Atch 1 PWS Laundry_MDG Laundry_14Nov19.pdf

Solicitation Number: FA480120Q0004

Attachment 1 Page 1 of 17

PERFORMANCE WORK STATEMENT (PWS)

LAUNDRY SERVICES

for

MEDICAL GROUP (MDG)

HOLLOMAN AFB, NM

14 November 2019

REVIEWED BY:

BOBBY G. MIDDLETON, Civ, DAF Date Contracting Officer Representative (COR) 49 MDSS/SGSM

LIANA L. VOGEL, Lt Col, USAF, MSC Date Administrator, 49 MDG/SGA Medical Service Contract Review and Authorization Activity

PATTI J. REN, Civ, DAF Date Quality Assurance Program Coordinator (QAPC), 49 CONS/PKP

APPROVED:

DateSALLY D. ROBERTS, Civ, DAF USAF

Contracting Officer, 49 CONS/PKA

21 Nov 19

21 Nov 19

04 Dec 2019

04 Dec 2019

MIDDLETON.BOBBY.

GENE.JR.1103169506

Digitally signed by

MIDDLETON.BOBBY.GENE.JR.1103169506

Date: 2019.11.21 09:54:01 -07'00'

VOGEL.LIANA.LU

CAS.1081721196

Digitally signed by

VOGEL.LIANA.LUCAS.1081721196

Date: 2019.11.21 11:58:18 -07'00'

Attachment 1 Page 2 of 17

TABLE OF CONTENTS

PARAGRAPH, DESCRIPTION ............................................................................................................ Page

1.0 DESCRIPTION OF SERVICES:

2.0 SERVICE SUMMARY (SS):

3.0 GOVERNMENT FURNISHED PROPERTY, SERVICES AND MATERIALS

4.0 GENERAL INFORMATION

5.0 APPENDICES

APPENDIX A – METHOD OF FINISH AND PACKAGING

APPENDIX B – INSPECTION OF LAUNDRY SERVICES

APPENDIX C – INVENTORY/MANIFEST FORM

APPENDIX D – REFERENCES AND/OR PUBLICATIONS

Attachment 1 Page 3 of 17

1.0 DESCRIPTION OF SERVICES:

1.1 Scope of Work:

The Contractor shall provide all personnel, equipment, tools, materials, supervision and other items and services necessary to perform laundry service. Multiple site pick-ups are required at Holloman AFB (HAFB), NM. Contract shall be performed in a manner that will provide clean laundry in accordance with local, county, state, federal and professional industry standards and as required in this PWS.

Payment shall be calculated based on dry bulk weight or per item as specified in bid sheet.

1.2 Service Schedule:

Service shall be in accordance with the schedule in the table below:

Pickup / Delivery Points and Days Location Monday Tuesday Wednesday Thursday Friday

Medical Clinic Area Bldg 23; Room 1D01 P,D P,D P,D

Dental Clinic Bldg 20; Rooms 143, 171 P,D P,D P,D

P-for pickup, D-for delivery

1.2.1. Hours of Operation:

The Contractor shall perform the on-site services required under this contract during the following hours:

7:30 am - 4:30 pm, Monday through Friday, except on U.S. holidays specified in section 1.2.2 of this PWS. No on-site work shall be scheduled or performed on holidays unless previously approved or directed by the COR. If the contractor desires to work on non-scheduled workdays, he/she must submit a written request to the COR for approval.

1.2.2. Service will not be required on the following Federal holidays. When one of these Holidays occurs on a scheduled pickup/delivery day the scheduled pick-up and delivery will be performed on the first work day following the holiday.

Day Holiday First Day of January New Year's Day* Third Monday of January Martin Luther King, Jr. Birthday Third Monday of February President’s Day Last Monday of May Memorial Day Fourth of July Independence Day* First Monday of September Labor Day Second Monday of October Columbus Day 11 November Veteran’s Day* Last Thursday of November Thanksgiving Day 25 December Christmas Day*

*If holiday falls on a Saturday, it will be observed on the preceding Friday. If it falls on a Sunday, it will be observed on the following Monday.

Attachment 1 Page 4 of 17

Pickup and delivery service is required on all other Federal holidays in accordance with this PWS unless otherwise coordinated through the Contracting Officer (CO).

1.2.3. AETC Family Day:

Several dates per year are designated by AETC/CC as “AETC Family Day”. The base is minimally manned on these days. Laundry service shall be continued according to this PWS unless otherwise coordinated through the CO.

1.2.4. Performance of Services during Crisis Declared by the National Command Authority:

All services performed under this contract have been determined to be non-essential for performance during crisis and, according to Department of Defense Instruction (DODI) 3020.37, it is determined that the Contractor will not be required to perform during crisis, except as annotated here within. The CO will verbally or in writing advise the Contractor of the effort required in such condition. CLINs X001 and X002 are determined to be critical and after three (3) days of Government shut down, services for these CLINs are to resume on the 4th day.

1.3. Medical/Dental Requirements

1.3.1. Laundry facility must comply with appropriate Air Force Instruction standards and directives at Appendix D. The Contractor's facility will be subject to inspection for sanitary conditions by the Government at any time.

1.3.2. Contractor is responsible for proper handling of medical linen and laundry in accordance with standards and directives at Appendix D. The contractor shall comply with all local health regulations and/or state laws pertaining to the transportation and handling of medical linen. For the purposes of this contract, all medical linen picked up will be treated as contaminated.

1.3.3. Annual Infection Control/Medical Laundry Compliance Inspection will be accomplish per AFI 44- 108, Infection Control Program, Para 3.11.1 inclusive. The COR will provide the Contractor a notification of the 49th Med Group's designated Infection Control Officer. This individual will conduct an inspection of the Contractor's facilities prior to award of a contract to assess compliance with the requirements for medical laundry set out in this PWS Upon award of a contract the Infection Control Officer will inspect the facility annually, using the checklist at Appendix B. The Contractor, COR, and CO will be given a copy of the inspection's findings. Discrepancies/deficiencies noted during this inspection will be re-inspected no more than 30 days later for correction. If the discrepancies/infractions are not corrected at the time of the re-inspection the COR shall record the discrepancy/deficiency and initiate and provide the CO a Contract Discrepancy Report (CDR) DD Form 2772 for issuance to the contractor. The contractor shall respond to the CDR in accordance with (IAW) instructions provided and return it to the CO within ten

(10) calendar days of receipt. The COR will retain the documented inspection reports in the contract surveillance files.

1.4. Piece Laundry:

All piece laundry will be returned to the originating pick up location. Contractor is responsible for providing suitable containers for laundry pick up and return. The Contractor will be accountable for all items while in their care. All cleaned items will be finished and packaged/bundled according to the table at Appendix A.

1.5. Bulk Laundry:

All bulk laundry will be returned to the originating pick up location. Contractor is responsible for providing suitable containers for laundry pick up and return. The Contractor will be accountable for all items while in their care. All cleaned items will be finished and packaged according to Appendix A.

Attachment 1 Page 5 of 17

1.5.1. Medical and Dental Lodging:

All laundry shall be returned wrapped or packaged as directed in this PWS at Appendix A. Bulk linen will be separated in carts by category of item. Items in carts will be covered with protective covering.

1.6. Re-performance of Laundry:

Any delivered article found to be dirty shall be re-cleaned at no additional cost to the Government. The Government will segregate and itemize these items and present them at the next scheduled pickup. The Contractor will re-launder them and return them segregated and itemized from the rest of the contents of the next delivery.

1.7. Unserviceable Articles:

During the laundering process the Contractor may notice items he believes to be unserviceable. All such items shall be returned to the Government after laundering in a separate bundle, clearly marked as "unserviceable."

1.8. Losses:

The Contractor will pay an equitable replacement cost for items reasonably determined to have been lost, damaged or destroyed while in the Contractor's possession. The Government will notify the Contractor within 24 hours of delivery of missing or damaged articles in that delivery. If the Contractor disputes the notification, the CO will determine the circumstances and validity of the claim against the Contractor. If the CO determines the article(s) to have been lost or destroyed while in the Contractor's possession a determination will be made of fair replacement value and given to the Contractor. The Contractor will reduce his next invoice by the amount of the determination and annotate in the invoice description.

1.8.1. Fair Wear and Tear:

The Contractor may claim that destruction or damage to articles is due to fair wear and tear. If the COR agrees, the Contractor is relieved of responsibility to replace that individual item. If no agreement can be reached, the CO will make a final decision.

1.9. Accountability:

The Contractor shall use the manifest/inventory form (Appendix C) listing all articles picked up at each site. The Contractor will confirm the numbers/weights on the Government inventory/manifest either at the pickup site or at his facility. If the Contractor's count or weight is 5% greater or less than the Government's, the Contractor shall immediately notify the designated Government contract representative.

The appropriate COR may then authorize adjustment of the inventory/manifest. The Contractor is responsible for laundering only the numbers of items or weights of material on the manifest/inventory, and this will be the basis for the Contractor's invoicing for any particular shipment or invoicing period. The Contractor will provide the Government an inventory of the items in each delivery using the form at Appendix C. Upon receiving a delivery, the Government will inventory the shipment. If the Government's count or weight is 5% greater or less than the amount shown as being delivered the Government contract representative will notify the Contractor within 24 hours to reconcile the difference. If the difference is determined to be due to loss while in the Contractor's possession, para 1.8.1 above will apply.

1.9.1. Laundered items included in any delivery which are not Government property will be identified by the Government and returned to the Contractor at the next scheduled pickup. The Contractor may not include them on any invoicing.

1.10. Workmanship and Sanitation:

The contractor's facility shall be open for inspection of Infection Control Conditions as stated in 1.3.3 at any time by a Government representative specified in writing by the CO.

Attachment 1 Page 6 of 17

1.10.1. Vehicle Interior Requirements:

Soiled items and clean items shall be transported in accordance with all state and local health regulations or laws. Articles are to be protected from contamination and soiling during transit to designated delivery points.

1.11. Contractor Full-Time Equivalent Reporting

The Contractor shall report ALL Contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for Holloman Air Force Base, NM via a secure data collection site. The Contractor is required to completely fill in all required data fields using the following web address http://www.ecmra.mil.

Reporting inputs will be for the labor executed during the period of performance for each Government fiscal year (FY), which runs 1 October through 30 September. While inputs may be reported any time during the FY, all data shall be reported no later than 31 October* of each calendar year. Contractor may direct questions to the Enterprise Contractor Manpower Reporting Application (ECMRA) help desk.

*Reporting Period: Contractor is required to input data by 31 October of each year.

Uses and Safeguarding of Information: Information from the secure web site is considered to be proprietary in nature when the contract number and contractor identity are associated with the direct labor hours and direct labor dollars. At no time will any data be released to the public with the contractor name and contract number associated with the data.

User Manuals: Data for Air Force service requirements must be input at the Air Force ECMRA link.

However, user manuals for government personnel and contractors are available at the Army ECMRA link at http://www.ecmra.mil.

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2.0 SERVICE SUMMARY (SS):

Performance Objective

PWS

Para. Performance Threshold

SS-1 Adherence to Pick up / Delivery Schedule Items must be delivered in accordance with the dates and times specified in the PWS.

1.2. No more than three (3) incidents of missed/delayed

pickup/deliveries per contract year.

SS-2 Processing and Packaging Laundered items must be returned clean and finished/bundled/packaged per table in Appendix A.

1.3.

Through

1.7.

No more than 3% of items in any particular delivery/shipment require re-laundering. No more than 10% of all laundry processed in a contract year requires re-laundering.

SS-3 Accountability Quantities of items delivered and invoiced must match quantities on pickup tickets/manifests

1.8., 1.9.

&1.9.1.

No more than 5% difference in number of any items or weights listed on inventory/manifest and invoiced for on any shipment/delivery.

SS-4 Medical/Dental cleaning Medical/Dental laundry processes must meet standards o f CDC Guidance and AFI 44-108, Infection Control Program

1.3.

Through

1.7.

Appendices

B & D

Contractor's facilities and processes must comply with AFI 44-108, para 3.11.1 inclusive, as evidenced by passing Holloman Infection Control Officer's periodic inspections. Deficiencies found on initial inspection will be re-inspected 30 days later for correction. No deficiencies allowable upon re-inspection.

3.0 GOVERNMENT FURNISHED PROPERTY, SERVICES AND MATERIALS

None

4.0 GENERAL INFORMATION:

4.1. Contractor Personnel:

4.1.1. Contract Manager:

The Contractor shall provide a representative who shall be responsible for the performance of the work.

The name of this person and an alternate(s) who shall act for the Contractor when the representative is absent shall be designated in writing to the CO no later than the pre-performance conference. Contract Manager/Alternate should be available to the Government during normal duty hours (7:30 am to 4:30 pm). The Contract manager or alternate shall be available to meet at Holloman AFB with Government personnel designated by the CO to discuss contract issues.

4.1.2. English Comprehension:

All Contractor personnel working on the contract shall read and understand the English language to the extent necessary to read and understand operation, safety, and health regulations.

Attachment 1 Page 8 of 17

4.1.3 Restriction on Hiring Government Personnel:

The Contractor shall not employ any person who is an employee of the United States Government, either military or civilian if the employment of that person would create a conflict of interest, unless such person seeks and receives approval in accordance with the Department of Defense Joint Ethics publications.

4.2. Quality Control Plan:

The Contractor shall develop and maintain a Quality Control Plan (QCP) that has been accepted by the Government to ensure that laundry services are performed in accordance with commonly accepted commercial practices and the contract requirements. The Contractor shall submit the final written QCP plan 30 days after the award for acceptance.

4.3. Quality Assurance:

The Government will monitor the Contractor's performance using periodic surveillance of pick up/delivery operations, inspections of the contractor's facilities for adherence to Medical laundry standards, and validated customer complaints. The COR will maintain a file of all surveillance observations.

Government surveillance of tasks may occur at any time during contractor's performance. When a performance threshold has not been met/unsatisfactory (defect) or contractor performance has not been accomplished, the COR shall record defect and initiate and provide the CO a Contract Discrepancy Report (CDR) DD Form 2772 for issuance to the contractor. The contractor shall respond to the CDR in accordance with (IAW) instructions provided and return it to the CO within ten (10) calendar days of receipt.

4.3.1. Progress Meetings:

Periodic progress meetings will be held between the Contractor and Government. At these meetings the parties will discuss any problems or items of concern and generate solutions. These meetings are preferred to be held quarterly or more frequently if circumstances require, but no less than once a year.

4.4. Methods of Surveillance:

4.4.1. Periodic Surveillance:

COR(s) qualified and assigned by the Government will inspect contractor pickup and delivery activities on an intermittent basis for adherence to cleanliness, finish, packaging/bundling, agreement of pickup and delivery counts or weights, and adherence to delivery schedules.

4.4.2. Validated Customer Complaints:

This method is initiated when the COR receives a customer complaint. If the complaint is validated, it results in a required service being re-performed to the performance standards as stated in the PWS and Service Summary without additional expense to the Government. The CO shall make final determination of the validity of customer complaints.

4.5. Security Requirements. Unclassified – access to classified information not required.

4.5.1. Illegal Aliens: The Contractor shall not hire an illegal alien to work or perform any service on Holloman AFB (HAFB). Employees who are not U.S. citizens can only be persons possessing a current resident alien immigrant status (Green Card) or if a non-resident immigrant must possess a current Employment Authorization Document. While on HAFB, non-U.S. citizen employees must be able to produce for inspection the appropriate credential: Green Card or Employment Authorization Document.

Any illegal alien found on the installation shall be immediately detained by the base security forces and barred from the installation.

4.5.2. Listing of Employees: The Contractor shall maintain a current listing of employees that require

Attachment 1 Page 9 of 17 access to HAFB. The list shall include the employee's name and social security number and type of investigation if contract work involves unescorted entry to Air Force (AF) restricted areas or other sensitive areas designated by the installation commander. The list shall be provided to the Program Manager and sponsoring agency security manager. An updated listing shall be provided when an employee's status or information changes (i.e. termination, reassignment, etc.) or when a new employee is added.

4.5.3. Security Training: The Contractor ensures all employees receive initial and recurring (annual) security education training from the sponsoring agency security manager. Training must be conducted IAW DoDM 5200.01, Volume 1, DoD Information Security Program, and AFI 16-1404, Air Force Information Security Program. Contractor personnel who work in AF controlled/restricted areas must be trained IAW AFI 31-101, Integrated Defense. The sponsoring agency controlled area monitor will provide this training when required.

4.5.4. Pass and Identification Items: The Contractor shall ensure the pass and identification items required for contract performance are obtained for their employees. Employees shall only be granted access to the installation to perform functions directly related to their respective contract. All contractor employees requiring unescorted access to HAFB shall be identified on a Visit Access Request (VAR) form. The Contractor shall submit a complete VAR through the Contracting Office to 49 SFS/S5AV no later than 7 duty/business days, and for foreign nationals, 14 duty/business days prior to requiring access to the installation.

4.5.5. Retrieving Identification Media: The Contractor shall return all identification media from employees who depart for any reason before the contract expires; i.e., terminated for cause, retirement, etc. The Contractor will notify the Government within 24 hours when unable to retrieve identification media from contract employees.

4.5.6. Travel Restrictions: Contractors are prohibited in areas of the installation other than their appropriate place of work and the routes to and from installation entry/exit points.

4.5.7. Traffic Laws: The Contractor and its employees shall comply with base traffic regulations.

Violations may result in the loss of base driving privileges and/or debarment from the installation.

4.5.7.1. Employees shall wear a seatbelt when operating or riding in any military, contractor-owned, or privately-owned vehicle while on the installation.

4.5.7.2. Speed limits on HAFB are 30 MPH unless otherwise posted. Be aware of reduced speed limits and exercise caution when driving in base housing and school zones.

4.5.7.3. All vehicle operators on the installation shall not use cell phones unless the vehicle is safely parked or unless they are using a hands-free device. The wearing of any other portable headphones, earphones or other listening devices (except for hand-free cellular phones) while operating a motor vehicle is PROHIBITED.

4.5.8. Weapons, Firearms, and Ammunition: Employees are prohibited from possessing weapons, firearms, or ammunition on themselves or within military, contractor, or privately-owned vehicle while on

HAFB.

4.5.9. For Official Use Only (FOUO): The Contractor shall comply with DoDM 5200.01-V4, Enclosure 3, DoD Information Security Program: Controlled Unclassified Information (CUI), requirements. This

Attachment 1 Page 10 of 17 manual sets policy and procedures for the disclosure of records to the public and for marking, handling, transmitting, and safeguarding FOUO material.

4.5.10. Reporting Requirements: Contractor personnel shall report to an appropriate authority any information or circumstances of which they are aware may pose a threat to the security of DoD personnel, contractor personnel, resources, and classified or unclassified defense information.

4.5.11. Physical Security: The Contractor shall be responsible for safeguarding all Government property and controlled forms provided for contractor use. At the end of each work period, all Government facilities, equipment, and materials shall be secured.

4.5.12. Controlled/Restricted Areas: The Contractor shall implement local base procedures for entry to AF controlled/restricted areas where Contractor personnel will work. An AF Form 2586, Unescorted Entry Authorization Certificate, must be completed and signed by the sponsoring agency security manager before a restricted area badge will be issued. Contractor employees must have a completed and favorable Tier 1 or higher investigation (or DoD-determined equivalent investigation) before receiving a restricted area badge. Interim access can be granted in accordance with AFMAN 16-1405, Air Force Personnel Security Program Management. The sponsoring agency security manager will process personnel security investigation for trustworthiness determination through the 49 WG/IP Personnel Security Office.

4.5.12.1. Escorted Entry Procedures: Unless granted unescorted entry (see procedures below), all contractor employees will be escorted while in AF controlled/restricted areas on HAFB. When escorted, employees shall remain with their assigned escort at all times while in controlled/restricted areas. Escort responsibility rests with the sponsoring agency. An escort briefing will be provided to all escorted employees prior to entering a controlled/restricted area. Persons providing escort are responsible for providing this briefing. Escort officials assume responsibility for the safe and secure conduct of escorted employees and are required to maintain constant surveillance and control of employees at all times while in a controlled/restricted area.

4.5.12.2. Unescorted Entry Procedures: An AF Form 2586, Unescorted Entry Authorization Certificate, must be completed and signed by the sponsoring agency security manager before a restricted area badge will be issued. Employees must have a completed and favorable Tier 1 security investigation before receiving a restricted area badge. Interim access can be granted in accordance with AFMAN 16-1405, Air Force Personnel Security Program Management. Unescorted entry will never be granted solely to avoid the inconvenience of escorted entry.

4.5.13. Photography: Photography in or within the close proximity of an AF controlled/ restricted area, flight line, or taxiway is strictly prohibited. Contractors that wish to take photos shall coordinate with the COR or Government Program Manager who will coordinate with the appropriate owning unit security manager for a photography clearance memorandum prior to taking photos.

4.5.14. Video/Still Imagery Devices: The use or possession of any device capable of capturing video and still images is strictly prohibited within any controlled/restricted area without written authorization from the installation commander or his/her designated representative. Individuals will be denied access to restricted/controlled areas if in possession of these devices.

4.5.15. Portable/Personal Electronic Devices (PED): The use of possession of all PEDs used for storing, processing, and/or transmitting information is strictly prohibited within all areas where classified material is discussed, briefed, stored, or processed without written authorization from the Designated Approval Authority.

Attachment 1 Page 11 of 17

4.5.16. Key Control: The Contractor shall establish and implement methods of making sure all keys and/or combinations issued to the contractor by the Government are not lost or misplaced and are not used by unauthorized persons. The Contractor shall not duplicate any keys issued by the Government. The Government requires keys/combinations to the contractor's area of responsibilities. The Contractor shall supply a key or combination to the Fire Department in the event of an emergency.

4.5.16.1. The Contractor shall immediately report to the COR any occurrences of lost or duplicated keys, compromised lock combinations, or use by unauthorized persons.

4.5.16.2. In the event keys, other than master keys, are lost or duplicated, the contractor may be required, upon written direction of the contracting officer, to re-key or replace the affected lock or locks without cost to the Government. The Government may, however, at its option, replace the affected lock or locks or perform re-keying and deduct the cost of such from the monthly payment due the contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the contractor.

4.5.16.3 The Contractor shall prohibit the use of keys or combinations, issued by the Government, by any other persons other than the contractor's employees and the opening of locked areas by contractor employees to permit entrance of persons other than contractor employees engaged in performance of contract work requirements in those areas.

4.6. Records Management and Freedom of Information Action (FOIA) Requirements.

4.6.1 Records Management (RM) (June 2017). The Contractor shall provide accountability and ensure all records and documents generated during the period of this contract are made available to the Government at all times.

4.6.2 Freedom of Information Act (FOIA) and Privacy Act (PA) (July 2015). The Contractor shall comply with DoDM 5400.7_R, DoD Freedom of Information Act (FOIA) Program and AFI 33-332, Air Force Privacy and Civil Liberties Program. These regulations set policy and procedures for the disclosure of records to the public and for marking, handling, transmitting, and safeguarding Personally Identifiable Information (PII) material.

4.7 Contractor Furnished Items:

4.7.1. Pick up/Delivery Vehicles (must be an enclosed vehicle)

4.7.2. All packaging and marking materials.

4.7.3. Laundry Carts and Liners (plastic)

4.7.4. Clothing hangers

4.7.5. Delivery tickets (original and 1 copy)

4.7.6. Any other supplies, material, and equipment necessary to perform the services required by the contract.

5.0 APPENDICES

A. Method of Finish and Packaging B. Inspection of Laundry Services (Checklist) C. Inventory/Manifest Form D. References and/or Publications

Attachment 1 Page 12 of 17

Attachment 1, Appendix A Page 13 of 17

APPENDIX A – METHOD OF FINISH AND PACKAGING

Codes Description D Dry F Fold B Bundle P Press with flat work ironing equipment or commercial ironing equipment W Wash MS Medium starch OH Return finished work on a hanger WP Wrapped in plastic PB Return in plastic bag PC Protective Covering Bulk Bulk

ITEM FINISH &

PACKAGING PACKAGE

Med Group Requirement (Includes Dental) Blanket, Cotton F/B/PC Bulk Gown, Exam F/B/PC Bulk Pillowcase P/OH/PB Bulk Sheets P/OH/PB Bulk Surgery Towels, Green F/B/PC Bulk Towels, White F/B/PC Bulk Curtain, Bedside P/OH/PB Bulk Scrubs, MTF* P/F/B Bulk Coat, Lab, White P/OH/PB OH *Medical Treatment Facility

Attachment 1, Appendix B Page 14 of 17

APPENDIX B – INSPECTION OF LAUNDRY SERVICES

49th Medical Group (ACC), Holloman AFB, NM

References: Association for Professional in Infection Control (APIC) Text of Infection Control & Epidemiology, 2000

A. PLANT FACILITY YES NO

1. Ventilation system has adequate intake, filtration, exchange rate and exhaust

2. Separation of clean and soiled areas by a physical barrier, negative air pressure – soiled linen/positive air pressure – clean to soiled

3. Environmental conditions are adequate: temperature, humidity, cleanliness of area etc.

4. Adequate hand washing facilities available

5. Eating, drinking and smoking is prohibited in all work areas

B. PERSONNEL YES NO

1. Employees participate in relevant continuing education program with documentation available. For example, training in personal hygiene, hand washing, and bloodborne pathogen transmission and proper use of personal protective equipment (PPE)

2. Personal protective equipment available and in use: gowns, aprons, masks, eye protection

3. Employees remove PPE before leaving receiving/sorting area

4. Hepatitis B vaccine required for all employees

5. Personnel are free of infections

6. Staffing is adequate

C. DELIVERY YES NO

1. Clean linen transported in containers exclusively for clean linen, clean hampers lined with plastic or reusable liners, placed in clean cart with a secure plastic or reusable cover

2. Separation of clean and soiled linen. (The containers used to transport soiled linen may be used to transport clean linen if they are properly cleaned first)

3. Cleaning of carts/trucks is properly done by steam cleaning or with soap and water solution.

In either case, followed by germicidal agent.

D. SOILED LINEN PROCESSING YES NO

1. Soiled linen is handled as little as possible and with minimum agitation

2. Compliance with standard/universal precautions is observed in the soiled linen area – sharps disposal units available

3. Wash formula: adequate temperature, time soap/detergent/bleach used: 71C/160F x 25 minutes

4. Washer thermometer visible

5. Thermometer calibration data available

6. Linens to be destroyed are processed prior to disposal

E. HOUSEKEEPING YES NO

1. Adequate cleaning procedures are developed and implemented regarding:

a. Cleaning and care of equipment and work areas

b. Maintenance of cleaning schedules

c. Documentation of cleaning

F. QUALITY ASSURANCE YES NO

1. The provider shall have a written policies and procedures covering areas of responsibility relating to the service provided

2. The provider shall maintain documentation of the identification of problems and methods to resolve them.

Attachment 1, Appendix B Page 15 of 17

3. The provider and the user shall periodically review the laundry/linen program

NOTES:

Attachment 1, Appendix C Page 16 of 17

APPENDIX C – INVENTORY/MANIFEST FORM

49 Medical Group Government Ship Count

Contractor Receive Count

Difference Reconciliation

Contractor Ship Count

Government Receive Count

Blanket, Cotton Gown Exam Pillowcase Sheets Surgery Towels, Green Towels, White Curtain, Bedside Scrubs Coat, Lab, White

Contractor Pick Up

Date_________________ Signature_________________________________________

Printed Name______________________________________

Delivered To Holloman

Date_________________ Signature_________________________________________

Printed Name______________________________________

Attachment 1, Appendix D Page 17 of 17

APPENDIX D – REFERENCES AND/OR PUBLICATIONS

PUBLICATION NO. NAME DATE APPLICABLE

PARAGRAPH

AFI 44-108 Infection Control Program 14 July 2015 Para 3.11.1 inclusive

DoDM 5200.01, Volume 1 DoD Information Security Program 4 May 2018 All

DoDM 5200.01, Volume 4 DoD Information Security Program: Controlled Unclassified Information (CUI)

9 May 2018 Enclosure 3

AFI 16-1404 Air Force Information Security Program 14 September 2018 All

AFMAN 16-1405 Air Force Personnel Security Program Management 1 August 2018 All

DoDM 5400.7_R Department of Defense Freedom of Information Act 25 January 2017 All

AFMAN 33-302 Freedom of information Act (FOIA) 27 April 2018 All

AFI 33-332 Air Force Privacy and Civil Liberties Program 14 February 2019 All

AF Form 2586 Unescorted Entry Authorization Certificate 1 July 2019 NA

N/A (provided by the Government)

Holloman AFB Visit Access Request (VAR) 13 May 2019 NA

All publications can be located at http://www.e-publishing.af.mil/