HCAI, OSHPD panel urges early collaboration and an "inspect to pass" mindset for hospital construction

A webinar hosted by the Department of Health Care Access and Information (HCAI) and the Office of Statewide Health Planning and Development (OSHPD) Hospital Building Safety Board on collaborative inspection approaches urged hospital owners, design professionals, contractors and inspectors to adopt a coordinated, proactive approach to construction inspections.

Michael Davies, a certified hospital inspector and moderator, framed the session around three pillars—code, plan review and field inspection—and said the field inspection is where theoretical compliance becomes validated. "Inspect to pass is the mental attitude with which you approach your inspection duties," Davies said, adding that the phrase is intended to emphasize collaboration, transparent communication and proactivity, not to give contractors "a free pass."

Gary Dunker, speaking from an owner’s perspective, emphasized owner responsibility and cited the legal basis for inspection: "The California Health and Safety Code says the hospital governing board or authority shall provide for and require competent and adequate inspection during construction," he said, describing inspection as a legal, not optional, obligation. Dunker urged owners to stay involved, set quality standards, hire competent inspection teams and allocate administrative and technological resources to support inspections.

Belinda Young, senior principal and healthcare regional leader at HOK Architecture, urged early engagement of trade partners and IORs in design to reduce last-minute ACDs and NMAs that lead to costly change orders. "When you bring in HCAI, IORs, contractor, and trade partners early in the design process, you can review proposed details prior to plan review," she said.

From the contractor’s vantage, Cody Bartley of DPR Construction urged a layered quality-control approach beginning in preconstruction, recommending mock-ups and project-specific checklists. "We would like to pass 100% of inspections the first time," Bartley said, noting that aligning subcontractors and IOR expectations early reduces rework, schedule disruption and safety incidents.

Panelists explained inspection types required under Title 24—continuous inspection (ongoing IOR presence), periodic inspection (inspection-request driven), and TIO (test, inspection and observation) activities that often must occur as elements are installed. The speakers highlighted practical steps: read specs early, review submittals, hold preinstallation meetings, walk projects frequently, inspect mock-ups, and prepare closeout documentation from day one.

Monica Colosi of HCAI described the agency’s support role: monitoring IOR performance, offering voluntary training and a Construction Administration Proficiency (CAP) program, issuing templates such as a voluntary IOR daily report, and publishing "tip of the day" guidance. She said CAP certification is currently based on the 2022 code cycle and the program will transition to the 2025 code in the next cycle; webinars and exams are offered annually.

In Q&A, speakers addressed common concerns: HVAC misalignment often causes change orders; early trade involvement and sample lab reports can reduce surprises on TIO approvals; and Title 24 requires continuous inspection duties for IORs, meaning inspectors should raise issues they observe while walking a site rather than wait for a formal inspection request. The presenters encouraged open, tactful communication and emphasized that inspections should not be "weaponized" to settle disputes.

The webinar lasted about 90 minutes; materials including a handout were provided in the GoToWebinar handout tab. Attendees were told that certificates of completion and answers to unanswered questions would be sent to registered participants via hbsbsupportstaff@hcai.ca.gov. The panel closed by urging project teams to prioritize early coordination, robust QC, and routine, documented inspection practices to keep hospitals safe and on schedule.