ICRA ILSM.xlsx

XLSX spreadsheet 72 KB Posted

Attached to
Z1DA--Installation of Additional Environmental Monitors Federal contract opportunity
Solicitation number
36C25621R0131
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16

About this file

This document is a presolicitation notice for the installation of additional environmental monitors at the Southeast Louisiana Veterans Health Care System in New Orleans. The contractor shall provide all labor, materials, tools, equipment, and expertise necessary to install 19 room pressure monitors, 3 temperature and humidity sensors, and upgrade the campus-wide Johnson Controls building automation system. The project number is 629-21-102 and cost range is between $500,000 to $1,000,000. This is a 100% set-aside for service-disabled veteran-owned small businesses. Interested SDVOSBs must be verified in the Vendor Information Pages database and registered in the System for Award Management to be considered for award. The solicitation will be issued on June 4, 2021 on beta.SAM.gov and questions should be directed to the contracting officer, Bill Geary.

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Other files for this federal contract opportunity

Other files attached to Z1DA--Installation of Additional Environmental Monitors, newest first.
File Type Posted
S04 Site Visit Sign-In Sheet (06.17.2021).pdf PDF
36C25621R0131 0001.docx DOCX document
EXHIBIT C SUBCONTRACTOR INFORMATION AND CONSENT.docx DOCX document
MANUAL Setra Installation and Operating Manual.pdf PDF
PHOTO 4CC01A.jpg JPG image
PHOTO 4BC02.jpg JPG image
DRAWING 1AI102 M1 IP OVERALL SECOND FLOOR PLAN.pdf PDF
DRAWING 1A104-QUESTION MARK M3 IP OVERALL FOURTH FLOOR PLAN.pdf PDF
26 05 11 Requirements for Electrical Installations.pdf PDF
01 45 00 Quality Control.pdf PDF
GENERAL DECISION NUMBER LA20210041.pdf PDF
36C25621R0131 SOL.docx DOCX document
EXHIBIT B PAST AND PRESENT PERFORMANCE QUESTIONNAIRE.docx DOCX document
DRAWING 1AI104-B2 IP Fourth Wall Types Building B2.pdf PDF
CHART M11 Environmental Monitor Room Location List.pdf PDF
26 05 19 Low Voltage Electrical Power Conductors and Cables 600 Volts and Below.pdf PDF
23 05 11 Common Work Results for HVAC.pdf PDF
09 91 00 Painting.pdf PDF
02 41 00 Demolition.pdf PDF
01 33 23 Shop Drawings Product Data and Samples.pdf PDF
01 00 00 General Requirements.pdf PDF
00 01 10 Table of Contents.pdf PDF
SOW (Final).pdf PDF
EXHIBIT G LIST OF RETURNABLES.docx DOCX document
EXHIBIT F REQUEST FOR INFORMATION FORM.docx DOCX document
EXHIBIT A PERFORMANCE RELEVANCY SURVEY.docx DOCX document
DRAWING 2AI104-D2 M4 DNT FOURTH FLOOR PLAN - AREA D1 AND D2.pdf PDF
DRAWING 2AI103-D2 M5 DNT THIRD FLOOR PLAN - AREA D1 AND D2.pdf PDF
DRAWING 2AI102-G2 M8 DNT SECOND FLOOR PLAN - AREA G1 AND G2.pdf PDF
DRAWING 1AI103-QUESTION MARK M2 IP OVERALL THIRD FLOOR PLAN.pdf PDF
26 05 33 Raceway and Boxes for Electrical Systems.pdf PDF
23 09 23 Direct Digital Control System For HVAC.pdf PDF
01 42 19 Reference Standards.pdf PDF
Justification and Approval (Brand Name).pdf PDF
DRAWING 2AI104-E2 M7 DNT FOURTH FLOOR PLAN - AREA E1 AND E2.pdf PDF
EXHIBIT E SURETY FORM.docx DOCX document
EXHIBIT D CONTRACTOR EVALUATION FORM CONSTRUCTION SAFETY.docx DOCX document
JCI Temperature Humidity Sensor Cutsheet.pdf PDF
CUTSHEET Serta Room Pressure Monitor Cutsheet.pdf PDF
DRAWING 8AS103 M9 RESEARCH THIRD FLOOR PLAN.pdf PDF
DRAWING 2AI102-F2 M10 DNT SECOND FLOOR PLAN - AREA F1 AND F2.pdf PDF
DRAWING 1AI104-C1 IP Fourth Wall Types Building C1.pdf PDF
DRAWING 1AI104-B1 IP Fourth Wall Types Building B1.pdf PDF
2AI102-E2 M6 DNT SECOND FLOOR PLAN -AREA E1 AND E2.pdf PDF
09 29 00 Gypsum Board.pdf PDF
07 84 00 Firestopping.pdf PDF
01 35 26 Safety Requirements.pdf PDF
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Directions

Instructions
1. On tab 1 fill in information for Project Title or Type of Work, Project No., COR., and Start and Completion Date.
2. Input a brief Description of work.
3. On tab 8 Give a detailed step by step description of work, and all risks/hazards associated with each step of the work, and the step being taken to reduce/ eliminate the risks/ hazards..
4. review tab 2 and determine what type of work is being done and the level of risk to patients and staff. Once the type and risk level have been determind return to tab1 and input those into the ICRA form just below the Brief Description, then take those findings and locate them on the chart just below that to determine the overall project class.
5. After determining the over all project class go to tab 3. Depending on the over all project class it will tell what precautions that need to be put into place prior to construction starting and remain in place throughout construction, and what steps that need to be done after construction is complete to ensure the work area is completely clean.
6.Review tab 4 for any Life Safety Conditions and answer the questions Yes/No in the top chart, any yes answers will give you measures in the lower chart that need to be put into place prior to construction and remain in place throughout construction.
7. Review tab 9, fill all blpcks a possible. Any question Contact the GEMS coordinator at ext 72015.
7. Once the form has been completed it needs to be sent/ brought to the Construction Safety Committee for review and approval. If anyone has any question about the ICRA they will contact the person submitting the form for clarification prior to approval.
8. Please try to submit ICRA's to the committee the week prior to the start date.
9. The committee will be reviewing ICRA's for all current projects and any new ICRA's that have been submitted for approval on Friday's prior to Construction Safety Rounds.
10. Only emergency ICRA's should be walked through for approval.
The committee consists of
Safety Management/ Construction/ GEMS Coordinator/ Industrial Hygiene- Michael Adams, Kim Robinson, Latricia Walrath, Matthew Rowley, Kiarra Mackey, Jeremy Sellers
Facilities Management/ Project Engineering/ Mainteance & Operations- Kristen Russell, Angela McKenzie, Tony Clark, Kenneth Ward, Gerald Faulkner, Edwin Chin, Femi Osunbunmi, Robert Chaplin, Jabari Jones
Police Services- Robert Kenyon, Connie Washington, Joshua Anderson, Rodney Robvias
Quality Management/ Infection Control- Serelda Bowman-Young , Lori Jefferson, Debbie Lepre, Jemichael Manora
Patient Safety- Randy Decuir, Chris Cahill, Jenny Duplantier
Contracting- Leslie Robinson, William Geary (Biloxi)
AFGE/ NFFE Representatives- Yolan Bender, Anne Fisher
Clinical Engneering- Mariel Paciera, Jennifer Boudreaux, Meghan Glaviano, Austin Sandlin, Liana Soileau

1-ICRA

Infection Control Risk Assessment (ICRA) Checksheet
Project Title or Type of Work: Installation of Additional Environmental MonitorsProject No._____629-21-102_______
In-house Representative/ Supervisor___Raynard Bender__________Location: Inpatient Building
COR/ Representative______Edwin Chin___________________Start Date:_____July 1, 2021_____________
Completion Date:__October 1, 2021
Brief description of the construction or maintenance project:
This project will add room pressure monitors at entries to hospital ward spaces where COVID-19 patients are currently
housed. Temperature and humidity sensors will be added to reduce manual readings each day. The JCI BAS will be upgraded to a newer versions.
upgraded to a newer version.
Type of construction project--choose from drop-down box (see "Types & Risk" tab):C
Patient Risk Group--choose from drop-down box (see "Types & Risk" tab):LowALowI
BMediumII
Class of Infection Control Precautions (select from grid)CHighIII
Construction Project TypeDHighestIV
Patient Risk GroupTYPE ATYPE BTYPE CTYPE DProject Class
LowIIIIIIII/IVIII
MediumIIIIIIIV
HighIIIIII/IVIV
HighestIIIII/IVIII/IVIV
Other ConsiderationsComments
Air QualityThe contractor will seal the areas per VA requirements where dry wall construction is to take place.
NoiseMinimal noise.
VibrationsNone.
UtilitiesNone.
Emergency proceduresCall Ploice at 911.
SecurityContractors will have a VA escort present.
Construction Safety Assessment Team Concurrence
MemberSignatureDate
Construction Safety
Safety Management
Engineering Services (CE, M&O, Projects)
Infection Control/ QM
Patient Safety
GEMS
Industrial Hygiene
EMS
SPHM&FPM

Other Comments

Sheet1

Sheet2

Sheet3

Sheet4

Sheet5

2-Types & Risk TYPE A Inspection and Non-Invasive Activities Includes, but is not limited to:

Removal of ceiling tiles for visual inspection limited to 1 tile per 50 square feet Painting (but not sanding) Wall covering, electrical trim work, minor plumbing, and activities which do not generate dust or require cutting of walls or access to ceilings other than for visual inspection.

TYPE B Small scale, short duration activities which create minimal dust Includes, but is not limited to:

Installation of telephone and computer cabling Access to chase spaces Cutting of walls or ceiling where dust migration can be controlled TYPE C Work that generates a moderate to high level of dust or requires demolition or removal of any fixed building components or assemblies Includes, but is not limited to:

Sanding of walls for painting or wall covering Removal of floor coverings, ceiling tiles and casework New wall construction Minor duct work or electrical work above ceilings Major cabling activities Any activity which cannot be completed within single work shift TYPE D Major demolition and construction projects Includes, but is not limited to:

Activities which require consecutive work shifts Requires heavy demolition or removal of complete cabling systems New Construction

Low RiskMedium RiskHigh RiskHighest Risk
Office areas

Medical records Non-patient care areas Cafeteria Cardiology clinic Echocardiography Endoscopy Nuclear Medicine Physical Therapy Radiology/MRI Respiratory Therapy CCU Emergency Room Laboratories (specimen) Admissions Outpatient Surgery Pharmacy Post Anesthesia Care Unit (PACU) Surgical Units Any area caring for immunocompromised patients Cardiac Cath Lab

SPS

Intensive Care Units Medical Units Negative pressure isolation rooms Oncology Operating rooms Invasive procedure rooms

3-ICRA2

Infection Control Risk Assessment (ICRA) Checksheet (check appropriate requirements)

December 31, 1899
ClassDuring Construction ProjectUpon Completion of Project
IExecute work by methods to minimize raising dust from construction operations.Immediately replace ceiling tile displaced for visual inspection.
IIProvide active means to prevent airborne dust from dispersing into atmosphere.Wipe work surfaces with disinfectant.
Water mist work surfaces to control dust while cutting.Wet mop and/or vacuum with HEPA-filtered vacuum before leaving work area.
Seal unused doors with duct tape.Remove isolation of HVAC system in areas where work is being performed.
Block off and seal air vents.Contain construction waste before transport in tightly covered containers.
Place dust mat at entrance and exit of work area.
Remove or isolate HVAC system in areas where work is being performed to prevent contamination of duct system.
IIIClass II (those checked) plus:Do not remove barriers from work area until completed project is inspected by Safety and Infection Control and thoroughly cleaned by Environmental Management.
yComplete all critical barriers i.e. sheetrock, plywood, plastic, to seal area from non-work area or implement control cube method (cart with plastic covering and sealed connection to work site with HEPA vacuum for vacuuming prior to exit) before construction begins.yRemove barrier materials carefully to minimize spreading of dirt and debris associated with construction.
yMaintain negative air pressure within work site utilizing HEPA equipped air filtration units.yVacuum work area with HEPA filtered vacuums.
yCover transport receptacles or carts. Tape covering unless solid lid.yWet mop area with disinfectant.
IVClass III (those checked) plus:See other Classes.
Seal holes, pipes, conduits, and punctures appropriately.
Construct anteroom and require all personnel to pass through this room so they can be vacuumed using a HEPA vacuum cleaner before leaving work site or they can wear cloth or paper coveralls that are removed each time the worker leaves the worksite.
All personnel entering work site are required to wear shoe covers. Shoe covers must be changed each time the worker exits the work area.

4-ILSM Const

Interim Life Safety Measures (ILSM) Assessment for Construction and Maintenance
Project Title or Type of Work:Installation of additional environmental monitors
Project No.629-21-102
Evaluate the project using the criteria below to determine which ILSM are applicable.
DeficiencyY or N?DeficiencyY or N?
Blocking off an approved exitNInstalling sprinkler system (out of service)NY
Rerouting of primary egress pathNSignificantly modifying smoke or fire barrier wallsNN
Rerouting of secondary egress pathNAdding an addition to an existing structureN
Rerouting of traffic to emergency care centerNTaking fire alarm / sprinkler system out of service >4 hoursN
Major renovation of an occupied floorNDisconnecting 4 or more alarm devices >4 hoursN
Replacing the fire alarm system (out of service)NAll / part of medical gas alarm panels out of serviceN
1Notify the fire department and initiate a fire watch.
2Post signage identifying the location of alternative exits to everyone affected.
3Inspect exits in affected areas on a daily basis.
4Provide temporary but equivalent fire alarm and detection systems for use when a fire system is impaired.
5Provide additional firefighting equipment.
6Use temporary construction partitions that are smoke-tight, or made of noncombustible or limited-combustible material that will not contribute to the development or spread of fire.
7Increase surveillance of buildings, grounds, and equipment, giving special attention to construction areas and storage, excavation, and field offices.
8Enforce storage, housekeeping, and debris-removal practices that reduce the building’s flammable and combustible fire load to the lowest feasible level.
9Provide additional training to those who work in the hospital on the use of firefighting equipment.
10Conduct one additional fire drill per shift per quarter. All areas.
11Conduct one additional fire drill per shift per quarter. Local area.
12Inspect and test temporary systems monthly.
13Conduct education to promote awareness of building deficiencies, construction hazards, and temporary measures implemented to maintain fire safety.
14Train those who work in the hospital to compensate for impaired structural or compartmental fire safety features.

5-ILSM Defic

Interim Life Safety Measures (ILSM) Assessment for Life Safety Code Deficiency
Deficiency:0
Evaluate the deficiency using the criteria below to determine which ILSM are applicable.
DeficiencyY or N?DeficiencyY or N?
Corridor door latching / gap / rating problemsNNonconforming building construction typeNY
Fire door latching / gap / rating problemsNImproperly protected vertical openingsNN
Smoke door latching / gap / rating problemsNLarge penetration in fire / smoke barriersN
Lacking a code-compliant barrierNCorridor walls do not extend to the structureN
Fire exit stairs discharge improperlyNFire protection systems* failure <4 hoursN*alarm, detection or

suppression

Excessive travel distance to approved exitNFire protection systems* failure >4 hoursN
Lacking two remote exitsNHazardous area not properly protectedN
1Notify the fire department and initiate a fire watch.
2Post signage identifying the location of alternative exits to everyone affected.
3Inspect exits in affected areas on a daily basis.
4Provide temporary but equivalent fire alarm and detection systems for use when a fire system is impaired.
5Provide additional firefighting equipment.
6Use temporary construction partitions that are smoke-tight, or made of noncombustible or limited-combustible material that will not contribute to the development or spread of fire.
7Increase surveillance of buildings, grounds, and equipment, giving special attention to construction areas and storage, excavation, and field offices.
8Enforce storage, housekeeping, and debris-removal practices that reduce the building’s flammable and combustible fire load to the lowest feasible level.
9Provide additional training to those who work in the hospital on the use of firefighting equipment.
10Conduct one additional fire drill per shift per quarter. All areas.
11Conduct one additional fire drill per shift per quarter. Local area.
12Inspect and test temporary systems monthly.
13Conduct education to promote awareness of building deficiencies, construction hazards, and temporary measures implemented to maintain fire safety.
14Train those who work in the hospital to compensate for impaired structural or compartmental fire safety features.

6-ILSM Contract ILSM Formal Contract

Project Title / Deficiency:Installation of additional environmental monitorsProject No.:629-21-102
COTR:Edwin ChinContractor:Richland Industries

Location and Description of Work:

This project will add room pressure monitors at entries to hospital ward spaces where COVID-19 patients are currently
housed. Temperature and humidity sensors will be added to reduce manual readings each day. The JCI BAS will be upgraded to a newer versions.
Date of this Formal Contract:March 31, 2021
Mandatory ILSMYesNo
1Notify the fire department and initiate a fire watch.
2Post signage identifying the location of alternative exits to everyone affected.
3Inspect exits in affected areas on a daily basis.
4Provide temporary but equivalent fire alarm and detection systems for use when a fire system is impaired.
5Provide additional fire-fighting equipment.
6Use temporary construction partitions that are smoke-tight, or made of noncombustible or limited-combustible material that will not contribute to the development or spread of fire.
7Increase surveillance of buildings, grounds, and equipment, giving special attention to construction areas and storage, excavation, and field offices.
8Enforce storage, housekeeping, and debris-removal practices that reduce the building’s flammable and combustible fire load to the lowest feasible level.
9Provide additional training to those who work in the hospital on the use of firefighting equipment.
10Conduct one additional fire drill per shift per quarter. All areas.
11Conduct one additional fire drill per shift per quarter. Local area.
12Inspect and test temporary systems monthly.
13Conduct education to promote awareness of building deficiencies, construction hazards, and temporary measures implemented to maintain fire safety.
14Train those who work in the hospital to compensate for impaired structural or compartmental fire safety features.
Staff Training
Subject(s)
(use above numbers)Names/Groups TrainedDate
Dates of Fire Drills
AreaDateTimeAreaDateTime

7-Inspection

MEDVAMC CONSTRUCTION SAFETY INSPECTION FORM

Project Title: Installation of additional environmental monitors Project Number: 629-21-102

Inspector:Inspection Date:
Possible ILSMs from the Construction Safety AssessmentRequired?In Place?Comments
YesNo
1Notify the fire department and initiate a fire watch.
2Post signage identifying the location of alternative exits to everyone affected.
3Inspect exits in affected areas on a daily basis.
4Provide temporary but equivalent fire alarm and detection systems for use when a fire system is impaired.
5Provide additional firefighting equipment.
6Use temporary construction partitions that are smoke-tight, or made of noncombustible or limited-combustible material that will not contribute to the development or spread of fire.
7Increase surveillance of buildings, grounds, and equipment, giving special attention to construction areas and storage, excavation, and field offices.
8Enforce storage, housekeeping, and debris-removal practices that reduce the building’s flammable and combustible fire load to the lowest feasible level.
9Provide additional training to those who work in the hospital on the use of firefighting equipment.
10Conduct one additional fire drill per shift per quarter. All areas.
11Conduct one additional fire drill per shift per quarter. Local area.
12Inspect and test temporary systems monthly.
13Conduct education to promote awareness of building deficiencies, construction hazards, and temporary measures implemented to maintain fire safety.
14Train those who work in the hospital to compensate for impaired structural or compartmental fire safety features.
Other Construction Issues
YNN/AYNN/AComments
Construction area warning sign posted?Adequate lighting provided in all work areas?
All construction doors (including interstitial) closed and locked?Hand held and mounted equipment properly guarded?
Evidence of dust and debris tracked to outside of barrier?Aisles and passageways in good repair, kept clear and properly marked?
Mat/carpet at entrance?Egress to and from work site unobstructed?
Floor, wall, ceiling penetrations sealed properly?Fire extinguisher on site?
Ladders in good condition?
Hot Work or Confined Space Permits posted?MSDS available on site?
Area free of insects and rodents?Gas cylinders secured?
Area under negative pressure?Evidence of smoking?
Ventilation system adequately removes toxic dust and gases from work environment?Electrical power cords in good condition?
Workers wearing or have available appropriate PPE?Guardrails and toe boards provided for scaffolding that is open at all sides?
Safety harnesses being worn for work >6’ off the ground?Additional Comments:

8-Detailed Description of Work Detailed Description of Work

Install 19 room pressure monitors.
Install 3 temperature / humidity sensors.
Upgrade Campus wide Johnson Controls Building Automation System.
Demo and add new dry wall for room pressure monitors to route electrical and tubing.
Add graphics to BAS.

9- NEPA checklist

9- NEPA

Project: Installation of additional environmental monitorsLocation: Inpatient Building
Project Number: 629-21-102
Type of Project:Project Description: Addition of environmental monitors.
Operation and Maintenance Activities
Repairs/Renovation Project
XNew Construction Project
Lease
Other
Level of NEPA Analysis:Other Environmental Permits/Analysis Needed: None.
XCategorical Exclusion
Environmental Assessment Needed
Environmental Impact Statement Needed
Project Impacts:
Would the proposed activity involve or generate any of the following?
SOURCEYESNOSOURCEYESNOSOURCEYESNO
Air Emissions
including GHGsxLiquid EffluentxRCRA or CERCLA
Sitesx
AsbestosxPetroleum StoragexWetlandsx
Excess NoisexSolid WastexPermit
Modificationx
Utility ModificationxHazardous WastexChemical
Use/Storagex
Soil DisturbancexBiological
ResourcesxAestheticsx
Water TreatmentxRadioactive WastexWater/Well Usex
Water Flow
ModificationxMixed WastexOtherx
Determination:
xI find the proposed project qualifies as a CATEGORICAL EXCLUSION with no
extraordinary circumstances. Specify which CATEX:
I find that the proposed project MAY have a significant effect on the environment;
therefore, an ENVIRONMENTAL ASSESSMENT will be prepared.
EIS
Recommended by:Project ManagerDate:
Approved by:Chief, Eng. ServiceDate:
Approved by:GEMS PMDate:

1. Repair, replacement and new installation of primary or secondary electrical distribution systems; 2. Repair, replacement and new installation of components such as windows doors, roofs, and site elements such as sidewalk, patios, fences, retaining walls, curbs, water distribution line and sewer lines which involve work totally within VA property boundaries;

3. Routine VA grounds and facility maintenance activities;

4. Procurement and activities for goods and services for routing facility operations maintenance and support;

5. Interior construction or renovation;

6. New construction of 75,000 gross square feet or less;

7. Development of 20 acres of land or less within an existing cemetery, or development on acquired land of five acres or less.

8. Actions which involve support or ancillary appurtenances for normal operation;

9. Leases, licenses, permits, and easements;

10. Reduction in force resulting from workload adjustments, reduced personnel or funding levels, skill imbalances or other similar causes;

11. VA policies, actions and studies which do not significantly affect the quality of the human environment; 12. Preparation of regulations, directives, manuals, or other guidance that implement, but do not substantially change, the regulations, directives, manuals, or other guidance of higher organizational levels or another Federal agency, and

13. Actions, activities. Or programs that do not require expenditure of Federal funds.

*38CFR Part 26.6(b)(1)

Examples of VA's Extraordinary Circumstances The following examples are illustrative of Extraordinary Circumstances where an action would typically require further NEPA evaluation (an EA or EIS).

These are not intended to be comprehensive, but they will help you to identify extraordinary circumstances when they exist.

1. Greater scope or size than normally experienced for a particular categorical exclusion

2. Actions in highly populated or congested areas

3. Potential for degradation, although slight, or existing poor environmental conditions

4. Use of unproven technology

5. Potential presence of an endangered species, archaeological remains, or other protected resources

6. Potential presence of hazardous or toxic substances

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