Exhibit C_ASR.pdf

Veterans Recovery Center – ASR Package

VA Southern Nevada Health Care System

Veterans Recovery Center

AGENCY SPECIFIC REQUIREMENTS

EXHIBIT C

LESSOR:______GOVERNMENT:______

Table of Contents

DELINEATED AREA

SPACE REQUIREMENTS

Parking

General Design Criteria

Conceptual Plan Area Table

Finish Schedule

Building Entrances and Exits

Partitions

Doors and Hardware

Plumbing Fixtures, Trim, and Equipment

Legionella Mitigation

Fire Extinguishers

Electrical and Lighting

General

Raceways and Receptacles

Lighting Fixtures

Audio Visual Systems

ADMINISTRATIVE REQUIREMENTS

Pest Control

Frequency of Building Maintenance

Janitorial Service

SIGNAGE REQUIREMENTS

Exterior Signs

Interior Signs

References

Telecommunications

General Requirements

Telecommunications Room Requirements

PHYSICAL SECURITY

ATTACHMENTS

Attachment A – VA Leased CBOC Design Narrative (LDN)

Attachment B – Room Data Matrix (RDM)

Attachment C – Conceptual Floor Plan

Attachment D – Program For Design (PFD)

Attachment E – Room Templates for Leased Space

DELINEATED AREA

General Notes The Veterans Recovery Center is an integral part of the VA Southern Nevada Health Care System (VASNHS) and is currently located at 3525 West Cheyenne Avenue, North Las Vegas, NV. To provide better continuity of care, VA Southern Nevada Health Care System is requesting a new lease to be located within the boundaries provided in the map below.

Approximate Borders of Delineated Area:

Generally, within city limits of Las Vegas, NV.

• North – W Lake Mead Blvd – Beginning at the intersection of S Buffalo Dr and W

Lake Mead Blvd. and ending at the intersection of W Lake Mead Blvd and N 5th St.

• East – Las Vegas Blvd – Beginning at the intersection of W Lake Mead Blvd and N

5th St, continuing to Las Vegas Blvd N and ending at the intersection of S Las Vegas

Blvd and W Spring Mountain Rd.

• South – W Spring Mountain Rd – Beginning at the intersection of S Las Vegas Blvd and W Spring Mountain Rd. and ending at the intersection of W Spring Mountain Rd.

and S Buffalo Dr.

• West – S Buffalo Dr – Beginning at the intersection of S Buffalo Dr and W Spring

Mountain Rd and ending at the intersection of S Buffalo Dr and W Lake Mead Blvd.

SPACE REQUIREMENTS

Lessor to comply with VA PG-18-12 Mental Health Outpatient Services Design Guide (hereafter referred to as “DG”), Lessor to comply with VA Leased CBOC Design Narrative (attachment A) (hereafter referred to as “LDN”), and Room Data Matrix (attachment B) (hereafter referred to as “RDM”), for building tenant improvement or built-to-suit mental health clinic.

Contiguous space is not required. Ground floor occupancy is preferred, but if space is not on ground floor, a minimum of two elevators is required.

Location should be minimum 400 walkable feet from the following establishments:

marijuana dispensary, firearm store, shooting range and gentleman’s club/strip club.

Parking Provide total 90 minimum – 120 maximum parking spaces, 25 of which are reserved for exclusive VA use. Of the parking spaces, provide 5 handicap parking stalls with aisles on both sides. Compliance with the Architectural Barriers Act Accessibility Standards (ABAAS) is mandatory, but if there are local accessibility standards that apply in the project’s jurisdiction, the most stringent requirements must be followed. One of the handicap stalls must be sized to meet VA requirements for van accessible parking as noted in VA Barrier Free Design Standard. For the reserved GOV spaces, secure parking is desired. Provide a “Reserved for GOV” parking sign; exact verbiage to be provided during design.

General Design Criteria Lessor shall provide architectural design services in accordance with the DG, LDN, RDM and Room Templates for Leased Space (attachment E). Reference Building Requirements for Leased Spaces - Office of Construction & Facilities Management for required documents. In case of any conflict with this ASR document, reference attachment a and b with due approval from the CO.

Other Applicable Standards: all available at links:

i) VA The Joint Commission (TJC) Requirements for Behavioral Health and Laboratory categories.

ii) Interagency Security Committee Policy for Leased Facilities.

iii) VA PG-18-9 SPACE Planning Criteria (263).

iv) VA PG-18-14 Room Finishes, Door & Hardware Schedule (263).

v) VA PG-18-10 Design Manuals - Signage Design Manual.

vi) VA Directive 0730

LESSOR:______GOVERNMENT:______

https://www.cfm.va.gov/til/dGuide/dgMHOP.pdf https://www.cfm.va.gov/til/sDetail/Div32ExtImprov/SD321723-01.pdf https://www.cfm.va.gov/til/sDetail/Div32ExtImprov/SD321723-01.pdf https://www.cfm.va.gov/til/etc/dsBarrFree-2025-05.pdf https://www.cfm.va.gov/til/rTemplate/LeasingCBOCw.asp https://www.cfm.va.gov/til/leasing.asp https://www.cfm.va.gov/til/leasing.asp https://www.jointcommission.org/resources/news-and-multimedia/fact-sheets/facts-about-behavioral-health-care-accreditation/ https://www.jointcommission.org/what-we-offer/accreditation/health-care-settings/laboratory-services/ https://www.cfm.va.gov/realProperty/VASupplementChapterDocs/Chapter_19_5_20_2024.pdf https://vatilms.va.gov/vatilms/criteria-viewer/85524?type=application%2Fpdf&title=Community%20Based%20Outpatient%20Clinic%20(PACT)%20Interim&name=spChapter263.pdf https://vatilms.va.gov/vatilms/criteria-viewer/80211?type=application%2Fpdf&title=Room%20Finishes,%20Door,%20and%20Hardware%20Schedule&name=RoomFinishes.pdf https://vatilms.va.gov/vatilms/criteria-viewer/90050?type=application%2Fpdf&title=Signage%20and%20Wayfinding&name=dmSignage-2025-02-19.pdf

The Lessor’s design team shall utilize and incorporate all VHA’s Mental Health Outpatient Services Design Guide into the new leased space design and provide required tenant improvements to support specialized mental health treatment settings for Veterans.

Lessor’s Designer will provide room-by-room layouts outlining exam table, patient lifts, privacy curtains, stool, workstation and media-mounts, casework, bookcases, and room furniture locations so Lessors MEP design team can determine plumbing, electrical power, and data drop locations.

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.

Conceptual Plan Area Table Note: all areas are approximate as reflected in the Conceptual Floor Plan (attachment C)

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

Room Qty Area Net Area CBOC Vestibule / Indoor Buffer, Bldg Sprt 2 120 240 CBOC Lactation Room, Wm Vet Svc 1 80 80 Reception 2 235 470 CBOC Veteran / Guest Seating, Bldg Sprt 1 415 415 Patient Interview Room, Clncl Sprt 3 120 360 Waiting, Family, 8 People 1 225 225 Dining Room, Veterans 1 220 220 CBOC Refreshment Station, Bldg Sprt 1 40 40 CBOC Refreshment Seating, VC Svc 1 40 40 CBOC Vending Area, VC Svc 2 30 60 Shared Group / Multifunction Room, CBOC 5 300 1500 Shared Group / Multifunction Storage Room, CBOC 5 60 300 Laundry Room 1 160 160 Universal Non-Patient Toilet / Shower, Bldg Sprt 4 85 340 Computer Training Room, Veterans 1 304 304 Exam Room, Patient Aligned Care Team (PACT) 4 125 500 Exam Room, Womens Health 2 125 250 Resuscitation, CBOC 1 210 210 Consultation Room 28 125 3500 Women Veteran Patient Toilet, Bldg Sprt 2 75 150 Universal Patient Toilet, Bldg Sprt 4 60 240 Clean Utility Room, Lgstcs Svc 2 65 130 Soiled Utility Room, Lgstcs Svc 2 60 120 CBOC Accessible Patient Height & Weight Station, Clncl Sprt 2 60 120 Family Consult Room, Chpln Svc 2 140 280 CBOC Point of Use Equipment Alcove, Clncl Sprt 3 50 150 CBOC Clinical Staff Workstation, Stff Sprt 42 56 2352

LESSOR:______GOVERNMENT:______

https://www.cfm.va.gov/til/dGuide/dgMHOP.pdf https://www.cfm.va.gov/til/dGuide/dgMHOP.pdf

CBOC Team Copy / Supply Alcove, Stff Sprt 3 50 150 CBOC Point of Use Medication Alcove, Phrm Svc 3 50 150 CBOC Housekeeping Aides Closet (HAC), Bldg Sprt 4 60 240 CBOC Receiving Area, Lgstcs Svc 1 100 100

STORAGE - NON-PERISHABLE 1 100 100

STORAGE - CLOTHING 1 100 100

CBOC Full Gas Cylinder Storage Room, Lgstcs Svc 1 40 40 CBOC Empty Gas Cylinder Storage Room, Lgstcs Svc 1 40 40 CBOC Clinical Supplies Storage Room, Lgstcs Svc 1 40 40 CBOC Telecommunications Room (TR), OIT 1 100 100 CBOC Operations Room, Pol Svc 1 160 160 CBOC Holding Room, Pol Svc 1 60 60 CBOC Secure Storage Room, Pol Svc 1 30 30 CBOC Police Personal Property Locker Alcove, Stff Sprt 2 30 60 CBOC Staff Workroom / Storage Room, Clncl Sprt 2 140 280 CBOC Staff Conference Room, Educ Svc 2 240 480 Shared Office, Stff Sprt 9 120 1080 CBOC Universal Staff Toilet, Bldg Sprt 4 65 260 CBOC Staff Personal Property Locker Alcove, Stff Sprt 2 40 80 CBOC Clinical Neighborhood Staff Multipurpose Room / Breakroom, Stff Sprt 2 170 340

Net Square Feet (NSF) Total 16,646 Net Area to Gross Area Conversion Factor 1.5

Net Usable Square Footage (NUSF) Total 24,969

Finish Schedule The Lessor or Lessor’s designer to reference the Program for Design (PFD) (attachment D), LDN and RDM required for finishes, STC ratings, ceiling heights, door size and type, hardware sets, HVAC space ventilation, number of electrical receptacles, lighting controls and fixture types, and number of standard density work area outlets for each room type.

Lessor to schedule re-carpeting and re-painting of the facility at a minimum, every 5 years during the duration of the lease.

Manufacturer’s trade names and numbers used herein are only to identify colors, finishes, textures and patterns. Products of other manufacturers that meet equal or better requirements of the technical specifications will be acceptable upon approval in writing by the contracting officer for finish requirements.

The items below are in addition to the room data matrix where required:

Window Coverings:

• Provide roller shades, MechoShade or approved equal, for all exterior windows.

Blackout shades shall be provided for windows within Conference Rooms, Classrooms, or other Multipurpose Rooms for presentations.

• Type: manual, single roller except at locations with blackout shades where double rollers are required.

• Shade Cloth: ThermoVeil.

Acoustic Ceiling Tile:

• Noise Reduction Coefficient (NRC): ASTM C423, minimum 0.55 unless specified otherwise.

• Ceiling Attenuation Class (CAC): ASTM E413, 40-44 range unless specified otherwise.

• Light Reflectance (LR): minimum 0.75.

• Fire Performance: ASTM E119, Class A.

• Metal suspension system: ASTM C635, exposed grid, heavy duty, 15/16”; caulk wall to grid intersection in color to match grid.

• Tile: lay-in, 2’x2’, white.

Pattern Assumptions:

• Assume two accent paint walls per room.

• Assume 15% accent tile in all tile locations.

• Assume 25% accent floor patterns.

Building Entrances and Exits Public doors shall be capable of being remotely locked and unlocked from the reception desk in the main lobby. Secondary public entrance doors shall prevent unauthorized access.

Means of egress doors that do not function as entrances shall be provided with delayed action and alarmed emergency egress hardware. Means of egress shall not be obstructed by the installation of security devices such as guard stations, screening equipment, or other security devices. The main public entrance to the leased space shall contain an Automatic Door Operator (ADO) on each door leading from the building exterior into the main waiting/reception area.

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. Non-bearing interior partitions shall be capable of supporting equipment and furnishings specified for the clinic.

Provide fire and/or smoke rated partitions that comply with published UL, FM Global, or IBC designs. Extend all layers of gypsum board, on both sides of studs, from floor to underside of structure above on the following partitions:

1) Fire rated partitions

2) Security partitions for all Police areas

3) Smoke barriers

4) Sound rated partitions

5) Corridor partitions as required by building code.

Doors and Hardware Contractor to provide a keying system which matches the existing system currently in use at the main facility campus. Cores to be built by the contractor to VA requirements and turned over to the VA for install. All locksets shall be mortise type where required by VA design and security criteria.

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.

Provide card reader system for the entrances to the facility. Locations to be determined during design. System shall be compatible with the existing facility’s system, Identiv uTrust TS Scramblepad HF/LF Terminal PoE Wiegand Reader. Provide all cabinets, power supplies, door contacts, and other hardware and software associated with this system.

Plumbing Fixtures, Trim, and Equipment Lessor shall provide Plumbing systems in accordance with LDN and RDM. Utilize and incorporate the latest edition of VA Plumbing Design Manual as needed.

The items below are in addition to the LDN and RDM where required:

Water closets, urinals, sinks and lavatories shall be vitreous China. Bariatric water closets shall be rated at 1,000 pound [454 kg] capacity. Waterless urinals are not permitted. Service sinks (mop sink/basin) shall be floor mounted.

Faucets and showerheads shall be chromed brass, or stainless steel; plastic trim is not permitted. Faucets shall be laminar flow; aerators are not permitted. Electronic hands-free controls shall be provided at all hand washing sinks and lavatories.

Provide high/low drinking fountain and a standalone water bottle filler. Drinking fountain must be wall-hung, self-contained, electric wheelchair accessible. Hot water re-circulation pump shall be all bronze, with timer-based controls.

Legionella Mitigation There are currently no EPA enforceable regulations governing the levels of Legionella bacteria in potable water systems; however, EPA has issued a Maximum Contaminant Level Goal (MCLG) of 0 ppm [mg/L]. Municipal water supplies and wells can carry Legionella, so it is a given that the bacteria will be introduced into the facility potable water system at some time. The A/E will consider the following design recommendations:

Provide means to easily remove and disinfect all outlet devices such as showerheads and faucets, etc. Utilize self-draining showerheads.

https://www.cfm.va.gov/til/dManual/dmPlbg.pdf

1) Provide a 3⁄4" ball valve at the end of each piping section as a means to drain heated (above 140 °F [60 C̊]) flushing hot water that will be used for initial and supplemental disinfection. Ball valve shall be within 50 feet [15.24 meters] of a floor sink, floor drain, sink, or lavatory.

2) Mix hot/cold water as near the showerhead and faucets as possible.

Eliminate all dead legs in the piping system.

3) Subsequent to piping disinfection required per IPC, and as part of the commissioning process, disinfect the potable water systems against Legionella by one of the following methods:

• Thermal Eradication: Flush 145°F water through all outlets for a period of at least 30 minutes.

• Chlorine: Flush free chlorine at a level of 2 parts per million (PPM) or greater for a period of at least 2 hours. Further information can be found in ASHRAE paper CH-03-3-2.

Fire Extinguishers Portable fire extinguishers recessed in cabinets shall be provided, inspected, and maintained by the Lessor in accordance with National Fire Protection Association (NFPA) 10, Standard for Portable Fire Extinguishers.

Recessed cabinets shall be provided in occupied areas and conspicuously marked. Size fire extinguisher cabinets to accommodate a 2.5 gallon [9.5 liters] pressurized water extinguisher.

Lessor shall adhere to recurring fire extinguisher inspections in accordance with the following:

The Joint Commission EC.02.03.05 The Joint Commission requirement for inspection of fire extinguishers is once per calendar month. There is no minimum and maximum requirement for the interval of days between monthly inspections, but best practice is to maintain an interval as close to 30 days as reasonably possible. The date (MMDDYYYY) the inspection was performed and the initials of the person performing the inspection shall be recorded.

NFPA 10 7.2.1.2 Portable fire extinguishers should be inspected at least monthly, not exceeding 31 days, and more frequently if circumstances dictate. This includes a check for damage, obstructions, proper mounting, pressure gauge readings, and the presence of safety seals.

https://www.jointcommission.org/en-us/knowledge-library/environment-of-care/fire-protection https://studylib.net/doc/27492016/nfpa-10-2022

Electrical and Lighting Lessor shall provide Electrical and Lighting systems in accordance with the LDN and RDM. Utilize and incorporate the latest edition of VA Electrical Design Manual and VA Lighting Design Manual as needed.

The items below are in addition to the LDN and RDM where required:

General Perform all lighting calculations based on illumination criteria per the IES Lighting Handbook, latest edition. Calculations shall include room name, room number, fixture type chosen for the room, number and type of lamps to be used in the room, required illumination level, calculated illumination level, and all assumptions used.

Raceways and Receptacles Electrical distribution components shall have copper bussing. Each panelboard shall contain 25% spare breakers. 100% emergency power with AST for all mission critical sections or can be a standby power system for when serving non-health care related loads.

• Install all wiring in raceways. All wiring shall be copper. All circuits and branch circuits shall have a separate equipment grounding conductor of appropriate size per the NEC.

• No more than 3 branch circuits are allowed to run in one homerun.

• No more than 6 receptacles shall be installed on a single circuit. All receptacles shall comply with NEMA, NFPA, and UL. Duplex Receptacles shall be hospital-grade, single phase, 20 ampere, 120 volts, 2-pole, 3-wire, NEMA 5-20R, with break-off feature for two-circuit operation.

• Lessor shall provide two duplex (QUAD) outlets and adequate data drops for each computer workstation and central printer locations.

• Ground Fault Circuit Interrupter (GFCI) Duplex Receptacles shall be provided at locations within three feet of a water source such as a sink and provided at all outdoor locations. GFCI's shall be an integral unit, hospital-grade, suitable for mounting in a standard outlet box, with end-of-life indication and provisions to isolate the face due to improper wiring.

• Interior wall plates for receptacles shall be type-302 stainless steel. Outdoor receptacles shall be weatherproof.

Lighting Fixtures Select fixtures and light sources with long operating lives; which utilize controlling elements (lenses, louvers, reflectors, etc.) designed to provide the best utilization of emitted light at the task location; that are appropriate for the ambient temperature; and that are not prone to dirt accumulation. In high ceiling areas, locate fixtures for maintenance access or provide access for maintenance equipment.

Exterior lighting shall comply with energy requirements and should comply with Dark Sky principles. When required by VA, exterior lighting designs are to meet the requirements

LESSOR:______GOVERNMENT:______

https://www.cfm.va.gov/til/dManual/dmElec-2025-03.pdf https://vatilms.va.gov/vatilms/criteria-viewer/90711?type=application%2Fpdf&title=Lighting%20Design&name=dmLighting-2022-01.pdf https://vatilms.va.gov/vatilms/criteria-viewer/90711?type=application%2Fpdf&title=Lighting%20Design&name=dmLighting-2022-01.pdf of local outdoor lighting codes. Criteria recommended in the IESNA Guideline for Security Lighting for People, Property, and Public Spaces (latest edition) shall govern the lighting design. Exterior lighting shall be coordinated with physical security, SSTV, and landscaping requirements.

Audio Visual Systems All conference, group, exam and consult rooms which have monitors and or TV’s shall have one data drop, 120 VAC duplex port and TV monitor supports. All waiting rooms and staff lounge shall have power and data port for television service connections installed.

ADMINISTRATIVE REQUIREMENTS

The lessor shall have an onsite building superintendent or a locally designated representative available to promptly respond to deficiencies and immediately address all emergency situations.

Pest Control Lessor shall coordinate application of pesticide and only apply pesticide in a manner that VA agrees is protective of the health of patients, employees, and visitors. The Lessor shall provide additional service at the request of VA, if any signs of re-infestation appear.

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

• Provide interior and exterior extermination of insects and rodents. Use of chemicals shall conform to EPA and State requirements.

• Pest management is to be done using an integrated pest management approach that minimizes the use of toxic chemicals. Pesticide shall only be applied by persons deemed qualified by EPA and state requirements.

Frequency of Building Maintenance Lessor shall develop a written maintenance plan with VA that identifies routine maintenance for lighting, mechanical, emergency and exit lights, fire extinguishers and all building service equipment, including replacing filters at appropriate frequencies.

The Lessor shall also perform other work as necessary to meet code or to maintain a safe and healthy environment. The lessor shall address any other issues that may arise on an as-needed basis.

Janitorial Service A. The Lessor shall provide janitorial services for the leased space, public areas, entrances, and all other common areas and shall provide replacement of supplies. The janitorial services shall be provided during normal business hours.

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

1) Use products that are packaged ecologically.

2) Use products and equipment considered environmentally beneficial and/or recycled products that are phosphate-free, non-corrosive, non-flammable, and fully biodegradable; and,

3) Minimize the use of harsh chemicals and the release of irritating fumes.

4) Examples of acceptable products may be found at www.gsa.gov/p2products.

C. The Lessor shall be responsible for collecting regulated medical waste. Medical waste and full sharps containers shall be collected and placed in hazardous waste receptacles in the soiled utility room. Biohazard trash cans and liners to be provided by the lessor. Removal and disposal to be coordinated by VA. The janitorial staff shall comply with applicable Federal, State, and Local safety and fire regulations and codes.

D. In addition to the janitorial services listed on the lease document, include the following level of services:

1) Daily. Wipe down and disinfect exam tables. Empty and collect regulated medical waste, including sharps containers.

2) Quarterly. Launder, sanitize and replace exam room privacy curtains. Clean and disinfect curtains when it is visibly soiled, after any spill of blood or body fluids and after every isolation case.

3) As Required. Replace worn floor coverings (this includes the moving and returning of furnishings).

http://www.gsa.gov/p2products

SIGNAGE REQUIREMENTS

VA Mandatory Signage is to be used at all VA properties. Additionally, leased properties must follow local lessor guidelines and city and state signage codes, laws, ordinances, and permitting regulations in which they are located.

Lessors A/E shall develop and submit a signage plan for review and approval by the Contracting Officer Representative (COR) during design development.

Interior signage systems shall include identification, directional, informational, and code required signage. The Lessor shall list during design the type, message, and locations in accordance with VA Signage Standards.

Lessor shall purchase and install all interior signs during construction and/or activation per the VA approved design.

Signage to be provided and installed by lessor:

• All life safety and code required signage to comply with local regulatory requirements.

• All room and wayfinding signage required by the final approved floor plan, including:

o Check-in and Check-out signs over the reception desk, and o When patients walk out of exam rooms, provide signs directing them to the check-out desk and the front lobby

• Hardware and installation for the Emergency Exit Plan signage. Inserts to be provided and installed by the VA.

• For all parking to be utilized by the VA as a result of the lease, provide appropriate parking lot signage per VA Signage Design Guide Section 6; PL-12.03 parking stall designation.

• If lease includes stairwells and elevators within the leased space, provide appropriate signage per VA Signage Design Guide Section 8.

• Refer to VA Signage Design Guide Section 1 Design Elements for relevant specifications for typography, letter spacing, contrast, colors, images, and other design elements to be incorporated into all signage provided.

• Refer to VA Signage Design Guide Section 4 Exterior Signs, Section 8 Code and Life Safety Signs and Section 9 Interior Signs for planning guidelines, standard construction details and installation details.

• All message layouts and verbiage to be determined during design.

• Overall Signage Specifications:

o Font: Helvetica Bold.

o Interior Frames: Aluminum, flat surface with square corners.

o Background: Pantone 2965C.

o Cover: clear, non-glare acrylic.

Exterior Signs A complete exterior signage program to include identification, directional, informational, and regulatory signage. Exterior signage shall include all Mandatory VA signage such as no weapons signage at all VA entrances.

• Provide two or more monument signs as required to direct patients and visitors to the building from the main thoroughfare. The final sign types and quantity of signs for the project will depend on the selected site. Careful consideration of the location of monument signs shall be taken to avoid sight triangle encroachment.

• Wall mounted building signs shall be prominently located to be visible from street approach in accordance with VA-approved building elevations.

• Exterior Sign Types:

o EI-01.03 Site Monument

Location: minimum one exterior monument sign to be this sign type, internally illuminated, for primary identification.

o EI-03.01 Post and Panel Building Identification Location: depending on location and total number of monument signs required, additional exterior monument signs provided may be this sign type; non-illuminated with external lighting.

o EN-05.01-03 Single Post Identification, Informational and Directional Sign Location: depending on project site.

Used to identify GOV reserved parking spaces, bike lockers/racks

(dependent on location), and other identified needs during the design process.

o EN-06.01-09 Wall Mounted signs Location: depending on project site.

Used to identify building numbers, separate entrances, specialty parking, bike lockers/racks, and other identified needs during the design process.

o PL-12.03 Single Post & Panel Parking Stall Designation Location: depending on parking location.

Used to: identify or control specific parking areas, spaces, or stalls.

o PL-12.03 Single Post & Panel Parking Stall Designation Location: at accessible parking stalls Used to: identify accessible parking stalls.

Interior Signs

• Interior Sign Types:

o IN-01.01.01 Emergency Exit Plan Location: as required for exiting; minimum at all decision points within the exit path (hallways); determined by final approved floor plan.

o IN-01.31 Fire Equipment Identification Sign

Location: use at all fire extinguishers.

o IN-04.01 Primary Room Identification with Insert Location: refer to Program; most used sign type for individual rooms.

Workstations: provide similar/smaller type with acrylic hanger to go over cubicle walls identifying each workstation. Provide primary IN-

04.03 sign type for each room that has the individual workstations within.

o IN-04.02 Secondary Room Identification with Insert Location: use for building system rooms such as electrical or mechanical rooms.

o IN-07.01-.02 Room Sign with Indicator (In Use) and Paper Insert

Location: refer to Program.

o IN-08.01 No Smoking Location: common areas including hallways, waiting, and vestibules;

determined by final approved floor plan layout.

o IN-08.02 Prohibit Instructional and Control

Location: staff only area(s); determined by final approved floor plan.

o IN-09.01-.06 Restroom Identification

Location: Restrooms; IN-09.03 is shown for all restrooms on the Program; if separate Men and Women toilets are provided for the public toilets, use the appropriate sigs IN-09.01 and IN-09.02 respectively. As all restrooms are to be designed as handicap accessible, signs IN-09.04-.06 should not be used.

o IN-09.08 Pictogram and Symbol Location: Message Layout F sized to incorporate at bottom of IN-

09.01-.06 restroom identification sign for restrooms with baby changing stations.

o IN-11.01-.04 Informational or Instructional Location: refer to Program.

o IN-13.01 Perpendicular (Flag) Mount Location: use for wayfinding and to identify restrooms located in long hallways; determined by final approved floor plan layout.

o IN-14.06-.10 Wall Directional with Insert

Location: for wayfinding; at decision points in hallways; determined by final approved floor plan layout.

o IN-15.55 Ceiling Mounted Directional and Identification with Insert Location: refer to Program and for wayfinding; determined by final approved floor plan layout.

o IN-15.56/15.65/15.66/15.76 Ceiling Mounted Directional and

Department ID with Insert Location: for wayfinding; similar to and/or in lieu of IN-14.06-.10 or

IN-15.55; determined by final approved floor plan layout.

References All signage requirements are excerpts from the VA Signage and Wayfinding Design Guide latest edition, referenced within this document include:

01-Introduction, Acknowledgments & Design Elements

04-Exterior Signs

08-Code and Life Safety Signs

09-Interior Signs https://vatilms.va.gov/vatilms/criteria-viewer/90050?type=application%2Fpdf&title=Signage%20and%20Wayfinding&name=dmSignage-2025-02-19.pdf

Telecommunications Lessor shall provide architectural design services in accordance with the LDN, RDM and the following:

-VA Infrastructure Standard for Telecommunications Spaces

-VA Master Construction Specifications, Division 27 Communications

-VA Electrical Design Manual

Lessor shall coordinate with VA Communications point of contact (POC) for equipment and telecommunications room requirements.

General Requirements Each patch panel will be labeled as directed by the Contracting Officer or Contracting Officer’s Representative.

Data cables are not to pass within 6 inches of fluorescent lights, speakers, or motors mounted above the ceiling.

Intrusion Detection System: Provide connectivity for an intrusion detection system with control panels at each entrance to the space as well as other location designated by the Contracting Officer.

Telecommunications Room Requirements The items below are in addition to the LDN and RDM where required:

1. Automatic door closure installed.

2. Room Door Hinges will be “sealed” to prevent tampering and face room interior.

3. Room door should have a sign specifying “Authorized Personnel Only” https://www.cfm.va.gov/til/telecom/OIT-ISTS.pdf https://vatilms.va.gov/vatilms/reports/PG-18-1%20Master%20Construction%20Specifications/VA%20Specs https://www.cfm.va.gov/til/dManual/dmElec-2025-03.pdf

PHYSICAL SECURITY

Lessor shall be responsible for security monitoring, including duress alarms and intrusion detection. Fire and intrusion detection system monitored 24 hours per day which alarms at the closest Police and Fire Department.

Fire alarm system as required in VA leased space and shall be designed such that they are not affected by vacancies in adjacent spaces. Reference 3.1.1 Fire Alarm Systems of the lease for additional requirements.

Emergency power backup is required for all alarm systems, fire detection systems, entry control devices, lighting, etc., and special equipment. Alarms require immediate and uninterrupted power.

The Government reserves the right, prior to the submission of final revised proposals, to require additional security measures to meet specific tenant occupancy requirements, as may be determined by the Government’s building security assessment or any type of Government risk assessment evaluation of the proposed building, location, and tenant mix. Utilize and incorporate the latest edition of VA Physical Security and Resiliency Design Manual as needed.

https://vatilms.va.gov/vatilms/criteria-viewer/93024?type=application%2Fpdf&title=Physical%20Security%20and%20Resiliency&name=dmPhySec-2025-06.pdf https://vatilms.va.gov/vatilms/criteria-viewer/93024?type=application%2Fpdf&title=Physical%20Security%20and%20Resiliency&name=dmPhySec-2025-06.pdf

ATTACHMENTS

Attachment A – VA Leased CBOC Design Narrative (LDN)

SECTION 1

INTRODUCTION

VA Leased CBOC Design Narrative June 9, 2024 Section 1 - Page 1

1. INTRODUCTION

2. GENERAL REQUIREMENTS

2.1 General

2.2 Codes

2.3 Standards

2.4 References

2.5 Pricing Standards

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, 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

4.3.8 Privacy Curtains / Screens

4.3.9 Flooring, Carpet

June 9, 2024 Section 1 - Page 2

4.3.10 Special Architectural Conditions for Surgical and Endovascular Services

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 Humidification System

4.4.7 HVAC Piping Systems

4.4.8 Air Distribution and Duct Systems

4.4.9 HVAC Insulation Systems

4.4.10 Testing, Adjusting and Balancing

4.4.11 Automatic Temperature Control Systems

4.4.12 Temperature, Humidity and Pressure Monitoring

4.4.13 Special Conditions

4.5 Plumbing

4.5.1 References

4.5.2 Plumbing Design Basis

4.5.3 Medical Gases

4.5.4 Special Conditions

4.6 Electrical

4.6.1 Standby Generator

4.6.2 Special Conditions

4.7 Lighting

4.7.1 General

4.7.2 Indoor Lighting Specifics

4.7.3 Lighting Controls

4.7.4 LED Drivers

4.7.5 Special Conditions

4.8 Telecommunications

4.8.1 Scope of Work

4.8.2 Pathways

4.8.3 Spaces

4.8.4 Telecommunications Bonding and Grounding

4.8.5 Equipment Racks and Equipment Cabinets

4.8.6 Power Distribution Units and Uninterruptable Power Supplies

4.8.7 Telecommunications Infrastructure Plant

4.8.8 Special Systems

5. Hardware Groups and Modifiers

June 9, 2024 Section 1 - Page 3

SECTION 1 - INTRODUCTION

1.1 The purpose of this Leased CBOC Design Narrative is to consolidate the governing codes, standards, references, and guidelines in a document that provides performance-based standards for a VA leased CBOC.

1.2 The governing codes, standards, and references are based on a VA affiliated outpatient clinic.

1.3 The design of the VA leased CBOC shall be based on the Prototype for Standardized Design and Construction of Community Based Outpatient Clinics which is described in Part 3 Planning and Design Criteria.

1.4 This document, and the associated Room Data Matrix (RDM), provides performance-based standards for rooms/functions that are a part of the project’s Program for Design. If there are standards covered by this document, or room types in the RDM, that are not a part of a specific project’s Program for Design, those standards are considered not applicable to that specific project. However, standards added to the grey “additional requirements” boxes in this document are project specific and are applicable.

1.5 Commonly Used Acronyms and Definitions:

PCMH Patient Centered Medical Home

A team based, comprehensive, coordinated patient care model (refer to PACT) PACT Patient Aligned Care Team

Provides service to veterans that is patient-centered with the right care at the right time by the right person. A typical “teamlet” serving a veteran consists of four caregivers: A Primary Care Provider – physician (MD), physician assistant (PA) or nurse practitioner (NP); a Registered Nurse (RN); a clinical staff assistant (LPN or Medical Assistant) and an administrative staff member (Clerk).

CBOC Community Based Outpatient Clinic Is VA-operated, VA-funded, or VA-reimbursed site of care which is located separate from a VA Medical Facility. A CBOC can provide primary, specialty, subspeciality, mental health, or any combination of healthcare delivery services that can be appropriately provided in an outpatient setting.

PFD Program for Design Net square feet (NSF) listing of all spaces and rooms that are to be included in a construction project.

VA Veterans Affairs VHA Veterans Health Administration VISN Veterans Integrated Services Network RDM Room Data Matrix

SECTION 2

GENERAL REQUIREMENTS

VA Leased CBOC Design Narrative June 9, 2024 Section 2 - Page 1

SECTION 2 – GENERAL REQUIREMENTS

2.1 General

2.1.1 The codes and standards listed below indicate minimum performance requirements.

Minimum requirements or standards may be exceeded by site specific project design.

2.1.2 Compliance is required with applicable codes and standards throughout the process of design, construction, acceptance, and on-going maintenance of the facility.

2.1.3 Design and construction of the CBOC shall be in compliance with the requirements of the GSA Form L100 Global Lease as well as the codes and standards listed below.

This Leased CBOC Design Narrative covers construction materials and standards not fully addressed by the codes, standards, and references below.

2.1.4 Use the most current edition at the date and time of bid submission.

2.2 Codes

2.2.1 All VA leased CBOC facilities are to conform to the most recent applicable codes, which include but is not limited to following:

2.2.1.1 State and local codes as required by the local Authority Having Jurisdiction

(AHJ).

2.2.1.2 National Fire Protection Association (NFPA), NFPA 101 Life Safety Code and those codes and standards referenced by NFPA 101. (NFPA 99 Health Care Facilities Code, etc.)

2.2.1.3 NFPA 70B Standard for Electrical Equipment Maintenance, NFPA 70E Workplace Electrical Safety, NFPA 75 Standard for the Fire Protection of Information Technology.

2.2.1.4 Architectural Barriers Act Accessibility Standards (ABAAS), current edition.

2.2.1.5 International Building Code (IBC): The latest edition shall be used for structural, wind load and seismic design.

Additional Code information:

• Lessor shall work with AHJ to properly determine occupancy type, with the following considerations:

o List rooms or procedures that are planned that may render a patient incapable of self-preservation.

• Applicable to NFPA 99, the facility is considered Category (Insert determined category from risk assessment or insert table that shows different categories for different departments.)

2.3 Standards

2.3.1 All leased CBOC facilities are to conform to the following standards:

2.3.1.1 FGI Guidelines for the Design and Construction of Outpatient Facilities, current edition (referred to as FGI Guidelines herein).

2.3.1.2 The Joint Commission (TJC) accreditation standards apply to the facility under the affiliated VA medical center license. Building construction and on-going

June 9, 2024 Section 2 - Page 2 maintenance procedures shall meet TJC standards. Lessor shall provide and submit all documentation that is required for TJC requirements.

2.3.1.3 Facility Security Level (FSL) shall be as outlined in GSA Form L100 Global Lease.

2.3.1.4 Sustainability standards shall be as outlined in GSA Form L100 Global Lease.

2.3.1.5 American Society of Heating, Refrigerating and Air-Conditioning Engineers

(ASHRAE) Standard 170, Ventilation of Health Care Facilities, current edition (referred to as ASHRAE 170 herein)

2.3.1.6 ASHRAE Standard 12, Minimizing the Risk of Legionellosis Associated with Building Water Systems, current edition.

2.3.1.7 ASHRAE Standard 188, Legionellosis: Risk Management for Building Water Systems, current edition.

2.3.1.8 ASHRAE Standard 62.1, Ventilation for Acceptable Indoor Air Quality, current edition (referred to as ASHRAE 62.1 herein)

2.3.1.9 ANSI/ASHRAE/IES Standard 90.1-2019 -- Energy Standard for Buildings Except Low-Rise Residential Buildings

2.3.1.10 Sheet Metal and Air Conditioning Contractors National Association (SMACNA) Standard, HVAC Duct Construction Standards - Metal and Flexible.

2.3.1.11 USP General Chapter 795 Pharmaceutical Compounding – Nonsterile Preparations

2.3.1.12 USP General Chapter 797 Pharmaceutical Compounding – Sterile Preparations

2.3.1.13 USP General Chapter 800 Hazardous Drugs - Handling in Healthcare Settings

2.3.1.14 Association for the Advancement of Medical Instruments (AAMI) standards as applicable to SPS and RME storage

2.3.1.15 Illuminating Engineering Society North America (IESNA) Handbook - latest edition

2.3.1.16 VA Signage Design Manual PG 18-12

2.3.1.17 H 18-8 Seismic Design Handbook is required when the clinic includes

Ambulatory Surgery

2.3.1.18 VA HVAC Design Manual (Specifically regarding the AHU design requirements for Pharmacy Compounding Suite, Sterile Processing Service (SPS), and Surgical Suite)

2.4 References

2.4.1 The following guides, manuals, and other references developed by VA are for reference only:

2.4.1.1 VA Enterprise Facility IT Support Infrastructure Standard, most current.

2.4.1.2 Prototype for Standardized Design and Construction of Community Based

Outpatient Clinicshttps://www.cfm.va.gov/til/prototypes.asp#CBOC

2.4.1.3 PACT Space Module Design Guide

https://www.cfm.va.gov/til/dGuide/dgPACT.pdf

2.4.1.4 Room Templates, Leased Community Based Outpatient Clinics https://www.cfm.va.gov/til/rTemplate/LeasingCBOCw.asp

2.4.1.5 VA Design Guides (PG18-12)

2.5 Pricing Standards

LESSOR:______GOVERNMENT:______

https://www.cfm.va.gov/til/prototypes.asp#CBOC https://www.cfm.va.gov/til/dGuide/dgPACT.pdf https://www.cfm.va.gov/til/rTemplate/LeasingCBOCw.asp

June 9, 2024 Section 2 - Page 3

2.5.1 Building Shell Definition

2.5.1.1 Building shell is the complete enveloping structure, the base building systems, the complete HVAC system, and the finished common areas (building common and floor common) of a building that adjoin the occupant areas.

2.5.1.2 Any demolition cost necessary shall be included in the building shell rental rate.

2.5.1.3 Third-party green building certification do not change what elements are considered part of building shell or tenant improvements. Instead, building elements may be required to have certain attributes, such as low volatile organic compound emissions.

2.5.1.4 Section 3 of the L-100 provides minimum requirements of the shell. Any further requirements identified in this LDN to items in Section 3 shall remain shell unless specifically designated as TI.

2.5.1.5 The following table shows the Shell requirements of the Base Building and the Occupant Areas.

June 9, 2024 Section 2 - Page 4

Base Building Occupant Areas

Base structure and building enclosure components (windows with exterior finishes) and any required enhancements (canopies, progressive collapse, etc.)

are complete.

Broom-clean concrete floor slab, with a flat and level floor.

Base building electrical and plumbing systems (e.g., central fire alarm, chiller plant, cooling tower) are complete and functional.

Gypsum wallboard, spackled and prime painted, on exterior perimeter walls and tenant demising walls, without suite entry door.

Entire HVAC system is complete and functional. Conditioned space per the RDM.

All common areas, such as lobbies, elevators, fire egress corridors and stairwells, garages, and service areas are complete.

Suspended acoustical ceiling system including grid and lay-in tiles (or other building standard). Lighting luminaires should be installed in the ceiling grid for an open office plan at the rate of fixtures per 80 USF. Lighting controls with ambient lighting adjusted per daylight availability, occupancy, vacancy, or other building automation system signals.

Building common restrooms are complete and operational.

Tappable domestic water riser, service sanitary drain, sanitary vent, ready for extension to tenant demised areas.

All electrical power distribution panels and circuit breakers available in electrical closets, with capacities at 120/208 volt, 3- phase, 4-wire and 277/480 volt, 3-phase, 4-wire.

Any portion of a code required alternate power source (emergency generator, Essential Electrical System, etc.), required to support building life safety requirements including but not limited to transfer switches and distribution.

Designated connection point to the central fire alarm system for extension to tenant demised areas.

All fire alarm devices necessary required by tenant layout and AHJ.

Fire suppression system ready for extension to tenant demised areas.

Sprinkler mains and distribution piping in a protection layout (open plan) with heads turned down, concealed with an escutcheon or trim plate, are installed.

Conduit pathways to distribution backboard within a demarcation room for connection to tenant telecommunications MCR or TR.

All security requirements designated as “Shell” in the Facility Security Level (FSL) Appendix are complete.

Proposed and required exterior site (property) improvements required for VA’s use of the premises and local municipality required off-site improvements are complete.

June 9, 2024 Section 2 - Page 5

2.5.2 Tenant Improvement Definitions

2.5.2.1 TIs are the finishes and fixtures that typically take space from the shell condition to a finished, usable condition. The resulting space is complete and meets applicable building codes.

2.5.2.2 TIs are typically items in addition to the items listed in the table above.

2.5.2.3 Section 5 of the L-100 provides minimum requirements of the TI. Any further requirements identified in this LDN to items in Section 5 shall remain TI unless specifically designated as Shell.

2.5.2.4 Typical Tenant Improvements include:

2.5.2.4.1 Electrical wiring, outlets, and horizontal conduit, including cable trays and hooks, within the demised premises. Telephone jacks, data, jacks, and horizontal conduit, including cable trays and hooks, within the demised premises.

2.5.2.4.2 Carpeting or other floor covering; raised access flooring.

2.5.2.4.3 Plumbing fixtures withing the demised premises and all distribution, drainage and vent piping connecting to the building core – except for common bathrooms.

2.5.2.4.4 Partitioning and wall finishes

2.5.2.4.5 Doors, sidelights, frames, and hardware.

2.5.2.4.6 Millwork

2.5.2.4.7 Window treatments

2.5.2.4.8 Adjustments or repositioning of fire sprinkler to avoid conflict with partitioning; additional sprinklers required by code to meet layout.

2.5.2.4.9 VA required signage on site, in the common areas and within the demised premises.

2.5.2.4.10 Additional lighting over the open office layout at a rate of fixtures per 80

USF.

2.5.2.4.11 Exterior site amenities required such as therapy gardens, gait training therapy areas and dining areas (site amenities proposed as building improvements by the lessor shall be shell).

2.5.2.4.12 Interior and exterior components of special systems required such as nurse call and duress systems.

2.6 CPM Schedule Requirements

CPM Schedules must include the following milestones.

2.6.1 Permits Received

2.6.2 Structure Complete (steel erection)

2.6.3 Dry-in (skin and windows)

2.6.4 Conditioned Space (HVAC equipment startup)

SECTION 3

PLANNING AND DESIGN CRITERIA

May 1, 2024 Section 3 - Page 1

SECTION 3 – PLANNING AND DESIGN CRITERIA

3.1. Background

3.1.1. VHA has committed to the development of a patient-centered medical home model for enhanced outpatient primary care services to veterans. The result was a patient care delivery model and a set of planning and design standards.

3.2. Community Based Outpatient Clinics (CBOC) Planning Approach

3.2.1. The development of the PACT Planning Module was complimented by the development of a Prototype for Standardized Design and Construction of Community Based Outpatient Clinics. Using the PACT Module as the building block, prototypes were developed for three types and sizes of outpatient facilities.

3.3. Room Data Matrix

3.3.1. A collection of typical rooms within leased CBOCs. It lists the required finishes, STC ratings, ceiling heights, door size and type, hardware sets, HVAC space ventilation, number of electrical receptacles, lighting controls and fixture types, and number of standard density work area outlets for each room type.

3.3.2. The Lessor shall associate rooms listed on the program for design with the room data matrix by room name. Use department level room names and types when available, otherwise use general room/space for like room function.

3.3.3. FGI Equivalent for ASHRAE 170 – Where HVAC space ventilation requirements are omitted, ASHRAE 170 Tables 8-1 and 8-2 shall be followed. Column “FGI Equivalent for ASHRAE 170” lists the equivalent room name for use in the tables.

3.3.4. FGI Equivalent for Table 1.2-5 “Minimum Sound Isolation” - Where Column “STC” in the Room Data Matrix states “See FGI”, Column “FGI Equivalent for Table 1.2-5 Minimum Sound…