Exhibit C Concept Drawing with Program for Design.pdf

SHARED GROUP

OCB21

MH STORAGE

OCB24

MH STOR

OCB24

SHARED GROUP

OCB21

BLOOD DRAW

CL821

BLOOD DRAW

CL821

TOILET

SB198

LAB

CL823

RECEPTION/ADMIN

SS218

EYE FITTING &

DISPENSE

CEY91

EYE TEAM WORK

AREA

RADIOLOGY, GEN

PURPOSE

CI011

EYE EXAM

CEY53

EYE EXAM

CEY53

TELE RETINAL

IMAGING

CEY62

OPTOMETRY

TESTING

CEY52

PATIENT

ENROLLMENT

OFFICE

SC274

TOILET

SB163

TOILET

SB163

AUDIOMETRIC

STORAGE

SB721

TEST ROOM

CAS11

HEARING AID

FITTING

CAS94

HEARING AID

FITTING

CAS94

PAT TLT

SB201

STORAGE,

PROSTHETICS

APPLIANCES

CPR56

PRM STOR

CT233

PRM TREATMENT

EXERCISE AREA

CT232

RAD TECH

CI012

STORAGE, PMR

CONTROL ROOM

CAS11

TELECOMMUNICATIONS

SC391

CLEAN SUPPLIES

SB741

STAFF LOUNGE

SS262

LACTATION

CWV11

CONFERENCE

SB291

STORAGE, MED

EQUIP

SB721

STAFF LOCKERS

SS251

STERILE SUPPLIES

SB763

RECYCLE, TRASH,

BIO

SB244

HAD

SC063

TOILET

SB191

PACT EXAM

OCB31

PACT EXAM

OCB31

PACT CONSULT

SC271

PACT EXAM

OCB31

PACT EXAM

OCB31

PT/OT EXAM

CT231

PACT CONSULT

SC271

PACT EXAM

OCB31

PACT EXAM

OCB31

PACT CONSULT

SC271

POINT OF USE MED

SV581

PACT EXAM

OCB31

PACT EXAM

OCB31

PACT CONSULT

SC271

PACT EXAM

OCB31

PACT EXAM

OCB31

CLINIC DIRECTOR

OFFICE

SS209

NURSE MANAGER

OFFICE

SS209

TELE-RETINAL

SC249

TELE-HEALTH

SC249

BARIATRIC EXAM

OCB37

WOMEN'S TLT

SB159

WOMEN'S EXAM

CWV16 PATIENT TLT

SB201

POINT OF USE MED

SV581

STAFF TLT

SB191

SPC EXAM CON

TOILET

BARIATRIC EXAM

OCB37

SPC EXAM CON SPC EXAM CON

PAT TLT

SB201 SPC EXAM CON SPC EXAM CON

HBPC

SS217

HBPC STORE

SB741

MH CONSULT

OCM05

MH CONSULT

OCM05

MH EXAM

OCM05

MH CONSULT

OCM05

MH CONSULT

OCM05

MH CONSULT

OCM05

WC STOR

SB262

VESTIBULE

SB291

PATIENT CORRIDOR

PACT TEAM WORK AREA

SS218

PATIENT CORRIDOR

PATIENT CORRIDOR

PACT TEAM WORK AREA

SS218

A L C

O V

E

SCALES

SC066

PATIENT

ED

KIOSK

VENDING AREA

SV692

VOLUNTEER

OCB16

WAITING

SB001

WAITING

SB003

WAITING

SB003

FAMILY WAITING

SB051

117' - 2" 48' - 3" 13' - 1"

178' - 6"

/2

/2

CARTS

SC079

CARTS

SC079

AUDIOMETRIC BOOTH

SB272 SB272

STAFF WORKROOM

STORAGE

SC231

UTILITIES

COPIER/SUPPLY

SS268

COPIER/SUPPLY

SS268

CLEAN SUPPLY

STORAGE

CL831

BLOOD DRAW

CL821

VETERAN VIDEO

CONNECT

SB244

COLD SPRING RD, INDIANAPOLIS, IN

01/17/2023ROUDEBUSH VA- CBOC CONCEPT (BLOOMINGTON)

SCALE: 1/8" = 1'-0"SB104

1 CONCEPT FLOOR PLAN

N

PROGRAM FOR DESIGN

BLOOMINGTON NEW SPACE CRITERIA

UPDATED TO REFLECT CHANGES IN SEPS PROGRAMMING

BLOOMINGTON INDIANA

Projected Year: 2023 Midpoint Year: 2027

VISN: 11 State: IN Station ID: 583 Station: Indianapolis

Installation: Richard L. Roudebush VA Med. Cntr.

Project Created: 22 Mar 2022 09:27AM ET by Julie Webb Space Plan Last Edited: 30 Jun 2022 08:43AM ET by Julie Webb

Contents List Created: 22 Mar 2022 09:59AM ET by Julie Webb Contents List Last Edited: 30 Jun 2022 08:43AM ET by Julie Webb

Report Generated: 30 Jun 2022 08:44AM

Department: 1 - COMMUNITY BASED OUTPATIENT CLINIC (CBOC) (265)

Functional Area: 1 - OUTDOOR PUBLIC AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 SB101 CBOC Veteran Drop-off, Bldg Sprt 0 0 1 1

1 SB103 CBOC Bicycle Rack Area, Bldg Sprt 0 0 1 1

1 SB104 CBOC Service Dog Walk Area, Bldg Sprt 0 0 1 1

FA Totals: Room Qty: 3 Net Area: 0 Gross Area: 0

Department: 1 - COMMUNITY BASED OUTPATIENT CLINIC (CBOC) (265)

Functional Area: 2 - INDOOR PUBLIC AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 SB262 CBOC Wheelchair Corral / Parking, Clncl Sprt 60 60 1 0

1 SB291 CBOC Vestibule / Indoor Buffer, Bldg Sprt 0 0 1 1

FA Totals: Room Qty: 2 Net Area: 60 Gross Area: 90

Privacy Act - FOR OFFICIAL USE ONLY

Program For Design (30 Jun 2022 08:44AM)

BLOOMINGTON NEW SPACE CRITERIA

UPDATED TO REFLECT CHANGES IN SEPS PROGRAMMING

BLOOMINGTON INDIANA

Functional Area: 3 - VETERAN WELCOME AREA / MAIN STREET

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 OCB16 Veteran Information / Welcome Area Storage Alcove, CBOC 40 40 1 1

1 SB003 CBOC Veteran / Guest Seating, Bldg Sprt 575 575 1 1

1 SB051 CBOC Family Seating, Bldg Sprt 90 90 1 1

1 SB163 CBOC Bariatric Patient Toilet, Bldg Sprt 75 75 1 1

1 SB191 CBOC Universal Single Occupant Toilet, Bldg Sprt 65 65 1 1

1 SB244 CBOC Housekeeping Aides Closet (HAC), Bldg Sprt 0 0 1 1

1 SC274 CBOC Veteran Video Connect Station, Clncl Sprt 60 60 1 1

1 SS203 CBOC Patient Enrollment Office, Stff Sprt 110 110 1 0

FA Totals: Room Qty: 8 Net Area: 1,015 Gross Area: 1,523

Department: 1 - COMMUNITY BASED OUTPATIENT CLINIC (CBOC) (265)

Functional Area: 4 - CAFE / REFRESHMENT AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 SB207 CBOC Outdoor Seating, Bldg Sprt 0 0 1 1

1 SV692 CBOC Vending Area, VC Svc 250 250 1 1

FA Totals: Room Qty: 2 Net Area: 250 Gross Area: 375

Privacy Act - FOR OFFICIAL USE ONLY

Program For Design (30 Jun 2022 08:44AM)

BLOOMINGTON NEW SPACE CRITERIA

Functional Area: 5 - VETERAN EDUCATION / GROUP CARE AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 OCB21 Shared Group / Multifunction Room, CBOC 300 300 1 0

1 OCB21 Shared Group / Multifunction Room, CBOC 300 300 1 0

2 OCB24 Shared Group / Multifunction Storage Room, CBOC 70 140 1 0

FA Totals: Room Qty: 4 Net Area: 740 Gross Area: 1,110

Department: 1 - COMMUNITY BASED OUTPATIENT CLINIC (CBOC) (265)

Functional Area: 6 - PHYSICAL MEDICINE, PROSTHETICS & ORTHOTICS AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 CPR56 CBOC Prosthetics Supplies Storage Room, Prsthtcs Svc 100 100 1 0

1 CT231 CBOC PT/OT Patient Care Room, PMR Svc 125 125 1 0

1 CT232 CBOC PT/OT Multiple Treatment Station Room, PMR Svc 350 350 1 0

1 CT233 CBOC PT/OT Equipment Storage Room, PMR Svc 80 80 1 0

1 CT237 CBOC Clinical Supply Storage Room, PMR Svc 60 60 1 0

FA Totals: Room Qty: 5 Net Area: 715 Gross Area: 1,073

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Program For Design (30 Jun 2022 08:44AM)

BLOOMINGTON NEW SPACE CRITERIA

Functional Area: 7 - LABORATORY MEDICINE AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

2 CL821 CBOC Blood Draw Station, Path Svc 65 130 1 0

1 CL822 CBOC Bariatric Blood Draw Station, Path Svc 80 80 1 1

1 CL823 CBOC Laboratory Specimen Processing, Path Svc 150 150 1 1

1 CL831 CBOC Laboratory Clean Supply Storage Room, Path Svc 60 60 1 1

1 SB198 CBOC Specimen Collection Toilet, Bldg Sprt 65 65 1 0

FA Totals: Room Qty: 6 Net Area: 485 Gross Area: 728

Department: 1 - COMMUNITY BASED OUTPATIENT CLINIC (CBOC) (265)

Functional Area: 8 - IMAGING AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 CI011 CBOC Radiology Class 1 Imaging Room, Imgng Svcs 300 300 1 0

1 CI012 CBOC Radiology Class 1 Imaging Control Alcove, Imgng Svcs 75 75 1 0

FA Totals: Room Qty: 2 Net Area: 375 Gross Area: 563

Privacy Act - FOR OFFICIAL USE ONLY

Program For Design (30 Jun 2022 08:44AM)

BLOOMINGTON NEW SPACE CRITERIA

Functional Area: 9 - PATIENT CARE AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 CAS11 CBOC Audiometric Booth Patient Care Room, ASLP Svc 260 260 1 0

2 CAS94 CBOC Hearing Aid Fitting Patient Care Room, ASLP Svc 140 280 1 0

1 CEY52 CBOC Optometry Testing Patient Care Room, Eye Clnc 140 140 1 0

2 CEY53 CBOC Optometry Patient Care Room, Eye Clnc 140 280 1 0

1 CEY62 CBOC Tele Retinal Imaging Patient Care Room, Eye Clnc 125 125 1 1

1 CEY91 CBOC Eyeglass Fitting & Dispensing Patient Care Room, Eye Clnc 125 125 1 0

1 CWV16 Women Veteran Patient Care Room, CBOC 125 125 1 1

13 OCB31 General Patient Care Room, CBOC 125 1,625 1 0

2 OCB37 Multi-Use / Bariatric Patient Care Room, CBOC 180 360 1 1

6 OCM05 CBOC Counseling Patient Care Room, CB MH 125 750 1 0

1 SB001 CBOC Dilation Seating Alcove, Bldg Sprt 60 60 1 0

1 SB159 CBOC Women Veteran Patient Toilet, Bldg Sprt 75 75 1 1

2 SB201 CBOC Patient Toilet, Bldg Sprt 75 150 1 0

2 SC066 CBOC Accessible Patient Height & Weight Station, Clncl Sprt 40 80 1 1

2 SC249 CBOC Telehealth Patient Care Room, Clncl Sprt 125 250 1 0

6 SC271 CBOC Consult Patient Care Room, Clncl Sprt 125 750 1 0

FA Totals: Room Qty: 44 Net Area: 5,435 Gross Area: 8,153

Privacy Act - FOR OFFICIAL USE ONLY

Program For Design (30 Jun 2022 08:44AM)

BLOOMINGTON NEW SPACE CRITERIA

Functional Area: 10 - TEAMWORK AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

2 SC079 CBOC Point of Use Equipment Alcove, Clncl Sprt 50 100 1 0

4 SS217 CBOC Hoteling Workstation, Home Based Primary Care 48 192 1 0

24 SS218 CBOC Clinical Staff Workstation, Stff Sprt 56 1,344 1 0

2 SS268 CBOC Team Copy / Supply Alcove, Stff Sprt 50 100 1 0

1 SS291 CBOC Huddle Space, Stff Sprt 180 180 1 0

2 SV581 CBOC Point of Use Medication Alcove, Phrm Svc 50 100 1 0

FA Totals: Room Qty: 35 Net Area: 2,016 Gross Area: 3,024

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Program For Design (30 Jun 2022 08:44AM)

BLOOMINGTON NEW SPACE CRITERIA

Functional Area: 11 - LOGISTICS AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 SB106 CBOC Covered Drop-off / Pick-Up, Bldg Sprt 0 0 1 1

1 SB244 CBOC Housekeeping Aides Closet (HAC), Bldg Sprt 0 0 1 1

1 SB272 CBOC Recycling Holding Station, Bldg Sprt 40 40 1 0

1 SB289 CBOC Trash Holding Room, Bldg Sprt 60 60 1 0

1 SB721 CBOC Medical Equipment Storage Room, Lgstcs Svc 150 150 1 1

1 SB721 CBOC Medical Equipment Storage Room/Lab, Audiology Service 140 140 1 0

1 SB741 CBOC Clinical Supplies Storage Room, Home Based Primary Care 100 100 1 0

1 SB741 CBOC Clinical Supplies Storage Room, Lgstcs Svc 100 100 1 1

1 SB763 CBOC Sterile Supplies Storage Room, Lgstcs Svc 100 100 1 1

1 SC391 CBOC Telecommunications Room (TR), OIT 170 170 1 1

1 SC393 CBOC Demarc Room, OIT 0 0 1 1

FA Totals: Room Qty: 11 Net Area: 860 Gross Area: 1,290

Privacy Act - FOR OFFICIAL USE ONLY

Program For Design (30 Jun 2022 08:44AM)

BLOOMINGTON NEW SPACE CRITERIA

Functional Area: 13 - MANAGEMENT AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 SC063 CBOC Clinical Training Materials Storage Room, Clncl Sprt 60 60 1 0

1 SC231 CBOC Staff Workroom / Storage Room, Clncl Sprt 120 120 1 1

2 SS209 CBOC Shared Leadership Office, Stff Sprt 100 200 1 1

1 SS218 CBOC Administrative Staff Workstation, Stff Sprt 56 56 1 1

4 SS218 CBOC HAS Workstation, Stff Sprt 56 224 1 0

1 SS268 CBOC Copy / Supply Station, Stff Sprt 40 40 1 0

FA Totals: Room Qty: 10 Net Area: 700 Gross Area: 1,050

Department: 1 - COMMUNITY BASED OUTPATIENT CLINIC (CBOC) (265)

Functional Area: 14 - STAFF WELLNESS AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 CWV11 CBOC Staff Lactation Room, Wm Vet Svc 75 75 1 0

2 SB191 CBOC Universal Staff Toilet, Bldg Sprt 65 130 1 1

1 SS251 CBOC Staff Personal Property Locker Alcove, Stff Sprt 100 100 1 0

1 SS262 CBOC Clinical Neighborhood Staff Multipurpose Room / Breakroom, Stff Sprt 220 220 1 1

1 SS275 CBOC Staff Outdoor Eating Area, Stff Sprt 0 0 1 1

FA Totals: Room Qty: 6 Net Area: 525 Gross Area: 788

Dept Totals: Room Qty: 138 Net Area: 13,176 Gross Area: 19,764

Bldg Totals: Room Qty: 138 Net Area: 13,176 Sum of Dept Gross Area: Gross Area: 26,68119,764

Privacy Act - FOR OFFICIAL USE ONLY

Program For Design (30 Jun 2022 08:44AM)

BLOOMINGTON NEW SPACE CRITERIA

Privacy Act - FOR OFFICIAL USE ONLY

Program For Design (30 Jun 2022 08:44AM)

BLOOMINGTON NEW SPACE CRITERIA

Building Area Summary And Net to Gross Factor Breakdown

Current Building Factor applied to this Project: 1.35

Building GSF

Current 26,681

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Program For Design (30 Jun 2022 08:44AM)

BLOOMINGTON NEW SPACE CRITERIA

PFD_BLOOMINGTON NEW SPACE CRITERIA