Attachment_1-_Performance_Work_Statement.pdf

Attachment 1 of Solicitation# FA520519QMG06

Revised: Jul 19

1/20

PERFORMANCE BASED WORK STATEMENT

MEDICAL LAUNDRY AND DRY CLEANING

SERVICE

MISAWA AIR BASE, JAPAN

Jul 19

35 MDSS/SGSMF

2/20

Table of Contents

Page

1 – DESCRIPTION OF SERVICES/GENERAL INFORMATION 3

2 – SERVICES SUMMARY 11

3 – SECURITY INFORMATION 13

4 – APPENDICES:

4.1. WORKLOAD ESTIMATES/PACKAGING AND METHOD OF FINISH 15

4.2. LAUNDRY FACILITY INSPECTION CHECKLIST 18

3/20

1. DESCRIPTION OF SERVICES/GENERAL INFORMATION. This is Non-Personal Service. This service contract is classified as not “mission-essential”. Contractor shall furnish all labor, materials, supervision, tools, equipment and transportation to ensure that laundry and dry cleaning services are provided for the articles produced by the medical group at Misawa Air Base, Japan in accordance with (IAW) this Performance-Based Work Statement (PWS) and in a manner to meet generally accepted commercial practice or industry standards for cleanliness, safety, sanitation and serviceability. The most current editions of the following guidelines should be used for reference in meeting generally accepted commercial practice and industry standards: AFI 44-108, Infection Control Program, Center for Disease Control (CDC) Guidelines for Environmental Infection Control in Health-Care Facilities and The Healthcare Laundry Accreditation Council’s (HLAC) Accreditation Standards for processing Reusable Textiles for Use in Healthcare Facilities.

1.1. The contractor shall be responsible for pick-up and delivery of articles, as well as the return of unserviceable articles to the Hospital on Misawa AB. If any articles are lost or damaged during the contractor’s performance, repair or replacement shall be rendered at the expense of the contractor at the option of the U.S. Government.

1.1.1. The Contractor assumes liability for any and all property entrusted to them during the cleaning process and shall be obligated to safeguard such property at all times until custody is transferred back to U.S. Government control.

1.1.2. The contractor shall ensure to protect the U.S. Government’s interests at all times by planning for and making ready all manner and means to satisfactorily receive and process the estimated workload quantities of laundry and dry cleaning articles as stipulated in APPENDIX 4.1, WORKLOAD ESTIMATES/PACKAGING AND METHOD OF FINISH of this PWS.

1.2. PICK-UP AND DELIVERY.

1.2.1. The contractor shall provide pick-up and delivery service as specified in paragraph 1.10.3 of this PWS. The frequencies and times specified shall be considered the minimum acceptable standards for performance. Customers needing additional delivery/pick-up must coordinate with the Linen Manager or representative to receive approval. Contractor shall return all items except for Curtains within three (3) calendar days of pick-up. The contractor shall return Curtains within seven (7) calendar days of pick-up. Delivery times will be tracked by comparing pick-up and delivery receipts, to match dates and quantities.

1.2.2. UNSERVICEABLE ARTICLES. The contractor shall return all unserviceable and non-repairable articles in a separate bundle to the government. All unserviceable articles will be laundered, but packaged separately, marked accordingly, and shall be returned to the U.S.

Government’s representative at the respective pick-up and delivery points.

1.3. COUNT OF ARTICLES.

1.3.1. The contractor shall be liable for the return of the same quantity of items and same kind of articles furnished for service under this contract.

4/20

1.3.1.1. The contractor shall utilize “each” as the primary unit of measure for tracking and accounting for all items laundered or dry cleaned under this contract.

1.4. TRANSFER SLIPS AND INVOICES.

1.4.1. TRANSFER SLIPS. The contractor shall provide original slips accurately recording all pick-up and delivery transactions to the Contracting Officer’s Representative (COR). One copy of each slip shall be provided to the Medical Group's Linen Exchange by the end of each day a transaction is made and one copy be retained in contractor’s record file.

1.4.1.1. Signature on the pick-up slips and delivery slips shall constitute an agreement between the contractor and the U.S. Government representative as to the accuracy of the count of articles in and out the pick-up/delivery point.

1.4.2. INVOICES. This contract contains DFARS Clause 252.232-7003, Electronic Submission of Payment Requests. This clause requires invoices for supplies and services purchased by the DoD be submitted via the Wide Area Workflow (WAWF) system at https://wawf.eb.mil/.

1.5. LOSS OR DAMAGE.

1.5.1. The contractor shall reimburse the U.S. Government for any loss or damage to articles furnished for service under the contract.

1.5.1.1. Validation of any claims for loss or damage shall be made by the Contracting Officer (CO) based on factual (documented) evidence produced by the U.S. Government’s representatives and/or the contractor.

1.5.2. NON-REIMBURSABLE REPAIRS. Except for articles determined to be unserviceable, the contractor shall repair all minor rips, tears, pulled or open seams and holes caused by the contractor during the contract cleaning process, using threads and materials of comparable quality, color, color fastness and texture as was used in the original manufacture specifications of the article. The contractor shall also replace all broken and missing buttons with suitable replacements of similar color, appearance and quality, if cause of such damage is attributable to the contractor. All such repairs shall be made at no additional costs incurred by the government.

1.6. SPECIAL INSTRUCTIONS FOR MEDICALLY RELATED ARTICLES.

1.6.1. Soiled and clean linen articles shall be stored, handled, and transported separately at all times. The use of enclosed carts for such articles shall be employed at all times including transportation to and from the laundry facility. The transportation truck will be cleaned on a monthly basis or sooner if truck cargo area becomes soiled, contaminated or dirty.

https://wawf.eb.mil/

5/20

1.6.2. Articles identified as contaminated with potentially infectious material (potentially infectious material soaked in blood, other body fluids, feces, human tissue, etc.) shall be:

(1) Separate from other medically related soiled articles for the purpose of souring them before laundering.

(2) Treated to prevent from spreading microorganisms to the environment.

(3) Transported with double bagging using protective bags provided by the government to prevent any instance where the outside of a bag used in the carrying of medical linen may become contaminated.

1.6.3. When handling linen for pick or drop-off, the clean linen shall be delivered before the soiled linen is picked up. Personal protective equipment shall be worn during pick-up and be removed afterwards. At the laundering facility, similar procedures must be in place to prevent cross contamination.

1.6.4. LINEN CARTS. The contractor will provide the appropriate size linen carts. One cart will be for clean linen and the other will be for dirty linen. The clean and dirty linen carts will be distinguishable by color; clean carts will be one color while dirty carts will be a different color.

At no time will clean linen be carried in a dirty linen cart and at no time will dirty linen be carried in a clean linen cart. The linen carts will be used for transporting linen from the contractor’s truck to the hospital's clean linen room and to pick up dirty linen from the dirty linen room and transport to the contractor’s truck.

1.6.4.1. Soiled linen carts must be cleaned and disinfected after every use. Clean linen carts shall be cleaned with disinfectant or steam weekly at a minimum, or sooner if visibly soiled or suspected contaminated.

1.6.5. The linen carts shall protect the linen from spreading microorganisms when soiled, and from the environment (rain, dust, contamination, etc.) and shall have closable lids. Before the linen carts (clean or soiled) are moved from the storage location, linen facility, or mode of transportation, the lid shall be closed to protect the linen.

1.7. CLEANLINESS AND FINISH.

1.7.1. All articles delivered from cleaning shall conform to the current generally accepted industry standards of quality, cleanliness, finish and appearance.

1.7.1.1. All bundled articles shall be delivered wrapped in a sanitary plastic film. All articles on hangers shall be encased in a plastic film cover or bag to prevent soiling during transportation and temporary storage.

1.7.1.2. The contractor shall ensure that all medically related articles returned after cleaning be packaged and delivered in protective plastic wrapping. Linen storage shelves used in the storage or transportation of medically related linen shall be kept clean, neat and sanitary at all times.

6/20

The linen carts used for the transportation of cleaned and packaged linen shall protect the packaged linen from environmental contamination such as rain, snow, dust, or other such hazards.

1.7.2. Items that have not been properly cleaned or finished to acceptable industry standards or within the standards listed in appendix 4.1 of this PWS, shall, in accordance with clause FAR 52.212-4(a) inspection/acceptance, be re-cleaned by the contractor at no additional cost to the U.S. Government. Such articles returned and reported by the customer as unsatisfactory shall be verified by COR by utilizing guidelines set forth and located in Part 2, Services Summary (SS) portion of this PWS. The contractor shall be responsible to ensure the article(s) returned are identified and packaged separately for delivery after re-performance has been satisfactorily accomplished.

1.7.3. DRAPERIES. The contractor shall re-shape draperies to their original size, with pleats, after cleaning.

1.7.4. NURSERY, PEDIATRIC AND OTHER HOSPITAL GARMENTS AND LINENS.

All nursery, pediatric and/or medically related garments shall be treated with a souring agent, be washed and then rinsed completely free of all soap residue, and then treated with a fabric softener in sufficient quantities to insure fluffiness and sanitation of medical garments.

1.7.5 LINEN USED FOR AN ANIMALS. Linens used for animals shall be separated from other linens washed. Animal linens shall be packaged only with animal used linens. Any non-animal linen found with animal hair will be reprocessed at no additional cost to the Government in accordance with FAR 52.212-4(a) Inspection/acceptance. Any non-animal linens found with animal hair will be reported to the contracting office and may incur an out of cycle inspection of the contractor’s wash facilities to ensure compliance.

1.8. LAUNDRY FACILITY.

1.8.1. The laundry facility should enforce practices in compliance with the most current editions of the guidelines listed in Section 1.

1.8.1.1. A “Clean Zone” area should be discernible by a yellow tape on the floor. Only clean carts, identified by color, would be allowed in that area.

1.8.1.2. Physical barriers and signs should define the soiled linen areas. Linen separation is not to be performed in the washing and drying rooms.

1.8.1.3. It is recommended that linen sorting not be performed in the washing and drying rooms.

If linens are sorted in the washing and drying rooms, gowns worn by workers will be color coded to designate and distinguish between those handling soiled linens and those handling clean linens. Handlers should only handle the linen appropriate for their gown color and not transfer between handling clean and dirty linen.

7/20

1.8.1.4. The laundry facility should be equipped with sufficient ventilation to minimize the dissemination of contaminants. The ventilation system should at minimum include adequate intake, filtration, exchange rate, and exhaust system.

1.8.2. To comply applicable guidelines, the contractor-operating cleaning facility shall be inspected by the Linen Manager and Infection Control Officer (ICO) on an annual basis.

Annually the cleaning facility inspection shall include a representative from the contracting office and the COR. The inspection will be performed using the Laundry Facility Inspection Checklist (LFIC) at Appendix 4.2.

1.8.3. During the course of the facility check, if the procedures or facility are found not to meet outlined requirements in this PWS, the contractor shall take corrective actions to resolve any and all discrepancies to meet the requirements of the PWS within 90 days after the inspection. The government will conduct a follow-up inspection within 30 days from the contractor’s notification that corrective action has been completed.

1.9. QUALITY ASSURANCE. The government will appoint a COR to monitor performance to ensure services are received. The COR will evaluate the contractor’s performance through intermittent on-site inspections of receipt and investigation of complaints from base personnel.

The government may inspect each task as completed. The government may increase or decrease the number of inspections as deemed appropriate based upon the contractor’s performance. The contractor shall be responsible for initially validating customer complaints presented by the COR. If complaints go unresolved between the contractor and COR, the case will be forwarded to CO for final determination.

1.9.1. U.S. GOVERNMENT REMEDIES. The CO shall follow the requirements of Federal Acquisition Regulation (FAR) 52.212-4, Contract Terms and Conditions for Commercial Items, as incorporated into the contract, for contractor’s failure to correct nonconforming services.

1.9.2. PERFORMANCE EVALUATION MEETINGS. The subsequent performance evaluation meetings shall be scheduled on an annual basis, unless requirements for such meeting(s) are determined necessary by unanimous concurrence among the parties concerned;

the Government (the CO, and the COR) and the contractor.

1.10 Performance of Services During Crisis Declared by the National Command Authority or Overseas Combatant Commander. This service contract is not classified as “mission-essential” during a crisis as declared by the National Command Authority or Overseas Combatant Commander. In the event of such a crisis, the CO or the COR will direct the contractor employee to continue/discontinue the service due to base closure. Until such a notification, the contractor employee are required to continue the performance.

1.11. HOURS OF OPERATION.

1.11.1. NORMAL HOURS. The 35th Medical Group's normal business hours are 0730 to 1630 Monday through Friday. The contractor shall maintain similar customer service hours to successfully meet the obligations under this PWS.

8/20

1.11.2. RECOGNIZED HOLIDAYS. The contractor is not required to perform services that fall on the following days:

New Year’s Day 1st of January Martin Luther King Jr’s Birthday 3rd Monday of January Washington’s Birthday 3rd Monday of February Memorial Day Last Monday of May Independence Day 4th of July Labor Day 1st Monday of September Columbus Day 2nd Monday of October Veteran’s Day 11th of November Thanksgiving Day 4th Thursday of November Christmas Day 25th of December

NOTE: When a holiday falls on a Saturday or Sunday, the contractor shall consider the Friday preceding the holiday or the Monday following the holiday as the observed holiday for contract performance purposes.

1.11.3. PICK UP AND DELIVERY SCHEDULE.

Bldg. No. Organization pick-up time delivery time days per week 99 35 MDG 1300 to 1500 1300 to 1500 MONDAY - THURSDAY 99 35 MDG 0900 to 1100 0900 to 1100 FRIDAY

1.12.1.1. CONTRACT MANAGER. The contractor shall provide a contract manager who shall be responsible for the performance of the contract. The contract manager shall have full authority to act on behalf of the contractor on all contract matters relating to the daily operation of this contract. The contract manager’s information shall be provided to the CO and COR prior to the start of the contract.

1.12.1.2. The contract manager shall be able to read, write, speak, and understand English, or an interpreter provided by the contractor may be provided to work alongside the contract manager.

The contract manager or alternate(s) shall be available during normal duty hours and be able to meet with U.S. Government personnel designated by the CO within three (3) duty days.

1.12.2.1. CONTRACT EMPLOYEES. Contract personnel shall present a neat appearance and be easily recognized as contractor employees. This may be accomplished by wearing distinctive clothing bearing the company name or by wearing appropriate badges that contain the contractor’s company name and the employee’s name.

1.12.2.2. The contractor shall not employ persons for work on this contract if such an employee is identified by the CO as a potential threat to the health, safety, security, general well being, or operational mission of Misawa AB and its population.

9/20

1.12.2.3. The contractor shall not employ any person who is presently an employee of the U.S.

Government when and if the employment of that person would create a conflict of interest or perception of conflict nor shall the contractor employ any person who is presently an employee of the Department of the Air Force, either military or civilian, unless such a person seeks and receives prior approval from his or her commander. Active Duty members receive approval through the completion of an AF IMT 3902: Application and Approval for Off-Duty Employment. The CO shall request confirmation of completion of this form at any time during the contract period. In addition, the contractor shall not employ any person presently employed with the Department of the Air Force if such employment would constitute conflict of interest.

1.13. MISAWA AIR BASE FIRE PREVENTION. The contractor shall be responsible for fire prevention in all contracted areas, and be free from any potential fire hazards. The contractor shall comply with the following fire prevention guidance. Fire Reporting: 1) The primary emergency reporting number on Misawa Air Base is 911 or 0176-53-1911 from off base. Fire Department operations take place out of Bldg. 947 and 3003 for main base, and Bldg. 1940 for the north housing area. 2) On-base telephones if any, in the on-base warehouse(s) shall have “911” stickers. 3) All contractor-employed personnel shall be familiar with fire reporting numbers and procedures, and shall put the number “0176-53-1911” into his/or her mobile-phone.

Vehicles: 1) Access for fire fighting vehicles must be maintained at all working sites. 2) Contractor’s vehicles shall not be parked within 15 feet of any fire hydrant of Fire Department connections. 3) Contractor’s vehicles shall give the right-of-way to responding fire/emergency vehicles. Electrical Hazards: 1) All of the contractor’s electrical tools and equipment shall be in good (original) working condition and its maintenance shall be done properly in compliance with manufacturer’s maintenance instructions. 2) All extension cords used shall be equipped with circuit breakers and plugged directly in the outlets (no other extension cords). 3) Building utility panels shall not be blocked by contractor tools/supplies. Storage: 1) Flammable liquids shall not be stored inside the warehouses, next to the buildings, or near exit ways. 2) Fire protection systems shall not be obstructed at any time. Carpet storage shall be neat in a manner which does not present a fire/safety hazard and do not block the access to where fire-extinguishers are mounted.

1.13.1. SAFETY REQUIREMENTS. The Contractor shall comply with the Japanese, Industrial Safety and Health Act, located at http://www.japaneselawtranslation.go.jp/law/detail/?id=1926&vm=&re=

1.14. BASE ACCESS. The contractor shall obtain base identification and vehicle passes for all contractor personnel who make frequent visits to or perform work in this contract. The contractor shall submit applications for base passes (listed below) to the Contracting Office, or all employees, including subcontractor employees, and vehicles requiring access to Misawa Air Base in order to perform this contract.

5AF Form 99EJ, Application for Base Pass, for employees.

35 FW Form 54, Application for Vehicle.

Upon completion of this contract, the Contractor shall return all employee and vehicle passes to the Visitor Control Section (35 SFS/PI), Bldg. 301, and obtain a certification of receipt. The http://www.japaneselawtranslation.go.jp/law/detail/?id=1926&vm=&re

10/20 contractor shall submit a copy of certification of receipt to Contracting Office in a timely manner.

1.15. Required Insurance.

(a) The contractor shall procure and maintain during the entire period of his/her performance under this contract, the following minimum vehicle insurance.

Property Damage – ¥2,000,000

(b) Prior to the commencement of work hereunder, the contractor shall provide the Contracting Office a certificate or written statement of above required insurance. The contractor is required to notify the Contracting Office immediately upon cancellation or of any material change in the policies adversely affecting the interests of the Government.

(c) The contractor agrees to insert the substance of this clause including this paragraph c, in all subcontracts hereunder.

1.16. DEFINITION OF WORDS AND TERMS.

Clean Articles: Finished articles returned for use that are dry and free of all signs of visible soil, lint and objectionable or unpleasant odors. All spots and stains have been removed where possible without damage to the fabric.

Defective Service: A service output that does not meet the standards of performance specified in the contract and PWS for that service and may, at the option of the U.S. Government need to be re-performed to become satisfactory acceptable under the contract.

Dry Cleaning: The cleaning of articles of fabric through immersion in dry cleaning solvents or chemicals through mechanical action. Dry cleaning may also include pre-spotting and use of soaps and synthetic detergents as is necessary to remove soil and stains.

Laundering: The process by which soiled items of fabric are cleaned, treated and/or disinfected, to include cleaning by machine or by hand, in water solutions or detergents and other additives. For the purposes of the contract, the term also includes repellent treating, bleaching, bluing, chemical rinse (sour), starching, ironing and pressing operations as required for the types of fabric and the degree and nature of soiling.

Medically Related Articles: These are articles which are used exclusively in and for a hospital environment. They may or may not require special cleaning requirements, practices, processes or standards as prescribed for in this contract. These may include but not limited to articles cleaned for wear exclusively by official hospital staff and/or hospital patients receiving care in hospital in-patient or out-patient status.

11/20

Performance Threshold: Establishes the performance level required by the government by percentage of required conformance to or number of deviations from the performance objective to be considered acceptable.

Quality Assurance (QA): A planned and systematic pattern of all actions necessary to provide confidence that adequate technical requirements are established; products and services conform to established technical requirements; and satisfactory performance is achieved. For the purposes of the contract, quality assurance refers to actions by the U.S. Government and actions as a result of customer complaint.

Quality Assurance Surveillance Plan (QASP): A document used by the COR to evaluate acceptable delivered services and compliance of the contractor's performance to meet the government's requirements.

Contracting Officer’s Representative (COR): A functionally qualified person who performs quality assurance functions in support of the U.S. Government-contracted services who ensures the services rendered by the contractor are verified, complete and acceptable.

Repairable Items: Articles of fabric with minimal damage, such as minor rips, tears normally less than four (4) inches, pulled or open seams, holes, broken or missing buttons and zippers.

Services Summary (SS): A listing of the service outputs under the contract that are considered critical to mission accomplishment that must be closely monitored and evaluated by the Quality Assurance Surveillance Plan (QASP) on a regular basis, that identifies the minimal acceptable performance standard and requirements of each listed output.

Performance-Based Work Statement (PWS): A performance–based description of the services required by an authorized U.S. Government’s functional activity.

Unserviceable Articles: Items of fabric which, due to excessive wear, damage, or discoloration are no longer useable or repairable for the purpose intended.

Water Repellent Treatment: The machine or hand treatment of fabric items with either solvents or aqueous solutions of water-repellent compounds.

2. SERVICES SUMMARY. The Services Summary (SS) table below lists service functions that are considered critical to contract performance and to the operational areas for which they affect. The contractor shall ensure the successful execution of these service standards at all times. A defect in these services shall result when the percentage of correct service shown in the right column of this table is not met. 100% performance is required when, due to the unique nature and importance of the service, the service, if not performed, or performed un-satisfactorily, cannot be re-performed with a successful outcome. When this occurs, a defect will be recorded and reported to the CO for appropriate action.

2.1. SERVICES SUMMARY TABLE.

12/20

Performance Element Performance Objective PWS

Para.

Performance Threshold

Inspection Method

Schedule

Schedule deliveries shall be on-time and correct quantities of articles returned to original point of service.

1.2., 1.10

Contractor shall return all items except for Curtains within three

(3) calendar days of pick-up. The contractor shall return Curtains within seven

(7) calendar days of pick-up.

No more than 3 defects (validated customer complaints or COR identified deficiencies) per month.

100% Surveillanc e or Valid Customer complains

Quality

The contractor shall meet the special cleaning and linen handling requirements for medically related articles.

1.6

Contractor provides the service IAW the standards.

No more than two (2) defects (validated customer complaints or COR identified deficiencies) per month.

100% Surveillanc e or Valid Customer Complaints

The contractor shall use linen carts distinguishable by color for dirty and clean linen.

The carts will be closed and sealed when being moved from one place to another during transport.

1.6

Contractor provides the service IAW the standards.

No more than two (2) defects per month.

100% Surveillanc e

The contractor shall maintain cleanliness, bundling and packaging standards as required in this PWS. Items that have not been properly cleaned or finished to acceptable industry standards listed in

1.7

Contractor provides the service IAW the standards.

No more than two (2) defects (validated customer complaints or COR identified deficiencies) per month

100% Surveillanc e or Valid Customer Complaints

13/20

Appendix 4.1 of this contract.

Regulatory Compliance

To prevent the infections via cleaned items, the contractor-operating cleaning facility shall be maintained IAW the Laundry Facility Inspection Checklist (LFIC) criteria and terms in the PWS.

1.8.2

The facility and facility operations and linen handling are maintained IAW standards.

Findings are corrected within 90 days after inspection

Periodic Surveillanc e (Annually)

3. SECURITY INFORMATION

3.1 SECURITY REQUIREMENTS

Security and base access requirements are contained in clause 5352.242-9000 “Contractor Access to Air Force Installations.” Contractor employees will be required to obtain and display identification badges. Anticipate delays in getting commercial vehicles on base and allow time for commercial vehicles to reach their destination by driving designated routes at posted speed limits throughout the base. Procedures for commercial vehicle access to the base are subject to change without prior notice. The services to be performed by the contractor during the period of this contract shall at all times and places be subject to review by an authorized representative(s) such as the Site Security Manager(s).

3.1.1 ID Passes, Badges and Vehicle Stickers: The contractor is responsible to obtain such clearances and/or passes as required for his/her employees to enter military installations on Misawa AB prior to start to work. The contractor shall be responsible for all passes issued to his/her employees under this contract. Applications shall be coordinated through the Contracting Officer or designated representative. At the time of application, Security Forces may conduct a background check on employees. Upon termination of employment, the contractor shall be responsible for returning identification cards and base passes to Security Forces within 24 hours.

3.2 Anti-Terrorism. Random Antiterrorism Measures (RAMs). RAMS are conducted on Misawa Air Base at varying times during a 24-hour period and may consist of measures such as spot checks of identification credentials, random vehicle searches, and site security sweeps. The contractor is subject to participating and cooperating with RAMS as directed by competent authority. Anticipate increased RAMS during implementation of elevated Force Protection Conditions (FPCONs).

3.2.1 Reporting Suspicious Activity. It is the responsibility of all personnel working and residing on Misawa Air Base to be alert for detecting and reporting suspicious criminal or terrorist activity. The contractor shall immediately report any on-base observed suspicious activity to the 35 SFS/BDOC, Bldg. 646. All contractor-employed personnel shall be familiar with suspicious activity reporting numbers and procedures. The primary number for reporting

14/20 suspicious activity on Misawa Air Base is 911from a base phone or 0176-53-1911 from a mobile phone or off-base.

4. APPENDICES.

4.1. Workload Estimates/Packing and Method of Finish

4.2. Laundry Facility Inspection Checklist, Misawa Air Base, Japan

15/20

APPENDIX 4.1

WORKLOAD ESTIMATES/PACKAGING AND METHOD OF FINISH

No. Item Size (Inches) Color

Estimated Quantity per Year

Package Quantity Method of Finish

1 Bag, Soiled , Linen 41x30 Blue 4,200 10EA (W) (WP) (F) 2 Blanket, Infant 30x37 White 1,170 10EA (W) (WP) (F) 3 Blanket 66x80 Green 60 1EA (W) (WP) (F) 4 Blanket 66x90 White 5,500 3EA (W) (WP) (F) 5 Blanket 63x86 White 30 1EA (W) (WP) (F) 6 Bathmat 17x26 Beige 30 1EA (W) (WP) (F) 7 Coat, Medical, Attendant White 1000 1EA (W) (WP) (OH) (P) (S) 8 Coat, Pajama, Adult Blue, Navy 150 10EA (W) (WP) (F) (P) 9 Coat, Pajama, Pediatric Animal Print 30 3EA (W) (WP) (F) 10 Cover, Mattress 38x80 White 320 3EA (W) (WP) (F) 11 Diaper 24x20 White 770 10EA (W) (WP) (F) 12 Dress Nurses White 30 1EA (W) (WP) (OH) (P) (S) 13 Drape, Eye Sheet 24x24 Green 300 10EA (W) (WP) (F) (P)

14 Gown, Operating Green, White 730 3EA (W) (WP) (F)

15 Gown, Infant Circus Print 60 3EA (W) (WP) (F)

16 Gown, Patient Blue, Various Print

3,800 3EA (W) (WP) (F)

17 Hat, Surgical Various Prints

250 1EA (W) (WP) (F) (P)

18 Hot Pack Cover 17x28 Gray 30 3EA (W) (WP) (F)

19 Jacket Green, Blue, Red, Gray 7,500 10EA (W) (WP) (F) (P)

20 Napkin 19x19 Green, Blue, Red 10 3EA (W) (WP) (F) (P)

21 Pillow Bed 28x21 White, Blue 30 1EA (W) (WP) 22 Pillow Case 30x20 Green 4,000 10EA (W) (WP) (F) (P) 23 Pillow Case 30x20 White, Pink 8,300 10EA (W) (WP) (F) (P)

24 Robe, Dressing Blue & White Stripe 650 3EA (W) (WP) (F)

25 Sheet, Flat 72x108 Green 9,600 10EA (W) (WP) (F) (P) 26 Sheet, Flat 72x108 White 5,000 10EA (W) (WP) (F) (P) 27 Sheet, Fitted 36x84 White 900 10EA (W) (WP) (F)

28 Shirt, Operating Green, Blue, Black, Navy, Red, Gray

20,300 10EA (W) (WP) (F) (P)

29 Smock, Dentist Blue, Navy, White 200 5EA (W) (WP) (F) (P)

30 Swaddle Beige, White 430 3EA (W) (WP) (F)

31 Tablecloth 63x108 Green, White, Navy 10 3EA (W) (WP) (F) (P)

16/20

32 Towel, Bath 24x50 White, Beige 7,700 10EA (W) (WP) (F)

33 Towel, Hand 17x30 Green, Blue, White 17,000 10EA (W) (WP) (F) (P)

34 Trousers, Operating Green, Blue, Black, Navy, Red, Gray

20,300 10EA (W) (WP) (F) (P)

35 Trousers, Pajama Adult Blue, Navy 150 10EA (W) (WP) (F) (P)

36 Trousers, Pajama Pediatric Yellow, Blue, Green Circus 40 3EA (W) (WP) (F)

37 Undershirt, Infant White 600 10EA (W) (WP) (F) 38 Washcloth 12x12 White, Beige 4,400 10EA (W) (WP) (F) 39 Wrapper Light 9x33 Blue 36 1EA (W) (WP) (F) (P) 40 Wrapper, Sterilization 24x24 Green 220 10EA (W) (WP) (F) (P) 41 Wrapper, Sterilization 36x36 Green 500 10EA (W) (WP) (F) (P) 42 Wrapper, Sterilization 54x54 Green 250 10EA (W) (WP) (F) (P) 43 Curtain 86x69 Green 10 1EA (W) (DC) (WP) (P) (F) (FP) 44 Curtain 86x122 Green 65 1EA (W) (DC) (WP) (P) (F) (FP) 45 Curtain 86x140 Green 85 1EA (W) (DC) (WP) (P) (F) (FP) 46 Curtain 86x175 Green 40 1EA (W) (DC) (WP) (P) (F) (FP) 47 Curtain 86x246 Green 15 1EA (W) (DC) (WP) (P) (F) (FP) 48 Curtain 95x140 Green 20 1EA (W) (DC) (WP) (P) (F) (FP) 49 Curtain 86x69 Blue 5 1EA (W) (DC) (WP) (P) (F) (FP) 50 Curtain 86x85 Blue 5 1EA (W) (DC) (WP) (P) (F) (FP) 51 Curtain 86x126 Blue 5 1EA (W) (DC) (WP) (P) (F) (FP) 52 Curtain 86x165 Blue 5 1EA (W) (DC) (WP) (P) (F) (FP) 53 Curtain 86x140 Stripe 35 1EA (W) (DC) (WP) (P) (F) (FP) 54 Curtain 86x175 Stripe 20 1EA (W) (DC) (WP) (P) (F) (FP) 55 Curtain 86x240 Stripe 20 1EA (W) (DC) (WP) (P) (F) (FP) 56 Curtain 86x143 Brown 5 1EA (W) (DC) (WP) (P) (F) (FP) 57 Curtain 86x228 Brown 5 1EA (W) (DC) (WP) (P) (F) (FP)

17/20

Method of Finish Key Legend

(B) Return in plastic garment bag

(D) Tumble Dry

(F) Fold (FP) Flameproof (GRP) Grouped and cleaned as ONE Lot (Bag) Per Customer (MT) Chemical Treat (dust control mops) (OH) Return finished work on hangers

(P) Press on commercial pressing equipment

(S) Starch

(T) Tie items with twine/string (TT) Tie item with twine/string and tag with date

(W) Wash (WK) Wrap finished work in kraft paper (WP) Wrap finished work in plastic (CC) Color Coded (Colored items shall be packaged and sorted by same type and color (DC) Dry Cleaning

18/20

APPENDIX 4.2

LAUNDRY FACILITY INSPECTION CHECKLIST

PLANT FACILITIES:

1. The laundry facility should be planned, equipped and ventilated as to minimize the dissemination of contaminants. The ventilation system should include adequate:

a. Intake

b. Filtration

c. Exchange rate

d. Exhaust

2. Soiled linen separated from clean linen processing area by:

a. Physical design or barrier

b. Negative air pressure in the soiled linen area

c. Positive airflow from the clean to soiled area

SOILED LINEN:

1. Gloves and appropriate personal protective equipment (PPE) should be worn based on likelihood of contact of exposed skin and clothing with soiled linen.

2. Soiled linen handled as little as possible with minimum of agitation.

3. Hand washing facilities in area.

4. Sharps disposal container in area.

5. Handlers of soiled linen were not also handlers of clean linen without first changing all

PPE and hand washing.

WASHING AREA:

1. Temperature of water must be compatible with the detergent.

2. Temperature gauge on the washer must register temperature of water accurately.

3. Washer must be in good mechanical working order and maintained well.

4. Chemicals used to launder linen must be identified in writing.

19/20

5. Personnel working in sorting and soiled areas area must change all PPE, wash hands and put on new PPE.

DRYING AREA:

1. Dryers need to be adjacent to washers.

2. Temperatures and time settings on dryers need to be specific and standardized for each load.

3. Lint vents must be cleaned prior to each load.

4. A clean cart must be used to remove dry, clean linen from each dryer.

SORTING AREA:

1. A clean table or area must be available to fold linen.

2. The sorting area must be kept clean and free from food, soiled item and foreign debris.

3. Linen will be packaged in similar plastic packaging prior to shipment.

4. Linen not acceptably cleaned will be sent back to washers for a secondary washing process.

IRONING AREA:

1. Linen will be sent through presses in similar processes.

2. Presses will be dusted at the beginning of each day.

WRAPPING AREA:

1. A moisture repellent wrap will cover the entire bundle of similar assembled linen.

2. Wrapped bundles of linen will be placed in linen carts that are specifically designated for (only) clean linen transport to the medical treatment facility.

3. Clean linen transport carts will be cleaned with a disinfectant or steam on a weekly basis or sooner if cart becomes soiled.

TRANSPORTATION:

1. Transportation truck will be cleaned on a monthly basis or sooner if truck cargo area becomes soiled, contaminated or dirty.

20/20

2. Clean wrapped linen will be transported in clean carts in the transport truck.

POLICIES AND PROCEDURES:

1. Written policies and procedures to cover all areas of responsibility related to service provided for this medical treatment facility will be provided and adhered to.

TRAINING / EDUCATION:

1. Appropriate annual and new employee training will be provided to workers covering personal hygiene and hand washing technique.

2. Appropriate annual and new employee training will be provided to workers covering use and application of personal protective equipment.

3. Appropriate annual and new employee training will be provided to workers covering blood-borne pathogen organisms and transmission.

4. Employees will have received Hepatitis B vaccine series or signed waiver of denial on file with employer.

5. A needle stick protocol / follow-up will be available for employees.

Signature of Inspector Hospital Representative / Date

Job Title

(Inspector is usually the Infection Control Officer or their designated representative)

Inspection Team Associates:

(Those who accompany the Inspector: signatures not required)

Date of Inspection