Exhibit B - ASR - Reno CRRC - Final.pdf

COMMUNITY RESOURCE AND

REFERRAL CENTER (CRRC)

RENO, NV

AGENCY SPECIFIC

REQUIREMENTS

Delineated Area, Program, Administrative

Requirements, Site Requirements, Room

Requirements, Signage Requirements Schedule of Finishes, Infrastructure

Requirements, IT Requirements

VA Sierra Nevada Health Care System

TABLE OF CONTENTS

Delineated Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 - 5

Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 - 9

Administrative Requirements . . . . . . . . . . . . . . . . . . 10 - 20

Site Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . 21 - 26

Room Requirements . . . . . . . . . . . . . . . . . . . . . . . . 27 - 119

Signage Requirements . . . . . . . . . . . . . . . . . . . . . .120 - 165

Schedule of Finishes . . . . . . . . . . . . . . . . . . . . . . . 166 - 172

Infrastructure Requirements . . . . . . . . . . . . . . . . .173 - 175

IT Requirements . . . . . . . . . . . . . . . . . . . . . . . . . .176 - 179

COMMUNITY RESOUCE AND

REFERRAL CENTER

AGENCY SPECIFIC REQUIREMENTS

Delineated Area, Program, Administrative

Requirements, Site Requirements, Room

Requirements, Signage Requirements

Schedule of Finishes, Infrastructure

DELINEATED AREA

General Notes

This office’s Veterans Community is unique and requires access to multiple programs and services. Currently these programs and services are in various locations around the downtown area, including the medical center at Kirman Avenue. These programs and services include but are not limited to: Mental Health, Outreach, HUDVASH, PRRC, RANGE, Homeless Primary Care (H-PACT), employment services, rehabilitation and medication monitoring services, and access to laundry and shower.

Countless Veterans miss out on the full range of programs available to them due to these services being spread out. Some are unable or unwilling to visit the main campus.

In order to provide better continuity of care, VA Sierra Nevada Health Care System is requesting a new lease to be located within the boundaries provided in the map below.

This would allow all the programs and services offered to be collocated at one facility while allowing for easier access to services for this unique Veteran population.

Ideal location would be located along 4th Street just east of downtown with access to regular bus line service. Other considerations for location are proximity to the medical center located at 975 Kirman Avenue and ease of access. For the Veteran population served by this clinic, it is not preferred to be on the same block/immediately adjacent to a school or police station. Offered space may not be considered if located within 300 walkable feet (front door to front door) of the following establishments: firearm stores, shooting ranges, brothels, adult shops/cinemas, and gentleman’s clubs/strip clubs.

Offered space may not be considered if located within 100 walkable feet (front door to front door) of the following establishments: bar/clubs (except those within establishments that predominantly function as a restaurant), marijuana/CBD dispensaries, casinos, pawn shops, residential neighborhoods, and liquor stores.

Approximate Borders of Delineated Area:

North: N. McCarran Parkway

East: S. McCarran Parkway

South: S. McCarran Parkway

West: Keystone Ave extended to California Ave extended to Skyline Blvd.

Reference Map

Reno, Nevada, excerpt from Google Maps

AGENCY SPECIFIC REQUIREMENTS

Delineated Area, Program, Administrative

Requirements, Site Requirements, Room

Requirements, Signage Requirements

Schedule of Finishes, Infrastructure

PROGRAM

ROOM

QTY

UNIT

AREA

NET

AREA

ROOM

CODE

GUIDE

PLATE

REF

GUIDE

PLATE

PAGE #

SIGN

TYPE

ROOM NOTES

Communication

Center/Reception

NSTA1

RECP1

Section 4-18 thru 4-21

IN-15.55

Minimum one counter at each location at

ADA/ABAA accessible height; open reception windows; furniture will be utilized in lieu of built-in counters

Nurse Station

NSTA1

RECP1

Section 4-18 thru 4-21

IN-15.55

Minimum one counter at each location at

ADA/ABAA accessible height; open reception windows; furniture will be utilized in lieu of built-in counters

Toilet, Public 2 60 120 TNPG1 TLTU1 Section 4-26 thru 4-29

IN-09.03

Include drinking fountains (high and low)

Toilet, Patient 4 60 240 TPG01 TLTU1 Section 4-26 thru 4-29

IN-09.03

Toilet, Non-Patient 2 60 120 TNPG1 TLTU1 Section 4-26

IN-09.03

Quiet Room 1 80 80 DAYR1 N/A N/A IN-07.05

Kitchen 1 150 150 IPK01 4.13 4-83 thru 4-

IN-04.03

Kitchen portion of guideplate only applies

Group Therapy 2 300 600 OPMH1 4.3 4-16 thru 4-

IN-07.05

Multipurpose

Classroom

1 485 485 CLR10 4.16

4-105 thru 4-

IN-07.05

Requires multiple in-floor power and data

Social Activities/

Dining/Multipurpose

1 485 485 SL001 4.12

4-76 thru 4-

IN-07.05 Adjacent to kitchen

CWT Workspace 1 160 160 OTGC1 N/A N/A IN-04.03 Requires power and data for 3 workstations

Office, Clinical 3 100 300 OFA09 4.5 4-30 thru 4-

IN-04.03

1 HCHV, 1 HUD VASH,

1 PRRC

Interview Rooms 10 100 1,000 OFDC1 4.5 4-30 thru 4-

IN-04.03

Same set up as Office, Clinical

AREA

NET

AREA

ROOM

CODE

GUIDE

PLATE

REF

GUIDE

PLATE

PAGE #

Workstations

2,576

OFA07

N/A

IN-04.03

(SIM)

6 PRRC, 3 VOC Rehab, 18 HCHV, 19 HUD

VASH; open office concept to be split among a few team rooms with audible isolation from hallway and other rooms similar to Exam Rooms (STC 45-

50); requires power and data placed appropriately to route through the furniture;

requires dedicated power and data for multi-function device in each team room

Workstation, Touchdown

2 36 72 OFA07 N/A N/A

IN-04.03

(SIM)

RANGE; separate from the Team Room

Staff Lounge 1 300 300 SL001 N/A N/A IN-04.03

Lockers, Changing 1 120 120 LR002 N/A N/A IN-04.03

Locker Area, Staff

Personal Property

1 60 60 LR004 N/A N/A IN-04.03

Lockers per Schedule of

Finishes

Waiting

WTG08

IN-11.02

8 people; requires backing, power, data and cable for wall-mounted monitor

Kiosk, Patient Check-

In

RECP4

IN-11.01

Adjacent to Waiting;

requires power and data for 1 kiosk

Workstation, Patient

Education

CLSC1

IN-11.01

Adjacent to Waiting;

requires power and data for 1 workstation

Height / Weight

Station 1 40 40 PEHW1 N/A N/A IN-04.03 Requires power for scale

Shower, Patient 8 70 560 SHPMH N/A N/A IN-04.03 All showers to be

ADA/ABAA accessible

Toilet, Patient 1 60 60 TLTU1 TLTU1 Section 4-26

IN-09.03 Adjacent to showers

Laundry

CLHLD

4 washers and 4 dryers;

adjacent to patient shower area

Exam Room 4 120 480

EXPA1

EXRG3

4.3A

7.1

33 thru 35

7-2 thru 7-6

IN-04.03

2 HPACT, 1 SMI PACT,

1 PRRC/RANGE/VOB

AREA

NET

AREA

ROOM

CODE

GUIDE

PLATE

REF

GUIDE

PLATE

PAGE #

Consult Room 1 120 120 OFDC2 4.7 4-43 thru 4-

Medication Room

MEDP1

MEDP1

Section 4-10 thru 4-13

Requires temperature and humidity control;

power and data for pyxis and medical refrigerators; no exterior openings

Utility, Soiled

USCL1

USCL1

Section 4-22 thru 4-25

Holding room only; no utility sink required; no exterior openings

Utility, Clean Supply

SRSE1

SRSE1

Section 4-2 thru 4-5

Requires temperature and humidity control;

power and data for two omni-cells; no exterior openings

Housekeeping Aids

Closet (HAC)

1 60 60 JANC1 JANC1

Section 4-6 thru 4-8

IT Closet 1 200 200 TETRI TETR1 4-84 thru 4-

Storage, General 2 100 200 SRS01 N/A N/A IN-04.03 1 Social Activities, 1 Occ

Therapy

Storage, Equipment 1 100 100 CLHS4 N/A N/A IN-04.03

Storage, Medical

Equipment

1 60 60 SRE01 N/A N/A IN-04.03

Workspace, Police

One-way glass that can oversee the entrance; no ability for up and over access from adjacent spaces

TOTAL NSF 9,998

DEPT NET TO

GROSS

1.35

TOTAL DGSF 13,497

AGENCY SPECIFIC REQUIREMENTS

Delineated Area, Program, Administrative

Requirements, Site Requirements, Room

Requirements, Signage Requirements

Schedule of Finishes, Infrastructure

ADMINISTRATIVE

REQUIREMENTS

Tests and Inspections

Lessor may use their own documentation format/template for reporting out on required tests and inspections, however, the documentation must include ALL required information as specified in NFPA 101, 72, 99, Joint Commission, and any other applicable code requirement.

All tests and inspections must meet the attached Joint Commission criteria for the Life

Safety and selected Environment of Care (EC) standards. As these requirements may change over the course of the multi-year lease, any changes to these requirements will be forwarded to the Lessor. In addition, the following Joint Commission criterion on timing of inspections shall be adhered to:

• Weekly Inspections must be conducted on the same day of the week each week

• Monthly Inspections must be conducted on the same day of the same week each month

• Quarterly Inspections must be conducted within 10 calendar days each quarter

• Semi-annual Inspections must be conducted within 20 calendar days each 6 months

• Annual Inspections must be conducted within 30 calendar days each year

• Beyond Annual Inspections must be conducted within 45 calendar days

Fire Protection and Suppression Testing and Inspection: refer to requirements on attached

Joint Commission criteria for the Life Safety and selected Environment of Care (EC) standards. This includes but is not limited to fire sprinkler systems and fire alarm systems.

Fire Extinguishers:

• All required fire extinguishers and cabinets shall be provided by the Lessor

• Monthly fire extinguisher inspections are completed by the VA, CBOC Manager or designee

• Annual fire extinguisher inspections are to be completed by the Lessor as part of maintaining fire safety equipment

Fire alarm system shall be designed such that it is not affected by vacancies in adjacent spaces.

Emergency Power Systems are Maintained and Tested: refer to requirements on attached

Joint Commission criteria for the Life Safety and selected Environment of Care (EC) standards. This includes but is not limited to exit signs and emergency lights.

On-going Maintenance and Repairs

All preventative and corrective maintenance shall be performed by the Lessor if it was provided/installed by the Lessor, e.g. building systems, fixtures (light fixtures, plumbing fixtures, flagpole, etc.). Exceptions to this are the following on consumables:

• Ceiling tiles:

o If the tile is soiled, Lessor to replace since it is due to the building o If the tile is broken, VA will replace unless it was directly related to Lessor activity

• Light bulbs:

o Will be replaced by the VA o Ballasts or other light fixture issues to be repaired/replaced by the Lessor

Rounding with the Lessor or designee shall be conducted with the Contracting Officer’s

Representative (COR) every six months. The timing will be determined by the VA and will align 1-2 months prior to Environment of Care (EOC) rounds.

EOC rounds are conducted at lease sites semi-annually by the VA. Any EOC rounds findings shall be repaired or replaced within 10 calendar days of notification to the Lessor.

Emergency maintenance/repairs shall be completed same day.

High priority maintenance/repairs shall be completed within three calendar days.

Average priority maintenance/repairs shall be completed within 30 calendar days.

Low priority maintenance/repairs shall be completed within 60 calendar days.

If bugs and/or rodent issues are identified, the Lessor shall have a contractor onsite to mitigate within two calendar days.

If Lessor is unable to perform the maintenance/repairs within the above-referenced timeframes, the VA will fix/replace and bill the Lessor for the time and materials.

This Joint Commission document has been further revised 2/22/2018 to incorporate VHA requirements per the “George Mills Concurrence on 23 Issues, effective 4-Sep-2017 “ document. The

Revised: November 29, 2017 - VHA 2/22/2018 to reflect items in VA-TJC agreement dated Sep 2017

The following pages present documentation required by the Hospital Accreditation program Life Safety (LS), and selected Environment of Care (EC) standards. The Life Safety surveyor will begin review of these documents soon after arrival for the onsite survey.

Surveyors may request other EC and LS documents, as needed, throughout thesurvey.

Organizations may want to consider using this tool in their continuous compliance and survey readiness efforts.

issue number from that document is identified in the right hand column below.

This Joint Commission document has been further revised 2/22/2018 to incorporate VHA requirements per the “George Mills Concurrence on 23 Issues, effective 4-Sep-2017 “ document. The

Life Safety and Environment of Care – Document List and Review Tool Legend: C=Compliant; NC=Not compliant; NA=Not applicable; IOU=Surveyor awaiting documentation

Revised Nov 29, 2017 by TJC; and by VHA 2/22/2018

Copyright: 2018 The Joint Commission Organization Guide, January 2018 102

STANDARD - EPs See Legend

Document / Requirement Yes No C NC NA IOU

LS.01.01.01 Buildings serving patients comply with NFPA 101 (2012 2018 edition)

EP 1 Individual assigned to assess Life Safety Code® compliance

EP 2 Building Assessment to determine compliance with Life Safety Code®

EP 3 Current and accurate drawings w/ fire safety features & related square footage

a. Areas of building fully sprinklered (if building only partially sprinklered)

b. Locations of all hazardous storage areas

c. Locations of all fire-rated barriers

d. Locations of all smoke-rated barriers

e. Sleeping and non-sleeping suite boundaries, including size of identified suites

f. Locations of designated smoke compartments

g. Locations of chutes and shafts

h. Any approved equivalencies or waivers

EP 5 Deemed Hospitals: Documentation of inspections and approvals made by state or local AHJs

VA not “Deemed”

COMMENTS:

Issue #19

Issue #1

Document / Requirement

Addressed in policy?

Implemented as required?

C NC NA IOU Yes No Yes No

LS.01.02.01 Interim Life Safety Measures (ILSM)

EP 1 ILSM policy identifying when and to what extent ILSM implemented

EP 2 Alarms out of service 8 or more hours in 24 hours or sprinklers out of service more than 10 hours in 24 hours in an occupied building - Fire watch / Fire Dept.

notification

EP 3 Signs for alternate exits posted

EP 4 Daily inspection of routes of egress (See also 19.7.9.2 RE: daily inspections)

EP 5 Temporary but equivalent systems while system is impaired

EP 6 Additional firefighting equipment provided

EP 7 Smoke tight non-combustible temporary barriers

EP 8 Increased surveillance implemented

EP 9 Storage and debris removal

EP 10 Additional training on firefighting equipment

EP 11 Additional fire drill per shift per quarter

Issue #14

This Joint Commission document has been further revised 2/22/2018 to incorporate VHA requirements per the “George Mills Concurrence on 23 Issues, effective 4-Sep-2017 “ document. The

Life Safety and Environment of Care – Document List and Review Tool Legend: C=Compliant; NC=Not compliant; NA=Not applicable; IOU=Surveyor awaiting documentation

Revised Nov 29, 2017 by TJC; and by VHA 2/22/2018

Copyright: 2018 The Joint Commission Organization Guide, January 2018 103

Document / Requirement

Addressed in policy?

Implemented as required?

C NC NA IOU Yes No Yes No

LS.01.02.01 Interim Life Safety Measures (ILSM)

EP 12 Temporary systems tested and inspected monthly

EP 13 Additional training on building deficiencies, construction hazards, temp measures

EP 14 Training for impaired structural or impaired compartment fire safety features

EP 15 Other ILSM's

STANDARD - EPs See Legend

Document / Requirement Yes No C NC NA IOU

EC.02.03.01 Hospital Manages Fire Risk – Fire Response Plan

EP 9 The written fire response plan describes the specific roles of staff and LIPs at and away from fire including

• When and how to sound and report fire alarms

• How to contain smoke and fire

• How to use a fire extinguisher

• How to assist and relocate patients

• How to evacuate to areas of refuge

Document / Requirement Frequency Q 1 Q 2 Q 3 Q 4/

Annual C NC NA IOU

EC.02.03.03 Fire Drills

EP 1 Fire drills once per shift per quarter: Health Care and Ambulatory Health Care (If available, please provide five quarters of fire drill data)

Quarterly

EP 2 Fire drills every 12 months from date of last drill: Business

Occupancies Annually

EP 3 When quarterly fire drills are required, ALL are unannounced

• Drills held at unexpected times and under varying conditions

• Drills include transmission of fire alarm signal andsimulation of emergency fire conditions

Quarterly

Issue #23

This Joint Commission document has been further revised 2/22/2018 to incorporate VHA requirements per the “George Mills Concurrence on 23 Issues, effective 4-Sep-2017 “ document. The

Life Safety and Environment of Care – Document List and Review Tool Legend: C=Compliant; NC=Not compliant; NA=Not applicable; IOU=Surveyor awaiting documentation

Revised Nov 29, 2017 by TJC; and by VHA 2/22/2018

Copyright: 2018 The Joint Commission Organization Guide, January 2018 104

Document / Requirement Frequency Q 1 Q 2 Q 3 Q 4/

Annual C NC NA IOU

EC.02.03.03 Fire Drills

EP 4 Staff participate in the drills according to the hospital's fire response plan

YES NO

EP 5 Critiques include fire safety equipment and building features, and staff response

YES NO

Document / Requirement Frequency Q 1/ Semi

Q 2 Q 3/ Semi

Q 4/ Annual C NC NA IOU

EC.02.03.05 Fire Protection and Suppression Testing and Inspection

EP 1

Supervisory Signals-including: Control valves; pressure supervisory; pressure tank, pressure supervisory for a dry pipe

(both high and low conditions), steam pressure; water level supervisory signal initiating device; water temperature supervisory; and room temperature supervisory.

EP 2

Water flow devices Semiannually

Tamper switches Semiannually

EP 3 Duct, heat, smoke detectors, pull boxes Annually

EP 4

Notification devices (audible & visual), and door-releasing devices

EP 5 Emergency services notification transmission equipment Annually

EP 6

Electric motor-driven fire pumps tested under no-flow conditions Monthly

Diesel-engine-driven fire pumps tested under no-flow conditions Weekly

EP 7 Water storage tank high and low level alarms Annually

Semiannually

EP 8 Water storage tank low water temp alarms (cold weather only) Monthly (prior to heating season)

EP 9 Sprinkler systems main drain tests (at lead-in to buildings) on all Annually risers (Quarterly - where sole water source is through backflow preventer)

EP 10

Fire department connections inspected (Fire hose connections

N/A)

EP 11 Fire pump(s) tested – under flow Annually

EP 12 Automatic Standpipe flow test every 5 years 5 years

EP 13 Kitchen suppression semi-annual testing Semiannually

Issue #16

Issue #16

Issue #2

Issue #16

Issue #16

This Joint Commission document has been further revised 2/22/2018 to incorporate VHA requirements per the “George Mills Concurrence on 23 Issues, effective 4-Sep-2017 “ document. The

Life Safety and Environment of Care – Document List and Review Tool Legend: C=Compliant; NC=Not compliant; NA=Not applicable; IOU=Surveyor awaiting documentation

Revised Nov 29, 2017 by TJC; and by VHA 2/22/2018

Copyright: 2018 The Joint Commission Organization Guide, January 2018 105

Document / Requirement Frequency Q 1/ Semi

Q 2 Q 3/ Semi

Q 4/ Annual C NC NA IOU

EC.02.03.05 Fire Protection and Suppression Testing and Inspection

EP 14 Gaseous extinguishing systems inspected (no discharge req.) Annually

EP 15 Portable fire extinguishers inspected monthly Monthly

EP 16 Portable fire extinguishers maintained annually Annually

EP 17 Fire hoses hydro tested 5 years after install; every 3 years thereafter

5 years / 3 years

EP 18

Smoke and fire dampers tested to verify full closure 1 year after install

At least every 6 years thereafter

EP 19 Smoke detection shutdown devices for HVAC tested Annually

EP 20 All horizontal and vertical roller and slider doors tested Annually

EP 25 Inspection and testing of door assemblies by qualified person

Fire doors are required to be inspected annually (NFPA 101, 8.3.3.3.1).

Doors in smoke barriers, doors in smoke partitions, and doors serving hazardous areas are also required to be inspected annually (i.e., doors that are required to be self- or auto-closing) (NFPA 101, 8.8).

Annually

EP 27 Elevators with fire fighters’ emergency operations are tested monthly. The test completion dates and results are documented.

(For full text, refer to NFPA 101-2012 2018: 9.4.3; 9.4.6)

EP 28 Documentation of maintenance testing and inspection activities for EPs 1-20 and 25 includes: activity name; date; inventory of devices, equipment or other items; frequency; contact info for person performing activity; NFPA standard; activity results

NFPA 101

New EP

Issue #16

STANDARD - EPs See Legend

Document / Requirement Frequency YES NO / Missing Date

C NC NA IOU

EC.02.04.03 Medical equipment inspection, testing and maintenance

EP 10 All occupancies containing hyperbaric facilities comply with construction, equipment, administration, and maintenance requirements of NFPA 99-2012 2018: Chapter 14.

This Joint Commission document has been further revised 2/22/2018 to incorporate VHA requirements per the “George Mills Concurrence on 23 Issues, effective 4-Sep-2017 “ document. The

Life Safety and Environment of Care – Document List and Review Tool Legend: C=Compliant; NC=Not compliant; NA=Not applicable; IOU=Surveyor awaiting documentation

Revised Nov 29, 2017 by TJC; and by VHA 2/22/2018

Copyright: 2018 The Joint Commission Organization Guide, January 2018 106

Document / Requirement Frequency YES NO / Missing Date

C NC NA IOU

EC.02.05.01 Manages risks associated with utility systems

EP 5 Identifies activities and associated frequencies, in writing, for inspecting, testing, and maintaining all operating components of utility systems on the inventory. These activities and associated frequencies are in accordance with manufacturers’ recommendations or with strategies of an alternative equipment maintenance (AEM) program.

Note 1: The strategies of an AEM program must not reduce the safety of equipment and must be based on accepted standards of practice. * Note 2: For guidance on maintenance and testing activities for Essential Electric Systems (Type I), see NFPA 99-2012: 6.4.4. 2018:

6.3.4 Footnote *: An example of guidelines for physical plant equipment maintenance is the American Society for Healthcare Engineering (ASHE) book Maintenance Management for Health Care Facilities.

EP 14 Minimizes pathogenic biological agents in cooling towers, domestic hot and cold-water systems, and other aerosolizing water systems.

For hospitals that use Joint Commission accreditation for deemed status purposes the following policies, procedures and reports will be reviewed:

• Facility risk assessment to identify where Legionella and other opportunistic waterborne pathogens could grow and spread in the facility water system

• Water management program that considers the

ASHRAE industry standard and the CDC toolkit

• Testing protocols and acceptable ranges for control measures o Documented results of testing o Corrective actions taken when control limits are not maintained

VA not “Deemed”

EP 15 In critical care areas designed to control airborne contaminants

(such as biological agents, gases, fumes, dust), the ventilation system provides appropriate pressure relationships, air-exchange rates, filtration efficiencies, temperature and humidity.

(form of and frequency of assessment per hospital policy)

Note: For more information about areas designed for control of airborne contaminants, the basis for design compliance is the Guidelines for Design and Construction of Health Care Facilities, based on the edition used at the time of design (if available).

This Joint Commission document has been further revised 2/22/2018 to incorporate VHA requirements per the “George Mills Concurrence on 23 Issues, effective 4-Sep-2017 “ document. The

Life Safety and Environment of Care – Document List and Review Tool Legend: C=Compliant; NC=Not compliant; NA=Not applicable; IOU=Surveyor awaiting documentation

Revised Nov 29, 2017 by TJC; and by VHA 2/22/2018

Copyright: 2018 The Joint Commission Organization Guide, January 2018 107

Document / Requirement Frequency YES NO / Missing Date

C NC NA IOU

EC.02.05.07 Emergency Power Systems are Maintained and Tested

EP 1 Battery powered egress lights tested monthly – 30 seconds; visual inspection of EXIT signs

Monthly

EP 2 Battery powered egress lights tested annually – 90 minutes; or replace all batteries every 12 months and during replacement, perform random test of 10% of all batteries for 1 ½ hours

EP 3

Functional test of Level 1 SEPSS, monthly; Level 2 SEPSS, quarterly, for 5 minutes or as specified for its class Annual test at full load for 60% of full duration of its class

Monthly

Note 1: Non-SEPSS tested per manufacturer’s specifications Per Mfr.

Note 2: Level 1 SEPSS defined for critical areas and equipment

Note 3: Class defines minimum time which SEPSS is designed to operate at rated load without recharging

EP 4 Emergency power supply system (EPSS) inspected weekly, including all associated components and batteries

Weekly

EP 5 Emergency generators tested monthly for 30 continuous minutes under load (plus cool-down)

Monthly

EP 6 Monthly load test for diesel-powered emergency generators conducted with dynamic load at least 30% of nameplate rating or meets mfr. recommended prime movers’ exhaust gas temperature;

OR

Monthly

Emergency generators tested once every 12 months using supplemental loads of 50% of nameplate rating for 30 minutes, followed by 75% of nameplate rating for 60 minutes for total of 1 ½ continuous hours

Annually

EP 7 All transfer switches monthly/12 times per year Monthly

EP 8 Fuel quality test to ASTM standards Annually

EP 9 Generator load test once every 36 months for 4 hours 36 Months

EP 10 Generator 4 hour test performed at, at least 30% nameplate 36 Months

This Joint Commission document has been further revised 2/22/2018 to incorporate VHA requirements per the “George Mills Concurrence on 23 Issues, effective 4-Sep-2017 “ document. The

Life Safety and Environment of Care – Document List and Review Tool Legend: C=Compliant; NC=Not compliant; NA=Not applicable; IOU=Surveyor awaiting documentation

Revised Nov 29, 2017 by TJC; and by VHA 2/22/2018

Copyright: 2018 The Joint Commission Organization Guide, January 2018 108

Document / Requirement

THIS MAY BE SCORED AS CONDITIONAL OR

STANDARD

C NC NA IOU YES NO

EC.02.05.09 Medical Gas and Vacuum Systems are Inspected and Tested

EP 1 Test, inspect and maintain critical components of piped medical gas systems: Source, distribution, master panels, area alarms, automatic pressure switches, shut-off valves, flexible connectors and outlets

No prescribed frequency; recommend risk assessment if < annual

Per policy

EP 2 Location of and signage for bulk oxygen systems On Bldg. Tour

EP 3 Emergency oxygen supply connection On Bldg. Tour

EP 4 Review medical gas installation/modification/breech certification results for cross connection, purity, correct gas, and pressure As applicable

EP 5 Medical gas supply and zone valves are accessible and clearly labeled On Bldg. Tour

EP 6 Handling, transfer, storage, labeling, transfilling of cylinders Per policy

Legend: C=Compliant; NC=Not compliant; NA=Not applicable; IOU=Surveyor awaiting documentation

Revision: 11/29/2017 by TJC and by VHA 2/22/2018

COMMUNITY RESOURCE

AND REFERRAL CENTER

AGENCY SPECIFIC REQUIREMENTS

Delineated Area, Program, Administrative

Requirements, Site Requirements, Room

Requirements, Signage Requirements

Schedule of Finishes, Infrastructure

SITE REQUIREMENTS

General Notes

Site work and amenities shall conform to VA standards in regards to items such as flag poles, exterior signage, and physical security requirement protection.

Environmental Compliance

The following references should be consulted to ensure environmental compliance of the lease site.

• VA’s NEPA Implementing Regulations – 38 CFR Part 26

• NEPA law and implementing regulations, including but not limited to:

o NEPA of 1969, as amended

▪ Public Law [Pub.L.] 91-190

▪ 42 United States Code [U.S.C.] 4321-4370F o Council on Environmental Quality (CEQ) regulations implementing NEPA

▪ 40 Code of Federal Regulations [C.F.R.] Parts 1500-1508

Parking

Provide total 75 parking spaces, available for VA use at all times. Of the 75, provide five handicap parking stalls with aisles on both sides complying with ABAAS and per the attached standard detail “Parking Stall Layout”. This will allow sufficient parking for all VA staff at the site, 8-10 GOV vehicles for staff use, and parking for visitors/patients. For the

GOV spaces, provide a “Reserved for GOV” sign.

Bike Racks and Lockers

Provide bike rack(s), enough to accommodate 10 bikes.

• Bike Rack Location(s):

o Provide ample clearance between racks and curbs, buildings, etc. to allow free movement of the bike o Provide at least 5 feet of unobstructed clearance to utilities, loading zones, or handicapped parking spaces o Be at least 15 feet from any fire hydrant o Be at least 50 feet from building entrances o Be at least 60 feet from any bus stops or shelters o Place bike parking in a highly visible, well-lit, safe area on the site o Locate rack(s) so that parked bicycles don’t block the pedestrian path o Bike parking should be convenient to the building entrance(s) and street access, but away from normal pedestrian and auto traffic o Avoid locations that require bicycles to travel over stairs o Separate bicycle parking, auto parking, and road areas with space and a physical barrier preventing motor vehicles from damaging parked bicycles

• Bike Rack Specifications:

o Rack must be constructed of steel pipe or tubing, round or square, and be securely anchored to an immoveable level surface o Rack must provide support for the bicycle frame by holding it upright and allowing at least two points of contact for locating a cable or U-shaped lock o Prevent the wheel of the bicycle from tipping over o Enable the frame and one or both wheels to be secured o Support bicycles without a diamond-shaped frame with a horizontal top tube o Not bend wheels or damage other bicycle parts o Accommodate a wide range of bicycle shapes and sizes o Be simple to operate o Not include protruding bars that could trip or injure cyclists or pedestrians o Provide access area of minimum 4 feet 6 inches at each end of the rack(s)

• Bike Rack Type:

o Keep racks simple; “staple” style or similar preferred o Vertical wall-mounted racks are an alternative to horizontal racks and may be acceptable if there is ample wall space o Bike corrals can be installed in standard parking space footprints, 10 bikes in place of one car

• Avoid the Following:

o “Comb” style racks: does not allow the bike frame to be readily secured o “Wave” style racks: not ideal as they can be confusing to use and frequently used incorrectly, limiting capacity o “Toast” style racks: designed to only secure wheels, not frames o Very low bar-type racks: can be a hazard to pedestrians o Hiding racks in concealed, less public, or back of house areas o Placing racks too close to buildings, plants, walkways, etc. thus preventing easy access to parking

Provide four bike lockers with the following specifications:

• Interlocking modular bicycle storage system

• Bank of lockers to include two end panels for two outside lockers

• Inside lockers to be interlocking

• Each unit must include double door entry with a diagonal partition that creates two triangular stalls

• Secures one bike per door

• Total of two, double door units to hold four bikes

• Materials: high strength material that will not crack, dent, warp or corrode under normal exterior conditions; rust free; impact resistant; flame resistant V-1 rating;

graffiti/UV resistant paint finish; color finish to be pale gray such as Gibraltar Grey

RAL 7047; vandal resistant; flame resistant V-1 rating

• Requirements for V-1 Rating:

o The specimens may not burn with flaming combustion for more than 30 seconds after either application of the test flame o The total flaming combustion time may not exceed 250 seconds for the 10 flame applications for each set of 5 specimens o The specimens may not burn with flaming or glowing combustion up to the holding clamp o The specimens may not drip flaming particles that ignite the dry absorbent surgical cotton located 300 mm below the test specimen o The specimens may not have glowing combustion that persists for more than 60 seconds after the second removal of the test flame

• Locks: purchase with pad lockable swing handle to secure user supplied padlock or bicyclist U-lock

• Ability to change lock system to digital access in the future to any of the following options: alarm lock with proximity smart card; blue tooth cellular access to reserve, access and lock unit with use of smart phone, end use of locker with a click, locker user can be contacted by phone or text messaging

• Secure to concrete pad as recommended by the manufacturer

• Features to include:

o Must be made in the USA o Lockers to be relocatable, expandable and interlocking o Resistant to seasonal climate changes o 10-year warranty and favorable 30-year lifespan history

• Location: convenient to the front entrance; to be approved by the VA during design

Flagpole

Flagpole must be provided on the property in accordance with VA Criteria. Contractor shall provide all labor, materials and equipment necessary to accomplish the installation of an exterior light to illuminate the American flag located outside the clinic site. The light shall properly illuminate the flag and be controlled by a power circuit located within the clinic.

The feed from the clinic to the light shall be buried below ground and the conductors shall be enclosed in exterior rated conduit. Specifications:

• Overall length: 23 feet

• Exposed height: 20 feet

• Top diameter: 3”

• Butt diameter: 5”

• Wall thickness: .125”

• Flagpole weight: 92 lbs

• Max unflagged wind speed: 250 mph

• Max flagged wind speed: 120+ mph

• Cast aluminum revolving truck assembly stainless steel bearing concealed inside a cylindrical hood

• Stainless steel aircraft cable halyard

• Two chrome plated swivel bronze snap hooks

• Plastic covered counterweight with beaded sling

• Internal winch with removable hand crank

• Machine spun aluminum flash collar

• 16 gauge galvanized corrugated ground sleeve

AGENCY SPECIFIC REQUIREMENTS

Delineated Area, Program, Administrative

Requirements, Site Requirements, Room

Requirements, Signage Requirements

Schedule of Finishes, Infrastructure

ROOM REQUIREMENTS

General Project Description

The information contained in this package is for a 13,496 – 15,520 ABOA building tenant improvement or build-to-suit to replace the existing Community Resource and Referral

Center.

The Facility Guidelines Institute’s Guidelines for Design and Construction of Hospitals and

Outpatient Facilities, latest edition, shall be used as the primary standard for design and construction of VA leased facilities.

VA leased facilities are required to incorporate all applicable Joint Commission requirements.

The design and construction shall follow all State and local building codes and regulations.

Occupancy Groups & Exiting

The occupancy of the requested lease will be Office, Group B occupancy as defined by the VA-adopted edition of the International Building Code and NFPA 101.

General Notes

Per HIPPA, patient confidentiality must be maintained when providing personal information to interview clerks and/or other staff, particularly at the main entrance Check-in/Reception counter and Waiting areas. The facility Privacy Officer will review the submitted layouts and make recommendations to assure the highest level of patient confidentiality is provided at these critical areas.

Room Size Tolerances: allowable room size variance from stated program requirements is +/-5%.

Room Naming Conventions: meet with VA stakeholders to develop room naming conventions prior to finalizing design.

Provide a minimum clear dimension of six feet (6’-0”) in all hallways to accommodate the passage of two wheelchairs. Some circumstances in the design of a facility may require a greater clear hallway dimension for patient safety and functionality.

Refer to the Infrastructure Requirements section for specific information on building systems including mechanical, electrical, and plumbing. Refer to the Physical Security

Requirements section for specific information on security camera system specifications and installation, electronic door hardware, and other physical security aspects.

Partitions

Sound protection must comply with provided STC ratings shown on room criteria. Wall details must be submitted for review by VA for STC rating compliance.

Doors and Hardware

All doors and hardware shall be designed in accordance with VA criteria: PG-18-14 Room

Finishes, Door, and Hardware Schedule. Below are facility requirements for specific components.

Contractor to provide a keying system which matches the existing Medeco XT system currently in use at the main facility campus (https://www.medeco.com/en/products/).

Cores to be built by the contractor to VA requirements and turned over to the VA for install.

All locksets shall be mortise type. Mortise lockset Stanley Part #BES45H7A15S626AM, modified as necessary to fit the specific required function of the lockset.

Use door closers only where required by code and/or VA criteria, unless noted otherwise.

For future flexibility for storage rooms, all storage rooms shall be equipped with door closers. Door closers should not be allowed to stay open in the door’s fully open position.

Facility standard for door closers are as follows:

• Closer with fire alarm connection: LCN 4040 SE Arm STD

• Closer without fire alarm connection: LCN 4040 XP w/ LCP super smooth

4040H or LCN 4041 SHCUSHAL

Doorstops shall be provided for all doors, even on automatic doors.

Provide card reader system for the clinic. Card reader locations to be determined during design. System shall be compatible with the existing facility system Lenel United

Technologies, including but not limited to LNL-2220 Intelligent Dual Reader Controller, LNL-1320 Series 2 Dual Reader Interface Module, LNL-1100 Series 2 Input Control

Module. It is anticipated that one to four doors will be set up on the card reader system, including the door to the IT Closet. Provide all cabinets, power supplies, door contacts, and other hardware and software associated with this system.

Security Cameras

Provide security camera system with up to 12 cameras located strategically throughout the site to cover both the interior and exterior environment. System should feed to a monitor in the Police workspace. Camera locations and capabilities to be reviewed by VA

Police during design.

http://www.medeco.com/en/products/)

Furniture, Fixtures, and Equipment

The following furniture, fixtures, and equipment will be purchased and installed by the VA:

• Furniture including cubicle panels, workstations, chairs, tables, benches, file cabinets, storage cabinets, bookcases, lamps, stools

• Kitchen equipment including refrigerators, microwaves, coffee makers

• Medical equipment including exam tables, medication dispensing, medical supply dispensing, racks/shelves, blood pressure monitors/sphygmomanometers, sharps containers, carts, glove dispensers, scales, ophthalmoscope/otoscopes, telehealth monitors, hampers, chart holders, IV stands, paper cup dispensers

• Wall mounted accessories including whiteboards, TVs and mounting brackets, clocks, coat hooks

• Cubicle curtains

• Floor care equipment including vacuums, floor scrubbing machines, carts

• IT accessories including desktops, laptops, printers, monitors, keyboards, mice, phones, video conference equipment

• Cleaning accessories including soap dispensers, hand sanitizer dispensers, paper towel dispensers

• Trash bins

• Washers and dryers

• Artwork

All wall mounted items listed on the room requirements and not listed as VA purchased/installed above, to be purchased/installed by the Contractor including, but not limited to, seat cover dispensers, mirrors, grab bars, mop racks, built-in shelving.

All ceiling mounted items listed on the room requirements to be purchased/installed by the

Contractor including, but not limited to cubicle curtain tracks.

Room Templates Disclaimer

Room templates are a critical component to VA Technical Information Library (TIL) which provides standards for all VA planning, design, and construction projects. Room templates are department and room aligned criteria describing space, room contents, and other technical requirements for the development of VA projects. Room templates communicate the Basis of Design (BOD) and are required to be utilized by project teams working on new construction and renovations of existing facilities. The material contained in the room template constitutes a standard for VA planning, design, and construction. Any substantial variance from standards shall be considered only as required to accommodate specific site, functional, and operational conditions. Each substantial variance shall have a basis of rationale and be documented in the project record.

Clinicians, Providers, primary users, and other stakeholders shall be involved in project specific development of room templates and BIM test-fits to best adapt standards for specific functional, operational, and site conditions and to provide optimum services environments for Veterans. Stakeholder involvement and requirements shall be documented in the project record.

Room templates are not project-specific. Site specific issues must be addressed with the context of VA standards and applied to each individual project. Use of this room template does not preclude the need for, nor absolve planners, designers, and constructors of their responsibility to provide compete, functional, safe, and secure designs suited to the unique requirements of each project.

Equipment and systems are shown in an illustrative, performance-based format and are not intended to depict, suggest, or otherwise constitute endorsement of any specific product or manufacturer. Manufacturers should be consulted for actual dimensions, configurations, and utility requirements.

References

All room requirements are excerpts from the graphical design guides on the VA Office of

Construction & Facilities Management Technical Information Library (TIL) located at:

https://www.cfm.va.gov/til.

NOTE: Applicable TIL standards will be upheld unless noted otherwise in this document.

Design Guides referenced within this document include:

Mental Health Facilities

Mental Health Outpatient Services

Patient Aligned Care Team (PACT)

Ambulatory Care (Hospital Based)

Office of Information and Technology

Additional references available on the TIL that should be consulted for requirements include, but are not limited to, the following:

Design Criteria

Architectural Accessibility, Barrier Free Design

Design Guides (PG-18-12)

Design Manuals (PG-18-10)

Physical Security and Resiliency *Applicable sections only; per section

1.4.6 VA Leased Facilities, “The implementation of physical security for leased facilities is to comply with the Interagency Security Committee (ISC) http://www.cfm.va.gov/til

Risk Management Process. Leased facilities are not required to comply with physical security and resiliency requirements in this manual.”

Signage and Wayfinding

Standard Details

PG-18-1 Master Construction Specifications

PG-18-3 Design and Construction Procedures

PG-18-4 Standard Details and CAD Standards

PG-18-10 Architectural Design Manual

PG-18-13 Barrier Free Design Standard (included as part of this section)

PG-18-14 Room Finishes, Door, and Hardware Schedule

VA Barrier Free Design Standard

A Supplement to the Architectural Barriers Act Accessibility Standards (ABAAS)

PG-18-13

January 1, 2017 rev 11/1/18

Office of Construction & Facilities Management Facilities Standards Service

PG 18-13 - VA BARRIER FREE DESIGN STANDARD January 1, 2017 rev 11/01/2018

VA Barrier Free Design Standard

The Architectural Barriers Act (ABA) insures that buildings financed with federal funds are so designed and constructed as to be accessible to everyone. This law requires all construction, renovation, or leasing with federal funds to meet the Architectural Barriers Act Accessibility Standard (ABAAS). ABAAS was made effective May 9, 2006 for new construction and alterations, June 30, 2006 for lease-construction facilities, and February 7, 2007 for all other leased facilities. ABAAS replaces the Uniform Federal Accessibility Standards (UFAS), which was VA’s previous standard for accessibility.

This supplement to ABAAS tailors some of the requirements to better meet the barrier free needs of the Department of Veterans Affairs (VA) in its facilities.

Previous requirements have been simplified and abbreviated so that these six pages replace the former 26-page VA Barrier Free Design Handbook (H-08-13).

The following comparison tables are to assist contracted Architect/Engineer firms and VA staff in designing accessible facilities for the VA. Paragraph numbers correspond to ABAAS paragraph numbers.

Planners and designers are to be guided by ABAAS, the exception being where the more stringent VA requirement is noted in the tables.

Minimum Requirements

REQUIREMENT VA ABAAS NOTES

Sites - parking spaces accessible 1% greater than ABAAS 1

SCI/D Facilities 0.2 accessible spaces per Inpatient bed; 0.5 per Long- Term Care bed; 5.6 per Outpatient Exam Room.

Dedicated for SCI/D patients

Hospital Outpatient Facilities

Rehabilitation and Outpatient Physical Therapy Facilities

10% of total spaces

20% of total spaces

10% of total spaces

20% of total spaces

Buildings- accessible seating, assembly areas

1% greater than ABAAS 2

VA GUIDELINES ARE THE SAME AS ABAAS FOR MOST REQUIREMENTS.

WHERE VA REQUIREMENTS DIFFER, SEE BELOW.

http://www.access-board.gov/ada-aba/aba-standards-gsa.cfm http://www.access-board.gov/ufas/ufas-html/ufas.htm http://www.access-board.gov/ufas/ufas-html/ufas.htm

Accessible Route

Width, min. Patient Care Areas 1800 mm (6'-0") 900 mm (3'-0") 3

Width, min. Administrative Areas 1500 mm (5'-0") 900 mm (3'-0") 3

Slope, maximum (including parking spaces)

1:33 (3%) 1:20 (5%) 4

Minimum gradient of walk requiring rest areas every 60 000 mm (200')

1:50 1:33 5

Turning Radius 1650 mm (5’-6”) 1500 mm (5’-0”) 31

Turning Radius, Bariatric 1800 mm (6’-0”) 1500 mm (5’-0”) 31

Floor Surfaces

REQUIREMENT VA ABAAS NOTES

Changes in level Not permitted on SCI floors No requirement 6

Carpet cushion or padding Not permitted Permitted

Parking and Passenger Loading Zones

REQUIREMENT VA ABAAS NOTES

Access aisle requirement for accessible parking spaces

1500 mm (5'-0") each side 1525*mm (5'-0") 1 per 2 spaces.

Passenger loading area "communication system" for assistance at SCI units

Yes No requirement 9

Curb Ramps

REQUIREMENT VA ABAAS NOTES

Width, minimum 1200 mm (4'-0") 900 mm (3'-0") 10

Ramps

REQUIREMENT VA ABAAS NOTES

Maximum slope 1:20 1:12 11

Maximum length, within range of 1:33 -1:26

12 000 mm (40' ) 60 000 mm (200') 12

Maximum length, within range of 1:25 -1:20

10 500 mm (35' ) 60 000 mm (200') 12

Minimum clear width 1200 mm (4'-0") 900 mm (3'-0") 13

Minimum size level landing, where doors swing into landing

1800 mm x 1800 mm (6'-0" x 6'-0")

1500 mm x 1500 mm (5'- 0" x 5'-0")

Stairs

Handrail height 850 mm (34") 750 mm-850 mm (30”-34")

Elevators (Passenger)

REQUIREMENT VA ABAAS NOTES

Minimum width of elevator doors 1200 mm (4'-0") 900 mm (3'-0") 16

Minimum car size 2400 mm x 1850 mm (8'-0" x 6'-2") platform size

1730*mm x 1370*mm (68" x 51") car inside dimensions

Double set of handrails Yes No requirement 18

Windows

REQUIREMENT VA ABAAS NOTES

Sill height in patient bedrooms 600 mm (24") maximum No requirement 19

Doors and Doorways

REQUIREMENT VA ABAAS NOTES

Patient Care Delivery Areas with patient bed, stretcher or gurney access, minimum width

1200 mm (4' -0") 1100 mm (3' - 8") 20

Water Closets

REQUIREMENT VA ABAAS NOTES

Grab bar configuration Double swing-up bars for all patient toilets/shower rooms on Nursing Units

Side & back bars for all accessible water closets.

Toilet Stalls

Minimum accessible stall size 1650 mm x 1800 mm (5'-6" x 6'-0")

1500 mm x 1420*mm (5'- 0" x 4'-8")

Minimum size wheelchair "front-transfer" stall

1050 mm x 1800 mm (3'-6" x 6'-0")

900 mm x 1650 mm (3'-0" x 5'-6")

Grab bars Required in all stalls Required in accessible stalls

Shower Stalls (Patient)

Minimum stall dimensions 1200 mm x 1200 mm (4'-0" x 4'-0")

900 mm x 900 mm (3'-0” x 3'-0”) or 750 mm x 1500 mm (2'-6" x 5'-0”)

Grab bars Horizontal plus vertical bars Horizontal bars only 30

Toilet Rooms

REQUIREMENT VA ABAAS NOTES

Inpatient Bedroom Toilet Rooms, Minimum width of toilet room entrance doors

1200 mm (48") 850 mm (34") 24

Cafeterias

REQUIREMENT VA ABAAS NOTES

Knee clearance, for minimum 5% tables

675 mm (2'-3") and 725 mm (2'-5") for at least 5%

675 mm (2'- 3") 26

Cutlery and supply height 1000 mm-1200 mm (40" - 48")

1350 mm (54") max. 27

Health Care Facilities

REQUIREMENT VA ABAAS NOTES

Medical/Surgical Nursing Units, percent of patient bedrooms accessible

100% 10% 28

Medical/Surgical Nursing Units, percent of toilet rooms accessible

100% 10% 28

*ABAAS indicates slightly different metric equivalents than the ones which VA has adopted.

Information gathered from data provided by the Department of Health and Human Services; the National Center for Health Statistics; and the Department of Veterans Affairs, Office of Planning and Management Analysis (see SURVEY OF DISABLED VETERANS, OPMA-M 043-90-1).

1. The percent of disabled at VA hospitals is much higher than the percent of disabled in the general population. Two percent may be adequate for the general population. The percentage of disabled drivers/passengers is much higher in the veteran population. ABAAS Table 208.2 shows varying accessible parking space requirements. 1 out of every 6 accessible parking spaces shall be a van accessible parking space. Other VA Hospital service lines may have different requirements.

2. A higher percentage of sick and disabled make up the VA population than make up the general population. ABAAS Table 221.2.1.1 shows varying wheelchair space requirements in assembly areas.

3. It takes a minimum of 1500 mm (5’-0”) for two wheelchairs to pass. Wheelchairs have increased in size in recent years, so 1800 mm (6’-0”) is recommended for Patient Care Delivery Areas where wheelchair usage is commonplace.

4. The disabled population used by ABAAS to determine an acceptable slope for using public accommodations is stronger and younger than are veterans at VA facilities.

5. Previous studies used a younger, more fit, population to determine the minimum slope and distance for a disabled person’s travel capability.

6. Current standards are based on an active, independent…