29
As submitted to California's Office of Statewide Health Planning and Development in accordance with Senate Bill 499 (SB 499) requirement for all general acute care hospitals with Structural Performance Category 1 (SPC-1) buildings to report annually with seismic safety compliance status, beds and services. Senate Bill 499 (SB 499) Hospital Report Office of Statewide Health Planning and Development Facilities Development Division Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact 2 e-mail Address: Contact 3 e-mail Address:: Name of Submitter: Submission Date: 11672 Glendora Community Hospital 150 W. Route 66 Glendora East Valley Glendora Hospital LP 2017 [Confidential data left blank intentionally.] [Confidential data left blank intentionally.] Brad Hawn 10/18/2017 1:45:29 PM Provide the Hospital Owner and Year of Report per Section 130061(e) [Confidential data left blank intentionally.] OSHPD FDD SB499 Report 10/20/2017 6:30 AM Data Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

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Page 1: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

As submitted to California's Office of Statewide Health Planning and Development in accordance with Senate Bill 499 (SB 499) requirement for all general acute care hospitals with Structural Performance Category 1 (SPC-1) buildings to report annually with seismic safety compliance status, beds and services.

Senate Bill 499 (SB 499) Hospital ReportOffice of Statewide Health Planning and DevelopmentFacilities Development Division

Facility Number:

Hospital Owner/Licensee:

City:

Address:

Facility Name:

Year of Reporting:

Contact 1 e-mail Address:

Contact 2 e-mail Address:

Contact 3 e-mail Address::

Name of Submitter:

Submission Date:

11672

Glendora Community Hospital

150 W. Route 66

Glendora

East Valley Glendora Hospital LP

2017

[Confidential data left blank intentionally.]

[Confidential data left blank intentionally.]

Brad Hawn

10/18/2017 1:45:29 PM

Provide the Hospital Owner and Year of Report per Section 130061(e)

[Confidential data left blank intentionally.]

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

Page 2: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

For buildings For buildings which are planned for rebuild, retrofit or replacement this report shall identify; Whether the hospital owner intends to rebuild, retrofit or replace the building to SPC2, SPC3, SPC4, SPC4D or SPC5 per 130061(c)(1)(A). The deadline, as described in Section 130060 or 130061.5,for rebuild, retrofit or replacement of the building that the hospital owner intends to meet, and the applicable extension for which the hospital owner has been approved per Section 130061(c)(1)(B)

Bldg.No. Building Name Alternate Building Address

Building Resolution

Final SPC RatingIf Required

Extension Date

Anticipated Completion Date

01/01/2020SPC2RetrofitOriginal BuildingBLD-00151

150 W. Route 66 07/01/2019

01/01/2020SPC2RetrofitEmergency BuildingBLD-00152

150 W. Route 66 07/01/2019

01/01/2020SPC2Retrofit1966 Addition - WestBLD-00153

150 W. Route 66 07/01/2019

01/01/2020SPC2Retrofit1966 Addition - EastBLD-03521

150 W. Route 66 07/01/2019

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:2 of 29Report Year:

Page 3: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Original BuildingBuilding No: BLD-00151 No Retrofit/Replacement Project:

11672 H142627-19-00

0 11/12/2014

FIEL No 10/8/2015 12:00:00

AM

07/01/2015

Facility Number

Project Number

Sub Num Scope Date In

Plan Approved Date

Projected Start Date

Projected Completion Date Status

CEQA Review

For each building which is planned for rebuild, retrofit or replacement, provide the project numbers, per Section 130061(c)(1)(C). The projected construction start date or dates and projected Completion date or dates per Section 130061(c)(1)(D) and the most recent project status and approvals per Section 130061(c)(1)(E).

Emergency BuildingBuilding No: BLD-00152 No Retrofit/Replacement Project:

11672 H142627-19-00

0 11/12/2014

FIEL No 10/8/2015 12:00:00

AM

07/01/2015

Facility Number

Project Number

Sub Num Scope Date In

Plan Approved Date

Projected Start Date

Projected Completion Date Status

CEQA Review

For each building which is planned for rebuild, retrofit or replacement, provide the project numbers, per Section 130061(c)(1)(C). The projected construction start date or dates and projected Completion date or dates per Section 130061(c)(1)(D) and the most recent project status and approvals per Section 130061(c)(1)(E).

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:3 of 29Report Year:

Page 4: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

1966 Addition - WestBuilding No: BLD-00153 No Retrofit/Replacement Project:

11672 H142627-19-00

0 11/12/2014

FIEL No 10/8/2015 12:00:00

AM

07/01/2015

Facility Number

Project Number

Sub Num Scope Date In

Plan Approved Date

Projected Start Date

Projected Completion Date Status

CEQA Review

For each building which is planned for rebuild, retrofit or replacement, provide the project numbers, per Section 130061(c)(1)(C). The projected construction start date or dates and projected Completion date or dates per Section 130061(c)(1)(D) and the most recent project status and approvals per Section 130061(c)(1)(E).

1966 Addition - EastBuilding No: BLD-03521 No Retrofit/Replacement Project:

11672 H142627-19-00

0 11/12/2014

FIEL No 10/8/2015 12:00:00

AM

07/01/2015

Facility Number

Project Number

Sub Num Scope Date In

Plan Approved Date

Projected Start Date

Projected Completion Date Status

CEQA Review

For each building which is planned for rebuild, retrofit or replacement, provide the project numbers, per Section 130061(c)(1)(C). The projected construction start date or dates and projected Completion date or dates per Section 130061(c)(1)(D) and the most recent project status and approvals per Section 130061(c)(1)(E).

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:4 of 29Report Year:

Page 5: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

BLD-00151 Original Building

X

X

Nursing

Building Number: Building Name:

IntensiveCare

X

X

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

X

X

X

X X

X

XX

XX

X101

255040

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

10

0

21

30

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

992

0

7099

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

X

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

X ObstetricalCesarean/Deliv

Provide the number of inpatient beds and patient days per type of service per building per Section 130061(c)(1)(F)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:5 of 29Report Year:

Page 6: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

BLD-00152 Emergency Building

X

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

X X

X

X

X

21

133921

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

ObstetricalCesarean/Deliv

Provide the number of inpatient beds and patient days per type of service per building per Section 130061(c)(1)(F)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:6 of 29Report Year:

Page 7: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

BLD-00153 1966 Addition - West

X

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

X

6

3836

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

ObstetricalCesarean/Deliv

Provide the number of inpatient beds and patient days per type of service per building per Section 130061(c)(1)(F)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:7 of 29Report Year:

Page 8: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

BLD-03521 1966 Addition - East

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

X

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

ObstetricalCesarean/Deliv

Provide the number of inpatient beds and patient days per type of service per building per Section 130061(c)(1)(F)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:8 of 29Report Year:

Page 9: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

BLD-00151 Original Building

40 2550

30 0

0 0

5 992

5 0

0 0

0 0

0 0

0 0

0 0 101 101

21 7099

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:9 of 29Report Year:

Page 10: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

BLD-00152 Emergency Building

21 1339

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 21 21

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:10 of 29Report Year:

Page 11: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

BLD-00153 1966 Addition - West

6 383

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 6 6

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:11 of 29Report Year:

Page 12: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

BLD-03521 1966 Addition - East

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:12 of 29Report Year:

Page 13: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

BLD-00151 Original Building Retrofit

BLD-00152 Emergency Building Retrofit

BLD-00153 1966 Addition - West Retrofit

BLD-03521 1966 Addition - East Retrofit

For all buildings at the facility, indicate which ones are scheduled for general acute service removal.

Building Number Building Name

Building to be Removed / Replaced / Rebuilt

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:13 of 29Report Year:

Page 14: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

No proposed new buildings to be constructed at this or another site.

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:14 of 29Report Year:

Page 15: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

No data reported for Section 130061 (c)(2)(A) , (B), or (C)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:15 of 29Report Year:

Page 16: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

No data reported for Section 130061(c)(2)(D).

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:16 of 29Report Year:

Page 17: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

No data reported for Section 130061(c)(2)(D).

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:17 of 29Report Year:

Page 18: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

No data reported for whether the general acute care services and beds will be relocated to a new, existing or retrofitted building and any corresponding building sites or project numbers for buildings with a Building Resolution of "Rebuild" or "Replace" per Section 130061(c)(2)(E).

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:18 of 29Report Year:

Page 19: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

No data reported for Section 130061(c)(3).

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:19 of 29Report Year:

Page 20: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

BLD-00151 Original Building

X

X

X

X

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

X

X

X

X

X

X

X

X

X

X

X

X

X

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any general acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:20 of 29Report Year:

Page 21: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

BLD-00152 Emergency Building

X

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

X

X

X

X

X

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any general acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:21 of 29Report Year:

Page 22: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

BLD-00153 1966 Addition - West

X

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

X

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any general acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:22 of 29Report Year:

Page 23: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

BLD-03521 1966 Addition - East

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

X

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any general acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:23 of 29Report Year:

Page 24: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

BLD-00151 Original Building

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general acute care hospital building per Section 130061(c)(5)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:24 of 29Report Year:

Page 25: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

BLD-00152 Emergency Building

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general acute care hospital building per Section 130061(c)(5)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:25 of 29Report Year:

Page 26: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

BLD-00153 1966 Addition - West

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general acute care hospital building per Section 130061(c)(5)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:26 of 29Report Year:

Page 27: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

BLD-03521 1966 Addition - East

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general acute care hospital building per Section 130061(c)(5)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:27 of 29Report Year:

Page 28: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

No data reported for Section 130061(e)

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:28 of 29Report Year:

Page 29: Office of Statewide Health Senate Bill 499 (SB 499 ......BLD-03521 1966 Addition - East Nursing Building Number: Building Name: IntensiveCare Pediatric/Adol escent Psychiatric Nursing

No data reported for Section 130061(e) .

OSHPD FDD SB499 Report 10/20/2017 6:30 AMData Last Update: 10/18/2017 Submission Date: 10/18/2017 Printed:

116722017 Glendora Community Hospital Glendora Page:29 of 29Report Year: