Chippewa County Health Department COVID-19 Screening Tool.pdf

CHIPPEWA COUNTY HEALTH DEPARTMENT

508 Ashmun Street, Suite 120 Sault Ste. Marie, Michigan 49783 www.chippewahd.com

COVID-19 Essential Workplace Screening Tool

Employee Name:

Date: Time In:

In the past 24 hours, have you experienced:

If you answer “yes” to any of the symptoms listed above, or your temperature is 100.4° F or higher, please do not go into work. Self-isolate at home and contact your primary care physician’s office for direction. You should also:

• Isolate (do not leave) at home for a minimum of 7 days since symptoms first appear, AND

• Have 3 days without fevers (without the use of medicine) and improvement in respiratory symptoms

In the past 14 days, have you:

Had close contact with an individual diagnosed with COVID-19? ☐Yes ☐No Travelled via airplane internationally or domestically? ☐Yes ☐No

If you answer “yes” to either of these questions, please do not go into work. Self-quarantine at home for 14 days.

For more information visit www.chippewahd.com.

Home Health & Hospice Personal & Family Health Environmental Health Main Fax

906.635.1568 906.635.1566 906.635.3620 906.253.1466

Fever (felt feverish or above 100.4° F) ☐Yes ☐No New or worsening cough: ☐Yes ☐No Shortness of breath: ☐Yes ☐No Sore throat: ☐Yes ☐No Diarrhea: ☐Yes ☐No Current temperature:

° F

COVID-19 Essential Workplace Screening Tool

This tool is for workplaces that are essential to remain open with staff on-site during the COVID-19 pandemic. Chippewa Health Department recommends:

• Check all employees for fever or other symptoms if they will enter facilities or buildings.

• Maintain 6 feet of distance between people.

• Emphasize frequent and proper hand washing. Make sure sinks are well supplied.

• Work remotely whenever possible.

• Do not share space or equipment. If this is not possible, have employees wash their hands before and after using shared equipment. Clean and sanitize equipment between uses.

• Any employee with cold symptoms or underlying health conditions should stay home or work remotely.

If an employee arrives to work ill or becomes ill at work, send them home immediately. If they are having trouble breathing or cannot keep fluids down, have them contact their health care provider right away.

If visitors or customers show signs of illness (such as coughing or sneezing), employees should try and stay at least six feet away. If this is not possible, contact should be limited to under 10 minutes.

The public should have access to tissues, trash receptacles, and a no-touch hand sanitizer dispenser if possible.

If an employee tests positive for COVID-19, the employee needs to stay home and isolate themselves. You must protect the confidentiality of the employee. Make sure surfaces and work areas the employee came into contact with are disinfected with an EPA-approved cleanser. Close personal contacts (less than six feet distance for greater than 10 minutes while symptomatic) should stay at home and quarantine for 14 days.

If an employee is at home following an exposure to COVID-19 (quarantine), they may return to work after 14 days. If they become sick at home, they should follow isolation guidance.

If an employee is sick at home (isolation), they may return to work seven days after the symptoms started AND they are 72 hours fever-free without the use of fever-reducing medication.

For the most up-to-date information on COVID-19, please visit the following:

• Chippewa County: chippewahd.com

• Michigan: https://www.michigan.gov/coronavirus

• United States: https://www.cdc.gov/coronavirus/2019-ncov/index.html

Home Health & Hospice Personal & Family Health Environmental Health Main Fax

906.635.1568 906.635.1566 906.635.3620 906.253.1466