ICRA_PRA 502-23-707 Replace Wayfinding Signage .pdf

Project Risk & Impact Assessment Appendix D

Date of Print Review: Demolition Start Date:

Estimated Project Length: 200 Days Project Risk

NO# 2026-001

Required OSHA Training: (10hr, 30hr) Scope of Project: 502-23-707 Replace Wayfinding and signage.

Services Render Inoperative: None Overall EOC Effect to Which Areas: All

Activity Type and Description and Class: Remove and install new signage

Activity Type and Description Control Measures Inspection/upkeep generally defined as follows: 1. Immediately replace any ceiling tile, close access panels, etc., upon completion of work.

2. Site visits to the construction area are required weekly by members of multi-disciplinary team. Site visits will be documented on standard checklist.

3. Site specific safety plan, task hazard analysis, and hazard communication required to be provided by the contractor and approved where a contract is in place. For internal work the shop involved must work with Safety to ensure proper precautions are in place.

4. Must address identified hazards and controls that will be implemented to ensure minimal impact to patients, employees, contractors, and facility.

Communication and coordination plan for all affected areas

• Work can be completed in a single shift, not to exceed 10 hours.

• Patients, employees and/or visitors may be in the area depending on the activity,

• Work that does not create dust or debris.

• Work that does not create vapor or fumes.

• Removal of ceiling tiles or access to mechanical or electrical chase for visual inspection that will not impair fire safety systems and are limited to 1 tile per 50 square feet with limited exposure time (not to exceed an hour for each tile) within the shift.

• Minor interior updates (e.g., replacing floor or ceiling tiles, carpentry work to include hanging signage, and painting with hand tools) that do not create vibration or noise, Limited building system maintenance that does not require Lock Out Tag Out (LOTO) such as plumbing on potable systems limited to faucet replacement, steam trap replacement etc. and electrical work such as replacement of bulbs, receptacles, or switches.

Small scale Construction, Renovation and general All control measures in the row above and the maintenance/repair work, generally defined as follows: following:

1. Hazard communication chemical inventory required to be provided by the contractor and approved.

2. Where construction, Renovation and maintenance are done in an accredited facility, and ILSM assessment is required to be done and ILSMs put into place in accordance with TJC LS.01.02.01 and the local facility policy including Fire watch if necessary. Staff is trained and the ILSM is verified regularly

3. Hot Work or burn permits in place and staff trained

4. LOTO procedures in place and staff trained on their use

5. Site visits will be reviewed using the criteria in standardized guide.

Daily inspections of the site are to be conducted by the General Contractor or shop supervisor and documented on their daily log.

• Prolonged work that may take longer than a single shift but not exceeding six months.

• Patients and employees are not to be in the area until activity is completed.

• Work that creates some noise and vibration due to power tool use.

• Selective demolition/removal of preexisting floor covering, casework, lay-in ceiling, or other architectural elements that may o disturb asbestos, lead or silica o create the potential for falling objects o create vibration and/or noise more than 80 dB(A) in surrounding areas.

o cause penetrations in fire or smoke barrier

• Plumbing work such as the installation of new sinks, showers and toilets and associated plumbing that requires utility outages or work on the steam system that may require:

o LOTO o The use of compressed gas cylinders

• Electrical work such as installation of conduit and wire for lighting, receptacles and switches for an area, the installation of conduit and wire for new devices such as terminal units, fans etc. Electrical work such as installation of cabling/wiring/conduit for a single device, installation of new device such as a light fixture that require LOTO.

• Air Handler and/or fan shutdown/startup and HVAC work such as replacement of a single diffuser, single terminal unit, a single device and the installation of ductwork, diffusers, and terminal units for an area that may require:

o Work on ladders o Rigging, hoisting, or lifting of equipment or materials overhead

• Modification of existing fire alarm and suppression systems requiring system outages and ILSMs or obstruction of exits and or impact on corridors.

• Architectural, structural, or any other work that may cause vapors or fumes such as:

o Roofing work o Flooring work

Painting or other large-scale use of such substances.

Large-scale construction, renovation, or maintenance generally defined as follows:

• Work exceeding 6 months in duration.

• Patients and employees are not to be in the area until activity is completed.

• Excavation or heavy equipment use taking place o Dig safe required utility location o Trench safety o Dust control plan o Equipment exhaust, Noise, Vibration

• Confined space entry required (permit required or not)

• Requires crane work o General crane work o Lift over buildings

• Includes elevated work o Roof work, fall protection o Window work, scaffolding and fall protection o Odor control

• Welding, cutting or use of torches requiring burn permits

• Demolition of building components and infrastructure including removal of multiple doors, walls, framing, ceilings, flooring, piping, electrical and HVAC that may o require asbestos, lead or silica abatement o create the potential for falling objects o create vibration and/or noise more than 90 dB(A) in surrounding areas.

o cause breaches to fire or smoke barrier

• The installation building components such as new walls, ceilings and doors including framing, drywall and associated plaster work that requires transport of significant materials through building and up elevators i.e., weight limits of floors and elevators

All control measures in the two rows above and the following Activity Hazard Analyses and Control Plans (check all that apply):

1. Excavation safety plan in place 0

2. Dust control plan in place 0

3. Pollution prevention plan in place E

4. Dig safe paperwork in place E

5. Crane lift plan in place 0

a. Crane placement

b. Crane swing

c. Crane load evaluation

6. Fall protection plan in place and staff trained 0

7. Confined entry plan in place and staff trained 0

• Plumbing work requiring LOTO and system shutdown and startup such as the installation of:

o new medical gas systems, o steam/heating hot water, condensate systems, o Potable water and sanitary drainage, multiple sinks, showers, and toilets including associated plumbing.

• Electrical work such as installation of electrical feeders, distribution panels, conduit and wire for lighting, receptacles and switches for an area, the installation of conduit and wire for new devices such as terminal units, fans etc. requiring LOTO and system isolation.

• Installation of fire alarm and suppression systems requiring outages of those systems and ILSMs or closure of exits/corridors

Mechanical work such as the installation of air handling equipment, associated ductwork, diffusers, heat exchangers, terminal units and controls requiring lifting and support of equipment and systems.

High Interest Assessment Items

Construction Specific

Operational Impact

Team Involvement

X

Noise Type: ElDrilling CI Blasting CI Pounding CI Heavy Equipment 0 Motors CI Other:

Asbestos

0 High CI Medium Low

Severity: Low CI Mild CI Moderate CI High CI Severe Duration: U Short 0 Brief CI Intermittent CI Frequent 0 Prolonged CI Continuous

Vibration Type: El Primary CI Secondary CI Other:

X

Access and Waiting Areas

Severity: 0 Low CI Mild CI Moderate CI High D Severe Duration: CI Short CI Brief CI Intermittent 0 Frequent CI Prolonged CI Continuous

Interim Life Safety Measure (ILSM) (Obtained through the VA Fire Department)

X

Infection Control Hazards (See Infection control permit)

Air Quality Issues Type: CI Fumes CI Dust CI Mold CI Smoke CI Chemicals Severity: CI Low CI Mild 0 Moderate CI High CI Severe Duration: CI Short CI Brief CI Intermittent CI

Security Systems Impaired

Utility Issues Type: CI HVAC CI Med Gas CI Power CI Water CI Suction Impact: CI Modified Operational CI Shut Down Duration: El Short CI Brief CI Intermittent 0

Overcrowding/Patient Flow

Potable Water (VHA Directive 1061) Type: CI New Lines CI Replacement 0 Tap CI Repair

Potential impact of water system on growth or transmission

ADJACENT AREA 3 ADJACENT AREA 1

,00 j

AREA BELOW

AREA ABOVE

of Waterborne pathogens

Severity: 0 Low 0 Mild 0 Moderate LI High 0 Severe Duration: 0 Short 0 Brief 0 Intermittent 0 Frequent 0 Prolonged 0 Continuous Disinfection required:

Disinfection: 0 Yes 0 No

Patient Care Effected Comments Impaired Access to Facility Trenching/Shoring/Holes (Excavation safety Plan with permit required) Electrical Work (Live electrical plan required if working in Live panel) Lock Out Tag Out (LOTTO) (LO/TO Plan required) Hot Work (Hot work Permits Required) Scaffolding (Scaffolding Plan required with Card system) Fall Protection (Fall Protection Plan required)

Overhead Hazards/Crain Operation (Lift Plan required with permit) Infection Control Permit is required and continuous monitoring in place (Permit should be posted Prior to work) Confined Space (Confined Space Plan required with Permit) Fire Wall Penetrations

Heat or Flames

X

Limit Access to Care

Clinical Alarms Impairment Generator Power Equipment Modifications Air/Oxygen/Suction

(AOV)

Smoke Producing Operations Weekly Inspections required

Access to IT Closet or data systems VISN Notifications

All employee notification on ISLM issued during the construction of this project

Identify the areas and associated patients that will be affected by the construction/renovation/maintenance activity (see the Figure for a visual representation of adjacent affected areas).

Affected Adjacent Area Assessment Area Service(s)/Type(s) of Area(s) (e.g., OR, Unit/Ward, Sterile Processing, Administrative, etc)*

Point of Contact

(POC)

POC Contact Information

Construction plan communicated to

POC?

Activity Area**

Area Above

Area Below

Adjacent Area 1

Adjacent Area 2

Adjacent Area 3

Adjacent Area 4

Adjacent Area 5

Building Water Distribution System Risk Assessment

Building Occupant

Risk Group(s)

Office Areas

• Conference

Rooms

• Administration

WMC-1 WMC-2 WMC-3 WMC-3

Cafeterias

• Lobbies

LI

• Family Waiting „. ','.;)\

Areas

WMC-1 WMC-2 WMC-3 WMC-4

; 1 _

1 g, Modest

Emergency

Department

• Acute Surgical

- 7:r" i'

-1.•

Unit

, WMC-2 WMC-3 WMC-3 OR 4 WMC-4

• Low-Risk I.I.

Maternity High

Dialysis

• ICU's

• Bone Marrow

Transplant Units

WMC-2 WMC-3 WMC-3 OR 4 WMC-4

Baseline measurements:temperature, pH, residual oxidant (FRO), etc. Focus on pre- and

WMC-1 post-work Flushing with measurements of temperature & FRO on hot & cold water. Log & report data.

WMC-2

All components of WMC-1. Establish enclosure to prevent aerosolized water from leaving work area and keep up until work is complete. EVS to perform cleaning priorto use/occupancy.

All components of WMC-2. Additio nal protocols for verification through regular (daily/weekly)

WMC-3 flushing,free residual oxidant (FRO) logs, evaluating of any disinfection procedures to be performed, and inspection of work completed. Validation through envi ro n mental testing.

WMC-4

All components of WMC-3. Conduct a pre-work risk assessment and prepare a project-specific

WMC plan following risk, establish risk management aligned with ANSI/ASHRAE Standard.

188. Set up milestones leading up to first day of patient occupancy. Implemented by project/facilityWMT.

CONSTRUCTION PROJECT BLUEPRINT AND IN FIELD

SAFETY AND HEALTH ASSESSMENT RISK BASED CRITERIA

CLASS CONSTRUCTION ACTIVITY RISK PRECAUTIONS REQUIRED

CLASS

I

Type A: Inspection and Non-Invasive Activities.

Includes, but is not limited to:

1. Small scale removal of ceiling tiles for visual inspection or minor installation.

2. Painting (but not sanding).

3. Wall covering, electrical trim work, minor plumbing, and activities that do not generate dust or require cutting of walls.

Low or Moderate

Risk Patients Only

High Risk Requires Class II

Precautions

1. Execute work by methods to minimize raising dust from construction operations.

2. Immediately replace a ceiling tile displaced for visual inspection.

CLASS

II

Type B: Small scale, short duration activities that create minimal dust.

Includes, but is not limited to:

1. Access to chase spaces.

2. Cutting of walls or ceiling where dust migration can be controlled.

3. Installation of telephone and computer cabling

Low or Moderate

Risk Patients Only

High Risk Requires Class III

Precautions

1.Notify staff in the immediate area.

2. Provide active means to prevent airborne dust from dispersing into air.

3. Water mist work surfaces while cutting.

4. Seal unused doors with duct tape.

5. Block off and seal air vents.

6. Place dust mat at entrance/exit of area.

7. Contain construction waste before transport in tightly covered containers.

8. Upon completion, wipe work surfaces with disinfectant, wet mop and/or vacuum and remove isolation of HVAC system.

CLASS

III

Type C: Work that generates a moderate to high level of dust or requires demolition or removal of any fixed building components and assemblies or new construction.

Includes, but is not limited to:

1. Sanding of walls for painting or wall covering.

2. Removal of floor coverings, ceiling tiles, and casework.

3. New wall construction.

4. Uncontained duct, HVAC or electrical work above ceiling,

5. Major cabling activities.

6. Any other project where high levels of dust are generated.

Moderate or High-Risk Patients

Only Low Risk Requires Class II

Precautions

In addition to Class II Precautions above, 1.Obtain IC concurrence before construction begins.

2. Complete all critical barriers, i.e., sheetrock, plywood, plastic, to seal from non-work area or implement control cube method (cart with plastic covering/sealed connection to work site with vacuuming prior to exit) before construction begins.

3. Isolate HVAC system in area and maintain negative air pressure within work site.

4. Cover transport receptacles or carts.

5. Seal holes, pipes, conduits, and punctures.

6. Personnel required ensuring shoes are not tracking when leaving the work site.

7.Upon completion, do not remove barriers until inspected by Safety and IC and thoroughly cleaned by EMS. Remove barrier materials carefully to minimize spreading of dirt and debris.

PATIENT RISK GROUP

Medium Risk Group

Administrative Offices Lobbies Public Corridors Elevators Day Rooms Canteen Retail Store

Outpatient, Urgent Care and Primary Care Clinics Laboratory Radiology and Nuclear Medicine Physical Therapy Respiratory Therapy Pharmacy Food Services Interim Care and Medical Units

SPD Storage/Sterilization TB Negative Pressure isolation rooms Operating Room Urgent Care Morgue

INFECTION CONTROL PRECAUTIONS

TB Risk Assessment Based upon CDC Guidelines for preventing the transmission of TB in Healthcare Setting 2005

X

Low Risk <3 TB Patients/year Inpatient & Outpatient

Medium Risk > 3 TB _ Patients/year Inpatient & Outpatient

Potential on Going Transmission Evidence of ongoing M.

Tubercubsis Transmission regardless of setting.

Construction Site Location

X

Low Risk: Administrative Offices, Lobbies, Public Corridors, Elevators, Day Rooms, Canteen Retail Store, Pharmacy and Food Services

X

Medium Risk:

Outpatient, Urgent Care and Primary Care Clinics, Laboratory, Radiology, Physical Therapy, and Respiratory Therapy

X

High Risk: SPD Storage/Sterilization, TB Negative Pressure isolation rooms, Operating Room, Morgue, X Low risk: 0 - 37

Medium Risk: 38 - 75

High Risk: 76 — 111+

Hospital Layout

X

Low risk:

Office Areas Lobbies/Corridors Mechanical Rooms And any other area with exceptions listed in the Medium or High risk

X

Medium Risk:

Building 7- Yellow team, Green team, Blue team, Dental, Radiology, Gold Team, Short Stay, Surgery, Women's Health, Rehabilitation Medicine, Cardiology Patient Services, Respiratory Therapy, Patient rooms Building 45 Building 9- Mental Health

X

High Risk:

Urgent care Rm Endoscopy Rm Morgue Outpatient Surgery Pharmacy Recovery Surgical units Negative pressure rooms

Overall Risk Assessment

X

Low risk: No TB test required for this project.

Medium Risk: Annual TB test is required by all construction workers for this project.

High Risk: TB test within 90 days prior to construction is required by all construction workers for this project.

X CLASS

I

1. Execute work by methods to minimize raising dust from construction operations.

2. Immediately replace any ceiling tile displaced for visual inspection. (No permit required)

1. Provides active means to prevent air-borne dust 5. Place dust mat at entrance and exit of work

CLASS from dispersing into atmosphere. area.

II 2. Water mist work surfaces to control dust while 6. Contain construction waste before transport in cutting. tightly covered containers.

3. Seal unused doors with duct tape. 7. Upon completion, wipe work surfaces with

4. Block off and seal air vents. (Permit Required) disinfectant, wet mop and/or vacuum and remove isolation of HVAC system.

CLASS

In addition to Class II Precautions above,

1. Obtain IC concurrence before construction

5. Seal holes, pipes, conduits, and punctures appropriately

III & IV begins. 6. Personnel are required to ensure shoes are

2. Complete all critical barriers or implement not tracking dust and soil when leaving the work control cube method before construction begins. site.

3. Control airflow: Isolate HVAC system in areas 7. Upon completion, do not remove barriers until where work is being performed and maintain inspected by Safety and Infection Control and negative air pressure within work site. thoroughly cleaned by EMS. Remove barrier

4. Cover transport receptacles or carts. materials carefully to minimize spreading of dirt and debris.

(Permit Required)

Additional requirements: Signage replacement should not require negative air or opening up wall. If the scope of work changes then the risk must be re-evaluated.

Chief Engineering Service:

Date: t 2, z‘ Facilities Safety Manager:

Date: - 7 - 2 4.

Patient Safety Manager:

Date..

Infection Control Nurse: asdl-- Date:

Green Environmental Manager:

Date: / -/2/2,b Emergency Management:69 , Date: / - 7-,z 6, Employee Health: s '

Date: 1 -F 2(4 Police Service:

Date:

Project C.O.R. :

Date: 2.-S- 2_.(,, FORM DISPOSITION: RETURN TO THE SAFETY STAFF FOR EVALUATION.

Rev_02

Statement of Work

Project No. 502-23-707 Replace Wayfinding and Signage

Alexandria VA Health Care System, Pineville, LA

Scope:

The primary scope of this project includes replacing and updating the existing signage in an existing 5-story (including the basement) 230,000 SF Hospital building with multiple existing signage systems. Many of the existing signs are outdated and do not comply with current ADA/ABA code and VA requirements.

Interiors

Interior construction Some wall repairs for interior signage replacement are planned into the project. If necessary for signage replacement, the project will include, the wall finish being repaired to match existing wall finish. Existing finishes have been identified as painted gypsum board walls. The scope of the interior signage will include the following:

- Improve all internal wayfinding signage to help patients/visitors and employees to navigate to the desired destination within the facility.

- Install/improve signage for departments, room names, room numbers, elevators, lobbies, stairways, corridors and exits.

- Install signage for amenity markers such as café, canteen, toilet rooms, ATM, barber shop, etc.

- Install/improve signage to be code compliant for braille, color blindness, and memory challenged patients, visitors, and staff

- Install/improve signage for emergency, life safety, and egress requirements.

-Install/improve warning signs such as high voltage, hazardous materials and biohazards, etc.

- Install new wall covering at all elevator lobbies.

Temporary partitions must be provided as necessary to accommodate construction phasing to allow for the removal of existing signage and installation of new signage systems to comply with the ICRA requirements of the facility. These partitions will be constructed of wood or light gauge metal framing with poly film and gypsum board to prevent the spread of construction dust and debris.

Objective:

1. To ensure all requirements of contract drawings and specifications are met and completed by the completion date provided in contract documents.

2. To ensure that all construction activities are performed in such a manner as to ensure safe and correct operation and in compliance with applicable local, state and federal regulations and contract drawings and specifications.

Rev 02

Tasks:

Furnish all labor, tools, materials, equipment and supervision necessary for the work to replace the existing Alexandria VAHCS wayfinding and signage as detailed in the Drawings and Specifications for this project.

Special Condition:

Prior to mobilization and commencement of any construction, the contractor shall conduct a mandatory thorough survey and investigation of all the work sites for the Replace wayfinding and signage Project.. The contractor shall be responsible for choosing the process He/She deems necessary to employ that will provide the most accurate data of the existing conditions at these sites. Once this information is obtained, the contractor shall prepare a report listing all discrepancies, conflicts and remedies to all conflicts. This report shall be submitted as Submittal #1. The Resident Engineer/COR will review for technical feasibility. Once approved, the Contracting Officer will request a formal proposal for the corrective work.

Approval of this cost proposal will be required prior to the commencement of any corrective construction.

Delivery:

All personnel in the contractor's services shall have certified or proper training on the tasks they perform.

The Project Engineer or COR shall be informed by the contractor of the following situations/events in writing:

• The anticipated start date of any contract work.

• As soon as it is known that the work will take longer than expected.

• As soon as it is known that a possible change order will have to happen.

• To provide a written plan for corrective action for any work that cannot be completely within contract specified time.

• Inform COR if contractor needs to stay outside of normal operating hours.

• Contractor Payment Application shall be provided at the beginning of each month for the previous month work that has been completed.

All work shall be completed in accordance with contract drawings and specifications.

All required contract works completed shall be approved and accepted by Project Engineer or COR prior to accepting and approving contractor application for payment.

Security and General Requirements:

All on-site work should be completed between the hours of 8am and 4:30pm CST, Monday through Friday excluding holidays unless otherwise listed in the tasks section or other working hours are approved by the COR.

Contractor shall obtain an access badge from the VA Police Departmentwhile performing work on-site for their self, their employees and all subcontractors under their authority.

Security and privacy requirements vary depending on the equipment to be serviced and the service being performed. Contractor personnel may be required to complete any or all of the following but not limited to:

• Online training.

• Read, sign, and comply with 'Contractor Rules of Behavior'.

• Submit to finger printing and background investigation.

• Provide network security information as requested for any equipment used in the

VA facilities.

• The extent of these requirements shall be determined by Project Engineer or COR using current facility Information Technology and Privacy rules in cooperation with experts in those departments.

Parking shall be limited to established concrete or improved rock parking lots, Project Engineer or COR will advise which parking lots to use. Contractors and personnel are not allowed on the grass area unless specifically authorized by the Project Engineer. U.S.

District Court Violation Notices shall be issued for parking violations.

The contractor and all employees shall comply with all applicable Alexandria VA Health Care System fire, safety, and traffic regulations.

The contractor is to field verify existing conditions.

All work is to be performed within all ASME, OSHA, EPA, VA, and Federal, State and local codes and regulations.

No roadway, drainage ditch, pedestrian walkway, or any other service, utility, or access to any of the above is to be blocked or rendered unusable for any length of time during this project unless previously approved by the Project Engineer.

All work, materials, storage of materials and equipment, repair procedures and unforeseen problems or circumstances are to be coordinated with the Project Engineer.

Work on this project shall not begin until authorized by the Contracting Officer.

The title Project Engineer or COR shall refer to the Contracting Officer's Representative.

Work to be conducted on a Fully Operational VA Hospital Campus, in and around Mental Health and Long Term Care facilities. Tools and equipment shall be kept under close watch to prevent patient injury.

Place of Performance:

• Work shall be performed, with issuance of Notice to Proceed, at the Alexandria VA

Health Care System, Pineville, LA, or in the immediate vicinity as required by this Scope of Work.

• Equipment or Government property may be removed from the facilities with prior permission from Project Engineer or COR and the Department Director.

Period of Performance:

The construction portion of this project will consist of two separate periods, each of which must be preceded by a NTP issued by contracting.

1. Pre-construction period — 60 Days — Contractor to provide the following deliverables before the end of this period:

a. Submittal log of all submittals to be approved during the course of the project

b. Pre-tab report

c. Site survey of pre-existing conditions as described in paragraph titled "special conditions".

d. All submittals which are to be approved by the AE and VA COR.

2. Construction period — All contractually required work and tests must be successfully completed within 120 calendar days of issuance of Notice to Proceed for construction.

ISO Requirements:

- The C&A requirements do not apply, therefore a Security Accreditation

Package is not required.