements are identified and included in the plan. Infection Control should be included in one meeting during the process.

f. Design Development

i. The purpose of this project phase is to confirm the plan and begin to provide detail for each space. The Mechanical, Electrical, Plumbing and structural elements of the plan begin to take shape during design development. Note that schematic design may be folded into design development.

ii. ICRA permits and PCRA forms should be completed during design development for large or complex projects to ensure that all infection control and construction risks can be assessed and addressed during construction documentation.

g. Construction Documentation

i. The purpose of this project phase is to solidify the plan, resulting in a complete set of drawings ready for construction bids. This includes all aspects of the program from an architectural and engineering perspective. If required, construction documents are reviewed and approved by FORT PECK SERVICE UNIT. The first portion of the PCRA-ICRA Permit must be completed and included in the construction documents for Safety review.

ii. The Project Engineer will prepare a package for review by the Construction Safety Inspection Team during construction documentation. This package will include:

1) A drawing of the project area

2) PCRA-ICRA form

3) Interim Life Safety Measures (ILSM) Assessment Form

iii. Separate PCRA-ICRA and ILSM forms are required for space adjacent to or remote from the construction area. This ensures that the appropriate precautions are taken, particularly since those precautions likely differ from the main project area.

h. Construction Administration

i. The purpose of this project phase is to prepare for, commence and complete renovation or construction in the project area. Requirements apply not only to the construction area, but to spaces adjacent to or remote from the main project area.

ii. Prior to the start of renovations, the Project Engineer convenes a pre-construction meeting that includes Infection Control and Safety. During this meeting:

1) The infection control practitioner reviews the PCRA-ICRA requirements with the contractor, who signs-off on the form.

2) The safety officer reviews the ILSMs with the contractor, who signs-off on the form.

3) The contractor’s daily check-list is reviewed with the contractor, noting that the log must be maintained on site at all times.

4) Required signs are provided.

iii. The Safety Officer is responsible for implementing the following ILSM’s as deemed required:

1) Notifying the Local Fire Department

2) Implementing a fire watch (as an ILSM – hot work fire watches are the responsibility of maintenance and contractors)

3) Providing additional training as needed

4) Conducting additional fire drills

5) Providing localized staff training

6) Providing building / organizational education

iv. The Project Engineer (through contractor as directed) is responsible for implementing the following measures as deemed required:

1) Posting additional exit signs and inspecting exits

2) Installing temporary fire alarm and detection systems

3) Providing additional fire-fighting equipment

4) Installing temporary construction barriers

5) Providing increased surveillance of the work site

6) Controlling combustible loading of the work site

7) Inspecting and testing temporary systems monthly

v. The Project Engineer, infection control practitioner and safety officer (or his / her designee) visits the site independently throughout construction. The type and intensity of construction activities will dictate the frequency. The following time frames are used for construction site visits:

1) The Project Engineer will inspect on a weekly basis

2) The Safety Officer (of his / her designee) will inspect construction sites when an ILSM for a significant impairment is present

3) The Infection Control Preventionist will inspect:

i. Level II: at the start and completion of work ii. Level II and IV: on a weekly basis

vi. It should be noted that different time frames may be necessary or advisable based on specific circumstances.

vii. Upon completion of the work, and if the scope dictates, Infection Control and the Project Engineer inspect site to ensure that all work is complete, the area appropriately cleaned. If applicable, Safety inspects the site to ensure that new or different fire safety elements (i.e., evacuation maps, fire extinguishers, exit signs) are in place.

i. Monitoring

i. Implementation of ILSM’s will be monitored by the Safety Officer.

ii. Contractors are responsible for providing copies of the Contractor’s Daily Check List to Engineering monthly. The previous month’s data should be received no later than the 5th of the following month.

iii. Project Engineers will file Site Observation Reports in the PCRA- ICRA / ILSM Safety files.

Reports should include any correspondence or documentation related to a deficiency and the corrective action with the report.

iv. On a monthly basis, Engineering will prepare a report for review at a Safety Committee meeting. Data submitted will include:

1) Summary of project activity for the past month

2) Audit of Site Observation reports

v. Reports and forms are reviewed by the Safety Committee monthly and maintained in Engineering and Safety sites.

5. Appendices: Appendix A, PCRA-ICRA Form with ILSMs

Project Description:

PART 1: INFECTION CONTROL RISK ASSESSMENT

Type A☐ Inspection and Non-Invasive Activities.

Include, but are not limited to:

☐ Removal of ceiling tiles for visual inspection limited to 1 tile per 50 square feet ☐ Painting (sanding limited to <10% of area).

☐ Wall covering, electrical trim work, minor plumbing, and activities that do not generate dust or require cutting of walls or access to ceilings other than for visual inspection.

Type B ☐ Small scale, short duration activities that create minimal dust.

Include, but are not limited to:

☐ Installation of telephone and computer cabling.

☐ Access to chase spaces using doors or hatches (not cutting).

☐ Sanding of walls for painting or wall covering (minor repairs – not sanding for drywall finishing)

Type C ☐ Work that generates a moderate to high level of dust or requires demolition or removal of any fixed building components or assemblies.

Includes, but is not limited to:

☐ Sanding (>50% of surface area – drywall finishing).

☐ Cutting of walls or ceilings.

☐ Removal of floor coverings, ceiling tiles, and casework. (>50% of surface area) ☐ New wall construction.

☐ Minor duct work or electrical work above ceilings.

☐ Major cabling activities.

☐ Any activity that cannot be completed within a single work shift.

Type D ☐ Major demolition and construction projects.

Includes, but is not limited to:

☐ Activities that require consecutive work shifts.

☐ Requires heavy demolition or removal of a complete cabling system.

☐ New construction.

Appendix A PCRA-ICRA Form with ILSMs Combined Pre-Construction and Infection Control Risk Assessment Matrix of Precautions for Construction Projects Project Title____________________

☐ Office areas ☐ Out Doors

☐ Electrical or Mechanical Rooms ☐ Social Work

☐ Retail Store

☐ Stairwells ☐ Conference Rooms ☐ Hallways ☐ EMS Areas ☐ Physical and Occupational Therapy ☐ Outpatient Areas

☐ Waiting Rooms ☐ Sleep Lab

☐ Mental Health (outpatient only) ☐ Prosthetics / Orthotics ☐ Domiciliary ☐ Primary Care Clinics ☐ CBOCs ☐ Urgent Care ☐ Kitchen or Food Preparation / Dining / Canteen ☐ Echocardiography ☐ Radiology/MRI/CT

☐ Respiratory Therapy

☐ Nuclear Medicine ☐ Senior Mental Health (In Patient or Senior) ☐ Community Living Center (CLC) ☐ Clean Supply ☐ Cardiac Cath, EP Lab or Cardiology ☐ Sterile Processing Service (SPS) ☐ All inpatient medical or surgical units ☐ Care Units: PACU, MICU, SICU, TCU ☐ Spinal Cord Injury

(SCI)

☐ Negative pressure isolation rooms ☐ Outpatient chemotherapy or Oncology areas ☐ Operating Rooms/Surgery Area ☐ Endoscopy ☐ Dialysis

☐ Bronchoscopy

☐ Pharmacy

☐ Clinical Laboratories ☐ Treatment /Procedure Rooms

IC Matrix Class of Precautions: Construction Project by Patient Risk Group and Construction Project Type

Patient Risk Group / Activity Type

Note: Infection Control approval is required for ALL construction or renovation activities.

Step 3: ☐Class I ☐Class II ☐Class III ☐Class IV

operations.

2. For visual inspection only, dampen ceiling tile with water spray before removing. Replace a ceiling tile immediately after inspection; do not leave unattended.

Clean up ceiling tile and flooring surfaces below with HEPA filtered vacuum or damp mop.

generating dust, or

unscented +disinfectant, which has manufacturer’s labeling as a bactericide, tuberculocide, virucide, and fungicide.

3. There shall be no standing, uncovered water during construction. This includes water in equipment drip pans and open containers within the construction areas. All accidental spills must be cleaned up and dried within 12 hours. Remove and dispose of porous materials that remain damp for more than 72 hours.

in areas when work and area cleanup has been completed.

construction begins.

2. Maintain Negative Pressure Ventilation +(NPV) at 0.01" Water Column (WC) within the work site utilizing NPV machine.

construction.

carefully to minimize spreading of dirt and debris associated with construction.

2. Do not remove barriers from work area until completed project n is thoroughly and inspected by COR, Safety and Infection Control.

Do construction documents include all infection control requirements?

☐Yes ☐No ☐N/A

Identify the areas surrounding the project area, assessing potential impact.

Identify the impact and any precautions necessary to minimize disruptions to surrounding areas:

Identify specific site of activity, e.g., patient rooms, medication room, etc:

Identify containment measures using prior assessment. What types of barriers such as solid wall barriers? Will barrier entry ways require doors or zipper flaps? Will HEPA filtration be required?

Note: Renovation/construction area shall be isolated from the occupied areas during construction and shall be negative with respect to surrounding areas.

Consider potential risk of water damage. Is there a risk due to compromising structural integrity (e.g., wall, ceiling, roof)?

☐ Yes ☐ No

Work hours: Can or will the work be done during non-patient-care hours?

Do plans allow for adequate number of isolation/negative airflow rooms due to those taken out of service during construction?

☐ Yes ☐ No ☐ N/A

Do the plans allow for the required number and type of hand washing sinks due to those taken out of service during construction?

☐ Yes ☐ No ☐ N/A

Does the infection control staff agree with the minimum number of sinks due to those taken out of service during construction for this project? (Verify against the American Institute of Architects Guidelines for types and area.)

☐ Yes ☐ No ☐ N/A

Does the infection control staff agree with the plans relative to clean and soiled utility rooms in lieu of those taken under construction?

☐ Yes ☐ No ☐ N/A

Tuberculosis Risk Assessment. A risk assessment must be conducted for the transmission of TB to the contracted construction workers based upon the construction site location, patient population, hospital layout, and the defined risk as outlined in the “CDC Guidelines for preventing the transmission of Mycobacterium Tuberculosis in Health-Care Setting, 2005.”

☐ Construction project is high risk for TB transmission. Detail safety measures. Requires contractor pre- testing.

☐ Construction project is low risk for TB transmission. No pre-contract testing required.

Who is responsible for daily cleaning inside work area?

Is terminal cleaning required at the end of each work day?

☐ Yes ☐ No

If yes, who is responsible for coordinating the terminal cleaning?

Are there any special needs required for terminal cleaning at the end of the project?

☐ Yes ☐ No

If yes, list special needs.

Do construction drawings show locations and details of construction barriers?

☐ Yes ☐ No ☐ N/A

Do construction drawings show necessary modifications to the HVAC system needed to meet NPV requirements?

☐ Yes ☐ No ☐ N/A

Do construction documents require the contractor to provide a pressure indicator?

☐ Yes ☐ No ☐ N/A

Do the construction drawings show the general location of waste dumpster(s) or bins?

☐ Yes ☐ No ☐ N/A

Do the construction documents require the contractor to submit detailed safety and infection control plans for approval (i.e. location and types of barriers)?

☐ Yes ☐ No ☐ N/A

PART 2: PRE-CONSTRUCTION RISK ASSESSMENT

Utility Interruptions and/or impact:

During the course of the project are any of the following likely to be interrupted or impacted in any area of the facility?

Yes No

Water Supply (Including shutting off any valves)

Sewer Service Roof/Storm Drainage

Ventilation Systems Oxygen

Medical Vacuum Other Medical Gases:

For any systems where interruptions are foreseen, describe the steps to be taken to mitigate the impacts:

Describe preventative measures that will be taken to insure that an unplanned interruption will not occur:

To be completed if the water supply will be interrupted or impacted in any way: ☐N/A

Will valves be shut off longer than 48 hours?

Required Actions if YES: Flush plumbing lines from closed valve to all outlets for a minimum of 10 minutes at highest temperature.

Will the project modify any valves in the existing plumbing system?

Will the project modify existing plumbing lines less than or equal to 18 feet?

Required Actions if YES to either or both: New pipe, fittings, and valves required for connection may be spray-disinfected or swabbed with a minimum of 1-5 percent solution of chlorine just prior to being installed. Flush plumbing lines from closed valve to all outlets for a minimum of 10 minutes at highest temperature. After the appropriate procedures have been completed, the existing main may be returned to service prior to the completion of bacteriological testing in order to minimize disruptions to the facility. Bacteriological testing is required to be completed per AWWA standards.

Will the project modify install any new plumbing lines?

Will the project modify existing plumbing lines greater than 18 feet?

Required Actions if YES to either or both: Follow all AWWA requirements.

Do construction documents show any additional work related to water safety, including but not limited to: AWWA requirements, responsibility of contractor for flushing and disinfecting, etc.

☐Yes ☐No ☐N/A

Noise and Vibration Assessment:

List any activities that will generate noise and/or vibration likely to be disruptive.

Activity:

Time & Duration: Mitigation Strategies:

Activity:

Time & Duration: Mitigation Strategies: Safety Hazards:

List any hazardous materials to be used or stored within the project area:

Is the work likely to generate any noxious or unusual odors?

☐ Yes ☐ No If yes, what steps will be taken to minimize impact:

Are there any known or suspected contaminants?

☐ Asbestos ☐ Lead ☐ Mold ☐ No known or suspected contaminants List steps to be taken to minimize impact:

Does the planned work include any of the following?

List steps to reduce/mitigate risk of any items checked:

Will there be hot work done on this project?

☐ Yes ☐ No If yes, a hot work permit will be required.

Will the project move, change access to, or hinder the use of an eyewash and/or shower station?

☐ Yes ☐ No If yes, describe plan to mitigate risk.

PART 3: INTERIM LIFE SAFETY MEASURES (ILSM)

Project Evaluation Review the project/repair using the following criteria and indicate whether each item is applicable by marking the appropriate box. For any “YES” responses, coordinate with the Safety Office to review the required actions for appropriate interim life safety measures. In the Interim Life Safety Summary Sheet (PART II) at the bottom of this document, list specifically how the required interim life safety measures will be implemented for this project/repair impacting Life Safety. For the INTERIM LIFE SAFETY MEASURES Daily Inspection sheet (PART III), copy the measures from PART II into PART III, and issue PART III only to the Contractor for daily ILSM inspections.

1. Does the project/repair have the potential of affecting an exit or other means of egress?

2. Will the affected exit be used by other than the contractor’s/maintenance personnel?

Required Actions: If a means of egress is obstructed, an alternate must be designated and training is required for those persons affected. Safety office will conduct/coordinate training. Means of exiting construction/repair areas must be inspected on a daily basis to prevent blockages due to debris. This needs to be documented and can be done by the contractor/shop foreman or shop designee.

1. Does the project/repair have the potential to obstruct access to the emergency department?

2. Does the project/repair have the potential of obstructing access for fire department connections, hydrants, or fire lanes?

Required Actions: If an emergency access is obstructed, an alternate means of access must be designated and the Fire Department and Police must be notified by the Safety Office of the alternative.

1. Does the project have the potential of impairing existing fire alarm, detection, or suppression systems?

2. Will temporary fire protection systems be required as part this project/repair?

Required Actions: If a fire protection or alarm system is to be rendered non-operational for more than 4 hours out of a 24-hour period, either a substitute system or a fire watch must be initiated. If neither of these methods can be implemented, the area must be closed down and evacuated. All of these measures must be coordinated with the Safety Office, Police, and the affected staff.

1. Will construction compromise any fire or smoke partitions or barriers?

Required Actions: If construction/repair involves major breaches in fire or smoke barriers, the contractor must erect temporary walls around the construction area equal to the barrier that has been compromised.

1. Does the area affected by the project warrant placement of additional fire protection equipment?

2. Will additional firefighting training be required by affected personal?

Required Actions: If the fire load of a particular area is significantly increased over normal due to construction, additional firefighting equipment (such as fire extinguishers) will be required. If any of this additional firefighting equipment is of a different type than that already available in the affected area, training in the use of this equipment for staff or contractor personnel is required.

1. Will variance to existing medical center smoking policy be permitted?

Required Actions: If designated smoking areas are impacted or closed due to construction, temporary areas may need to be established.

1. Does the project involve the storage of flammable or combustible materials?

2. Does the project have the potential for creating flammable or combustible debris?

Required Actions: Surveillance of construction sites will need to be increased to prevent the accumulation of excess flammable or combustible debris. The fire load of the construction area must be kept to a minimum.

1. Does the project warrant additional fire drills within the affected areas?

Required Actions: If the life safety features of a particular area are adversely impacted by construction, then the frequency of fire drills must be increased to two per shift per quarter for healthcare/lodger occupancies. Adverse impacts would include blocked fire exits, impaired fire alarm or sprinkler systems, or major compromises in fire or smoke barriers or compartments.

1. Does the project present additional hazards, such as excavations, construction storage or field offices, crane work, high voltage, confined spaces, scaffolding, etc., which warrant increased hazard surveillance?

Required Actions: If yes, then additional project surveillance is warranted to identify potential life safety issues.

1. Do construction workers need to be restricted to dedicated corridors, elevators, or exits?

2. Is special ventilation required for the area during construction?

3. Will any disruptions of the water/plumbing system affect the purity of potable water?

4. Will the construction activities be hazardous to immune-compromised patients?

Required Actions: Any construction activities that adversely affect occupational health issues must be reviewed to minimize the effects. If negative pressurization is required for “special ventilation”, then include a daily reporting of the pressure measurement as part of the the daily ILSM log.

1. Does the project have the potential of affecting structural features of the fire safety systems?

2. Does the project have the potential of affecting compartmentalization features of the fire safety systems?

3. Does the project have the potential for negatively affecting infection control procedures?

Required Actions: Affected personnel must be notified when fire safety systems or infection control procedures are compromised and trained in temporary changes in procedures to compensate for the impaired systems. Examples are the need for alternate fire exits, alarm or sprinkler systems or to evacuate behind secondary fire barriers or compartments due to fire or smoke partition compromises.

1. Does the project present life safety code deficiencies or construction hazards which warrant facility-wide education of personnel concerning the interim life safety measures?

2. Does the project present occupational health deficiencies which warrant facility- wide education of personnel concerning those procedures?

Required Actions: Training must be provided facility wide to educate staff, patients and visitors to any life safety system that is impaired throughout the entire building. In addition, the Fire Department and Police will be notified.

Part 4: APPROVALS:

Contracting Officer’s Representative (COR):

Safety:

Infection Control:

Patient Safety:

Project Superintendent:

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