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Social Distancing Protocol – (site name, address) (edit as needed based on company policy and practices)
Business name: (XYZ Company) Facility Address: (123 Main St, San Jose, CA 95133) Approximate gross square footage of space open to the public: (xxx,000 ft2) (XYZ Company) must implement all applicable measures listed below, and be prepared to explain why any measure that is not implemented is inapplicable to our business. Signage: ☒ Signage at each public entrance of the facility to inform all employees, visitors and/or vendors that they should (refer to Attachment 1): - avoid entering the facility if you have a cough or fever; - maintain a minimum six-foot distance from one another; - sneeze and cough into a cloth or tissue or, if not available, into one’s elbow; and - do not shake hands or engage in any unnecessary physical contact. ☒ Signage posting a copy of this Social Distancing Protocol at each public entrance to the facility. Measures To Protect Employee Health: ☒ Everyone who can carry out their work duties from home has been directed to do so. ☒ All employees have been told not to come to work if sick. ☐ Symptom checks are being conducted before employees may enter the workspace. Employees must self-monitor for symptoms, as it is not feasible for (XYZ Company) to complete before the start of work ☒ All desks or individual workstations are separated by at least six feet. ☒ Break rooms, bathrooms, and other common areas are being disinfected, on the following schedule: ☒ Break rooms: Daily ☒ Bathrooms: Daily ☒ Other: all high contact surfaces: Daily ☒ Disinfectant and related supplies are available to all employees at the following location(s): in cubicle areas, offices and trucks ☒ Hand sanitizer effective against COVID-19 is available to all employees at the following location(s): front entrance, each desk and will be maintained as long as supplies are available ☒ Soap and water are available to all employees at the following location(s): breakroom, lunchroom and bathrooms ☒ Copies of this Protocol have been distributed to all employees and placed (are available on internal employee portal) ☒ Other—XYZ Company maintains a Health Advisory Committee that meets regularly and distributes information daily on an internal employee portal) Measures To Prevent Crowds From Gathering (check all that apply to the facility): ☒ Limit the number of visitors and/or vendors in the office at any one time to 10, which allows everyone to easily maintain at least six-foot distance from one another at all practicable times. ☒ Post an employee at the front desk to ensure that the maximum number of visitors and/or vendors in the facility set forth above is not exceeded. You may contact (Company Contact) with any questions or comments about this protocol at (123-456-7890) or (contact @company.com).
Company Logo
Social Distancing Protocol – (site name, address) (edit as needed based on company policy and practices)
Attachment 1 – Facility Signage
HELP PREVENT THE SPREAD OF COVID-19
AVOID ENTERING THE FACILITY IF YOU HAVE A COUGH OR FEVER MAINTAIN A MINIMUM SIX-FOOT DISTANCE FROM ONE ANOTHER SNEEZE AND COUGH INTO A CLOTH OR TISSUE OR, IF NOT AVAILABLE, INTO ONE’S ELBOW; AND DO NOT SHAKE HANDS OR ENGAGE IN ANY UNNECESSARY PHYSICAL CONTACT
Refer to (XYZ Company) Social Distancing Protocol posted at the entrance.