36C25018B0425-00001019.docx

Attachment #1 – Construction Health and Safety Form

VAMC Competent Person (CP):

Zachary Schmidt Date: 12/21/2017

In-House or contracted Out: Contracted Out

CP Qualifications: 30 Hour Construction Safety Course

Scope of Project:

This project will correct various exterior deficiencies throughout the Fort Thomas campus. This project will update and correct items including curbs, fencing, landscaping, walk ways, wayfinding, windows, lightning protection, loading dock, masonry cracking, and other upgrades needed to the exterior of the Fort Thomas campus.

RISK ASSESSMENT MATRIX: IC GUIDELINES FOR CONSTRUCTION

Includes, but is not limited to:

· removal of ceiling tiles for visual inspection limited to 2 tile per 50 square feet

· painting (but not sanding)

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

Includes, but is not limited to:

· installation of telephone and computer cabling

· access to chase spaces

· cutting of walls or ceiling where dust migration can be controlled.

Includes, but is not limited to:

· sanding of walls for painting or wall covering

· removal of floor coverings, ceiling tiles and casework

· 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.

Includes, but is not limited to:

· activities which require consecutive work shifts

· requires heavy demolition or removal of a complete cabling system

· new construction.

· Office areas

· Halls (excluding inpatient care units

· DOM

· PTSD

· Fisher House (unless Oncology patient)

· Outpatient Mental Health

· Echocardiography

· Endoscopy

· Respiratory Therapy

· Outpatient Clinics (including Eye and CBOC)

· Canteen/Food Court

· Food and Nutrition Service

· Halls (inpatient care units)

· PM&R

· Emergency Room

· Pharmacy

· Radiology/Nuclear Medicine/MRI

· Dental

· CLC

· All other inpatient care units

· Any area caring for immunocompromised patients

· Cardiac Cath Lab/Interventional Radiology

· Sterile Processing Services

· Intensive Care Units

· Negative pressure isolation rooms

· Oncology

· Operating rooms

· Laboratories

· Post Anesthesia Care Unit/Outpatient Surgery

· Dialysis

Patient Risk Group

CONSTRUCTION RISK REDUCTION PLAN

CONSTRUCTION ACTIVITY

IC RISK GROUP

Type A: Inspection, non-invasive, minor

Low Risk

Type B: Small scale, short duration, moderate levels.

Medium Risk

Type C: Moderate to high level of dust.

High Risk

Type D: Major demolition and construction projects.

Highest Risk

ICRA Class for This Project: Class I for exterior work and Class III for interior work

Description of Required Infection Control Precautions by Class

2. Immediately replace a ceiling tile displaced for visual inspection

2. Provide active means to prevent airborne dust from dispersing into atmosphere.

3. Water mist work surfaces to control dust while cutting.

4. Seal unused doors with duct tape.

5. Block off and seal air vents.

6. Place dust mat at entrance and exit of work area

7. Remove or isolate HVAC system in areas where work is being performed.

8. Contain construction waste before transport in tightly covered containers.

9. Perform daily site cleanup.

1. Wipe work surfaces with disinfectant.

2. Wet mop and/or vacuum with HEPA filtered vacuum before leaving work area.

3. Remove isolation of HVAC system in areas where work is being performed.

2. Complete all critical barriers i.e. sheetrock, plywood, plastic, to seal area from non-work area or implement control cube method (cart with plastic covering and sealed connection to work site with HEPA vacuum for vacuuming prior to exit) before construction begins.

3. Maintain negative air pressure within work site utilizing HEPA equipped air filtration units.

1. Do not remove barriers from work area until completed project is inspected by the owner’s Safety Department and Infection Control Department and thoroughly cleaned by the owner’s Environmental Services Department.

2. Remove barrier materials carefully to minimize spreading of dirt and debris associated with construction.

3. Vacuum work area with HEPA filtered vacuums.

4. Wet mop area with disinfectant.

5. Remove isolation of HVAC system in areas where work is being performed.

2. Seal holes, pipes, conduits, and punctures appropriately.

3. Construct anteroom and require all personnel to pass through this room so they can be vacuumed using a HEPA vacuum cleaner before leaving work site or they can wear cloth or paper coveralls that are removed each time they leave the work site.

4. All personnel entering work site are required to wear shoe covers. Shoe covers must be changed each time the worker exits the work area.

5. Do not remove barriers from work area until completed project is inspected by the owner’s Safety Department and Infection Control Department and thoroughly cleaned by the owner’s Environmental Services Department.

1. Do not remove barriers from work area until completed project is inspected by the owner’s Safety Department and Infection Control Department and thoroughly cleaned by the owner’s Environmental Services Department.

2. Remove barrier material carefully to minimize spreading of dirt and debris associated with construction.

3. Cover transport receptacles or carts. Tape covering unless solid lid

4. Vacuum work area with HEPA filtered vacuums.

5. Wet mop area with disinfectant.

6. Remove isolation of HVAC system in areas where work is being performed.

TB Risk Assessment

Areas to Consider:

1. Morgue

2. Research

3. Microbiology

4. Bronchoscopy

Will contactors be required to have Tuberculosis (TB) testing based up a pre-construction risk assessment for the transmission of Tuberculosis (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” (see subpar. 5v)?

If yes, the contractor must provide written certification that all contract employees assigned to the work site have had a pre-placement tuberculin screening within 90 days prior to assignment to the worksite and been found to be with negative screening reactions. This can be the CDC two-step skin testing or a Food and Drug Administration (FDA)-approved blood test. Contract employees manifesting positive screening reactions to the tuberculin must be examined according to current CDC guidelines prior to working on VHA property. Subsequently, if the employee is found without evidence of active (infectious) pulmonary TB, a statement documenting examination by a physician must be on file with the employer (construction contractor), noting that the employee with a positive tuberculin screening test is without evidence of active (infectious) pulmonary TB. If the employee is found with evidence of active (infectious) pulmonary TB, the employee would require treatment with a subsequent statement as outlined in subparagraph 4q (11) (c) before being allowed to return to work on VHA property.

TB Risk Determination: No

INTERIM LIFE SAFETY MEASURES

LEVEL

ACTIVITY

ILSM PRECAUTIONS

I

II

III

___1. Ensure free and unobstructed exit access and exits. Staff receives additional training when alternative exits are designated. Buildings or areas under construction must maintain escape routes for construction workers at all times. Means of exiting construction are inspected daily.

___2. Ensure free and unobstructed access to emergency services and for fire, police and other emergency forces.

___3. Ensuring fire alarm, detection, and suppression systems are in good working order. A temporary, but equivalent system shall be provided when any fire system is impaired. Temporary systems must be inspected and tested monthly.

___4. Ensuring temporary construction partitions are smoke tight and built of noncombustible or limited combustible materials that will not contribute to the development or spread of fire in accordance with VA Master Specification, General Requirements.

___5. Provide additional fire-fighting equipment and train personnel in its use.

___6. Prohibit smoking in or adjacent to construction areas.

___7. Developing and enforcing storage, housekeeping, and debris removal practices that reduce the buildings flammable and combustible fire load to the lowest feasible level.

___8. Conduct a minimum of two fire drills per shift per quarter (> 90 days duration).

___9. Increase hazard surveillance of buildings, grounds and equipment, with special attention to excavations, construction areas, construction storage, and field offices.

___10. Training personnel to compensate for impaired structural or compartmentation features of fire safety.

___11. Conducting organization wide safety education programs to promote awareness of any LSC deficiencies, construction hazards and these ILSM. Conduct familiarization tours and site visits for local Fire Department, when necessary.

___12. Provide fire watch or evacuate buildings in the event that the sprinkler system is taken out of service for more than 10 hours in a 24-hour period or the fire alarm system is taken out of service for more than 8 hours. Not applicable for planned (scheduled) construction activities that result in the sprinkler system being taken out of service for more than 10 hours in a 24-hour period or the fire alarm system being taken out of service for more than 8 hours if a 2 hour construction barrier is in place.

Defining “Out of Service” Responsibilities

Rationale: Other features of fire protection are not compromised during the event such as additional smoke detectors or sprinkler heads in the affected area.

Rationale: During a controlled event, the organization would be managing the deficiency. The area would be continually monitored, and ILSM should be implemented as per policy.

C. Shutting off a zone valve to the sprinkler system or disabling a fire alarm zone for more than 4 hours.

Rationale: During a controlled event, the organization would be managing the deficiency. The area would be continually monitored, and ILSM would be implemented as per policy.

Additional Construction Safety Questions

Will Project create potential air quality issues other than identified in ICRA? Is any work or equipment near air intakes? Are Volatile Organic Compounds VOC being used? If yes, please explain and note plans to minimize: Yes, Yes, No; Will work with staff to mitigate

Will project create potential noise issues? If yes, please explain and note plans to minimize:

Yes, will work with staff to minimize disruption

Will project create potential vibration issues? If yes, please explain and note plans to minimize: No

Is contractor required to provide 14 days’ notice for utility shutdowns?

Will contractor/COTR follow Utility Shutdown SOP when utilities are shut down?

Will contractor be given emergency notification telephone numbers for unplanned utility failures? Yes

Will project create a potential for leaks? If yes, please include in contract for contractor to dike any floor penetration in construction area. No

Any additional potential issues that effect EOC: No

Will contractors be instructed to wear badges at all times while on site? Will police be notified if project takes place on off-hours? Yes, Yes

Will contract require general and sub-contractor’s construction workers all complete the OSHA 10-hour construction worker course or the 30-hour construction course with OSHA certified training? Yes

Has/will the construction safety committee reviewed drawings and specs and signed off on each design submission? Yes

Will Contracting Officer be requested to evaluate and consider past safety records of prospective contractors in the awarding of contracts? Yes

Will contractor submittals include the names, qualifications and training dates for contractor CP designated to administer the site specific safety program, as well as the CP for other activities as required by OSHA regulation (such as scaffolds, cranes, excavation, etc.) Will COR provide copy of the site-specific safety program to the Construction Safety Committee? Yes

Is any portion of the project related to a special field that the CP does not have the required background for (for example, scaffolding, cranes, or excavation)? Will another VA Employee be CP for those special fields? No

Contractor will need to ensure demolition dust is not blown into building or duct systems

Will project require Construction Health and Safety Team construction site surveillance? Yes

SIGNATURES:

Project COR

Infection Control

Date:

Safety Manager

Chair – Construction Health & Safety Team

Attachment #1 – Construction Health and Safety Form