36C25519Q0237-012.pdf

QASP Matrix /Quarterly Report Format

CONTRACT #

Quarterly Report is due no later than the 15th of the beginning of each new quarter

1) Task Order #: 2) Contractor:

3) COR: Danielle White 4) Surveillance Period:

Contracting Officer’s Representative Overall Comments:

Task Deliverable Acceptable Quality Level

Method of Surveillance

Observation

1.All Nursing Certification

Basic Cardiac Life Support (BCLS) certification.

100% compliance

COR to confirm prior to employment

2. ICU (RNs only) and OR/PACU (RNs only)

Advanced Cardiac Life (ACLS) certification

100% compliance COR to confirm prior to employment

3. Medication Administration

Contractor employee’s shall utilize the Bar Code Medication Administration

(BCMA)

Inspecting the services to determine whether or not the performance meets the performance standards; and review of any other appropriate electronic records.

4. Assessments.

Complete all assessments accurately and timely documentation

Inspecting the services to determine whether or not the performance meets the performance standards; and review of any other

5. Customer Service/Patient Reviews

Complaints Zero validated complaints.

Inspecting the services to determine whether or not the performance meets the performance standards; and review of any other

6. Unscheduled absences and Tardiness

Unplanned Absences and Tardiness

No more than two

(2) incidences calling off work per year. No more than two (2) incidents of tardiness per quarter.

Review of schedules and patterns.

List Key Personnel:

Christina Komba, Nurse Manager

Karen Heath‐Shaw, Nursing Officer of the Day

Stella Packard, Nursing Officer of the Day

Kathy Swann, Nursing Officer of the Day