TFOME Covid-19 Safety Assessment

• Conducted on

  Date

• Facility/ Area

• Have COVID precautions been properly implemented? (ie. barriers, signage, sanitizer, face covers, etc.)

  Yes

  No

  N/A

• Do employees of the facility/ area have access to adequate COVID protection supplies? (sanitizer, facecovers, wipes, gloves, etc.)

  Yes

  No

  N/A

• Were all Engineers, contract or CS, observed to be PROPERLY wearing face covers and social distancing?

  Yes

  No

  N/A

• Were all Technicians, contract or CS, observed to be PROPERLY wearing face covers and social distancing?

  Yes

  No

  N/A

• Were all other employees (other contracts, subcontractors, CS's from another org.) observed to be properly wearing face covers and social distancing.

  Yes

  No

  N/A

• Were the employees requiring the use of an N95 observed wearing the N95 correctly and were the employees clean shaven?

  Yes

  No

  N/A

• Are work stations, benches, work areas, computer stations, etc. properly distanced, guarded, or otherwise set up to protect users and other employees from potential COVID spread?

  Yes

  No

  N/A

• Were any other COVID precaution violations or concerns observed during the inspection?

  Yes

  No

  N/A

Finalize

• Completed by

  Sign