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EXHIBIT A
PERFORMANCE REQUIREMENT SUMMARY (PRS)
| Performance Objective |
| Performance Standard |
| Acceptable Quality Level (AQL) |
| Method of Inspection |
Paras 5.1. - 5.1.3.3. Patient Room Service
| Prepare and deliver Patient Trays |
| Items are prepared IAW regular or therapeutic diet orders and recipes. |
| 95% of the time |
| Periodic |
| Food items on tray match menu selections are correct serving size and temperature. |
| 95% of the time |
| Periodic |
| Tray contents are in compliance with all local MTF patient safety policies. Clinical examples include but are not limited to ensuring prohibited service ware is not delivered to psych ward; no identified allergens or restricted items on tray, etc. |
| 99% of the time |
| Periodic and Performance Evaluation Meetings |
| Trays are checked to confirm accuracy. |
| 99% of the time |
| Periodic |
| Trays prepared and delivered within 40 minutes of receipt of order. |
| 95% of the time |
| Periodic |
| Trays delivered to correct patient (if not left with Ward Nurse) |
| 99% of the time |
| Periodic |
| Para 5.2-5.2.4. Bulk Nourishments |
| Assemble, measure, weigh and mix ingredients IAW bulk nourishment ward requirements; rotate ward stock to ensure no items are expired. |
| 95% of the time |
| Periodic |
Para’s 5.3.-5.3.2.7. MTF Dining Room Services
| Prepare menu items. |
| Menu items prepared IAW PPS or SOP |
| 95% of the time |
| Periodic |
| Set up serving and self- service areas. |
| Serving and self- service areas set up NLT 5 minutes prior and not earlier than 30 minutes prior to period and IAW PPS |
| 95% of the time |
| Periodic |
| Paras 5.4-5.4.6. Grab and Go Service |
| Provide Grab and Go items IAW PPS or local SOP. |
| 95% of the time |
| Periodic |
Para’s 5.6.4.-5.6.4.9. Cash Collection
| 5.6.4.3. Operate cashier stations |
| Provide correct change to customer. |
| 98% of the time |
| Periodic |
| Customer wait time not to exceed 3 minutes |
| 98% of the time |
| Periodic |
| 5.6.4.6.-5.6.4.9. Maintain chain of custody of cash |
| Maintain a continuous and auditable trail of cash. |
| 100% of the time |
| 100% inspection |
Para’s 5.6.5.–5.6.5.12. Cleanliness and Sanitation
| Clean, sanitize food contact surfaces and equipment in food preparation, serving and self-service and storage locations |
| Fully compliant or substantially compliant status received from unannounced Preventive Medicine monthly inspections. SP shall pass follow up inspection. |
| No more than two less than substantially compliant ratings annually, not to exceed one non- compliant rating annually. |
| 100% inspection |
| Receive passing grade on routine internal inspections |
| 90% of the time |
| Periodic |
5.6.6.-5.6.6.6.Supply
| 5.6.6.2.-5.6.6.5.Properly request, receive, store and issue supplies |
| Submit daily request to support Patient Room Service and dining services. |
| 95% of the time |
| Periodic |
| Properly receive deliveries, store and issue supplies |
| 95% of the time |
| Periodic |
| 5.6.6.6. Maintain inventory control of supplies and materials. |
| Maintains inventory at established stock levels (where applicable) |
| 95% of the time |
| Periodic |
| Coordinates and conducts joint monthly inventory and submits complete and accurate inventory reports to the NCOIC. |
| 98% of the time |
| 100% Inspection |
5.6.7.-5.6.7.5. Training
| Contract employees are trained and assessed for competency |
| Training materials, attendance records and competency assessments up-to-date IAW contractors training schedule and MTF requirements. All materials, records and assessments are available to NCOIC. |
| 95% of the time |
| Periodic |
NOTE: IAW PWS Chap 3. The Government is responsible for providing facilities, equipment and maintenance and the SP is responsible for monitoring operability of Government Furnished Equipment and reporting malfunctions to the Government. TB MED 530-TSFC inspection form DD Form 2973 documents inspection of all areas of safety and sanitation. Non-compliance on items relating to the physical facility, installation, maintenance and operability of equipment will not be considered the fault of the CSP unless problems were not reported to the Government, were caused by CSP misuse or failure to properly clean or maintain.
Department of the Army Medical Command