The NPC-4 Evaluation of the Sutter Health Radiation Oncology Center consisted of reviewing as-built documentation and validating the existing NPC-4 components found within the Radiation Oncology Center (ROC). A matrix was developed and the previously-approved OSHPD components within the ROC were identified and included within the matrix. The Oncology department was operational during the validation and the remediation phase. The team met with user groups to create work flow that minimized disruption by working after hours and by mobilizing room-by-room rather than a conventional approach of mobilizing each discipline throughout the entire space at once. The team provided equipment supports, anchorage, non-structural wall support, upgraded seismic bracing and anchorage of the existing NPC components and prepared an OSHPD compliance plan for the Women’s and Children’s Center and ROC.