ATTACHMENT 3 TEMPORARY LODGING EVALUATION CHECKLIST.pdf
PDF 162 KB Posted
- Attached to
- V231--Hotel Lodging for Veterans Federal contract opportunity
- Solicitation number
- 36C25523Q0555_1
About this file
This document contains a checklist for evaluating temporary lodging facilities and a related federal contract opportunity notice for providing hotel lodging services to veterans receiving medical care through the Harry S. Truman Memorial Veterans' Hospital in Columbia, Missouri.
The checklist contains 50 criteria for rooms and bath areas that lodging facilities must meet in order to be eligible for referrals through the hospital, including requirements for locks, smoke detectors, lighting, furniture, cleanliness, and amenities. The federal contract opportunity seeks a contractor to furnish standard room supplies and services at their established lodging facility to accommodate veterans who must travel for medical evaluation. Lodging will only be provided for medically stable patients normally discharged to their home. The Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 15 is listed as the contracting agency.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25523Q0555 0001 Amendment Questions and Answers 1.12.2024.pdf | ||
| 36C25523Q0555.pdf | ||
| ATTACHMENT 5 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP).pdf | ||
| ATTACHMENT 1 CRITERIA FOR ELIGIBILITY FOR TEMPORARY LODGING OR HOPTEL.pdf | ||
| ATTACHMENT 4 CONTRACTOR CERTIFICATION - IMMIGRATION AND NATIONALITY ACT OF 1952.pdf | ||
| ATTACHMENT 2 VHA DIRCTIVE 1107 VA FISHER HOUSE AND OTHER TEMPORARY LODGING 2023.pdf |
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Text version
Temporary Lodging Evaluation Checklist
NAME OF FACILITY:
ADDRESS:
ROOM REQUIRMENTS (40 out of 50 = 80%) YES NO NA
1 Primary lock on all doors/dead-bolt/all windows 2 Door has a viewport/window 3 Smoke detector 4 Active light switch at main entry to unit 5 Sufficient lamps to properly illuminate the room for reading or writing 6 At least one chair (in good condition) 7 Writing surface (in good condition) 8 A nightstand or equivalent ( in good condition) 9 Clothes hanging facilities; drawers or clothes storage area 10 Television (if provided/functioning) 11 Telephone (functioning/direct dial or 24 hour switchboard) 12 Waste basket 13 Electrical Outlets (functioning) 14 Alarm/clock radio 15 Adequate space for one piece of luggage 16 Shades, draperies or blinds on all windows 17 Window covering effectively shut out light from outside 18 Heating system (functioning/reasonably quiet) 19 Air Conditioning system (functioning/reasonably quite)
OVERALL ROOM CLEANLINESS
20 Free of insects/rodents
No dust/dirt/liter/stains/cobwebs
22 Odorless/Clean windows
ROOM CARPETING
23 Not dirty/stained/worn out/torn
ROOM WALLS/CEILING
24 Clean/no peeling paint 25 Free of defects such as cracks, holes or stains
MATTRESS/BOX SPRINGS
26 Non-sagging/ sized to fit bed frame 27 Odorless, not stained 28 Non protruding/unbroken
OTHER BEDDING REQUIREMENT
29 Clean pillow(s)/pillow cases
Two clean sheets, mattress pad
31 Clean pillow case(s) 32 Suitable, clean blanket, bedsheet
BATH AREA
33 Private bath (with no carpeting in commode area 34 Adequate ventilation (fan/window) 35 Adequate lighting
TOILET
36 Functioning/clean
SHOWER/TUB
37 No grout problems/cracks 38 Adequate water pressure/hot water 39 Non-skid pad/strips 40 Shower curtain/tub enclosure clean and free from tears and mildew
VANITY/SINK
41 Functioning/clean 42 Adequate water pressure/hot water 43 Adequate light fixture above vanity/mirror/electrical outlet convenient to mirror
BATH TOWELS
44 One quality bath/hand/wash towel/bath mat 45 Towel rack
OTHER BATH REQUIREMENTS
46 Spare toilet tissue/facial tissue 47 One wrapped drinking glass per person 48 Bathroom waste basket 49 One individually wrapped bar of soap per person
OVERALL BATH AREA CLEANINESS/WALLS/CEILING
50 No hair/stains/odor/no peeling paint/free of defects such as cracks, holes or stains
TOTAL
SCORE:_____________
EVALUATORS:
NAME TITLE SIGNATURE/DATE
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