Exhibit B - Agencys Specific Requirements_ASR.pdf

West Branch VA Clinic

RLP

36C25024R0209 Agency Specific Requirements

ALEDA E. LUTZ VA MEDICAL CENTER

The Agency Specific Requirements (ASRs) do not reduce the minimum requirements contained within the Lease. These ASRs provides specific agency requirements, which may be complementary, more specific, or more stringent than those of the Lease minimum requirements.

SECTION SECTION TITLE

SECTION 1 SCOPE OF WORK

1.01 INTRODUCTION

1.02 STATEMENT OF WORK (SOW)

SECTION 2 FLOOR PLAN-DRAWING

SECTION 3 SCHEDULE B ITEMS AND ROOM LISTING

SECTION 4 JANITORIAL SERVICES AND SITE MANAGEMENT

SECTION 5 LEASE DESIGN NARRATIVE

SECTION 6 OPERATIONS AND MAINTENANCE O&M PLAN

SECTION 7 SAFETY FIRE PROTECTION EM APPENDIX

SECTION 8 LESSOR PERFORMANCE TRACKING CRITERIA

SECTION 9 ROOM DESIGN MATRIX

SECTION 10 OIT - TELECOMMUNICATIONS LAYOUT

PAGE

EXCEL FILE ATTACHED

ACKNOWLEDGED:

LESSOR SIGNATURE DATE

SECTION 1 SCOPE OF WORK

1.01 INTRODUCTION

The Department of Veterans Affairs is seeking 17,000 (NUSF) Net Usable Square Feet not to exceed 22,950 (RSF) Rentable Square Footage of contiguous of clinical space for a CBOC in the City of West Branch.

The lease shall be full serviced and follow the standard specifications and requirements for a New/Replacing Lease as per the GSA Global Lease or Simplified Lease.

1.02 STATEMENT OF WORK (SOW)

Contractor shall completely prepare site for building operations, including demolition and removal of any existing structures, and furnish labor and materials and perform work for construction of a Community Based Outreach Clinic (CBOC) in West Branch, Michigan.

Work includes design, general construction, alterations, mechanical, plumbing, and electrical work, low voltage work, civil, utility systems, removal of existing structures and construction.

Contractor shall follow all applicable building codes.

The period of performance (POP) for the work is estimated at 360 calendar days, the firm POP will be determined after completion of the construction drawings (CDs) and a VA-approved schedule.

The Joint Commission Links:

The Joint Commission | Healthcare Environment and Facilities Programs (va.gov)

Location of most recent TJC checklist:

2019 All Accreditation Programs Organization SAG (va.gov) http://vaww.hefp.va.gov/topics/joint-commission http://vaww.hefp.va.gov/sites/default/files/files/2021-08/Life%20Safety%20and%20Environment%20of%20Care%20-%20Document%20List%20and%20Review%20Tool%206-21%20%28R1%29.pdf

SECTION 2

FLOOR PLAN

SECTION 3

SCHEDULE B -

ROOM LISTING

Schedule B

Functional Area Room Qty JSN Item Description Provider CLINIC MANAGEMENT Private Office, PACT Team Area 14

A1010 Telecommunication Outlet CC A1015 Telephone, Desk, Mulitple Line VV A5145 Hook, Garment, Double, SS, Surface Mounted CC

CLINIC MANAGEMENT Administrative Work Area 1 A1010 Telecommunication Outlet CC A1015 Telephone, Desk, Mulitple Line VV

Base cabinet, solid surface top, wall cabinets 8'‐0" CC 1 A5145 Hook, Garment, Double, SS, Surface Mounted CC

CLINIC MANAGEMENT Administrative Supervisor 1 A1010 Telecommunication Outlet CC A1015 Telephone, Desk, Mulitple Line VV

1 A5145 Hook, Garment, Double, SS, Surface Mounted CC CLINIC MANAGEMENT Call Center 1 A1015

A1010 Telecommunication Outlet CC A1015 Telephone, Desk, Mulitple Line VV

1 A5145 Hook, Garment, Double, SS, Surface Mounted CC CLINIC MANAGEMENT MSA Reception

5 A1015 Telephone, Desk, Multiple Line VV A6105 Counter, Recepton Control, Built‐In CC

8 Sound Dampening Acoustic Panels CC Privacy Slider Windows W/ Locks CC Duress Button's for each MSA station CC Door Buzzers for MSA’s 2 door buzzers per station CC AI Phone Front Door Video Doorbell CC Nurse Call System Monitor, Visual/Audible Alarm CC Base cabinet, solid surface top, wall cabinets 8'‐0" CC Hook, Garment, Double, SS, Surface Mounted CC

CLINIC MANAGEMENT VESTIBULE 1

Walk off Mat Carpet CC Unit Heater CC

CLINIC MANAGEMENT Waiting Room 1 A5220 Bracket, Television, Wall Backing VC

Military seals, wall backing VC

A5075 Dispenser, Soap, Disposable VC

A5082 Dispenser, Paper Towel, Sensor, Hands Free CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC

Functional Area Room Qty JSN Item Description Provider Base Cabinets 4'‐0", Solid Surface Countertop, coffee station CC

Drinking fountain CC

LABORATORY SERVICE Blood Specimen Collection Room

2 A5077 Dispenser, Hand Sanitizer, Hands‐Free VC 2 A5108 Waste Disposal Unit, Sharps VC 2 A5107 Dispenser, Glove, Triple Box VC 2 A5180 Track, Cubical, Surface Mounted CC 2 CE030 Cabinet, W/H, 2 SH, 2 GBO, Sloping Top, 36x30x13 CC 2 A5145 Hook, Garment, Double, SS, Surface Mounted CC 2 Counter, 36”H, 24”D x 7’‐6”L with 24”x42” return. CC

Nurse Call Pull Station, Visual Light and Audible CC LABORATORY SERVICE Laboratory, General 1

A1011 Telephone, Desk, 1 Line VV

A1013 Telephone, Wall Mounted, Multiple Line VV

A5070 Dispenser, Soap, Disposable VC

A5082 Dispenser, Paper Towel, SS, Surface Mounted CC

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd VC

A5108 Waste Disposal Unit, Sharps VC

C0045 Frame, Apron, 1 Drawer CC

C02C0 Cabinet, U/C/B, 1 Shelf, 1 Drawer, 1 DO, 24"w CC C02D0 Cabinet, U/C/B. 4 Drawer, 24"w CC C03G0 Cabinet, Base, 2 Shelf, 2 Door, 36x30x22 CC C05P0 Cabinet, Sink, U/C/B, 2 Door, 48"w CC CA040 Cabinet, W/H, Open, 2 SH, Sloping Top, 38x36x18 CC CE040 Cabinet, W/H 2 SH, 2 DO, Sloping Top, 38x36x18 CC CS270 Sink, stainless steel, 10x25x15 ID CC CT060 Countertop, solid surface CC P1965 Eyewash, Sink Mounted CC P3000 Lavatory, Vitreous China, Wall Hung CC

LABORATORY SERVICE Lab Refrigerator Storage 1 CC

LABORATORY SERVICE Toilet, Specimen Collection 1 A1067 Mirror, Float Glass, ADA Accessible CC A5070 Dispenser, Soap, Disposable VC

Functional Area Room Qty JSN Item Description Provider A5082 Dispenser, Paper Towel, Sensor, Hands Free CC A5090 Dispenser, Sanitary Napkin, SS, Surface Mounted VC A5109 Grab Bar, 1‐1/4" Dia, SS, 2 Wall, W/C Accessible, Bariatric CC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5200 Dispenser, Toilet Tissue, SS, 2‐Roll, Surface Mounted CC P3000 Lavatory, Vitreous China, Straight Back CC P9050 Toilet, Wall Hung, Siphon Jet CC A5077 Dispenser, Hand Sanitizer, Hands‐Free VC A5108 Waste Disposal Unit, Sharps VC A5180 Track, Cubical, Surface Mounted CC

Specimen Pass Through Box CC Nurse Call Pull Station, Visual Light and Audible CC Drug screening remote water shutoff valves CC

PATIENT ALIGNED CARE

TEAM CLINIC

Alcove, Height / Weight Accessible Station

2 CC

Hook, Garment, Double, SS, Surface Mounted CC InPro Handrail CC

PATIENT ALIGNED CARE

TEAM CLINIC

Exam Room, Patient Aligned Care Team (PACT)

A1012 Telephone, Wall Mounted, 1 Line VC A5070 Dispenser, Soap, Disposable VC U5082 Medical Grade Cabinet: Dispenser, Paper Towel INTEGRATED INTO

UPPER

CC

U5107 Medical Grade Cabinet: Dispenser, Gloves INTEGRATED INTO UPPER CC A5108 Waste Disposal Unit, Sharps VC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5180 Track, Cubicle, Surface Mounted CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC U4116 Sphygmomanometer, Aneroid, Wall Mounted VV U4200 Otoscope/Ophthalmoscope, Wall Mounted VV

PATIENT ALIGNED CARE

TEAM CLINIC

Exam Room, Specialty 2

A1012 Telephone, Wall Mounted, 1 Line VC A5070 Dispenser, Soap, Disposable VC

Functional Area Room Qty JSN Item Description Provider U5082 Medical Grade Cabinet: Dispenser, Paper Towel INTEGRATED INTO

UPPER

CC

U5107 Medical Grade Cabinet: Dispenser, Gloves INTEGRATED INTO UPPER CC A5108 Waste Disposal Unit, Sharps VC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5180 Track, Cubicle, Surface Mounted CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC U4116 Sphygmomanometer, Aneroid, Wall Mounted VV U4200 Otoscope/Ophthalmoscope, Wall Mounted VV

PATIENT ALIGNED CARE

TEAM CLINIC

Exam Room, Women's Health 1

A1012 Telephone, Wall Mounted, 1 Line VC A5070 Dispenser, Soap, Disposable VC U5082 Medical Grade Cabinet: Dispenser, Paper Towel INTEGRATED INTO

UPPER

CC

U5107 Medical Grade Cabinet: Dispenser, Gloves INTEGRATED INTO UPPER CC A5108 Waste Disposal Unit, Sharps VC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5180 Track, Cubicle, Surface Mounted CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC U4116 Sphygmomanometer, Aneroid, Wall Mounted VV U4200 Otoscope/Ophthalmoscope, Wall Mounted VV

PATIENT ALIGNED CARE

TEAM CLINIC

Exam Room, Procedure 1

A1012 Telephone, Wall Mounted, 1 Line VC A5070 Dispenser, Soap, Disposable VC U5082 Medical Grade Cabinet: Dispenser, Paper Towel INTEGRATED INTO

UPPER

CC

U5107 Medical Grade Cabinet: Dispenser, Gloves INTEGRATED INTO UPPER CC A5108 Waste Disposal Unit, Sharps VC

Functional Area Room Qty JSN Item Description Provider A5145 Hook, Garment, Double, SS, Surface Mounted CC A5180 Track, Cubicle, Surface Mounted CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC U4116 Sphygmomanometer, Aneroid, Wall Mounted VV U4200 Otoscope/Ophthalmoscope, Wall Mounted VV P1965 Eyewash, Sink Mounted CC M7405 Ceiling Mounted Light CC

PATIENT ALIGNED CARE

TEAM CLINIC

Triage 1

A1012 Telephone, Wall Mounted, 1 Line VC A5070 Dispenser, Soap, Disposable VC U5082 Medical Grade Cabinet: Dispenser, Paper Towel INTEGRATED INTO

UPPER

CC

U5107 Medical Grade Cabinet: Dispenser, Gloves INTEGRATED INTO UPPER CC A5108 Waste Disposal Unit, Sharps VC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5180 Track, Cubicle, Surface Mounted CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC U4116 Sphygmomanometer, Aneroid, Wall Mounted VV U4200 Otoscope/Ophthalmoscope, Wall Mounted VV

PATIENT ALIGNED CARE

TEAM CLINIC

Toilet, Women's Health Exam 1

A1067 Mirror, Float Glass, ADA Accessible CC A5070 Dispenser, Soap, Disposable VC A5082 Dispenser, Paper Towel, Sensor, Hands Free CC A5090 Dispenser, Sanitary Napkin, SS, Surface Mounted VC A5109 Grab Bar, 1‐1/4" Dia, SS, 2 Wall, W/C Accessible, Bariatric CC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5200 Dispenser, Toilet Tissue, SS, 2‐Roll, Surface Mounted CC P3000 Lavatory, Vitreous China, Straight Back CC P9050 Toilet, Wall Hung, Siphon Jet CC

Functional Area Room Qty JSN Item Description Provider A5077 Dispenser, Hand Sanitizer, Hands‐Free VC A5108 Waste Disposal Unit, Sharps VC A4995 Table, Diaper Changing, Wall Mounted VC

Nurse Call Pull Station, Visual Light and Audible CC

PATIENT ALIGNED CARE

TEAM CLINIC

Toilet, Procedure Exam 1

A1067 Mirror, Float Glass, ADA Accessible CC A5070 Dispenser, Soap, Disposable VC A5082 Dispenser, Paper Towel, Sensor, Hands Free CC A5090 Dispenser, Sanitary Napkin, SS, Surface Mounted VC A5109 Grab Bar, 1‐1/4" Dia, SS, 2 Wall, W/C Accessible, Bariatric CC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5200 Dispenser, Toilet Tissue, SS, 2‐Roll, Surface Mounted CC P3000 Lavatory, Vitreous China, Straight Back CC P9050 Toilet, Wall Hung, Siphon Jet CC A5077 Dispenser, Hand Sanitizer, Hands‐Free VC A5108 Waste Disposal Unit, Sharps VC A4995 Table, Diaper Changing, Wall Mounted VC

Nurse Call Pull Station, Visual Light and Audible CC

PATIENT ALIGNED CARE

TEAM CLINIC

Telehealth Exam 3

A1012 Telephone, Wall Mounted, 1 Line VC A5070 Dispenser, Soap, Disposable VC U5082 Medical Grade Cabinet: Dispenser, Paper Towel INTEGRATED INTO

UPPER

CC

U5107 Medical Grade Cabinet: Dispenser, Gloves INTEGRATED INTO UPPER CC A5108 Waste Disposal Unit, Sharps VC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5180 Track, Cubicle, Surface Mounted CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC U4116 Sphygmomanometer, Aneroid, Wall Mounted VV

U4200 Otoscope/Ophthalmoscope, Wall Mounted VV

PATIENT ALIGNED CARE

TEAM CLINIC

Mental Health CVT 1

Functional Area Room Qty JSN Item Description Provider A1015 Telephone, Desk, Mulitple Line VV A5145 Hook, Garment, Double, SS, Surface Mounted CC

PATIENT ALIGNED CARE

TEAM CLINIC

Exam Room, Mental Health 1

A1012 Telephone, Wall Mounted, 1 Line VC A5070 Dispenser, Soap, Disposable VC U5082 Medical Grade Cabinet: Dispenser, Paper Towel INTEGRATED INTO

UPPER

CC

U5107 Medical Grade Cabinet: Dispenser, Gloves INTEGRATED INTO UPPER CC A5108 Waste Disposal Unit, Sharps VC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5180 Track, Cubicle, Surface Mounted CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC U4116 Sphygmomanometer, Aneroid, Wall Mounted VV U4200 Otoscope/Ophthalmoscope, Wall Mounted VV

PATIENT ALIGNED CARE

TEAM CLINIC

Exam Room, Nurse Procedure 1

A1012 Telephone, Wall Mounted, 1 Line VC A5070 Dispenser, Soap, Disposable VC U5082 Medical Grade Cabinet: Dispenser, Paper Towel INTEGRATED INTO

UPPER

CC

U5107 Medical Grade Cabinet: Dispenser, Gloves INTEGRATED INTO UPPER CC A5108 Waste Disposal Unit, Sharps VC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5180 Track, Cubicle, Surface Mounted CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC U4116 Sphygmomanometer, Aneroid, Wall Mounted VV U4200 Otoscope/Ophthalmoscope, Wall Mounted VV

SPECIALTY EXAM Shoe Fitter Office / Storage 1 A1015 Telephone, Desk, Mulitple Line VV

Functional Area Room Qty JSN Item Description Provider A5145 Hook, Garment, Double, SS, Surface Mounted CC A5070 Dispenser, Soap, Disposable VC U5082 Medical Grade Cabinet: Dispenser, Paper Towel INTEGRATED INTO

UPPER

CC

U5107 Medical Grade Cabinet: Dispenser, Gloves INTEGRATED INTO UPPER CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC

SPECIALTY EXAM Grinder Room, Shoe Fitter, Orthotics

A1010 Telecommunication Outlet CC A1012 Telephone, Wall Mounted, 1 Line CV D3550 Evacuation System, Laboratory, Dental CC F0230 Chair, Drafting, Rotary VV F2020 Can, Trash, 44 Gallon VV F3200 Clock, Battery, 12" Diameter VV L2205 Hood, Fume, Floor Standing, Expolsion Proof CC L8285 Oven, Drying, Medium, 3 Cubic Foot CC P2000 Eyewash, Wall Mounted, Hands‐Free CC T0180 Cabinet, Storage, Tool, F/Mounted CC T0285 Drill Press, Floor Mounted, Tilt Table VV T0400 Grinder, Floor Mounted, Pedestal VV T0740 Sander, Disk, 12" Wheel VV T1510 System, Vacuum Forming CC T9400 Vise, Machinists, Swivel Base CC

SPECIALTY EXAM Optometry, Eye Lane 3 A1015 Telephone, Desk, Mulitple Line VV A5145 Hook, Garment, Double, SS, Surface Mounted CC A5070 Dispenser, Soap, Disposable VC A5047 Medication Cabinet VC

Optometry desk unit, wall cabinets, Eye Designs Vela Collection CC A5108 Waste Disposal Unit, Sharps VC A5082 Dispenser, Paper Towel, Sensor, Hands Free CC P3000 Lavatory, Vitreous China, Straight Back CC

Eye Exam Chair VV Slit Lamp VV Ophthalmic Instrument Stand VV

Functional Area Room Qty JSN Item Description Provider Activity Screen VV

SPECIALTY EXAM Optometry, Fitting Equipment 1 A1015 Telephone, Desk, Mulitple Line VV A5145 Hook, Garment, Double, SS, Surface Mounted CC A5070 Dispenser, Soap, Disposable VC U5082 Medical Grade Cabinet: Dispenser, Paper Towel INTEGRATED INTO

UPPER

CC

U5107 Medical Grade Cabinet: Dispenser, Gloves INTEGRATED INTO UPPER CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC

SPECIALTY EXAM Optometry, Office 1 A1015 Telephone, Desk, Mulitple Line VV A5145 Hook, Garment, Double, SS, Surface Mounted CC

SPECIALTY EXAM Optometry, Technician 1 A1015 Telephone, Desk, Mulitple Line VV A5145 Hook, Garment, Double, SS, Surface Mounted CC A5070 Dispenser, Soap, Disposable VC U5082 Medical Grade Cabinet: Dispenser, Paper Towel INTEGRATED INTO

UPPER

CC

U5107 Medical Grade Cabinet: Dispenser, Gloves INTEGRATED INTO UPPER CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC

SPECIALTY EXAM Radiology X‐Ray, Exam 1 A1010 Telecommunication Outlet CC A1012 Telephone,Wall Mounted,1 Line CV

A1066 Mirror, Float Glass, With SS Frame CC

A1132 Rail,Accessory Mounting,Exam,Side B CC A1200 Lift System,Overhead,Patient Room CC

Functional Area Room Qty JSN Item Description Provider A5075 Dispenser,Soap,Disposable VC A5077 Dispenser,Hand Sanitizer,Hands‐Free VC A5080 Dispenser,Paper Towel,SS,Surface Mounted CC A5106 Waste Disposal Unit,Sharps w/Glove Dispenser VC A5107 Dispenser,Glove,Surgical/Examination,Wall Mntd CC A5145 Hook,Garment,Double,SS,Surface Mounted CC A5180 Track,Cubicle,Surface Mounted,With Curtain CC C03G0 Cabinet,U/C/B,2 Shelf,2 Door,36x30x22 CC C04Q0 Cabinet,ADA Sink,Wall‐Mounted CC CD030 Cabinet,W/H,2 Shelf,2 DO,Sloping Top,38x30x13 CC CS070 Sink,SS,Single Compartment,7.5x16x16 ID CC CT020 Countertop,Solid Surface CC F0205 Chair,Side With Arms VV F0340 Stool,Self Adjusting VV F0350 Stool,Step,Retractable Caster VV F0360 Footstool,Straight w/Handle VV F2000 Basket,Wastepaper,Fire Resistant VV F3200 Clock,Battery,12" Diameter VV M0755 Flowmeter,Oxygen,Low Flow CC M0765 Regulator,Vacuum CC M3070 Hamper,Linen,Mobile,w/Lid VV M3073 Container,Biohazard Waste,Step‐on,Fire Safe VV M4255 Stand,IV,Adjustable VV M4645 Patient Transfer Device VV M8810 Stand,Mayo VV X1405 Stand,Bucky,Vertical,Tilt,Automatic CC X3145 Screen,X‐Ray,Protective,Mobile CC X3155 Rack,Apron/Gloves,Mobile VV X5900 Radiographic Unit,80 kW,Non‐Tilt Table VV

SPECIALTY EXAM Radiology, Office 1 A1010 Telecommunication Outlet CC A1015 Telephone, Desk, Mulitple Line VV A5145 Hook, Garment, Double, SS, Surface Mounted CC

SPECIALTY EXAM Radiology, Dressing 1 A1030 Locker, 2 Person, Over/Under CC

A1080 Mirror, Posture, Wall Mounted CC

Functional Area Room Qty JSN Item Description Provider A5025 Bench, Locker Room, Portable VV A5109 Grab Bar, 1‐1/4" Dia., SS, 2 Wall, W/C Accessible CC

A5145 Hook, Garment, Double, SS, Surface Mounted CC

SUPPORT AREA Treatment Exercise Area 1 electrical outlets, 3‐line telecommunications data outlet with location to be determined per IT specifications, lighting to be controlled by motion

CC

A1014 Telephone, Wall Mounted, 1 Line with Speaker VC A5070 Dispenser, Soap, Disposable VC A5082 Dispenser, Paper Towel, Sensor, Hands Free CC C04P0 Cabinet, Sink, U/C/B, 2 Door, 36x36x22 CC CT025 Countertop, Solid Surface, with Sink Combination CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC U03F0 Medical Grade Cabinet: Undercounter Cabinet CC A5108 Waste Disposal Unit, Sharps VC

Ceiling mounted Arjo lift with walking track CC Wall Backing for wall mounted exercise equipment CC

SUPPORT AREA PT Office 1 electrical outlets, 3‐line telecommunications data outlet with location to be determined per IT specifications, lighting to be controlled by motion

CC

SUPPORT AREA PT Treatment Exam 1 A1012 Telephone, Wall Mounted, 1 Line VC A5070 Dispenser, Soap, Disposable VC U5082 Medical Grade Cabinet: Dispenser, Paper Towel INTEGRATED INTO

UPPER

CC

U5107 Medical Grade Cabinet: Dispenser, Gloves INTEGRATED INTO UPPER CC A5108 Waste Disposal Unit, Sharps VC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5180 Track, Cubicle, Surface Mounted CC UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC U4116 Sphygmomanometer, Aneroid, Wall Mounted VV

Functional Area Room Qty JSN Item Description Provider U4200 Otoscope/Ophthalmoscope, Wall Mounted VV

SUPPORT AREA PT Storage 1 Install electric and telecommunications as needed. CC

MENTAL HEALTH CLINIC Consult Room 5 A1015 Telephone, Desk, Mulitple Line VV A5145 Hook, Garment, Double, SS, Surface Mounted CC

PATIENT ALIGNED CARE

TEAM CLINIC

PACT SW PCMHI SW Office 1

A1015 Telephone, Desk, Mulitple Line VV A5145 Hook, Garment, Double, SS, Surface Mounted CC

PATIENT ALIGNED CARE

TEAM CLINIC

Private Office 15

A1015 Telephone, Desk, Mulitple Line VV A5145 Hook, Garment, Double, SS, Surface Mounted CC

PATIENT ALIGNED CARE

TEAM CLINIC

Office, Shared 1

A1015 Telephone, Desk, Mulitple Line VV A5145 Hook, Garment, Double, SS, Surface Mounted CC

PATIENT ALIGNED CARE

TEAM CLINIC

Office, Hotseat 1

A1015 Telephone, Desk, Mulitple Line VV A5145 Hook, Garment, Double, SS, Surface Mounted CC

PATIENT ALIGNED CARE

TEAM CLINIC

Storage, CPR

GFCI duplic electrical outlet at sink, duplex electrical outlets as required by CC

PATIENT ALIGNED CARE

TEAM CLINIC

Clean Utility 1 CC

Clean Room Ceiling Tiles CC

Functional Area Room Qty JSN Item Description Provider

PATIENT ALIGNED CARE

TEAM CLINIC

General Storage 10 CC

PATIENT ALIGNED CARE

TEAM CLINIC

Soiled Utility 1 CC

Clean Room Ceiling Tiles CC

PATIENT ALIGNED CARE

TEAM CLINIC

Medication Room 1 CC

UD040 Medical Grade Cabinet: Wall Cabinet CC US010 Medical Grade Cabinet: Sink ‐ stainless steel drop in CC UT030 Solid Surface: Countertop CC

Medical Grade Cabinet: Undercounter Cabinet CC U03F0 Cabinet, U/C/B, 1 Shelf, 2 Half DR, 2 DO, 36x30x22 CC P3000 Eyewash, Sink Mounted CC

Clean Room Ceiling Tiles CC

PATIENT ALIGNED CARE

TEAM CLINIC

PACT Teamlet Room 2 Telecommunications outlets as determine by final configuration. Duplex electrical outlets as needed to supply each workstation. Counter as needed based on layouts with data and electrical

CC

Nurse Call Station Monitors, Visual Light and Audible CC

PATIENT ALIGNED CARE

TEAM CLINIC

Equipment Alcove 4 Telecommunications outlets as determine by final configuration. Duplex electrical outlets as needed to supply each workstation. Counter as needed based on layouts with data and electrical

CC

Base cabinet, solid surface top, wall cabinets 4'‐8"

PATIENT ALIGNED CARE

TEAM CLINIC

Group Room 2

C04E0 Cabinet, U/C/B, 2 DO, 36x36x22 CC UT021 Countertop, Solid Surface, with Stainless Sink Combination CC CE040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 36x36x13 CC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5220 Bracket, Television, Wall Backing CC A5210 Bracket, Television, Flat Panel VV

TV Box connection Electrical, HDMI, Network CC

PATIENT ALIGNED CARE

TEAM CLINIC

Toilet, PACT Patient 4

A1067 Mirror, Float Glass, ADA Accessible CC A5070 Dispenser, Soap, Disposable VC A5082 Dispenser, Paper Towel, Sensor, Hands Free CC A5090 Dispenser, Sanitary Napkin, SS, Surface Mounted VC

Functional Area Room Qty JSN Item Description Provider A5109 Grab Bar, 1‐1/4" Dia, SS, 2 Wall, W/C Accessible, Bariatric CC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5200 Dispenser, Toilet Tissue, SS, 2‐Roll, Surface Mounted CC P3000 Lavatory, Vitreous China, Straight Back CC P9050 Toilet, Wall Hung, Siphon Jet CC A5077 Dispenser, Hand Sanitizer, Hands‐Free VC A5108 Waste Disposal Unit, Sharps VC

Nurse Call Pull Station, Visual Light and Audible CC A4995 Table, Diaper Changing, Wall Mounted VC

PATIENT ALIGNED CARE

TEAM CLINIC

Toilet, Staff 4

A1067 Mirror, Float Glass, ADA Accessible CC A5070 Dispenser, Soap, Disposable VC A5082 Dispenser, Paper Towel, Sensor, Hands Free CC A5090 Dispenser, Sanitary Napkin, SS, Surface Mounted VC A5109 Grab Bar, 1‐1/4" Dia, SS, 2 Wall, W/C Accessible, Bariatric CC A5145 Hook, Garment, Double, SS, Surface Mounted CC A5200 Dispenser, Toilet Tissue, SS, 2‐Roll, Surface Mounted CC P3000 Lavatory, Vitreous China, Straight Back CC P9050 Toilet, Wall Hung, Siphon Jet CC A5077 Dispenser, Hand Sanitizer, Hands‐Free VC A5108 Waste Disposal Unit, Sharps VC

Nurse Call Pull Station, Visual Light and Audible CC

PATIENT ALIGNED CARE

TEAM CLINIC

Mothers Room 1

A1067 Mirror, Float Glass, ADA Accessible CC P3000 Lavatory, Vitreous China, Straight Back CC A5070 Dispenser, Soap, Disposable VC A5082 Dispenser, Paper Towel, Sensor, Hands Free CC

SUPPORT AREA Communications Room, OIT 1 3 A0900 Relay Rack, Alumninum ‐ 42" per Rack CC 16 A0901 Cable Management, Horizontal Base Unit CC 3 A0902 Rear Wire Frame CC 3 A0903 Rear Hinged Cover, for LAN Rack CC 16 A0902 Rear Wire Strain Relief CC 3 A0904 Fiber Optic Cabinet, 36 Port, Rack Mounted CC 12 A0908 Patch Panel, 110 Block/RJ‐45, Cat 5E, 48 Port, 568A CC 3 Cable Management, Vertical Front/Back for LAN Rack CC

Functional Area Room Qty JSN Item Description Provider 1 Mini Split HVAC Unit CC

SUPPORT AREA (Tenant Space)

Housekeeping Aides Closet

(HAC)

Floor Sink CC Eye Wash CC

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd CC SUPPORT AREA Staff Breakroom 1 CC

A5077 Dispenser, Hand Sanitizer, Hands‐Free VC A1012 Telephone, Wall Mounted, 1 Line CC A5220 Bracket, Television, Wall Backing CC A5210 Bracket, Television, Flat Panel CC A5070 Dispenser, Soap, Disposable VC A5082 Dispenser, Paper Towel, SS, Surface Mounted CC

2 A5145 Hook, Garment, Double, SS, Surface Mounted CC U02C0 Cabinet, U/C/B, 1 Shelf, 1 Drawer, 1 DO, 36x18x22 CC U02D0 Cabinet, U/C/B, 4 Drawer 36x18x22 CC U04P0 Cabinet, Sink, U/C/B, 2 Door 36x42x22 CC UB020 Cabinet, W/H, 2 Shelf, 1 DO, Sloping Top, 38x24x13 CC

Cabinet. W/H, 2 Shelf, 2 DO Sloping Top18x36x13 CC Cabinet, W/H, 2 Shelf, 1 DO, Sloping top, 18x36x13 CC

CS230 Sink, SS, Double Compartment, 10x14x16 ID CC UT020 Countertop, Solid Surface CC

Drinking Fountain/Water Bottle Filler CC SUPPORT AREA Lobby Restroom 2 A1067 Mirror, Float Glass, ADA Accessible CC

A5145 Hook, Garment, Double, SS, Surface Mounted CC A5070 Dispenser, Soap, Disposable VC A5082 Dispenser, Paper Towel, Sensor, Hands Free CC A5090 Dispenser, Sanitary Napkin, SS, Surface Mounted VC A5109 Grab Bar, 1‐1/4" Dia, SS, 2 Wall, W/C Accessible, Bariatric CC A5200 Dispenser, Toilet Tissue, SS, 2‐Roll, Surface Mounted CC P3000 Lavatory, Vitreous China, Straight Back CC P9050 Toilet, Wall Hung, Siphon Jet CC A5108 Waste Disposal Unit, Sharps VC A4995 Table, Diaper Changing, Wall Mounted VC

Nurse Call Pull Station, Visual Light and Audible CC OUTDOOR AREA Exterior 1

3 Picnic tables CC 4 Park benches CC

Functional Area Room Qty JSN Item Description Provider

GENERAL ENTIRE CLINIC 1 CC

Roller shades ‐ every window VC InPro Handrail in patient corridors CC InPro Cornerguards in corridors CC

15 Medical WiFi Data Pulls CC 10 PACS (badge readers tied to Saginaw VAMC main system) CC 16 Keypads CC 18 Interior Security Cameras ( tied to Saginaw VAMC main system tied to Saginaw VAMC main system)

CC

12 Exterior Security Cameras tied to Saginaw VAMC main system CC 6 Solar Tubes CC

Emergency Generator (Capability to power entire clinic) CC Owner Provided Guest Wireless Internet CC

30 Force Protection Bollards/Boulders CC Interior and Exterior Signage and Interior Wayfinding Signage CC

Space Description: ROOMS Sq. Ftg. (ea)* Cum. Area notes Primary Care Exam 17 125 2125 x Consult Room 5 110 550 x Women's Health / Procedure Exam 2 159 318 x Women's Health / Procedure Toilet 2 52 104 x Triage Room 1 125 125 x Nurse Procedure 1 125 125 x Shoe Fitter Office / Storage 1 186 186 x Shoe Fitter Orthotics Grinder Room 1 84 84 x Specialty Exam 2 126 252 x Exam Room 3 118 354 x PACT Team Room 2 534 1068 x PACT Team Alcoves 4 17 68 x Private PACT Team Offices 14 72 1008 x Radiology 1 378 378 x Radiology office / storage 1 138 138 x Radiology Dressing 1 74 74 x Hot Seat Room 1 145 145 x Height and Weight Alcove 2 20 40 x MH Exam room 1 120 120 x Optometry / Eye lane 3 130 390 x Optometry / tech space 1 130 130 x Optometry Office 1 139 139 x Optometry / Fitting 1 101 101 x Shared Office Team Area 1 90 90 x

PCMHI / PACT SW office 1 117 117 x

Mothers Room 1 62 62 x MH CVT 1 120 120 x Vestibule 1 293 293 x RQI training / CPR storage 1 36 36 x Telehealth Exam Rooms 2 126 252 x Telehealth Exam Room 1 150 150 x Group Room 2 247 494 x PT Gym 1 896 896 x PT Office 1 101 101 x PT Storage 1 80 80 x PT Exam 1 120 120 x Lab Procedure Room 1 359 359 x Blood Specimen Collection 2 80 160 x Lab Restroom 1 72 72 x Medication Room 1 91 91 x Staff Breakroom 1 511 511 x Administrative Supervisor 1 97 97 x Call Center 1 97 97 x Reception - Check-in Area 1 467 467 x Admin Work area 1 115 115 x Nurse Manager Office 1 108 108 x Storage 1 34 34 x Lobby Restroom 2 67 134 x Patient Hall Restroom 4 60 240 x Staff Bathrooms 2 52 104 x Staff Bathrooms 2 72 144 x General Storage Staff area 1 40 40 x General small storage 4 29 116 x Storage 1 75 75 x Storage 1 60 60 x General Storage Team Area 2 36 72 x Soiled Utility 1 72 72 x Waiting Room 1 1821 1821 x Clean Utility 1 216 216 x *IRM Hub Room 1 150 150 x *Housekeeping Closet 1 96 96 x *FMS HVAC Machinery & Utility Room 1 376 376

Subtotal 120 16660 *Allowance for Corridors, Common areas.

(35%) 5831 Total 22491

WEST BRANCH SUPPLEMENTAL LEASE/CURRENT and FUTURE NEEDS

*Space requirements and Sq. Ftg. Estimates, according to VACO Clinical Standards.

SECTION 4

JANITORIAL AND SITE

MANAGEMENT SERVICES

Section 4 Janitorial Services and Site Management Services

1.1 GENERAL JANITORIAL SERVICES

The lessor shall furnish all supplies, materials, machinery, appliances, supervision, and labor necessary to provide complete janitorial services for the entire leased clinic space. Services shall be provided in all interior and exterior areas of the leased premises to provide a clean, neat, and attractive appearance by performing the functions described below. The Lessor shall make careful selection of cleaning products and equipment to ensure they are packaged ecologically, environmentally beneficial and/or recycled products that are phosphate-free, non-corrosive, non-flammable, and fully biodegradable, and minimize the use of harsh chemicals and the release of irritating fumes.

The Lessor shall select paper and paper products with recycled content conforming to EPA’s CPG.

Performance will be based on the Contracting Officer’s evaluation of results, not the frequency or method performance.

1.2 MATERIALS AND PROCEDURES

A. Standards

It is the Lessor’s responsibility to maintain the clinic in a condition that meets all housekeeping and sanitization requirements of this solicitation and the current standards of the Joint Commission

(JC).

B. Work Schedule

Work will be accomplished at times indicated. Work schedule shall be from 7:00 AM to 8:00 PM, (or as requested by the LCO), Monday through Friday and 8:00 AM to 12:00 PM, Saturday. The Lessor shall ensure that sufficient employees are available to prepare the clinic to see patients at 7:00 AM, to be available to promptly clean up spills, keep the public and specimen collection toilet rooms clean, and keep the toilet rooms stocked with sufficient paper products and soap.

Mechanical equipment such as vacuum cleaners, burnishers, scrubbing machines, etc., shall not be used during patient appointments.

C. Janitorial Staff and Supervision

Janitorial staff will have access throughout the building; therefore, none of the janitorial staff may have a police record for anything more serious that traffic or parking violations. There shall be a janitorial staff supervisor, present on site on duty always when janitorial staff is in the building. Any person whose work or conduct is found to be unacceptable by the Government shall be removed from the janitorial staff. Smoking, if permitted, is only permitted in designated areas only.

Possession of weapons is prohibited. Enclosed containers, including tool kits, shall be subject to search. Janitorial company’s standard uniforms are acceptable, if they clearly identify the company and the occupation of the individual. Janitorial staff will be required to wear photo identification badges.

D. Safety and Special Procedures

The Lessor shall consider the clinical environment and ensure that the janitorial staff is instructed on applicable safety precautions and special requirements. These requirements may include, but are not limited to, such conditions as cleaning of human secretions, blood etc. from both floors and walls. Lessor will be notified of areas that need terminal cleaning. Terminal cleaning is defined as complete wipe down of all sinks, walls, countertops, casework, exam tables, etc., with germicide, and mopping of the floor with germicide. If the space has a privacy curtain, it will require to be replaced. These areas require the use of gloves, gowns, masks, and shoe covers. The Lessor shall be responsible to ensure staff are competent on common hazards requiring a terminal clean in a healthcare setting. Lessor is responsible to provide competency to VA COR and demonstrated staff knowledge. The Lessor shall be responsible for collecting of sharps containers and hazardous materials. See “ALL AREAS” below under “Daily Cleaning Requirements” for method of handling sharps and hazardous waste. The janitorial staff shall comply with applicable Federal, State, and Local safety and fire regulations and codes. The Lessor shall immediately bring to the attention of the Government any fire and/or safety deficiencies. The Lessor shall take reasonable precautions to promote a safe environment within the lease premises.

E. Equipment and Materials

All equipment and materials used in the performance of this contract will be cleaned and stored properly at the end of the workday. Cleaning carts and/or equipment will not be left unattended for any reason while patients are in the clinics. No food or drink shall be stored on cleaning carts or in housekeeping closets. Lessor shall ensure all equipment, tools, and supplies meet necessary safety requirements and janitorial staff has full working knowledge of their use. An EPA registered germicide will be used to clean all patient areas, floors, examination tables, and medical equipment.

The Lessor shall provide all labor, materials, supplies, machinery, and appliances that may be necessary or appropriate in the performance of janitorial services.

The Lessor shall provide supplies such as toilet tissue, multifold paper towels, toilet seat covers, and Medicated Vestal (or approved equivalent) hand soap. The Lessor shall provide plastic linings for all trash receptacles. Provide clear plastic lining for non-hazardous waste trash receptacles and red plastic linings for hazardous waste trash receptacles. Housekeeping aide closets are located throughout the clinic for storage of supplies and equipment. The Lessor shall keep a minimum of two weeks’ stock of supplies on hand. All accumulated waste shall be removed and disposed of in the dumpsters. Hazardous waste and sharps containers shall be picked up, appropriately packaged for removal from the site and stored in a designated negative pressure storage area.

Supplies to be used shall be approved by the Government. Basis of design for specifications of supplies are as follows:

1. Toilet tissue: Roll type, 4-1/2 inches wide, single ply

2. Paper towels: Multi-fold, 10-1/8 inches wide

3. Hand soap: Medicated Vestal

4. Trash receptacle liners:

i. Polyethylene, flat type, 33 inches long, 52 inches wide, 0.66 millimeters thick

ii. Polyethylene, flat type, 24 inches long, 33 inches wide, 0.31 millimeters thick

iii. Polyethylene, red bags (bio hazard) 33 inches long, 52 inches wide and 24 inches long, 33 inches wide

5. Furniture polish: Spray type for use on wood and wood veneer

6. Window cleaner: Ammonia type sufficient to remove smoke film and dust

7. Air freshener cartridges in bathrooms: Johnson Wax Good Sense

8. Upholstery cleaners: Dry or foam type recommended for fabric upholstery

9. Germicide: EPA-registered

10. Resilient floor tile cleaner and maintainer: As recommended by manufacturer of resilient flooring

11. Floor finish: High-speed floor finish as recommended by manufacturer of resilient flooring

12. Floor sealer: As recommended by manufacturer of resilient flooring

13. Floor stripper: As recommended by manufacturer of resilient flooring

14. Toilet seat covers: Paper, white

A copy of the MDS sheets for all products used shall be maintained at the clinic and shall be available for review by VA upon request. MDS sheets shall be maintained in each housekeeping closet and shall be reviewed semiannually by the lessor for accuracy. When new products are introduced, the MDS sheets shall be updated.

F. Selection of Cleaning Products

The Lessor shall make careful selection of janitorial cleaning products and equipment to:

1. Use products that are packaged ecologically; Use products and equipment considered environmentally beneficial and/or recycled products that are phosphate free, non-corrosive, non-flammable, and fully biodegradable; and

2. Minimize the use of harsh chemicals and the release of irritating fumes.

NOTE: Examples of acceptable products may be found at www.gsa.gov/products

G. Selection of Paper Products

The Lessor shall select paper and paper products (e.g. restroom tissue and paper towels) with recycled content conforming to EPA’s CPG.

H. Waste and Recycling

The Lessor shall have no responsibility for disposing of hazardous or pathological waste. The Lessor shall provide collection, disposal, and recycling for all other waste materials generated by the VA. Recycling of paper, plastic, aluminum, toner cartridges and cardboard is required.

Locate waste and recycling containers near the loading dock/service area in accordance with security requirements. The Lessor shall provide and maintain adequate quantity of trash container(s), including compacting equipment as required, based on volume of waste and frequency of collection. Lessor to provide the necessary covered containers with daily or weekly collection and removal from site for refuse, trash, and garbage. The Lessor shall provide the covered recycling containers and shall collet and remove recycled materials weekly.

1.3 TASKS AND ASSOCIATED FREQUENCIES

A. As Required/Requested Requirements

a. Terminal Cleaning

i. Any room where patients with suspected infectious disease have been examined will be thoroughly cleaned with germicide (terminal cleaning). Two step method (clean twice) for all such cleaning.

b. Walk Off Mats

i. Lessor shall provide walk off mats at all patient/visitor/employee entrances.

ii. Walk off mats shall be professionally cleaned a minimum of twice yearly.

iii. Wall off mats shall have the characteristics for heavy traffic in a healthcare facility.

iv. Orient mat to fit in location to provide best coverage.

v. Color of mats to match building carpet/color scheme.

vi. Mats are to be kept clean and in good repair.

vii. Mat material/type to be 3M TM Carpet Matting 8850 or approved equal.

http://www.gsa.gov/products

c. Umbrella Stands and Bags

i. Lessor shall furnish and install umbrella bag stands at each patient and employee entrance.

ii. Lessor to stock umbrella bags as necessary.

iii. Bag type to be Uline H-2953 46” Bag Stand and S-17365 Large Bags or approved equal.

iv. Bag stands shall be reviewed daily to ensure adequate stock.

d. Replace light bulbs as necessary.

e. Appropriately address non-scheduled janitorial tasks.

B. Daily Cleaning Requirements

a. Building Entrances

i. Pick up trash around entrances and vestibules.

ii. Empty trash receptacles.

b. Primary Care Area (prior to patient appointments each operational day)

i. All primary care areas shall be wet mopped using a germicide before patients are seen.

ii. Wipe down all exam tables with a clean cloth dampened with germicide.

iii. Clean and disinfect sinks and countertops.

iv. Clean and refill soap dispensers.

v. Clean and refill all paper towel dispensers.

vi. Review level of sharps container and replace with new insert sleeve as necessary.

vii. Clean mirrors.

viii. Wipe down all walls with protection with a clean cloth dampened with germicide.

c. Specialty Care Area (completed after patient appointments have concluded each operational day)

i. Treatment rooms shall be cleaned and disinfected after each patient procedure. (Coordinate with VA COR on patient appointment schedule for times when cleaning shall take place)

ii. All floors shall be wet mopped using a germicide.

iii. Wipe down all exam tables with a clean cloth dampened with germicide.

iv. Clean and disinfect sinks, countertops, equipment, etc.

v. Wipe down all walls with a cloth dampened with germicide.

vi. Clean and refill soap dispensers.

vii. Clean and refill all paper towel dispensers.

viii. Review level of sharps container and replace with new insert sleeve as necessary.

ix. Clean mirrors.

d. All Areas (complete throughout each operational day, without impacting employees, patients, and visitors)

i. Trash receptacles shall be emptied, cleaned and liners changed.

ii. Trash shall be removed from the building and placed in appropriate containers.

iii. Medical Waste and Hazardous Waste shall be emptied and cleaned.

iv. Boxes and other empty containers, to be disposed of, shall be removed from the building, and placed in appropriate containers.

v. Hazardous waste and full sharps containers shall be collected in red plastic bags and placed in cardboard boxes provided.

vi. Cardboard boxes shall be sealed with tape and placed in hazardous collection room for removal and disposal off site by others.

vii. Spills, body fluids, etc. shall be cleaned from floors and walls immediately upon notification.

viii. Remove black scuff marks from corridor floors as necessary.

e. All Areas (complete after patient appointments have been concluded for each operational day. Electrical equipment shall only be used during this time.)

i. Complete other required janitorial services.

ii. Dust furniture, desks (do not disturb papers on desks), machines, phones, file cabinets, window ledges, etc.

iii. All resilient tile floor areas shall be swept and wet mopped with germicide.

iv. Vacuum and spot clean carpets.

v. Carpeted areas and mats shall be vacuumed.

vi. Remove black scuff marks from corridor floors as necessary.

vii. Spot clean walls and doors.

viii. Spot clean any carpet stains.

f. Direct Patient Care Areas: Radiology, lab/phlebotomy, physical therapy, etc.

(complete after patient appointments have concluded for each operational day)

i. Sweep and wet mop with germicide.

ii. Wipe down all exam tables or any patient chair with a clean cloth dampened with germicide.

iii. Clean and disinfect sinks and countertops, including Reception areas.

iv. Clean and refill soap dispensers.

v. Clean and refill paper towel dispensers.

vi. Review level of sharps container and replace with new insert sleeve as necessary.

vii. Clean mirrors.

viii. Wipe down all walls with protection with a clean cloth dampened with germicide.

g. All Restrooms (completed during daily operational hours)

i. All restrooms shall be swept and wet mopped at least twice each day.

ii. All paper products and hand soap shall be replenished.

iii. Review feminine hygiene products and replenish as necessary. Restock of feminine hygiene products will be provided by the VA through the VA COR.

iv. All surfaces, including commodes, urinals, walls, mirrors, counters, and sinks, shall be cleaned and disinfected. Sponges and cloths shall not be used to clean commodes and urinals. Commodes and urinals shall be cleaned with disposable items that are disposed of after cleaning commodes and/or urinal in each toilet room. Items used to clean commodes and urinals shall not be used in turn for cleaning other items or wiping down other surfaces. Clean exterior of commodes and urinals first, followed by cleaning of the interior.

h. Flu Stations (completed during daily operational hours)

i. Review product stock at flu stations (tissue, hand sanitizer, and/or face masks) and replenish as necessary. Restock of such items will be provided by the VA through the VA COR.

i. Ceramic Tile Areas (other than restrooms) (complete after patient appointments have concluded on each operational day)0

i. Ceramic tile floors shall be swept, and damp mopped. If dirt build up occurs, ceramic tile floors shall be scrubbed when determined that it is required by the

VA COR.

j. Corridors, Waiting Areas, Administrative Areas, Behavioral Health (complete after patient appointments have concluded on each operational day)

i. The areas shall be swept, wet mopped with a neutral cleaner, and burnished.

ii. Carpeted areas shall be vacuumed.

k. Restricted Areas (Clean Supply/Medication Storage, Warehouse, OIT, Telephone Room, Police Station/Security, and any other area specified by the VA COR) (complete during operational day hours when VA department staff are present)

i. Trash receptacles shall be emptied, and liners changed.

ii. The areas shall be swept, wet mopped with a neutral cleaner and burnished.

iii. Areas with cushioned flooring shall be maintained in accordance with manufacturer’s recommendations.

iv. Carpeted areas shall be vacuumed.

v. Restrooms shall be swept and wet mopped once each day and all paper products and hand soap replenished.

vi. All restroom surfaces, including commodes, urinals, walls, mirrors, counters, and sinks, shall be cleaned and disinfected.

vii. Hazardous waste and full sharps containers shall be collected in red plastic bags and placed in cardboard boxes provided.

l. GIP Storage (complete during operational day hours when VA staff are present)

i. Trash receptacles shall be emptied, and liners changed.

ii. Flooring shall be swept and wet mopped with a neutral cleaner.

iii. Daily documentation of housekeeping tasks in each GIP rooms shall be completed (cleaning log provided by VA Logistics Department via VA COR)

m. Conference Rooms (if unoccupied)

i. The areas shall be swept, wet mopped with a neutral cleaner, and burnished.

ii. Carpeted areas shall be vacuumed.

iii. Dust furniture, desks (do not disturb papers on desk), machines, phones, file cabinets, window ledges, etc.

iv. Clean and disinfect all tabletop surfaces and chair arms with germicide.

v. Areas with cushioned flooring shall be maintained in accordance with manufacturer’s recommendations.

n. Waiting Room Tables, Doors, Walls, and Trim

i. Dust tables, ledges, sills, moldings, and baseboards.

ii. Neatly arrange all reading materials

iii. Clean and disinfect all tabletop surfaces and chair arms with germicide.

o. Mirrors and Glass Cleaning

i. Clean all mirrors and glass at entrances (fingerprints, smudges, etc.)

p. Housekeeping Aide Closet

i. Clean sinks, floor, and shelves.

q. Isolation Rooms (rooms with positive and/or negative pressure relationships to adjacent space)

i. Any room where patients with suspected infectious disease have been examined will be thoroughly cleaned with germicide (terminal cleaning). Two step method (clean twice) for all Isolation Rooms.

r. Water Coolers

i. Clean water coolers.

ii. Housing shall be wiped down. Particular attention shall be given to top surface and spout to prevent lime build-up, bacterial growth, etc.

C. Weekly Cleaning Requirements

a. Furniture (complete after patient appointments have been concluded on an operational day)

i. Clean as necessary, but not less than weekly.

ii. Vacuum upholstered furniture.

b. All Restrooms (complete during operational hours if the closure of the restroom does not exceed a half hour. If these weekly tasks cannot be completed within that timeframe along with the daily restroom cleaning tasks, complete this task after patient appointments have concluded for the day)

i. Scrub floors and ceramic tile base and wipe down with germicide.

ii. Clean ceramic tile walls and wipe down with germicide.

iii. Spot wash painted walls as necessary.

iv. Damp wipe toilet stall partitions and waste receptacles with germicide.

c. Doors, Walls, Trim, Sills, and Ledges

i. Spot wash (for fingerprint, smudges, etc.) as necessary but no less than once weekly.

d. Mechanical/Electrical/MEP Equipment Rooms

i. The area shall be swept and wet mopped with a neutral cleaner.

ii. Collect, remove, and dispose of refuse, trash, and garbage from the space.

e. OIT Data Closets (complete during operational hours of day when VA staff are present to provide escort)

i. Areas shall be swept and wet mopped with a neutral cleaner.

ii. Collect, remove, and dispose of refuse, trash, and garbage.

f. Glass Cleaning (complete throughout operational day, without impacting employees, patients, and visitors)

i. Clean interior and exterior of door and entrance glass in waiting areas, exam rooms, offices, specialty areas, and treatment/isolation rooms.

g. Floor Maintenance of Resilient Tile Areas (complete after patient appointments have concluded for the operational day. When completing these tasks, maintain access for building occupants for fire egress. For areas within VA restricted access areas, coordinate work with VA COR)

i. Apply cleaning soap, as recommended by resilient tile manufacturer, scrub and re-wax hallways, waiting rooms, and lobbies.

D. Monthly Cleaning Requirements

a. Furniture (complete after patient appointments have concluded on an operational day)

i. Polish all furniture as necessary, but not less than monthly.

b. Air Conditioning Grilles and Registers (complete after patient appointments have concluded on an operational day)

i. Vacuum all grilles and registers.

ii. Clean…