HCAI (OSHPD) plan review: check a healthcare set before you submit

Hospital review is strict because the law expects hospitals to keep working after an earthquake. The Alfred E. Alquist Hospital Facilities Seismic Safety Act of 1983 followed the collapse of hospitals in the 1971 Sylmar earthquake, according to HCAI's seismic program overview. It requires hospital buildings to be designed and built to resist earthquake forces as far as practical, and it preempts local jurisdictions from enforcing building standards on hospital buildings. That is why the state, not the city, reviews them.

SB 1953 (1994) added deadlines for existing buildings. Under HCAI's seismic safety rules, buildings rated SPC 2 must stop providing general acute care services by January 1, 2030. For a hospital working toward that date, every extra review round uses time it may not have.

HCAI describes the standard path on its project process page and its plan review processes and goals page:

1. Create the project in the eServices Portal and upload the construction documents within ten days.
2. Triage. Each submittal is logged and triaged within five days to decide whether it is complete. It is taken in for full review, expedited, handled over the counter if it is small, or returned as incomplete.
3. Plan review. Reviewers issue comments by discipline.
4. Backcheck. You resubmit all previously remarked documents with a complete written response to each comment.
5. Approval comes when every comment is resolved and HCAI has the stamped construction documents.
6. Construction. Building permit, an Inspector of Record running the testing, inspection, and observation program, an HCAI compliance officer, and post-approval documents such as amended construction documents and deferred submittals.
7. Closure, run by the design professional of record, with final verified compliance reports and a final cost affidavit.

Large projects can use Integrated Review instead, which replaced Phased Plan Review and Collaborative Review. Under PIN 50 it requires a presubmittal meeting for projects of $20 million and over, and HCAI credits it with cutting the time to first approval by up to six months.

HCAI does not publish a ranked list of its most frequent comments. It does say what slows approval, and it publishes the items it checks at triage.

What HCAI says slows approval (plan review processes and goals): "incomplete submittals, missing information, not responding to all comments on plans before submitting for backcheck, unusually complex projects, quality of design."

What the structural triage list looks for (2025 structural triage reminder list):

• Design data on the drawings, per 1603A
• The list of components that need special seismic certification, per 1705A.14.3
• A deferred submittal list
• The HCAI project number on the documents
• Calculations that are substantially complete, with an index and design basis
• A completed testing, inspection, and observation (TIO) form
• The site data report, submitted early

What gets an electronic submittal sent back (electronic submittal requirements): sheets in the wrong orientation, sheet numbers longer than ten characters, password-protected or locked files, and sheets without a clear space of about 3 by 4 inches for the HCAI stamp in the same place on every sheet.

Many of these are coordination problems, not design problems: a sheet number that doesn't match the index, a deferred item listed in one place and missing from another, a schedule that disagrees with the plan it describes.

1. Confirm the class (OSHPD 1, 1R, 2, 3, 4, 5, or 6) and who reviews it. For OSHPD 3 clinics, check whether the local building official or HCAI will review.
2. Download the current reminder lists for your class and each discipline from HCAI's forms, applications, and reminder lists page, and walk the set against them.
3. Check that every sheet in the index exists, with the same number and title, and that no sheet number is longer than ten characters.
4. Check that every detail and section callout points to a real detail on a real sheet.
5. Compare door, room, equipment, and finish schedules with the plans that tag them.
6. Put structural design data on the drawings, list the components that need seismic certification, and attach a completed TIO form.
7. List every deferred submittal in one place, and make sure the drawings refer to the same list.
8. Include calculations with an index and design basis, and submit the site data report early.
9. Flatten and unlock the PDFs, orient every sheet correctly, and leave the same stamp space on every sheet.
10. At backcheck, resubmit every remarked sheet and answer every comment in writing, even the ones you disagree with. See how to respond to plan check comments.

For accessibility items, the accessibility plan review checklist covers the plan checks that apply to most projects.