Attachment K Contractors Manual Feb 2017.pdf

CONSTRUCTION SAFETY HANDBOOK

FOR

CONTRACTORS

Veterans Affairs Medical Center West Palm Beach, Florida

Office of Occupational Safety and Health Facilities Management Service

561-422-6715

Foreword

Welcome to the West Palm Beach VA. Your project supports the Medical Center’s mission of providing quality care to our nation’s veterans in a safe and therapeutic environment.

This Construction Safety Handbook for Contractors is prepared by Occupational Safety and Health (OSH), Facilities Management Service. The Handbook is one method of communicating key requirements of the Medical Center’s

Construction Safety Program. The Handbook is not intended to be a comprehensive nor exhaustive reference of all the applicable Federal, State or local construction safety and health program requirements, standards, regulations, or guidelines that may impact contracted work. Contractors are responsible for becoming aware of and abiding by applicable rules, regulations, standards, codes, guidelines and similar governing safety and health policies, procedures and memorandum. Each Section of this Handbook is designed to provide the contractor with VHA and Medical Center specific information that will facilitate an effective and comprehensive job site safety plan.

Kathy R. Frazier, Occupational Safety and Health Manager

Facility Safety Officer

Office 561-422-6715/8237

Cell 561-248-2690

Phyllis Edwards, OSH Program Support

Office 561-422-6715

Juluri Anandarao, Medical Physicist, Radiation Safety

Officer

Office 561-422-6959

Cell 561-660-2334

Raphael Ciano, GEMS (Green Environmental Management

Systems) Program Manager

Office 561-422-7445

Cell 561-248-5174

Michael Lettera, Fire Safety Specialist

Office 561-422-6713

Cell 561-662-0479

The Occupational Safety and Health (OSH) office is located on the 4th floor, Room 4B272.

The Medical Center Director designates the Occupational

Safety and Health (OSH) Manager as the Facility Safety

Officer with the authority to intervene when construction conditions pose an immediate threat to health, life, equipment or facilities. Intervention may include an interruption of work until an imminent danger or other unsafe condition is resolved. In the absence of the OSH

Manager, the Chief, Facilities Management Service serves as the Acting Facility Safety Officer.

OSH’s mission is to promote and protect the safety and health of patients, visitors, staff and the environment through education, hazard surveillance, and regulatory compliance.

OFFICE OF OCCUPATIONAL SAFETY AND HEALTH

Regulatory authorities/applicable regulations include but are not limited to:

• Veteran Health Administration (VHA)

• Federal Acquisition Regulations (FAR)

• Veterans Affairs Acquisition Regulations (VARR)

• Occupational Safety and Health Administration (OSHA)

• National Institute of Occupational Safety and Health

(NIOSH)

• National Fire Protection Association (NFPA)

• US Environmental Protection Agency (US EPA)

• Florida Department of Environmental Protection (FDEP)

• Florida Department of Health (FDOH)

• The Joint Commission for Accreditation of Healthcare

Organizations (TJC), and

• State, county and local statutes.

It is the policy of this Medical Center that all work performed by VAMC staff or contractor personnel be performed in a safe manner and in accordance with all applicable laws and regulations. Contractors shall ensure that all personnel working for them or on their behalf have been briefed on the contents of this handbook.

Submission of Contractor’s Site Safety Plan

A copy of the Contractor’s Site Safety Plan, specific to the contracted work, must be submitted to OSH and will be kept on file for the duration of the project.

Department of Veterans Affairs (DVA) and

Veterans Health Administration (VHA) Construction Safety

The DVA and VHA, recognizing the need to ensure the safest possible environment of care for patients, staff, and visitors, published VHA Directive 2011-036, ‘Safety and

Health During Construction’ to establish policy for maintaining safety during construction activities as defined by OSHA. The scope of the Directive includes construction/renovation work performed at VHA owned or leased facilities regardless of whether the work is performed by Medical Center or contracted staff. A copy of the Directive is included in SECTION A. Questions should be addressed to the Contracting Officer.

OSHA Compliance

Compliance with OSHA 1926 Construction Standards is required.

Medical Center Construction Safety Policy

Medical Center Memorandum 548-138S-194, ‘Safety and Health

During Construction/Renovation’ included in SECTION B establishes policy and procedures for the Medical Center construction safety program. The Medical Center

Construction Safety Team inspects construction sites weekly as a minimum. Inspection criteria follow CFR 1926 OSHA

Construction regulations and National Fire Protection

Association codes and standards. The inspection team reports deficiencies to the Project Engineer/Contracting

Officer’s Representative (COR), the Contracting Officer

(CO) and the Medical Center Construction Safety Committee

(CSC). Deficiencies and the contractor’s corrective actions are uploaded to the Project Tracking Report on the VHA

Service Support Center by the Medical Center Project

Engineer/COR.

A key element of the Medical Center Construction Safety program is the Safety and Infection Prevention/Control Pre-construction Risk Assessment in SECTION C. The risk assessment is completed in a team meeting of Medical Center

Safety and Infection Control staff, the COR and the contractor. Completion of this document is required by VHA, the Medical Center, the Office of the Inspector General

(OIG) and The Joint Commission (TJC) for Accreditation of

Healthcare Facilities. The risk assessment evaluates the impact of the project on general safety, patient/visitor/staff safety, fire safety, interim life safety, the environment, hazardous materials and wastes, emergency operations and infection prevention and control.

Other Medical Center Requirements

Communication between contractors/subcontractors and the

Medical Center COR are critical to maintaining construction safety and successfully completing the project. Timely communication among key stakeholders is critical for:

• Lock-out/Tag-out (LO/TO). Facilities Management

Service’s policy is included in SECTION D.

• Complete or partial shut-downs of a utility system, including fire detection, alarm and/or sprinkler system. Shut down of any utility system requires collaboration and pre-planning between the Contractor and the Medical center. The Medical Center’s policy is included in SECTION E.

• Temporary closure or obstruction of any egress corridor or door must be coordinated with the COR and

OSH. The temporary obstruction or change in egress path must be evaluated for implementation of Interim

Life Safety Measures.

• Hot Work/Open Flame requires completion of a Hot Work permit in accordance with Facilities Management’s policy included in SECTION F.

• Work that involves above ceiling wall penetrations requires an above ceiling permit, included in in

SECTION G.

• Any other working conditions that impact the safety of the site, workers, staff, patients, members of the public.

Work on ‘live’ electrical system components is prohibited.

For unusual circumstances when work on energized electrical system components cannot be avoided, the contractor is required to inform the COR, and follow procedures for notifications to and approval of the Medical Center

Director and Chief, Facilities Management Service. The work must have the written approval of the Medical Center

Director to proceed. Approvals require a minimum of 24 hours’ notice. VHA Directive 1028, Electrical Power

Distribution Systems, is included in SECTION H.

Interstitial Spaces

If the scope of work includes the interstitial spaces, the contractor must ensure workers are oriented to the potential trip hazards, overhead hazards, narrow passages, and column markings. Workers must orient themselves to the space prior to beginning work. Interstitial doors are required to be secured at all times for contractor, staff and patient safety. Doors must not be propped open or have the positive latching defeated by paper or tape.

Lightning Protection Systems

The roofs, atrium roofs, and pre-cast walls of the parking garage are equipped with cables and rods for lighting protection. Workers should orient themselves to the location of the rods and cabling prior to beginning work in protected areas. No part of the system is to be compromised or disabled without the approval of the COR.

Fire Safety

The Medical Center complies with the National Fire

Protection Association (NFPA) codes. The building is built to ‘defend in place’ based on the assumption that patients are not capable of self-preservation and cannot be evacuated. The building is fully sprinklered and equipped with an addressable fire detection, alarm and extinguishment system. OSH conducts fire drills 24/7.

Drills are conducted without advance notice to staff. In a fire emergency or during a drill, contracted workers must follow the directions of Medical Center staff, the COR or

Riviera Beach Fire Rescue.

Disabling of fire detection, occupant notification systems, extinguishment systems, or building compartmentation systems (e.g. magnetic door holders) must be requested in writing 24 hours in advance through the COR to the OSH

Manager.

If a smoke detector must be temporarily capped to avoid a false alarm caused by dust, the contractor is required to designate one of his workers with primary responsibility to remove the cap when a false alarm is no longer a risk. The contractor should designate a worker as a back-up to the primary to ensure the cap is removed. All caps must be removed before the end of the shift. The Medical Center recommends attaching a long strip of tape to the cap as a visual reminder. Smoke detectors must not remain capped overnight.

Ceiling tiles are critical to proper functioning of smoke detectors and must remain in place if removal compromises activation of the smoke detector.

Hot Work/Open Flame

A Medical Center Hot Work permit must be completed prior to any hot work/open flame work. The permit is obtained from the COR and requires review and approval by the OSH Manager and Chief, Facilities Management Service. Hot work must be completed in accordance with all applicable safety regulations and standards. A fire extinguisher must be available and accessible on the site prior to the beginning of the work. A fire watch shall remain in place for a minimum of 30 minutes after completion of the work.

Construction Waste Management

Waste containers and dumpsters must be compliant with applicable requirements of NFPA 241. Dumpsters should be kept as far away from buildings as feasible. NFPA 1

(Uniform Fire Code 2015 Edition) specifies that dumpsters and containers with an individual capacity of 1.5 yd3 (40.5 ft3) or greater are not to be located within 10 horizontal feet of building openings, combustible walls, or combustible roof eave lines. Even this distance may not be sufficient, based on the capacity and contents of the dumpster. When a dumpster must be located close to a building, consideration must be given to exposure protection such as masonry walls, protection of openings with fire-rated doors and windows, and sprinkler protection.

Dumpsters shall not create an exposure for other combustible storage and items such as gas cylinders and fuel-operated fork lift trucks. Dumpsters must be secured against unauthorized access by fencing or other means.

Where feasible, contractors should consider using smaller capacity dumpsters and dumpsters equipped with a metal lid.

General Trash

Worker food and drink containers must be disposed in a designated container during the work shift and the trash removed daily at end of shift. Abandoned food and drink containers can attract pests and create unhealthy conditions for workers, Medical Center staff and patients.

No hazardous waste is allowed to be mixed with general trash. See Hazardous Materials paragraph below.

Smoking

Smoking is prohibited inside the Medical Center, inside interstitial spaces, and on the roof. Any violation of this policy is grounds for immediate Medical Center action.

Smoking is permitted in posted designated smoking areas.

Interim Life Safety Measures

Interim Life Safety Measures (ILSM) are actions taken to provide an equivalent level of fire safety when Life

Safety Code (NFPA 101) deficiencies are created by construction activities.

If the contracted work requires any component of the life safety systems to be disabled or modified, ILSM’s will be implemented to establish an equivalent level of life safety for workers, staff, patients and visitors.

Communication with the COR and OSH Manager is critical.

The components of the life safety systems include, but are not limited to: fire detection devices, fire notification visual and audible signaling devices, mass notification systems, fire extinguishment equipment, exit signs, fire and smoke walls, fire and smoke doors, exits, corridors, emergency accesses to the buildings, sprinkler connections, standpipes, portable fire extinguishers, fire dampers, magnetic door releases and manual pull alarms.

If the fire alarm, detection or extinguishment system is out of service for 4 or more hours, a fire watch will be required and must be coordinated with OSH.

Elements of an interim life safety assessment are listed in the risk assessment form in SECTION C. Communication with the COR and OSH is critical to maintaining the life safety integrity of the building and protecting patients, staff and visitors from potential life safety risks.

Hazardous Materials and Safety Data Sheets

Contractors are required to submit copies of Safety Data

Sheets (SDS) to OSH through the COR and CO for all hazardous materials and substances used on the job. All containers must be labeled in accordance with OSHA and EPA regulations.

If a hazardous substance spill occurs, the contractor must notify the COR, CO or Chief, Facilities Management so appropriate notification procedures can be initiated. VA

Police, OSH and Environmental Management Service will respond to secure the area and clean a spill of VA materials. The contractor will have primary responsibility to clean spills of contractor materials. All spills must be cleaned up in accordance with SDS recommendations and regulatory requirements.

Any spill of a hazardous material over 5 gallons must be reported to the COR, OSH office and Florida Department of

Environmental Protection.

Green Environmental Management Systems

(GEMS)

The Medical Center, as a federal facility, is required by

Presidential Executive Order 13148, to be environmentally responsible and to reduce and recycle wastes. Contractors are expected to management waste in an environmentally responsible manner and waste management requirements are included in construction contract specifications.

Construction waste bins must be kept neat and clean.

Containers should be constructed so as to allow rainwater to drain out, preventing standing water and possible pest infestation.

Management and disposal of any hazardous waste generated by the contractor is the contractor’s responsibility.

The volume and or weight of recycled materials must be reported to the GEMS Program Manager in OSH through the

COR.

Emergency Management

The Medical Center uses colors to designate emergency codes. Medical Center staff is trained to activate emergency response procedures. Most “Codes” are announced over the public address system located in the corridors and assembly areas. “Code” announcements begin with 5 beep tones followed by an announcement of the Code and its location. ONLY designated Medical Center staff should respond to the location of the Code. The Codes are:

Code Green Disruptive Behavior

Code Black Activation of the emergency operations plan

Code Orange Bomb Threat (To avoid undue panic, Code

Orange is communicated face to face rather than on the public address system. Follow instructions from staff, VA Police, or

Riviera Beach Fire Rescue.)

Code Blue Medical Emergency

Code White Critical Incident (blandishment of weapon, active shooter, taking of hostage)

Code Purple Computer Downtime

Code Gray Medical Gas (Oxygen) Failure

Code Red Fire

Code Green – A Code Green is called by Medical Center staff when the behavior of a patient, visitor, or staff member escalates to the point the person is perceived to be a threat to self or others. Code Green Team members respond.

Do not go to the location announced in the Code Green call.

Keep your personal safety your top priority. A Code Green

ALL CLEAR is announced when the situation is resolved.

Code Black – Activation of the Medical Center Emergency

Operations Plan. Activation of emergency operations could be for a variety of reasons. Medical Center staff and/or the COR provides information and directions to the

Contractor.

Code Orange – Bomb Threat. To avoid panic and undue confusion, this Code IS NOT announced over the public address system but is communicated face to face. The COR, CO or VA Police may verbally communicate a Code Orange to contractors. You may be asked to participate in a bomb search of your work site. You will be most familiar with the work site and able to identify any questionable containers. You must follow all instructions of the COR, VA

Police, Riviera Beach or Palm Beach County Fire Rescue, or

Palm Beach County law enforcement.

Code Blue – Medical Emergency. A Code Blue is called for a cardiac or respiratory arrest. The location is announced.

Code Blue Team members will respond. Please stay away from the area so that emergency equipment and patient transport are not hindered.

Code White – Critical Incident. During a critical incident, if lives are threatened, plain language avoids miscommunication. In the event someone has taken a hostage, fired a weapon or is brandishing a weapon, dial 5555 and describe what you are seeing. VA Police will respond. If you are in the building, follow the instructions of VA staff. Workers outside the building must follow instructions from VA staff, VA Police, Riviera Beach and

Palm Beach County Police/Fire Rescue.

Code Purple – A Code Purple announces a computer service disruption. Routine computer operations are suspended until system problems are identified and resolved. Contingency plans are in place for the duration of the Code Purple.

Code Gray – A Code Gray is an interruption in the medical gas system, specifically the oxygen distribution system.

Contingency plans are in place to distribute back-up oxygen cylinders to patients until normal service is restored.

Code Red – A Code Red is a fire event.

In the event you find the fire, follow RACE as outlined below:

R – Rescue people in immediate danger. If inside the hospital or Community Living Center, the primary evacuation path is horizontal, on the same floor, away from the fire.

If you become endangered at the farthest location away from the fire, evacuate to the floor below. If in the Community

Living Center (CLC), exit to the opposite end of the CLC.

The evacuation path for outlying buildings is to the outside.

A – Alarm. Reporting the fire requires two actions. #1 -

Pull the nearest manual alarm. #2 - Dial *0 on any Medical

Center phone (not cell phones) and report a “Code Red”.

Tell the Operator the location and do not hang up until the

Operator repeats the location correctly. Room numbers in the Medical Center are alpha-numeric, i.e., 4B-292 can be reported as 4 ‘B as in Bravo’, 292. Locations outside the

Medical Center must be clearly identified by adjacent landmarks, parking lot numbers, street names, etc.

C – Close doors. Confine the fire. Clear the hallways.

E – Evacuate. Move away from the fire and take others with you.

If you are inside the Medical Center during a Code Red, follow the instructions of near-by staff. Upon arrival, Riviera Beach Fire Rescue is the authority having jurisdiction. Follow the instructions of VA staff, VA

Police and Riviera Beach Fire Rescue.

In your work area, learn the locations of pull stations, fire extinguishers and exits. Pull stations are located at each exit, stairwell, and within 200 feet of travel throughout the building. 10-pound dry chemical fire extinguishers are located throughout the building, including elevator penthouses. Extinguisher locations are marked by red signs with a white extinguisher logo.

For all emergency codes announced over the public address system, contractor staff must stand clear of the hallways to allow emergency personnel and equipment to move quickly into the area. Follow instructions from VA staff, VA

Police, or Riviera Beach and/or Palm Beach County Police and Fire Rescue.

OSH conducts unannounced fire drills on all shifts. Drills are conducted monthly so all staff receive training and have an opportunity to practice Code Red response procedures. In addition, OSH conducts internal emergency exercises and participates in community emergency exercises to test disaster response and recovery. The dates of emergency drills will be communicated to contractor staff and drills will be planned to have no or minimal impact on construction work and contractor staff.

Hurricane season warrants special consideration since mitigation of impacts and preparedness will present several challenges for contractors and construction work in progress. Advance planning for securing work sites and materials is critical. The Medical Center, focused on patient and facility safety, will begin readiness preparations as much as 10 days in advance of anticipated landfall. Your cooperation is critical. For out of town workers, county shelter information is available through local media, local Red Cross, Co, COR, and other Medical

Center staff.

Security

Security is a cooperative effort. VAMC Police enforce VA, federal, state and local regulations to protect patients, staff, volunteers, visitors, and contract workers. VAMC

Police also protect private and government property and preserve a peaceful and secure environment at the Medical

Center 24/7.

Contractor staff must wear an ID badge at all times. The badge must be visibly displayed on a shirt or jacket and never worn below the waist.

All contract workers are required to obey traffic, parking and security regulations. Everyone must secure personal possessions and cooperate with VA Police.

Contract workers noting a suspicious person or any suspicious or criminal act should notify Police at ext.

7312 and report the person or incident to their supervisor.

Traffic and Parking Regulations

• Park in designated areas.

• Do not block emergency fire rescue access to the building. Do not block access to fire hydrants and sprinkler connections.

• Observe all posted speed limits, “No Parking” signs, reserved handicapped parking spaces, STOP signs, directional arrows, barricades, and patient drop-off points.

• Shuttle buses transport patients from outlying parking lots to drop off points on the top deck, west end of the building. The Palm Tran bus stop is adjacent to the front circular drive off of Military Trail. Delivery trucks are continuously arriving and departing during the day. During

‘high-season’, staff and visitor parking is congested and pedestrian traffic is at its peak. Please stay alert and stay safe.

• Most pedestrians are patients. Many have mobility challenges and/or hearing deficits. Don’t assume – watch out FOR them.

Patient Safety “Do What’s Right - What’s Safe - For The Patient”

We must emphasize this facility is more than a construction site, it’s a hospital. While providing care to the patient, we are also responsible for the patient’s safety and the safety of the environment of care. Unsafe or unplanned construction activities could negatively impact patients, patient care delivery systems, life support utilities, and patient treatment or diagnostic equipment. Good communication is basic to safety. Anytime that construction work could impact electrical systems, emergency access to areas and or critical life support systems, the integrity of the fire alarm system, or create loud noise, dust or vibration, contractors must coordinate the work with the

COR so that potential or real impacts on patients and patient support systems can be evaluated and minimized, eliminated or accomplished during non-routine time frames.

Patient safety, good communication, and team work are critical to successful completion of the project.

Rules for Patient Care Areas…

• Patient records and other information concerning patients are CONFIDENTIAL. Do not discuss a patient’s illness or personal information with anyone, including the patient.

• Speak softly while in patient care areas, in the hospital corridors and other areas where people are working or patients are resting. Radios and cell phones must be

TURNED OFF and NOT USED inside designated areas. Signs are posted and must be observed.

• If patients ask for help or advice please refer them to a VA employee for assistance.

• Do not make suggestions to patients about treatments or suggest remedies, never give or purchase any food or drinks for a patient. Do not give or purchase cigarettes, matches, lighters or other smoking materials to a patient.

• Do not enter any patient room. If the work requires you to enter a patient room, the nurse in charge will advise you regarding personal protective equipment and other precautions to protect you and the patient.

• Do not enter the operating or recovery rooms, medical or surgical intensive care units unless the COR or other staff engineer accompanies you. If there is a need to enter another patient care area, please so do only with the permission of the COR or designee.

• Do not move or touch a patient, nor raise the head of a bed of a patient. Inform nursing staff of all patient requests.

• If you need to relocate medical equipment, consult with the COTR who can contact the appropriate Biomedical

Engineering staff.

For any questions, please contact the Occupational Safety and Health office at ext. 6715 or Kathy Frazier, the

Construction Safety Officer and Safety Manager at ext. 8237 or cell 561-248-2690.

SECTIONS:

A - VHA DIRECTIVE 2011-036, Safety and Health During

Construction, dated September 22, 2011

B - MCM 548-138S-194, Safety and Health During

Construction/Renovation

C - Construction Safety, Infection Prevention and Control

Risk Assessment

D - Facilities Management Service Policy 7.8 SOP Including

Lockout Tagout Procedures, dated May 16, 2013

E – Facilities Management Service Policy 1.11 Planned

Interruption of Utility Systems Service, dated January 4, F – Engineering Service Policy 1.10 Open Flame Control, dated January 4, 2013

G – Above Ceiling Permit

H - VHA DIRECTIVE 1028, Electrical Power Distribution

Systems, dated July 25, 2014

***Engineering Service Policy on Permit Required

Confined Space is under review and will be included upon revision

Date of last revision February, 2017.