Exhibit B Agency Specific Requirements 5 22.pdf

ASR – EXHIBIT B LESSOR:_______ GOVERNMENT: ___________ Page # of #

RLP #

Coldwater Clinic Lease Request Proposal

Department of Veterans Affairs Battle Creek VA Healthcare System

Agency Specific Requirements

The Agency Specific Requirements (ASRs) do not reduce the minimum requirements contained within the Lease. These ASRs provides specific agency requirements, which may be complementary, more specific, or more stringent than those of the Lease minimum requirements.

Battle Creek VA Healthcare System

SECTION 1 SCOPE OF WORK

1.01 INTRODUCTION

1.02 STATEMENT OF WORK (SOW)

1.03 SPACE DETAILS

1.04 PROCUREMENT/INSTALLATION REQUIREMENTS……………………………………………………………8

SECTION 2 SCHEMATIC FLOOR PLAN-DRAWING

SECTION 3 ROOM LISTING……

SECTION 4 JANITORIAL SERVICES AND SITE MANAGEMENT

SECTION 5 LEASE DESIGN NARRATIVE

SECTION 6 OPERATIONS AND MAINTENANCE O&M PLAN

SECTION 7 SAFETY FRIRE PROTECTION EM APPENDIX

SECTION 8 LESSOR PERFORMANCE TRACKING CRITERIA

SECTION 9 PROGRAM FOR DESIGN

SECTION 10 OFFICE OF INFORMATION TECHNOLOGY TELECOMMUNICATIONS LAYOUT………72

FINAL APPROVAL:

VA MEDICAL CENTER – APPROVING AUTHORITY SIGNATURE DATE

LESSOR SIGNATURE DATE

SECTION 1 SCOPE OF WORK

1.01 INTRODUCTION

The Department of Veterans Affairs is seeking 10,000 (NUSF) Net Usable Square Feet not to exceed 13,500 (RSF) Rentable Square Footage of contiguous of clinical space for a CBOC in the city of Cold Water, Michigan.

The lease shall be full serviced and follow the standard specifications and requirements for a New/Replacing Lease as per the GSA Global Lease or Simplified Lease.

Hours of the VA Operation Lessor shall provide electronic key access to VA employees into the building at locations at VA’s discretion for the hours including but not limited to those below. VA access to the property will be 7:00 a.m. until 5:00 p.m., Monday through Friday. Additional VA access outside of these hours maybe requested on a non-recurring basis as requirements arise.

1.02 STATEMENT OF WORK (SOW)

Contractor shall completely prepare site for building operations, including demolition and removal of any existing structures, and furnish labor and materials and perform work for construction of a Community Based Outreach Clinic (CBOC) in Cold Water, Michigan.

Work includes design, general construction, alterations, mechanical, plumbing, and electrical work, low voltage work, civil, utility systems, removal of existing structures and construction.

Contractor shall follow all applicable building codes.

The period of performance for the work is 360 calendar days.

1.03 SPACE DETAILS

Entry Vestibule

• Forty-two inches (42”) minimum entrance door with air lock and automatic push button door opener.

• Sensors shall be motioned detector type with self-contained units mounted on the headers. If sliding doors are utilized and accepted as required exits, the doors shall be designed to open manually in the event of a power failure.

• Walk-off entry mats shall be provided and maintained by lessor.

• Hand sanitizer dispenser, wall mounted.

Reception

• Thirty-two inches (42”) minimum clearance entrance door, entry lock set.

• Space and utilities for two (2) staff workstations with opening and countertop for wheelchair access.

• Panic button to be mounted to VA-provided furniture in locations determined by the VA. Main panic alarm station console to be in reception.

• Main nurse call station console.

• Space and utilities for one (1) multi-function printer.

• Clock.

• Coat hooks.

• Full size step-on opener trashcan.

• Hand sanitizer dispenser, wall mounted.

Wheelchair Alcove

• Space for three (3) VA provided wheelchairs.

• Location should be near entry vestibule and/or reception.

Waiting Room

• All doors to waiting room to have forty-two inches (42”) minimum door. Doors from waiting area to clinical care spaces to have card reader access and automatic push button door opener.

• Television.

• Full size step-on opener trashcan.

• Hand sanitizer dispenser, wall mounted.

Drinking Fountain Alcove

• Alcove sized to minimum one (1) drinking fountain with water bottle fill dispenser.

Lab with blood specimen collection

• Entry doors to be forty-two inches (42”) minimum with privacy lock set.

• A minimum of ten (10’0”) lineal feet of both upper and lower casework with under mounted stainless-steel sink.

• Handheld eye wash station with temperature control mixing valve at sink.

• Ceiling mounted cubical curtain track sized to fit around blood specimen chair.

• Clock.

• Coat hooks.

• Trashcan, twelve (12) gallons, hands free.

• Biohazard collection bin, six (6) gallons, hands free, red.

• Sharps container, lockable, three (3) gallons, wall mounted.

• Glove box holder, wall mounted.

• Hand sanitizer dispenser, wall mounted.

• Lab Toilet with Keyed Water Shutoff

• Lab to be provided independent HVAC temperature controls to adjust temperature within due to increased electrical heat producing equipment present.

Alcove, Height/Weight Accessible Station

• Scale.

• Stadiometer, wall mounted.

• Coat hook.

• Hand sanitizer dispenser, wall mounted.

Alcove, Equipment

• Hand sanitizer dispenser, wall mounted.

Alcove, Supply

• Lockable cabinets.

• Hand sanitizer dispenser, wall mounted.

Alcove, Medication

• Lockable cabinets.

• Hand sanitizer dispenser, wall mounted.

Alcove, Team Copy/Supply

• Lockable cabinets.

• Hand sanitizer dispenser, wall mounted.

Alcove, Staff Personal Property Locker

• Lockable lockers.

• Clock.

• Coat hooks.

• Trashcan, twelve (12) gallons, hands free.

Refreshment Station

• Lockable cabinets.

• Space available in reception area to support refreshment station.

Exam Room

• Entry doors to be forty-two inches (42”) minimum with privacy lock set.

• Room pressure: Neutral.

• Panic button mounted to VA-provided furniture.

• Sink, wall mounted.

• Paper towel dispenser.

• Soap dispenser.

• Hand sanitizer dispenser.

• Clock.

• Coat hooks.

• Trashcan, twelve (12) gallons, hands free.

• Biohazard collection bin, six (6) gallons, hands free, red.

• Sharps container, lockable, three (3) gallons, wall mounted.

• Glove box holder, wall mounted.

• Ceiling mounted track for cubicle curtain, sized to fit around exam bed.

• Diagnostic set, wall mounted.

• Privacy Curtain, Architex DRx6001 Consult Room

• Entry doors to be forty-two inches (42”) minimum with privacy lock set.

• Room pressure: Neutral.

• Panic Button mounted to VA-provided furniture.

• Hand sanitizer dispenser.

• Clock.

• Coat hooks.

• Trashcan, twelve (12) gallons, hands free.

Conference Room/Group Therapy

• Entry doors to be forty-two inches (42”) minimum with privacy lock set.

• Television, wall mounted.

• Eight (8) coat hooks, wall mounted.

• Clock.

• Trashcan, twelve (12) gallons, hands free.

• Hand sanitizer dispenser.

Storage Room

• Entry door to be thirty-six inches (36”) minimum clearance, storage room lock set.

• Room pressure: Positive.

• Space cannot have a water source or window.

Staff Lounge

• Entry door to be thirty-two inches (32”) minimum clearance, entry lock set.

• A minimum of six (6’-0”) lineal feet of both upper and lower casework with under mounted stainless-steel sink and countertop surface to accommodate a microwave and coffee pot.

• Panic button to be mounted on wall.

• Ten (10) coat hooks.

• Clock.

• Hand sanitizer dispenser.

Open Administrative Space

• Entry door to be forty-two inches (42”) minimum, entry lock set.

• Space and utilities for eight (8) staff workstations.

• Sink, wall mounted.

• Panic button per staff workstation to be mounted to VA provided furniture.

• Ten (10) coat hooks.

• Clock.

• Hand sanitizer dispenser.

• Trashcan, twelve (12) gallons, hands free.

IT Room

• The size of this room shall be a minimum of ten feet (10’) x thirteen feet (13’).

• No windows are allowed.

• No floor drains are allowed.

• Four feet (4’) x eight feet (8’) sheets of three-quarter inch (¾”) fire retardant plywood mounted on the wall and painted.

• Four (4) 208VAC/60 HZ/30 AMPS, single phase electrical outlets on dedicated circuits.

• Four (4) 120VAC/60 HZ/20 AMPS, single phase electrical outlets on dedicated circuits.

• Data rack, Hubbell model HPW96RR19 or equal, eight (8’) feet high. Minimum one (1) required.

• Include data punch down panels per the data requirements listed throughout the functional room listing to accommodate approximately forty-eight (48) data outlets with two (2) jacks each and an additional forty-eight (48) spares.

• Follow all security requirements in VA Handbook 0730 Security and Law Enforcement, Appendix B Physical Security Requirements and Options.

• Exterior walls of brick and masonry construction are acceptable. Exterior walls which are composed of wood frame and siding require an interior backing of steel security screen mesh or sheet partition.

• Doors must be fitted with a mortise lock with a deadlock feature with interior hinges and swing outward from the IT room.

• No glass doors or doors with glass panes.

• All perimeter room walls, including drywall, must extend from floor slab to structure above to ensure physical security, in which case no ceiling is required. Interstitial overhead areas which enable entry into a secure room from an unsecured room must be barricaded by the installation of a suitable partition in the interstitial space with prevents “up and over” access. Ventilation grills on doors and air circulation ducts which exceed 0.06 m2 (100 square inches) in areas must be reinforced to prevent their removal from outside of the room. Other possible access means such as dumbwaiter shafts, roof or wall ventilator housing, trapdoors, etc., must be secured by appropriate means.

• A motion intrusion detection alarm system shall be installed which detects entry into the room.

Equipment which operates on the principle of narrow beam interception, door contacts, microwave, or photoelectric eye are unacceptable. Intrusion detectors must have the following essential features:

o An internal, automatic charging direct current (DC) standby power supply and a primary alternating current (AC) power operation.

o A remote, key operated activation/deactivation switch installed outside the room and adjacent to the room entrance door frame.

o An automatic reset capability following an intrusion detection.

o A local alarm level of eighty decibels (80 dB) minimum to ninety decibels (90 dB) maximum within the configuration of the protected area.

• Dedicated heating, ventilation, and air conditioning (HVAC) unit for IT closet that maintains temperature and humidity levels within the facility where information system resides at acceptable levels (per information system manufacturer requirements) and consistently monitors temperature and humidity. Designed to accommodate the telecommunications system: it shall provide a sixty-five (65) to seventy-five (75) degree temperature range and a forty (40) to sixty

(60) relative humidity range twenty-four (24) hours a day, seven (7) days a week, in order to minimize damage to government-owned-equipment (GOE) delicate electronic circuits for computerized systems only. Install a dedicated split air conditioning unit with thermostat located in the room. Condensate must be pumped from the room to a drain in another area and not have a floor drain in this room.

• Emergency power off (EPO) for all power to IT closets which are on a separate panel than main circuit board. Switch shall be clearly labeled, easily accessible and protected from unauthorized activation.

• Automatic emergency lighting on separate circuit for information systems that activates in the event of a power outage or disruption and that covers emergency exits and evacuation routes within the facility.

• Provide master shutoff valve(s) for water source(s) within proximity to information systems that are accessible to VA staff. Shutoff valves should be located outside of the IT closet.

• Fire suppression and detection devices/systems for the information system that are supported by an independent energy source, activate automatically, and notify the organization and emergency responders in the event of a fire, provide automatic notification of any activation to the organization and emergency responders, and provides automatic fire suppression capability for the information system when the facility is not staffed on a continuous basis. (Can include but not limited to sprinkler systems, handheld fire extinguishers, fixed fire hoses, and smoke detectors)

• The room shall not be located directly below laboratories, kitchens, laundries, toilets, showers, or other areas where water service is provided.

• The door requires multifactor security (deadbolt and another form of electronic security), to permit two (2) form identification and data collection twenty-four (24) hour per day seven (7) days per week, of entrance, exit, and duration within room (Example forms of identification are badge, key card, electronic cipher pin, and biometrics).

• Doors and frames shall be two (2) hour fire resistive construction. Provided intrusion detection will provide door and lock status sensors and motion detectors.

1.04 PROCUREMENT/INSTALLATION REQUIREMENTS

• These requirements are not inclusive to all items required by the Lessor for a full and acceptable product.

Item Procurement

Installation

Signage - interior Lessor Lessor Signage - exterior Lessor Lessor Flagpole - exterior Lessor Lessor Casework/Millwork Lessor Lessor Nurse Call Lessor Lessor Panic Buttons Lessor Lessor Soap dispenser - wall mounted Lessor Lessor Baby Changing Station Lessor Lessor

Paper Towel Holder Lessor Lessor Trashcan - twelve (12) gallons, hands free Lessor Lessor Trashcan - four (4) gallons, hands free Lessor Lessor Biohazard Bin - six (6) gallons, hands free, red GOV GOV Clock Lessor Lessor Coat Hook Lessor Lessor Sharps disposal container, lockable, wall mounted Lessor Lessor Stadiometer, wall mounted Lessor Lessor hand sanitizer dispenser, wall mounted Lessor Lessor Toilet paper dispenser Lessor Lessor Glove box holder, wall mounted Lessor Lessor Feminine product dispenser, wall mounted GOV Lessor Feminine hygiene receptacle, wall mounted Lessor Lessor Privacy Curtain track, ceiling mounted Lessor Lessor Privacy Curtain Lessor Lessor Furniture GOV GOV Walk off entry mat Lessor Lessor Scale, wall mounted GOV Lessor Television with mount, wall mounted GOV Lessor Eye Wash Station, handheld with mixer valve Lessor Lessor Diagnostic set, wall mounted GOV Lessor Data Rack and associated OIT Room Requirements Lessor Lessor InPro Handrail in corridors InPro Cornerguards in corridors Roller shades - every window Lessor Lessor Marker/Tack board GOV Lessor Grab bars Lessor Lessor Chart holder Lessor Lessor Artwork GOV GOV 10 PACS (badge readers tied to Battler Creek VAMC main system)

Lessor Lessor

12 Interior Security Cameras (Tied to Battle Creek VAMC main system)

Lessor Lessor

10 Exterior Security Cameras (Tied to Battle Creek VAMC main system)

Lessor Lessor

Emergency Generator (Capability to power entire clinic) Lessor Lessor Owner Provided Guest Wireless Internet Lessor Lessor Patient Lift (Womens Health and Procedure Room) Lessor Lessor

SECTION 2 SCHEMATIC FLOOR PLAN

2.01 DESIGN SCHEMATIC

The schematic below is representative of the layout required for this space. The Lessor is responsible for using the room schedule in section 1.01 and this layout to adapt the Government’s requirements to the space. Specific questions regarding the layout should be directed to the Lease Contracting Officer for resolution. The Government shall not be responsible for errors, omissions, or assumptions made by the Lessor in the adaption of the Government’s requirements to the Lessor’s space.

SECTION 3 ROOM LISTING

COLDWATER VA CLINIC ROOM LISTING

Space Description: ROOMS Sq. Ftg.

(ea)* Cum. Area Vestibule / Indoor Buffer 1 120 120 Public Heath Kiosk 1 20 20 Lactation Room 2 80 160 Interview Patient Care Room 1 140 140 Information / Welcome Area Alcove 1 20 20 Veteran and Guest Seating 1 260 260 Family Seating 1 60 60 General Storage 1 30 30 Bariatric Patient Toilet 1 75 75 Universal Single Occupant Toilet 3 75 225 Housekeeping Aides Closet (HAC) 2 60 120 PACT Teamwork Shared Office 1 100 100 Veteran Video Connect Station 1 80 80 Refreshment Station 1 80 80 Vending Area 1 30 30 Shared Group Room 1 240 240 Shared Group Storage Room 1 60 60 General Exam Room 6 120 720 PACT Storage 1 56 56 Blood Draw Station 1 80 80 Bariatric Blood Draw Station 1 100 100 Laboratory Specimen Processing 1 125 125 Laboratory Clean Supply Room 1 60 60 Specimen Collection Toilet 1 65 65 Tele-Retinal Imaging Exam Room 1 140 140 Women Veteran Exam Room 1 140 140 Women Veteran Exam Room Toilet 1 75 75 Multi-Use Bariatric Exam Room 1 210 210 Podiatry Exam Room 1 140 140 Counseling Patient Care Consult 1 125 125

Patient Height and Weight Alcove 1 60 60 Telehealth Exam Room 1 150 150 Equipment Alcove 1 50 50 Supply Alcove 1 50 50 Hoteling Workstation 1 96 96 Clinical Staff Workstation 1 224 224 Copy/Supply Alcove 1 50 50 CBOC Huddle Space 1 180 180 Medication Alcove 1 50 50 Full Gas Cylinder Storage 1 40 40 Empty Gas Cylinder Storage 1 40 40 Medical Equipment Storage Room 1 80 80 Clinical Supplies Storage Room 1 60 60 Telecommunications Room (OIT) 1 100 100 Staff Workroom/ Storage Room 1 140 140 Staff Conference Room 1 240 240 Share Leadership Office 1 140 140 ID/Photo Alcove 1 56 56 HAS Storage 1 85 85 Staff Locker Alcove 1 40 40 Clinical Neighborhood Staff Room 1 125 125 Staff Wellness/Fitness Room 1 160 160 PACT Pharmacist Office 1 120 120 Admin/Flex Office 1 100 100 Logistics Entrance/Drop-Off 1 0 0 Covered Drop-Off/Pickup 1 0 0 Veteran Outdoor Seating Area 1 0 0 Staff Outdoor Eating Area 1 0 0 Subtotal 67 6292 *Allowance for Corridors, Common areas. (50%) 3146 Total 9438 *Space requirements and Sq. Ftg. Estimates, according to VACO Clinical Standards.

SECTION 4 JANITORIAL SERVICES AND SITE MANAGEMENT

1.1 GENERAL JANITORIAL SERVICES

The lessor shall furnish all supplies, materials, machinery, appliances, supervision, and labor necessary to provide complete janitorial services for the entire leased clinic space. Services shall be provided in all interior and exterior areas of the leased premises to provide a clean, neat, and attractive appearance by performing the functions described below. The Lessor shall make careful selection of cleaning products and equipment to ensure they are packaged ecologically, environmentally beneficial and/or recycled products that are phosphate-free, non-corrosive, non-flammable, and fully biodegradable, and minimize the use of harsh chemicals and the release of irritating fumes.

The Lessor shall select paper and paper products with recycled content conforming to EPA’s CPG. Performance will be based on the Contracting Officer’s evaluation of results, not the frequency or method performance.

1.2 MATERIALS AND PROCEDURES

A. Standards

It is the Lessor’s responsibility to maintain the clinic in a condition that meets all housekeeping and sanitization requirements of this solicitation and the current standards of the Joint Commission (JC).

B. Work Schedule

Work will be accomplished at times indicated. Work schedule shall be from 7:00 AM to 8:00 PM, (or as requested by the LCO), Monday through Friday and 8:00 AM to 12:00 PM, Saturday. The Lessor shall ensure that sufficient employees are available to prepare the clinic to see patients at 7:00 AM, to be available to promptly clean up spills, keep the public and specimen collection toilet rooms clean, and keep the toilet rooms stocked with sufficient paper products and soap.

Mechanical equipment such as vacuum cleaners, burnishers, scrubbing machines, etc., shall not be used during patient appointments.

C. Janitorial Staff and Supervision

Janitorial staff will have access throughout the building; therefore, none of the janitorial staff may have a police record for anything more serious that traffic or parking violations. There shall be a janitorial staff supervisor, present on site on duty always when janitorial staff is in the building.

Any person whose work or conduct is found to be unacceptable by the Government shall be removed from the janitorial staff. Smoking, if permitted, is only permitted in designated areas only. Possession of weapons is prohibited. Enclosed containers, including tool kits, shall be subject to search. Janitorial company’s standard uniforms are acceptable, if they clearly identify the company and the occupation of the individual. Janitorial staff will be required to wear photo identification badges.

D. Safety and Special Procedures

The Lessor shall consider the clinical environment and ensure that the janitorial staff is instructed on applicable safety precautions and special requirements. These requirements may include, but are not limited to, such conditions as cleaning of human secretions, blood etc. from both floors and walls. Lessor will be notified of areas that need terminal cleaning. Terminal cleaning is defined as complete wipe down of all sinks, walls, countertops, casework, exam tables, etc., with germicide, and mopping of the floor with germicide. If the space has a privacy curtain, it will require to be replaced. These areas require the use of gloves, gowns, masks, and shoe covers.

The Lessor shall be responsible to ensure staff are competent on common hazards requiring a terminal clean in a healthcare setting. Lessor is responsible to provide competency to VA COR and demonstrated staff knowledge. The Lessor shall be responsible for collecting of sharps containers and hazardous materials. See “ALL AREAS” below under “Daily Cleaning Requirements” for method of handling sharps and hazardous waste. The janitorial staff shall comply with applicable Federal, State, and Local safety and fire regulations and codes. The Lessor shall immediately bring to the attention of the Government any fire and/or safety deficiencies. The Lessor shall take reasonable precautions to promote a safe environment within the lease premises.

E. Equipment and Materials

All equipment and materials used in the performance of this contract will be cleaned and stored properly at the end of the workday. Cleaning carts and/or equipment will not be left unattended for any reason while patients are in the clinics. No food or drink shall be stored on cleaning carts or in housekeeping closets. Lessor shall ensure all equipment, tools, and supplies meet necessary safety requirements and janitorial staff has full working knowledge of their use. An EPA registered germicide will be used to clean all patient areas, floors, examination tables, and medical equipment. The Lessor shall provide all labor, materials, supplies, machinery, and appliances that may be necessary or appropriate in the performance of janitorial services.

The Lessor shall provide supplies such as toilet tissue, multifold paper towels, toilet seat covers, and Medicated Vestal (or approved equivalent) hand soap. The Lessor shall provide plastic linings for all trash receptacles. Provide clear plastic lining for non-hazardous waste trash receptacles and red plastic linings for hazardous waste trash receptacles. Housekeeping aide closets are located throughout the clinic for storage of supplies and equipment. The Lessor shall keep a minimum of two weeks’ stock of supplies on hand. All accumulated waste shall be removed and disposed of in the dumpsters. Hazardous waste and sharps containers shall be picked up, appropriately packaged for removal from the site and stored in a designated negative pressure storage area. Supplies to be used shall be approved by the Government. Basis of design for specifications of supplies are as follows:

1. Toilet tissue: Roll type, 4-1/2 inches wide, single ply

2. Paper towels: Multi-fold, 10-1/8 inches wide

3. Hand soap: Medicated Vestal

4. Trash receptacle liners:

i. Polyethylene, flat type, 33 inches long, 52 inches wide, 0.66 millimeters thick

ii. Polyethylene, flat type, 24 inches long, 33 inches wide, 0.31 millimeters thick

iii. Polyethylene, red bags (bio hazard) 33 inches long, 52 inches wide and 24 inches long, 33 inches wide

5. Furniture polish: Spray type for use on wood and wood veneer

6. Window cleaner: Ammonia type sufficient to remove smoke film and dust

7. Air freshener cartridges in bathrooms: Johnson Wax Good Sense

8. Upholstery cleaners: Dry or foam type recommended for fabric upholstery

9. Germicide: EPA-registered

10. Resilient floor tile cleaner and maintainer: As recommended by manufacturer of resilient flooring

11. Floor finish: High-speed floor finish as recommended by manufacturer of resilient flooring

12. Floor sealer: As recommended by manufacturer of resilient flooring

13. Floor stripper: As recommended by manufacturer of resilient flooring

14. Toilet seat covers: Paper, white

A copy of the MDS sheets for all products used shall be maintained at the clinic and shall be available for review by VA upon request. MDS sheets shall be maintained in each housekeeping closet and shall be reviewed semiannually by the lessor for accuracy. When new products are introduced, the MDS sheets shall be updated.

F. Selection of Cleaning Products

The Lessor shall make careful selection of janitorial cleaning products and equipment to:

1. Use products that are packaged ecologically; Use products and equipment considered environmentally beneficial and/or recycled products that are phosphate free, non-corrosive, non-flammable, and fully biodegradable; and

2. Minimize the use of harsh chemicals and the release of irritating fumes.

NOTE: Examples of acceptable products may be found at www.gsa.gov/products

G. Selection of Paper Products

The Lessor shall select paper and paper products (e.g. restroom tissue and paper towels) with recycled content conforming to EPA’s CPG.

H. Waste and Recycling

The Lessor shall have no responsibility for disposing of hazardous or pathological waste. The Lessor shall provide collection, disposal, and recycling for all other waste materials generated by the VA. Recycling of paper, plastic, aluminum, toner cartridges and cardboard is required.

Locate waste and recycling containers near the loading dock/service area in accordance with security requirements. The Lessor shall provide and maintain adequate quantity of trash container(s), including compacting equipment as required, based on volume of waste and frequency of collection. Lessor to provide the necessary covered containers with daily or weekly collection and removal from site for refuse, trash, and garbage. The Lessor shall provide the covered recycling containers and shall collet and remove recycled materials weekly.

1.3 TASKS AND ASSOCIATED FREQUENCIES

A. As Required/Requested Requirements

a. Terminal Cleaning

i. Any room where patients with suspected infectious disease have been examined will be thoroughly cleaned with germicide (terminal cleaning). Two step method (clean twice) for all such cleaning.

b. Walk Off Mats

i. Lessor shall provide walk off mats at all patient/visitor/employee entrances.

ii. Walk off mats shall be professionally cleaned a minimum of twice yearly.

iii. Wall off mats shall have the characteristics for heavy traffic in a healthcare facility.

iv. Orient mat to fit in location to provide best coverage.

v. Color of mats to match building carpet/color scheme.

vi. Mats are to be kept clean and in good repair.

http://www.gsa.gov/products

vii. Mat material/type to be 3M TM Carpet Matting 8850 or approved equal.

c. Umbrella Stands and Bags

i. Lessor shall furnish and install umbrella bag stands at each patient and employee entrance.

ii. Lessor to stock umbrella bags as necessary.

iii. Bag type to be Uline H-2953 46” Bag Stand and S-17365 Large Bags or approved equal.

iv. Bag stands shall be reviewed daily to ensure adequate stock.

d. Replace light bulbs as necessary.

e. Appropriately address non-scheduled janitorial tasks.

B. Daily Cleaning Requirements

a. Building Entrances

i. Pick up trash around entrances and vestibules.

ii. Empty trash receptacles.

b. Primary Care Area (prior to patient appointments each operational day)

i. All primary care areas shall be wet mopped using a germicide before patients are seen.

ii. Wipe down all exam tables with a clean cloth dampened with germicide.

iii. Clean and disinfect sinks and countertops.

iv. Clean and refill soap dispensers.

v. Clean and refill all paper towel dispensers.

vi. Review level of sharps container and replace with new insert sleeve as necessary.

vii. Clean mirrors.

viii. Wipe down all walls with protection with a clean cloth dampened with germicide.

c. Specialty Care Area (completed after patient appointments have concluded each operational day)

i. Treatment rooms shall be cleaned and disinfected after each patient procedure. (Coordinate with VA COR on patient appointment schedule for times when cleaning shall take place)

ii. All floors shall be wet mopped using a germicide.

iii. Wipe down all exam tables with a clean cloth dampened with germicide.

iv. Clean and disinfect sinks, countertops, equipment, etc.

v. Wipe down all walls with a cloth dampened with germicide.

vi. Clean and refill soap dispensers.

vii. Clean and refill all paper towel dispensers.

viii. Review level of sharps container and replace with new insert sleeve as necessary.

ix. Clean mirrors.

d. All Areas (complete throughout each operational day, without impacting employees, patients, and visitors)

i. Trash receptacles shall be emptied, cleaned and liners changed.

ii. Trash shall be removed from the building and placed in appropriate containers.

iii. Medical Waste and Hazardous Waste shall be emptied and cleaned.

iv. Boxes and other empty containers, to be disposed of, shall be removed from the building, and placed in appropriate containers.

v. Hazardous waste and full sharps containers shall be collected in red plastic bags and placed in cardboard boxes provided.

vi. Cardboard boxes shall be sealed with tape and placed in hazardous collection room for removal and disposal off site by others.

vii. Spills, body fluids, etc. shall be cleaned from floors and walls immediately upon notification.

viii. Remove black scuff marks from corridor floors as necessary.

e. All Areas (complete after patient appointments have been concluded for each operational day. Electrical equipment shall only be used during this time.)

i. Complete other required janitorial services.

ii. Dust furniture, desks (do not disturb papers on desks), machines, phones, file cabinets, window ledges, etc.

iii. All resilient tile floor areas shall be swept and wet mopped with germicide.

iv. Vacuum and spot clean carpets.

v. Carpeted areas and mats shall be vacuumed.

vi. Remove black scuff marks from corridor floors as necessary.

vii. Spot clean walls and doors.

viii. Spot clean any carpet stains.

f. Direct Patient Care Areas: Radiology, lab/phlebotomy, physical therapy, etc.

(complete after patient appointments have concluded for each operational day)

i. Sweep and wet mop with germicide.

ii. Wipe down all exam tables or any patient chair with a clean cloth dampened with germicide.

iii. Clean and disinfect sinks and countertops, including Reception areas.

iv. Clean and refill soap dispensers.

v. Clean and refill paper towel dispensers.

vi. Review level of sharps container and replace with new insert sleeve as necessary.

vii. Clean mirrors.

viii. Wipe down all walls with protection with a clean cloth dampened with germicide.

g. All Restrooms (completed during daily operational hours)

i. All restrooms shall be swept and wet mopped at least twice each day.

ii. All paper products and hand soap shall be replenished.

iii. Review feminine hygiene products and replenish as necessary. Restock of feminine hygiene products will be provided by the VA through the VA COR.

iv. All surfaces, including commodes, urinals, walls, mirrors, counters, and sinks, shall be cleaned and disinfected. Sponges and cloths shall not be used to clean commodes and urinals. Commodes and urinals shall be cleaned with disposable items that are disposed of after cleaning commodes and/or urinal in each toilet room. Items used to clean commodes and urinals shall not be used in turn for cleaning other items or wiping down other surfaces. Clean exterior of commodes and urinals first, followed by cleaning of the interior.

h. Flu Stations (completed during daily operational hours)

i. Review product stock at flu stations (tissue, hand sanitizer, and/or face masks) and replenish as necessary. Restock of such items will be provided by the VA through the VA COR.

i. Ceramic Tile Areas (other than restrooms) (complete after patient appointments have concluded on each operational day)0

i. Ceramic tile floors shall be swept, and damp mopped. If dirt build up occurs, ceramic tile floors shall be scrubbed when determined that it is required by the VA COR.

j. Corridors, Waiting Areas, Administrative Areas, Behavioral Health (complete after patient appointments have concluded on each operational day)

i. The areas shall be swept, wet mopped with a neutral cleaner, and burnished.

ii. Carpeted areas shall be vacuumed.

k. Restricted Areas (Clean Supply/Medication Storage, Warehouse, OIT, Telephone Room, Police Station/Security, and any other area specified by the VA COR) (complete during operational day hours when VA department staff are present)

i. Trash receptacles shall be emptied, and liners changed.

ii. The areas shall be swept, wet mopped with a neutral cleaner and burnished.

iii. Areas with cushioned flooring shall be maintained in accordance with manufacturer’s recommendations.

iv. Carpeted areas shall be vacuumed.

v. Restrooms shall be swept and wet mopped once each day and all paper products and hand soap replenished.

vi. All restroom surfaces, including commodes, urinals, walls, mirrors, counters, and sinks, shall be cleaned and disinfected.

vii. Hazardous waste and full sharps containers shall be collected in red plastic bags and placed in cardboard boxes provided.

l. GIP Storage (complete during operational day hours when VA staff are present)

i. Trash receptacles shall be emptied, and liners changed.

ii. Flooring shall be swept and wet mopped with a neutral cleaner.

iii. Daily documentation of housekeeping tasks in each GIP rooms shall be completed (cleaning log provided by VA Logistics Department via VA COR)

m. Conference Rooms (if unoccupied)

i. The areas shall be swept, wet mopped with a neutral cleaner, and burnished.

ii. Carpeted areas shall be vacuumed.

iii. Dust furniture, desks (do not disturb papers on desk), machines, phones, file cabinets, window ledges, etc.

iv. Clean and disinfect all tabletop surfaces and chair arms with germicide.

v. Areas with cushioned flooring shall be maintained in accordance with manufacturer’s recommendations.

n. Waiting Room Tables, Doors, Walls, and Trim

i. Dust tables, ledges, sills, moldings, and baseboards.

ii. Neatly arrange all reading materials

iii. Clean and disinfect all tabletop surfaces and chair arms with germicide.

o. Mirrors and Glass Cleaning

i. Clean all mirrors and glass at entrances (fingerprints, smudges, etc.)

p. Housekeeping Aide Closet

i. Clean sinks, floor, and shelves.

q. Isolation Rooms (rooms with positive and/or negative pressure relationships to adjacent space)

i. Any room where patients with suspected infectious disease have been examined will be thoroughly cleaned with germicide (terminal cleaning). Two step method (clean twice) for all Isolation Rooms.

r. Water Coolers

i. Clean water coolers.

ii. Housing shall be wiped down. Particular attention shall be given to top surface and spout to prevent lime build-up, bacterial growth, etc.

C. Weekly Cleaning Requirements

a. Furniture (complete after patient appointments have been concluded on an operational day)

i. Clean as necessary, but not less than weekly.

ii. Vacuum upholstered furniture.

b. All Restrooms (complete during operational hours if the closure of the restroom does not exceed a half hour. If these weekly tasks cannot be completed within that timeframe along with the daily restroom cleaning tasks, complete this task after patient appointments have concluded for the day)

i. Scrub floors and ceramic tile base and wipe down with germicide.

ii. Clean ceramic tile walls and wipe down with germicide.

iii. Spot wash painted walls as necessary.

iv. Damp wipe toilet stall partitions and waste receptacles with germicide.

c. Doors, Walls, Trim, Sills, and Ledges

i. Spot wash (for fingerprint, smudges, etc.) as necessary but no less than once weekly.

d. Mechanical/Electrical/MEP Equipment Rooms

i. The area shall be swept and wet mopped with a neutral cleaner.

ii. Collect, remove, and dispose of refuse, trash, and garbage from the space.

e. OIT Data Closets (complete during operational hours of day when VA staff are present to provide escort)

i. Areas shall be swept and wet mopped with a neutral cleaner.

ii. Collect, remove, and dispose of refuse, trash, and garbage.

f. Glass Cleaning (complete throughout operational day, without impacting employees, patients, and visitors)

i. Clean interior and exterior of door and entrance glass in waiting areas, exam rooms, offices, specialty areas, and treatment/isolation rooms.

g. Floor Maintenance of Resilient Tile Areas (complete after patient appointments have concluded for the operational day. When completing these tasks, maintain access for building occupants for fire egress. For areas within VA restricted access areas, coordinate work with VA COR)

i. Apply cleaning soap, as recommended by resilient tile manufacturer, scrub and re-wax hallways, waiting rooms, and lobbies.

D. Monthly Cleaning Requirements

a. Furniture (complete after patient appointments have concluded on an operational day)

i. Polish all furniture as necessary, but not less than monthly.

b. Air Conditioning Grilles and Registers (complete after patient appointments have concluded on an operational day)

i. Vacuum all grilles and registers.

ii. Clean baseboard grilles and all air diffusers.

c. Waiting Areas, Exam Rooms, Offices, Specialty Area, Isolation/Treatment Rooms (complete after patient appointments have concluded on an operational day)

i. Wash waste receptacles with germicide.

d. Floor Maintenance of Storage Areas

i. Sweep storage areas.

E. Quarterly Cleaning Requirements

a. Building Interior (complete after patient appointments have concluded on an operational day)

i. Dust window coverings and blinds.

ii. Dust handrails and handrail brackets.

iii. Light fixtures checked and cleaned.

iv. Clean elevator tracks.

F. Semi-Annual Cleaning Requirements

a. Furniture (complete after patient appointments have concluded on an operational day)

i. Shampoo upholstered furniture during January and July

b. Floor Maintenance of Resilient Tile Areas (complete after patient appointments have concluded on an operational day. When completing this task, maintain access for building occupant life safety egress. For flooring that is within an area deemed ‘restricted’, coordinate time with VA COR to complete task.)

i. Strip floors, apply sealer, apply wax, and refinish all resilient tile floors.

c. Floor Maintenance of Carpet Areas (complete after patient appointments have concluded on an operational day. When completing this task, maintain access for building occupant life safety egress. For flooring that is within an area deemed ‘restricted’, coordinate time with VA COR to complete task.)

Carpets shall be professionally steam cleaned and soil resistant treatment applied during January and July.

i. If cleaning cannot remove soiled/stained marks lessor shall replace carpeting in kind.

d. Glass

i. Wash inside glass and clean interior of all window frames and window stools.

G. Annually

a. Lessor shall ensure that staff entry into their position and then annually thereafter, that VA training course 10203 Privacy and HIPPA training be completed and passed.

b. Course training materials will be provided by the VA COR.

c. Completed staff training documentation to be submitted to VA COR.

H. Every Three Years

a. Lessor shall ensure that staff who are assigned biohazard tasks associated with handling, collecting, packing, and signing the associated manifest complete and pass the required tests to perform such work.

b. VA COR will provide training materials.

c. Tests shall be completed upon staff entry to such position and then every three years thereafter.

d. Completion certificates shall be posted in the biohazard accumulation room.

I. Pest Control

a. Control pests as appropriate, using Integrated Pest Management techniques, as specified in the VA Environmental Management Integrated Pest Management Technique Guide (E402-1001).

b. Provide quarterly interior and exterior extermination of insects and rodents. The lessor shall provide additional service at the request of the VA, if any signs of re-infestation appear.

i. For interior extermination of insects and rodents upon any sign of infestation, lessor shall provide documentation to the VA COR on how the space was treated and what was found. Lessor to provide terminal cleaning, as deemed necessary, post treatment.

c. Lessor shall provide necessary treatments when notified by VA COR of bed bug, fleas, mites, etc. exposure in the facility. Lessor to provide terminal cleaning, as deemed necessary, post treatment.

2.1 BUILDING MAINTENANCE BY LESSOR

The Lessor is responsible for total maintenance of the leased premises. The Lessor must have a building superintendent or a local, designated representative available to promptly correct deficiencies or attempt to correct deficiencies upon written notice of such condition from the VA.

The Lessor’s superintendent or designated representative shall correct or attempt to correct deficiencies within the timeframes specified in the Operating and Maintenance plan and agreed to by the Government. If no substantial attempt has been made to correct the deficiencies within the specified time, action will be taken by the VA to correct such deficiencies and the cost of repairs will be deducted from the next month’s rental payment.

The Lessor shall provide the labor, material, and supervision to adequately maintain the structure, the roof, the exterior walls, windows, doors and any other necessary building appurtenances to provide watertight integrity, structural soundness, and acceptable appearance.

The Lessor’s maintenance responsibility includes initial supplies of all items, materials, and equipment necessary for such maintenance. All maintenance work will be done in accordance with applicable local Building Codes and ordinances, and inspection certificates will be displayed as appropriate.

Maintenance by Lessor includes, but is not limited to, interior and exterior care of the building the site; all sidewalks, parking areas, driveways, private access roads, lawns, and shrubbery, utilities and building service equipment including all repairs and replacements. All equipment and systems shall be maintained to provide reliable service without unusual interruption, disturbing noises, exposure to fire or safety hazards, or unusual emissions of dirt.

Lessor shall maintain the Essential Electrical System as required by NFPA and Joint Commission, including but not limited to, weekly, monthly, annually, and triennial tests and activities.

2.2 FREQUENCY OF MAINTENANCE

A. As Required/Requested Requirements

a. Lessor responsible for replacement of worn floor or wall coverings (this includes the moving and returning of furnishings and equipment), unless caused by negligence on the part of the VA.

b. Water the grass and plantings as necessary to maintain their health and attractive appearance.

c. Fertilize all plants and trees with type of fertilizer recommended by manufacturer.

d. Dead plantings or lawn shall be replaced with the like kind immediately. Partially dead plantings may be trimmed if, after trimming, a good appearance is maintained.

e. Rake and remove leaves to ensure a good appearance of the site.

f. Clean HVAC units inside and out upon any signs of mildew or bacterial growth.

g. Pans in HVAC units shall be treated as required to prevent mildew or bacterial growth.

h. Before operational hours, remove snow and ice from all entrances, sidewalks, parking lots and approaches. In the even of snow or freezing rain during working hours, removal must occur withing one hour from receipt of notification by VA staff.

Lessor shall be deemed the ‘spotter’ for weather events at the site to determine necessary response.

i. All building equipment shall follow manufacturer recommendations for preventative maintenance.

j. Lessor shall provide VA COR owner level access to work order system platform being utilized to review/monitor status of preventative maintenance, inspections, work orders, etc.

k. Lessor responsible for the privacy curtains. Lessor shall replace the privacy curtains if they are visibly soiled, when performing terminal cleans in a space with such curtain or as determined by the VA COR. Curtains shall be replaced with clean curtains.

B. Weekly

a. Mow and edge lawns weekly during the growth season.

C. Monthly

a. Remove weeds from around building, parking areas, all landscaped areas (including lawn) and fence borders (both sides of fence).

b. Mow and edge lawns at least once a month during the dormant season.

c. Trim and prune shrubbery and trees to maintain an attractive appearance.

Shrubbery shall be not allowed to grow up and cover windows.

d. Lessor to provide VA COR monthly reports on the quantity of recyclables and Lessor generated hazardous waste.

D. Quarterly

a. Trim/maintain onsite landscaping as required; complete during the hours of 7:00 am

– 5:00 pm.

E. Semi-Annually

a. Replace all filters in the HVAC system. Replace on a more frequent basis if required by the manufacturer’s recommendations.

b. Remove all washable patient privacy curtains and replace with clean curtains.

F. Three Times Per Year

a. Fertilize all lawn areas. Fertilize application prior to the start of the growth season shall contain week killer per manufacturer’s recommendations.

G. Annually

a. Clean interior of all double wall HVAC units and drain pans.

b. Re-mulch all planting beds.

c. Lessor shall provide the VA COR a certified report from an independent 3rd party test and balance company identifying the airflow in CFM, the air changes per hour (ACH) and pressure differential for all rooms identified having positive or negative pressure relationships to the adjacent space (isolation room, procedural rooms, etc.) At a minimum, the report will include the room number, minimum CFM required, minimum ACH required, minimum pressure differential required, actual CFM, actual ACH, actual pressure differential and date that the testing occurred. The first certified report for all room types is due within 45 day of building acceptance.

i. If report indicates a change in original room design, Lessor shall immediately notify VA COR and provide corrective action plan.

2.2 EXTERIOR CLEANING

A. Lessor’s Responsibilities

The Lessor shall maintain the leased premises to provide a clean, neat, and attractive appearance by performing the functions outlined below.

a. Daily

i. Building entrances and gazabos. Pick up trash, litter, and debris.

b. Three Times Weekly

i. Sweep landings, steps, and sidewalks

ii. Police all sidewalks, parking areas, green areas, planting beds, driveways, lawns, shrubbery, outside loading dock areas, platforms, etc. to maintain a neat attractive appearance. This shall include, but not limited to, the removal of debris, litter, trash, limbs, etc. (from both sides of fences, if applicable)

c. Monthly (completed after building has closed, allowing for parked cars to be at a minimum)

i. Parking lot sweeping.

d. Quarterly

i. Clean bugs from the interior and exterior of light lenses.

j. Clean balconies, ledges, courts, areaways, gutters, and flat roofs.

k. Clean mildew from exterior of building, sidewalks, and roof areas, etc.

l. Trim/maintain onsite landscaping (complete during the hours of 7:00 am –

5:00 pm)

e. Semi-Annually

i. Wash outside of all exterior windows, glass located over and in exterior and vestibule doors, and all exterior plate glass around entrances, lobbies, vestibules, and skylights.

ii. Drainage System: (complete during the hours of 7:00 am – 5:00 pm. Off tour work is also permitted to complete these tasks.)

1. Inspect and clean all onsite catch basins and storm drain inlets of trash, leaves, and other deleterious materials.

2. Detention/retention and silting basins shall be inspected and cleaned of weeds and overgrowth to ensure proper drainage is maintained.

3. Basin bottoms should be scarified to maintain the integrity of the drainage design.

f. Annually

i. Clean exterior of building. Remove all spider webs, wasp nests, stains, etc.

g. Every Three Years (must be completed during nonoperational hours)

i. Curb painting

ii. Parking lot line striping

SECTION 5 LEASE DESIGN NARRATIVE

November 29, 2022

VA Leased CBOC Design Narrative

LEASED CBOC DESIGN NARRATIVE

TABLE OF CONTENTS

VA Leased CBOC Design Narrative November 29th, 2022

Table of Contents - Page 1

1. INTRODUCTION

2. GENERAL REQUIREMENTS

2.1 General

2.2 Codes

2.3 Standards

2.4 References

3. PLANNING AND DESIGN CRITERIA

3.1 Background

3.2 PACT Guiding Principles

3.3 Community Based Outpatient Clinics (CBOC) Planning Approach

3.4 Room Data Matrix

3.5 Surgical Design Criteria

4. TECHNICAL NARRATIVE

4.1 Site/Civil

4.1.1 Pedestrian and Vehicle Access & Circulation

4.1.2 Parking

4.1.3 Site Grading

4.2 Architecture

4.2.1 General Criteria

4.2.2 Accommodations for Care of Patients of Size

4.2.3 Acoustics

4.2.4 Equipment/Accessories/Furnishings

4.2.5 Signage and Wayfinding

4.2.6 Critical Dimensions

4.2.7 Entry Canopies

4.2.8 Elevators

4.2.9 Slab Depressions and Thickened Slabs

4.2.10 Millwork

4.2.11 Joint Sealant Systems

4.2.12 Doors and Frames

4.2.13 Hardware

4.2.14 Pharmacy Dispensing Windows

4.2.15 Radiation Shielding

4.2.16 Radio Frequency Shielding and Magnetic Shielding

4.3 Interior Design

4.3.1 General Criteria

4.3.2 Acoustic Ceiling Tile

4.3.3 Concrete Floor Treatment

4.3.4 Fiberglass-Reinforced Panels

4.3.5 Painting

4.3.6 Wall Protection

4.3.7 Window Shades

LEASED CBOC DESIGN NARRATIVE

TABLE OF CONTENTS

VA Leased CBOC Design Narrative November 29th, 2022

Table of Contents - Page 2

4.3.8 Privacy Curtains / Screens

4.3.9 Flooring, Carpet

4.4 Mechanical

4.4.1 References

4.4.2 HVAC Design Basis

4.4.3 Air Handling Units (AHUs)

4.4.4 Exhaust Systems

4.4.5 Cooling System

4.4.6 Hot Water Heating System

4.4.7…