Title Page

  • Company Name

  • Conducted on

  • Prepared by

  • Location

WORKSITES

  • Deputize workplace coordinator(s) charged with addressing COVID-19 issues

  • Maintain 6-foot distancing when possible; discourage shared spaces

  • Frequently disinfect all high-touch areas (Additional Guidance)

  • Post signage for employees and customers on good hygiene

  • Ensure proper ventilation (OSHA guidance)

  • Avoid gatherings (meetings, waiting rooms, etc) of more than 10 people

  • Implement symptom monitoring protocols (including workplace temperature monitoring and symptom screening questions) where possible<br><br>● Best practice is to implement a temperature check station at the entrance to the business. If this is not feasible, employee will check for symptoms at home and report symptoms either electronically or on paper per the system created by the business

  • Eliminate or regularly disinfect any items in common spaces (i.e., break rooms) that are shared between individuals, e.g.,, condiments, coffee makers, vending machines)

  • Provide appropriate protective gear like gloves, masks, and face coverings and encourage appropriate use

EMPLOYEES

  • Require employees showing any symptoms or signs of sickness, or who has been in contact with known positive cases to stay home. Connect employees to company or state benefits providers

  • Provide flexible or remote scheduling for employees who need to continue to observe Stay-at-Home, who may have child or elder care obligations, or who live with a person who still needs to observe Stay-at-Home due to underlying condition, age, or other factors

  • Encourage and enable remote work whenever possible

  • Minimize all in-person meetings

  • Provide hand washing facilities/stations and hand sanitizer

  • Encourage breaks to wash hands or use hand sanitizer

  • Phase shifts and breaks to reduce employee density

  • Wear appropriate protective gear like gloves, masks, and face coverings and encourage appropriate use

TO PROTECT CUSTOMERS

  • Create special hours for people at higher risk of severe illness from COVID-19

  • Encourage and facilitate 6-foot distancing inside of the business for all patrons

  • Encourage use of protection like gloves, masks, and face coverings

  • Provide hand sanitizer at entrance

  • Install shields or barriers where possible between customers and employees

  • Use contactless payment solutions, no touch trash cans, etc. whenever possible

SIGN OFF

  • Name and Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.