COVID-19 Safety Checklist for Seafarers (ICS)

• Conducted on

  Date

• Prepared by

• Name of Ship

• Location
  Address

• 1. Have any crew members visited an area where a COVID-19 case has been reported within the past 14 days?

  Yes

  No

  N/A

• 2. Have any crew members been in close contact with someone who showed respiratory symptoms and who has been to a place with a confirmed COVID-19 case in the last 14 days?

  Yes

  No

  N/A

II. Observations at Work

• 1. Are there handwashing guides near handwashing stations advising crew to wash their hands with soap and water for at least 20 seconds?

  Yes

  No

  N/A

• 2. Are crew members following handwash guidelines?

  Yes

  No

  N/A

• 3. Do crew members actively avoid touching their face, mouth, nose, and eyes, especially after handling and/or touching an unsanitized item or surface?

  Yes

  No

  N/A

• 4. Are crew members covering their noise and mouth with disposable tissue shen sneezing, couging, wiping, and blowing the nose and are they disposing of the used tissue immediately?

  Yes

  No

  N/A

• 5. Are crew members practicing social distancing of at least 1 meter (3 feet), especially those that are coughing, sneezing, or may have a fever?

  Yes

  No

  N/A

• 6. Do all crew members wear protective masks on board?

  Yes

  No

  N/A

• 7. Are high-touch, high occupancy surfaces and areas regularly sanitized after work?

  Yes

  No

  N/A

III. Plans and Initiatives

• 1. Is there a written and implemented Outbreak Management Plan on board?

  Yes

  No

  N/A

• 2. Is there a written and implemented Pre-boarding Screening?

  Yes

  No

  N/A

• 3. Are crew members trained to recognize the signs and symptoms of COVID-19 so that prompt action can be taken when there is a potential case on board?

  Yes

  No

  N/A

• 4. Are there isolation protocols to quarantine crew members that are suspected to have COVID-19?

  Yes

  No

  N/A

IV. Essential Supplies

• 1. Is there an adequate supply of soap and clean water for handwashing?

  Yes

  No

  N/A

• 2. Is there an adequate supply of sanitary gel with at least 70% alcohol?

  Yes

  No

  N/A

• 3. Are all crew members provided with protective masks?

  Yes

  No

  N/A

V. Sign Off

• Full name and signature of ship operator of health officer

  Sign