Title Page
-
Conducted on
-
Prepared by
-
Location
Preventive/Control Measures Before Entry
-
Are there signages on COVID-19 safety measures in the premises?
-
Are the signages readable and in good condition?
-
Are there directional signages for human traffic in the area?
-
Are the signages clear and understandable?
-
Are health declaration forms available at the entrance?
-
Are employees and visitors to the plant accomplishing the health declaration/questionnaire?
-
Are the health declaration forms completely and properly filled up?
-
What action is taken when there are issues in the health declaration form?
-
Are body temperature measurement equipment available at the entrance?
-
Are body temperatures being checked for everyone entering?
-
What action is taken when a person has temperature above 37.5 C?
-
Is there a hand washing facility at the entrance?
-
Is the hand washing facility functional (water supply, soap availability, and hand drier)?
-
Are all people washing their hands before entering?
-
Is handwashing properly done?
-
Is there alcohol or hand sanitizer available at the entrance?
-
Are people coming in using the alcohol and hand sanitizer?
-
Is there a disinfectant foot bath at the entrance?
-
Is the foot bath in good condition and with adequate disinfectant solution (wet)?
-
Are people coming in using the disinfectant foot bath?
-
Are the users of the foot bath observing the correct length of time of stepping on the foot bath?
-
Are people coming in observing at least 1 meter of physical distancing?
-
Are workers entering the workplace wearing face masks?
-
Is there an isolation area at the entrance?