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20150610145528790.pdf��ta��rri Memorandum Date To From Project Project Subject Vt rd d: June 8, 2015 Leif Bjorback, wilding Official Kent Gregory Edmonds Center for Outpatient Surgery 13065 Plan check 2014-0117 response to comments In response to Plan Review Comments dated March 11, 2014 please see the following responses. 1. Please update references on sheet A0.10 to the current use of the surgical center group 1-1.2 to B ambulatory care facility. Please see review comments from John Westfall which are similar to what this Building Division review is concerned within regards to the ACF requirements. IBC 304.1 and 422. I believe that there are 2 ways to interpret the application of the new IDC requirements over the previous, more restrictive code under which the facility was originally build. 1) The existing 2 hour occupancy separation wall that original separated the 11.2 and D occupancies may still be recognized as an occupancy separation that divides 6 ambulatory care facility from P. In this view the D occupancy to the east of the 2 hour separation wall would have only one care recipient incapable of self-preservation, falling below the threshold of 4 defined in 422.2. This area would then not be required to comply with 422.1 — 422.7. The existing occupancy to the west of the separation wall meets the requirements of 422.1 — 422.7. 2) The other way to view this requirement would be assume that the 2 hour separation wall is no longer required, and is therefore ignored. In this case the whole surgery center would still comply with the requirements of 422 at follows: 422.2: the surgery center is separated from adjacent areas with a fire partition installed per 708. 422.3: the surgery center is subdivided by a smoke compartment designated by the note "1 hour wall'. 422.4: each compartment has adequate space to provide 30 nsf of refuge space for per occupant. 422.5: each compartment has independent egress. 422.6: An automatic sprinkler system is provided throughout. And 422.7: a fire alarm system is provided. 2, On sheet M3.01 please add fire smoke dampers on 2 existing ducts that penetrate the 2 hour wall or OR #1 on gridline 4, or explain why these may not be required by code. Please see revised Mechanical drawings. Please also see attached Rice Group letter dated 6/5/15 addressed to DOH further responding to DOH requirements. Created on 62/2015 4:26 PM Response 6O CIty Comments . page I of 2 t 425 I1 /14 R3(7) 2191 1 1 nondsthJ v31W, Suite Zlt) nc root n din the Skater of ashingtort ,,,, , tr c (;b in r [tecis,cofn I� r" �i 3. Provide mcopy of the Department of Health review letter for the project. Any DOH requirements identified in the letter must bnincorporated /nthe building permit plan set for city review prior boissuance of the permit. Please see attached DOH review letter dated June 8, 2015 giving authorization to commence construction (reference page 3). In response to John Westfall's 2/24/14 memo, please see the following responses: 1. Please see response ho#1 above. 2. The proposed scope of work will have NO CHANGE to the code analysis, please see response to #1 on page one. The only recognized change is the code designation change from 11.2 to B -ASF in the area adjacent to the proposed work area. There ianodesignation change etthe proposed area ofwork. The code change designation ianoted onthe drawings. The existing Medical Gas storage area iointhe basement ofthe building. There iaNOCHANGE huthe medical gas storage area. Changes hmthe Medical Gas distribution system iolimited bothe work area and noted onM2.UO. 3. See revisions on AO.1 0 Code Analysis Sheet that indicates location of Medical Gas storage at the Basement level. There are no proposed changes to medical gas types, storage quantities, or storage locations. (2) additional Medical Vacuum outlets are added atthe work area. Created on 6�2/20 t 5 4:26 PNI - Response tOCity Comments - page 2 of2 t*��78,om op//mmAve vxSuite zw um,pmo^'Cimmeuotr,� C)fa*`xmomp 1�� Vii' 110EGroup, Consulting Engineers June 5, 2015 Steve Pennington Washington State Department of Health 111 Israel Rd. SE Tumwater, WA 98501 Reference: CRS# 60416195 Stevens Pavillion Suite 140 7320 216t" St. SW Dear Mr. Pennington: The following is in response to your correction comments dated June 5, 2015. Please find below our itemized responses to each respective comment and department. Each item addressed was clouded on the respective plan sheet. 5) The code required OSA ACH was incorrect. The number has been changed to 3 ACH of OSA. The system is still supplying 17.2 ACH of OSA. 6) Fire smoke dampers have been added to the existing ducts that penetrate the 2 hour wall of OR#1 at gridline 4. 8) The smoke venting process has been added to page 113.01. When the local smoke detector is activated, motorized dampers in the low wall returns close and the motorized damper in the ceiling grille opens. The smoke is then evacuated from the ceiling. I trust this is satisfactory for you to complete your individual reviews and sign off. Please notify us immediately if you need additional information. Sincerely, Paul Goto RICE Group INC., E.I.T. Letter of Transmittal June 8, 2015 Washington State Department of Hualth Construction Review Services I 1 I Israel Rd. SE Tumwater, WA 98501 PO Box 47852 Olympia, Washington 98504-7852 www.doh.wa.gov/crs tel. 360-236-2944 fax. 360-236-2321 Project Info: Local AHJ: City of Edmonds ❑ CRS# 60416195 Project 7320 216th St SW Ste 140 Edmonds Center for Outpatient Surgery location: Edmonds, WA 98026-8028 WAC 246-330 Ambulatory Surgery Facilities DSHS, Div. Of Alcohol & Substance Abuse Initial Review ASC OR Expansion Local Permit #: ❑ Key People: ❑ Contact: N/A Assigned DOH Steve Pennington / Matthew Campbell L&I, Bill Eckroth, Electrical Section ❑ Reviewer: steve.pennington@doh.wa.gov ❑ L&I, John Harvey, Factory Assembled Structures Facility Edmonds Center for Outpatient Surgery Facility Contact: Same as Administrator Administrator: D. Chris Douglas ® CRS File 7320 216th St SW Edmonds, WA 98026 (425) 673-3901 x. X. d.douglas@proliancesurgeons.com Architect / TGB Architects Local AHJ: City of Edmonds Engineer: Dave Letrondo, AIA Leif Bjorback 21911 761 Ave W (425) 771-0220 Edmonds, WA 98026 bjorback@ci.edmonds.wa.us (425) 778-1530 x. X. Consultant: Rice Group Inc Consultant: AWA Electrical Consultants, Inc Paul Goto Sally Sanders 20201 Cedar Valley Rd Ste 120 19015 36th Ave W Ste E Lynnwood, WA 98036 Lynnwood, WA 98036 (425) 774-3829 x. (425) 775-1799 x. paulg@ricegroup.com sally@awaelec.com Contact: N/A Contact: N/A X. Copies To: X. ® Local AHJ: City of Edmonds ❑ DOH Child Birth Center Licensing ® Architect / Engineer: TGB Architects a DOH Office of Investigations & Inspections ® Consultant: Rice Group Inc DSHS, Div. Of Alcohol & Substance Abuse ® Consultant: AWA Electrical Consultants, Inc ❑ DSHS, Aging & Adult Services Admin. ❑ Contact: N/A ❑ L&I, Bill Eckroth, Electrical Section ❑ Contact: N/A ❑ L&I, John Harvey, Factory Assembled Structures ❑ ® CRS File Page 1 of 9 Plan Review Comments for Project #60416195 r aclhty data c;ertnicate: Facility Name: Edmonds Center for Outpatient Surgery Site Address: 7320 216th St SW Ste 140 Edmonds, WA 98026-8028 Estimated Date of Occupancy: Currently Occupied Licensee UBI#: 601484763 Critical Access Facility: ❑ Yes ® No This project infills an existing room to convert it to a fourth class "C" operating room and evaulates the existing service for the additonal loads a fourth room adds to those services. General anethesia is used and procedures include, ortho, ent, general, gyn, but no endoscopy. Facility bills medicare. The data above is based on the information presented to CRS. Any change in the facility or facility program that causes the above information to be incorrect is subject to review by CRS. Approval for construction is not approval for licensure. A copy of the facility data certificate will be sent to the licensing agency. Page 2 of 9 Plan Review Comments for Project #60416195 Occupancy B Construction 2-A U O Applicable Code: 2000 NFPA 101 Group: Type: W U Qualifies for Assisted Living Funding Program ❑ Yes ❑No Number of qualifying units: W�U 2006 FGI Guidelines CA pW Number of Current: N/A Added: Removed: Total: HBeds: >, Automatic Fire Sprinkler System: ® Yes ❑ No Type 13 aAutomatic Fire Alarm System: ®Yes ❑ No 00 Compartmentation req'd: ®Yes ❑No Smoke Control System Provided: ❑ Yes ®No Wo aSpecial Delayed Egress Control: ❑ Yes ®No Location: d Certificate of Need Required: ® Yes ❑No CON Approval Granted: ❑ Yes ®No CON Number: This project infills an existing room to convert it to a fourth class "C" operating room and evaulates the existing service for the additonal loads a fourth room adds to those services. General anethesia is used and procedures include, ortho, ent, general, gyn, but no endoscopy. Facility bills medicare. The data above is based on the information presented to CRS. Any change in the facility or facility program that causes the above information to be incorrect is subject to review by CRS. Approval for construction is not approval for licensure. A copy of the facility data certificate will be sent to the licensing agency. Page 2 of 9 Plan Review Comments for Project #60416195 Number of units: Private occupancy: Two person occupancy: aBased on size of rooms used for sleeping Residents U O Based on size of common rooms Residents FH Maximum allowable licensable beds: W U Qualifies for Assisted Living Funding Program ❑ Yes ❑No Number of qualifying units: W�U This project infills an existing room to convert it to a fourth class "C" operating room and evaulates the existing service for the additonal loads a fourth room adds to those services. General anethesia is used and procedures include, ortho, ent, general, gyn, but no endoscopy. Facility bills medicare. The data above is based on the information presented to CRS. Any change in the facility or facility program that causes the above information to be incorrect is subject to review by CRS. Approval for construction is not approval for licensure. A copy of the facility data certificate will be sent to the licensing agency. Page 2 of 9 Plan Review Comments for Project #60416195 Edmonds Center for Outpatient Surgery WAC 246-330 Ambulatory Surgery Facilities Initial Review ASC OR Expansion Project Status: - Authorized to Begin Construction — This project is not approved for use or licensure. The construction documents have been reviewed and construction can begin, subject to construction pertnittingfrom the local building official. This project will not be approved until the comments labeled as "not approved" have been resolved by providing a written response to each of the comments. When referencing drawings or attached materials, provide sheet; or page #, revision # and date as applicable. Additional comments may follow based on design team response and site inspections may be required to verify compliance. Please note the following: ® The stamped "Authorization to Begin Construction" drawings will be delivered to the Facility Administrator. These shall be kept available on site for inspection during construction and post occupancy survey. ■ Any changes/deviations (incl. change orders or addenda) from the approved documents must be submitted to the Department for review and approval. ■ Beginning construction prior to resolving the attached comments will constitute facility acknowledgement that you are proceeding at your own risk. ® Please include your CRS number on all communications to Construction Review Services. PROJECT CLOSE-OUT REQUIREMENTS You must notify the department when construction is complete by completing the following steps: ✓ Verify that you have resolved all of the comments on this form and have submitted any revisions ✓ Complete the Online Notification of Construction Completed at: httn://www.doh.`va.gov/NotittcationofCom letion.aspx ✓ Email or fax a copy of the approval from the local building department (final permit approval or certificate of occupancy); and ✓ Email or fax a floor plan showing the scope of work. ✓ Email: fslcrs@doh.wa.gov Fax: 360-236-2321, Attn: Construction Review Once your construction project is complete, you may contact the DOH Office of Customer Service for help with adjusting or amending your license to add this project. Their telephone number is 360-236-4700. You can monitor project status at www.doh.wa.g_ov/crs. Page 3 of 9 Plan Review Comments for Project # 60416195 Edmonds Center for Outpatient Surgery WAC 246-330 Ambulatory Surgery Facilities Initial Review ASC OR Expansion Preliminary Comments Q e E 0 U Preliminary Conference —November 711, 2013 Attendees: Steve Pennington (steve.pennini!tonndoh.wa.gov) - Department of Health Kent Gregory - TGB Architects Chris Douglas - Edmonds Surgery Jean Ann Mulcahy - Edmonds Surgery The preceding are preliminary notes provided as information and for use preparing the construction documents. These preliminary notes may be revised during subsequent submissions/conferences. Additional preliminary comments may be made during subsequent submissions. Items Received: Initial sketch Tl General: ➢ Contact Certificate of Need to review the implications of adding additional surgeons with the changes in this practice. Contact Karen Nidermayer at (360) 236-2957. ➢ Provide an infection control risk assessment. T2 Life Safety: ➢ Provide as part of the project submittal up to date plans showing all rated walls, smoke barriers and required exiting. ➢ A number of exit access pathway lights, battery packs were not operational and need to be replaced as a maintenance item and not part of this project. ➢ Exiting after walk through and designation of those exit paths is acceptable. T3 Electrical: ➢ The essential electrical system will need to be evaluated for sizing of the generator, having all the required loads on it, providing the required branches for life safety, critical and equipment. T4 Medical records: ➢ The medical records are not electronic and are stored in a locked room in the front business area and no project work is needed in this location. T5 Reception/waiting: ➢ No project related work is needed in these areas. Page 4 of 9 Plan Review Comments for Project # 60416195 Edmonds Center for Outpatient Surgery WAC 246-330 Ambulatory Surgery Facilities Initial Review ASC OR Expansion Q 0 U T6 Recovery: ➢ The required number of PACU, level two recovery spaces is acceptable for a four operating room facility. ➢ Floor will need to be evaluated for the ability to clean and not harbor bacteria or mold, with special emphasis in the PACU area as part of project. T7 Janitors closet SC -124: ➢ The janitor's closet is required to be negatively pressurized to adjacent spaces and this room tested neutral as there was no exhaust located in the ceiling. This will be a project requirement to modify this condition. T8 Recovery Nurses stations: ➢ Medications were secured as required and other than maintenance related items, No project work is expected in this area. T9 Sectioning room # SC -150: ➢ This room was negatively pressurized as required and no work is expected in this room as part of the project. T10 Medical gas manifold room and vacuum pump room. ➢ Both of these rooms meet the requirements for a level one medical gas system and no project related work is expected in these rooms. The oxygen manifold is 8 cylinders each, for in use and reserve. T11 Main electrical room: ➢ Many combustible items are stored in this room in front of the electrical panels blocking working clearances and should not be stored there. This is a maintenance item/fire hazard that needs to be quickly addressed and not part of the project T12 Sterile storage area SC -136 ➢ The room tested properly for a positive pressure relationship ➢ These areas have a plenum return system that is causing dust problems and must be changed to support a constant positive pressure relationship and to solve the dust problem. Contact Steve Pennington to discuss solutions that we have used at other facilities. This will be a project required upgrade. T13 Soiled holding SC -133: ➢ Room tested for a negative pressure relationship and there is no expected project related work in this room. Page 5 of 9 Plan Review Comments for Project # 60416195 Edmonds Center for Outpatient Surgery WAC 246-330 Ambulatory Surgery Facilities Initial Review ASC OR Expansion 0 G E E 0 U T14 Staff changing rooms: ➢ Address scrubs being stored out in the open by adding doors to these cabinets to prevent cross contamination or another solution. T15 Clean processing and storage SC -140: ➢ This space tested negatively pressurized to adjacent corridors and is required to be positively pressurized. Will be part of project, but should be rebalanced as soon as possible before project to provide the correct pressure relationship. ➢ Leveler blinds on windows need to be removed as they are not cleanable as part of project. ➢ Overhead lights do not have lenses in them that are not cleanable and can allow dust to come into space from the plenum. This will be part of project to correct. ➢ Provide a means to monitor humidity with a top limit of 70% RE. T16 Decontamination room: ➢ This room met the negative pressure relationship requirements and other than some maintenance/operational items, there are no project related work expected. T17 New Operating room: ➢ Provide a hard lid ceiling in this room. ➢ Provide non -aspirating supply air diffusers creating the sterile field around the table. ➢ Provide task lighting including at least one of which has a battery back up feature. ➢ HVAC needs to provide 15 ACH minimum or which three are from outdoors. ➢ Provide smoke ventilation for this room. ➢ Provide 2 oxygen outlets and three suction outlets for a class "C" operating room. ➢ Review door hardware for the push/ pull feature. ➢ Caulk all gaps including around casework, top of "J" molding around light fixtures and air grill in new ceiling. ➢ Provide a scrub sink outside of the room and adjacent to the entry door. ➢ Verify or provide a minimum of a Mery 14 final air filter. ➢ Provide means to manage humidity in this room. ➢ Provide clean room sprinkler heads in this room. T18 Housekeeping closet: ➢ Provide a dedicated housekeeping closet for the surgery area. T19 Corridor # SC -149: ➢ The ceiling in this area and corridor SC -129 will be required to have a washable ceiling tile. Part of project to correct. Page 6 of 9 Plan Review Comments for Project # 60416195 Edmonds Center for Outpatient Surgery WAC 246-330 Ambulatory Surgery Facilities Initial Review ASC OR Expansion ➢ The lights in both the above corridors do not have lenses and are therefore not cleanable and subject to no protection below from tube breakage. Part of project to correct. T20 Existing three operating rooms: ➢ Not part of project. T21 Equipment room SC -127: ➢ Is being used for clean storage in a covered cart. ➢ This room has no ventilation, so no open clean storage can be done here. ➢ Maybe a good location for the dedicated housekeeping. T22 Existing patient restrooms: ➢ No project work expected. T23 Medicare one hour wall: ➢ Design/contractor should verify that the one hour fire barrier has complete fire stopping of all penetrations. Page 7 of 9 Plan Review Comments for Project # 60416195 Edmonds Center for Outpatient Surgery WAC 246-330 Ambulatory Surgery Facilities Initial Review ASC OR Expansion Plan Review Comments: Q � o a E U d 7- 1 l El Two complete plans and specifications for the fire alarm system installation or modification shall be submitted for review and approval prior to system installation. The department reserves the right to defer plan review and inspections to the local authority having jurisdiction (AHJ). Plans and specifications shall include, but not be limited to, a floor plan; location of all alarm -initiating and alarm -signaling devices; alarm -control and trouble -signaling equipment; annunciation; power connection; battery calculations; conductor type and sizes; voltage drop calculations; name, address, and phone number of the agency receiving off -premises transmission of alarm; and the manufacturer, model numbers, and listing information for all equipment, devices, and materials. Incomplete plans and specifications will be returned without review. Plans and specifications may be submitted separately from construction documents during the construction of the project. For small renovation projects in which devices are only to be relocated or very few devices are to be added, provide two plans that shows the relocation of devices which may be submitted for review in lieu of the above requirements. This information can be included on the electrical or architectural plans. Verify with Department staff to determine if the scope of your project meets this criteria. Section 907. 1, International Fire Code Recommend that fire alarm strobe/horn not be installed inside of the new operating room as a safety concerns during surgery. 2 El Two sets of sprinkler system working plans shall be submitted for review and approval before any equipment is installed or remodeled. The department reserves the right to defer plan review and inspections to the local authority having jurisdiction (AHJ). Deviation from approved plans will require permission. Plans and specifications, including hydraulic calculations, that are incomplete or are not stamped by a Washington State Licensed Fire Sprinkler Contractor, will be returned without review. Plans and specifications may be submitted separately from construction documents during the construction of the project. For small renovation projects in which heads are only to be relocated, a plan that shows the relocation of devices can be submitted for review in lieu of the above requirements. Section 903. 1, International Fire Code Provide clean room concealed fire sprinkler heads in the new operating room to meet the monolithic ceiling requirements of 2006 FGI 3.7-5.2.2.2(2) (2) Restricted areas. Ceilings in restricted areas such as operating rooms shall be monolithic, scrubbable, and capable of withstanding chemicals. Cracks or perforations in these ceilings are not allowed. Page 8 of 9 Plan Review Comments for Project # 60416195 Edmonds Center for Outpatient Surgery WAC 246-330 Ambulatory Surgery Facilities Initial Review ASC OR Expansion ❑x Provide a structural engineer stamp on the design of the overhead surgery light support as seen in section # 7 of sheet A0.10 per WAC 246-330-510 (1) 4 Mx Provide a dedicated housekeeping closet for the surgery area per 2006 FGI 3.7-2.5.8 2.5.8 Housekeeping Room A housekeeping room containing, a floor receptor or service sink and storage space for housekeeping supplies and equipment shall be provided exclusively for the surgical suite. ❑x Room pressurization schedule on sheet M1.01 shows the operating room to only have 2 air exchanges from the outside and it is required to have 3 outside air exchanges per Table 2.1-2 of the 2006 FGI 6 El Provide afire damper in the 18"X12" return air duct and the 10" round duct where they penetrate the two hour fire barrier at grid line 4/H per NFPA 90A 3-3.1.1 (reference sheet M3.00) 7 ❑x Where are the other life safety loads such as exit signs, exit access pathway lighting, nurse call systems located if not on the life safety panel. WAC 246-330-510 0 How is smoke venting provided in the new operating room per NFPA 99 Chapter 5-4.1.2 5-4.1.2 Supply and exhaust systems for windowless anesthetizing locations shall be arranged to automatically vent smoke and products of combustion. 9 0 Provide the paint specification to be used on the walls and ceiling of the new operating room that supports the scrubbing and resistance to chemical use. WAC 246-330-510 10 ❑x A final inspection is required approximately one week prior to final building permit approval. Contact Steve Pennington at 360-236-2944 or by e-mail at steve.pennington(a�doh.wa.gov Compliance with the comments above provided by the Department of Health Construction Review Services are necessary for this facility to meet the requirements of the applicable licensing regulations found in the Washington State Administrative Code and associated references. These comments do not relieve the facilityfrom the responsibility to meet the requirements of any other applicable federal, state or local regulations. In the event of conflicts between other jurisdictions and these written comments, the most stringent shall apply. Page 9 of 9 Plan Review Comments for Project # 60416195