D.2 Surveillance Checklist.docx

This is a Surveillance Checklist document for monitoring contractor performance under a Ground Ambulance service contract at the Louis A. Johnson VA Medical Center (Hershel "Woody" Williams VAMC) located in Huntington, West Virginia. The checklist establishes quality assurance procedures and performance objectives that the contractor must meet during the contract period.

The surveillance checklist outlines six key performance standards with corresponding thresholds and monitoring methods. These standards require the contractor to: (1) provide ambulance service in accordance with contract terms with 95% compliance monitored through surveillance of each patient pick-up; (2) maintain all vehicles in clean and orderly condition free from hazards at 95% compliance with 100% surveillance; (3) maintain preventive maintenance and repair procedures documented in individual vehicle files with 95% compliance verified through quality assurance procedures; (4) furnish qualified personnel to accomplish all services under the contract with 100% compliance monitored through 100% surveillance; and (6) ensure a licensed Emergency Medical Vehicle Operator (EMVO) provides written sanitation procedures conforming to OSHA blood-borne pathogens protocol standards with 100% compliance and 100% surveillance. All performance objectives are subject to continuous government oversight and verification throughout the contract period to ensure contractor compliance and protection of veteran safety.