590-22-990 Modernize Boiler Plant SOW.pdf

ARCHITECT-ENGINEER DESIGN SCOPE OF WORK

Hampton VA Medical Center

Hampton, Virginia

PROJECT NUMBER: 590-22-990

PROJECT TITLE: Modernize Boiler Plant

AE PERIOD OF PERFORMANCE:

DESIGN TIME FRAME: 585 Calendar days from Notice to Proceed (NTP) CONSTRUCTION SOLICITATION PERIOD: Six (6) months from the time Engineering submits package to contracting. Designer shall answer pre-bid RFIs and provide updated construction documents to capture any changes made through the procurement process.

CONSTRUCTION TIME FRAME (CPS): 730 Calendar days from construction award date.

ESTIMATED COST OF CONSTRUCTION MAGNITUDE: VAAR 836.204(h)(1) Between $10,000,000 and $20,000,000.

CRITERIA FOR DESIGN AND PROJECT DEVELOPMENT (as applicable to project)

The references listed below are not intended to be all inclusive. The A/E shall ensure that all applicable references and/or standards are followed.

Note: The documents listed below can be found at the following website: http://www.cfm.va.gov/til/ PG-18-1 Master Construction Specifications PG-18-3 Design and Construction Procedures PG-18-4 Standard Details and CAD Standards PG-18-5 Equipment Guide List H-18-8 Seismic Design Handbook PG-18-9 Space Planning Criteria, and VA-Space & Equipment Planning System (VA-SEPS) PG-18-10 Design Manuals (by discipline) PG-18-12 Design Guides (graphical, by function) PG-18-13 Barrier Free Design Guide PG-18-14 Room Finishes, Door, and Hardware Schedules PG-18-15 Minimum Requirements for A/E Submissions PG-18-17 Environmental Guidance -VA Cost Estimating Requirements -VA Signage Design Guide -VA Commissioning Process Manual / Under Special Requirements & Studies -VA Equipment Guide List, Program Guide PG-7610 -VA Accessibility Requirements and Uniform Accessibility Standards -VA Design Alerts -VA Title Block Layout -VA OHI Report No. 13-01189-267 -VHA Directive 1061 -VHA Boiler and Associated Plant Safety Device Testing Manual (Latest Edition) -VHA Directive 1810(1) Boiler and Boiler Plant Operations -National Codes and Standards (Latest Editions) -International Building Code (Latest Edition) -Physical Security Design Manual for VA Facilities http://www.cfm.va.gov/til/ http://www.cfm.va.gov/TIL/spec.asp http://www.cfm.va.gov/TIL/cPro.asp http://www.cfm.va.gov/TIL/sDetail.asp http://www.cfm.va.gov/TIL/equip.asp http://www.cfm.va.gov/TIL/seismic.asp http://www.cfm.va.gov/TIL/planning.asp http://www.cfm.va.gov/til/dManual.asp http://www.cfm.va.gov/til/dGuide.asp http://www.cfm.va.gov/TIL/accessibility.asp http://www.cfm.va.gov/til/room/RoomFinishes.pdf https://www.cfm.va.gov/til/aeDesSubReq.asp http://www.cfm.va.gov/til/spclRqmts.asp#EC

-- Services --

Provide professional Architect/Engineer services to include:

1. Site investigation including permits.

2. Architectural, Civil, Structural, Mechanical, Electrical, Plumbing, Telecom and Environmental

(e.g., soil boring, erosion control, etc.)

3. Environmental Survey (lead, asbestos, mold identification, etc.)

4. Construction drawings and specifications

5. Third party construction estimates

6. Construction period services

6.1. Submission review with recommendations and approvals (e.g., change proposals, Requests for Clarification/Information, product submittals, shop drawings, testing support)

6.2. Site visits per VA request

6.3. Update drawings as-built conditions from contractor record drawings, VA correspondence during construction

6.4. Air monitoring during abatement/remediation

6.5. A/E will respond either by phone, email, or on-site within a 24-hour period when requested.

6.6. Final Inspection

7. Conduct Infection Control Risk Assessment (ICRA) in conjunction with VA Safety/Infection Control staff

-- Project Scope --

GENERAL:

The Architect/Engineer (A/E) shall provide design and construction period services for NRM construction project 590-22-990. The project includes renovation of existing boiler plant and removal of existing boilers and various equipment from existing boiler plant, building 15. Project performs complete renovation of the boiler plant including equipment and systems (three main boilers, economizers, control panels, condensate tanks, blow down tanks, feed pumps, air compressors, fans and motors, variable frequency drives, fuel oil service pumps, water softeners, sump pumps, chemical pumps and all associated piping, valves, fittings, supports and all components needed to make the system functional. The AE shall evaluate the entire structure and provide repairs/upgrades to building structure, masonry, windows/grilles, HVAC system, plumbing, electrical power, lighting and interior floor plan and finishes.

In addition, the AE shall evaluate the feasibility of two options. Option 1 is to continue to operate existing boilers while new boilers are installed in the abandoned half of the structure. Option 2 is to install temporary boilers in the abandoned half of the structure and operate them to supply steam to the facility while the existing boilers are replaced.

The boiler plant renovation shall be designed to comply with all current VA design and safety standards, including VHA Boiler and Associated Plant Safety Device Testing Manual. In addition, the building shall be updated as needed to meet the VA’s Mission Critical Facility requirements and comply with the latest VA design manuals/design guides, including the Physical Security and Resiliency design manual.

Design shall comply with VA guidelines and specifications. Design manuals/guides and specifications can be found at http://www.cfm.va.gov/TIL/. Design shall also meet all applicable http://www.cfm.va.gov/TIL/ codes and standards including energy efficiency/certification requirements. A/E shall examine all design manuals/guides listed on the TIL to determine applicability to this project. Reference the Healthcare Environment and Facilities Program (HEFP) Boiler Plant website for additional policies and guidelines at http://vaww.hefp.va.gov/topics/boiler-plants. Proposed work is located at Hampton VA Medical Center.

Completed design shall result in a cost that is within the budget limitations. To ensure this, the A/E shall set up one or more bid deduct alternatives totaling 10% of the construction cost. If the base bid cost exceeds budget and deduct alternates do not bring the project within the construction budget, the A/E shall re-design or take necessary steps to reduce the cost so that budget limitations are not exceeded.

The A/E shall include in his design any environmental permits that may be required for construction (i.e., VPDES, US Army Corps of Engineers) and ensure proper erosion control measures are also included in the contract documents for construction. The A/E shall assist the construction contractor in acquiring needed permits.

Perform a thorough analysis of the current and projected steam and hot water demand and distribution piping. AE firm will need to calculate steam usage from equipment drawings and site investigation since there is no monitoring of steam usage.

Fire safety systems design to extend and / or reconfigure existing systems. Provide complete systems including fire suppression, isolation, alarm, and sensing. Project documents will be approved by a licensed professional Fire Protection Engineer. Fire safety review will include a review of impact on life safety of adjacent spaces and coordination with all drawings including MEP drawings.

The A/E shall determine if existing utility systems have sufficient capacity to accommodate the renovation work. This includes performing load studies if needed. If so, modify existing systems as required to meet current design standards. If there is insufficient capacity, the A/E shall present design solutions to satisfy the needs of this project. The A/E shall include the chosen solution in the design. Include telephone, data, TV, public address, MEP, storm systems, etc.

The A/E shall make a thorough investigation of the existing site for the proper design of the project.

Existing conditions shall be determined by verifying information from field investigations and any documentation that may be available. A survey shall be conducted to obtain sufficient information to permit designers to develop a detailed cost estimate and schematics. The entire Veterans Affairs drawing files (if existing) will be made available and accessible along with reproduction materials, but the A/E shall provide the manpower to reproduce prints. AutoCAD drawings are also available for use contingent they are existing. This information is the best available, but the Government does not guarantee its accuracy or completeness. The A/E investigation of field conditions shall be performed in a competent, professional manner in accordance with Architectural Design Manual PG 18-10. Site utility locations will be verified by the A/E (VA staff will not mark utilities but will assist with locating if workload permits). The A/E shall photo-document all cut-points for demolition of all utilities and remaining systems, photo-document all tie-in points for future systems.

Provide Mechanical design including detail of the mechanical construction requirements for heating, ventilating, air conditioning, refrigeration, fire, and safety, plumbing and sanitary engineering.

Include commissioning of HVAC system, boilers, and associated equipment. Provide a conditioned space where operators can monitor plant operations. Design shall comply with the most current http://vaww.hefp.va.gov/topics/boiler-plants

ASHRAE 90.1 and the VA Sustainability Program. The boilers and associated equipment shall be digitally controlled and compatible with VA Information Technology requirements. Provide at least two workstations with sufficient power and data for boiler plant staff to monitor plant operations.

HVAC equipment for conditioned spaces and IT closets shall meet VA’s BACNET requirements and monitored by authorized staff using a VA computer running a web-based application.

Provide Electrical design documents to include electrical, data and telephone closets, power distribution systems, auxiliary power systems, lighting, switching, fire and safety, video surveillance, public address, security, and signal systems. Any existing systems (including but not limited to telecom, fire and safety, public address, etc.) will be evaluated and reused, extended, or modified where feasible. The project will be designed utilizing emergency power panels per VA standards.

The building renovation will be designed to utilize combined infra-red/motion occupancy sensors, day lighting control for spaces with windows or skylights, and VA Required Foot-candle lighting levels shall be maintained within the lighting densities listed in the most current ASHRAE 90.1.

Conduct electrical load studies as needed to ensure sufficient power is included.

Provide Structural design setting forth in detail the structural construction requirements including all structural plans, elevations, sections, structural construction requirements, schedules, and calculations sizing all columns, beams, slabs, and coordinate the work with other design disciplines, especially the mechanical and architectural disciplines.

Provide Architectural design including facility floor and roof plans, sections, elevations, details, schedules, selection of building systems and materials, discipline coordination and fire safety systems and controls. If space/funding permits include a conditioned space for a break room, male & female bathrooms, and office for non-supervisory staff.

Provide bound specifications and 100% construction drawings with all xref’s bound. Construction documents will be required to be furnished in hard copy, electronic .dwg files (AutoCAD 2018 or most current at the time of final design submission) and electronic .pdf files. All AutoCAD drawings (including subcontractors) shall be in an organized drawing file system using its “Project Browser/Navigator”.

Provide Cost estimates detailing quantities of materials, labor, profit, overhead, insurance, taxes, etc.

in the format found at https://www.cfm.va.gov/til/dManual/dmCost.pdf

Life safety and infection control will be considered during all phases of design. Final construction documents will detail measures to be taken by the contractor to assure life safety and infection control. Laydown areas and storage for materials shall be identified in the early stages of the design.

A pre-construction risk assessment will be completed and included by the 35% submission.

Provide Plans for phasing construction to minimize impact on the medical center will be incorporated into the construction documents. Plan construction to include impacts on the medical center such as relocating patient and staff equipment, providing temporary barriers, providing temporary utilities, minimizing impact on patient flow, etc. Provide a construction schedule showing expected duration of each phase, the number/timing of utility outages with no work being performed on weekends/holidays.

https://www.cfm.va.gov/til/dManual/dmCost.pdf

Provide construction period services to include shop drawings review, site inspections, and RFI response. In addition, the A/E shall provide scope of works, and cost estimates for any RFI response that causes a cost change due to design errors and omissions.

Incorporate in the preliminary drawings the pre-construction risk assessment/evaluation as the sample shown at the end of this statement of work, see page 11.

-- Site Investigations --

EXPECTATION: A/E shall make site visits as necessary to survey existing conditions.

Make site visits as required to determine existing as-built conditions affecting this project. Note:

Information including drawings and other documentation provided to the A/E is used as reference only.

All additional references and specifications are available in VHA’s Technical Information Library at address https://www.cfm.va.gov/til/. A/E shall field verify every aspect that relates to the project.

Coordinate visits with the Project Manager/Contracting Officer Representative (COR) as assigned after award. The A/E shall arrange for and oversee the performance of such investigations. AutoCAD architectural background drawings will be provided by the VA upon request. The A/E shall field verify all dimensions, wall layouts, etc. A/E shall field verify every aspect that relates to the project.

-- Design Review Schedule --

EXPECTATION: Submit review package so they are received on the noted day.

Review Due Date (Calendar Days After NTP)

Initial Project Design Meeting (PDT) 10 Feasibility Study 45 VA Review Period (60 days) 105 35%percent construction documents 195 VA Review Period (60 days) 255 65%percent construction documents 345 VA Review Period (60 days) 405 95% percent construction documents 495 VA Review Period (60 days) 555 100% Construction Documents 585

Note: NTP will be issued at award. A/E will be required to attend and take minutes from each PDT meeting. Minutes will be submitted electronically to the Project Manager/COR and Contracting Officer within three calendar days of each meeting. The 35%, 65%, 95% and 100% submissions start upon receiving the review comments from the prior submission.

-- Design Requirements/Submissions – https://www.cfm.va.gov/til/

EXPECTATIONS:

Submit complete review package in accordance with the following requirements and guidelines outlined in https://www.cfm.va.gov/til/aeDesSubReq.asp. Please pay specific attention to the schematic, design, and construction submission requirements. As appropriate depending upon the complexity of the design, the A/E with VA approval, may elect to delete individual submissions where not required (i.e., Do not address A. Site Development, Landscaping for interior renovation projects).

Design shall comply with the VA BIM & CAD standards located on the TIL at VA BIM & CAD Standards.

COST ESTIMATING:

Philosophy - Cost management is the task – the cost estimate is the tool. The AE shall manage the execution of the project within the VA programmed construction budget. The VA programmed construction budget will not be made known until after design award. The entire AE design team will take ownership of the project construction budget and be an advocate for successful execution of the project within the available funding. The cost estimator’s role must be viewed as a critical element of project cost management. Rather than limiting responsibilities to simply reporting costs, the estimator must be an integral part of the design team, continually interacting and providing input to design decisions at every stage of development.

Objective - Cost estimates for the base bid shall be within the VA programed construction budget. If the cost estimate is outside of the construction budget, the AE is responsible for notifying the VA of potential budget issues, providing non-scope impacting recommendations to get the estimate with the required budgeted construction cost while providing design documents that correspond accordingly.

Design submissions with cost estimates greater than the allowable budget are grounds for rejecting a design submission. The final construction document submission estimate shall not be greater than the VA programed construction budget and not less the -5% of the VA programed construction budget.

Recapitulation and Level of Detail - Refer to VA Cost Estimating Manual.

Timing of Submission - Responsible decisions cannot be made without knowing the associated cost.

Cost documentation must be delivered at the same time as other design submissions. The AE is responsible for managing workflow and communications to ensure that this can be accomplished. It is understood that some details may change in the final days preceding a submission. Cost data shall be submitted on the most up to date design information possible, with a narrative of any late developments that will affect cost.

DEDUCTIVE ALTERNATES, AE INDEPENDENCY LETTER AND EQUIPMENT/SYSTEM

DECISION TREE:

The AE shall provide a design identifying a minimum of 10% of the construction budget as deductive alternates. Each alternate shall be progressively deductive in nature and shall be non-scope impacting.

The VA and AE shall work collaboratively to ensure project remains viable for medical center operations within the allotted budget. The VA will have the final determination on the AE recommended bid deducts. Items removed as bid deducts shall be evaluated to determine impacts to the remainder of the design. Certain bid deducts could require a separate design to keep the design intent viable. Items identified as ‘yes’ in question 1 of the below decision tree shall not be removed as bid deductive alternates. Items identified as ‘yes’ in question 2, 3, or 4 of the below decision tree shall https://www.cfm.va.gov/til/aeDesSubReq.asp https://www.cfm.va.gov/til/projReq.asp https://www.cfm.va.gov/til/projReq.asp not be removed as bid deductive alternates without explicit consent from the Contracting Officer through the facility Chief Engineer. Items identified as ‘no’ in question 4 shall not be included as part of the construction project, however, utilities and site prep for such equipment (or future equipment) is permissible.

The AE shall include a letter of independency certifying that the design project is independent of any other project and/or source of funding to activate. This letter will be required at 100% design completion. The following decision tree provides guidance on what is allowed to have an alternate source of funding (not through the construction project).

Decision Tree

1. Is the item necessary to meet requirements for an occupied building? This includes all governing code required items, such as fire alarm. If yes, the item is to be funded within the construction project.

If no, proceed to question 2.

2. Is the item covered by OCFM's Master Construction Specifications PG-18-1, Divisions 1 through 10, 13 through 26, or 28 through 48? If yes, the item is to be funded within the construction project. If no, proceed to question 3.

3. Is the item covered in OCFM's Master Construction Specifications PG-18-1, Division 27 and not IT equipment*? If yes, the item is to be funded within the construction project. If no, proceed to question 4.

4. Is the item covered in OCFM's Master Construction Specifications PG-18-1, Number 12 31 00, 12 32 00, 12 34 00, or 12 36 00? If yes, the item is to be funded within the construction project. If no, then the equipment must be funded by the facility’s respective equipment fund from medical care appropriations.

*IT equipment includes computers, monitors, keyboards, docking stations, phones, printers, scanners, etc. Cabling and raceways for IT equipment is not included as part of IT equipment.

Other Non-IT equipment includes physical access control systems, data closet racks, WI-FI (both patient and medical), temp track, testing and punch down of the information systems etc.

NOTE: ALL DESIGN SUBMISSIONS WILL BE REVIEWED BY REVIEWED BY VA

STAFF AT THE LOCAL, VISN AND NATIONAL LEVEL. THE A/E IS TO

INCORPORATE ALL COMMENTS FROM THESE GROUPS.

FOR EACH SUBMISSION DELIVER ONE (1) CD CONTAINING ALL SUBMISSION

DOCUMENTATION AND ONE (1) FULL SIZE, THREE (3) HALF SIZE DRAWINGS, AND

ONE (1) SPECIFICATIONS BOOK AND (1) NARRATIVE REPORT PER SUBMISSION. IN

ADDITION, PROVIDE:

Feasibility Study:

Provide proposed space layouts for renovation, equipment, utility/infrastructure requirements, etc.

Budget estimate for proposed with breakouts for equipment, materials, labor.

Achieve a consensus on design approach (Option 1 or Option 2) before proceeding to 35% design.

Complete SS1 and SS2 Checklist

Design Development (DD1) 35%:

Address all comments from the Feasibility Study review.

Identify and provide all design calculations.

Identify all existing utilities and utilities requirements.

Complete DD1 Checklist Pre-TAB of existing impacted HVAC Systems per HVAC Design Manual Preliminary Estimate Provide a 3D model of the existing conditions and new work. The model shall be able to be opened by Revit 2023.

Design Development (DD2) 65%:

Address all comments from the DD1 Submission review.

Complete DD2 Checklist Updated Estimate Color boards showing the interior design scheme (fabrics, finishes, furniture layout and plans) for each area, east west and center, include an inventory of materials/manufactures recommended for use for approval and prepared for order by the VA Interior Designer. The color, name and all applicable identifying numbers shall be placed on the board and be easily read without removing the physical samples.

Provide a 3D model of the existing conditions and new work. The model shall be able to be opened by Revit 2023.

Design Development (CD1) 95%:

Address all comments from the DD2 Submission review.

Design all finishes.

Finalize required submittals.

Complete CD1 Checklist Updated Estimate Provide two digital project renderings of the facility, each from a different perspective.

Provide a 3D model that includes FFE- furnishings and equipment (if vendor models are available). The model shall be able to be opened by Revit 2023.

The Signage & Way-Finding Plan shall identify each type of sign and the planned location.

Demonstrate that the design can be constructed. The A/E shall show paths for equipment to be removed from the building and installed in the building. Take into consideration the path(s) materials are to be moved and clearances with surroundings.

Contract Documents (Bid documents):

Submit an updated, complete package of all contract requirements including final estimate.

The Drawing Cover Page shall be submitted for approval signatures. If necessary, update and submit until approved by the VA.

Provide a submittal register containing all necessary submittals by specification section in an

Excel spreadsheet. Checklist to be utilized to track/monitor submittal process.

Complete project related sections of Standard Detail-Div 23-Schedules.xlsx Provide a Gantt chart of the estimated construction schedule showing work that is expected to last 30 or more days in duration, including submittals. Include expected material lead times.

Provide a 3D model that includes FFE- furnishings and equipment (if vendor models are available). The model shall be able to be opened by Revit 2023.

-- Construction Period Services –

PROVIDE:

Assist the VA to determine whether the contractor or subcontractor meets qualification requirements, supported by written recommendations of any problems or litigation encountered in the past based on firsthand knowledge.

Review all submittals (including specified equipment and installation submittals) and shop drawings and provide recommendations to the VA within fourteen (10) calendar days.

Review and provide replies to contractor generated RFIs when required by the COR within seven (7) calendar days.

Review contractor's cost estimates and provide recommendations to the VA.

The A/E shall review the Contractor’s requests for information and cost proposals for construction change orders when requested by the COR. The A/E’s reply regarding his/her review of cost proposals and his/her recommendations shall include an independent breakdown of costs in detail, quantities, and unit prices and shall cover both additions and deductions of labor, materials, and equipment. The A/E shall also supply cost estimates as requested by the COR for Request for Proposals for anticipated changes.

Assist the VA is resolving design issues during building commissioning.

Make site visits on requests of the VA and prepare written reports to include agreed upon changes in design as determined necessary during the construction.

Allow for 6 site visits as directed and scheduled by the COR. Visits made based on errors and omissions in design will be at no cost to the VA.

Participate in partial/final acceptance inspections (one each per phase, not included in the six site visits above) as scheduled and generate punch list items for completion. The punch list shall reference the contract documents for specific deficiencies (i.e., specification section, drawing detail, etc.)

• Prepare as-built drawings on original set with A/E’s stamp, based on record drawings that the contractor kept during construction. Transpose contractor’s as-builts to AutoCAD (.dwg) and provide a set of updated as-builts on CD within 30 days to the Project COR. Update 3D model with any significant changes from design (wall or equipment locations). Final drawing submittal will include hard copies as described for other submissions as well as a CD clearly labeled with the project name, number and submittal date containing:

1. Folder labeled “bid documents.”

a. All specifications bound in one (1) word document (make sure spec sections are separated by page breaks and that new sections start on right hand page)

b. All drawing sheets in one .pdf file.

2. Folder labeled “DWGs” with subfolders containing engineering disciplines (Architectural, MEP, Structural, Civil, etc.) which includes the .arj file (for every discipline) to launch and organize the drawing file system and make all drawings the current project inside of AutoCAD.

3. Folder labeled “PDF sheets” containing separate .pdf documents for each discipline.

4. Folder labeled “cost estimate” containing a copy of the final construction cost estimate documents.

5. Folder labeled “calculations” containing final calculation documents.

6. Folder labeled “specifications” with a word document for each spec section.

7. Folder labeled “misc.” for IH reports, materials testing, VPDES permit, soils tests, sustainability checklist, etc.

8. Upon construction completion, red line drawings will be furnished to the A/E to prepare as built drawings. Final as built drawings will be furnished as master building drawings in a format prescribed by the VA.

-- Period of Performance –

Design completion: 585 calendar days max; includes VA design reviews.

Procurement timeframe: Six (6) months from the time Engineering submits package to contracting. Designer shall answer pre-bid RFIs and provide updated construction documents to capture any changes made through the procurement process.

Construction period services: 730 calendar days from construction award date Total contract period: 1495 calendar days

VHA Pre-Construction Risk Assessment (PCRA)

PCRA Introductory Information and Instructions

Use this template as a baseline for performing facility Pre-Construction Risk Assessments (PCRA) for Construction, Renovation, and Maintenance work (referred to as the “activity” in this document). The template provides minimum requirements for categorizing activity type(s) and safety risk to determine the level of precautions needed to prevent impact related to Construction, Renovation and Maintenance on patients, employees, and contractors.

Ensure that the activity statement of work and any drawings available are used for the PCRA assessment and included in the project file with the completed PCRA.

Communication and coordination of all types of activity with affected areas are to be included among the control measures. The development of communication and coordination plans must begin during the activity planning phase.

Facilities may customize this template to incorporate site-specific information and requirements.

NOTE: This VHA PCRA template pertains specifically to non-infection-related safety for Construction, Renovation, and Maintenance activities. It must be used in conjunction with the VHA Infection Control Risk Assessment (ICRA) for the activity, if required, which specifically addresses infection risks outside the scope of this PCRA.

PERMIT: See the last page of this document for a fillable permit form to be used for posting at the activity site.

Activity Location:

Activity Name, Number, and/or Brief Description:

Table 1 - Construction, Renovation, and/or Maintenance Activity Type and Control Measures

NOTE: If any of the bulleted criteria in a higher activity type pertains to the work that will be done (even if the other criteria are in a lower type), use the higher activity type for the VHA PCRA.

Controls defined in Table 1 for the activity must be in place before the activity begins and maintained until work is completed and the area is activated. Control measures for each activity must also include the control measures in the preceding row(s).

As the activity progresses, a full re-evaluation of remaining activity type and risk is required prior to changing the level of control measures.

Activity Type determined from Table 1:

Activity Type and Description Control Measures Inspection/upkeep generally defined as follows:

• Work can be completed in a single shift, not to exceed 10 hours.

• Patients, employees and/or visitors may be in the area depending on the activity.

• Work that does not create dust or debris.

• Work that does not create vapors or fumes.

• Removal of ceiling tile or access to mechanical or electrical chase for visual inspection that will not impair fire safety systems and are limited to 1 tile per 50 square feet with limited exposure time (not to exceed an hour for each tile) within the shift.

1. Immediately replace any ceiling tile, close access panels, etc., upon completion of work.

2. Site visits of construction area are required weekly by member of multi-disciplinary team.

Site visits will be documented on standard checklist.

3. Site specific safety plan, task hazard analysis, and hazard communication required to be provided by the contractor and approved where a contact is in place. For internal work the shop involved must work with Safety to ensure proper precautions are in place.

• Minor interior updates (e.g., replacing floor or ceiling tiles, carpentry work to include hanging signage, and painting with hand tools) that do not create vibration or noise.

• Limited building system maintenance that does not require Lock Out Tag Out (LOTO) such as plumbing on potable systems limited to faucet replacement, steam trap replacement etc. and electrical work such as replacement of bulbs, receptacles, or switches.

4. Must address identified hazards and controls that will be implemented to ensure minimal impact to patients, employees, contractors, and facility.

5. Communication and coordination plan for all affected areas

Small scale Construction, Renovation, and general maintenance/repair work, generally defined as follows:

• Prolonged work that may take longer than a single shift but not exceeding six months.

• Patients and employees are not to be in the area until activity is completed.

• Work that creates some noise and vibration due to power tool use.

• Selective demolition/removal of preexisting floor covering, casework, lay-in ceiling, or other architectural elements that may.

o disturb asbestos, lead or silica.

o create the potential for falling objects.

o create vibration and/or noise more than 80 dB(A) in surrounding areas.

o cause penetrations in fire or smoke barrier

• Plumbing work such as the installation of new sinks, showers and toilets and associated plumbing that requires utility outages or work on the steam system that may require:

o LOTO o The use of compressed gas cylinders

• Electrical work such as installation of conduit and wire for lighting, receptacles and switches for an area, the installation of conduit and wire for new devices such as terminal units, fans etc. Electrical work such as installation of cabling/wiring/conduit for a single device, installation of new device such as a light fixture that require

LOTO.

• Air Handler and/or fan shutdown/startup and HVAC work such as replacement of a single diffuser, single terminal unit, a single device and the installation of ductwork, diffusers, and terminal units for an area that may require:

o Work on ladders o Rigging, hoisting, or lifting of equipment or materials overhead

• Modification of existing fire alarm and suppression systems requiring system outages and ILSMs or obstruction of exits and or impact on corridors.

• Architectural, structural, or any other work that may cause vapors or fumes such as:

o Roofing work o Flooring work o Painting or other large-scale use of such substances.

All control measures in the row above and the following:

1. Hazard communication chemical inventory required to be provided by the contractor and approved.

2. Where construction, Renovation and maintenance are done in an accredited facility, and ILSM assessment is required to be done and ILSMs put into place in accordance with TJC LS.01.02.01 and the local facility policy including Fire watch if necessary. Staff is trained and the ILSM is verified regularly.

3. Hot Work or burn permits in place and staff trained.

4. LOTO procedures in place and staff trained on their use.

5. Site visits will be reviewed using the criteria in standardized guide.

6. Daily inspections of the site are to be conducted by the General Contractor or shop supervisor and documented on their daily log.

Large-scale construction, renovation, or maintenance generally defined as follows:

• Work exceeding 6 months in duration.

• Patients and employees are not to be in the area until activity is completed.

• Excavation or heavy equipment use taking place.

o Dig safe required utility location.

o Trench safety o Dust control plan o Equipment exhaust, Noise, Vibration

• Confined space entry required (permit required or not)

All control measures in the two rows above and the following Activity Hazard Analyses and Control Plans (check all that apply):

1. Excavation safety plan in place ☐

2. Dust control plan in place ☐

3. Pollution prevention plan in place ☐

4. Dig safe paperwork in place ☐

5. Crane lift plan in place ☐

a. Crane placement

b. Crane swing

c. Crane load evaluation

6. Fall protection plan in place and staff trained ☐

• Requires crane work.

o General crane work o Lift over buildings

• Includes elevated work.

o Roof work, fall protection.

o Window work, scaffolding and fall protection.

o Odor control

• Welding, cutting or use of torches requiring burn permits.

• Demolition of building components and infrastructure including removal of multiple doors, walls, framing, ceilings, flooring, piping, electrical and HVAC that may.

o require asbestos, lead, or silica abatement.

o create the potential for falling objects.

o create vibration and/or noise more than 90 dB(A) in surrounding areas.

o cause breaches to fire or smoke barrier

• The installation building components such as new walls, ceilings and doors including framing, drywall and associated plaster work that requires transport of significant materials through building and up elevators i.e., weight limits of floors and elevators.

• Plumbing work requiring LOTO and system shutdown and startup such as the installation of:

o new medical gas systems, o steam/heating hot water, condensate systems, o Potable water and sanitary drainage, multiple sinks, showers, and toilets including associated plumbing.

• Electrical work such as installation of electrical feeders, distribution panels, conduit and wire for lighting, receptacles and switches for an area, the installation of conduit and wire for new devices such as terminal units, fans etc. requiring LOTO and system isolation.

• Installation of fire alarm and suppression systems requiring outages of those systems and ILSMs or closure of exits/corridors

• Mechanical work such as the installation of air handling equipment, associated ductwork, diffusers, heat exchangers, terminal units and controls requiring lifting and support of equipment and systems.

7. Confined entry plan in place and staff trained ☐

Table 2. Affected Adjacent Area Assessment

In addition to the minimum precautions noted above for the Activity Type, it is critical that the activity be coordinated with the areas adjacent to the activity to ensure operations in those areas are not disrupted or impacted. List the adjacent areas in Table 2 below and develop activity-specific coordination plans and associated communication plans with each area to address activity work that could impact or disrupt the operation of the areas, in general as follows:

• If adjacent area is vacant (e.g., work outside, construction of new building, etc.):

o Coordination is typically not necessarily other than potentially traffic flow and pedestrian.

access.

• If adjacent area is non-continuously occupied (e.g., areas where outpatient care is provided, employee health, etc.):

o Develop a list of activities that will potentially impact or disrupt the operation of the area (e.g., work involving noise, vibration or exit obstruction) and meet with POC to coordinate execution of work in a way that mitigates the impact (e.g., conduct work after hours).

• If adjacent area is occupied continuously (e.g., areas where inpatient care is provided, residential areas such as Community Living Centers, etc.):

o Develop a list of activities that will potentially impact or disrupt the operation of the area

(e.g., work involving noise, vibration or exit obstruction) and meet with POC to coordinate execution of work in a way that mitigates the impact (e.g., move affected party temporarily).

Area Service(s)/Type(s) of Area(s)

(e.g., OR, Unit/Ward, Sterile Processing, Administrative, etc.) *

Point of Contact

(POC)

POC Contact Information

Construction plan communicated to POC?

Activity Area**

Area Above

Area Below

Adjacent Area 1

Adjacent Area 2

Adjacent Area 3

Adjacent Area 4

* There may be more than one Service/type of area for each row. List all. The information entered on this table must be used in the ICRA if required.

** List the area(s) in which the construction/renovation/maintenance activity will occur.

Infection Control Risk Assessment (ICRA)

Consult with Infection Prevention and Control regarding the assessment of potential infection risks associated with the activity and the need for control measures. See VHA Directive 7715 and the VHA ICRA Template for more information.

Is an ICRA required for the Activity? Yes ☐ No ☐

Pre-Construction Risk Assessment (PCRA) Permit

This page must be posted at the entrance to the project area, or other designated area Unique permit number:

Location and brief description of construction/renovation/maintenance

Project manager Project start date Contact phone number Completion date Contractor or lead shop Permit expiration date

Activity Type Inspection/Upkeep, Small-scale, or Large-scale)

Activity Type Control measures to be in place for the duration of the activity.

(Check the box for the Activity Type to indicate the Control Measures)

Inspection/Upkeep

1. Immediately replace any ceiling tile, close access panels, etc., upon completion of work.

2. Site visits of construction area are required weekly by member of multi-disciplinary team. Site visits will be documented on standard checklist.

3. Site specific safety plan, task hazard analysis, and hazard communication required to be provided by the contractor and approved.

4. Must address identified hazards and controls that will be implemented to ensure minimal impact patients, employees, contractors, and facility.

5. Communication and coordination plan for all affected areas

Small-scale

All control measures in the row above and the following:

1. Hazard communication chemical inventory required to be provided by the contractor and approved.

2. ILSMs in place and staff trained on situation.

3. Hot Work or burn permits in place and staff trained.

4. LOTO procedures in place and staff trained on their use.

5. Site visits will be reviewed using the criteria in standardized guide.

6. Daily inspections of the site are to be conducted by the General Contractor and documented on their daily log.

Large-scale

All control measures in both rows above and the following Activity Hazard Analyses and Control Plans as applicable (check all that apply):

1. Excavation safety plan in place ☐

2. Dust control plan in place ☐

3. Pollution prevention plan in place ☐

4. Dig safe paperwork in place ☐

5. Crane lift plan in place ☐

a. Crane placement

b. Crane swing

c. Crane load evaluation

6. Fall protection plan in place and staff trained ☐

7. Confined entry plan in place and staff trained ☐

*The location of all Activity Hazard Analyses and Control Plans (excavation, dust, pollution, etc.) as applicable shall be identified on this permit and shall be made available to all workers on the job.

Additional requirements:

Is an Infection Control Risk Assessment (ICRA) required for the Activity? Yes ☐ No ☐

Infection Prevention and Control signature:

Date:

Project Manager signature Date

Safety Officer signature Date

Chair, Construction Safety Committee signature

Date

All design submissions will be submitted in accordance with the Program Guide PG-18-15, Volume C; A/E Submission Instructions for Minor and NRM Construction Program. These submission requirements may be found at the following web site https://www.cfm.va.gov/til/aeDesSubReq.asp. Each review submission will require 1 CD with all documents included, Project Narrative, 1 full size, bound sets of plans, 3 C size bound sets of plans, and 1 complete set of specifications, bound in 3 ring binders with specification sections clearly tabbed. Only 1 bound copy of calculations and cost estimates is required. Other applicable program guides can be found at http://www.cfm.va.gov/contract/ae.asp.

https://www.cfm.va.gov/til/aeDesSubReq.asp http://www.cfm.va.gov/contract/ae.asp