Maine COVID-19 Prevention Checklist Guide for Spas and Close-Contact Personal Services

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Employees

“Employees” referred to in this document include anyone providing services in an establishment.
Employees should consider whether they can work safely if they have any of these conditions and supervisors should discuss potential risks for individuals with the following: • People 65 or older • People who live in a nursing home or long-term care facility • People of all ages with underlying medical conditions, particularly if not well controlled, including: • People with chronic lung disease or moderate to severe asthma • People who have serious heart conditions • People who are immunocompromised: Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune-weakening medications • People with severe obesity (body mass index [BMI] of 40 or higher) • People with diabetes • People with chronic kidney disease undergoing dialysis • People with liver disease
Workers should stay at home if they are sick. Supervisors should ask all workers to self-screen for COVID-19 symptoms using either of the following approaches: • Use an electronic or app-based self-screening form, such as the Coronavirus Self-Checker available on the federal CDC’s homepage. • Self-screen using the following questions: • Do you feel ill or are you caring for someone who is ill? • In the past two weeks, have you been exposed to anyone who tested positive for COVID-19?
Adjust training practices to limit the number of people involved and allow for 6-foot spacing; use virtual/video/audio training when possible.
Provide employees training on: • hand hygiene • physical distancing guidelines and expectations • monitoring personal health • proper wear, removal, and disposal of personal protective equipment • laundering of face coverings and uniforms: Cleaning and Disinfecting Your Facility, How to Disinfect: Laundry (CDC) • cleaning protocols, including how to safely and effectively use cleaning supplies: Guidance for Cleaning and Disinfecting Public Spaces, Workplaces, Businesses, Schools and Homes (CDC)
Consider employee training in safe de-escalation techniques.

Building Considerations

Take steps to improve ventilation in the building. • Increase the percentage of outdoor air (e.g., using economizer modes of HVAC operations) potentially as high as 100% (first verify compatibility with HVAC system capabilities for both temperature and humidity control as well as compatibility with outdoor/indoor air quality considerations). • Increase total airflow supply to occupied spaces, if possible. • Disable demand-control ventilation (DCV) controls that reduce air supply based on temperature or occupancy. • Consider using natural ventilation (i.e., opening windows if possible and safe to do so) to increase outdoor air dilution of indoor air when environmental conditions and building requirements allow.
Take steps to ensure that all water systems and features (for example, drinking fountains) are safe to use after a prolonged facility shutdown to minimize the risk of Legionnaires’ disease and other diseases associated with water. • Consider restricting the use of water fountains to refill only with instruction for individuals to wash or sanitize hands after use.

Client Services

Ask each client the following questions when they set up their appointment and again when they arrive in order to screen for illness: • Do you feel ill or are you caring for someone who is ill? • In the past two weeks, have you been exposed to anyone who tested positive for COVID-19?
Appointments • Schedule appointments with adequate time in between to reduce the number of clients in the establishment at a single time and to allow time to properly clean and disinfect in between clients. • If multiple massage practitioners work at one facility, stagger session schedules to prevent crowding in reception areas. • Employers should be held accountable for allowing their employees to have enough time to allow for proper disinfection without repercussions.
Signage • Post a sign that states services will not be offered to or given by anyone who is exhibiting signs of COVID-19 virus. People with these symptoms or combinations of symptoms may have COVID-19: • Cough • Shortness of breath or difficulty breathing • Fever • Chills • Repeated shaking with chills • Muscle pain • Headache • Sore throat • New loss of taste or smell • Symptoms may appear 2-14 days after exposure. Learn more about COVID-19 symptoms. • Place signage at entrances and throughout building (particularly high traffic areas such as reception counters) alerting workers and clients to required occupancy limits, physical distancing requirements, and face covering policies.
Maintain physical distancing at all times. • Spacing between persons within the establishment should be at least six feet, except when staff are servicing clients. • Consider additional spacing between work stations, divider shields, and/or develop alternate work schedules to accomplish this.
For contact tracing purposes, to the extent practicable, establishments should maintain a record including contact information for visitors and staff who have direct prolonged interaction. • Based on current knowledge, a close contact is someone who was within 6 feet of an infected person for at least 15 minutes starting from 48 hours before illness onset until the time the patient is isolated. Close contacts should stay home, maintain social distancing, and self-monitor until 14 days from the last date of exposure.

Personal Protective Gear, Supplies, and Clothing (all practitioners)

Provide workers with up-to-date COVID-19 information and training on safe donning, doffing, and disposal of personal protective equipment such as gloves and masks.
Face coverings • Establishment employees must wear face coverings at all times. • Require clients to wear face coverings at all times. Consider providing face coverings to clients.
Face Shields • Employees are advised to wear face shields, in addition to face coverings, when providing close personal services to clients. If face shields are not available, other eye covering is advised, in order of preference, use goggles, or eyeglasses.
Gloves • Use nitrile or vinyl, unpowdered gloves anytime the potential exists to come into contact with blood or body fluids including when a client has broken skin in an area where massage is provided or when the practitioner has broken skin on the hands or forearms. • Gloves might be worn when handling potentially contaminated laundry, but are not necessary so long as the practitioner practices correct hand hygiene.
Personal Protective Equipment • Clean and disinfect reusable personal protective equipment or discard in a closed container.

Cleaning and Disinfection

Wash hands with soapy, warm water, for a minimum of 20 seconds between every client service.
Ensure that soap and paper towels are available at all sinks.
Each establishment shall be thoroughly cleaned and disinfected prior to reopening and then daily.
Disinfect all surfaces, tools, implements, equipment, and linens, even if cleaning occurred prior to the closing of the establishment. • Clean all surfaces and tools with hot soapy water or cleaning wipes (if using wipes, be sure to cover surface thoroughly) before disinfecting. • Contact time refers to how long the disinfectant is visibly wet on the surface, allowing it to destroy the pathogens. Typical contact time for immersion/sprays is 10 minutes, for disinfectant wipes is 2-4 minutes. Observe contact time on label to allow disinfectant to work properly. • Disinfection is for hard, non-porous surfaces such as glass, metal, and plastic.
Disinfectant only works on a clean surface, so clean all surfaces and tools with hot soapy water, Ship-shape or cleaning wipes (if using wipes, be sure to cover surface thoroughly) before disinfecting.
Clean and disinfect all equipment between clients.
Porous/soft surfaces cannot be disinfected and must only be used once and then discarded (e.g., tools such as cardboard files and buffers).
Launder all linens, towels drapes, and smocks in hot soapy water and dry completely at the warmest temperature allowed and store in a closed cabinet. Store all used/dirty linens in an airtight container.

Reception Area

Avoid practices such as handshaking or hugging when greeting clients.
Suspend “self-service” food stations.
Remove all unnecessary items such as samples, magazines, newspapers, service menus, any other unnecessary paper products and decor.
Clean and disinfect all seats and tables; since cloth chairs are difficult to properly clean and disinfect, consider plastic covering.
Clean and disinfect reception desk. Consider discontinuing use of paper appointment books or cards and replace with electronic options.
Employees should frequently wash their hands after the using the phones, computer, cash register and/or credit card machine. Clean and disinfect these surfaces between each use. Plastic shields on keyboards and other high-touch devices can help with ease of cleaning.
Avoiding the exchange of cash can help greatly in preventing spread of virus, but if this is unavoidable, be sure to wash and sanitize hands well after each transaction. The use of credit/debit transactions is preferred, using touch/swipe/no signature technology. Keep six feet away during transactions and remain masked.
Clean and disinfect all retail areas, daily, including products. Place a sign prohibiting clients from self-serving in the retail area and to ask for assistance. Remove and discard all “Test” products.
Clean and wipe all door handles and other surfaces that are regularly touched by clients and staff with disinfectant wipes.
Provide hand sanitizer and tissues for employees and clients and trash bin for disposal.
Consider floor stickers and signage that provide guidance for maintaining 6 feet of physical distance.
Consider using signage to communicate to the client that thorough sanitation procedures are in place.
Consider providing physical barriers to protect clients and staff such as partitions or plexiglass barriers.

Restrooms

Limit restroom occupancy for group restrooms to incorporate physical distancing and avoid formation of waiting lines outside of restrooms.
Clean and disinfect restrooms on a regular and scheduled basis (see Cleaning and Disinfection section).
Ensure bathrooms are supplied adequately with soap, water, and drying materials.
Place trashcan by door.
Remove anything that does not have to be in the restrooms (e.g., magazines, décor).
Post handwashing signs in the restrooms for both employees and clients.

Work Areas

Limit face-to-face contact with clients to the extent possible.
Work Stations • Between each client session, clean and disinfect any surface the practitioner or client might touch before, during, and/or after sessions. • Clean and disinfect all reusable tools, implements, and items and store in an airtight closed container. • Clean and disinfect all appliances used in connection with servicing clients between each client. • Clean and disinfect all linen hampers and trash containers daily and only use closeable containers with disposable linings. • Provide hand sanitizer at all work locations for employees and clients. • Consider installing non-porous physical barriers such as partitions or plexiglass barriers between workstations, if applicable.

Aesthetic Services (Skin Care)

Clients must wear a face covering while receiving services. Any treatment or procedure that requires the removal of the client face covering may not be performed at this time. Face coverings can include taped-on variants as long as they are double-thickness fabric (e.g. so that light is not visible through the fabric) and cover both nostrils and the mouth. The covering must be fully adhered at all points along its perimeter with a material similar to skin tape. Masks must be applied prior to entering shared service space. (Updated 7/10/20)
Service chairs and beds, including headrests, shall be cleaned and disinfected between each client service. The chair or bed shall be made of or covered in a non-porous material capable of being cleaned and disinfected.
After each client, tools and implements coming into direct contact with a client shall be cleaned and disinfected in accordance with Chapter 26.
Chemical exfoliation procedures are limited to the removal of surface epidermal cells of the skin by using only non-medical strength cosmetic preparations consistent with the manufacturer’s labeled instructions.
Paraffin wax shall be used in accordance with the manufacturer’s instructions and shall be kept free of any debris and kept covered. All units or systems shall be cleaned and disinfected after each use and in accordance with the manufacturer's recommendations.
Applicators should not be left standing in the wax or be dipped into the wax after coming into direct contact with the client. Wax may not be reused on another client under any circumstances.

Pools

Hot tubs and hydrotherapy may be offered provided that clients are maintaining physical distancing at all times and using a face covering. Face coverings should not be worn if doing so would interfere with the safe operation of the hot tub or hydrotherapy tub/pool, or present a concern if clients are or may be fully immersed in water. When a face covering becomes wet or soiled, it should be changed.
Hot tubs and hydrotherapy tubs must be cleaned and disinfected frequently. Surfaces touched by clients above the water should be cleaned and disinfected between uses.
Consider developing a policy that provides a time limit for hot tub use.

Saunas and Steam Rooms

Saunas and steam rooms should remain closed at this time due to limited ventilation and fresh air exchange and the challenges associated with maintaining disinfected surfaces and physical distancing guidelines.