While all Performance Standards are applicable to this investment, IFCs environmental and social due diligence indicates that the investment will have impacts which must be managed in a manner consistent with the following Performance Standards. If IFCs investment proceeds, IFC will periodically review the the project’s ongoing compliance with the Performance Standards

PS 1 – Assessment and Management of Environmental and Social Risks and Impacts
PS 2 - Labor and working conditions
PS 3 - Resource Efficiency and Pollution Prevention
PS 4 – Community Health, Safety and Security
If IFC’s investment proceeds, IFC will periodically review the the project’s ongoing compliance with the Performance Standards

This project has been classified as a Category B project. Social and environmental issues reviewed during appraisal include: Sala Uno’s Environmental and Social Management System (ESMS) and assessment of the Company''s capacity to manage environmental and social issues during construction/reconditioning, and operation of diagnostic and vision centers; sustainable design for building space and conditioning; operation, including life and fire safety, water, wastewater and waste management as appropriate; management of hazardous materials including bio-hazards; use of sustainable materials and appliances; labor and working conditions, occupational health and safety.

SalaUno’s occupied rented facilities located within the urban area of Mexico City. Projected expansion will not involve land acquisition or involuntary resettlement and thus PS5 does not apply. As there are no biodiversity, indigenous peoples or cultural property in this project, PS6, PS7 and PS8 do not apply.

IFC's appraisal considered the environmental and social management planning process and documentation for the project and gaps, if any, between these and IFCs requirements. Where necessary, corrective measures, intended to close these gaps within a reasonable period of time, are summarized in the paragraphs that follow and (if applicable) in an agreed Environmental and Social Action Plan (ESAP). Through the implementation of these measures, the project is expected to be designed and operated in accordance with Performance Standards objectives.

Policy. As part of its management system the Company has established an overarching policy defining the environmental and social objectives and principles that guide the project to achieve sound environmental and social performance commensurable to its size and characteristics.

Identification of Risks and Impacts. Prior to starting operations SalaUno identified substantive risks and impacts including life and fire safety risks, and potential impacts on the community. Following its assessment, the Company took appropriate action as described below. Local authorities did not require a full environmental and social impact assessment. For each step of the expansion process the Company will systematically review the structural soundness of the building leased for this purpose and undertake improvements as necessary. As part of the Ministry of Health’s certification requirements, as described below, the Company will upgrade the life and fire safety (LFS) system of its current and new installations. The Company will ensure that LFS systems are consistent with international good practice as per the Environmental and Social Action Plan (ESAP).

Management Program

SalaUno, as part of the Mexican Health System, is regulated by the norms and policies of Mexico’s Ministry of Health, which require health institutions to implement a management system focused on stringent quality of service, health and safety, and environmental standards. Beyond these requirements, which are the basis for the Company’s operative and administrative processes, the Company has been constantly creating new strategies to improve process efficiency, patients’ experience and staff satisfaction. SalaUno has created a Continuous Improvement Plan which is based on the principles of Lean Manufacturing, Six Sigma and Total Quality Management. To implement this plan, SalaUno has defined strategies for regular monitoring and improvement of all clinical and administrative processes. For patients’s experience and staff satisfaction, SalaUno has created the Experience Committee divided in two working groups, each one related to patients’ and employees’ experience. These working groups discuss and implement initiatives to offer a better service for our patients, and a better working environment for SalaUno’s team.

SalaUno is seeking Ministry of Health certification of its management systems, which is mandatory after one year of operation and must be renewed every year. Currently SalaUno is undergoing a pre-certification process to confirm compliance with applicable requirements and identify any gaps. The Company hired a consulting group specialized on health institutions certification to assist them in this process. In the long term, SalaUno intends to get certifications under international standards such as ISO 9000 for quality management systems, and Great Place to Work for working environment and employees’ satisfaction.

Organization. SalaUno has experienced and efficient medical and
administrative teams focused on its substantive roles and responsibilities pertaining eye health at the base of the pyramid. Whenever other expertise is required, such as resource efficiency, occupational or life and fire safety, the company hires experts to take action as appropriate. The Company has dedicated staff to manage issues concerning the Ministry of Health’s certification, requirements, including environmental, occupational health and safety (EHS) and LFS. Going forward the company will ensure that EHS and LFS are consistent with international good practice as per IFC Performance Standards and EHS Guidelines.

Emergency Preparedness and Response. All of SalaUno’s employees attended an 8-hour emergency training course to prepare them for potential emergencies. This course has the following modules: prevention and responses in case of fire, security policies in case of an earthquake, health and security and first aids. In these training events, responsibilities were assigned to ensure that everyone knew what to do in case of an emergency.

Community Engagement. As part of its substantial community service operations, the Company regularly undertakes outreach campaigns in the vicinity of SalaUno. Company staff reaches out to the community and offers free consultations to identify eye ailments, educate patients about them and offer free cataract surgeries through Fundación Cinépolis if they require it. The Company systematically engages with the neighboring Community and municipal authorities to facilitate any issues of concern including potential nuisance, traffic, and parking issues.

Community Grievance Mechanism. The vicinity of SalaUno in a busy neighborhood of Mexico City has many hospitals and health-care clinics. Apart from these, there are apartment buildings, small shops, restaurants and a couple of shopping centers. It is not envisaged that Sala Uno will have any deleterious effects on the surrounding community. Any grievances are posed by the neighboring community are addressed immediately by administrative staff as appropriate or elevated to Sala Uno Management for its attention.

Human Resources Policy and Management. The Company has a human resources policy, which explains the workers’ rights under national labor and employment law as well as applicable collective agreements, including employees’ rights related to hours of work, wages, overtime, compensation and benefits upon beginning the working relationship and any material changes thereafter. This policy, in the form of an employee handbook, is provided to all employees upon inception. Employees at SalaUno are unionized and have a collective bargaining agreement.

SalaUno pays a reasonable salary as per PS2, which in this case is above the minimum wage of 3,000 (three thousand) pesos per month, and respects working hours as required by the Federal Labor Law. The strict implementation of the Company’s payroll policy, in which human resources, finance, and administration units participate, ensures that the Company pays in full and on time.

At inception the human resources process requires the following: passing all psychometric tests and interviews; turn in all the documents required for the position; professional Qualifications approved (for medical and clinical areas, mostly); employment references of previous jobs.

Staff Structure and Organization. SalaUno currently has 68 employees, 75% of whom are women. Apart from the Company’s executive directors, most employees are contracted through two subsidiaries of SalaUno Salud SAPI SA de CV: Vista Uno Asociados SA de CV employs 53 employees, and Servicios Ejecutivos Visual Uno SC 13.

The project will lead to a significant increase in the workforce. The project includes the opening of various Diagnostic and Surgical Centers that will employ hundreds of people. For 2014, Sala Uno expects the workforce to increase to 144 employees. By 2018, the Company expects to have more than 1,000 employees.

Protecting the Workforce. SalaUno is fully compliant with national labor legislation, which comprises the National Labor Law and the Social Security Law. The collective bargaining agreement includes benefits over and above labor law requirements.



Employees hired by Vista Uno Asociados SA de CV and SalaUno Salud SAPI de CV have the benefits provided by labor law and the social security law mentioned above which include health insurance coverage. Employees from Servicios Ejecutivos Visual Uno SC are associates of the company and do not have the same benefits as the rest of the personnel. Social security and health insurance benefits for Company executives are provided upon individual agreement.

Occupational Health and Safety (OHS). Sala Uno’s human resources policy and the Company’s ESMS include OHS and life and fire safety procedures, which all employees are strictly required to follow. Sala Uno systematically records all accidents, with or without lost time. Since its inception Sala Uno has had only two minor occupational incidents, which were promptly attended to at a neighboring hospital with minimum lost time.Whilst t
he Company does not undertake greenfield construction, the buildings that SalaUno rents are carefully reviewed for structure stability and life and fire safety. Whenever necessary the Company contracts workers to make all the necessary improvements to ensure the safety of employees and patients. Construction and physical improvement contracts include a clause to comply in full with labor law including OHS.

Resource Conservation and Energy Efficiency. The government supplies the water (Sistema de Agua de la Ciudad de México) and electricity (Comisión Federal de Electricidad). In order to reduce the consumption of electricity the Company is changing all the lamps for fluorescent or LCD as appropriate, and has installed high-efficiency refrigeration and cleaning appliances, as well as medical devices such as autoclaves.

Pollution Prevention, The company has no air emissions and wastewater is discharged to the municipal sewer according to local regulations and by-laws.

Waste Management. Waste is systematically separated by source and characteristics. Medical waste is retrieved and disposed of by a government certified service providers (Aseca and Medam). Recyclable waste is gathered and sold for recycling. Other rubbish is collected by the municipality and disposed of at sanitary landfills.

Hazardous Materials. SalaUno follows a rigorous procedure with the hazardous material that comes from the Operating Room. There is a person responsible for ensuring and documenting Aseca’s collection of hazardous materials.

Greenhouse Gases. The company uses electricity and small amounts of gas for light and power. The estimate emissions of greenhouse gases, mostly related to electricity consumption is approximately 2,500 Tonnes of CO2 equivalent per year.

Community Health, Safety and Security. Sala Uno’s activities do not pose health, safety or security risks to the neighboring community. The main concern of the Company is the safety of its patients and personnel within the premises of vision centers, diagnosis and surgical areas. Given that Sala Uno’s facilities are located at either side of the street, special attention is given to safety when traversing between facilities, especially when crossing the street.

Life and Fire Safety. The company fulfills the Ministry of Health’s (SSA) certification requirements for primary care clinics and specialty consultation, including life and fire safety requirements. SSA certification follows standards are consistent with international good practice. Given that the clinics are located in a highly seismic area of Mexico City, prior to starting operation Sala Uno engaged experts to assess the structural soundness of the buildings, which were reinforced as recommended by the experts. Similarly, in order to fulfill SSA’s life and fire safety requirements, the company used the services of an expert and made the necessary improvements as advised.

For each step of the expansion process the Company will systematically review the structural soundness of the building leased for this purpose and undertake improvements as necessary. As part of the Ministry of Health’s certification requirements, as described below, the Company will upgrade the life and fire safety (LFS) system of its current and new installations. The Company will ensure that LFS systems are consistent with international good practice as per the Environmental and Social Action Plan (ESAP). Progress of application of LFS provisions will be included in the Company’s Annual Monitoring Report (AMR)

Emergency Preparedness and Response. All of SalaUno’s employees attended an 8-hours emergency training course to prepare them for possible emergencies. This course has the following modules: prevention and responses in case of fire, security policies in case of an earthquake, health and security and first aids. In these trainings, responsibilities were assigned so everyone knows what they should be doing in case of an emergency.

Security personnel. The Company’s security arrangements are consistent with good international practice in terms of hiring, rules of conduct, training, equipping and monitoring such personnel, and applicable law. SalaUno’s security personnel is outsourced to a government certified company named Legión Malta.

As part of its substantial community service operations, the Company regularly undertakes outreach campaigns in the vicinity of SalaUno. Company staff reaches out to the community and offers free consultations to identify eye ailments, educate patients about them and offer free cataract surgeries through Fundación Cinépolis if they require it. The Company systematically engages with the neighboring Community and municipal authorities to facilitate any issues of concern including potential nuisance, traffic, and parking issues.

Sala Uno
Mérida # 204
Col. Roma Norte
México D.F.

Broad Community Support is not applicable for this project

S.no	Description	Anticipated Completion Date	Status
1	Certification of Life and Fire Safety System - Design. Provide third party certification by a qualified professional agreeable to IFC that the life and fire safety aspects of the designs of (i) greenfield construction projects; and (ii) substantial expansions (25% of more) in the case of existing facilities, in both cases where the buildings are accessible to patients or other members of the public comply with all relevant national and an internationally-accepted life and fire safety code. In the case of greenfield projects, the certification should be issued before foundations are built. In the case of expansions over 25%, the certification should be issued before expansion work starts.	07/07/2026	Completed
2	Certification of Life and Fire Safety System – Completion of Construction. A qualified professional agreeable to IFC shall provide a professional certification affirming that facility as built incorporated all elements of the life and fire safety design previously certified to IFC.	06/15/2015	In Progress