A series of OSHPD-1 tenant improvement projects were completed across the Bill Holmes Tower and North Tower, totaling over 31,000 square feet of shelled space. These included the addition of two new operating rooms, three nuclear medicine machines with full radiation protection, 24 ICU rooms with supporting clinical infrastructure, and various exam and testing rooms such as echo, pulmonary function, and EKG technician workrooms. Additional support spaces included staff lounges, offices, nurse stations, storage, reading rooms, and family lounge amenities. On the CHOC West Building roof, two new shade structures were installed, including structural modifications, attachment plates, and surface-mounted lights to support play area use.