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Home My WebLink AboutGrant Related - BOCC (003)GRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12:00pm on Thursday) REQUESTING DEPARTMENT: BOCC REQUEST SUBMITTED BY: K Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Kal'f I@ Stockton CONFIDENTIAL INFORMATION: ❑YES ®NO DArE:10/14/2026 PHONE:2937 1-KA ❑Agreement / Contract ❑AP Vouchers ❑Appointment / Reappointment ❑ARPA Related ❑ Bids / RFPs / Quotes Award ❑ Bid Opening Scheduled ❑ Boards / Committees ❑ Budget ❑ Computer Related ❑ County Code ❑ Emergency Purchase ❑ Employee Rel. ❑ Facilities Related ❑ Financial ❑ Funds ❑ Hearing ❑ Invoices / Purchase Orders *Grants — Fed/State/County ❑ Leases ❑ MOA / MOU ❑ Minutes ❑ Ordinances ❑ Out of State Travel ❑ Petty Cash ❑ Policies ❑ Proclamations ❑ Request for Purchase ❑ Resolution ❑ Recommendation [:]Professional Serv/Consultant ❑ Support Letter ❑ Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB Reimbursement request from McKay Healthcare on the Strategic Infrastructure Program (SIP) No. 2026-06, Kitchen Expansion for current and future growth, in the amount of $4,060.00 If necessary, was this document reviewed by accounting? ❑ YES ❑ NO 7 N/A If necessary, was this document reviewed by legal? ❑ YES ❑ NO W N/A DATE OF ACTION: 691U12-9:> APPROVE: DENIED ABSTAIN D2: D3; DEFERRED OR CONTINUED TO: WITHDRAWN - 4/23/24 GRANT COUNTY STRATEGIC- INFRASTRUCTURE PROGRAM PROJECT CERTIFICATION This form must be signed and returned, with an invoice, for the approved funding, before reimbursement can be approved by Grant County. SIP Project Proposal Number: 2026-06 SIP Funding Recipient: McKay Healthcare SIP Project Description: Kitchen Expansion for Current/Future Growth 1, the undersigned, do hereby certify under penalty of perjury, that the materials have been famished, the services rendered, and/or the labor performed as described in the project proposal for the above -referenced SIP Project and that I am authorized to authenticate and certify to this claim. I also certify that this claim of L4LO60.00 is just and due and is an unpaid obligation against Grant County. Further, according to the SIP Project Funding Policies, I attest that at the next audit of my entity, this project shall be called to the attention of the Washington State Auditor's Office and an emphasis audit will be requested to assure that these funds were expended toward the project and according to the intent of the proposal. Signature Audra Gutierrez-Ritari Printed Name elk, ato Date Signed Administrator Title Administrator Printed Title Completed, signed original certification and invoice can be mailed to: Grant Administrative Specialist, PO Box 37, Ephrata, WA 98823 or emailed to the Grants Administrative Specialist, Kstockton@grantcountywa.gov Reimbursement #1 in the amount of $ 4 0*00 ATTACHMENT 4 McKAY HEALTHCARE 669 Department of Health 10/07/2026 96467 ,-invoice Number invoice Date escription -------- T--Gross —Amount Discount Taken Net Amount Paid --r D 10072026 10/07/2026 Construction Review Application $4t660.00 $0,00 $4.060.00 -------- - -- - - �u= _, 0.00-1- $0.00 $4,060. 00 1 .... ... .. . McKAY HEALTHCARE US BANK 6041 096467 127 SECOND AVE SW - PO 9OX 819 96-6SI11232 SOAP LAKE, WA 98851 10/07/2026 (509)246-1111 PAY TO THE $ $4,060-00 ORDER OF U0 Four Thousand Sixty Dollars and 00 Cents DOUARS Department of Health PO BOX 1099 Olympia, WA 98507-1099 MEMO 1,66o4 10 9 C34r3W11 1: 123 206S 161: IS 3 2 100 20 L34112 669 Department of Health 10/07/2026 - -- - ----- 96467 Yr�»» GrossAn�unfj Discount Taken' Net Amount Paid Invoice Number :Invoice Date Description [�-0072026 10/07/2026 Construction Review Application $4,060.00 $0.00 $4t06O.00 If _�, jW00C $41060.00-' $0.001 $4,060-0 October 7, 2026 Depm-tment of Health P.O. Box t099 Olympia, WA 98507-1099 Re: Project Title: Kitchen renovation Facility Name:: McKay Healthcare and Rehabilitation Center (McKay Healthcare) Owner: Public Hospital District No. 4 of Grant County, Washington Dear Construction Review staff and professionals: Introduction. Enclosed please find our application and check for the plan review fee in the amount of $4,060 based on WAC 246-314-990. A project cost estimate is based in part on third -party cost estimator at MACC, LLC. We will await instructions for uploading drawings and related documents concerning resident protection measures during construction. Attachments to be filed clectronicaltv, A six (6) drawing set consisting of architectural, structural, structural calculations, mechanical, electrical and plumbing aspects of this project including C) C� construction notes. Three (3) resident protection level documents identified by management include: Infection Control and Risk Assessment KRA ), Interim Life Safety Measures (IL ), and Functional Program (FP) documents. Brief Proiect Descri, ton. The scope of work described in the drawings in more detail includes: 1) modification of a salon area and storage room adjacent to the kitchen to improve workflow and facilitate serving to the main dining area for residents and access to future serving corridor that is fully designed (hereafter referred to as the Serving Area): and 2) a new steel doorway frame and doorway cut from the Serving Area to the Kitchen (see structural drawings) fitted with an automatic closing; feature tied to the fire alarm system. The new Serving Area includes relocation of a wall and corresponding reduction in size of the salon area, removal of storage cabinets, relocation of a door to the main dining area, and a reconflorured ceiling. Lastly, this project micludes wiring, electrical outlets, and more efficient LED lighting, tr g a0 BOX 819 Sol p LAKIC WA 93851 'J 110) 9 2) A 6 111 MCXJ rA 00C_ Current old cart oath to dining New Serving area - Fi I Resident 1 . . . . . 6-u! dining I . -- ----------- Future serving corridor to new facility The new doorway to the Serving Area will greatly aid staff in cutting down the time and resources C7 C� needed tocet hot meals to residents. This modification will also make possible food delivery when C� new facilities currently designed and awaiting funding are actually constructed. 0 Z� Kitchen Area. Except for the new door -way, no physical changes are proposed within the kitchen area except: 1) existing fixed wooden cabinets will be replaced with more efficient mobile stainless steel storage; 22) affected surface areas will be finished and repainted to match existing t__ surface finishes; 3) more energy efficient LED lighting will be installed with dinuner and C� Z-15 automatic shut off controls. A list of equipment is included for future in -kind replacement as needed but is not part of the current project. Fire & HVAC Support. The facility as it exists now and as proposed is fully protected by an automatic sprinkler system, and no chancres are envisioned. Mechanical ventilation is existing xistina in all areas involved,, and no changes are anticipated. The existing- adjacent rooms have both conditioned air supply and exhaust ducting which will remain. Preliminary Ficld vcrification indicates that no chancres in the location of existing ventilation is anticipated, however. contractors will be required to field verify existing conditions and relocate as needed. Plumbing. The contractor will demo existing? Area., salvage sink and casework in the Salon or replace existing plumbing connections and angle stop valves for reuse. A new wall mount hand sink and carrier is included in the Serving Area. Contractor will connect existing cold and hot water supply lines and existing waste & vent connections. Contractor to field verify. Please acknowledge receipt at your early convenience and provide VOUr instructions for uptoading files to the common Box filing systern. Thank you. I .' 20 50,X 3119 SOAP LAKE, WA 98851 (539) 246-!111 WWOV MC'XAYPIiILTWCiQi OQG Sincerely, Cliff Sears Project 'Manager C� esears@nwi.net (5509) 398-7234 eG 8OX 8)? iOA) WA 98851 (5 0 9) 2 1 A Y A T H C A *W*A" SW �smva 14e JJPHealth Construcfion Review Services 360-236-2944 http:1JWww.doh-wa.gov1C5.-W Construction Review �ppllcation Packet N Contents: 1. 505-047... Construction Review Application Index Page ............................ 1 Page 2. 505-118 ... Construction Review Application Fee Information .....................1 Page 3. 505-048 ... Construction Review Application Checklist and Instructions ... 3 Pages 4. 505-046... Construction Review Application ............................................. 3 Pages Important [nforEnation: Incomplete applications will be returned without review. In order to process your request you must submit the following: 1. Application and Fee Mail your completed application and your check or money order payable to: Department of Health P.O. Box 1099 Olympia, WA 98507-1099 2. Drawings / Supporting documents • Hard Copy Submittals: Send two copies of the drawings and one copy of all other documents to: Department of Health Construction Review Services 111 Israel Rd SE MS 47852 Tumwater, WA 98501 • Electronic Submittals: Login and upload instructions will be provided via email after your application has been processed. DOH 505-047 September 2015 RAft AP& ... lnformation: Every application must be submitted with the appropriate fee based on the following services. Construction review fees are outlined in WAC 246-314,990. In the "Project Type" box in the upper right corner, identify the appropriate type of review based on the following choices. Please contact our office at 360-236-2944 if you have any questions. ® Plan Review —Check this box if the project is either: New Construction or alterations/Renovation: Fees are based on the initial project cost, which includes all costs directly associated with the project. See page two of this application. Building Conversion: A conversion is an existing non -licensed facility wishing to be licensed. Fees are based on the value of existing construction (per sf). ❑ Installation of Finishes only Review—$150 flat fee. These projects require no physical modifications and include the installation of finishes such as carpet, vinyl wall covering, wallpaper, exterior siding, or paneling applied to an existing surface as the exposed surface. ❑ Technical Assistance - $500 flat fee. [❑ Mobile Unit Review / Mobile Unit Site Review—$575 flat fee for first submission and $285 for each additional submission. A separate application is required for the review of the mobile unit, and the site installation of that mobile unit. F-1 Change of Approved Use Review—$150 -flat fee. Change of use is a change in the function of a room that does not alter the physical elements and construction is not required to meet the regulations for the intended use (i.e. patient room to office). The facility must be currently licensed. Note: If you checked the wrong box and submit an incorrect fee, you may receive a deficient fee statement or refund. DOH 505-047 September 2015 Construction Review Services 360-236-29 4 httP,:11www.doh,wa-g2.v/cra Application Checklist and Instructions ❑ Please indicate if you have previously submitted an application for the scope of work defined by the project. Examples include.- technical assistance projects that have become real projects or projects where the scope has significantly changed. Section #1: Demographic Information: Owner/Operator Information Legal Owner/Operator Name: Enter the owner's name as it appears on the UBI/ Master Business License. Z Mailing Address: Enter the legal owner/operator's complete mailing address. Z Uniform Business Identifier Number (UBI #): Enter your Washington State UBI #. All Washington State businesses must have UBI #'s- City, county, and state government departments also have U131 #'s. M Phone: Enter the owner/operator's phone. Email and Web Address: Enter the owner/operator's email and Web address, if applicable. Facility Information Facility Name: Enter the facility's name as advertised on signs or website. The facility name should match the name given to the Department in previous applications, and should be the same as indicated on the facility license (if currently licensed). Site Address: Enter the facility's physical street location of the location where the construction or renovation will occur including city, state, zip and county. Be sure to include a suite number, if you have one. Phone: Enter the facility's phone number. DOH 505-048 September 2015 Page 2 of 3 Application Checklist and Instructions (continued) Section #2: Project/Facility Details: Type of Facility: Check the most appropriate type of facility/license. If your facility has multiple licenses, a separate application must be submitted for each license type. Enhanced services, residential treatment, and assisted living facilities provide different types of services. Check the applicable boxes for the type of services planned. For example, assisted living facilities may provide contract services such as: ALS—Assisted Living Services EARC/EARC-SDCP—Enhanced Adult Residential Care (Specialized Dementia Care Program) ARC Adult Residential Care Creation of new license: If this project creates a newly licensed facility, check the box next to "creates a new license". If this project amends a license, such as renovating licensed space or adding a new building to an existing license, check the box next to it 11 amends a current license , I� Change in bed capacity: Determine if the 24 hour stay bed capacity is changed by this project. Check the most appropriate box. Ili Estimated Date of Construction Completion: Enter the estimated date in which the construction will be completed. Igl Projects that correct citations: Check yes if this project was created to correct a deficiency or correction cited in a state inspection or federal survey. Additional details: If you are not sure about an item, please leave it blank. • IBC construction type and occupancy group: Provide the classification as defined by International Building Code. Fire alarm system provided: Check yes if there is an interconnected system of fire alarm devices in the building. • Fire sprinkler system provided: Check yes if there is an automatic fire sprinkler system in any or all of the buildings. Building permit jurisdiction: Fill in the name of the building department that you would get a permit from for this project, if one were required. Section #3: Project Cost Estimate: Enter the estimated cost for new construction and alterations/renovations on the appropriate lines. Project cost shall include the cost of all project -related costs except taxes; architectural or engineering fees; and land acquisition fees. Certain equipment costs may be waived from being included in the construction cost upon the approval of CRS. A request shall be made to CRS in writing before the approval can be granted. Mee calculafor is available for your use. For Building Conversions, enter the total square feet of the area to be reviewed. To determine the value of the building, multiply the total square feet by the cost per square foot data found on our website. You do not use this section for any flat fees. DOH 505-048 September 2015 Page 2 of 3 Application Checklist and Instructions (continued) Section #4: Project Description: Project Title: The project title should identify the work to be performed, will remain the same throughout the project, and should be a limited number of characters. All submissions shall be identified by the facility name and project title. Project title examples: Proposed boarding home, lobby renovation, change office to resident room. Z Project Description: Enter a brief project description. For renovations, include the location Within the facility where the renovation will occur (e.g., third floor, west wing, etc.). Section #5: Project Communications: Provide contact information for those individuals that you want to be copied on project correspondence. CRS will email review comments to each individual listed. Facility Administrator: Enter the administrator name, phone number, and email address. Acceptable alternates to the administrator include the CEO, CFO, or COO. Facility Contact: Enter the contact name, phone number and email address. Provide a cell phone number if available. This should be a designated representative of the facility who can make broad decisions about the project and facility operation, not the design professional in charge of the project. Design Professional in Charge: Enter the firm's name, main contact, address, phone, cell, and email address. Additional Contacts: Enter additional project contacts that would be helpful during the review of this project. This can include engineers, contractors, and project managers. We strongly recommend listing the mechanical, electrical, and plumbing engineers. 0 Section #6: Document Delivery Method: Choose delivery method: Projects can be submitted one of two different ways: Hard copy submissions require delivery of two paper copies of the stamped and signed drawings. Electronic submissions require upload of PDF files to the department's secure file transfer (SFT) site. You must pick one method that will remain consistent for the duration of the project. F-1 Hard copy delivery contact: If you choose the hard copy method, provide the contact details for where the approved copies of the paper drawings will be delivered. This person is also responsible for ensuring the drawings are delivered to and maintained at the project site. Electronic data manager: If you choose the electronic method, provide the contact details for the person who will be responsible for maintaining the password for the secure file transfer site. This person is also responsible for ensuring the drawings are sent to and maintained at the project site. Z Signature: Signature of legal owner or authorized representative. Date signed. Print name and title of legal owner or authorized representative DOH 505-048 September 2015 Page 3 of 3 This page intentionally left blank. DOH 505-048 September 2015 Page 3 of 3 He th Send application with fees to: Department of Health P.O. Box 1099 Olympia, WA 98507-1099 Deliver hard copy drawings and project materials to: Construction Review Services 111 Israel Rd SE P.O. Box 47852 Turnwater, WA 98501 360-236-2944 http:11www.doh .wa_._qov/cors Please Check One: ® Plan Review ❑ Finish only ❑ Technical Assistance r_1 Mobile Unit or Mobile Unit Site 1-1 Chanae of Approved Use Only Revenue:0597633200 Aaft Construction Review .011cation LI-ve yogubmitted an application for this project before (e.g. an application for technical assistance)? ff Yes No If yes, provide the CRS project number 1. Demo he Infates .,y,- n�_.r.1_ :�.� r�..k.._u. Owner torinto Ion Legal Owner/Operator Name Public Hospital District No. 4 of Grant County, Washington Mailing Address P.O. Box 819 - - -- - - ---------- - ---- City Soap Lake State WA Zip Code 98851 County Grant UB1 # Secretary of State #) 601-155-810 Phone (enter 10 digit#) (509) 246-1111 J Email address audra@mckayhealthcare.org Web Address www.mckayhealthcare.org Each 19111%111 51111latIon x. r Facility Name McKay Healthcare and Rehabilitation Center Site/Physical Address 127 2nd Ave. SW Suite ' City Soap Lake State WA Zip Code 98851 County Grant Facility Contact Phone (enter 10 digit#) FQr DOH Use Applicable Fee-, Fee Received-, Balance Due_ CRS Project No.: DOH 505-048 September 2015 Page 3 of 3 2a P, oJeottracilily DeEa11s_. __.._.;_�._� _ ._,_. �y��_._ _ _ 1 Type of Facility/License: ❑Hospital ❑Psychiatric Hospital M State Facility ❑ Hospital -licensed Outpatient Clinic ❑Child Birth Center El Food Service ❑ Mobile Unit El Hospice Care Center El Correctional Facility El Alcohol & Chemical Dependency Hospital ❑Ambulatory Surgery Facility Nursing Home ❑ Enhanced Services Facility (ESF) ❑ Residential Treatment Facility ❑Assisted Living Facility (Choose One-) (Choose all that apply-.) (Choose contracts, if applicable:) ❑ ESF—Nursing Home R Mental R ALS R ESF—Assisted Living 0 Chemical ❑ EARC/EARC-SD ❑ ESF—Adult Family Home i [:1 ARC ❑ Restraint This project (choose one): M Creates a new license amends a current license (adds or renovates a building) This project (choose one): Z does not change bed capacity El adds bed capacity ❑ reduces bed capacity Estimated date of construction completion Does this project correct a citation? April 30, 2027. Yes 0 No If known provide the following: IBC construction type: IBC Occupancy Group: Fire Alarm System Provided? Fire Sprinkler System Provided? 0 Yes F1 No 21 Yes [I No 3. Prtljfl►Ct Cost E iMatQk Fee Calculator (This is not for flat fees list on page one of thi-s—application) New Construction Cost Estimate Alterations/Renovations Building Conversion Fixed installed equipment � Equipment Cost Adjustment* Construction Cost Estimate Total Fee from table (WA C 246-314-990) total square feet of area= _$24010001 is $ 41060 ---------------- Architect Reduction* Less % Previously Licensed Reduction* Less % Adjusted Fee $4,060 *Must be pr e -approved bv DOH Construction Review Services. Attach copy of approval. AL PFUJI -- 'set Description (attach additional pages if necessary) Project Title: McKay Healthcare Kitchen Renovation Description: Instal[ structural support and concrete saw cut new door. Renovate existing storage space into new serving area as shown on the drawings. Update electrial srvice as specified on electrical drawings. Replace built in cabinets with stainless steel movable storage units. (Existing kitchen equipment to remain. McKay will replace as needed - not part of the contractor's scope of work). --- - --------- DOH 505-046 September 2015 Page 2 of 3 COI so PrAec M nk acili(Facility aclminisftatoL, CEO, CFO,,., Fty Name Audra Gutierrez-R itari --- -- ------- - -------- [Phone (509) 246-8038 Email Address audra@m,c,kayhealthcare.org DOH 505-046 September 2015 Page 3 of 3