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  • Business Name

  • 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

  • Practice social distancing by implementing measures such as floor tape demarcation of six-foot distances in checkout lines

  • Consider stalling plexiglass partitions

  • Provide workers and customers with tissues and trash receptacles.

  • Train workers in proper hygiene practices and the use of workplace controls

  • 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


Planning 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.