2C RLP 36C10F23R0105 Appendix A_2 Lease Design Narrative LDN The Villages FL OPC 11_2_2023.pdf

July 20, 2023

VA Leased OPC Design Narrative

LEASED OPC DESIGN NARRATIVE

TABLE OF CONTENTS

VA Leased OPC Design Narrative Draft

Table of Contents - Page 2

1. INTRODUCTION

2. GENERAL REQUIREMENTS

2.1 General

2.2 Codes

2.3 Standards

2.4 References

3. PLANNING AND DESIGN CRITERIA

3.1 Background

3.2 PACT Guiding Principles

3.3 Outpatient Clinics (OPC) Planning Approach

3.4 Department Specific Planning and Design Criteria

3.4.1 General

3.4.2 Lobby

3.4.3 PACTs

3.4.4 Telehealth

3.4.5 Audiology

3.4.6 Eye Clinic

3.4.7 Mental Health Clinic

3.4.8 Physical Medicine and Rehabilitation (PMAR)

3.4.9 Prosthetics

3.4.10 Radiology and MRI

3.4.11 Pathology and Lab

3.4.12 Pharmacy

3.4.13 Engineering/Biomed

3.4.14 Logistics

3.4.15 Police Service

3.4.16 Canteen Service

3.4.17 OIT

3.4.18 Sterile Processing Service

3.4.19 GI Suite

3.4.20 Critical Access Unit

4. TECHNICAL NARRATIVE

4.1 Site/Civil

4.1.1 Pedestrian and Vehicle Access & Circulation

4.1.2 Parking

4.1.3 Site Grading

4.2 Photographic Documentation

4.3 Architecture

4.3.1 General Criteria

4.3.2 Accommodations for Care of Patients of Size

4.3.3 Acoustics

VA Leased OPC Design Narrative Draft

Table of Contents - Page 3

4.3.4 Equipment/Accessories/Furnishings

4.3.5 Signage and Wayfinding

4.3.6 Critical Dimensions

4.3.7 Entry Canopies

4.3.8 Elevators

4.3.9 Slab Depressions

4.3.10 Millwork

4.3.11 Joint Sealant Systems

4.3.12 Doors and Frames

4.3.13 Hardware

4.3.14 Pharmacy Pass-throughs

4.3.15 Radiation Shielding

4.3.16 Radio Frequency Shielding and Magnetic Shielding

4.4 Interior Design

4.4.1 General Criteria

4.4.2 Acoustic Ceiling Tile

4.4.3 Concrete Floor Treatment

4.4.4 Fiberglass-Reinforced Panels

4.4.5 Painting

4.4.6 Wall Protection

4.4.7 Window Shades

4.4.8 Privacy Curtains / Screens

4.5 Mechanical

4.5.1 References

4.5.2 HVAC Design Basis

4.5.3 Air Handling Units (AHUs)

4.5.4 Exhaust Systems

4.5.5 Cooling System

4.5.6 Hot Water Heating System

4.5.7 Humidification System

4.5.8 HVAC Piping Systems

4.5.9 Air Distribution and Duct Systems

4.5.10 HVAC Insulation Systems

4.5.11 Testing, Adjusting, and Balancing

4.5.12 Automatic Temperature Control Systems

4.5.13 Special Conditions

4.6 Plumbing

4.6.1 References

4.6.2 Plumbing Design Basis

4.6.3 Materials

4.6.4 Medical Gases

4.6.5 Special Conditions

4.7 Electrical

VA Leased OPC Design Narrative Draft

Table of Contents - Page 4

4.7.1 Standby Generator

4.8 Lighting Scope

4.8.1 General

4.8.2 Indoor Lighting Specifics

4.8.3 Lighting Controls

4.8.4 LED Drivers

4.9 Telecommunications

4.9.1 Scope of Work

4.9.2 Pathways

4.9.3 Spaces

4.9.4 Telecommunications Bonding and Grounding

4.9.5 Equipment Racks and Equipment Cabinets

4.9.6 Power Distribution Units (PDUs) and Uninterruptible Power Supplies (UPSs)

4.9.7 Telecommunications Infrastructure Plant (TIP)

4.9.8 Systems Scope

5. Hardware Groups and Modifiers

SECTION 1

INTRODUCTION

VA Leased OPC Design Narrative Submission –August 24, 2022 Section 1 - Page 1

SECTION 1 - INTRODUCTION

1.1 The purpose of this Leased OPC Design Narrative is to consolidate the governing codes, standards, references, and guidelines in a document that provides performance-based standards for a VA leased outpatient clinic (OPC).

1.2 The governing codes, standards, and references are based on a VA affiliated OPC. This document will be supplemented as needed to cover additional healthcare services.

1.3 The design of the VA leased OPC is based on the VA Design Guide PG-18-12 (PACT (Patient Aligned Care Team) Space Module Prototype for Standardized Design and Construction of Outpatient Clinics which is described in Part 3 Planning and Design Criteria.

1.4 Commonly Used Acronyms and Definitions:

PCMH Patient Centered Medical Home

A team based, comprehensive, coordinated patient care model (refer to PACT) PACT Patient Aligned Care Team

Provides service to veterans that is patient-centered with the right care at the right time by the right person. A typical “teamlet” serving a veteran consists of four caregivers: A Primary Care Provider – physician (MD), physician assistant (PA) or nurse practitioner (NP); a Registered Nurse (RN); a clinical staff assistant (LPN or Medical Assistant) and an administrative staff member (Clerk).

OPC Outpatient Clinic A lease-based facility providing outpatient services that is physically separated but administratively attached to a VA Medical Center.

PFD Program for Design Net square feet (NSF) listing of all spaces and rooms that are to be included in a construction project.

VA Veterans Affairs VHA Veterans Health Administration VISN Veterans Integrated Services Network

SECTION 2

GENERAL REQUIREMENTS

VA Leased OPC Design Narrative

Section 2 - Page 2

SECTION 2 – GENERAL REQUIREMENTS

2.1 General

2.1.1 The codes, standards, and references listed below indicate minimum performance requirements. Based on input from Owner representatives and recommendations from the architectural/engineering firm, minimum requirements or standards may be exceeded by site specific project design.

2.1.2 Compliance is required with applicable codes and standards throughout the process of design, construction, acceptance, and ongoing maintenance of the facility.

2.1.3 Design and construction of the OPC shall be in compliance with the requirements of the GSA Form L100 Global Lease and the codes, standards, and references listed below.

This Leased OPC Design Narrative covers construction materials and standards not fully addressed by the codes, standards, and references below.

2.1.4 Use the most current edition at the date and time of bid submission.

2.1.5 Lessor to accommodate early occupancy by VA for installation of High Tech / High Cost equipment such as MRI, Gen Rad, Flouroscopy, and CT Scan systems.

2.2 Codes

2.2.1 All VA leased OPC facilities are to conform to all applicable codes, which include but are not limited to following:

2.2.1.1 National Fire Protection Association (NFPA)

2.2.1.1.1 NFPA 70 National Electric Code

2.2.1.1.2 NFPA 75 Standard for the Fire Protection of Information Technology

(applicable when OPC contains a Data Center)

2.2.1.1.3 NFPA 99 Health Care Facilities Code and all standards referenced therein

2.2.1.1.4 NFPA 101 Life Safety Code

2.2.1.1.5 NFPA 110 Standard for Emergency and Standby Power Systems, current editions.

2.2.1.2 Architectural Barriers Act Accessibility Standards (ABAAS), current edition.

2.2.1.3 International Building Codes (IBC): 2018 or latest edition (within two years of release). The latest edition shall be used for structural and seismic design.

2.2.1.3.1 International Building Code

2.2.1.3.2 International Energy Code

2.2.1.3.3 International Mechanical Code

2.2.1.3.4 International Plumbing Code

2.2.1.4 State and local codes as required by the local Authority Having Jurisdiction (AHJ), and 2020 Florida Building Code

2.3 Standards

2.3.1 All leased OPC facilities are to conform to the following standards:

2.3.1.1 Facility to be Ambulatory Care Occupancy

2.3.1.2 FGI Guidelines for the Design and Construction of Outpatient Facilities, current edition (referred to as FGI Guidelines herein).

2.3.1.3 The Joint Commission (TJC) accreditation standards apply to the facility under the affiliated VA medical center license. Building construction and on-going

VA Leased OPC Design Narrative

Section 2 - Page 3 maintenance procedures shall meet TJC standards. Lessor shall provide and submit all documentation that is required for TJC requirements.

2.3.1.4 Facility Security Level (FSL) II shall be as outlined in GSA Form L100 Global Lease.

2.3.1.5 Sustainability standards shall be as outlined in GSA Form L100 Global Lease.

2.3.1.6 American Society of Heating, Refrigerating and Air-Conditioning Engineers

(ASHRAE) Standard 170, Ventilation of Health Care Facilities, current edition (referred to as ASHRAE 170 herein)

2.3.1.7 ASHRAE Standard 12, Minimizing the Risk of Legionellosis Associated with Building Water Systems, current edition.

2.3.1.8 ASHRAE Standard 188, Legionellosis: Risk Management for Building Water Systems, current edition.

2.3.1.9 ASHRAE Standard 62.1, Ventilation for Acceptable Indoor Air Quality, current edition (referred to as ASHRAE 62.1 herein)

2.3.1.10 ANSI/ASHRAE/IES Standard 90.1-2019 -- Energy Standard for Buildings Except Low-Rise Residential Buildings

2.3.1.11 Sheet Metal and Air Conditioning Contractors National Association (SMACNA) Standard, HVAC Duct Construction Standards - Metal and Flexible.

2.3.1.12 USP General Chapter 795 Pharmaceutical Compounding – Nonsterile Preparations

2.3.1.13 USP General Chapter 797 Pharmaceutical Compounding – Sterile Preparations

2.3.1.14 USP General Chapter 800 Hazardous Drugs - Handling in Healthcare Settings

2.3.1.15 Illuminating Engineering Society North America (IESNA) Handbook - latest edition

2.3.1.16 VA Signage Design Manual PG 18-12

2.3.1.17 Association for the Advancement of Medical Instruments (AAMI) standards as applicable to SPS and RME storage.

2.4 References

2.4.1 The following guides, manuals, and other references developed by VA are for reference only, however, they are applicable to VA leased OPCs:

2.4.1.1 VA Enterprise Facility IT Support Infrastructure Standard, most current.

2.4.1.2 Prototype for Standardized Design and Construction of Outpatient Clinics https://www.cfm.va.gov/til/prototypes.asp#OPC

2.4.1.3 PACT Space Module Design Guide

https://www.cfm.va.gov/til/dGuide/dgPACT.pdf

2.4.1.4 Infrastructure Standards for Telecommunication Spaces https://www.cfm.va.gov/til/dguide/OIT-InfrastrucStdTelecomSpaces.pdf

2.4.1.5 PG-18-10 Telecommunications and Special Telecom Systems Design Manual https://www.cfm.va.gov/til/dManual/dmTelecomm.pdf

2.4.1.6 PG-18-12 Office of Information and Special Telecom Systems Design Manual https://www.cfm.va.gov/til/dGuide/dgOIT.pdf

2.4.1.7 National Environmental Policy Act (NEPA) Interim Guidance for Projects https://www.wbdg.org/FFC/VA/VAENVIRO/nepa_guidance_2010.pdf https://www.cfm.va.gov/til/prototypes.asp#OPC https://www.cfm.va.gov/til/prototypes.asp#OPC https://www.cfm.va.gov/til/dGuide/dgPACT.pdf https://www.cfm.va.gov/til/dguide/OIT-InfrastrucStdTelecomSpaces.pdf https://www.cfm.va.gov/til/dManual/dmTelecomm.pdf https://www.cfm.va.gov/til/dGuide/dgOIT.pdf https://www.wbdg.org/FFC/VA/VAENVIRO/nepa_guidance_2010.pdf

VA Leased OPC Design Narrative

Section 2 - Page 4

2.4.1.8 Physical Security and Resiliency Design Manual

https://www.cfm.va.gov/til/PhysicalSecurity/dmPhySec.pdf

2.4.1.9 VA Barrier Free Design Standard

https://www.wbdg.org/FFC/VA/VAACCESS/dsBarrFree_11_2018.pdf

2.4.1.10 Program Guide PG 18-14 Room Finishes, Door, & Hardware Schedule – Chapter 265 Outpatient / PACT Clinic https://www.cfm.va.gov/til/room/RoomFinishes.pdf

2.4.1.11 Directive 0730 Security and Law Enforcement

https://www.va.gov/vapubs/search_action.cfm?formno=730&SortBy=Pub_Type _Desc

2.4.1.12 Physical Security and Resiliency Design Manual

https://www.cfm.va.gov/til/PhysicalSecurity/dmPhySec.pdf

2.4.1.13 Room Templates, Leased Outpatient Clinics

https://www.cfm.va.gov/til/rTemplate/LeasingOPCw.asp

2.4.1.14 Program Guide PG 18-10 HVAC Design Manual

https://www.wbdg.org/FFC/VA/VAACCESS/dsBarrFree_11_2018.pdf https://www.cfm.va.gov/til/room/RoomFinishes.pdf https://www.va.gov/vapubs/search_action.cfm?formno=730&SortBy=Pub_Type_Desc https://www.va.gov/vapubs/search_action.cfm?formno=730&SortBy=Pub_Type_Desc https://www.cfm.va.gov/til/rTemplate/LeasingOPCw.asp

SECTION 3

PLANNING AND DESIGN CRITERIA

Section 3 - Page 1

SECTION 3 – PLANNING AND DESIGN CRITERIA

3.1 Background

VHA has committed to the development of a patient-centered Outpatient Care Center for enhanced outpatient primary care services to veterans. The result was a patient care delivery model and a set of planning and design standards.

3.2 PACT Guiding Principles

An operational and planning design guide was developed which identified key principles and objectives. Refer to PACT Space Module Design Guide under References Section 2.4.

3.3 Outpatient Clinics (OPC) Planning Approach

The development of the PACT Planning Module was complemented by the development of a Prototype for Standardized Design and Construction of Outpatient Clinics. Using the PACT Module as the building block, prototypes were developed for three types and sizes of outpatient facilities.

3.4 Department-Specific Planning and Design Criteria

3.4.1 General

3.4.1.1 Furniture: All office desks are to be sit-stand. Provide appropriate data and power.

3.4.1.2 Provide a generator pad and back-up power.

3.4.1.3 Provide power and data at all Medical Equipment Storage and Clean Supply

Rooms.

3.4.1.4 Doors / Door Hardware

3.4.1.4.1 Provide push-plate auto-operators on doors to all patient toilet rooms not connected to treatment or procedure rooms.

3.4.1.4.2 Provide card readers on Clean Rooms.

3.4.1.4.3 Provide push button access at Soiled Rooms.

3.4.1.4.4 Patient-serving doors are to be 42” wide.

3.4.1.4.5 Doors to General Rad/Fluoroscopy Rooms to be equipped with a pair of doors that provide a minimum 50" clear opening. Door opening sizes for these rooms shall comply with site specific requirements with VAMC Imaging Contractor's requirements. These site-specific requirements will not be fully known until after Award of VAMC Imaging Vendor contract.

3.4.1.4.6 Provide contact sensors on all exterior doors for security.

3.4.1.5 Recessed walk-off mats are to be provided at all vestibules.

3.4.1.6 OIT

3.4.1.6.1 All computers are to be dual monitors on arms to lift off work surfaces.

3.4.1.7 Specialty

3.4.1.7.1 Operable partitions provided in Conference/Lounge, Shared Medical Appointments, and Mental Health Group Rooms shall be Skyfold brand.

3.4.1.7.2 All elevators should be sized to accommodate a stretcher.

3.4.1.7.3 Provide a white noise system in the following areas: all Patient Treatment

Rooms, Primary Care, Mental Health, Whole Health, Telehealth, Multispec, Pharmacy Waiting (dispensing windows), CAU.

3.4.1.7.4 Provide coat hooks on the backs of all doors.

3.4.1.8 Plumbing

Section 3 - Page 2

3.4.1.8.1 All floor drains are to be self-priming.

3.4.1.8.2 All eyewashes should be wall mounted with bowl; drains should be hard piped, and not a floor drain.

3.4.1.9 Interior Design

3.4.1.9.1 Provide wall protection typical at all corridors

3.4.1.10 Lessor-provided janitorial services

3.4.1.10.1 Lessor is to maintain ice makers per Station infection control requirements.

3.4.1.11 Manifold room: Provide nitrogen and oxygen.

3.4.1.12 Conference / Training Rooms (typical): Provide kitchenette with sink, garbage disposal, microwave, and full-height refrigerator.

3.4.2 Lobby

3.4.2.1 Provide a variety of seating heights to accommodate patients with sit/stand mobility issues.

3.4.2.2 Reception

3.4.2.2.1 Provide privacy/acoustic dividers between each check-in area.

3.4.2.1.1 Provide a 30” deep counter at staff side for safety.

3.4.3 PACTs

3.4.3.1 Provide swing doors at PACT Exam Rooms (no sliding doors)

3.4.3.2 PACT spaces to have sound baffling to minimize background noise transmission.

3.4.3.3 Exam room door hardware

3.4.3.3.1 Provide a lock on the exam room side of doors between patient corridor and exam room.

3.4.3.3.2 Provide a lock on the staff side of doors between exam room and PACT work area.

3.4.3.4 Provide a nurse call system with dome lights corresponding with all patient restrooms at:

3.4.3.4.1 Patient toilet in corridor.

3.4.3.4.2 PACT side near toilet to indicate which toilet.

3.4.3.4.3 Back staff corridor at the corresponding corridor.

3.4.4 Telehealth

3.4.4.1 All walls in each Telehealth Room are to be painted to be PPG 1238-2

Goddess Blue.

3.4.5 Audiology

3.4.5.1 Audiology Booths

3.4.5.1.1 Patient doors are to be 42”; provider doors are to be 36”; all doors are to swing out.

3.4.5.1.2 Provide nurse call and duress on provider side.

3.4.5.1.3 Inside of booth is to be 8’ clear from FF to ceiling with recessed sprinkler head.

3.4.5.1.4 Flooring is to be acoustic LVT.

3.4.5.1.5 Booths must be recessed so booth floor is level with finished floor. Power, data, HVAC, fire alarm must be provided to booths.

Section 3 - Page 3

3.4.5.1.6

3.4.6 Eye Clinic

3.4.6.1 Locate Fitting and Dispensing adjacent to Lobby space.

3.4.6.2 Do not locate eye lanes on exterior walls or walls with windows.

3.4.7 Mental Health Clinic

3.4.7.1 Provide additional acoustical isolation at the Transcranial Mag Room. Do not locate this room on walls with windows. Provide a dedicated circuit for this room.

3.4.7.2 A card reader is to be provided to access each Mental Health corridor from the Lobby side.

3.4.8 Physical Medicine and Rehabilitation (PMAR)

3.4.8.1 Exterior PMAR training

3.4.8.1.1 Provide direct access from Treatment Gym.

3.4.8.1.2 Exterior training area to be enclosed and provide privacy for patients

3.4.8.1.3 Provide a variety of surfaces for gait training

3.4.8.1.3.1 Provide concrete stairs for training

3.4.8.2 Provide ½”-thick rubber flooring. Integrate a pattern for gait measurement into flooring.

3.4.8.3 Include Solo-Step patient lift. Provide structural reinforcement and rail as necessary.

3.4.8.4 Equipment Storage Room

3.4.8.4.1 Provide plug mold with power and data at 48” AFF

3.4.8.5 Supervisor Office

3.4.8.5.1 Provide full-glass wall into the treatment area with pull-down shade.

3.4.9 Prosthetics

3.4.9.1 Provide pass-thru window for patient supply pick-up with roll-down shutter.

3.4.9.2 Provide 42” door between sub-wait and storage/work area.

3.4.10 Radiology and MRI

3.4.10.1 Provide ceiling lifts at Ultrasound, CT Scanning and MRI Rooms.

3.4.10.2 Provide two half-height lockers in each dressing room.

3.4.10.3 Provide Magnetic Field Always On signage at Zone 3 Doorway.

3.4.11 Pathology and Lab

3.4.11.1 Provide pass-thru window for specimen drop-off.

3.4.11.2 Provide wall protection to blood draw cubicles. Specimen shelf in specimen toilets, power for bariatric blood draw chair, biological cabinet with exhaust fan to outside, reagent grade water system to chemical analyzer and four sinks, automatic door operator activation button at lab reception.

3.4.11.3 Provide keyed water shut off switches at specimen collection restrooms.

3.4.11.4 Confirm HVAC requirements for cycles, temperature, negative pressure, and humidity with VA and provide monitoring system.

3.4.11.5 Provide infrastructure and utilities for ticket printing system (Qmatic).

3.4.11.6 Provide nurse call at Blood Draws and Specimen /Toilets.

3.4.11.7 Provide Duress at Reception and Blood Draws.

Section 3 - Page 4

3.4.11.8 Provide auto operator at lab entry door.

3.4.11.9 Provide sink-mounted eyewash.

3.4.11.10 Provide floor drains in lab area with seamless flooring.

3.4.11.11 Provide a minimum of two light fixtures in each Blood Draw Room.

3.4.11.12 Provide powered roll-down shutter between Lobby and Lab Reception.

3.4.11.13 Provide lab-grade casework: SEFA 8 – metal casework with phenolic counter tops

3.4.11.14 Provide double doors at the back entry to the lab for large deliveries.

3.4.11.15 Provide a minimum of the following power in the lab space: (30) data outlets,

(70) duplex outlets, (8) quad outlets, (20) power on strips attached to the walls,

(1) 240V receptacle for the compressor, (2) power poles in chem with (5) data outlets, (5) power outlets, and (2) 240V outlets

3.4.11.16 Provide anti-fatigue flooring in blood draw rooms.

3.4.11.17 Lab air compressor is to be in dental mechanical room and piped to lab.

3.4.12 Pharmacy

3.4.12.1 Vault is to have hard walls and ceiling (review physical security requirements).

Include day gate and window with shelf.

3.4.12.2 Provide ballistic level 3 rated glass at the dispensing areas.

3.4.12.3 Provide Pharmacy casework / shelving system, double entry on back corridor for pallet deliveries, comply with Physical Security Manual for Door Hardware and Wall Security Requirements.

3.4.12.4 Provide card readers in the consult rooms between consult and the rest of pharmacy.

3.4.12.5 Provide intercom with video at pharmacy back door and card reader.

3.4.12.6 This area is to have its own security system partitioned from the rest of the building.

3.4.12.7 Provide power from ceiling for robotic pharmacy equipment, on dedicated circuit.

3.4.12.8 Provide 10 half-height lockers in Lounge.

3.4.12.9 Provide fill master near a sink in the Pharmacy.

3.4.12.10 Provide Queuing bingo board for Pharmacy in the Lobby.

3.4.13 Engineering/Biomed

3.4.13.1 Provide wall-mounted stainless-steel sink with integral drain board, single basin.

3.4.13.2 Provide three (3) of each oxygen, vacuum and compressed air wall outlets.

3.4.14 Logistics

3.4.14.1 Provide recessed dock leveler and scissor lift (capacity of 8,000 pounds). Dock leveler should line up with overhead door. Scissor lift is to have a pit with drain.

3.4.14.2 Provide alarm system to be connected to main building system on a separate zone. Add building intrusion alarm system keypad at single personnel door to exterior.

3.4.14.3 Clear height in warehouse spaces must allow for full use of a three high pallet rack system.

Section 3 - Page 5

3.4.14.4 Provide two loading dock bays.

3.4.14.5 Exterior loading dock should be covered and extend 4’ past the end of the dock to provide coverage during loading.

3.4.14.6 Provide removable railing along the dock edge.

3.4.14.7 Provide air curtain and radiant heater at overhead door.

3.4.14.8 Gas cylinder and Biohazard storage is to be in hard walls with hard ceiling.

3.4.14.9 Provide emergency eyewash and shower inside with floor drain.

3.4.14.10 Locate a hose bib near the dock.

3.4.14.11 Follow physical security guidelines for Mail Room.

3.4.14.12 Locate light control for biohazard storage on exterior of room.

3.4.14.13 Provide intercom with video at man door on dock.

3.4.14.14 Provide powered overhead door.

3.4.14.15 Provide ramp or stairs from dock to ground level (verify LDN preference).

3.4.14.16 Lights, sprinklers, buildings should be located as high as possible.

3.4.14.17 Double doors between warehouse and the rest of the building are to be automatic. Provide card access into warehouse and push button out of warehouse.

3.4.14.18 Provide concrete floor densifier on warehouse floor.

3.4.14.19 Provide secured covered cage on dock for empty tanks.

3.4.15 Police Service

3.4.15.1 Provide Armory with hard walls and ceiling – meet VA armory requirements.

3.4.15.2 Provide a camera in Holding Room and Armory.

3.4.15.3 Armory alarm system is to be connected to main building alarm on separate partition.

3.4.15.4 Provide one-way glass viewing into the Lobby.

3.4.15.5 Provide dimmable lights.

3.4.15.6 Armory and Police Office are to have dual verification locks.

3.4.15.7 Department is to have direct access to exterior of building.

3.4.15.8 Provide ballistic rated walls and doors at interior walls.

3.4.16 Canteen Service

3.4.16.1 This service is a VA-designed Micro-market concept – grab-and-go, microwave, open front coolers, and coffee machines. No market staff personnel is required.

3.4.17 OIT

3.4.17.1 Provide dual authenticator card reader into MCR and all TRs with camera.

3.4.17.2 Provide door contact at all TRs.

3.4.17.3 Demarc room will be lessor-provided.

3.4.17.4 TRs need to be stacked.

3.4.17.5 Power mold at 48” AFF.

3.4.17.6 Provide a key pad card reader into Computer Work Room.

3.4.18 Sterile Processing Service

3.4.18.1 Provide single cart washer, automated only.

3.4.18.2 Provide critical high purity water supply, locate near SPS (does not need to be

Section 3 - Page 6 accessed within SPS). Critical high purity water supply shall comply with AAMI Standard ST108.

3.4.18.3 Follow mechanical requirements for this area for air pressure, temperature, humidity, cycles, dedicated handlers, etc.

3.4.18.4 The decontamination area shall be provided with NFPA 99C-Level clean compressed air system that is separate from patient and other medical air systems provided at the facility

3.4.18.5 Provide emergency shower and eyewash (Hard connected) in decontam, eyewash only in clean storage.

3.4.18.6 Provide floor drains in scope processing.

3.4.18.7 Provide push plate on door into PPE alcove.

3.4.19 GI Suite

3.4.19.1 Procedure rooms will have ceiling-mounted equipment.

3.4.19.2 Provide nurse call system with voice between procedure rooms, proceduralist room, and nurse station.

3.4.19.3 Provide piped medical gas.

3.4.20 Critical Access Unit

3.4.20.1 Provide plug mold with power and data at 48” AFF.

SECTION 4

TECHNICAL NARRATIVE

VA Leased OPC Design Narrative

Section 4 - Page 1

SECTION 4 – TECHNICAL NARRATIVE

4.1 Site/Civil

4.1.1 Pedestrian and Vehicle Access & Circulation

4.1.1.1 Minimum traffic width is 12’, and minimum sidewalk width in outer traffic ring is 4’. Curves for traffic lanes and radii at intersections must be adequately sized to prevent vehicles from encroaching on an opposing lane of traffic.

4.1.1.2 Provide driveway with vehicular drop-off point with covered walkway extending to Main Entrance. Access roads shall be configured to prevent vehicles from attaining speeds in excess of 25-mph. Parking aisles shall be configured to prevent vehicles from attaining speeds in excess of 10-mph. Avoid straight line vehicular approaches to the facility by access roads or parking lanes. Vehicles shall not be permitted to travel closer than 25-feet to the building. Design patient exterior areas that are conveniently accessible from the building without vehicular crossings and are oriented to the most favorable site climatic conditions. Provide locations and details of pavement striping and signing for parking, roadways, crosswalks, accessible parking and routes, and other special areas. A 10-mph speed limit must be marked at each aisle of parking and on roadways.

4.1.1.3 Provide an accessible route from the public right-of-way abutting the site to the accessible building entrance.

4.1.1.4 Provide a service area with a loading dock designed to accommodate the minimum required semi-truck size. Pavement shall be heavy duty concrete.

4.1.1.5 Service area shall accommodate vehicles that pick-up trash and recycled materials. Locate service area away from public and patient areas.

4.1.1.6 Provide reflective traffic control signs as required for intersections, no parking lanes, and guidance of site traffic.

4.1.1.7 Provide a minimum of two separate vehicular entrances to property.

4.1.2 Parking

4.1.2.1 Parking lots with 90-degree stalls must have minimum parking stall dimensions of 9’x18’, and a minimum drive aisle width of 24’. Angled parking must have one-way drive aisles with the same stall sizes as 90-degree parking. Angled parking drive aisle width must comply with a published design standard for a designated parking angle. Parking lot shall be minimum two-layer asphalt with access drive to front entrance heavy duty asphalt for fire truck / city bus. Heavy duty asphalt must be used on ALL travel ways. Motorcycle parking pads shall be concrete.

4.1.2.2 Lessor shall provide at a minimum a total of 950 parking stalls with 855 standard, 90 accessible and 5 van parking stalls. Golf cart parking, motorcycle parking, bicycle parking with rack, parking for four (4) government vehicles near ambulance/staff entry shall be provided.

Lessor shall provide six (6) Level 2 Electric Vehicle Charging Stations for GSA fleet vehicles. Electrical infrastructure shall be sized to accommodate a total of twenty (20) Electric Vehicle Charging Stations in the future. Design to be for government use and not for general public use.

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4.1.2.3 Provide signage for dedicated parking spaces (VA Police/ Volunteers / GSA Vehicles).

4.1.3 Site Grading

4.1.3.1 Roads and walks should have a typical cross slope of 2% unless adequate surface drainage is provided by other slope conditions. Refer to local DOT guidelines.

4.1.3.2 ABAAS criteria must be met for the entire site.

4.1.4 Flagpoles

4.1.4.1 The Lessor shall provide 2 flagpoles at a location to be approved by the Government. One flagpole shall extend at least 35 ft. above the ground, and the second flagpole shall extend at least 45 ft. above the ground. Each flagpole shall be equipped with rope and hardware for three flags. The Government will provide the flags. Exterior lighting (two each light fixtures spaced a minimum of 20 feet apart, mounted on the building or at grade) shall be provided to illuminate the flags at night. Automatic switching for light fixtures shall be provided. Provide a concrete pad (washed stone), minimum 150 sf, at the base of the flagpoles. The concrete pad shall be connected to the building with a sidewalk.

4.1.5 Golf Cart Parking

4.1.5.1 Furnish & install a secure/fenced covered golf cart parking station large enough for two eight passenger golf carts. Golf cart parking station will include charging stations for each of the two golf carts.

4.1.6 Walking Trail

4.1.6.1 Furnish and install a walking trail around the entire campus. Trail to be lighted and include 3-4 benches. Trail to be a smooth ABAAS compliant surface, wide enough for two wheelchairs.

4.1.7 Exterior Signage

4.1.7.1 Lessor to provide exterior monument sign and building sign.

4.1.8 Utilities

4.1.8.1 Lessor shall install a well for lawn sprinkling or provide separate meter for water. Separate electrical meter shall be provided by Lessor to handle service items responsible by Lessor such as: parking lot lighting and sprinkler pump.

4.1.9 VA Resident Engineer Trailer

4.1.9.1 The lessor shall provide one (1) office trailer 12’ X 46’ with two offices, conference room and a rest room for the sole use of the VA and its delegate, when present. Also, provide three (3) parking spaces reserved for the Government and their delegates. The office trailer shall be of the jobsite and may be within the prime contractor’s trailer complex. The trailer space shall have conditioned air and electricity for proper lighting and receptacles in accordance with typical office area standards. Access to high-speed wireless internet shall be provided. The office space shall contain the following items:

one (1) office desk, double pedestal, executive size, one (1) swivel chair with arms, two (2) armchairs, one (1) 5-drawer file cabinet, letter size, two (2) drawing rack, with 12-30 inch “Plan Hold” drawing hold, two (2) armchairs, one

(1) 5-drawer file cabinet, letter size, one (1) 1.5 Cu. Ft. microwave, one (1) full size refrigerator, one (1) Xerox orkCentre or approved equivalent Color / B&W

VA Leased OPC Design Narrative

Section 4 - Page 3 copier, Printer/copier/scanner at 35 ppm and handles 8”x10”, legal, and 11’x17”, one (1) conference tables, size 4' x 6', four (4) swivel chairs with arms, eight (8) conference chairs (armless with cushion seat foldable), one (1) plan table 4' x 7', two (2) worktables, folding 30" x 72" and 18” x 36”, two (2) Apple I PAD Pro 12” tablets with 365 and Adobe Pro and accessories, Wi-Fi + 4G service, 1 TB and Word app, with Signed/Numbered awarded SFO loaded. Loading of all drawings and specifications when “completed” after acceptance of final drawings should be up-loaded / accomplished at that time frame., one (1) 65” wall mounted monitor for conference room, two (2) handheld PDA’s, 1TB with cameras, first aid kit with supplies replenishment.

4.2 Photographic Documentation

4.2.1 During the construction period through completion, a 3rd party shall provide photographic documentation of construction progress and at selected milestones (such as blocking in walls, stub-up connection points for equipment, security mesh in wall (if required), walls going to deck (where required)) including electronic indexing, navigation, storage and remote access to the documentation, as per these specifications.:

4.2.1.1 The commercial photographer or the subcontractor used for this work shall meet the following qualifications:

Demonstrable minimum experience of five (5) years in operation with at least 500 projects documented to date providing documentation and advanced indexing/navigation systems including a representative portfolio of construction projects of similar type, size, duration and complexity as the Project.

Demonstrable ability to service projects throughout North America with operational resources within 150 miles of project, which shall be demonstrated by a representative portfolio of active projects of similar type, size, duration, and complexity as the Project.

Each digital image shall be taken with a professional grade camera with minimum size of 6 megapixels (MP) capable of producing 200x250mm (8 x 10 inch) prints with a minimum of 2272 x 1704 pixels and 400x500mm (16 x 20 inch) prints with a minimum 2592 x 1944 pixels.

Indexing and navigation system shall utilize actual AUTOCAD construction drawings, making such drawings interactive on an on-line interface. For all documentation referenced herein, indexing and navigation must be organized by both time (date-stamped) and location throughout the project.

Documentation shall combine indexing and navigation system with inspection-grade digital photography designed to capture actual conditions throughout construction and at critical milestones. Documentation shall be accessible on-line through use of an internet connection. Documentation shall allow for secure multiple-user access, simultaneously, on-line.

Construction progress for all trades shall be tracked at pre-determined intervals, but not less than once every thirty (30) calendar days throughout the project upon commencement of vertical construction (“Progressions”).

Progression documentation shall track both the exterior and interior construction of the building. Exterior Progressions shall track 360 degrees around the site and each building. Interior Progressions shall track interior

VA Leased OPC Design Narrative

Section 4 - Page 4 improvements beginning when stud work commences and continuing until Project completion.

Miscellaneous events that occur during any Contractor site visit, or events captured by the Department of Veterans Affairs independently, shall be dated, labeled and inserted into a Section in the navigation structure entitled “Slideshows,” allowing this information to be stored in the same “place” as the formal scope.

Customize project-specific digital photographic documentation of other details or milestones. Indexing and navigation accomplished through interactive architectural plans.

Monthly exterior progressions (360 degrees around the project) and slideshows (all elevations and building envelope). The slideshows allow for the inclusion of Department of Veterans Affairs pictures, aerial photographs, and timely images which do not fit into any regular monthly photo-path.

Regular (5 max) interior progressions of all walls of the entire project to begin at time of substantial framed or as directed by the Resident Engineer through to completion.

Images shall be taken by a commercial photographer and must show distinctly, at as large a scale as possible, all parts of work embraced in the picture.

Coordination of photo shoots is accomplished through Resident Engineer or other designated on-site point of contact. Contractor shall also attend construction team meetings as necessary. Contractor’s operations team shall provide regular updates regarding the status of the documentation, including photo shoots concluded, the availability of new Progressions or Exact-As-Builts viewable on-line and anticipated future shoot date.

Contractor shall provide all on-line domain/web hosting, security measures, and redundant server back-up of the documentation. Contractor shall provide technical support related to using the system or service.

4.3 Architecture

4.3.1 General Criteria

4.3.1.1 Refer to PG 18-14 for Finishes, Door, and Hardware Schedule listed by Room Type.

4.3.2 Accommodations for Care of Patients of Size

4.3.2.1 Facility is to be designed to accommodate patients of 750 lbs, minimum, throughout.

4.3.2.2 Refer to FGI Guidelines for Outpatient Facilities for accommodations for care of patients of size. Minimum requirements are to provide access to a Procedure Room and Procedure Room Toilet in one PACT Module. These spaces shall be designed for a 750 lbs person.

4.3.3 Acoustics

4.3.3.1 Refer to FGI Guidelines for Outpatient Facilities for acoustics requirements for enclosed rooms. Refer to PG 18-14 for information on rooms not covered under FGI or rooms with special acoustics requirements.

4.3.4 Equipment/Accessories/Furnishings

4.3.4.1 Refer to Project Contents List and Room Template sheets provided with the

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Section 4 - Page 5

RLP for equipment, accessories, and furnishings descriptions and locations.

Items to be provided and/or installed by Lessor are noted on the list. Provide partitions, partition backing, and above-ceiling structural support as required for wall and/or ceiling mounted equipment, accessories, and furnishings. Provide required utility connections for scheduled equipment.

4.3.5 Signage and Wayfinding

4.3.5.1 Refer to VA Signage Design Guide in Section 2.4 for signage standards and requirements, including dedication plaque.

4.3.5.2 Lessor needs to provide building evacuation signage.

4.3.6 Critical Dimensions

4.3.6.1 Patient-use corridors are to be 6’ minimum clear, typical.

4.3.6.2 Provide minimum 8’ minimum clear corridors at Audio Booth locations and

Critical Access Unit.

4.3.6.3 Provide an 8’ minimum clear path between ambulance vestibule and front entry vestibule.

4.3.6.4 Provide 8’ minimum clear path between Prep/Recovery and Endo Procedure

Rooms.

4.3.6.5 Provide 8’ minimum clear path between Warehouse and Lab and Pharmacy rear double doors.

4.3.6.6 Refer to PG 18-14 for required ceiling heights by room type.

4.3.7 Entry Canopies

4.3.7.1 Provide non-combustible lit canopies over the following locations: patient entry, ambulance building access point, staff entries, and receiving area/loading dock, and MRI pad if included (L-shape canopy walkway to trailer; canopy must be designed to overhang trailer.).

4.3.7.2 At patient entry, provide a covered patient drop-off zone with space for at least one full size passenger vehicle (19’ long covering driver) and an accessible access aisle.

4.3.7.3 At ambulance building access point, provide a drive-under covered patient pick-up zone with space for at least one ambulance and an accessible access aisle.

Verify typical ambulance size. Provide drive through ambulance area with canopy at the rear of the clinic in lieu of back-in space at ambulance pick-up area

4.3.7.4 Verify clearance from grade to underside of canopy for typical emergency and transport vehicles 14’-6” min.

4.3.7.5 Provide a covered canopy at loading dock a minimum 4’-0” extension beyond edge of loading dock maintaining clearance height for semi-truck.

4.3.7.6 Ensure appropriate site access and turning radius for emergency access vehicles.

4.3.8 Elevators

4.3.8.1 Where elevators are provided in a leased facility, all elevator cars shall accommodate an ambulance stretcher of 24”x84” in the horizontal open position and shall be identified by the international symbol for emergency medical services (star of life). The symbol shall be not less than 3” high placed inside on both sides of the hoist way door frame. If more than one-story, facility

VA Leased OPC Design Narrative

Section 4 - Page 6 to include a minimum of three patient and two service elevators.

4.3.8.2 All elevators are to be connected to emergency power.

4.3.9 Slab Depressions

4.3.9.1 At new construction, provide slab depression as required to provide flush threshold installation for example: audiology booths, MRIs, front vestibule mats, loading dock scissors life and dock leveler, Sterile Processing Cart Wash, utility box for dental chairs, and other equipment requiring recessed installation as recommended by equipment manufacturer. At existing construction, provide ramp to meet ABAAS.

4.3.9.2 Refer to Project Contents List provided with the RLP for equipment, accessories, and furnishings descriptions and locations.

4.3.10 Millwork

4.3.10.1 Conform to Architectural Woodwork Institute (AWI) and Woodwork Institute (WI) quality standards.

4.3.10.2 Wood Veneer Casework Construction: Combination of custom wood casework and countertops are to conform to program and functional requirements.

(Location: Lobby, Reception)

4.3.10.2.1 Construction: Flush overlay construction with concealed hinges. AWI custom grade.

4.3.10.3 Plastic Laminate Casework Construction: Custom plastic laminate casework is to conform to program and functional requirements. (Location: typical)

4.3.10.4 Construction: Flush overlay construction with concealed hinges, AWI Custom Grade.

4.3.10.4.1 Cabinet Hardware:

4.3.10.4.1.1 Concealed hinges, all metal, 110 degree opening, self-closing.

4.3.10.4.1.2 Full extension drawer guides, 100 lbs. capacity.

4.3.10.4.1.3 Door and drawer pulls: 4” center to center wire pull, 5/16” diameter round, 1 ¼” projection, satin chrome.

4.3.10.5 Solid Surface Fabrications: Hard, solid, non-porous mineral-filled acrylic resin

(methyl methacrylate) material in color to be selected by designer. Thickness:

1/2” minimum. Use solid surfaces that can withstand frequent disinfection with strong cleaning agents for sinks, work surfaces, patient furniture, and other locations that require frequent disinfection

4.3.10.5.1 Locations:

4.3.10.5.1.1 All built-in casework and counters to have solid surface countertops.

4.3.10.5.1.2 All counters in patient treatment areas to have solid surface countertop with 4” high minimum integral coved side and backsplash.

4.3.10.5.1.3 Where scheduled as wall protection, provide ¼” thick material with welded seams.

4.3.11 Joint Sealant Systems

4.3.11.1 Joints at plumbing fixtures, ceramic tile to be mildew resistant silicone.

4.3.12 Doors and Frames

4.3.12.1 Refer to PG 18-14 for door and hardware requirements by room type.

4.3.12.2 Finish: Prefinished in compliance with AWI Section 1500.

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4.3.12.3 Automatic Sliding Doors:

4.3.12.3.1 Main entries and ambulance entrances shall have automatic sliding doors.

4.3.12.3.2 Comply with BHMA Standard ANSI A156.10 (BHMA 1601), Power

Operated Pedestrian Door Standard and UL Standard UL 325, Electric Door, Drapery, Gate, Louver and Window Operators and Systems.

4.3.12.3.3 Service Life: Provide automatic sliding doors capable of operating without failure of any component, for not less than 300,000 open and close cycles, with normal maintenance as defined in manufacturer's standard operating manual.

4.3.12.4 Access Panels:

4.3.12.4.1 Flush stainless steel at toilet areas.

4.3.12.4.2 Flush gypsum board surface with concealed hinges at public and office areas.

4.3.12.4.3 Fire rated steel at rated construction.

4.3.13 Hardware

4.3.13.1 General Note

4.3.13.1.1 Provide extra heavy duty, Grade 1 hardware for all components.

4.3.13.2 Major components and finishes are as follows:

4.3.13.2.1 Hinges: Provide ball-bearing hinges of size, quantity, and duty level as recommended by manufacturer, unless specifically noted otherwise.

Provide non-removable pins (NRP) for reverse bevel doors that lock.

Hinges shall meet the requirements of ANSI/BHMA A156.1-06.

4.3.13.2.2 Electric Hinges/Electric Power Transfers: Provide electric hinge or mortise electric power transfer, as required by electric locking device(s). Provide sufficient number of concealed wires to accommodate electrified function of specified hardware. Locate at second hinge from bottom, and where used in conjunction with exit devices, locate hinge nearest to exit device. Provide mortar guard for each electrified hinge. Electric Hinges/Electric Power Transfers shall meet the requirements of ANSI/BHMA A156.1-06.

4.3.13.2.3 Flush Bolts/Coordinators: Provide automatic, semi-automatic (constant/self- latching), or manual flush bolts for inactive door of pairs for inactive door of pairs as indicated in the hardware group(s), and as required for metal or wood doors. Provide stop-mounted coordinator for labeled pairs with automatic flush bolts. Whenever bottom bolts are utilized, provide dustproof strike, as required for sill conditions. Provide top and bottom bolt configurations where required by opening conditions. Flush Bolts/Coordinators shall meet the requirements of ANSI/BHMA A156.16-08.

4.3.13.2.4 Locks: Provide cylindrical locksets and latches unless noted otherwise in hardware groups appendix, with functions specified in assigned hardware groups. Cylindrical locksets shall meet the requirements of ANSI/BHMA A156.2-03, and mortise locksets shall meet the requirements of ANSI/BHMA A156.13 2005, Operational Grade 1, and Security Grade 1.

Provide cylinders, backsets and strikes as recommended by manufacturer.

Electrified locking devices shall meet the requirements of ANSI/BHMA A156.25-07.

4.3.13.2.5 Exit Devices: Provide heavy-duty exit devices with functions specified in

VA Leased OPC Design Narrative

Section 4 - Page 8 assigned hardware groups. Fire exit devices shall comply with applicable building codes and be mounted to comply with accessibility codes. Devices must be UL listed as fire exit panic. Provide lever trim, cylinder dogging, and cylinders as indicated and per manufacturer’s recommendation. Exit devices shall meet the requirements of ANSI/BHMA A156.3-08.

4.3.13.2.6 Cylinders and Keying: Key locks/cylinders in groups with new master key or grandmaster key system as directed by Owner. Provide three (3) keys per lock. Provide construction master keying. Cylinders shall meet the requirements of ANSI/BHMA A156.5-14.

4.3.13.2.7 Electric Strikes: Provide heavy duty commercial Grade 1 electric strikes.

Provide strikes designed for use with latch/lock type specified at each opening. Electric strikes shall be UL listed as Burglary-Resistant Electric Door Strikes and where required shall be UL listed as Electric Strikes for Fire Doors and Frames. Provide fail-secure (non-fail-safe) type electric strikes, unless specified otherwise in hardware group. Provide power supply, transformer and rectifier for each strike as required, and verify voltage with Electrical Contractor. Provide spacer plates and accessories as required for installation. Electric Strikes shall meet the requirements of ANSI/BHMA A156.31-07. Magnetic locks are not permitted.

4.3.13.2.8 Closers: Provide heavy-duty non-sized closers with heavy-duty closer arms, adjustable to meet maximum opening force requirements of ADA and CBC if in California. Provide drop plates brackets and adapters as recommended by manufacturer according to site conditions. Provide closers meeting the requirements of UBC 7-2 and UL 10C Positive Pressure Tests. Mount closers on room side of corridor doors and stair side of stairway doors. Closers shall meet the requirements of ANSI A156.4-08

4.3.13.2.9 Electromagnetic and Electromechanical Release devices – Closer Holders:

Provide connection to fire alarm where required by code. Verify voltage with Electrical. Electromagnetic wall holders shall meet the requirements of

ANSI A156.15-06

4.3.13.2.10 Reference PG 18-14 for locations of kick plates and armor plates. Kick Plates/Armor plates: Provide kick plates – 10” tall x 2” less than door width x .050” thick; and armor plates – 34” tall x 2” less than door width x .050” thick. (At pairs provide plates for both doors – 1” less than door width.) Door Trim shall meet the requirements of ANSI/BHMA A156.6-05.

4.3.13.2.11 Push Plates/Pull Plates: Where specified in assigned hardware group, provide push plate – 6” x 16” x .050”, and pull plate – 4” x 16” x .050” plate with 3/4” round x 8” CTC pull. Door Trim shall meet the requirements of

ANSI/BHMA A156.6-05.

4.3.13.2.12 Stops: Provide stops as appropriate for opening/stop conditions, utilizing wall stops/bumpers, overhead stops, or stop arms on closers. Do not use floor stops unless specifically noted. Doorstops shall meet the requirements of wall stops ANSI/BHMA A156.16.08 and overhead stops

ANSI/BHMA

156.08-05.

4.3.13.2.13 Auxiliary Hardware shall meet the requirements of ANSI/BHMA A156.16-

08. Gasket: Where smoke gaskets are specified or required by fire rating, VA Leased OPC Design Narrative

Section 4 - Page 9 provide gasketing complying with UBC 7-2 AND UL-10C. Provide accessories, shims and fasteners as recommended by manufacturer.

Gaskets are to be installed in accordance with BHMA A156.22-05 regarding air leakage as tested per ASTM E 283.

4.3.13.2.14 Weather-seal: Provide threshold, sweep, and weather-strip at all exterior openings. Weather-seal shall meet the requirements of ANSI/BHMA A156.22-05. Thresholds shall meet the requirements of ANSI/BHMA A156.21-09.

4.3.13.2.15 Finishes: Provide US-26D (satin chrome) and associated finishes as applicable for products. Finishes shall meet the requirements of

ANSI/BHMA A156.18-06

4.3.13.2.16 Low Energy Automatic operators, ANSI A156.19-07. Heavy duty commercial grade. Provide complete with drop plates, bracket, or adapters for arms as required to suit details. Provide a terminal strip in an enclosed box near or above door that indicates connections for Security and Fire Alarm equipment and for electrified hardware items associated with proper door operation, as indicated by hardware group operational description.

Refer to floor plans for type of actuation devices and bollards if required.

Coordinate with Security Contractor for doors actuated by electronic access control system. Low energy door operators on patient restrooms must disengage when door is locked.

4.3.13.2.17 Electronic access control: Electronic access control system/device(s), power supplies (unless otherwise noted in hardware group) and monitoring/alarm(s) are provided with Security System. General Contractor to coordinate the provision and installation of the products. Refer to documents with Security Information for location(s) and type(s) of control(s). Connection by Electrical.

4.3.14 Pharmacy Pass-Throughs

4.3.14.1 Provide secure transaction drawer/pass through cabinet and window with amplified speak thru at Pharmacy Dispense windows for staff to patient transactions.

4.3.14.2 Provide rotating pass thru cabinet at Dispensing area. Basis of design:

https://www.tssbulletproof.com/product/lazy-susan-package-passer/

4.3.15 Radiation Shielding

4.3.15.1 For Radiology, Fluoroscopy, Mammography, CT scan, and Dental X-Ray

Rooms, obtain the services of a physicist to design, specify the level of radiation protection required, test and certifies the installations.

4.3.15.2 Comply with requirements of the National Council on Radiation Protection and Measurement (NCRP) Report #49.

4.3.15.3 Provide Physicists to design…