S02 DRAFT SOW - Erie Ventilation Survey _ Revised 06-22-2026.pdf

Statement of Work

Title:

Quarterly and Annual Ventilation Surveys at the Erie VA Medical Center

Background:

The Erie Veterans Affairs (VA) Medical Center requires quarterly and annual ventilation surveys across clinical, reusable medical device storage, laboratory, and laundry areas.

Ventilation surveys evaluate air flows, room pressure relationships, air exchange rates, and performance of critical environments such as operating rooms, sterile processing, negative-pressure isolation rooms, pharmacies, laboratories, and hazardous storage areas.

Routine and documented ventilation testing is required to maintain compliance with VA, Joint Commission, OSHA, and infection control standards. Ventilation surveys are also essential to ensure environmental safety for patients and staff, to support infection prevention, and to verify that spaces meet clinical and regulatory performance requirements.

General Requirements:

1. Place of Performance

Erie VA Medical Center 135 East 38th Street Erie, PA 16504

2. Schedule

2.1. Services will be performed between the hours of 7:00am and 4:30pm, Monday through Friday, unless otherwise approved by the Engineering Program Manager.

2.2. No overtime will be paid by the Government for services performed outside of the hours specified in Section 2.1 above.

2.3. The Contractor is to confirm the scheduled inspection date and time with the Engineering Program Manager at least 48 hours in advance of the planned visit date.

Specific Tasks:

1. Quarterly Ventilation Surveys

1.1. Frequency of Inspections

1.1.1. Each of the locations requiring quarterly testing must be surveyed four (4) times per contract year, during the months of September, December, March, and June.

1.2. Locations

1.2.1. The Contractor shall perform a survey of the ventilation Quarterly for the areas identified in Section 1.2.2. through 1.2.10. below. All rooms are located in the main building.

1.2.2. Sterile Processing Service (SPS) – First Floor

Location Room Number

Number of Supplies

Number of Returns

1 Decontamination 1F64 6 6 2 Decontamination

Gowning 1G15 1 0

3 Decontamination Restroom

1G15A 0 1

4 Decontamination Closet 0 1 5 Prep & Pack 1F37C 5 5 6 Prep & Pack Closet 1S250A 0 1 7 Steam Maintenance 1F37F 1 2 8 Clean Storage 1F45 6 4 9 Sterile Storage 1F50 2 1 10A Main Entrance 1S200 1 0 10B Lobby 1 0 10C Men’s Restroom 1S201 1 1 10D Women’s Restroom 1S202 1 1 10E Office Lobby 1S212 1 1 10F Breakroom 1S214 2 1 11 Biomedical Engineering

Work Area 1S216 6 2

12 Biomed Office 1S216A 1 1

1.2.3. Surgical Suites – Second Floor

Number of Supplies

Number of Returns

1 Endoscopy Room 1 2E93 7 2 2 Endoscopy Room 2 2E89 5 2 3 Operation Room 1 2E83 13 3 4 Operation Room 2 2E79 13 3

5 PACU 3 2B37 1 1

1.2.4. Laboratory – First Floor

Number of Supplies

Number of Returns

1 Histology 1G72C 4 2 2 Morgue 1G62 6 3

1.2.5. Pharmacy – First Floor

Number of Supplies

Number of Returns

1 Anteroom 1F12 1 1 2 Clean Room 1F12A 2 0 3 Chemo IV Hazardous

Room 1F12B 2 1

1.2.6. CLC Bravo – Fifth Floor

Number of Supplies

Number of Returns

1 Isolation 533 1 2 2 Clean Supply 502 1 0

1.2.7. Urgent Care Center – First Floor, Room 1DC4

Number of Supplies

Number of Returns

1 Exam Room 2 (Triage) 1DC4 1 1 2 Exam Room 3 1DC4 1 1 3 Exam Room 4 1DC4 1 1 4 Exam Room 5 1DC4 1 1 5 Exam Room 6 1DC4 1 1

1.2.8. Dental Clinic - Third Floor

Number of Supplies

Number of Returns

1 Equipment 3C27 1 1 2 Sterile Storage 3C21 1 1

1.2.9. Surgical Clinic - Third Floor

Number of Supplies

Number of Returns

1 Reusable Medical Device Room

319 1 1

2 Reusable Medical Device Room

320 3 1

3 Reusable Medical Device Room

327 1 1

4 Reusable Medical Device Room

328 1 1

1.2.10. Miscellaneous

Number of Supplies

Number of Returns

1 EMS Laundry – Basement BE11 1 2 2 EMS Soiled Linen –

Basement

BE02 1 1

3 Pulmonary Exam Room – Sixth Floor

625M 1 2

1.3. Documentation of Quarterly Ventilation Surveys

1.3.1. The Contractor must provide a complete report of the quarterly ventilation surveys, along with the drawings.

1.3.2. The columns of the report must be labeled as follows:

Column Name Data required

Room Name Use the room names provided in the sub-paragraphs of Section 1.2 above.

Actual Air Exchanges Number of air changes per hour.

Minimum Air Exchanges Number of minimum air changes per hour required.

Room Pressure Room pressure relationship of the room being measured, with respect to the area outside of the room. It will either be negative or positive, with an arrow showing direction.

Pass/Fail Check mark or other symbol for PASS and FAIL for any areas that do not pass.

1.3.3. The Contractor must provide a preliminary report, during the time of the survey, to determine if the ventilation requirements are met in the areas being measured.

2. Annual Ventilation Surveys

2.1. The Contractor will perform testing Annually for the following:

2.1.1. Waste Anesthetic Gas Monitoring, N2O Leak Detection, Vacuum

Terminal Performance, Nitrous Bank Leak Detection

a. Endoscopy Room 1

b. Endoscopy Room 2

c. Operating Room 1

d. Operating Room 2

2.1.2. Medical Piping Systems Evaluation, Carbon Monoxide (CO) Test, Carbon

Dioxide (CO2), Halogenated Hydrocarbons (HC), Methane, Dew Point.

a. Surgical Suite OR 1

b. Surgical Suite OR 2

3. Final Report Requirements

3.1. The Contractor must provide a final report to the Program Manager, after each quarterly and annual ventilation survey is performed.

3.2. The final report must include the following, at a minimum:

a. Date of service

b. Results of the testing

c. Recommendations to correct any failures

d. Signature of authorized VA Medical Center official

e. Copy of pertinent data and test results.

3.3. Refer to Section 1.3 for specific requirements for the documentation of quarterly ventilation surveys.

Privacy / Security Requirements:

1. On-Site Requirements

1.1. The Contractor’s representative shall report to the Erie VA Medical Center

Police Office to sign-in and obtain contractor identification badge prior to performing any testing.

1.2. After obtaining a contractor’s identification badge, the Contractor's representative shall notify the Engineering Program Manager to inform them of their presence on station.

1.3. Upon completion of the service, the Contractor's representative must call to inform the Engineering Program Manger that the services requested were completed.

2. Training

2.1. All contractor employees and subcontractor employees requiring access to VA information shall complete the following before being granted access to VA information:

2.1.1. Successfully complete the VA Privacy and Information Security Awareness and Rules of Behavior course and annually complete required security training.

2.1.2. Training certificates will be submitted to the Program Manager before the contractor can perform any work on site. See attachment A VA_Privacy_Training to complete the training.

3. Records Management Language for Contracts

When Federal agencies acquire goods or services, they need to determine what Federal records management requirements should be included in the contract. Federal contractors often create, send, or receive Federal records. Federal contracts should provide clear legal obligations describing how the contract employees must handle Federal records.

Agency records officers, procurement counsel, and acquisitions officers must discuss how to integrate records management obligations into their existing procurement processes. NARA has developed the following language to be included as an agency-specific term and condition in Federal contracts for a variety of services and products.

The majority of contracts should include language on records management obligations, but each contract should be evaluated individually. For example, the data-rights paragraph (Paragraph 10 below) may not be appropriate for all contracts. Instead, agencies may be better served by one of the established data-rights clauses in the Federal Acquisition Regulations.

This language should not replace specific records management requirements included within Federal information system contracts.

4. Records Management Obligations

A. Applicability This clause applies to all Contractors whose employees create, work with, or otherwise handle Federal records, as defined in Section B, regardless of the medium in which the record exists.

B. Definitions “Federal record” as defined in 44 U.S.C. § 3301, includes all recorded information, regardless of form or characteristics, made or received by a Federal agency under Federal law or in connection with the transaction of public business and preserved or appropriate for preservation by that agency or its legitimate successor as evidence of the organization, functions, policies, decisions, procedures, operations, or other activities of the United States Government or because of the informational value of data in them.

The term Federal record:

1. includes [Agency] records.

2. does not include personal materials.

3. applies to records created, received, or maintained by Contractors pursuant to their [Agency] contract.

4. may include deliverables and documentation associated with deliverables.

C. Requirements

1. Contractor shall comply with all applicable records management laws and regulations, as well as National Archives and Records Administration (NARA) records policies, including but not limited to the Federal Records Act (44 U.S.C.

chs. 21, 29, 31, 33), NARA regulations at 36 CFR Chapter XII Subchapter B, and those policies associated with the safeguarding of records covered by the Privacy Act of 1974 (5 U.S.C. 552a). These policies include the preservation of all records, regardless of form or characteristics, mode of transmission, or state of completion.

2. In accordance with 36 CFR 1222.32, all data created for Government use and delivered to, or falling under the legal control of, the Government are Federal records subject to the provisions of 44 U.S.C. chapters 21, 29, 31, and 33, the Freedom of Information Act (FOIA) (5 U.S.C. 552), as amended, and the Privacy Act of 1974 (5 U.S.C. 552a), as amended and must be managed and scheduled for disposition only as permitted by statute or regulation.

3. In accordance with 36 CFR 1222.32, Contractor shall maintain all records created for Government use or created in the course of performing the contract and/or delivered to, or under the legal control of the Government and must be managed in accordance with Federal law. Electronic records and associated metadata must be accompanied by sufficient technical documentation to permit understanding and use of the records and data.

4. [Agency] and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Records may not be removed from the legal custody of [Agency] or destroyed except for in accordance with the provisions of the agency records schedules and with the written concurrence of the Head of the Contracting Activity. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. In the event of any unlawful or accidental removal, defacing, alteration, or destruction of records, Contractor must report to [Agency]. The agency must report promptly to NARA in accordance with 36 CFR 1230.

5. The Contractor shall immediately notify the appropriate Contracting Officer upon discovery of any inadvertent or unauthorized disclosures of information, data, documentary materials, records or equipment. Disclosure of non-public information is limited to authorized personnel with a need-to-know as described in the [contract vehicle]. The Contractor shall ensure that the appropriate personnel, administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, documentary material, records and/or equipment is properly protected. The Contractor shall not remove material from Government facilities or systems, or facilities or systems operated or maintained on the Government’s behalf, without the express written permission of the Head of the Contracting Activity. When information, data, documentary material, records and/or equipment is no longer required, it shall be returned to [Agency] control or the Contractor must hold it until otherwise directed. Items returned to the Government shall be hand carried, mailed, emailed, or securely electronically transmitted to the Contracting Officer or address prescribed in the [contract vehicle]. Destruction of records is EXPRESSLY PROHIBITED unless in accordance with Paragraph (4).

6. The Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, contracts. The Contractor (and any sub-contractor) is required to abide by Government and [Agency] guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information.

7. The Contractor shall only use Government IT equipment for purposes specifically tied to or authorized by the contract and in accordance with [Agency] policy.

8. The Contractor shall not create or maintain any records containing any non-public [Agency] information that are not specifically tied to or authorized by the contract.

9. The Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected from public disclosure by an exemption to the Freedom of Information Act.

10. The [Agency] owns the rights to all data and records produced as part of this contract. All deliverables under the contract are the property of the U.S.

Government for which [Agency] shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest.

Any Contractor rights in the data or deliverables must be identified as required by FAR 52.227-11 through FAR 52.227-20.

11. Training. All Contractor employees assigned to this contract who create, work with, or otherwise handle records are required to take [Agency]-provided records management training. The Contractor is responsible for confirming training has been completed according to agency policies, including initial training and any annual or refresher training.

[Note: To the extent an agency requires contractors to complete records management training, the agency must provide the training to the contractor.]

D. Flowdown of requirements to subcontractors

1. The Contractor shall incorporate the substance of this clause, its terms and requirements including this paragraph, in all subcontracts under this [contract vehicle], and require written subcontractor acknowledgment of same.

2. Violation by a subcontractor of any provision set forth in this clause will be attributed to the Contractor.