Pandemic Plan Review Checklist Example.pdf

Pandemic (COVID-19/Coronavirus) Plan Review Checklist

This is a guide to what a Pandemic Safety Plan should contain. Upon review, these are the items GSA Region 6 looking for in a Pandemic Plan and will allow GSA Contracting

Officers/Contracting Officer Representatives/Subject Matter Experts to determine if the contractor submitting the plan understands the safety and health requirements of the work they are performing as it relates to a Pandemic “Coronavirus (SARS-CoV-2/COVID-19).” Most importantly GSA Contracting Officers/Contracting Officer Representative/Subject Matter Experts have to perform their due diligence to ensure the work contractors are performing does not jeopardize the safety and health of GSA employees, the tenants, contractors, or visitors on site.

Generally, a Pandemic “Coronavirus (SARS-CoV-2/COVID-19)” Safety Plan should contain the following:

NOTE: EXAMPLES USED IN THIS CHECKLIST ARE ONLY EXAMPLES. CONTRACTORS

WILL PERFORM THEIR OWN HAZARD ASSESSMENTS AND WRITE AND/OR SUBMIT

THEIR OWN PLAN ACCORDINGLY.

1) Title of Document:

● Document title should include “Pandemic (Coronavirus) Safety Plan” as part of description.

2) Date of Plan:

● Include the date of when the plan was written. If revisions are made to the initial plan, the new revision date can be used or the original date with the revision number can be used, i.e., March 12, 2020, Revision 1.

3) Introduction:

● Brief acknowledgement that there is an understanding that your Pandemic Safety Plan addresses the Coronavirus (SARS-CoV-2/COVID-19).

4) Location and Description of Work

● Describe the work you intend to perform.

Example Only: ACME employees are responsible for accomplishing the work required to operate and maintain the Federal Facility located at 133 Presidents Street, Kansas City, Missouri. This facility includes the main building, generator shed on the south side, and the boiler house.

5) Hazard Assessment

● Assessment o Your evaluation of the hazards (Pandemic/ SARS-CoV-2/COVID-19) associated with the work your employees are responsible for.

Example Only: Generally, ACME employees are at no greater risk than the public. In addition, ACME employees will not enter/work in spaces that have been identified by GSA/Tenant Agencies as having had a “COVID-19 (Coronavirus) Event” until the space has been isolated for 24 hours and then cleaned and disinfected unless an urgent request is placed by the GSA Contracting officer/Contracting Officer Representative. The ACME on-site project manager will contact the GSA Contracting Officer/Contracting Officer Representative/Building Manager at the start of each work shift to verify the list of spaces that have been identified as having a “COVID-19 (Coronavirus) Event” and placed off-limits until the space has been isolated for 24 hours and then cleaned and disinfected.

NOTE: It is an expectation that the GSA Contracting Officer/Contracting Officer Representative will immediately contact the ACME on-site project manager when a space has been placed off-limits and a space has been cleaned and disinfected and returned back to service.

NOTE: A “COVID-19 (Coronavirus) Event” has been defined as “an event where an individual with COVID-19 (Coronavirus confirmed or suspected) has occupied a building space and the space needs to be isolated for 24 hours and cleaned and disinfected.”

ACME employees will follow the CDC guidelines on what to do to protect themselves. Employees will follow the attached CDC guidelines on “Steps To Help Prevent The Spread Of COVID-19 If You Are Sick” (attached) ….

● Personal Protective Equipment (PPE) Required o PPE you are requiring your employees to use while working in the contaminated space(s).

Example Only: Generally, specific PPE is not required for the tasks performed by ACME employees. However, PPE is required in the event that an ACME employee is required to perform duties in a space that has been identified off-limits due to a “COVID-19 (Coronavirus) Event” and that has not been isolated for 24 hours and cleaned and disinfected. The ACME on-site project manager will assess the need to enter such space on a case-by-case basis and only at the specific request of the GSA Contracting Officer/Contracting Officer Representative. These requests will only be considered if the situation required is considered and emergency. At a minimum, ACME employees will use the following PPE: …

● Responsibilities o Describe who is responsible for the plan and who is going to ensure it is complied with. Also provide a list of key personnel associated with the contract and their contact information.

https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html

Example Only: The following is a list of key personnel associated with this contract and their contact information:

ACME Safety Manager – Rusty Pipe…Is responsible to ensure the contents of this plan. Also responsible for the safety program and safety training of ACME employees. Email: rusty.pipe@acme.com (C) 888-777-5555

ACME On-Site Project Manager - Ben Thair…Is responsible for ensuring this plan is implemented and enforced. Email: ben.thair@acme.com (C) 888-777-

ACME President – Ima Incharge…company president. Email ima.incharge@acme.com (C) 888-777-1111 o Plan must include the name and signature of person responsible for the plan.

The ACME Safety Manager (Rusty Pipe) is responsible for the contents of this plan. Rusty Pipe

6) Operating Procedures

● Must include the work practices and procedures you plan on using to keep your workers safe, i.e. steps employees must take to enter the space, work safely in the space, and what they need to do after exiting the space.

Example Only: Generally, ACME employees are at no greater risk than the public.

ACME employees will follow the CDC guidelines on what to do to protect themselves.

Employees will follow the attached CDC guidelines on “Steps To Help Prevent The Spread Of COVID-19 If You Are Sick” (attached) ….

ACME employees will not enter/work in spaces that have been identified by GSA/Tenant Agency as having had a “COVID-19 (Coronavirus) Event” until the space has been cleaned and disinfected. However, under certain circumstances, considered an emergency, ACME employees may be required to enter such spaces. ACME employees will use the following minimum PPE… ACME employees may be required to use additional PPE as directed by the ACME on-site project manager.

Example Only: ACME employees will not enter/work in spaces that have been identified by GSA/Tenant Agency as having had a “COVID-19 (Coronavirus) Event” until the space has been cleaned and disinfected under any circumstances.

● Must include disposal procedures for contaminated materials/PPE.

Example Only: ACME employees will properly dispose of PPE in biohazard marked plastic bags/containers as follows:… mailto:ima.incharge@acme.com

● Must include requirement to coordinate and communicate all contractor activities related to COVID-19 (Coronavirus) related activities through the GSA Contracting Officer/Contracting Officer Representative and Building Manager.

Example Only: The ACME On-Site Project Manager shall coordinate all COVID-19 (Coronavirus) related activities with the GSA Contracting Officer/Contracting Officer Representative. It is an expectation that the GSA Contracting Officer/Contracting Officer Representative will immediately contact the ACME on-site project manager when a space has been placed off-limits and a space has been cleaned and disinfected and returned back to service. The ACME On-Site Project Manager shall also coordinate and communicate COVID-19 (Coronavirus) related activities with the GSA Building Manager (if that individual is not the GSA Contracting Officer Representative).

Example Only: ACME employees will be briefed of all pertinent COVID-19 (Coronavirus) related information at the start of each work shift by the shift supervisor and anytime required at the discretion of ACME company officials…

7) Training

● Must include a copy of the training provided to employees. If the training is the same training used in other parts of the contractors safety program, training need not be duplicated. Please reference that training in the plan and provide a copy to GSA. Must include a list of employees trained.

Example Only: Generally, ACME employees are at no greater risk than the public.

ACME employees will follow the CDC guidelines on what to do to protect themselves.

Employees will follow the attached CDC guidelines on “Steps To Help Prevent The Spread Of COVID-19 If You Are Sick” (copy attached) ….

Training for the PPE required by this plan is covered in the ACME Safety Manual, chapter 19 and chapter 23. A copy of these chapters are attached…

8) Emergency Procedures

● Must include your emergency contacts, emergency/accident procedures (hospital location, first aid, etc.

Example Only: Emergencies will be reported to the following ACME mangers;

ACME On-Site Project Manager - Ben Thair…Is responsible for ensuring this plan is implemented and enforced. Email: ben.thair@acme.com (C) 888-777-6666

ACME Safety Manager – Rusty Pipe…Is responsible to ensure the contents of this plan.

Also responsible for the safety program and safety training of ACME employees. Email:

rusty.pipe@acme.com (C) 888-777-5555

● Must include your emergency plan.

Example Only: Actions required by this plan is covered in the ACME Safety Manual, chapter 2. A copy of this chapter is attached…

9) Reduction in Services/Contingency to Continue Business Operation and Service

● Must address a reduction in services/contingency to continue business operation and service as required per the GSA Contracting Officer responsible for the contract. Plan authors