Title Page

  • Business Name

  • Manufacturing Site Location
  • Conducted on

  • Prepared by

Return to Work Guidance Checklist

  • Review OSHA COVID-19 for more information on how to protect workers from potential exposures and guidance for employers, including steps to take for jobs according to exposure risk

  • Reference Links:
    OSHA COVID 19 page- https://www.osha.gov/SLTC/covid-19/

    Guidance for Employers - https://www.osha.gov/Publications/OSHA3990.pdf

  • Identify a workplace coordinator who will be responsible for COVID-19 issues and their impact at the workplace

  • Set policies and procedures related to illness, cleaning and disinfecting, and work meetings and travel

  • Establish flexible work hours such as staggered shifts, if feasible

  • Practice sensible social distancing and maintain six feet between co-workers, where possible

  • For work activities where social distancing is a challenge, consider limiting the duration of these activities or implementing innovative approaches, such as temporarily moving or repositioning workstations to create more distance or installing barriers (e.g., plexiglass shields) between workstations.

  • Train workers on how to properly put on, use and wear, take off, and maintain protective clothing and equipment.

  • Sending communications to remind employees who have symptoms (i.e., fever, cough, or shortness of breath) that they should notify their supervisors and stay home

  • Routinely clean and disinfect frequently touched objects and surfaces such as workstations, keyboards, telephones, handrails, and doorknobs

  • Cross-train employees to perform essential functions so the workplace can operate even if key employees are absent

Signatures

    Safety Team Representative
  • Name and Signature

  • Position

  • Management Team Representative
  • Name and Signature

  • Position

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.