**PROCUREMENT SENSITIVE**

MOST EFFICIENT ORGANIZATION

![](media/image1.wmf){width="1.9375in" height="1.9375in"}

Food Services

11/12/2023

National Institutes of Health

Food Services

MEO

[**Chapter 1. Introduction 1-1**](#introduction)

[1.1 Background 1-1](#background)

[1.2 Purpose 1-2](#purpose)

[1.3 Scope of the Study 1-2](#scope-of-the-study)

[1.4 Methodology 1-3](#methodology)

[1.5 Assumptions 1-3](#assumptions)

[1.6 MEO Format 1-3](#meo-format)

[Chapter 2. Most Efficient Organization
2-1](#__RefHeading___Toc125530480)

[2.1 Current Operations 2-2](#__RefHeading___Toc125530481)

[2.2 Management Analysis 2-12](#management-analysis)

[2.3 Proposed MEO 2-18](#__RefHeading___Toc125530483)

[Chapter 3. Quality Control Plan 3-1](#__RefHeading___Toc125530484)

[3.1 Overview 3-2](#__RefHeading___Toc125530485)

[3.2 Purpose 3-2](#__RefHeading___Toc125530486)

[3.3 Responsibility 3-2](#__RefHeading___Toc125530487)

[3.4 Record Keeping 3-2](#__RefHeading___Toc125530488)

[3.5 Annual Evaluation Instructions 3-2](#__RefHeading___Toc125530489)

[3.6 Completing the Annual Evaluation Report
3-2](#__RefHeading___Toc125530490)

[3.7 Completing the Letter of Certification
3-3](#__RefHeading___Toc125530491)

[3.8 Evaluation Score 3-3](#__RefHeading___Toc125530492)

[Chapter 4. Continuing Government Activity (CGA)
4-1](#__RefHeading___Toc125530493)

[4.1 General 4-2](#__RefHeading___Toc125530494)

[4.2 CGA Staffing Calculations 4-2](#cga-staffing-calculations)

[Chapter 5. Phase-In Plan 5-1](#__RefHeading___Toc125530496)

[5.1 General 5-2](#__RefHeading___Toc125530497)

[5.2 Assumptions, References and Affected Organizations
5-2](#__RefHeading___Toc125530498)

[5.3 Pre-Performance Decision Activities
5-2](#__RefHeading___Toc125530499)

[5.4 Post-Performance Decision Activities
5-3](#__RefHeading___Toc125530500)

[5.5 Utilities and Any Other Services And Costs To Be Transferred
5-6](#__RefHeading___Toc125530501)

[5.6 Indicators Of Successful Transition
5-6](#__RefHeading___Toc125530502)

[Chapter 6. Agency Cost Estimate 6-12](#agency-cost-estimate)

ATTACHMENTS

  ------------------ ------------------------------------------ ------------
  **Attachment       **Description**                            **Page**
  Number**                                                      

  Attachment 1       Current Nutrition Department               1
                     Organizational Chart                       

  Technical Exhibit  MEO Staffing Crosswalk                     TE-2-001-1
  2-001                                                         

  Technical Exhibit  MEO Workload Analysis                      TE-2-002-1
  2-002                                                         

  Technical Exhibit  MEO Position Descriptions                  TE-2-003-1
  2-003                                                         
  ------------------ ------------------------------------------ ------------

**National Institutes of Health**

**Food Services**

**MEO**

# Introduction

## Background

As an agency of the Department of Health and Human Services (DHHS), The
National Institutes of Health (NIH) is the primary Federal agency for
administering and supporting medical and behavioral research.

Composed of 27 Institutes and Centers (IC), the NIH is the steward of
medical and behavioral research for the Nation. Its mission is science
in pursuit of fundamental knowledge about the nature and behavior of
living systems and the application of that knowledge to extend healthy
life and reduce the burdens of illness and disability.

The NIH Clinical Center (CC) is one of the 27 ICs that establish NIH.
The CC is comprised of two facilities, the Mark O. Hatfield Clinical
Research Center and the Warren\
Grant Magnuson Clinical Center. The NIH CC serves as the nation's
premier research hospital for conducting clinical research to improve
the health of human kind. Numerous NIH guest scientists from around the
world collaborate in NIH CC activities. The NIH CC also offers training
in research medicine for physicians, medical students, and nursing
students. The CC does not customarily provide standard diagnostic and
treatment services. Patients volunteer, are recruited or are referred by
their Physicians and consent to participate in research studies
(protocols) and are treated without charge.

Through the Food Services function the NIH CC Nutrition Department
provides meals, nourishments, formulas, tube feedings and supplements to
patients who are in an inpatient unit, day hospital, outpatient clinic
or other location including, but not limited to, the Blood Bank and
Radiation Clinic. A state-of-the-art integrated food management computer
system, CBORD, allows for the integration of varied clinical and
research protocol needs through over 150 diet types and nutritional
analysis of patient food intake. The Food Service function of this
department also provides room service, meal assembly and preparation,
maintenance and the stocking of kitchen and food supplies.

> The mission of the NIH Clinical Center Nutrition Department is to
> provide cost efficient, comprehensive, and properly coordinated
> nutritional care, food services and research support of the highest
> quality to patients of the Clinical Center in support of biomedical
> research. The vision is to serve as a national model of excellence in
> provision of nutritional care, food services and research support. The
> Clinical Center is a research hospital that caters to an international
> clinical patient population that is unique. Patients that come to the
> Clinical Center are subject to research protocols and restrictions and
> may endure constant surveillance and medical testing by CC staff. Many
> of the patients are recruited and are sought after for the research
> studies, thus the CC strives to create a comfortable environment to
> encourage patients to continue to return. Therefore, it is extremely
> imperative that patients are given extraordinary service by the
> hospital. Many of the research patients may be the link to discovering
> new information on medical treatments and prevention and are
> ministered to with the utmost care. For these reasons the CC Nutrition
> Department Food Services operations strives to provide the CC patients
> quality service and respond to individual patient needs and requests
> affording the patients a comfortable visit in the CC. The Food
> Services operations provide needed consistency to patients so that
> they can feel at ease. With the addition of the room service
> operations patients are allowed much more flexibility to order an
> assortment of foods at times that are suitable for their needs.
>
> Room service allows patient's to telephone the call center and use a
> restaurant style menu that consists of a variety of foods. The menu
> choices include breakfast, lunch and dinner meals available throughout
> the day. Patients may place a meal order at their convenience between
> 6:30am-6:30pm and receive their food in a timely fashion.
>
> The CC Nutrition Department Food Services operations make every effort
> to attain all patient choices rather than sending a non-select tray
> while accommodating up to 150 different diet types. Paper Menu
> services are also provided for selected patient populations such as
> Spanish, kosher and behavioral health.

The Food Services operations also include the metabolic kitchen, which
is responsible for the preparation of meals for research protocols and
special diets. The preparation and attention that is involved in
producing a meal in the metabolic kitchen is very stringent and precise
from the portion sizes to the delivery of trays to protocol patients.

## Purpose

The purpose of this report is to present a Most Efficient Organization
(MEO) that is designed to provide the most efficient and cost-effective
Government organization proposed to perform the critical operations that
the CC Nutrition Department, Food Services function within NIH and
responsive to the Requirements Document dated November 21, 2005. This
report will also demonstrate the MEO's ability to achieve the levels of
quality of service outlined within the Requirements Document (RD).

The MEO is utilized as the foundation for developing the Governments
Agency Cost Estimate (ACE). Consequently, implementation of the proposed
MEO guarantees that the in-house workforce is as competitive as possible
against the Estimated Private Sector Cost Estimate (PSCE) during the
streamlined competition. The proposed MEO will have the ability to
perform all the work that has been identified in the RD, at the quality
levels defined therein. Since the MEO is being developed as part of an
A-76 study, all recommendations made are in accordance with OMB Circular
No. A-76 (Revised May 29, 2003).

Recommendations used to structure and authenticate the MEO are based on
qualified information obtained by the MEO team and verified with the NIH
CC Nutrition Department, which consists of mission and organizational
analysis, interviews, historical data, task analyses, and technical
estimates.

The result is an MEO that is practical, feasible, and will perform the
work required by the RD in accordance with applicable directives
utilizing sound management practices.

## Scope of the Study

The functional area under study is the Nutrition Department Food
Services operations situated in the Nutrition Department of the CC. The
number of Federal Government Full-time Equivalents (FTE) announced for
this study is 55.243 FTEs.

Of the 55.243 FTE there are currently 3.600 vacancies.

The breakout of FTE for the current organization is reflected in
Technical Exhibit 2-001. All positions under study are located at the
Clinical Center hospital in Bethesda, MD.

## Methodology

To develop the MEO, the MEO Team examined the current organization to
identify potential changes that will improve the organizational
structure, work processes and environment; and reduce costs while
maintaining organizational effectiveness and flexibility. In doing so, a
series of data collection techniques were implemented. All of the
techniques below were used in the preparation of this study, with
modifications based upon the circumstances specific to each functional
area.

-   Physical inspection of facilities.

-   Multiple interviews with affected staff and management.

-   Review of operational reports, and directives.

-   Examination of work flow, databases and other sources of historical
    workload data.

-   Review of Position Descriptions for each FTE within the
    organization.

-   The bargaining unit contract with the Local 2419 American Federation
    of Government Employees.

The data collection techniques used were focused on providing sufficient
information with which to evaluate potential process improvements and
varied enough to provide a multi-dimensional and accurate picture of the
processes at issue. The information collected was then subjected to
analysis and discussion by the MEO Team. From this analysis, a list of
preliminary findings and considerations resulted.

NIH CC indicated that the management analysis should be based upon
considerations, which were deemed logistically possible and easily
facilitated as key to the development of a successful product. The MEO
Team embraced the following key study considerations:

-   Provide recommendations that are realistic and feasible in the
    existing operating environment.

-   Involve the functional Directors to the maximum allowable extent.

-   Eliminate redundant and unnecessary movements of staff, materials,
    and equipment.

-   Eliminate excess cost and inefficient processes.

-   Carry out the A-76 work in a manner which will not interfere with
    ongoing activities.

-   Provide clearly documented evidence of findings and cost savings.

## Assumptions

The following assumptions are relevant to the development of the MEO.

-   The RD accurately describes the current Food Services performance
    requirements to satisfy the organizational mission.

-   The Government will provide all facilities, equipment, technology
    and materials, in kind or on a reimbursable basis.

## MEO Format

The MEO report follows the format below:

***Chapter 1*:** **[Introduction]{.underline}**. Describes the basis for
the study, its purpose and approach.

[*Section 1*: Background.]{.underline} Section 1 describes the National
Institutes of Health (NIH) Clinical Center (CC) and Nutrition Department
and the mission of the Center as well as the Department.

[*Section 2*: Purpose]{.underline}. Section 2 presents a discussion of
findings on key data and information that may be utilized to create
recommendations.

[*Section 3*: Scope of the Study]{.underline}. Section 3 outlines the
current organization and staffing structure.

[*Section 4*: Methodology]{.underline}. Section 4 describes the
methodology the MEO Team used to develop the new organization.

[*Section 5*: Assumptions]{.underline}. Section 5 presents a discussion
of assumptions the MEO Team made in order to develop the organization.

[*Section 6*: MEO Format]{.underline}. Section 6 outlines the format of
this document.

***Chapter 2*:** **[Most Efficient Organization]{.underline}**.

[*Section 1:* Current Operations]{.underline}. Section 1 describes the
current organization and operations of the functional services of the
Department. The current organization provides the baseline for the
analysis, recommendations, and MEO detailed in the following Chapters.

[*Section 2:* Management Analysis]{.underline}. Section 2 presents a
discussion of findings on key data and information that may be utilized
to create recommendations.

[*Section 3:* Proposed MEO]{.underline}. Section 3 outlines the MEO's
organizational and staffing structure.

***Chapter 3*:** **[Quality Control Plan]{.underline}**. Describes and
defines how the MEO will provide quality services and prevent problems
from occurring.

[*Section 1*: Overview:]{.underline} Section 1 gives an overview of how
the MEO will maintain a Quality Control Plan (QCP).

[*Section 2*: Purpose]{.underline}. Section 2 provides an overview of
the importance and use of the Quality Control Plan.

[*Section 3*: Responsibility]{.underline}. Section 3 presents a
discussion of the personnel responsible and tasks performed to verify
that Quality Control (QC) is correctly performed in the MEO.

[*Section 4*: Record Keeping]{.underline}. Section 4 describes the
importance of documentation for Quality Assurance Surveillance.

[*Section 5*: Annual Evaluation Instructions]{.underline}. Section 5
outlines the inspection criteria used to evaluate the MEO's performance
of RD tasks.

[*Section 6*: Completing the Annual Evaluation Report]{.underline}.
Section 6 identifies specific instructions on how to complete the
report.

[*Section 7*: Completing the Letter of Certification.]{.underline}
Section 7 presents the instructions needed to complete the Letter of
Certification.

[*Section 8*: Evaluation Score]{.underline}. Section 8 presents the
steps that follow the completion of the report.

***Chapter 4*: [Continuing Government Activity (CGA)]{.underline}**.
Outlines the staffing characteristics of the Government Organization
required for either an MEO or an outside Service Provider decision.

[*Section 1*: General.]{.underline} Section 1 covers the definition and
importance of staffing the CGA for the MEO or private sector Service
Provider.

[*Section 2*: CGA Staffing Calculations.]{.underline} Section 2 presents
a discussion of findings on key data and information that may be
utilized to create recommendations.

***Chapter 5*:** **[Phase In Plan]{.underline}**. Describes how The NIH
CC Nutrition Department will transition from the current organization to
a new Service Provider.

[*Section 1*: General.]{.underline} Section 1 describes the logistics of
a Phase-In Plan to replace the incumbent Service Provider.

[*Section 2*: Assumptions, References and Affected
Organizations.]{.underline} Section 2 lists key impacts of an A-76
study.

[*Section 3*: Pre-Performance Decision Activities.]{.underline} Section
3 outlines the planning steps and personnel actions required to initiate
and complete a successful phase-in to the new organization.

[*Section 4*: Post-Performance Decision Activities.]{.underline} Section
4 describes the personnel actions necessary and CGA actions included in
organizing and implementing the MEO.

[*Section 5*: Utilities and Any Other Services And Costs To Be
Transferred.]{.underline} Section 5 presents critical utilities and
services to transfer to the MEO or new Service Provider.

[*Section 6*: Indicators of a Successful Transition.]{.underline}
Section 6 itemizes key factors to a successful transition to a new
Service Provider.

***Chapter 6***: **[Agency Cost Estimate]{.underline}**. This document
will itemize the cost of the Government's MEO to be bid in the
Streamlined Competition.

Food Services Trends Analysis

# Most Efficient Organization

[**Chapter 2. Most Efficient Organization
2-1**](#most-efficient-organization)

[2.1 Current Operations 2-2](#current-operations)

[2.2 Management Analysis 2-12](#management-analysis)

[2.3 Proposed MEO 2-18](#proposed-meo)

  ----------------------------- -----------------------------------------
  ***Technical Exhibit          ***Title***
  Number***                     

  Technical Exhibit 2-001       MEO Staffing Crosswalk

  Technical Exhibit 2-002       MEO Workload Analysis

  Technical Exhibit 2-003       MEO Position Descriptions
  ----------------------------- -----------------------------------------

## Current Operations

Chapter 2 describes the current organization, mission and function
statements, operational environment and position responsibilities.

### Organizational Structure and Functions 

The Nutrition Department is organized into two different sections, the
Food Services operations and the Clinical Nutrition Services section.
Refer to Attachment 1 for more details.

The Food Services section is responsible for processing menus and room
service orders to the main kitchen via the call center. The food
services staff are responsible for main kitchen operations, delivery and
the retrieval of food trays in the different units in the hospital,
production of menu items, procurement of food items and non-food items
as well as monitoring kitchen inventory and supplies.

The Clinical Nutrition Services section retains the metabolic kitchen,
which is responsible for the preparation of meals for research studies
and special diets. The metabolic kitchen cooks are specially trained in
careful measurement, weighing, and preparation of specific meals for
patients in the different research studies that the Clinical Center
supports.

###  Current Staffing and Responsibilities

The RD describes all the work and functions required within the food
services organization except those identified as inherently governmental
(IG). Personnel assigned to the current organization are performing the
RD functions.

The public announcement for this study identified 69 federal government
employees. The total amount of FTE identified under the Federal
Activities Inventory Reform (FAIR) Act Inventory is 55.243.

**Table 1** below is the current staffing matrix for the NIH food
services. This matrix breaks down the current positions by series and
grade and also identifies those FTE that are vacant. 3.6 FTE of the
positions identified are now vacant.

The paragraphs that follow **Table 1** provide brief descriptions of
each position's major functions and responsibilities.

Table 1- CURRENT STAFFING MATRIX

  -------------------------------- -------------- ------------ ----------- ------------
  **CURRENT POSITIONS**                                                    

  **TITLE**                        **SERIES &     **AUTH       **EXCL FROM **Total
                                   GRADE**        POS.**       STUDY**     FTE**

  **Manager**                      ** **          ** **        ** **       ** **

  Manager                          Title 42 CRS   0.096        0.904       1.000

  Manager                          Commissioned   0.083        0.917       1.000
                                   Corps                                   

  Manager                          Title 42 CRS   0.156        0.844       1.000

  Manager                          Title 42 CRS   0.108        0.892       1.000

  **Supervisor**                                                            

  Supervisor                       WS-7404-07     1.000                    1.000

  Supervisor                       WS-7404-07     1.000                    1.000

  Supervisor                       WS-7404-07     1.000                    1.000

  Supervisor                       WS-7404-07     0.400                    0.400

  **Health Technician/Purchasing** ** **          ** **        ** **       ** **

  Health Technician (Dietetics)    GS-640-08      1.000                    1.000

  **Food Service Worker-Leader**                                            

  Food Service Worker-Leader       WL-7408-04     1.000                    1.000

  Food Service Worker-Leader       WL-7408-04     1.000                    1.000

  Food Service Worker-Leader       WL-7408-04     1.000                    1.000

  **Call Center**                  ** **          ** **        ** **       ** **

  Program Assistant (Previously    GS-303-8       1.000                    1.000
  Nutrition Database Technician-                                           
  GS-640-08 Position Title change                                          
  effective 12/11/2005)                                                    

  Food Service Assistant           GS-1603-05     0.200                    0.200

  Food Service Assistant (VACANT)  GS-1603-05     0.400                    0.400

  Food Service Assistant           GS-1603-07     1.000                    1.000

  Food Service Assistant           GS-1603-05     0.200                    0.200

  Food Service Assistant           GS-1603-05     0.200                    0.200

  Food Service Assistant           GS-1603-05     0.300                    0.300

  Food Service Assistant           GS-1603-06     1.000                    1.000

  Food Service Assistant           GS-1603-06     1.000                    1.000

  Food Service Assistant           GS-1603-06     1.000                    1.000

  Food Service Assistant           GS-1603-06     1.000                    1.000

  **Point of Service (POS)**                                                

  Nutrition Service Asst (OA)      GS-303-05      1.000                    1.000
  (VACANT)                                                                 

  Nutrition Service Asst (OA)      GS-303-05      1.000                    1.000

  Nutrition Service Asst (OA)      GS-303-06      1.000                    1.000

  Nutrition Service Asst (OA)      GS-303-06      1.000                    1.000

  Nutrition Service Asst (OA)      GS-303-06      1.000                    1.000

  Nutrition Service Asst (OA)      GS-303-06      1.000                    1.000

  **Metabolic Cooks**              ** **          ** **        ** **       ** **

  Cook-Metabolic                   WG-7404-08     1.000                    1.000

  Cook-Metabolic                   WG-7404-08     1.000                    1.000

  Cook-Metabolic                   WG-7404-08     1.000                    1.000

  **Cooks**                                                                 

  Cook                             WG-7404-08     1.000                    1.000

  Cook                             WG-7404-08     1.000                    1.000

  Cook                             WG-7404-08     1.000                    1.000

  Cook                             WG-7404-08     1.000                    1.000

  Cook                             WG-7404-08     1.000                    1.000

  Cook                             WG-7404-08     1.000                    1.000

  **Cooks/Cooks Assistants/Control                                          
  Center**                                                                 

  Cook Assistant (VACANT)          WG-7404-04     0.400                    0.400

  Cook Assistant (VACANT)          WG-7404-04     0.400                    0.400

  Cook Assistant                   WG-7404-04     0.400                    0.400

  Cook Assistant                   WG-7404-04     0.400                    0.400

  Cook Assistant                   WG-7404-04     0.400                    0.400

  Cook Assistant                   WG-7404-04     1.000                    1.000

  Cook Assistant                   WG-7404-04     1.000                    1.000

  Cook Assistant                   WG-7404-04     1.000                    1.000

  Cook Assistant                   WG-7404-04     1.000                    1.000

  Cook Assistant                   WG-7404-04     1.000                    1.000

  Cook Assistant                   WG-7404-04     1.000                    1.000

  **Food Service Workers**                                                  

  Food Service Worker              WG-7408-03     1.000                    1.000

  Food Service Worker              WG-7408-03     1.000                    1.000

  Food Service Worker              WG-7408-03     0.500                    0.500

  Food Service Worker              WG-7408-03     0.400                    0.400

  Food Service Worker              WG-7408-03     0.400                    0.400

  Food Service Worker              WG-7408-03     0.400                    0.400

  Food Service Worker (VACANT)     WG-7408-03     0.400                    0.400

  Food Service Worker (VACANT)     WG-7408-04     1.000                    1.000

  Food Service Worker              WG-7408-04     1.000                    1.000

  Food Service Worker              WG-7408-04     1.000                    1.000

  Food Service Worker              WG-7408-04     1.000                    1.000

  Food Service Worker              WG-7408-04     1.000                    1.000

  Food Service Worker              WG-7408-04     1.000                    1.000

  Food Service Worker              WG-7408-04     1.000                    1.000

  Food Service Worker              WG-7408-04     1.000                    1.000

  Food Service Worker              WG-7408-04     1.000                    1.000

  Food Service Worker              WG-7408-04     1.000                    1.000

  Food Service Worker              WG-7408-04     1.000                    1.000

  Food Service Worker              WG-7408-04     1.000                    1.000

  Food Service Worker              WG-7408-04     1.000                    1.000

                                   **Total**      **55.243**   **3.557**   **58.800**
  -------------------------------- -------------- ------------ ----------- ------------

#### Current Positions -- Brief Descriptions

**Manager (Title 42 CRS and Commissioned Corps) .443 FTE**

The Manager positions are responsible for management and the overall
operations within their sections. All managers are responsible for the
administration and direction of the staff within their sections. The
Managers are also responsible for CGA tasks which include approval and
interpretation of new and/or policy clarification while directing any
decisions on policies for the Food Services operation.

**Supervisor (WS-7404-7) 3.400 FTE**

This position is responsible for supervising food service workers,
cooks, and cook assistants, point of service staff, food service
worker-leaders and call center staff, metabolic kitchen staff on
weekends and holidays. The incumbent supervises tray line set-up of
equipment, utensils, dishes, silverware, trays, condiments and food to
ensure maintenance of correct food temperatures and efficiency of tray
assembly. Position is responsible for assuring the timeliness and
completeness of tray pick-up on the units. Incumbent also manages the
production of meals at various stages from pre-preparation through
service and cleanup. Utilizes skills and technical knowledge about foods
to resolve unexpected problems, including the assistance of subordinates
with production duties. Assigns and monitors the work of subordinates to
ensure it is progressing on schedule, in accordance with standards for
safe and sanitary food handling practices, and that the quality and
quantity of products meet pre-determined standards. Responsibilities
also include preparing schedules, approving requests for leave,
assigning work and adjusting assignments based on current priorities and
staffing. Develops job routines and revises staffing plan to meet
changing requirements for service. Interviews and recommends appointment
of staff; provides on-the-job training or outside training needed;
determines standards of performance and evaluates performance of staff.
Counsel; recognizes exceptional performance; recommends disciplinary
action and effect discipline per current delegation of authority and
department policy. Plans quality of work related issues. Assures equal
treatment of all employees. Communicates effectively with subordinates
and supervisors to promote a team approach in the accomplishment for
common goals. Writes performance standards and makes formal appraisals
of subordinate work performance. Incumbent also opens and closes the
department 7 days a week 365 days a year, attends to cellular phone
calls and issues, implements new procedures, provides breaks and lunches
for employees. Collects quality control data and uses results to improve
quality. Completes a variety of official forms that may require decision
such as those for work related accidents and worker's compensation.
Other responsibilities include inventory of food and supplies, placing
orders from vendors and or requisitions from stock.

**Health Technician (Dietetics) (GS-640-08) 1.000 FTE**

Incumbent purchases food, supplies and equipment needed to support
program needs of a department that is divided into three requesting
sections, Office of Chief, Food Service and Clinical Nutrition Service.
Has delegated procurement authority under small purchase procedures, and
is responsible for a variety of acquisition methods to procure food,
dietary supplies, administrative and computer supplies and equipment,
services and subscriptions. Orders include perishables such as meat,
fresh fruits, vegetables, dairy or formulas with expiration dates. Is
involved in substantive matters such as what, where, under what terms
and conditions to purchase and the processing if a variety of
procurement documents. As a Health Technician is responsible for
maintaining the food supply needed to provide meal service to Clinical
Center patients. Provides information about the availability of food in
the market. Establishes and maintains food specifications and standards
to meet nutritional requirements. Conducts market searches of new
products; keeps Production manager informed about availability of items
(i.e. Shortages, seasonal products) and possible replacements or
substitutions. Locates sources of specific items required for protocols
and studies. Maintains database for inventory control, vendors, costs
and purchasing. Reviews historical information and makes recommendations
to change databases based on trends in usage and levels, menu changes,
market availability or cost, patient senses, and related factors.
Forecasts and places orders for food and dietetic supplies in absence of
production supervisor. Participates in conducting physical inventories
and/ or identifying discrepancies between physical and perpetual counts.
Enters receiving information in the Delpro system for the DFM technical
service contract and resolves any payment problems. Calculates and
adjusts discrepancies on vendor bills to correct billing. Prepares
monthly budget summary through spreadsheet application for prime vendor
purchase orders and cost. Manages the internal organization of the
requests and receipt or orders and the documentation of procurement
files. Incumbent must ensure compliance with all procurement regulations
and is subject to audits by the NIH auditors and the Inspector Generals
Office. Reviews, coordinates, and places orders for supplies, equipment
and services primarily through the use of purchase card and prime
vendors contact. When necessary, confers with requests to obtain
technical specifications to get better understanding of needs. Forwards
receiving information to Office of Financial Management (OFM) and
resolves payment problems. Resolves delivery problems such as incomplete
delivery, damage in transit, or items, which fail to meet specifications
with the vendor to obtain corrective actions. Coordinates exchange of
materials, equipment trade-in for a newer model or return for credit.
Verifies the accuracy of invoices and completeness of all receiving
documents. Collects data and compiles statistical reports using various
tools and spreadsheets, and updates computer files. Maintains bidder's
mailing lists for specific RFQ acquisitions. Establishes files and
filing systems to organize and maintain a comprehensive record of all
procurement activities carried out by the department.

**Program Assistant (GS-303-08) 1.000 FTE (Previously Nutrition Database
Technician (GS-640-08))**

This position is located in the Call Center. The responsibilities of
this position encompass a broad range of program activities. The
incumbent is a principle program support team member and is dedicated to
the provision of program support for a wide variety of activities within
the Food Service section of the Nutrition Department, CC. The incumbent
coordinates the receipt and computer processing of the
admission/transfer/discharge information, diet changes, and menu
selections for service of patient meals and nourishments. Enters daily
data into the computer system. Using written scripts receives phone
calls from patients and uses a computer to perform entry of patient
data, and menu selections. Confirms selections are consistent with diet
order and makes modifications with patient if needed. Verifies active
diet orders and other patient data using the hospital computer system.
Receives phone calls from nursing units with requests and problems with
food service. Identifies and takes the appropriate steps to meet the
request and/or resolve the problem(s). Generates reports for
distribution using the department's computerized menu software. Reports
and printouts are distributed to various sections or the department to
direct food ordering, production, and assembly functions. Conducts entry
of menus into department's computerized menu software. Identifies
computer software and hardware malfunctions and takes steps to resolve
routine problems. Provides assistance with tray assembly as needed.
Responds and cooperates with changes in workload. Actively supports and
participates in performance improvement activities, including but not
limited to tray assessments, meal rounds, and department committees.
Trains new employees and retrains existing employees to expand skills to
meet a changing work environment. Incumbent works persistently to find
causes of problems, is able to determine when a problem requires the
work of a higher skilled person. Assists with investigating occurrence
reports. Methodically reviews occurrence and provides statement of
resolution to permanently correct issue. Actively supports and
participates in performance improvement activities, including but not
limited to tray assessments, meal rounds, and department committees.
Generates nutrition call center work schedules, reassigns workloads as
needed, and coordinates approval of call center work schedules through
direct manager. Incumbent is responsible for collection and organization
of monthly quality assurance projects for the nutrition call center.
Quality assurance projects may include tracking menu entry and accuracy,
tracking number of received calls with completed problem resolutions,
and/or tracking patient room issues for CRIS/nursing teams.

**Food Service Assistant (GS-1603-05 to GS-1603-07) 6.300 FTE**

This position is located in the Call Center. The Managers of the Food
service section directly supervise the individuals in this position. The
duties include coordinating the diet related orders from admission to
discharge on every inpatient and outpatient who receives meals. The
incumbent coordinates the receipt and computer processing of
admission/transfer/discharge information, diet changes, and menu
selections for service of patient meals and nourishments. Enters daily
data into computer system. Using written scripts receives phone calls
from patients and used computer to perform entry of patient data, and
menu selections. Confirms selections are consistent with diet order and
makes modifications with patient if needed. This involves planning with
the patient, collecting data and calculating data. The precision
required by the process requires the use of the department's
computerized nutrition database. Verifies active diet orders and other
patient data using hospital computer system. Generates reports for
distribution using the department's computerized menu software. Reports
and printouts are distributed to various sections or the department to
direct food ordering, production, and assembly functions. Conducts entry
of menus into department's computerized menu software. Identifies
computer software and hardware malfunctions and takes steps to resolve
routine problems. Provides assistance with tray assembly as needed.
Responds and cooperates with changes in workload. Actively supports and
participates in performance improvement activities, including but not
limited to tray assessments, meal rounds, and department committees.

**Nutrition Service Assistant (GS-303-05 to GS-303-06) 6.000 FTE**

This position is responsible for tray delivery and collections to and
from patient's rooms, patient care units, or outpatient clinics. The
incumbent promptly removes soiled trays from patient's rooms and returns
them to the kitchen for dishwashing. Assignments include completing
inventory of bulk food and fluids for assigned unit pantries,
documenting supply needs and recording unit refrigerator temperatures.
The incumbent additionally uses the Nutrition Department computers to
perform entry of daily fluid orders and weekly bulk food orders to
generate a requisition. The incumbent completes inventory of bulk food
and fluids for assigned unit pantries. Uses worksheet with par levels to
determine bulk food/fluid needs. Takes temperature of unit pantry
refrigerators and records temperature on log. Fills pantry and unit
refrigerators with supplies. Ensures all fluids have expiration dates
and all outdated items are discarded. Rotates stock so first in, first
out procedure is followed. Discards food not part of nutrition floor
stock. Reports maintenance and sanitation issues to supervisor. Other
duties include any other food services related duties such as meal
assembly and service. Reading tray assembly tickets and placing correct
food on trays as they proceed along the tray line. Load trays on
delivery cart and may collect patient menus. May collect satisfaction
surveys for Quality Assurance Data Collection. Additional duties may
include working in the call center answering the telephone to receive
menu selection from room service patients and entering selections into
computer system and printing a meal ticket.

**Cook-Metabolic (WG-7404-08) 3.000 FTE**

This position provides food service for patients who are on diets that
must be precisely controlled for research studies. The position entails
precise weighing and measuring of ingredients and foods, and
standardized preparation methods. Menus, diets, recipes, specific foods,
portion sizes, and quantities required for menus, meals and diets are
predetermined for the incumbent. Incumbent uses menus and standardized
recipes to independently schedule and prepare foods for meals in
accordance with quality and timeliness for service. This position
prepares the full range of foods required for constant diets/test meals
with strict compliance to precise standardization. Prepares special
liquid formulas. Incumbent precisely weighs and measures ingredients for
recipes, and portions foods to ensure standard servings and nutrient
content for research studies. Position precisely follows standardized
recipes of varying complexities to schedule cooking assignments.
Incumbent uses many cooking methods and procedures and effectively
applied knowledge of various cooking procedures to produce standard food
products. Incumbent interacts with patients and nurses regarding diet
orders, diet changes and food requests and teaches metabolic techniques
for food consumption. Responsibilities include assisting supervisor to
train new cooks in metabolic procedures and techniques. Coordinates the
work of lower grade cooks to ensure that a variety of foods are prepared
simultaneously so that meals are completed and served at times needed.
Incumbent assembles food for patients and verifies accuracy or
completeness of trays. Delivers meals directly to the patients and
returns to pick up trays after the meal to perform, analysis of any
foods not consumed. Weighs and records refused foods and prepares
replacements based on protocol requirements. Incumbent may be assigned
to take inventories and orders foods and prepares supply requisitions in
accordance with established guidelines. Incumbent maintains a clean,
orderly and sanitary work area. The incumbent may be assigned to assist
Health Technicians with duties such as menu collection and checking, or
may work in the main kitchen performing duties such as cooking,
weighing, and measuring in the ingredient room, checking/serving trays
on the patient tray line.

**Cooks (WG-7404-08) 6.000 FTE**

This position performs as a top-level senior cook using menus,
standardized recipes, and production tallies to independently schedule
and prepare foods for meals in accordance with quality and timeliness
standards for the service. Incumbent coordinates the food preparation
assignments of lower graded less skilled cooks and food service workers
who assist with preparation, ensuring that lower graded employees
perform cooking assignments correctly. Responsibilities include planning
and coordinating the preparation of either the entire line of meats and
entrees, or vegetables, or soups/gravies or bakery products for one or
more meals per day. Incumbent prepares and cooks a full range of foods
for bulk and for single orders including but not limited to room
service. Prepares and cooks a full line of breakfast, lunch and dinner
items; and a limited number of bakery type foods. Incumbent prepares
products that adhere to standardized recipes involving different levels
of difficulty to meet established standards. Incumbent makes judgments
about products being prepared at different steps during the preparation
process to ensure that quality meets standards. Responsibilities include
assisting supervisor with recipe development, standardization, and yield
testing. Incumbent performs quality control checks on food as required.
Assists cook assistants in performing food preparation tasks, and
coordinates the work of lower graded cooks to ensure that a variety of
foods are prepared simultaneously so that meals are completed and served
at times needed. Takes daily inventory of items stored in production
unit and communicates needs to Supervisor. Incumbent maintains a clean,
orderly and sanitary work area. Incumbent also sets up hot food station
with pasta, soups, gravies and other large quantity production food
items. The position also checks tray assembly line during peak meal
service time and replenishes as needed. Incumbent also works at any
assembly station on the tray line. Reads the tray assembly tickets and
places correct foods on trays as they proceed along the tray line, as
well as loading trays on delivery carts.

**Food Service Worker-Leader (WL-7408-04) 3.000 FTE**

This position serves as a working leader in the food service operations
in the main kitchen. The incumbent is responsible for directing WG-04
and lower food service workers on tray line and dish room set up,
service and sanitation. Responsibilities include informing employees
where they are stationed to work and also work as a checker to assure
that trays are complete and accurate, monitoring and enforcing tray
delivery standard. Also, obtains information and/or direction from
supervisor concerning tray line problems and reports action to be taken
to appropriate employees. Incumbent performs quality checks on tray line
items prior to service as deemed necessary by supervisor or manager.
Takes and records temperature of all tray line food. Incumbent
communicates with cooking staff of food items that are needed, and
instructs food service workers to serve the correct portion size using
the correct serving utensils. Assigns tasks to employees as necessary
and insures employee breaks are given adequately and coverage is
provided. Other duties include assisting with on-the-job training of
food service workers at the same or lower grade.

**Cooks Assistants (WG-7404-04) 8.000 FTE**

This position performs as an assistant to the cooks by preparing foods
to fulfill requirements for the regular and special diets of inpatients
and outpatients. A production schedule of foods requiring preparation
for a particular meal is provided to the incumbent for use in the duties
assigned. Incumbent seeks guidance from a cook or supervisor only when
non-routine assignments are performed. The position performs a full
range of simple cooking duties for items that require little or no
processing such as pancakes, eggs, hamburgers, etc. Incumbent also
prepares hot cereals, soups and gravies. Under the general guidance of a
cook the incumbent also performs food preparation tasks such as slicing
meat and cheese using the slicer, rolling out pie dough, mixing fresh
fruit, meat and vegetables salads and cooking ingredients for salads,
such as potatoes. Prepares salads and sandwiches to order. Uses
standardized recipes and exacting sanitation techniques. Measures and
mixes formulas, tube feeding, and special foods (milkshakes, and
nutritionally fortified foods). Incumbent also weighs measures, labels
and packages ingredients for recipes, using scales and measuring
devices. The position also sets up food for tray line with dishes,
flatware, napkins, condiments, and cold food items such as salads,
desserts and breads, as well as beverages. Incumbent also sets up hot
food on the steam table. Works at any assembly station on the tray line.
Incumbent reads the tray assembly tickets and places correct foods on
tray as they proceed along the tray line. Loads trays on delivery carts
and delivers trays to patient units. Position also delivers meals,
nourishments, picnics, menus and supplies to Patient Care Units, patient
rooms and outpatient units. Incumbent removes soiled trays from
patient's rooms and returns them to the kitchen for dishwashing. The
position also delivers selective menus to patients; collects completed
menus and delivers to health technicians. Incumbent breaks down tray
line by removing unused foods to the appropriate storage area or
discarding. Other duties include operating and cleaning kitchen
equipment and washing dishes. Incumbent receives non-food items as well
as food items for inventories. Responsibilities include inspecting and
counting deliveries, storing stock in designated areas, and filling
requisitions from food service sections. Incumbent uses department
computer to enter requisitions. Position transports food and other
nutrient related items to/from the loading dock to/from Nutrition
Services and within the Clinical Center. This includes food to patient
units utilizing motorized transportation equipment. Also, conducts daily
inspection of motorized transportation equipment. Using hitches on food
carts, connects and disconnects carts onto tugger and / or another food
cart. Conducts daily maintenance check of the motorized equipment
including the battery monitoring and charging. Communicates any issues
to supervisor or manager regarding equipment operation and maintenance.
Will use walkie-talkie to communicate to co-workers including
supervisors, tray passers, and kitchen personnel. Other duties as
assigned.

**Food Service Worker (WG-7408-03 to WG-7408-04) 17.100 FTE**

This position performs a variety of food service tasks in the areas of
meal assembly, service, ware washing, sanitation and safety, food
preparation and distribution. The work encompasses a variety of tasks
from meal delivery, inventory/ordering of patient care unit supplies in
day hospitals, outpatient clinic areas and inpatient units as well as
menu distribution and collection. The incumbent at the higher-grade
level is also responsible for final check of diet trays assembled by
lower graded food service workers. The position also sets up food for
tray line with dishes, flatware, napkins, condiments, and cold food
items such as salads, desserts and breads, as well as beverages.
Incumbent also sets up hot food on the steam table. This position works
at any assembly station on the tray line during peak service times.
Reads the tray ticket and places the correct food items on trays as they
proceed along the tray line. Loads meal trays onto delivery carts and
assembles complete room service trays during non-peak room service
times. Incumbent assembles fluids and bulk food supplies for
distribution to unit pantries. This position evaluates the accuracy,
completeness and appearance of each tray at the end of the tray line to
ensure that meals meet quality standards. Responsibilities include
breaking down the tray line and delivering soiled pans and utensils to
pot washing area. Incumbent also prepares and delivers bagged meals for
outpatient clinics. Takes inventory of bulk foods and fluids on Patient
Care Units, replaces expired products, records temperatures of unit
refrigerators. Position also delivers meals, nourishments, picnics,
menus and supplies to Patient Care Units, patient rooms and outpatient
units. The incumbent promptly removes soiled trays from patient's rooms
and returns them to the kitchen for dishwashing. Coordinates process of
tray delivery in kitchen by implementing established standards.
Incumbent is also responsible for performing simple cooking duties such
as preparing convenience foods utilizing microwave, toaster, griddle,
deep fat fryer and ovens. Under the general guidance of a cook, performs
food preparation tasks such as slicing meat and cheese using an
institutional slicer, mixing meat and vegetable salads, cooking
ingredients for salads, opens, pours and heats soup. Incumbent also,
portions salads, desserts, juices, and measures items for serving. Uses
standardized recipes and exacting sanitation techniques. Measures and
mixes formulas, tube feeding, and special foods (milkshakes, and
nutritionally fortified foods. Incumbent also weighs measures, labels
and packages ingredients for recipes, using scales and measuring
devices. Other duties include operating and cleaning kitchen equipment
and washing dishes. Position also assists with on-the-job-training with
food service workers at the same or lower grade levels.

### Internal and External Interfaces

There are working relationships currently in place within the CC
Nutrition Department Food Services operations; however, there are also
other critical interfaces between the CC Nutrition Department Food
Services operations and other Clinical Center departments. Constant
interactions with hospital unit staff are a daily affair.

> The external interfaces are very important in that the Food Services
> operations is a customer service based function. The CC Nutrition
> Department Food Services operations strives to provide the best
> possible service so that patients of the CC are comfortable and their
> nutritional needs are accommodated in every manner.

### Current Operations and Procedures

The Food Services function of the NIH CC Nutrition Department provides
meals, nourishments, formulas, tube feedings and supplements to patients
who are in an inpatient unit, day hospital, outpatient clinic or other
location including, but not limited to, the Blood Bank and Radiation
Clinic. The Food Services operations of the Nutrition Department also
provide room service, meal assembly and preparation, maintenance and the
stocking of kitchen and food supplies.

The work performed by the Food Services operations is critical to the
patients of the NIH, CC. The food services organization provides precise
preparation of foods for research protocols through its metabolic
kitchen as well as its ability accommodate 150 different diet types. In
order to maintain a comfortable environment for patients the Food
Services operations also provides room service with a varied menu of
breakfast, lunch, and dinner foods which can be served at any time
between 6:30am to 6:30pm seven days a week 365 days a year.

#### Operational Structure

As indicated in 2.1.1 the Nutrition Department is organized into two
different sections, the Food Services operations and the clinical
nutrition services section.

The Food Services section is responsible for processing menus and room
service orders to the main kitchen via the call center. The food
services staff are responsible for main kitchen operations, delivery and
the retrieval of food trays in the different units in the hospital,
production of menu items, procurement of food items and non-food items
as well as monitoring kitchen inventory and supplies.

The Clinical Nutrition Services section retains the metabolic kitchen,
which is responsible for the preparation of meals for research studies
and special diets. The metabolic kitchen cooks are specially trained in
careful measurement, weighing, and preparation of specific meals for
patients in the different research studies that the Clinical Center
supports.

Operations within the Food Services operations will remain the same with
some anticipated changes in staffing.

#### Work Schedule and Overtime

Currently the NIH CC Nutrition Department, Food Services operations
operates from 5:30am to 8pm seven days a week 365 days a year. Schedules
are posted two weeks in advance.

Currently, the staff have overlapping shifts that they work. In order to
perform more efficiently with less staff the MEO will be realigning the
schedules to make better use of staff time. With the changes in
positions the MEO will be able to utilize all their staff to their full
array of duties and cover all functions in the main kitchen as well as
eliminate redundancies. Breaks and lunches are scheduled in accordance
with the current Union contract. In addition, the amount of productive
non-overtime hours allowed per position per day had to be in accordance
with the current Union contract (which is currently less than 8 hours/
position/ day).

When there is a shortage of staff due to unanticipated leave or a
problem occurs, the staff are given the option to sign up for overtime.
There were approximately 2,434 hours of overtime used by the Food
Services operations last year. The MEO, due to the proposed staffing,
will not account for overtime, as efficiencies identified will allow the
Nutrition department, Food Services operations to meet its mission goals
without the use of any overtime.

#### Cross-Training

Currently, there is little or no cross training. Staff in each section
performs the duties and functions based on their position. The MEO
proposes on-the-job (OTJ) cross-training to be widely used.

Due to the proposed changes in staffing cross-training will be utilized
to support a more efficient and flexible operation.

Currently, some of the positions frequently serve as back up for one
another. There are also functions where an employee previously performed
a particular function and can assist in backfilling as required for
extended and other absences. This trend will continue for the MEO.

#### Training

Currently, all staff are trained and certified in the different
operations they need in order to perform their work. With some of the
proposed position changes additional staff will be trained in other
process, such as the motorized operating vehicles.

Staff will continue to attend informal and formal training sessions.
Technical Exhibit 5-001 provides the specific training that will
continue to be provided by the MEO. On the job training will also be
continuously provided for new and seasoned staff members.

#### Travel

Due to the nature of the functions performed by the NIH CC Nutrition
Department, Food Services operations travel is not an inherent
requirement and therefore does not impact the operations within the
organization.

## Management Analysis 

### Analysis of Current Mission and Functions

The current overall mission, core functions and organization of the NIH
CC Nutrition Department Food Services operations are expected to remain
the same during the performance periods under consideration. This
includes the tasks and duties of the current sections within the Food
Services organization. However, there are several anticipated changes to
staffing, which will increase staffing efficiency while reducing the
grade structure and some decrease to the current staffing. However, it
is noted that the CC, Nutrition Department Food Services operations has
decreased its staff in the past few years although there has been an
increase of workload due to the implementation of room service and the
expansion of the Clinical Center.

### Analysis of Current Organizational Structure

One of the most important aspects of creating an MEO is structuring the
new organization for the most efficient and cost effective performance
of work required by the RD. As a starting point of this development, the
MEO Team examined the current strengths and weaknesses of the
organization and its structure while identifying any weaknesses that
could be eliminated or readily identifiable efficiencies for the
Nutrition Department, Food Services operations to utilize.

In the course of its organizational analysis, the MEO Team identified
3.60 FTE within the Food Services operations that are currently vacant.
These vacant positions are identified as one GS-1603-05 Food Service
Assistant, one GS-303-05 Nutrition Service Assistant, two WG-7404-04
Cook Assistants, and a Food Service Worker WG-7408-03 and WG-7408-04. It
should be noted that the Food Services operations has decreased its
staff over the last 10 years by 30 percent. Based upon the current
mission and operations of the Food Services operations, the MEO
workforce will be able to efficiently and effectively meet the RD
requirements without 2.04 of the current 3.60 FTE worth of vacancies.

#### Strengths of Current Organizational Structure

A positive element that the MEO Team noted was the organizations ability
to adapt to the different changes that has occurred with the expansion
of duties and the increase in customers. In the past, there have been
many process improvements in the Nutrition Department Food Services
operations that have allowed the organization to perform extra work with
fewer staff. The department is in a constant state of reorganization
based on business processes and changing budgetary and staffing
environments. This restructuring has allowed the Nutrition Department,
Food Services operations to remain within their financial and FTE
budget. The implementation of a room service program for patients was
executed with no increase in FTE\'s, which is not typical in the
healthcare food service industry. The organization has absorbed
additional work activities in their move to the new wing of the CC
hospital due to its geographic size and layout, also with no additional
FTE\'s. The Nutrition Department was also able to move three clinical
health technicians back into clinical care with no additional FTE\'s.
This was all accomplished through continual process improvements and
technology, such as moving to a new computer system, which interfaces
with the hospitals patient information, and utilizing motorized
equipment to deliver trays to the furthest parts of the hospital wing.

Currently, all positions in the Food Service Operations are occupied by
government employees with a vast knowledge base of the Clinical Center
and its unique operations. The continuity of the long time staff members
assists in providing a sense of comfort and familiarity to the patients.
The Food Service operations function as a one stop, team oriented, all
point food service reliable resource.

The MEO Team was able to decrease total FTE by 6.7 and reduce
grade-levels of current staff based upon the complexity of the
assignments identified in the RD, interviews, and data collected.

Any change in the scope or amount of workload in the current
organization would pose many problems due to already reduced staffing
numbers over the years.

#### Weaknesses of the Current Organization Structure

In the course of its organizational analysis, the MEO Team identified
several limitations in the Food Services staffing. Based upon the data
collected, the RD, interviews, observations and a thorough review of the
position descriptions, several overlaps in duties were identified. Other
areas of concern pertained to the series and grades of the current staff
as well as the number of staff designated in each area. In evaluating
the current Office of Personnel Management classification policy and
guidance, it has been determined that some of the current positions are
not appropriately classified and unjustifiably over- graded. Therefore,
the MEO team has authorized the changes in position series and
classification as well as a decrease in the grade levels of the current
staff to correspond with the complexity of the tasks and work
assignments.

#### Supervisor to Employee Ratio

The MEO staffing with 3.723 Supervisors has a ratio of Supervisor to
employee at 11.9 to 1. Currently the ratio of Supervisor to employee is
13.8 to 1.

Supervisors assist management in the operation of the Food Services
operations. Currently, the Supervisors develop and directly execute
performance plans, develops employee schedules and staff assignments,
recognizes exceptional performance; recommends disciplinary action. The
Supervisors perform other administrative and personnel duties as well as
the tasks stated in the RD.

The Supervisors are not given specific employees to Supervise or a set
amount to supervise but share in the process. Performance plans are
performed with information that is provided from all the Supervisors as
well as feedback from management.

The Supervisors in the MEO will continue to carry out the duties and
tasks that the present organization performs.

#### MEO and Continuing Governmental Activities (CGA) Separation

As introduced conceptually earlier in this report, the analysis of the
current organization must consider those functions that are identified
as Inherently Governmental (IG) and which will be performed by the
Continuing Government Activity (CGA) and, as such, will not be part of
the competitive process. OMB Circular A-76 defines these types of
functions, some of which are performed in the NIH CC Nutrition
Department. These CGA responsibilities specifically involve performing
review and development of policy and procedure, budgetary
responsibilities, and Quality Assurance (QA). Other IG supervisory tasks
not part of the RD are performed by the Nutrition Department Chief.
These include CGA responsibilities such as approval of policies,
interpretation of policy and clarification, direction and decisions on
policies including Food Services needs and approval of design and
project funds in addition to initiation of management analyses and IG
employment issues. In general, the CGA will consist of those tasks and
functions that are IG or core to NIH, CC operations and therefore
non-contractible.

The OMB Circular A-76 Quality Assurance (QA) requirement, including
those positions that will oversee the performance of the Service
Provider whether it is the Government MEO or a private sector
contractor, should also be designated to the Project Manager (PM)
including the QA requirements.

Therefore, NIH, CC management will appoint selected individuals within
the CC Nutrition Department and outside the MEO Team to perform purely
QA functions and apportion the remainder to those positions in the MEO
dedicated to performing CGA. The methodology for apportioned costing of
positions that perform both CGA and MEO work will be reflected in the
final staffing crosswalk attached as Technical Exhibit 2-001.

### Analysis of Staffing Requirements

#### Grade Structure

The grade distribution of the workforce can be an obstacle to
cost-effective performance and successful competition with civilian
contracting firms. It is also mandatory that the grade distribution of
the workforce should be commensurate with the work it performs.
Achieving such a balance is often difficult in a Federal organization.
Attrition due to turnover also tends to create frequent vacancies at
lower-graded employees.

Additionally, in the Federal Government, supervisors and directors may
over-grade new positions in order to ensure hiring of "quality"
personnel, ultimately over-grading existing positions to retain
experienced personnel. Finally, a contributing factor, under the Federal
classification and compensation system, a worker may be awarded the
higher of two grades if he regularly performs even five (5) to ten (10)
percent of his work effort at the more highly graded level. It is
therefore incumbent upon management to concentrate the more complex
assignments among a limited number of workers to avoid unreasonable
escalation of grades for a larger population of the workforce.

Having a grade distribution that is skewed towards the upper grades
causes the organization to use highly skilled and paid workers to
perform tasks that would likely be executed by intermediate or
assistant-level personnel in a private sector organization. This is a
significant drawback when competing in the A-76 environment. In the
instance of the Nutrition Department, Food Services operations, the
current grades are disproportionately stable and not proportioned
towards the ultimate skill and task goal.

After meticulous analysis performed by the MEO Team, results show it to
be more cost effective for the Nutrition Department, Food Services
operations to reduce the grade levels of the majority of the positions.
In order to fulfill the vision and mission of the CC Nutrition
department the higher graded positions are not needed to serve the
specific needs of the organization based on the work assignments in the
RD. The functions of the Food Services operations can be performed by
staff at lower grades and still maintain the high standards of services
that the Food Services operations has been performing in the past.

Based upon the position descriptions, employee interviews and management
discussions it is established that there are redundancies and an overlap
in the position functions of the cook assistants, food service workers,
and POS workers. Office of Personnel Management (OPM) classification
standards support eliminating the Cook Assistant positions and POS
positions and replacing all the positions with the Food Service Worker
WG 3-4 and Cook WG-4 positions to perform some of the functions stated
in the RD.

The current position descriptions for the Food Services Assistant,
GS-1603-5/6 have been evaluated and determined to be appropriately
graded at the GS-5/6 level. It was also determined that the current
position descriptions for the Food Services Assistant, GS-1603-7 and
GS-1603-8 would combine the higher level duties to support a Food
Services Leader at the GS-7. The outcome resulted in the abolishment of
the Food Services Assistant, GS-1603-8 position. The GS-8 level Health
Technician (Dietetics) position was also downgraded to a GS-5 position
as the complexity of assignments were also found to be appropriate at a
lower grade level (based on OPM classification standards). The current
positions of Cook, WG-7404-4, 6 and 8 were reviewed. It was determined
that the work did not fully meet the criteria established by the Cook
classification standards to support a WG-7404-8, but instead a
WG-7404-6. Therefore, the MEO confirmed that the highest level of work
necessary in carrying out the Cook duties was at the WG-7404-6. For
recruitment purposes, the MEO resulted in the support of Cook positions
at the WG-7404-4 and 6 levels The current position of Cook Supervisor,
WS-7404-8, was re-evaluated and determined to be supportable at the
WS-7404-5. Due to the elimination of WG-7404-8 cooks, the highest level
of work supervised was at the full performance level of WG-7404-6, which
impacted the current classification of the position. All functions of
the current operational structure can be achieved by positions at lower
grades and at the same expectation level as discovered in assessing
classification standards for the appropriate positions needed for the
Food Services operations.

As noted in section 2.2.2.1 above, the MEO will eliminate 2.04 vacant
FTE positions to make the MEO more cost competitive. The savings to the
Nutrition Department, Food Services operations will be approximately
\$367,000 for the base year from elimination of some vacancies and
reducing the grade-levels.

#### Series Classification

The Office of Personnel Management (OPM) uses the
Position-Classification Standards to describe series and grade
information. Therefore the MEO Team, with support and guidance from the
Human Resources Advisor (HRA), analyzed each draft of the MEO Position
descriptions and tasks stated within the RD and verified and certified
that the positions were appropriately assigned the correct series and
grade to perform the work.

Based on OPM classification standards the 1603 series, Food Service
Assistant positions have been changed to a GS-640 series Health
Technician. The Health Technician Series, GS-640 covers positions
involving nonprofessional work of a technical, specialized, or support
nature in the field of health or medicine when the work is of such
generalized, specialized, or miscellaneous nature that there is no other
more appropriate series. The purpose of assigning this series was based
on a more accurate reflection of the duties supported where the
incumbent is providing support to dietitians to ensure patients are
receiving the correct nutrient values to their therapeutic or modified
diets.

The current position of Health Technician (Dietetics), GS-640-8, was
reviewed and should be appropriately assigned to the Food Services
Assistant Series, GS-1603. The rational for determining the Food
Services Assistant Series as the appropriate series was based on two
factors: (1) organizational mission and/or function and (2) recruitment
source. The subject position is providing support to the Office of the
Chief, Nutrition Department, and is responsible for procuring, receiving
and accounting for all food and non-food items essential to the mission
of the organization. The Food Services Assistant Series, GS-1603, covers
work that involves maintaining records related to food safety
inspections; collecting data for the budget of service operations;
ordering supplies for food services; and recording information on
equipment replacement schedules. Based on the facts identified above,
the position is appropriately assigned to the Food Services Series,
GS-1603.

OPM classification standards support the elimination of the Nutrition
Service Assistant (POS), 303 series as this particular series refers to
positions that primarily provide clerical support (there was no
justification to maintain this series based on the RD assignments). The
Nutrition Service 303 positions and Cook Assistant, 7404 positions were
eliminated and replaced by the Food Service Worker 7408-3/4 series and
Cook 7404-04 series. The current positions of Food Service Workers,
WG-7408-3/4 are accurately classified and did not result in a change in
current classification. The three (3) Food Service Worker-Leaders at the
WL-7408-04 series were eliminated as they were determined by the MEO
Team as redundant positions.

In accordance with OPM standards and under the guidance of the HRA,
position series, grade structure, and classification of the current
positions were modified to appropriately fit the tasks and assignments
outlined in the RD document. Employee interviews, evaluations of the
current position descriptions and the data gathered from the MEO Team
were also considered in the final decision making process. The MEO
crosswalk in TE-2-001 illustrates the specific modifications to both
grade and series changes.

### Analysis of Workload Data

The MEO Team took various approaches to determine the FTE requirement
for the Food Services MEO, including gathering technical estimates for
task times and conducting brainstorming sessions and multiple interviews
with the employees and the Management staff. The data gathered by the
MEO Team through its interviews was critical to accomplishing the
workload analysis and correctly sizing the MEO organization.

Beginning with the RD defined workload, the MEO Team gathered data to
determine the number of FTE required for the MEO to perform the RD work.
Gathering technical estimates for task durations involved several steps.
Initial durational times would serve as a basis of discussions for
gathering more in-depth task durations. A few interviews were conducted
where durational times were difficult to substantiate and to try and
capture the appropriate estimated time. When varied task times occurred,
an averaging and weighting of tasks times was performed based on
reasonability, reliability, and compatibility with the RD task and other
data. This system and analysis obtained reasonably reliable estimates
for average durations and level of effort to accomplish a task.

In all cases, the final technical estimates used in the study were
validated by the Nutrition Department, Food Services operations. The
next step was to calculate the FTE required for the performance of RD
work. OMB Circular No. A-76 mandates the use of 1776 hours as the
available productive hours per full-time employee, accounting for
holidays, annual and sick leave, and general training and meetings.
Dividing the total hours calculated by 1776 results in an estimated FTE
for the MEO to perform the required RD work.

The resulting analysis (displayed in Technical 2-002) shows that
approximately 51.683 FTE are required to perform the work required by
the RD. An additional .795 FTE is designated for Program Lead /
Metabolic Kitchen a responsibility that is a requirement in the RD
document. Based upon this analysis the MEO will staff 49.188 FTE to
account for estimated time variances and re-work processes. A matrix
showing how the current organizational positions crosswalk to the
proposed MEO staffing, is represented in Technical Exhibit 2-001. It
must be emphasized that FTE workload calculations are merely one step in
the formulation of the staffing, and the MEO Team used this data as it
iteratively considered the development of position descriptions,
alignment of work tasks, shift assignments and other factors. This
information is used in conjunction with the experience and expertise of
the team to ultimately decide the proper staffing mix, grade level, and
distribution.

During interviews, the question "What isn't getting done?" was asked.
The Management team was confident that they were accomplishing the
overall mission and goals of the Nutrition Department, Food Services
operations and could continue to do so in the future with the MEO
efficiencies and changes noted in this report.

### Analysis of Facilities, Equipment, and Materials and Supplies

#### Facilities

The facilities are adequate to perform the work of the RD and therefore
any changes for the MEO will not be considered as an efficiency gain for
the Food Services Organization.

#### Equipment

In the past two years, new equipment and minor renovations were made to
accommodate the demanding room service operation. Currently, the
equipment used by the current organization is adequate for the work
required in the RD.

#### Automated Information Systems and Software

The current organization has experienced recurring technology process
improvements. The organization has upgraded to a new computer system,
which interfaces with the hospitals patient information. The use of
motorized equipment to deliver trays to distant wings in the hospital
has assisted in reducing travel time.

It is estimated that additional new technology will be implemented in
the future, including touch-screen monitors in the call center. The
touch screen monitors are expected to increase productivity and decrease
the time it takes to receive an order. Also, the execution of a new
phone system in the call center will assist in tracking productivity and
better serve patients with a minimum amount of delay.

#### Materials and Supplies

Materials and supplies currently being utilized by the Food services
Organization will continue to be funded by the government, and therefore
this area is not a candidate for large savings.

### Analysis of Processes

Throughout the CC Nutrition Department, Food Service section the MEO
Team identified few processes that could be readily improved to either
save resources, improve levels of service, or both not already outlined
above.

## Proposed MEO

The paragraphs below describe the concept behind the development of the
MEO; the general findings of the study that impact MEO development, the
functional alignment of the MEO organization; and finally, the staffing
plan describing types, number and grades required to perform the work
required by the RD.

### MEO Development Concept

The development of the MEO involves the incorporation of a variety of
concepts that must be integrated to ultimately create an organization
that NIH CC Nutrition Department accepts as consistent with NIH's
mission and strategic goals and yet remains competitive for the A-76
cost comparison process. Basic concepts employed by the MEO Team
included:

-   Eliminate Team Leaders.

-   Eliminate overtime hours.

-   Match staffing (series, grades and numbers) to the complexity and
    volume of work.

-   Eliminate unneeded or redundant processes.

-   Adopt a contractor's cost perspective as appropriate.

The MEO Team realizes that Government and private sector organizations
operate differently and that there are differences in the risk
associated with developing a proposal in the A-76 environment. With this
in mind, the MEO Team has developed an MEO which is practical, feasible,
and performs the required work in accordance with applicable NIH
directives utilizing sound management practices while attempting to
balance the competitiveness of the organization and the risk inherent in
that process.

### General Findings

Based on the analysis and observations, the general findings of this
study that impact the development of the MEO are as follows:

-   The CC Nutrition Department has 3.60 FTE that were vacant but was
    still performing mission work to the quantity and quality required
    by the RD (in part by overtime hours).

-   The CC Nutrition Department currently has three (3) Food Service
    Worker-Leader positions, which can be converted to Food Service
    Worker, positions and perform the same work more cost efficiently.

-   The CC Nutrition Department currently has six (6) Cooks and
    three (3) Metabolic Cooks, which can be converted to nine (9), Cook
    positions cross-trained to cover both the Main Kitchen and the
    Metabolic Kitchen.

-   The CC Nutrition Department Call Center currently has 7.3 FTE (five
    full-time positions and five part-time positions) to cover the Call
    Center hours of operation, which can be reduced to 6.1 FTE, based on
    schedule re-alignment.

-   The CC Nutrition Department Point of Service workers and Cook
    Assistants/Control Center workers can be converted into Food Service
    Workers.

-   Some of the RD work/tasks being performed by the current
    organization appear to be able to be performed by employees of a
    different (lower) grade.

-   The grade level of most positions exceeds the RD work
    difficulty/complexity requirements.

-   The CC Nutrition Department operates as a fairly lean organization.
    The Department has lost a significant number of FTE (approximately
    30%) while workload remained the same or increased within the last
    ten years.

-   Quantitative and value-added efficiencies can be realized through
    vacant position elimination, rescheduling, and re-grading of most
    current positions.

### MEO Functional Organization

#### General

There were several proposed efficiency and structural options for MEO
consideration. All of the proposed options were considered in the
development of the MEO. The primary focus of the MEO Team was to create
an organizational structure that facilitated flexibility for the current
organization and limited disruption to the overall Department at NIH.
Efficiencies identified by the MEO are both readily applicable and
consist of the least intrusive means to obtain the most efficient
organization for cost comparison purposes given the constraints of the
current environment.

#### Functions and Alignment

The MEO Team processed all of the information gathered with a particular
focus on structure and staffing that would represent the most readily
available efficiencies while minimizing disruption to the Nutrition
Department. The MEO Team determined that facilities, functions, and
programs should remain the same as the current organization and that
structure and staffing should be changed.

Based on information gathered during interviews, and from workload,
position, and scheduling analysis, the MEO Team chose to eliminate a few
positions and FTE, re-classify several positions, and downgrade several
others. The WS-7404-07 Kitchen Supervisors, which originally accounted
for 3.4 FTE, were determined to be at a higher-level grade than the RD
work difficulty/complexity. The MEO therefore decided to downgrade the
Kitchen Supervisors to WS-7404-05's at 3.28 FTE's. In addition, the
three (3) Food Service Worker-Leaders were determined by the MEO Team as
redundant positions. The MEO Team decided to eliminate these three
positions and combine the remaining workload with the Food Service
Workers (see analysis below).

The MEO Team analyzed the Call Center staff and schedules and determined
that 6.1 FTE would be sufficient to cover the workload and hours of
operation instead of the current 7.3 FTE (a savings of 1.2 FTE). The 1.0
FTE GS-0303-08 Program Assistant in the Call Center was eliminated with
a 0.2 FTE GS-1603-05 Food Service Assistant since the workload didn't
support their time. Furthermore, the remaining 6.1 FTE in the Call
Center were changed to 1.6 FTE Part-Time GS-640-05 Health Technicians,
3.5 FTE Full-Time GS-640-06 Health Technicians, and 1.0 FTE GS-640-07
Health Technician-Leader.

The Nutrition Department Point of Service (POS) staff (currently 6.0 FTE
GS-0303-05/06 Nutrition Service Assistants) was determined to be graded
at a much higher level than the RD difficulty/complexity. A function and
classification analysis of the POS staff resulted in a position
reclassification and downgrade to WG-7408-03/04 Food Service Workers.
Additionally, the POS staff didn't need to be considered a separate
working group and were therefore combined with all the other Food
Service Workers. The same reasoning was determined for the 8.0 FTE
WG-7404-04 Cooking Assistants. The MEO Team combined a total of 34.1
FTE's from Food Service Worker-Leaders (mentioned above), Nutrition
Service Assistants (POS staff), Cooking Assistants, and existing Food
Service Workers and determined the proper classification and staffing of
these positions (based also on workload analysis and requirements)
should be:

-   Food Service Workers -- WG-7408-03: Total of 22.06 FTE's

-   Food Service Workers -- WG-7408-04: Total of 8.0 FTE's

-   Cooks -- WG-7404-04: Total of 2.0 FTE's

The net difference in FTE's realized through this analysis was a 2.04
FTE reduction.

The CC Nutrition Department currently has six (6) WG-7404-08 Cooks in
the Main Kitchen and three (3) WG-7408-08 Metabolic Cooks in the
Metabolic Kitchen for a total of 9.0 FTE. The MEO Team determined that
the 9.0 FTE is correct to account for the workload and hours of
operation, however, a classification analysis determined the grades to
be higher than the RD difficulty/complexity. Furthermore, there was no
logical reason to separate the Main Kitchen from the Metabolic Kitchen
from an organizational structure standpoint. The MEO team therefore
downgraded and combined the Cooks into one position called a WG-7408-06
Cook increasing efficiencies by cross-training both the Main Kitchen
Cooks and the Metabolic Kitchen Cooks who can assist in either kitchen
during each Kitchen's respective peak times.

The MEO Team also analyzed the 1.0 FTE GS-640-08 Health Technician
(Dietetics) and determined the position needed to be reclassified to a
GS-1603-05 Food Services Assistant. Furthermore, the workload of this
position didn't support a full FTE, but rather 0.8 of and FTE (realizing
a 0.2 FTE savings).

Overall staffing in the Clinical Center Nutrition Department was reduced
from 55.243 FTE to 51.683 FTE. Refer to the Crosswalk for a detailed
look at staffing changes. The MEO Functional Organization is depicted in
TE- 2-001.

**FIGURE X -- MEO FUNCTIONAL ORGANIZATION**

### MEO Staffing

#### General Approach

The staffing for the MEO is based on the quantitative analysis conducted
tempered with experience and operational considerations provided by a
variety of individuals including the Director, MEO Team members, the
Human Resources Advisor and, ultimately NIH. There is no single answer
for how a MEO should be constructed. The blending of the quantitative
methodologies and the qualitative elements is both an art and science
and factually dependent for each study conducted. The paragraphs below
briefly summarize how MEO positions were developed. Table 2 below shows
the proposed MEO Staffing Plan for the Clinical Center Nutrition
Department.

**Table 2** -- Proposed MEO Staffing Plan

  ------------------------------------------------------------------------
  **Position**                        **Series & Grade**   **FTE**
  ----------------------------------- -------------------- ---------------
  Manager -- Food Services Section    Title 42 CRS         0.108
  Chief                                                    

  Manager -- Supervisory Metabolic    Commissioned Corps   0.083
  Dietitian                                                

  Manager -- Production Dietitian     Title 42 CRS         0.096

  Manager -- Dietitian Informaticist  Title 42 CRS         0.156

  Program Lead/Metabolic Dietitian    Commissioned Corps   0.795

  Supervisor                          WS-7404-05           3.280

  Food Services Assistant             GS-1603-05           0.800

  Health Technician                   GS-0640-07           1.000

  Health Technician                   GS-0640-06           3.500

  Health Technician                   GS-0640-05           1.600

  Cook                                WG-7404-06           9.000

  Cook                                WG-7404-04           2.000

  Food Service Worker                 WG-7408-04           8.000

  Food Service Worker                 WG-7408-03           18.77

  **TOTAL**                                                **49.188**
  ------------------------------------------------------------------------

#### Functional Discussions

##### **Project Management**

The Food Services Section Chief will function as the PM and verify that
the specific work requirements and standards including QA are met. These
duties will be to ensure Quality Assurance (QA) Program requirements are
met, and to oversee performance of the Service Provider whether it is
the Government MEO or a private sector Service Provider.

Some MEO positions will be divided between Continuing Government
Activity (CGA) and MEO responsibilities as well. These responsibilities
are designated to the Title 42 and Commission Corp positions.

The Title 42 Manager -- Food Services Chief position will perform CGA
including QA and will act as the approval authority for development,
contract monitoring, training and other project management directed in
the contract in addition to approval of policies, interpretation of
policy and clarification, direction and decisions on policies including
NIH needs and approval of design and project funds in addition to
initiation of management analyses and IG employment issues noted in
section 2.2.2.4 of this report.

Fractional times devoted to MEO and CGA duties are listed in Technical
Exhibit 2-001 in the last two (2) columns as MEO/CGA fractional FTE
allocations. For A-76 purposes however, only the fractional FTE
performing RD required tasks will be reflected in the Agency Cost
Estimate.

##### **Operations** 

The MEO staffing has 6.055 fewer positions than the current
organization, and is comprised of a substantially different mix of
positions and grades. The MEO Team considered two (2) major factors in
reducing the number of positions. First, the workload analysis and time
per workload occurrences could not justify the current organizational
staffing levels. Second, the hours of operations required a less than
full reduction in the number of positions in order to staff enough
personnel to cover the food service hours.

The grade of the proposed MEO positions was driven by the descriptions
of work and programs in the RD and information provided by the employees
and MEO Team members. The blending of this information into the MEO
position descriptions (PDs) will result in some reclassification of
PD's.

##### **Operations Support**

The Clinical Center Nutrition Department positions are still able to
accomplish the original duties with minimal burden. This will continue
for MEO purposes.

#### MEO Positions -- Brief Descriptions

**Position Description Titles (GS levels)**

See attached documents Technical Exhibit 2-003

#### Current to MEO Staffing Comparison

Technical Exhibit 2-001, MEO Staffing Crosswalk, provides a complete
list of the positions included in the study, positions eliminated,
positions added, and the final MEO staffing.

**TECHNICAL EXHIBIT 2-001**

**MEO Staffing Crosswalk**

**See Attached.**

**TECHNICAL EXHIBIT 2-002**

**MEO Workload Analysis**

**See Attached.**

Food Services

# Quality Control Plan

[**Chapter 3. Quality Control Plan 3-1**](#quality-control-plan)

[3.1 Overview 3-2](#overview)

[3.2 Purpose 3-2](#purpose-1)

[3.3 Responsibility 3-2](#responsibility)

[3.4 Record Keeping 3-2](#record-keeping)

[3.5 Annual Evaluation Instructions
3-2](#annual-evaluation-instructions)

[3.6 Completing the Annual Evaluation Report
3-2](#completing-the-annual-evaluation-report)

[3.7 Completing the Letter of Certification
3-3](#completing-the-letter-of-certification)

[3.8 Evaluation Score 3-3](#evaluation-score)

  ---------------------------------- ------------------------------------
  ***Technical Exhibit Number***     ***Title***

  Technical Exhibit 3-001            Annual Evaluation Report

  Technical Exhibit 3-002            Comments/ Justification Form

  Technical Exhibit 3-003            Letter of Certification

  Technical Exhibit 3-004            QA Requirements Matrix
  ---------------------------------- ------------------------------------

## Overview

In accordance with the New OMB Circular NO. A-76 (revised May 29, 2003),
Attachment B, paragraph E. 4. (2) Regardless of the selected Service
Provider, after implementing a performance decision, The NIH CC
Nutrition Department shall implement the Quality Assurance Surveillance
Plan (QASP). The QASP used in the 2005 NIH A-76 studies is a matrix
document that outlines the tasks, workload, performance standards, and
surveillance method for each task. This QASP Instruction document
provides procedures for systematic surveillance of the provided services
to ensure accordance with the requirements of the RD.

## Purpose

These instructions are being used to provide quality assurance
surveillance for the Government MEO, which won the A-76, streamlined
competition, under the Revised A-76 Circular. For clarity of language,
the group performing the services will be referred to as the in-house
MEO. This document seeks to guide users, in a step-by-step manner,
through the basic implementation, record keeping, and annual evaluation
needed to assure that the in-house MEO's performance is evaluated and
meets the requirements outlined in the RD.

## Responsibility

NIH is responsible for implementing the QASP for the fiscal year (FY)
2006 A-76 Studies. This responsibility is further delegated below:

-   The Contract Officer (CO) of the Office of the Director (OD) will
    monitor, provide oversight, conduct evaluations, and maintain
    records to implement the QASP for each study.

-   The Quality Assurance Evaluator (QAE) will conduct the annual
    evaluations for their functional area.

-   The Project Officer will validate the annual evaluation.

## Record Keeping

Record keeping is vital to the quality assurance surveillance process
because the records serve as supporting documentation for subjective
evaluations. The level of documentation has focused on annual reports to
support the evaluation and performance of the in-house MEO. Continuous
excellent performance will allow a continuation of a normal level of
documentation, as outlined in these instructions. In the same manner,
performance that does not meet performance standards may require
additional levels of inspection and documentation as directed by the CO.

## Annual Evaluation Instructions

At the end of each fiscal year, the Project Officer will complete the
Annual Evaluation Report: Technical Exhibit 3-001. Prepare the Comments
and Justification form: Technical Exhibit 3-002, as necessary. Submit
the completed reports and form to the Office of the Director no later
than (Date) of the following fiscal year. The submission will also
include a Letter of Certification: Technical Exhibit 3-003.

## Completing the Annual Evaluation Report

For each task listed in the left hand column:

-   Assign points to each task based on its relative importance to
    meeting the requirements in the RD. The total number of points shall
    add to 100.

-   Describe the evaluation method. Evaluation methods may include
    different types of surveillance activities and analysis including,
    but not limited to direct observations, reconciliation reports,
    statistical analysis, and customer feedback.

-   Indicate if performance met the performance standards. The
    performance standards for each task are contained in Technical
    Exhibit 3-001: QA Requirements Matrix.

#### If performance has failed to meet the performance standards (i.e., a check mark in the "No" column), then a written justification must be entered on the Comments/Justification Form. 

#### The written justification should include, but not be limited to, a detailed explanation of why the in-house MEO failed to meet the performance standard, any corrective action plan to correct the problem, and what will be done to meet the standard in the future. 

-   Sign and date the form.

-   Provide to the Project Officer for approval.

-   The Project Officer signs and dates the form and provides to the
    Office of the Director.

## Completing the Letter of Certification

-   Sign and date the letter.

```{=html}
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-   Provide to the Project Officer (PO) for approval.

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```
-   The Project Officer signs and dates the letter and provides it to
    the Office of the Director.

## Evaluation Score

The CO will review the Evaluation Report and Comments/Justification Form
and provide to the Project Officer a written evaluation of the fiscal
year performance, as well as any additional requirements that are
necessary to meet established performance standards.

**Technical Exhibit 3-001**

Department of Health & Human Services

National Institutes of Health

\[OD Address\]

**Office of the Director**

**ANNUAL EVALUATION REPORT**

**FY: 2006**

+-------+------------------+---------+-----------------+-------+------+
| *     | **TASK**         | **P     | **EVALUATION    | **Met |      |
| *TASK |                  | OINTS** | METHOD**        | P     |      |
| NUM   |                  |         |                 | erfor |      |
| BER** |                  | **(Must |                 | mance |      |
|       |                  | add to  |                 | S     |      |
|       |                  | 100)**  |                 | tanda |      |
|       |                  |         |                 | rds** |      |
|       |                  |         |                 |       |      |
|       |                  |         |                 |   --- |      |
|       |                  |         |                 | ----- |      |
|       |                  |         |                 | - --- |      |
|       |                  |         |                 | ----- |      |
|       |                  |         |                 |   *   |      |
|       |                  |         |                 | *Yes* |      |
|       |                  |         |                 | *   * |      |
|       |                  |         |                 | *NO** |      |
|       |                  |         |                 |       |      |
|       |                  |         |                 |   --- |      |
|       |                  |         |                 | ----- |      |
|       |                  |         |                 | - --- |      |
|       |                  |         |                 | ----- |      |
+=======+==================+=========+=================+=======+======+
| **5.1 |                  |         |                 |       |      |
| FOOD  |                  |         |                 |       |      |
| SER   |                  |         |                 |       |      |
| VICES |                  |         |                 |       |      |
| GE    |                  |         |                 |       |      |
| NERAL |                  |         |                 |       |      |
| INF   |                  |         |                 |       |      |
| ORMAT |                  |         |                 |       |      |
| ION** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.1.1 |                  |         |                 |       |      |
| Work  |                  |         |                 |       |      |
| Manag |                  |         |                 |       |      |
| ement |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| Cont  |                  |         |                 |       |      |
| rol** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Event Drills     |         | 100% Inspection |       |      |
| 1.1.5 |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Computerized     |         | Random Sampling |       |      |
| 1.1.6 | Kitchen          |         |                 |       |      |
|       | Monitoring       |         |                 |       |      |
|       | System           |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Occurrence       |         | 100% Inspection |       |      |
| 1.1.7 | Reports          |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | General          |         | Random Sampling |       |      |
| 1.1.8 | Sanitation and   |         |                 |       |      |
|       | Sanitation       |         |                 |       |      |
|       | Standards        |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Tugger and       |         | Random Sampling |       |      |
| 1.1.9 | Pallet Jack      |         |                 |       |      |
|       | Maintenance      |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.1.2 |                  |         |                 |       |      |
| Ge    |                  |         |                 |       |      |
| neral |                  |         |                 |       |      |
| Food  |                  |         |                 |       |      |
| Se    |                  |         |                 |       |      |
| rvice |                  |         |                 |       |      |
| Requ  |                  |         |                 |       |      |
| ireme |                  |         |                 |       |      |
| nts** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Equipment        |         | Random Sampling |       |      |
| 1.2.1 | Cleaning and     |         |                 |       |      |
|       | Sanitizing       |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Food Service     |         | Random Sampling |       |      |
| 1.2.2 | Kitchen          |         |                 |       |      |
|       | Refr             |         |                 |       |      |
|       | igerator/Freezer |         |                 |       |      |
|       | Temperatures     |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Patient Unit     |         | Random Sampling |       |      |
| 1.2.3 | Refr             |         |                 |       |      |
|       | igerator/Freezer |         |                 |       |      |
|       | Temperatures     |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Dishwashing      |         | Random Sampling |       |      |
| 1.2.4 | Services         |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Refuse Removal   |         | Random Sampling |       |      |
| 1.2.5 |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.1.3 |                  |         |                 |       |      |
| Pr    |                  |         |                 |       |      |
| ocure |                  |         |                 |       |      |
| ment, |                  |         |                 |       |      |
| Del   |                  |         |                 |       |      |
| ivery |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| Rece  |                  |         |                 |       |      |
| ipt** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Inventory,       |         | Random Sampling |       |      |
| 1.3.1 | Research and     |         |                 |       |      |
|       | Ordering         |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Receive and      |         | Planned         |       |      |
| 1.3.2 | Record Store     |         | Sampling        |       |      |
|       | Room Materials   |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Requisition of   |         | Random Sampling |       |      |
| 1.3.3 | Store Room       |         |                 |       |      |
|       | Materials        |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Issuance of      |         | Random Sampling |       |      |
| 1.3.4 | Store Room       |         |                 |       |      |
|       | Materials        |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Store Room       |         | Random Sampling |       |      |
| 1.3.5 | Security         |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Budget and       |         | 100% Inspection |       |      |
| 1.3.6 | Reconciliation   |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Printer          |         | Random Sampling |       |      |
| 1.3.7 | Maintenance      |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **5.2 |                  |         |                 |       |      |
| NUTR  |                  |         |                 |       |      |
| ITION |                  |         |                 |       |      |
| CALL  |                  |         |                 |       |      |
| CEN   |                  |         |                 |       |      |
| TER** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.2.1 |                  |         |                 |       |      |
| Meal  |                  |         |                 |       |      |
| Req   |                  |         |                 |       |      |
| uests |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| Food  |                  |         |                 |       |      |
| Order |                  |         |                 |       |      |
| Pr    |                  |         |                 |       |      |
| ocess |                  |         |                 |       |      |
| ing** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Behavioral       |         | Random Sampling |       |      |
| 2.1.1 | Health           |         |                 |       |      |
|       | Processing       |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Room Service     |         | Customer        |       |      |
| 2.1.2 | Processing       |         | (Patient)       |       |      |
|       |                  |         | Survey          |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Bag Meal         |         | N/A             |       |      |
| 2.1.3 | Requests         |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Nourishment /    |         | Random Sampling |       |      |
| 2.1.4 | Snack Requests   |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Tube Feedings    |         | Random Sampling |       |      |
| 2.1.5 |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Emergency /      |         | Random Sampling |       |      |
| 2.1.6 | Immediate        |         |                 |       |      |
|       | Requests         |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Nutritional      |         | N/A             |       |      |
| 2.1.7 | Floor Stock      |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Behavioral       |         | Random Sampling |       |      |
| 2.1.8 | Health Picnic    |         |                 |       |      |
|       | Processing       |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Dental Soft      |         | N/A             |       |      |
| 2.1.9 | Trays            |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.2.2 |                  |         |                 |       |      |
| Menu  |                  |         |                 |       |      |
| A     |                  |         |                 |       |      |
| dmini |                  |         |                 |       |      |
| strat |                  |         |                 |       |      |
| ion** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Behavioral       |         | Random Sampling |       |      |
| 2.2.1 | Health Menu      |         |                 |       |      |
|       | Administration   |         |                 |       |      |
|       | and Delivery     |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Menu Replication |         | N/A             |       |      |
| 2.2.2 | and Stocking     |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Menu Update and  |         | N/A             |       |      |
| 2.2.3 | Maintenance      |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Menu and Patient |         | Random Sampling |       |      |
| 2.2.4 | Request          |         |                 |       |      |
|       | Translation      |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.2.3 |                  |         |                 |       |      |
| Inte  |                  |         |                 |       |      |
| rpret |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| Pr    |                  |         |                 |       |      |
| ocess |                  |         |                 |       |      |
| Pa    |                  |         |                 |       |      |
| tient |                  |         |                 |       |      |
| N     |                  |         |                 |       |      |
| utrit |                  |         |                 |       |      |
| ional |                  |         |                 |       |      |
| D     |                  |         |                 |       |      |
| ata** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Patient Status   |         | N/A             |       |      |
| 2.3.1 |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Determine        |         | Random Sampling |       |      |
| 2.3.2 | Current Patient  |         |                 |       |      |
|       | Diet Orders      |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.2.4 |                  |         |                 |       |      |
| Pe    |                  |         |                 |       |      |
| rform |                  |         |                 |       |      |
| CBORD |                  |         |                 |       |      |
| Nutr  |                  |         |                 |       |      |
| ition |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| Food  |                  |         |                 |       |      |
| Se    |                  |         |                 |       |      |
| rvice |                  |         |                 |       |      |
| Com   |                  |         |                 |       |      |
| puter |                  |         |                 |       |      |
| S     |                  |         |                 |       |      |
| ystem |                  |         |                 |       |      |
| Data  |                  |         |                 |       |      |
| En    |                  |         |                 |       |      |
| try** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Diet Order       |         | Random Sampling |       |      |
| 2.4.1 | Revisions and    |         |                 |       |      |
|       | Changes          |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Patient          |         | Random Sampling |       |      |
| 2.4.2 | Admissions and   |         |                 |       |      |
|       | Discharges       |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.2.5 |                  |         |                 |       |      |
| Pr    |                  |         |                 |       |      |
| oblem |                  |         |                 |       |      |
| Resol |                  |         |                 |       |      |
| ution |                  |         |                 |       |      |
| for   |                  |         |                 |       |      |
| Pa    |                  |         |                 |       |      |
| tient |                  |         |                 |       |      |
| Food  |                  |         |                 |       |      |
| Serv  |                  |         |                 |       |      |
| ice** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | System           |         | N/A             |       |      |
| 2.5.2 | Information      |         |                 |       |      |
|       | Changes and      |         |                 |       |      |
|       | Updates          |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.2.6 |                  |         |                 |       |      |
| Pr    |                  |         |                 |       |      |
| oblem |                  |         |                 |       |      |
| Resol |                  |         |                 |       |      |
| ution |                  |         |                 |       |      |
| of    |                  |         |                 |       |      |
| CBORD |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| CRIS  |                  |         |                 |       |      |
| Downt |                  |         |                 |       |      |
| ime** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Computer System  |         | N/A             |       |      |
| 2.6.1 | Troubleshooting  |         |                 |       |      |
|       | and Resolution   |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Computer System  |         | N/A             |       |      |
| 2.6.2 | Application      |         |                 |       |      |
|       | Downtime Menu    |         |                 |       |      |
|       | Order Processing |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.2.7 |                  |         |                 |       |      |
| Gen   |                  |         |                 |       |      |
| erate |                  |         |                 |       |      |
| Re    |                  |         |                 |       |      |
| ports |                  |         |                 |       |      |
| for   |                  |         |                 |       |      |
| Hos   |                  |         |                 |       |      |
| pital |                  |         |                 |       |      |
| Pat   |                  |         |                 |       |      |
| ients |                  |         |                 |       |      |
| Acco  |                  |         |                 |       |      |
| rding |                  |         |                 |       |      |
| to    |                  |         |                 |       |      |
| Cli   |                  |         |                 |       |      |
| nical |                  |         |                 |       |      |
| Cond  |                  |         |                 |       |      |
| ition |                  |         |                 |       |      |
| Conce |                  |         |                 |       |      |
| rning |                  |         |                 |       |      |
| Food  |                  |         |                 |       |      |
| Serv  |                  |         |                 |       |      |
| ice** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Missed Meal      |         | N/A             |       |      |
| 2.7.1 | Reports          |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Nourishment      |         | Random Sampling |       |      |
| 2.7.2 | Reports          |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Scheduled Room   |         | N/A             |       |      |
| 2.7.3 | Service Delivery |         |                 |       |      |
|       | Report           |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Advanced Ticket  |         | Random Sampling |       |      |
| 2.7.4 | Diet Order       |         |                 |       |      |
|       | Report           |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Census Report    |         | Random Sampling |       |      |
| 2.7.5 | with Notes       |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Selections       |         | N/A             |       |      |
| 2.7.6 | Report           |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **5.3 |                  |         |                 |       |      |
| MAIN  |                  |         |                 |       |      |
| KITC  |                  |         |                 |       |      |
| HEN** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.3.1 |                  |         |                 |       |      |
| Hot   |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| Cold  |                  |         |                 |       |      |
| Food  |                  |         |                 |       |      |
| Pr    |                  |         |                 |       |      |
| oduct |                  |         |                 |       |      |
| ion** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Food Preparation |         | Random Sampling |       |      |
| 3.1.1 |                  |         | and Customer    |       |      |
|       |                  |         | (Patient)       |       |      |
|       |                  |         | Survey          |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Tray Assembly    |         | Random Sampling |       |      |
| 3.1.2 |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Temperature Logs |         | Random Sampling |       |      |
| 3.1.3 |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.3.2 |                  |         |                 |       |      |
| Room  |                  |         |                 |       |      |
| Se    |                  |         |                 |       |      |
| rvice |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| Behav |                  |         |                 |       |      |
| ioral |                  |         |                 |       |      |
| H     |                  |         |                 |       |      |
| ealth |                  |         |                 |       |      |
| Un    |                  |         |                 |       |      |
| its** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Tray Delivery -- |         | Random Sampling |       |      |
| 3.2.1 | Room Service     |         | and Customer    |       |      |
|       |                  |         | (Patient)       |       |      |
|       |                  |         | Survey          |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Tray Delivery -- |         | Random Sampling |       |      |
| 3.2.2 | Behavioral       |         |                 |       |      |
|       | Health Units     |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Tray Removal     |         | Random Sampling |       |      |
| 3.2.3 | from Patient     |         |                 |       |      |
|       | Rooms and Areas  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Tray Removal     |         | Random Sampling |       |      |
| 3.2.4 | from Behavioral  |         |                 |       |      |
|       | Health Units     |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.3.3 |                  |         |                 |       |      |
| Pr    |                  |         |                 |       |      |
| epare |                  |         |                 |       |      |
| S     |                  |         |                 |       |      |
| pecia |                  |         |                 |       |      |
| lized |                  |         |                 |       |      |
| Foods |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| T     |                  |         |                 |       |      |
| herap |                  |         |                 |       |      |
| eutic |                  |         |                 |       |      |
| Proje |                  |         |                 |       |      |
| cts** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Celebratory      |         | Planned         |       |      |
| 3.3.1 | Functions and    |         | Sampling        |       |      |
|       | Catering         |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Special Food /   |         | Random Sampling |       |      |
| 3.3.2 | Snack Requests   |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Family Lodge     |         | Random Sampling |       |      |
| 3.3.3 | Assistance       |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.3.4 |                  |         |                 |       |      |
| Pr    |                  |         |                 |       |      |
| epare |                  |         |                 |       |      |
| First |                  |         |                 |       |      |
| Floor |                  |         |                 |       |      |
| C     |                  |         |                 |       |      |
| ontin |                  |         |                 |       |      |
| ental |                  |         |                 |       |      |
| Brea  |                  |         |                 |       |      |
| kfast |                  |         |                 |       |      |
| for   |                  |         |                 |       |      |
| Phleb |                  |         |                 |       |      |
| otomy |                  |         |                 |       |      |
| Patie |                  |         |                 |       |      |
| nts** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Continental      |         | Planned         |       |      |
| 3.4.1 | Breakfast        |         | Sampling        |       |      |
|       | Preparation and  |         |                 |       |      |
|       | Delivery         |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Continental      |         | Planned         |       |      |
| 3.4.2 | Breakfast        |         | Sampling        |       |      |
|       | Clean-Up and     |         |                 |       |      |
|       | Pick-Up          |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.3.5 |                  |         |                 |       |      |
| Ass   |                  |         |                 |       |      |
| emble |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| De    |                  |         |                 |       |      |
| liver |                  |         |                 |       |      |
| Nutr  |                  |         |                 |       |      |
| ition |                  |         |                 |       |      |
| Floor |                  |         |                 |       |      |
| St    |                  |         |                 |       |      |
| ock** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Patient Care     |         | Random Sampling |       |      |
| 3.5.1 | Unit Nourishment |         |                 |       |      |
|       | Stock            |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Quality Check    |         | N/A             |       |      |
| 3.5.2 |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.3.6 |                  |         |                 |       |      |
| Ass   |                  |         |                 |       |      |
| emble |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| De    |                  |         |                 |       |      |
| liver |                  |         |                 |       |      |
| Bag   |                  |         |                 |       |      |
| Me    |                  |         |                 |       |      |
| als** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Order Receipt    |         | Random Sampling |       |      |
| 3.6.1 | and Meal         |         |                 |       |      |
|       | Preparation      |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Bag Meal         |         | Random Sampling |       |      |
| 3.6.2 | Delivery         |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.3.7 |                  |         |                 |       |      |
| Pr    |                  |         |                 |       |      |
| epare |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| De    |                  |         |                 |       |      |
| liver |                  |         |                 |       |      |
| Nou   |                  |         |                 |       |      |
| rishm |                  |         |                 |       |      |
| ents/ |                  |         |                 |       |      |
| Snack |                  |         |                 |       |      |
| s/Sup |                  |         |                 |       |      |
| pleme |                  |         |                 |       |      |
| nts** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Receive, Prepare |         | Random Sampling |       |      |
| 3.7.1 | / Assemble and   |         |                 |       |      |
|       | Deliver Patient  |         |                 |       |      |
|       | Nutrition        |         |                 |       |      |
|       | Requests         |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **5.4 |                  |         |                 |       |      |
| META  |                  |         |                 |       |      |
| BOLIC |                  |         |                 |       |      |
| KITC  |                  |         |                 |       |      |
| HEN** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.4.1 |                  |         |                 |       |      |
| Pe    |                  |         |                 |       |      |
| rform |                  |         |                 |       |      |
| Inve  |                  |         |                 |       |      |
| ntory |                  |         |                 |       |      |
| Co    |                  |         |                 |       |      |
| ntrol |                  |         |                 |       |      |
| of    |                  |         |                 |       |      |
| Food  |                  |         |                 |       |      |
| /Food |                  |         |                 |       |      |
| Suppl |                  |         |                 |       |      |
| ies** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Identification   |         | N/A             |       |      |
| 4.1.1 | of Menu Items    |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Special Requests |         | N/A             |       |      |
| 4.1.2 |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Metabolic        |         | N/A             |       |      |
| 4.1.3 | Kitchen Weekly   |         |                 |       |      |
|       | Inventory        |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.4.2 |                  |         |                 |       |      |
| Store |                  |         |                 |       |      |
| Meta  |                  |         |                 |       |      |
| bolic |                  |         |                 |       |      |
| Ki    |                  |         |                 |       |      |
| tchen |                  |         |                 |       |      |
| Food  |                  |         |                 |       |      |
| /Food |                  |         |                 |       |      |
| Suppl |                  |         |                 |       |      |
| ies** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Metabolic        |         | Random Sampling |       |      |
| 4.2.1 | Kitchen Store    |         |                 |       |      |
|       | Room Maintenance |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.4.3 |                  |         |                 |       |      |
| Re    |                  |         |                 |       |      |
| quest |                  |         |                 |       |      |
| Meta  |                  |         |                 |       |      |
| bolic |                  |         |                 |       |      |
| Ki    |                  |         |                 |       |      |
| tchen |                  |         |                 |       |      |
| Food  |                  |         |                 |       |      |
| Pre   |                  |         |                 |       |      |
| parat |                  |         |                 |       |      |
| ion** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Protocol Meal    |         | Random Sampling |       |      |
| 4.3.1 | Preparation      |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Protocol Meal    |         | N/A             |       |      |
| 4.3.2 | Verification     |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Protocol Meal    |         | N/A             |       |      |
| 4.3.3 | Communication    |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.4.4 |                  |         |                 |       |      |
| Asse  |                  |         |                 |       |      |
| mble, |                  |         |                 |       |      |
| Del   |                  |         |                 |       |      |
| iver, |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| Pick  |                  |         |                 |       |      |
| Up    |                  |         |                 |       |      |
| Pro   |                  |         |                 |       |      |
| tocol |                  |         |                 |       |      |
| F     |                  |         |                 |       |      |
| ood** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Assemble Meals   |         | N/A             |       |      |
| 4.4.1 |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Tray Delivery    |         | Random Sampling |       |      |
| 4.4.2 | and Pick Up      |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.4.5 |                  |         |                 |       |      |
| Pr    |                  |         |                 |       |      |
| ocess |                  |         |                 |       |      |
| Re    |                  |         |                 |       |      |
| fused |                  |         |                 |       |      |
| F     |                  |         |                 |       |      |
| ood** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Weigh In and     |         | Random Sampling |       |      |
| 4.5.1 | Process Refused  |         |                 |       |      |
|       | Food             |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Nourishment      |         | N/A             |       |      |
| 4.5.2 | Replacement      |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.4.6 |                  |         |                 |       |      |
| Meta  |                  |         |                 |       |      |
| bolic |                  |         |                 |       |      |
| En    |                  |         |                 |       |      |
| teral |                  |         |                 |       |      |
| Fo    |                  |         |                 |       |      |
| rmula |                  |         |                 |       |      |
| Ord   |                  |         |                 |       |      |
| ers** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Verification of  |         | N/A             |       |      |
| 4.6.1 | Formula Orders   |         |                 |       |      |
|       | and Dietitian    |         |                 |       |      |
|       | Communication    |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Process Diluted  |         | Random Sampling |       |      |
| 4.6.2 | or Mixed Enteral |         |                 |       |      |
|       | Formula          |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Process Refused  |         | Random Sampling |       |      |
| 4.6.3 | Formula          |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.4.7 |                  |         |                 |       |      |
| Dev   |                  |         |                 |       |      |
| elop, |                  |         |                 |       |      |
| S     |                  |         |                 |       |      |
| tanda |                  |         |                 |       |      |
| rdize |                  |         |                 |       |      |
| and   |                  |         |                 |       |      |
| Test  |                  |         |                 |       |      |
| Reci  |                  |         |                 |       |      |
| pes** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Recipe           |         | N/A             |       |      |
| 4.7.1 | Development      |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Recipe Taste     |         | N/A             |       |      |
| 4.7.2 | Test             |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| **    |                  |         |                 |       |      |
| 5.4.8 |                  |         |                 |       |      |
| Pr    |                  |         |                 |       |      |
| omote |                  |         |                 |       |      |
| Pati  |                  |         |                 |       |      |
| ents' |                  |         |                 |       |      |
| Compl |                  |         |                 |       |      |
| iance |                  |         |                 |       |      |
| with  |                  |         |                 |       |      |
| Res   |                  |         |                 |       |      |
| earch |                  |         |                 |       |      |
| Di    |                  |         |                 |       |      |
| ets** |                  |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+
| 5.    | Metabolic Food   |         | N/A             |       |      |
| 4.8.1 | Education        |         |                 |       |      |
+-------+------------------+---------+-----------------+-------+------+

Quality Assurance Evaluator
Signature:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Project Officer Signature: Date:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**TECHNICAL EXHIBIT 3-002**

Department of Health & Human Services

National Institutes of Health

\[OD Address\]

**Office of the Director**

**COMMENTS / JUSTIFICATION FORM**

\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--

FY: 2006

  ----------- -----------------------------------------------------------
  Task No. /  Comment / Justification
  Criteria    
  Statement   

              

              

              

              

              

              

              
  ----------- -----------------------------------------------------------

**TECHNICAL EXHIBIT 3-003**

Department of Health & Human Services

National Institutes of Health

\[OD Address\]

**Office of the Director**

**LETTER OF CERTIFICATION**

**DATE:**

**TO:** Contracting Officer

> Office of the Director

**FROM:** ([Project Officer]{.underline})

**SUBJECT:** Annual Evaluation Report Letter of Certification for
\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--

I have approved the FY 2006 Annual Evaluation Report. I have completed
the Comments /Justification Form and have developed a Corrective Action
Plan for those activities that do not meet performance standards as
established in the final Requirements Document (RD).

We are continuing to provide services that were the subject of the
competitive sourcing review and have maintained the workload level that
was assumed in the study. Furthermore, I certify that we are continually
performing in accordance with the scope, technical standards and
personnel requirements as specified in the RD. I have notified the
Contracting Officer of any changed conditions in my services, in
accordance with the Letter of Obligation.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Project Officer Date

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Contracting Officer Date

**TECHNICAL EXHIBIT 3-004**

**Requirements matrix**

+------+-------------+----------------------------------------+------+
| *    | **TASK      | **PERFORMANCE INDICATOR**              | **A  |
| *PWS | DE          |                                        | LP** |
| NUMB | SCRIPTION** |                                        |      |
| ER** |             |                                        |      |
+======+=============+========================================+======+
| *    |             |                                        |      |
| *5.1 |             |                                        |      |
| FOOD |             |                                        |      |
| SERV |             |                                        |      |
| ICES |             |                                        |      |
| GEN  |             |                                        |      |
| ERAL |             |                                        |      |
| I    |             |                                        |      |
| NFOR |             |                                        |      |
| MATI |             |                                        |      |
| ON** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .1.1 |             |                                        |      |
| Work |             |                                        |      |
| Ma   |             |                                        |      |
| nage |             |                                        |      |
| ment |             |                                        |      |
| and  |             |                                        |      |
| C    |             |                                        |      |
| ontr |             |                                        |      |
| ol** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Meal        | No Standard                            | N/A  |
| .1.1 | Service     |                                        |      |
|      | Hours of    |                                        |      |
|      | Operation   |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Internship  | No Standard                            | N/A  |
| .1.2 | Support     |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Co          | No Standard                            | N/A  |
| .1.3 | mmunication |                                        |      |
|      | Devices     |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Personnel   | No Standard                            | N/A  |
| .1.4 | Interfaces  |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Event       | Timeliness Standard: Acceptable        | TS:  |
| .1.5 | Drills      | performance requires that the Service  | 1%   |
|      |             | Provider prepare and submit input and  |      |
|      |             | recommendations, regarding the event   |      |
|      |             | drill, by the timeframe specified by   |      |
|      |             | the Project Officer 99% of the time.   |      |
+------+-------------+----------------------------------------+------+
| 5.1  | C           | Timeliness Standard: Acceptable        | TS:  |
| .1.6 | omputerized | performance requires that the Service  | 1%   |
|      | Kitchen     | Provider respond and take corrective   |      |
|      | Monitoring  | action within two hours of receiving   |      |
|      | System      | an alert 99% of the time.              |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Occurrence  | Quality Standard: Acceptable           | QS:  |
| .1.7 | Reports     | performance requires that the Service  | 20%  |
|      |             | Provider receive no more than 15       |      |
|      |             | validated occurrence reports per month | TS:  |
|      |             | 80% of the time.                       | 10%  |
|      |             |                                        |      |
|      |             | Timeliness Standard: Acceptable        |      |
|      |             | performance requires that the Service  |      |
|      |             | Provider gather all necessary          |      |
|      |             | information and prepare an accurate    |      |
|      |             | response for the Project Officer       |      |
|      |             | within the given timeframe 90% of the  |      |
|      |             | time.                                  |      |
+------+-------------+----------------------------------------+------+
| 5.1  | General     | Quality Standard:                      | QS:  |
| .1.8 | Sanitation  |                                        |      |
|      | and         | -   Acceptable performance requires    | -    |
|      | Sanitation  |     that the Service Provider          |  15% |
|      | Standards   |     accurately complete the Sanitation |      |
|      |             |     Solution Log (Exhibit 5 in the     | -    |
|      |             |     BTL) 85% of the time.              |   2% |
|      |             |                                        |      |
|      |             | -   Acceptable performance shall       | -    |
|      |             |     require that all of kitchen pots   |   1% |
|      |             |     and pans are cleaned, sanitized    |      |
|      |             |     and properly put away by the end   | TS:  |
|      |             |     of the work day 98% of the time.   | 10%  |
|      |             |                                        |      |
|      |             | -   Acceptable performance requires    |      |
|      |             |     that the Service Provider shall    |      |
|      |             |     score in compliance with the       |      |
|      |             |     policy, 99% of the time.           |      |
|      |             |                                        |      |
|      |             | Timeliness Standard:                   |      |
|      |             |                                        |      |
|      |             | Acceptable performance also requires   |      |
|      |             | that the Service Provider correct any  |      |
|      |             | issues discovered by the identified    |      |
|      |             | policy timeframe 90% of the time.      |      |
|      |             | Acceptable performance also requires   |      |
|      |             | that the Service Provider submit the   |      |
|      |             | written response to the Project        |      |
|      |             | Officer within 3 workdays.             |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Tugger and  | Quality Standard: Acceptable           | QS:  |
| .1.9 | Pallet Jack | performance requires that the Service  | .1%  |
|      | Maintenance | Provider perform tugger and pallet     |      |
|      |             | jack maintenance and complete the      |      |
|      |             | daily Tugger logs 99.9% of the time.   |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .1.2 |             |                                        |      |
| Gen  |             |                                        |      |
| eral |             |                                        |      |
| Food |             |                                        |      |
| Ser  |             |                                        |      |
| vice |             |                                        |      |
| Re   |             |                                        |      |
| quir |             |                                        |      |
| emen |             |                                        |      |
| ts** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Equipment   | Quality Standard: Acceptable           | QS:  |
| .2.1 | Cleaning    | performance requires that the Service  | 3%   |
|      | and         | Provider accurately utilize the        |      |
|      | Sanitizing  | Kitchen Equipment List (Technical      | TS:  |
|      |             | Exhibit 5.1-001) to ensure cleanliness | 1%   |
|      |             | 97% of the time.                       |      |
|      |             |                                        |      |
|      |             | Timeliness Standard:                   |      |
|      |             |                                        |      |
|      |             | -   Acceptable performance requires    |      |
|      |             |     that the Service Provider properly |      |
|      |             |     cleans and sanitizes kitchen       |      |
|      |             |     equipment by the end of the        |      |
|      |             |     workday 99% of the time.           |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Food        | Quality Standard: Acceptable           | QS:  |
| .2.2 | Service     | performance requires that the Service  | 2%   |
|      | Kitchen     | Provider contact the necessary         |      |
|      | Refrigera   | personnel to resolve issues and        | TS:  |
|      | tor/Freezer | situations 98% of the time.            | 1%   |
|      | T           |                                        |      |
|      | emperatures | Timeliness Standard: Acceptable        |      |
|      |             | performance requires that the Service  |      |
|      |             | Provider contact the necessary         |      |
|      |             | personnel within 15 minutes once the   |      |
|      |             | Rees System has notified and received  |      |
|      |             | a response from the Service Provider   |      |
|      |             | 99% of the time.                       |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Patient     | Quality Standard: Acceptable           | QS:  |
| .2.3 | Unit        | performance requires that the Service  | 2%   |
|      | Refrigera   | Provider contact the necessary         |      |
|      | tor/Freezer | personnel to resolve issues and        | TS:  |
|      | T           | situations 98% of the time             | 1%   |
|      | emperatures |                                        |      |
|      |             | Timeliness Standard: Acceptable        |      |
|      |             | performance requires that the Service  |      |
|      |             | Provider contact the necessary         |      |
|      |             | personnel within 15 minutes after      |      |
|      |             | initial corrective action has been     |      |
|      |             | attempted 99% of the time.             |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Dishwashing | Quality Standard:                      | QS:  |
| .2.4 | Services    |                                        |      |
|      |             | -   Acceptable performance requires    | -    |
|      |             |     that the Service Provider          |   2% |
|      |             |     accurately and completely log the  |      |
|      |             |     dishwashing machine temperature    | -    |
|      |             |     98% of the time.                   |  .1% |
|      |             |                                        |      |
|      |             | -   Acceptable performance requires    | -    |
|      |             |     that the Service Provider take     |   2% |
|      |             |     corrective action within five      |      |
|      |             |     minutes to rectify the temperature | TS:  |
|      |             |     99.9% of the time.                 | 1%   |
|      |             |                                        |      |
|      |             | -   Acceptable performance requires    |      |
|      |             |     that the Service Provider          |      |
|      |             |     completely and accurately record   |      |
|      |             |     the pot wash machine, cleaning     |      |
|      |             |     solution, and three compartment    |      |
|      |             |     sink temperature log 98% of the    |      |
|      |             |     time.                              |      |
|      |             |                                        |      |
|      |             | Timeliness Standard: Acceptable        |      |
|      |             | performance requires that the Service  |      |
|      |             | Provider, during each meal time,       |      |
|      |             | ensure the temperature meets all food  |      |
|      |             | service regulations 99% of the time.   |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Refuse      | Quality Standard: Acceptable           | QS:  |
| .2.5 | Removal     | performance requires that the Service  | 1%   |
|      |             | Provider remove refuse so that the     |      |
|      |             | kitchen areas do not resonant the odor |      |
|      |             | of spoiled food or create an           |      |
|      |             | unsanitary issue that could cause      |      |
|      |             | contamination to patient food 99% of   |      |
|      |             | the time.                              |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .1.3 |             |                                        |      |
| Proc |             |                                        |      |
| urem |             |                                        |      |
| ent, |             |                                        |      |
| Deli |             |                                        |      |
| very |             |                                        |      |
| and  |             |                                        |      |
| R    |             |                                        |      |
| ecei |             |                                        |      |
| pt** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Inventory,  | Quality Standard: Acceptable           | QS:  |
| .3.1 | Research    | performance requires that the Service  | 10%  |
|      | and         | Provider perform an accurate and       |      |
|      | Ordering    | complete inventory to ensure that the  |      |
|      |             | store room maintains the necessary     |      |
|      |             | levels and is not depleted of a needed |      |
|      |             | item causing delay to food preparation |      |
|      |             | and delivery time 90% of the time.     |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Receive and | Quality Standard: Acceptable           | QS:  |
| .3.2 | Record      | performance requires that the Service  | 2%   |
|      | Store Room  | Provider reject all non-acceptable     |      |
|      | Materials   | food, as determined by HACCP, so that  |      |
|      |             | the storeroom does not contain         |      |
|      |             | outdated or spoiled food 98% of the    |      |
|      |             | time.                                  |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Requisition | Quality Standard: Acceptable           | QS:  |
| .3.3 | of Store    | performance requires that the Service  | 10%  |
|      | Room        | Provider prepare requisitions          |      |
|      | Materials   | accurately and completely within two   |      |
|      |             | business days 90% of the time.         |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Issuance of | Quality Standard: Acceptable           | QS:  |
| .3.4 | Store Room  | performance requires that the Service  | .1%  |
|      | Materials   | Provider issue the correctly requested |      |
|      |             | food or fluid item 99.9% of the time.  | TS:  |
|      |             |                                        | 2%   |
|      |             | Timeliness Standard: Acceptable        |      |
|      |             | performance requires that the Service  |      |
|      |             | Provider issue foods, formulas, and    |      |
|      |             | non-food supplies by the requested     |      |
|      |             | time or for planned                    |      |
|      |             | meals/nourishments/snacks, issued in   |      |
|      |             | time to prepare and deliver the        |      |
|      |             | request by the standard delivery time  |      |
|      |             | 98% of the time.                       |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Store Room  | Quality Standard: Acceptable           | QS:  |
| .3.5 | Security    | performance requires that the Service  | 5%   |
|      |             | Provider completely and accurately log |      |
|      |             | the store room security information on |      |
|      |             | a daily basis 95% of the time.         |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Budget and  | Timeliness Standard: Acceptable        | TS:  |
| .3.6 | Rec         | performance requires that the Service  | .1%  |
|      | onciliation | Provider reconcile the credit card     |      |
|      |             | statement by the 13^th^ of the month   |      |
|      |             | 99.9% of the time.                     |      |
+------+-------------+----------------------------------------+------+
| 5.1  | Printer     | Timeliness Standard: Acceptable        | TS:  |
| .3.7 | Maintenance | performance requires that the Service  | 5%   |
|      |             | Provider stock printers with supplies  |      |
|      |             | (i.e., paper, toner cartridges) as     |      |
|      |             | needed 95% of the time.                |      |
+------+-------------+----------------------------------------+------+
| *    |             |                                        |      |
| *5.2 |             |                                        |      |
| N    |             |                                        |      |
| utri |             |                                        |      |
| tion |             |                                        |      |
| Call |             |                                        |      |
| Cent |             |                                        |      |
| er** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .2.1 |             |                                        |      |
| Meal |             |                                        |      |
| Requ |             |                                        |      |
| ests |             |                                        |      |
| and  |             |                                        |      |
| Food |             |                                        |      |
| O    |             |                                        |      |
| rder |             |                                        |      |
| Proc |             |                                        |      |
| essi |             |                                        |      |
| ng** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Behavioral  | Quality Standard: Acceptable           | QS:  |
| .1.1 | Health      | performance requires that the Service  | 1%   |
|      | Processing  | Provider enter a tray for all          |      |
|      |             | behavioral health in-house patients    |      |
|      |             | for each meal with the appropriate     |      |
|      |             | stamps 99% of the time.                |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Room        | Quality Standard: Acceptable           | QS:  |
| .1.2 | Service     | performance requires that the average  | .1%  |
|      | Processing  | monthly score on the Patient           |      |
|      |             | Satisfaction Survey be rated as Fair   |      |
|      |             | or above 99.9% of the time for the     |      |
|      |             | courtesy of the person taking the      |      |
|      |             | order of the received responses from   |      |
|      |             | the Patient Satisfaction Survey.       |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Bag Meal    | No Standard                            | N/A  |
| .1.3 | Requests    |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Nourishment | Quality Standard: Acceptable           | QS:  |
| .1.4 | / Snack     | performance requires that the Service  | 3%   |
|      | Requests    | Provider enter the nourishment / snack |      |
|      |             | request accurately on a room service   |      |
|      |             | ticket or a CBORD requisition 97% of   |      |
|      |             | the time.                              |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Tube        | Timeliness Standard: Acceptable        | TS:  |
| .1.5 | Feedings    | performance requires that the Service  | 20%  |
|      |             | Provider review, process, and take     |      |
|      |             | appropriate action regarding CRIS      |      |
|      |             | order requisitions within 15 minutes   |      |
|      |             | of receipt 80% of the time.            |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Emergency / | Timeliness Standard: Acceptable        | TS:  |
| .1.6 | Immediate   | performance requires that the Service  | 20%  |
|      | Requests    | Provider review, process, and take     |      |
|      |             | appropriate action regarding CRIS      |      |
|      |             | order requisitions within 15 minutes   |      |
|      |             | of receipt 80% of the time.            |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Nutritional | No Standard                            | N/A  |
| .1.7 | Floor Stock |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Behavioral  | Quality Standard: Acceptable           | QS:  |
| .1.8 | Health      | performance requires that the Service  | 1%   |
|      | Picnic      | Provider accurately enter behavioral   |      |
|      | Processing  | health picnic requests on a weekly     |      |
|      |             | basis 99% of the time.                 |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Dental Soft | No Standard                            | N/A  |
| .1.9 | Trays       |                                        |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .2.2 |             |                                        |      |
| Menu |             |                                        |      |
| Admi |             |                                        |      |
| nist |             |                                        |      |
| rati |             |                                        |      |
| on** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Behavioral  | Quality Standard: Acceptable           | QS:  |
| .2.1 | Health Menu | performance requires that the Service  | .1%  |
|      | Adm         | Provider                               |      |
|      | inistration |                                        |      |
|      | and         | accurately reflect the patient's name, |      |
|      | Delivery    | location and meal on the menu and send |      |
|      |             | to the correct unit 99.9% of the time. |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Menu        | No Standard                            | N/A  |
| .2.2 | Replication |                                        |      |
|      | and         |                                        |      |
|      | Stocking    |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Menu Update | No Standard                            | N/A  |
| .2.3 | and         |                                        |      |
|      | Maintenance |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Menu and    | Quality Standard: Acceptable           | QS:  |
| .2.4 | Patient     | performance requires that the Service  | 20%  |
|      | Request     | Provider translate all menus for       |      |
|      | Translation | non-English speaking patients'         |      |
|      |             | requests correctly 80% of the time.    |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .2.3 |             |                                        |      |
| I    |             |                                        |      |
| nter |             |                                        |      |
| pret |             |                                        |      |
| and  |             |                                        |      |
| Pro  |             |                                        |      |
| cess |             |                                        |      |
| Pat  |             |                                        |      |
| ient |             |                                        |      |
| Nut  |             |                                        |      |
| riti |             |                                        |      |
| onal |             |                                        |      |
| Da   |             |                                        |      |
| ta** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Patient     | No Standard                            | N/A  |
| .3.1 | Status      |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Determine   | Timeliness Standard: Acceptable        | TS:  |
| .3.2 | Current     | performance requires that the Service  | 20%  |
|      | Patient     | Provider review, process, and take     |      |
|      | Diet Orders | appropriate action regarding CRIS      |      |
|      |             | order requisitions within 15 minutes   |      |
|      |             | of receipt, 80% of the time.           |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .2.4 |             |                                        |      |
| Per  |             |                                        |      |
| form |             |                                        |      |
| C    |             |                                        |      |
| BORD |             |                                        |      |
| N    |             |                                        |      |
| utri |             |                                        |      |
| tion |             |                                        |      |
| and  |             |                                        |      |
| Food |             |                                        |      |
| Ser  |             |                                        |      |
| vice |             |                                        |      |
| Comp |             |                                        |      |
| uter |             |                                        |      |
| Sy   |             |                                        |      |
| stem |             |                                        |      |
| Data |             |                                        |      |
| Ent  |             |                                        |      |
| ry** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Diet Order  | Timeliness Standard: Acceptable        | TS:  |
| .4.1 | Revisions   | performance requires that the Service  | 20%  |
|      | and Changes | Provider review, process, and take     |      |
|      |             | appropriate action regarding CRIS      |      |
|      |             | order requisitions within 15 minutes   |      |
|      |             | of receipt, 80% of the time.           |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Patient     | Timeliness Standard:                   | TS:  |
| .4.2 | Admissions  |                                        | 20%  |
|      | and         | -   Acceptable performance requires    |      |
|      | Discharges  |     that the Service Provider review,  | TS:  |
|      |             |     process, and take appropriate      | 5%   |
|      |             |     action regarding CRIS order        |      |
|      |             |     requisitions within 15 minutes of  |      |
|      |             |     receipt 80% of the time.           |      |
|      |             |                                        |      |
|      |             | -   Acceptable performance requires    |      |
|      |             |     that the Service Provider          |      |
|      |             |     accurately determine patients that |      |
|      |             |     need discharging and complete in   |      |
|      |             |     the CBORD card file weekly 95% of  |      |
|      |             |     the time.                          |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .2.5 |             |                                        |      |
| Pro  |             |                                        |      |
| blem |             |                                        |      |
| Re   |             |                                        |      |
| solu |             |                                        |      |
| tion |             |                                        |      |
| for  |             |                                        |      |
| Pat  |             |                                        |      |
| ient |             |                                        |      |
| Food |             |                                        |      |
| S    |             |                                        |      |
| ervi |             |                                        |      |
| ce** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | System      | No Standard                            | N/A  |
| .5.2 | Information |                                        |      |
|      | Changes and |                                        |      |
|      | Updates     |                                        |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .2.6 |             |                                        |      |
| Pro  |             |                                        |      |
| blem |             |                                        |      |
| Re   |             |                                        |      |
| solu |             |                                        |      |
| tion |             |                                        |      |
| of   |             |                                        |      |
| C    |             |                                        |      |
| BORD |             |                                        |      |
| and  |             |                                        |      |
| CRIS |             |                                        |      |
| Do   |             |                                        |      |
| wnti |             |                                        |      |
| me** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Computer    | No Standard                            | N/A  |
| .6.1 | System      |                                        |      |
|      | Trou        |                                        |      |
|      | bleshooting |                                        |      |
|      | and         |                                        |      |
|      | Resolution  |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Computer    | No Standard                            | N/A  |
| .6.2 | System      |                                        |      |
|      | Application |                                        |      |
|      | Downtime    |                                        |      |
|      | Menu Order  |                                        |      |
|      | Processing  |                                        |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .2.7 |             |                                        |      |
| Gene |             |                                        |      |
| rate |             |                                        |      |
| Rep  |             |                                        |      |
| orts |             |                                        |      |
| for  |             |                                        |      |
| Hosp |             |                                        |      |
| ital |             |                                        |      |
| Pati |             |                                        |      |
| ents |             |                                        |      |
| A    |             |                                        |      |
| ccor |             |                                        |      |
| ding |             |                                        |      |
| to   |             |                                        |      |
| Clin |             |                                        |      |
| ical |             |                                        |      |
| C    |             |                                        |      |
| ondi |             |                                        |      |
| tion |             |                                        |      |
| Co   |             |                                        |      |
| ncer |             |                                        |      |
| ning |             |                                        |      |
| Food |             |                                        |      |
| S    |             |                                        |      |
| ervi |             |                                        |      |
| ce** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Missed Meal | No Standard                            | N/A  |
| .7.1 | Reports     |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Nourishment | Quality Standard: Acceptable           | QS:  |
| .7.2 | Reports     | performance requires that the Service  | 1%   |
|      |             | Provider review the accuracy of the    |      |
|      |             | date and meal daily 99% of the time.   |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Scheduled   | No Standard                            | N/A  |
| .7.3 | Room        |                                        |      |
|      | Service     |                                        |      |
|      | Delivery    |                                        |      |
|      | Report      |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Advanced    | Quality Standard: Acceptable           | QS:  |
| .7.4 | Ticket Diet | performance requires that the Service  | 1%   |
|      | Order       | Provider accurately edits the meal     |      |
|      | Report      | ticket in compliancy with the new diet |      |
|      |             | order 99% of the time.                 |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Census      | Quality Standard: Acceptable           | QS:  |
| .7.5 | Report with | performance requires that the Service  | .05% |
|      | Notes       | Provider accurately reflect new diet   |      |
|      |             | orders on meal tickets 99.95 % of the  |      |
|      |             | time.                                  |      |
+------+-------------+----------------------------------------+------+
| 5.2  | Selections  | No Standard                            | N/A  |
| .7.6 | Report      |                                        |      |
+------+-------------+----------------------------------------+------+
| *    |             |                                        |      |
| *5.3 |             |                                        |      |
| MAIN |             |                                        |      |
| K    |             |                                        |      |
| ITCH |             |                                        |      |
| EN** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .3.1 |             |                                        |      |
| Hot  |             |                                        |      |
| and  |             |                                        |      |
| Cold |             |                                        |      |
| Food |             |                                        |      |
| Prod |             |                                        |      |
| ucti |             |                                        |      |
| on** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Food        | Quality Standard:                      | QS:  |
| .1.1 | Preparation |                                        |      |
|      |             | -   Acceptable performance requires    | -    |
|      |             |     that the Service Provider prepare  |   1% |
|      |             |     the requested meal accurately      |      |
|      |             |     following established food safety  | -    |
|      |             |     procedures to eliminate the        |   1% |
|      |             |     potential of food born illness and |      |
|      |             |     inadvertent allergy contamination  |      |
|      |             |     99% of the time.                   |      |
|      |             |                                        |      |
|      |             | -   Acceptable performance requires    |      |
|      |             |     that the Service Provider ensure   |      |
|      |             |     that the prepared food falls       |      |
|      |             |     within the correct temperature     |      |
|      |             |     range as defined by the FDA Food   |      |
|      |             |     Code 99% of the time.              |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Tray        | Quality Standard: Acceptable           | QS:  |
| .1.2 | Assembly    | performance requires that the Service  | 10%  |
|      |             | Provider shall assemble trays that are |      |
|      |             | correct 90% of the time.               |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Temperature | Quality Standard:                      | QS:  |
| .1.3 | Logs        |                                        |      |
|      |             | -   Acceptable performance requires    | -    |
|      |             |     that the Service Provider ensure   |  .1% |
|      |             |     time standards are met and         |      |
|      |             |     temperature readings are performed |      |
|      |             |     to ensure that the food is         |      |
|      |             |     properly cooked and held to        |      |
|      |             |     temperatures that fall within the  |      |
|      |             |     HACCP guidelines 99.9% of the      |      |
|      |             |     time.                              |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .3.2 |             |                                        |      |
| Room |             |                                        |      |
| Ser  |             |                                        |      |
| vice |             |                                        |      |
| and  |             |                                        |      |
| Be   |             |                                        |      |
| havi |             |                                        |      |
| oral |             |                                        |      |
| He   |             |                                        |      |
| alth |             |                                        |      |
| Uni  |             |                                        |      |
| ts** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Tray        | Quality Standard:                      | QS:  |
| .2.1 | Delivery -- |                                        |      |
|      | Room        | -   Acceptable performance requires    | -    |
|      | Service     |     that the Service Provider deliver  |  15% |
|      |             |     all patient trays to the room      |      |
|      |             |     within 45 minutes of receiving the | -    |
|      |             |     room service request 85% of the    |  .1% |
|      |             |     time.                              |      |
|      |             |                                        |      |
|      |             | -   Acceptable performance requires    |      |
|      |             |     that the average monthly scores on |      |
|      |             |     the Patient Satisfaction Survey be |      |
|      |             |     rated as Fair or above 99.9% of    |      |
|      |             |     the time for the quality of        |      |
|      |             |     service, flavor and taste of food, |      |
|      |             |     appearance of the meal, meal       |      |
|      |             |     temperature, courtesy of the       |      |
|      |             |     person delivering the food,        |      |
|      |             |     courtesy of the person taking your |      |
|      |             |     order, timeliness of the meals,    |      |
|      |             |     and accuracy of the tray.          |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Tray        | Quality Standard:                      | QS:  |
| .2.2 | Delivery -- |                                        | 10%  |
|      | Behavioral  | -   Acceptable performance requires    |      |
|      | Health      |     that the Service Provider deliver  | QS:  |
|      | Units       |     all patient trays to the           | .1%  |
|      |             |     designated dining location within  |      |
|      |             |     the Behavioral Health Unit by 7:45 |      |
|      |             |     a.m. for breakfast, by 11:45 a.m.  |      |
|      |             |     for lunch, and by 4:45 p.m. for    |      |
|      |             |     dinner 90% of the time.            |      |
|      |             |                                        |      |
|      |             | ```{=html}                             |      |
|      |             | <!-- -->                               |      |
|      |             | ```                                    |      |
|      |             | -   Acceptable performance requires    |      |
|      |             |     that the average monthly scores on |      |
|      |             |     the Patient Satisfaction Survey be |      |
|      |             |     rated as Fair or above 99.9% of    |      |
|      |             |     the time for the quality of        |      |
|      |             |     service, flavor and taste of food, |      |
|      |             |     appearance of the meal, and meal   |      |
|      |             |     temperature.                       |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Tray        | Quality Standard: Acceptable           | QS:  |
| .2.3 | Removal     | performance requires that the Service  | 10%  |
|      | from        | Provider remove and return all trays   |      |
|      | Patient     | to the kitchen to ensure sufficient    |      |
|      | Rooms and   | trays, flatware and dishware are       |      |
|      | Areas       | available for the next meal 90% of the |      |
|      |             | time.                                  |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Tray        | Quality Standard: Acceptable           | QS:  |
| .2.4 | Removal     | performance requires that the Service  | 5%   |
|      | from        | Provider collect and return all trays  |      |
|      | Behavioral  | to the kitchen by the end of the       |      |
|      | Health      | workday 95% of the time, unless trays  |      |
|      | Units       | are unavailable for pick up.           |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .3.3 |             |                                        |      |
| Pre  |             |                                        |      |
| pare |             |                                        |      |
| Spe  |             |                                        |      |
| cial |             |                                        |      |
| ized |             |                                        |      |
| F    |             |                                        |      |
| oods |             |                                        |      |
| and  |             |                                        |      |
| The  |             |                                        |      |
| rape |             |                                        |      |
| utic |             |                                        |      |
| Pr   |             |                                        |      |
| ojec |             |                                        |      |
| ts** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Celebratory | Quality Standard: Acceptable           | QS:  |
| .3.1 | Functions   | performance requires that the Service  | 3%   |
|      | and         | Provider prepare the meal as agreed    |      |
|      | Catering    | upon 97% of the time.                  | TS:  |
|      |             |                                        | 3%   |
|      |             | Timeliness Standard: Acceptable        |      |
|      |             | performance requires that the Service  |      |
|      |             | Provider deliver the meal to the       |      |
|      |             | correct location by the time requested |      |
|      |             | 97% of the time.                       |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Special     | Quality Standard: Acceptable           | QS:  |
| .3.2 | Food /      | performance requires that the Service  | 15%  |
|      | Snack       | Provider accurately prepare the        |      |
|      | Requests    | request 85% of the time.               | TS:  |
|      |             |                                        | 3%   |
|      |             | Timeliness Standard: Acceptable        |      |
|      |             | performance requires that the Service  |      |
|      |             | Provider deliver the available special |      |
|      |             | snacks and food by the requested time  |      |
|      |             | 97% of the time.                       |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Family      | Quality Standard: Acceptable           | QS:  |
| .3.3 | Lodge       | performance requires that the Service  | 10%  |
|      | Assistance  | Provider provide available food and    |      |
|      |             | food service supplies to the Family    |      |
|      |             | Lodge by the delivery date 90% of the  |      |
|      |             | time.                                  |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .3.4 |             |                                        |      |
| Pre  |             |                                        |      |
| pare |             |                                        |      |
| F    |             |                                        |      |
| irst |             |                                        |      |
| F    |             |                                        |      |
| loor |             |                                        |      |
| Con  |             |                                        |      |
| tine |             |                                        |      |
| ntal |             |                                        |      |
| B    |             |                                        |      |
| reak |             |                                        |      |
| fast |             |                                        |      |
| for  |             |                                        |      |
| Ph   |             |                                        |      |
| lebo |             |                                        |      |
| tomy |             |                                        |      |
| Pa   |             |                                        |      |
| tien |             |                                        |      |
| ts** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Continental | Quality Standard: Acceptable           | QS:  |
| .4.1 | Breakfast   | performance requires that the Service  | 10%  |
|      | Preparation | Provider prepare and deliver foods and |      |
|      | and         | food service supplies to the requested |      |
|      | Delivery    | location between 7:00 a.m. -7:15 a.m.  |      |
|      |             | Monday -- Friday 90% of the time.      |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Continental | Timeliness Standard: Acceptable        | TS:  |
| .4.2 | Breakfast   | performance requires that the Service  | 10%  |
|      | Clean-Up    | Provider pick up the food and food     |      |
|      | and Pick-Up | materials between 9:00 a.m. -- 9:15    |      |
|      |             | a.m. Monday -- Friday 90% of the time. |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .3.5 |             |                                        |      |
| Asse |             |                                        |      |
| mble |             |                                        |      |
| and  |             |                                        |      |
| Del  |             |                                        |      |
| iver |             |                                        |      |
| N    |             |                                        |      |
| utri |             |                                        |      |
| tion |             |                                        |      |
| F    |             |                                        |      |
| loor |             |                                        |      |
| Sto  |             |                                        |      |
| ck** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Patient     | Quality Standard:                      | QS:  |
| .5.1 | Care Unit   |                                        |      |
|      | Nourishment | -   Acceptable performance requires    | -    |
|      | Stock       |     that the Service Provider stock    |   5% |
|      |             |     Patient Care Unit refrigerators    |      |
|      |             |     with in-stock / available items    | -    |
|      |             |     daily and pantries weekly so that  |   1% |
|      |             |     the items meet established par     |      |
|      |             |     levels 95% of the time right after |      |
|      |             |     restocking.                        |      |
|      |             |                                        |      |
|      |             | -   Acceptable performance also        |      |
|      |             |     requires that the Service Provider |      |
|      |             |     ensure that no expired food        |      |
|      |             |     remains in the pantry or           |      |
|      |             |     refrigerator 99% of the time.      |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Quality     | ( Standard provided in 5.3.5.1)        | N/A  |
| .5.2 | Check       |                                        |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .3.6 |             |                                        |      |
| Asse |             |                                        |      |
| mble |             |                                        |      |
| and  |             |                                        |      |
| Del  |             |                                        |      |
| iver |             |                                        |      |
| Bag  |             |                                        |      |
| Mea  |             |                                        |      |
| ls** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Order       | Quality Standard: Acceptable           | QS:  |
| .6.1 | Receipt and | performance requires that the Service  | 1%   |
|      | Meal        | Provider accurately prepare and label  |      |
|      | Preparation | the requested meal 99% of the time.    |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Bag Meal    | Timeliness Standard: Acceptable        | QS:  |
| .6.2 | Delivery    | performance requires that the Service  | 15%  |
|      |             | Provider deliver the bag meals by      |      |
|      |             | 10:30 a.m. for breakfast, by 1:00 p.m. |      |
|      |             | for lunch, and by 8:00 p.m. for dinner |      |
|      |             | 85% of the time.                       |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .3.7 |             |                                        |      |
| Pre  |             |                                        |      |
| pare |             |                                        |      |
| and  |             |                                        |      |
| Del  |             |                                        |      |
| iver |             |                                        |      |
| N    |             |                                        |      |
| ouri |             |                                        |      |
| shme |             |                                        |      |
| nts/ |             |                                        |      |
| Snac |             |                                        |      |
| ks/S |             |                                        |      |
| uppl |             |                                        |      |
| emen |             |                                        |      |
| ts** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.3  | Receive,    | Quality Standard: Acceptable           | QS:  |
| .7.1 | Prepare /   | performance requires that the Service  | 15%  |
|      | Assemble    | Provider deliver planned snacks by     |      |
|      | and Deliver | 10:00 a.m. for the morning snack, by   | TS:  |
|      | Patient     | 2:00 p.m. for the afternoon snack, and | 15%  |
|      | Nutrition   | by 8:00 p.m. for the evening snack 85% |      |
|      | Requests    | of the time.                           |      |
|      |             |                                        |      |
|      |             | Timeliness Standard: Acceptable        |      |
|      |             | performance also requires that the     |      |
|      |             | Service Provider deliver unplanned     |      |
|      |             | nourishments or snacks requests within |      |
|      |             | 45 minutes of the received request 85% |      |
|      |             | of the time.                           |      |
+------+-------------+----------------------------------------+------+
| *    |             |                                        |      |
| *5.4 |             |                                        |      |
| M    |             |                                        |      |
| ETAB |             |                                        |      |
| OLIC |             |                                        |      |
| K    |             |                                        |      |
| ITCH |             |                                        |      |
| EN** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .4.1 |             |                                        |      |
| Per  |             |                                        |      |
| form |             |                                        |      |
| I    |             |                                        |      |
| nven |             |                                        |      |
| tory |             |                                        |      |
| Con  |             |                                        |      |
| trol |             |                                        |      |
| of   |             |                                        |      |
| F    |             |                                        |      |
| ood/ |             |                                        |      |
| Food |             |                                        |      |
| Su   |             |                                        |      |
| ppli |             |                                        |      |
| es** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Ide         | No Standard                            | N/A  |
| .1.1 | ntification |                                        |      |
|      | of Menu     |                                        |      |
|      | Items       |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Special     | No Standard                            | N/A  |
| .1.2 | Requests    |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Metabolic   | Quality Standard:                      | QS:  |
| .1.3 | Kitchen     |                                        |      |
|      | Weekly      | -   Acceptable performance requires    | -    |
|      | Inventory   |     that the Service Provider perform  |  10% |
|      |             |     an accurate and complete inventory |      |
|      |             |     90% of the time.                   | -    |
|      |             |                                        |  10% |
|      |             | -   Acceptable performance requires    |      |
|      |             |     that the Service Provider prepare  |      |
|      |             |     CBORD requisitions and purchase    |      |
|      |             |     orders accurately and completely   |      |
|      |             |     90% of the time.                   |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .4.2 |             |                                        |      |
| S    |             |                                        |      |
| tore |             |                                        |      |
| M    |             |                                        |      |
| etab |             |                                        |      |
| olic |             |                                        |      |
| Kit  |             |                                        |      |
| chen |             |                                        |      |
| F    |             |                                        |      |
| ood/ |             |                                        |      |
| Food |             |                                        |      |
| Su   |             |                                        |      |
| ppli |             |                                        |      |
| es** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Metabolic   | Quality Standard: Acceptable           | QS:  |
| .2.1 | Kitchen     | Performance requires that the Service  |      |
|      | Store Room  | Provider ensure that all food and      | -    |
|      | Maintenance | formulas are dated with expiration     |  10% |
|      |             | dates 90% of the time and not used     |      |
|      |             | past their expiration dates 99.9% of   | -    |
|      |             | the time.                              |  .1% |
|      |             |                                        |      |
|      |             | Timeliness Standard: Acceptable        | TS:  |
|      |             | performance requires that the Service  | 1%   |
|      |             | Provider remove outdated items from    |      |
|      |             | the pantries or refrigerators upon     |      |
|      |             | expiration 99% of the time.            |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .4.3 |             |                                        |      |
| Req  |             |                                        |      |
| uest |             |                                        |      |
| M    |             |                                        |      |
| etab |             |                                        |      |
| olic |             |                                        |      |
| Kit  |             |                                        |      |
| chen |             |                                        |      |
| Food |             |                                        |      |
| P    |             |                                        |      |
| repa |             |                                        |      |
| rati |             |                                        |      |
| on** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Protocol    | Quality Standard:                      | QS:  |
| .3.1 | Meal        |                                        |      |
|      | Preparation | -   Acceptable performance requires    | -    |
|      |             |     that the Service Provider use the  |  .1% |
|      |             |     exact ingredients required by the  |      |
|      |             |     protocol recipe including the      |      |
|      |             |     exact product and brand names      |  -   |
|      |             |     99.9% of the time.                 |  20% |
|      |             |                                        |      |
|      |             | -   Acceptable performance requires    |      |
|      |             |     that the Service Provider shall    |  -   |
|      |             |     accurately weigh food within 2% of |  10% |
|      |             |     the stated weight 80% of the time, |      |
|      |             |     within 5% of the stated weight 90% |      |
|      |             |     of the time, and within 10% of the |  -   |
|      |             |     stated weight 99.9% of the time.   |  .1% |
|      |             |     The weight of the food shall be    |      |
|      |             |     document accurately and legibly    | -    |
|      |             |     99.9% of the time.                 |  .1% |
|      |             |                                        |      |
|      |             | Timeliness Standard: Acceptable        | TS:  |
|      |             | performance requires that the Service  | 1%   |
|      |             | Provider serve metabolic meals,        |      |
|      |             | snacks, and formulas within 15 minutes |      |
|      |             | of the requested delivery time 99% of  |      |
|      |             | the time.                              |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Protocol    | No Standard (included in 5.4.3.1)      | N/A  |
| .3.2 | Meal        |                                        |      |
|      | V           |                                        |      |
|      | erification |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Protocol    | No Standard                            | N/A  |
| .3.3 | Meal        |                                        |      |
|      | Co          |                                        |      |
|      | mmunication |                                        |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .4.4 |             |                                        |      |
| A    |             |                                        |      |
| ssem |             |                                        |      |
| ble, |             |                                        |      |
| Deli |             |                                        |      |
| ver, |             |                                        |      |
| and  |             |                                        |      |
| Pick |             |                                        |      |
| Up   |             |                                        |      |
| Prot |             |                                        |      |
| ocol |             |                                        |      |
| Fo   |             |                                        |      |
| od** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Assemble    | No Standard                            | N/A  |
| .4.1 | Meals       |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Tray        | Quality Standard: Acceptable           | QS:  |
| .4.2 | Delivery    | performance requires that the Service  | 1%   |
|      | and Pick Up | Provider accurately deliver and pick   |      |
|      |             | up patient meal trays, snack and       | TS:  |
|      |             | nourishment containers to the correct  | 1%   |
|      |             | requesting patient or nursing unit     |      |
|      |             | requestor 99% of the time.             |      |
|      |             |                                        |      |
|      |             | Timeliness Standard: Acceptable        |      |
|      |             | performance requires that the Service  |      |
|      |             | Provider deliver the tray to the       |      |
|      |             | correct patient as directed by the     |      |
|      |             | protocol schedule or within 15 minutes |      |
|      |             | of the patient's request 99% of the    |      |
|      |             | time.                                  |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .4.5 |             |                                        |      |
| Pro  |             |                                        |      |
| cess |             |                                        |      |
| Ref  |             |                                        |      |
| used |             |                                        |      |
| Fo   |             |                                        |      |
| od** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Weigh In    | Quality Standard: Acceptable           | QS:  |
| .5.1 | and Process | performance requires that the Service  |      |
|      | Refused     | Provider shall accurately re-weigh     | -    |
|      | Food        | food within 2% of the stated weight    |  20% |
|      |             | 80% of the time, within 5% of the      |      |
|      |             | stated weight 90% of the time, and     | -    |
|      |             | within 10% of the stated weight 99.9%  |  10% |
|      |             | of the time. The weight of the food    |      |
|      |             | shall be documented accurately and     | -    |
|      |             | legibly 99.9% of the time.             |  .1% |
|      |             |                                        |      |
|      |             | Timeliness Standard: Acceptable        | -    |
|      |             | performance requires that the Service  |  .1% |
|      |             | Provider re-weigh the food within one  |      |
|      |             | hour of receipt 80% of the time, and   | TS:  |
|      |             | within the same day 99.9% of the time. |      |
|      |             |                                        | -    |
|      |             |                                        |  20% |
|      |             |                                        |      |
|      |             |                                        | -    |
|      |             |                                        |  .1% |
+------+-------------+----------------------------------------+------+
| 5.4  | Nourishment | No Standard                            | N/A  |
| .5.2 | Replacement |                                        |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .4.6 |             |                                        |      |
| M    |             |                                        |      |
| etab |             |                                        |      |
| olic |             |                                        |      |
| Ent  |             |                                        |      |
| eral |             |                                        |      |
| For  |             |                                        |      |
| mula |             |                                        |      |
| Orde |             |                                        |      |
| rs** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | V           | No Standard                            | N/A  |
| .6.1 | erification |                                        |      |
|      | of Formula  |                                        |      |
|      | Orders and  |                                        |      |
|      | Dietitian   |                                        |      |
|      | Co          |                                        |      |
|      | mmunication |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Process     | Quality Standard:                      | QS:  |
| .6.2 | Diluted or  |                                        |      |
|      | Mixed       | -   Acceptable performance requires    | -    |
|      | Enteral     |     that the Service Provider shall    |  .1% |
|      | Formula     |     ensure all foods; liquid and       |      |
|      |             |     powered formulas are labeled with  | -    |
|      |             |     expiration dates and monitored.    |  .1% |
|      |             |     All opened and prepared items must |      |
|      |             |     have labeled expiration date       | -    |
|      |             |     recorded on the packaging 99.9% of |  .1% |
|      |             |     the time.                          |      |
|      |             |                                        | TS:  |
|      |             | -   Acceptable performance requires    | 1%   |
|      |             |     that prepare the requested formula |      |
|      |             |     using the exact product and brand  |      |
|      |             |     names, and amount 99.9% of the     |      |
|      |             |     time.                              |      |
|      |             |                                        |      |
|      |             | -   Acceptable performance requires    |      |
|      |             |     that ingredients are stored at the |      |
|      |             |     proper temperature. 99.9% of the   |      |
|      |             |     time.                              |      |
|      |             |                                        |      |
|      |             | Timeliness Standard: Acceptable        |      |
|      |             | performance requires that the Service  |      |
|      |             | Provider prepare replacement formula   |      |
|      |             | 99% of the time within one hour of the |      |
|      |             | request.                               |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Process     | Quality Standard: Acceptable           | QS:  |
| .6.3 | Refused     | performance requires that the Service  | .1%  |
|      | Formula     | Provider weigh the food and document   |      |
|      |             | findings accurately and legibly 99.9%  | TS:  |
|      |             | of the time.                           |      |
|      |             |                                        | -    |
|      |             | Timeliness Standard: Acceptable        |  20% |
|      |             | performance requires that the Service  |      |
|      |             | Provider weigh the formula within one  | -    |
|      |             | hour of receipt 80% of the time, and   |  .1% |
|      |             | within the same day 99.9% of the time. |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .4.7 |             |                                        |      |
| Deve |             |                                        |      |
| lop, |             |                                        |      |
| Sta  |             |                                        |      |
| ndar |             |                                        |      |
| dize |             |                                        |      |
| and  |             |                                        |      |
| Test |             |                                        |      |
| R    |             |                                        |      |
| ecip |             |                                        |      |
| es** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Recipe      | No Standard                            | N/A  |
| .7.1 | Development |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Recipe      | No Standard                            |      |
| .7.2 | Taste Test  |                                        |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .4.8 |             |                                        |      |
| Pro  |             |                                        |      |
| mote |             |                                        |      |
| P    |             |                                        |      |
| atie |             |                                        |      |
| nts' |             |                                        |      |
| Co   |             |                                        |      |
| mpli |             |                                        |      |
| ance |             |                                        |      |
| with |             |                                        |      |
| Rese |             |                                        |      |
| arch |             |                                        |      |
| Die  |             |                                        |      |
| ts** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.4  | Metabolic   | No Standard                            | N/A  |
| .8.1 | Food        |                                        |      |
|      | Education   |                                        |      |
+------+-------------+----------------------------------------+------+
| *    |             |                                        |      |
| *5.5 |             |                                        |      |
| CON  |             |                                        |      |
| TING |             |                                        |      |
| ENCY |             |                                        |      |
| PL   |             |                                        |      |
| ANNI |             |                                        |      |
| NG** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| **5  |             |                                        |      |
| .5.1 |             |                                        |      |
| Co   |             |                                        |      |
| ntin |             |                                        |      |
| uity |             |                                        |      |
| of   |             |                                        |      |
| Op   |             |                                        |      |
| erat |             |                                        |      |
| ions |             |                                        |      |
| Pl   |             |                                        |      |
| anni |             |                                        |      |
| ng** |             |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.5  | Contingency | No Standard *at this time*             | N/A  |
| .1.1 | Plan        |                                        |      |
|      | Development |                                        |      |
+------+-------------+----------------------------------------+------+
| 5.5  | Food        | No Standard *at this time*             | N/A  |
| .1.2 | Service     |                                        |      |
|      | Delivery    |                                        |      |
+------+-------------+----------------------------------------+------+

Food Services

# Continuing Government Activity (CGA)

[Chapter 4. Continuing Government Activity (CGA)
4-1](#continuing-government-activity-cga)

[4.1 General 4-2](#general-1)

[4.2 CGA Staffing Calculations 4-2](#__RefHeading___Toc86217808)

## General

As indicated in Chapter 2, the CGA will perform two (2) categories of
tasks and functions: (1) those that are inherently governmental or which
the RD Team has declared core to the Food Services operations, and (2)
the OMB Circular A-76 "Post Competition Accountability" or Quality
Assurance (QA) requirements. CGA performance should include all of the
tasks and functions performed by the current organization that [are not
included]{.underline} in the RD as well as the Circular A-76 QA function
as defined by the Quality Assurance Surveillance Plan (QASP). The
Project Officer will oversee the performance of the Service Provider
whether it is the Government MEO or a private sector Service Provider.

## CGA Staffing CALCULATIONS 

Table 4-1 -- Continuing Government Activity

  ----------------------------------------- ------------------ -----------
  **Position Title**                        **Series/Grade**   **FTE**

  Manager -- Food Services Section Chief    Title 42 CRS       0.096

  Manager -- Supervisory Metabolic          Commissioned Corps 0.917
  Dietitian                                                    

  Manager -- Production Dietitian           Title 42 CRS       0.844

  Manager -- Dietitian Informaticist        Title 42 CRS       0.892

  **FTE Total**                                                2.749
  ----------------------------------------- ------------------ -----------

Food Services

# Phase-In Plan

Chapter 5. Phase-In Plan [5-1](#phase-in-plan)

5.1 General [5-2](#general-2)

5.2 Assumptions, References and Affected Organizations
[5-2](#assumptions-references-and-affected-organizations)

5.3 Pre-Performance Decision Activities
[5-2](#pre-performance-decision-activities)

5.4 Post-Performance Decision Activities
[5-3](#post-performance-decision-activities)

5.5 Utilities and Any Other Services And Costs To Be Transferred
[5-6](#utilities-and-any-other-services-and-costs-to-be-transferred)

5.6 Indicators Of Successful Transition
[5-6](#indicators-of-successful-transition)

**Technical Exhibits**

[]{.mark}

  ---------------------------------- ------------------------------------
  ***Technical Exhibit Number***     ***Title***

  Technical Exhibit 5-001            Food Services Government Provided
                                     Training

  Technical Exhibit 5-002            Integrated Phase-In Timeline
  ---------------------------------- ------------------------------------

## General

This Chapter details a Phase-In Plan to replace the incumbent Service
Provider with the MEO, even if the agency is the incumbent Service
Provider. Accordingly, this chapter does not specifically address the
actions required to replace the incumbent provider with a private sector
contractor, although many of the actions required may be similar.

During phase-in, the CC Nutrition Department, Food Services shall
continue to provide quality service to its customers. This Plan requires
significant and well-coordinated efforts. The following Phase-In Plan
shall serve as the means by which successful implementation occurs.

The objective of the Phase-In Plan is to chart a course from the current
organization to the future Government-operated MEO as it takes over the
mission and functions of the areas that have been under study.

## Assumptions, References and Affected Organizations

### References

-   The Food Services Requirements Document.

-   The Food Services Quality Control Plan.

-   The Food services Quality Assurance Surveillance Plan (QASP).

-   The food Services Performance Work Statement.

-   The Food services Bidders Technical Library.

### Affected Organizations

The NIH, CC Nutrition Department Food Services is the designated
function under study and is directly affected.

## Pre-Performance Decision Activities

Planning for a transition may begin when the MEO has been completed and
the performance decision has been officially announced as a Government
decision. During the time between the completion of the MEO and the
announcement of the performance decision, the Office of Human Resources
is primarily planning the efforts associated with personnel actions.
During the same planning period, training requirements and resources
should be identified and plans for training may begin.

### Phase-In Team

To expedite the transition process, the Agency Tender Official (ATO),
the NIH Office of the Director (OD), point of contact (POC), and the
current Project Officer or designee shall establish a Phase-In Team
tasked with implementing the MEO while simultaneously mitigating any
adverse impact on the customers. The Phase-In Team, under the direction
of the current NIH OD POC, will address two (2) major functional areas:
Administrative/HR and Technical/Logistical. The Phase-In Team will thus
include two (2) sub-teams to address these functional areas. One (1)
sub-team will consist of personnel from the Human Resources Division.
The other sub-team will include technical personnel from specified areas
within NIH knowledgeable of CC Nutrition Department Food Services.

Each sub-team of the Phase-In Team will operate under a separate group
leader. The ATO and the Project officer or designee may chair or serve
on these sub-teams. The Administrative/HR sub-team will appoint members
as necessary and address all personnel transition issues. The
Technical/Logistical sub-team will be comprised of Subject Matter
Experts (SME) and technical personnel from within NIH who will assist in
transitioning to an MEO or Private Service Provider based upon the
outcome of the competition as well as training and other technical
requirements.

### Phase-In Team Duties

During the planning period, the Phase-In Team will:

-   Counsel and brief employees on transition. This includes change
    management and providing employees with the solid understanding of
    duties and responsibilities working in an MEO.

-   Identify any issues that may be related to the restructuring of the
    organization.

-   Share new job descriptions and performance standards.

-   Schedule and conduct inventory of accountable property.

-   Schedule and provide procedures for the transfer or disposal of any
    equipment, material, or facilities if a private sector Service
    Provider is selected.

-   Handle security issues with facility access (for private sector
    Service Providers).

## Post-Performance Decision Activities

Once the cost comparison has been conducted and the performance decision
is announced as Government performance, two (2) major parallel actions
are initiated -- personnel related actions to create the MEO and to
perform the Continuing Government Activities (CGA) logistics actions
identified in the MEO.

### Personnel Actions

The Human Resources Division will execute actions necessary to allow the
current organization to be structured to the new MEO and perform CGA.

#### Planning for Implementing the MEO

The implementation of the MEO and performance of the CGA should begin
immediately following notification of the award decision. The fractional
FTE for the MEO and CGA positions are identified in Technical Exhibit
2-001 MEO Staffing Crosswalk. Preliminary planning for the transition to
the MEO may begin anytime prior to this date. The Phase-In Team should
move the current organization to the MEO structure including CGA
responsibilities as soon as practical. Specifically:

-   During the time between the completion of the MEO and the
    announcement of the award, the Phase-In Team is primarily planning
    the efforts associated with personnel actions and any
    training/retraining if necessary.

-   During the planning phase, any new training/retraining requirements
    or opportunities should be identified, but should not begin until
    the first day of the MEO implementation. The objective of these
    training/retraining efforts is aimed at the new MEO personnel if
    required.

-   Plans for any security checks and clearances for any new MEO
    employees and the attendant documentation must be formulated with
    implementation to be completed prior to initiation of execution of
    the RD tasks by the MEO.

-   Fulfill all union bargaining obligations as appropriate.

### Technical/Logistics Actions

A Technical/Logistics sub-team headed by the ATO/Director will be
established to ensure that all actions supporting the MEO implementation
are coordinated with the Human Resources Team.

#### Technical/Logistical Transition Sub-Team Duties

After the award has been made, this Technical/Logistics sub-team will:

-   Establish operating procedures for conducting business during the
    transition period before the MEO is fully operational.

-   Schedule/coordinate any required training for MEO and CGA employees.

-   Determine workload and scheduling of personnel to meet workload
    demands.

-   Ensure all performance standards and productivity is maintained
    throughout the transition phase.

-   Coordinate the orderly disposition of any excess Government
    facilities, material or equipment that will not to be used by the
    MEO.

-   Coordinate the transfer of accountable property between incumbent
    and new Hand Receipt Holders as required.

-   Ensure any modifications and/or relocations are completed.

#### Training

The Phase-In Team Leaders are responsible for planning, executing and
coordinating any training required for MEO employees and the Director.
During the phase-in of the MEO, the Technical/Logistical sub-team will
review the MEO position descriptions and MEO staffing to decide which
positions may need training. Possible formal training courses MEO
personnel might need to attend include:

-   CBORD training.

-   New employee NIH CC orientation.

-   CC Nutrition Department orientation.

-   Kitchen equipment training.

-   Pneumatic tube training.

-   Disability awareness training.

-   Harassment training.

-   Motorized pallet jack/tugger training.

-   Protection of human research subjects training.

-   EEO training.

-   Diversity appreciation and communication training.

-   Customer service training.

-   Ergonomics (slips, trips, falls) training.

-   Age specific competency training.

-   Infection control training.

-   Patient confidentiality and privacy training.

-   Government ethics training.

-   Computer security awareness training.

-   Patient safety training.

-   Fire safety training-area specific.

-   Emergency procedures.

-   Hazard communication training.

-   Material safety data sheet/PPE training.

While formal training is important, informal training is in conjunction
also a useful and cost effective manner to ensure personnel can complete
their tasks within the performance standards defined in the RD. TE-5001
provides a more comprehensive description of the government provided
training.

#### Transfer of Accountable Property

The Phase-In Team lead shall designate an individual or individuals to
act as Property Managers on the Technical/Logistical sub-team and assist
in transitioning accountable property is required. The
Technical/Logistical sub-team will create a schedule for this transition
of property and will verify that all property transfers are completed by
the effective date of MEO implementation.

### Letter of Obligation

Pursuant to OMB Circular A-76, in the case of a Government Performance
Decision, the Agency must execute a Letter of Obligation with an
official responsible for the MEO performing the work in the RD. The
Circular specifies that the "Contracting Officer" have cognizance for
this action. Typically, "official responsible for performing the work"
is the Agency Tender Official or the PO identified and placed by the
Contracting Officer.

The Letter of Obligation is a formal agreement between the MEO and the
agency regarding the performance of work studied and competed. It
advises the MEO of the government's performance expectations and how
that performance will be monitored. It also makes the MEO aware of OMB
Circular A-76, Attachment B, Section E, **which clearly defines the Post
Competition Accountability requirements** that are applicable to the MEO
and the ramifications pertaining thereto for failure to perform.
Execution of this agreement is a critical step in the final phase of MEO
implementation.

### Timeline

An integrated Phase-In Timeline is presented in Technical Exhibit 5-001.
This timeline includes the major milestones necessary to transition to
the MEO. Specialized training of personnel, are independent and are
shown only in their relationship to the overall timing.

## Utilities and Any Other Services And Costs To Be Transferred

Any changes with regard to the use of utilities, to include changing any
accounts or payment requirements, or for any other cost transference,
should be performed, as appropriate, in the event of the award being won
by the MEO or a Private Service Provider. In addition, the Phase-In Team
shall:

-   Ensure the timely reassignment of telephone numbers and LAN access
    to the MEO.

-   Ensure the telephone number changes are incorporated in the next
    scheduled change to the NIH directory.

## Indicators Of Successful Transition

The following indicators will serve as measures of how well the current
organization transitioned to the MEO:

-   Was any initial disruption of the performance-based work output kept
    to a minimum and eliminated within a reasonable period of time?

-   Has the installation of the MEO and their initiation of RD tasks
    been implemented on schedule?

-   Is the MEO cost at or below the ACE?

-   Customer Feedback:

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-   Has an initial, baseline customer satisfaction survey been
    conducted?

-   Has an "after-MEO implementation" customer survey been conducted?

-   Has customer satisfaction, at the end of the transition period, been
    maintained, degraded, or improved?

```{=html}
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```
-   Is the quality level of work at the acceptable quality level
    designated in the RD Quality and Timeliness Standards?

-   Is the work output volume at the level designated in the RD
    (assuming customer demand is at those levels)? Has an output surge
    capability been planned or demonstrated?

-   Has the MEO been fully complied with?

    Technical Exhibit 5-001 Food Services Government --Provided Training

+----------------+----------+-----------+-------------+---------------+
| ***Training*** | ***Freq  | *         | ***         | ***Staff To   |
|                | uency*** | **Documen | Schedule*** | Attend***     |
|                |          | tation*** |             |               |
+================+==========+===========+=============+===============+
| New Employee   | Once     | Check     | Start of    | All Service   |
| NIH CC         |          | List      | Employment  | Provider      |
| Orientation    |          |           |             | Staff         |
|                |          |           |             |               |
| -   Patient    |          |           |             |               |
|     C          |          |           |             |               |
| onfidentiality |          |           |             |               |
|                |          |           |             |               |
| -   Ethics     |          |           |             |               |
|                |          |           |             |               |
| -   Diversity  |          |           |             |               |
|                |          |           |             |               |
|   Appreciation |          |           |             |               |
|     &          |          |           |             |               |
|                |          |           |             |               |
|  Communication |          |           |             |               |
|                |          |           |             |               |
| -   Patient    |          |           |             |               |
|     Safety     |          |           |             |               |
|                |          |           |             |               |
| -   Emergency  |          |           |             |               |
|     Procedures |          |           |             |               |
|                |          |           |             |               |
| -   Customer   |          |           |             |               |
|     Service    |          |           |             |               |
|                |          |           |             |               |
| -   Infection  |          |           |             |               |
|     Control    |          |           |             |               |
|                |          |           |             |               |
| -   Universal  |          |           |             |               |
|                |          |           |             |               |
|    Precautions |          |           |             |               |
|                |          |           |             |               |
| -              |          |           |             |               |
+----------------+----------+-----------+-------------+---------------+
| Nutrition      | Once     | Check     | Start of    | Train the     |
| Department     |          | List      | Employment  | Trainer \*    |
| Orientation    |          |           |             |               |
|                |          |           |             | (That one     |
|                |          |           |             | staff would   |
|                |          |           |             | then train    |
|                |          |           |             | the rest of   |
|                |          |           |             | the Service   |
|                |          |           |             | Provider      |
|                |          |           |             | Employees)    |
+----------------+----------+-----------+-------------+---------------+
| Kitchen        | Once     | Check     | Start of    | Train the     |
| Equipment      |          | List      | Employment  | Trainer       |
| Training       |          |           |             |               |
|                |          |           |             | (That one     |
|                |          |           |             | staff would   |
|                |          |           |             | then train    |
|                |          |           |             | the rest of   |
|                |          |           |             | the Service   |
|                |          |           |             | Provider      |
|                |          |           |             | Employees     |
|                |          |           |             | utilizing the |
|                |          |           |             | equipment)    |
+----------------+----------+-----------+-------------+---------------+
| CBORD Training | Once     | C         | Start of    | Train the     |
|                |          | ompetency | Employment  | Trainer       |
|                |          | A         |             |               |
|                |          | ssessment |             | (That one     |
|                |          |           |             | staff would   |
|                |          |           |             | then train    |
|                |          |           |             | the rest of   |
|                |          |           |             | the Service   |
|                |          |           |             | Provider      |
|                |          |           |             | Employees     |
|                |          |           |             | utilizing     |
|                |          |           |             | CBORD)        |
+----------------+----------+-----------+-------------+---------------+
| Pneumatic Tube | Once     | Sign      | Start of    | Train the     |
| Training       |          | Review    | Employment  | Trainer       |
|                |          | Statement |             |               |
|                |          |           |             | (That one     |
|                |          |           |             | staff would   |
|                |          |           |             | then train    |
|                |          |           |             | the rest of   |
|                |          |           |             | the Service   |
|                |          |           |             | Provider      |
|                |          |           |             | Employees     |
|                |          |           |             | utilizing the |
|                |          |           |             | tube system)  |
+----------------+----------+-----------+-------------+---------------+
| Disability     | Once     | Ce        | Start of    | All Service   |
| Awareness      |          | rtificate | Employment  | Provider      |
| Training       |          |           |             | Staff         |
+----------------+----------+-----------+-------------+---------------+
| Harassment     | Once     | Ce        | Start of    | All Service   |
| Training       |          | rtificate | Employment  | Provider      |
|                |          |           |             | Staff         |
+----------------+----------+-----------+-------------+---------------+
| Motorized      | Once     | Ce        | Start of    | All Service   |
| Pallet Jack /  |          | rtificate | Employment  | Provider      |
| Tugger         |          |           |             | Staff Working |
| Training       |          |           |             | with the      |
|                |          |           |             | Pallet Jack   |
|                |          |           |             | and Tugger    |
+----------------+----------+-----------+-------------+---------------+
| EEO Training   | Once     | Ce        | Start of    | All Service   |
|                |          | rtificate | Employment  | Provider      |
|                |          |           |             | Staff         |
+----------------+----------+-----------+-------------+---------------+
| Diversity      | Every 3  | Ce        | Start of    | All Service   |
| Appreciation   | Years    | rtificate | Employment  | Provider      |
| and            |          |           | -- then     | Staff         |
| Communication  |          |           | every 3     |               |
| Training       |          |           | years       |               |
+----------------+----------+-----------+-------------+---------------+
| Customer       | Every 3  | Pe        | Start of    | All Service   |
| Service        | Years    | rformance | Employment  | Provider      |
| Training       |          |           | -- then     | Staff         |
|                |          |           | every 3     |               |
|                |          |           | years       |               |
+----------------+----------+-----------+-------------+---------------+
| Ergonomics     | Annual   | Ce        | Once within | All Service   |
| (Slips, Trips, |          | rtificate | the         | Provider      |
| Falls)         |          |           | Calendar    | Staff         |
| Training       |          |           | Year        |               |
+----------------+----------+-----------+-------------+---------------+
| Age Specific   | Annual   | Ce        | Once within | Designated    |
| Competency     |          | rtificate | the         | Service       |
| Training       |          |           | Calendar    | Provider      |
|                |          |           | Year        | Staff         |
+----------------+----------+-----------+-------------+---------------+
| Infection      | Annual   | Ce        | Once within | All Service   |
| Control        |          | rtificate | the         | Provider      |
| Training       |          |           | Calendar    | Staff         |
|                |          |           | Year        |               |
+----------------+----------+-----------+-------------+---------------+
| Patient        | Annual   | Ce        | Once within | All Service   |
| C              |          | rtificate | the         | Provider      |
| onfidentiality |          |           | Calendar    | Staff         |
| and Privacy    |          |           | Year        |               |
+----------------+----------+-----------+-------------+---------------+
| Government     | Annual   | Ce        | Once within | All Service   |
| Ethics         |          | rtificate | the         | Provider      |
| Training       |          |           | Calendar    | Staff         |
|                |          |           | Year        |               |
+----------------+----------+-----------+-------------+---------------+
| Computer       | Annual   | Ce        | Once within | All Service   |
| Security       |          | rtificate | the         | Provider      |
| Awareness      |          |           | Calendar    | Staff         |
| Training       |          |           | Year        |               |
+----------------+----------+-----------+-------------+---------------+
| Patient Safety | Annual   | Ce        | Once within | All Service   |
| Training       |          | rtificate | the         | Provider      |
|                |          |           | Calendar    | Staff         |
|                |          |           | Year        |               |
+----------------+----------+-----------+-------------+---------------+
| Fire Safety    | Annual   | Ce        | Once within | All Service   |
| Training --    |          | rtificate | the         | Provider      |
| Area Specific  |          |           | Calendar    | Staff         |
|                |          |           | Year        |               |
+----------------+----------+-----------+-------------+---------------+
| Emergency      | Annual   | Ce        | Once within | All Service   |
| Procedures     |          | rtificate | the         | Provider      |
| Training       |          |           | Calendar    | Staff         |
|                |          |           | Year        |               |
+----------------+----------+-----------+-------------+---------------+
| Hazard         | Annual   | Ce        | Once within | All Service   |
| Communications |          | rtificate | the         | Provider      |
| Training       |          |           | Calendar    | Staff         |
|                |          |           | Year        |               |
+----------------+----------+-----------+-------------+---------------+
| Material       | Annual   | Ce        | Once within | Train the     |
| Safety Data    |          | rtificate | the         | Trainer       |
| Sheet / PPE    |          |           | Calendar    |               |
| Training       |          |           | Year        | (That one     |
|                |          |           |             | staff would   |
|                |          |           |             | then train    |
|                |          |           |             | the rest of   |
|                |          |           |             | the Service   |
|                |          |           |             | Provider      |
|                |          |           |             | Employees     |
|                |          |           |             | working in    |
|                |          |           |             | the kitchen)  |
+----------------+----------+-----------+-------------+---------------+
| NIH            | At start | Check     | As Needed   | Train the     |
| Spec           | of the   | List      |             | Trainer       |
| ific/metabolic | contract |           |             |               |
| Diets -        | and when |           |             | (That one     |
| Metabolic      | new      |           |             | staff would   |
| Kitchen        | diets or |           |             | then train    |
|                | p        |           |             | the rest of   |
|                | rotocols |           |             | the Service   |
|                | take     |           |             | Provider      |
|                | effect   |           |             | Employees)    |
+----------------+----------+-----------+-------------+---------------+
| Clinical       | Once     | Check     | Start of    | All Service   |
| Research       |          | List      | Employment  | Provider      |
| Information    |          |           |             | Staff that    |
| System (CRIS)  |          |           |             | utilize CRIS  |
| -- Clinical    |          |           |             |               |
| Center         |          |           |             |               |
| Training       |          |           |             |               |
+----------------+----------+-----------+-------------+---------------+
| Clinical       | As       | Check     | Start of    | Train the     |
| Research       | Needed   | List      | Employment; | Trainer       |
| Information    | -- when  |           |             |               |
| System (CRIS)  | new      |           | As Needed   | (That one     |
| -- Nutrition   | diets    |           |             | staff would   |
| Specific       | take     |           |             | then train    |
| Training       | effect   |           |             | the rest of   |
|                |          |           |             | the Service   |
|                |          |           |             | Provider      |
|                |          |           |             | Employees     |
|                |          |           |             | utilizing     |
|                |          |           |             | CRIS)         |
+----------------+----------+-----------+-------------+---------------+
| Therapeutic    | Once     | Check     | Start of    | Train the     |
| Nutrition      |          | List      | Employment  | trainer       |
|                |          |           |             |               |
| Specific to    |          |           |             | (That one     |
| NIH diets and  |          |           |             | staff would   |
| protocol diets |          |           |             | then train    |
|                |          |           |             | the rest of   |
|                |          |           |             | the Service   |
|                |          |           |             | Provider      |
|                |          |           |             | Employees)    |
+----------------+----------+-----------+-------------+---------------+

Train the Trainer Sessions -- These are sessions in which one staff
would attend the Government provided training and then return and train
the appropriate staff.

***NOTE:*** Initial trainings will be provided by the Government;
however, recurring training sessions shall be provided by the Service
Provider.

Technical Exhibit 5-002 Integrated Phase-In Timeline

  -------------- --------------------------------------------------------
  **Date**       **Event**

  D-Day          Decision Day (D-Day)

  D-Day          Establish the Phase-In Team and sub-teams

  D-Day          Conduct Preliminary Phase-In Planning

  D-Day + 2      Notify Employees of performance decision

  D-Day + 2      Announce Decision via FedBizOpps

  D-Day + 3      Commence Transition Period

  D-Day + 3      Develop Letter of Obligation

  D-Day + 5      Review MEO and Analyze Impact (Management)

  D-Day + 9      Sign Letter of Obligation

  D-Day + 31     Begin Formal Phase-In of MEO/CGA

  D-Day +        Ensure all performance standards and productivity are
  Performance    maintained throughout transition phase
  Period         

  D-Day +        Begin training/re-training for Government MEO

  D-Day +        Conduct/obtain training for QA positions in CGA

  D-Day +        Conduct orientation/cross-training for IG/Retained Tasks

  D-Day +        Implement QASP oversight by CGA

  D-Day + 50-60  Implement MEO
  -------------- --------------------------------------------------------

# Agency Cost Estimate

While an integral part of the MEO, the Agency Cost Estimate is an
entirely severable document that must be kept sealed until the time of
the cost comparison. It is therefore not embedded within the text of
this document, but is referenced for continuity and completeness of the
MEO documentation.

**Attachments and Technical Exhibits**

![](media/image3.jpeg){width="10.5in" height="7.875in"}