Appendix A for Routt County Public Health Order

APPENDIX A

MITIGATION PROTOCOL TEMPLATE NON-EVENT

(Updated 11/10/2020)

 

BUSINESS MAY FILL OUT THIS FORM OR DEVELOP THEIR OWN MITIGATION PLAN USING THIS FORM AS A TEMPLATE

·      Plans must be made available upon request by Routt County Public Health

·      Updates to Mitigation Plans may be required depending on changes to Public Health Orders or restriction levels.

BUSINESS NAME,

PHYSICAL ADDRESS

PHONE NUMBER:

PRIMARY CONTACT NAME:

PHONE NUMBER:

EMAIL:

SECTOR (CIRCLE ONE):  Campgrounds, Child Care, Children's Camps & Sports, Education K-12, Grocery Stores, Higher Education, Residential Care Facility, Limited Health Care Setting, Nursing Home, Manufacturing, Nursing Homes & Congregate-Care Facility, Office-Based Business, Outdoor Recreation, Personal Services, Real Estate & Field Services, Residential Camps, Restaurants & Food Services, Retail, Place Of Worship, Short-Term Rentals, Other (please specify): ______________________________________________________

WORK ENVIRONMENT (CHOOSE APPROPRIATE):  Capacity will depend on work environment; office settings dependent on number of employees and retail dependent on square footage.  Some work environments may include both office and retail space.  Use the Social Distancing calculator to determine capacity for retail space.

Approximate gross square footage of space open to the public: _________________________________

Approximate gross square footage of space total:  ____________________________________________

Total Office Capacity (number of work stations): _____________________________________________

Capacity at 50% and 25%: _______________________________________________________________

Businesses must implement all applicable measures listed below OR indicate why any measure that is not implemented is inapplicable to the business.

SIGNAGE: (check if yes)

  • Signage has been posted at each entrance of the facility or location to inform all employees and customers that they must:

    • avoid entering the facility or location if they have a cough or fever (or any other symptoms)

    • 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

    • not shake hands or engage in any unnecessary physical contact

    •  frequently wash their hands; and

    • cover their nose and mouth with a non-medical, cloth face-covering.

  • Signage has been posted with a copy of the Mitigation Protocol at each entrance to the facility or at a visible location for both employees and guests/patrons.

If not applicable, please state.

MEASURES TO PROTECT EMPLOYEE HEALTH: (check if yes)

  • Everyone who can carry out their work duties from home has been directed to do so (even if business is deemed critical/essential).

  • All employees have been told not to come to work if sick (including any of the following- headache, sore throat, fever, dry cough, recent inability to taste and smell, shortness of breath, ear aches, body aches, diarrhea, fatigue, vomiting and abdominal pain).

  • Employee(s) shall self-screen for COVID-19 symptoms each day, including measuring the employee’s temperature.  The employee is asked to sign a record that the symptom check was completed.   Any employee that exhibits COVID-19 symptoms must be excluded from work.   

  •  All desks, individual work stations or work areas are separated by at least six feet.

  • Break rooms, bathrooms, and other common areas, and other high-touch surfaces are being disinfected frequently, on the following schedule:

    • Break rooms:

    • Bathrooms:

    • Other:

  • Make disinfectant and related supplies available to all employees at their workstations and the following location(s):

  • Provide hand sanitizer effective against COVID-19 to all employees at workstations and the following location(s):

  • There are no employees that travel in and out of Routt County to perform work, or

  • If there are employees that travel in and out of Routt County to perform work, the following measures have been implemented in order to reduce that travel and therefore reduce the potential spread of COVID-19. Please describe:

  • Copies of this Protocol have been distributed to all employees.

  • Please List Any Additional Measures:

  • If not applicable: 

MEASURES TO PREVENT CROWDS FROM GATHERING:

  • Limit the number of customers in the facility at any one time to _____ which allows for customers and employees to easily maintain at least six-foot distance from one another at all practicable times.

  • Post an employee at the door to ensure that the maximum number of customers in the facility set forth above is not exceeded.

  • Place per-person limits on goods that are selling out quickly to reduce crowds and lines.

Explain:

Please List Any Additional Measures:

If not applicable:

MEASURES TO KEEP PEOPLE AT LEAST SIX FEET APART:

  • Place tape or other markings at least six feet apart in customer line areas inside the store and on sidewalks to public entrances with signs directing customers to use the markings to maintain distance.

  • Separate order areas from delivery areas to prevent customers from gathering.

  •  All employees have been instructed to maintain at least six feet distance from customers and from each other, except employees may momentarily come closer when necessary to accept payment, deliver goods or services, or as otherwise necessary.

Please List Any Additional Measures:

If not applicable:

MEASURES TO PREVENT UNNECESSARY CONTACT:

  • Prevent people from self-serving any items that are food-related.

  • Staff provides lids for cups and food-bar type items by staff; not for customers to grab.

  • Bulk-item food bins are not available for customer self-service use.

  • Contactless payment systems have been provided or, if not feasible, sanitizing payment systems regularly. Describe:

  • Provide curb-side drop-off/pick-up of products.

If not applicable: 

MEASURES TO INCREASE SANITIZATION:

  • Provide disinfecting wipes that are effective against COVID-19 near shopping carts and shopping baskets.

  • Assign employee(s) to disinfect carts and baskets regularly.

  • Hand sanitizer, soap and water, or effective disinfectant is available to the public at or near the entrance of the facility, at checkout counters, and anywhere else inside the facility or immediately outside where people have direct interactions.

  • Disinfect all payment portals, pens, and styluses after each use. Disinfect all high-contact surfaces frequently.

Please List Any Additional Measures:

If not applicable:

MEASURES TO REDUCE EXPOSURES IN EMPLOYEE SHARED TRANSPORTATION:

  • Employee(s) self screen for COVID-19 symptoms each day and exclude if symptomatic. 

  • Hand sanitizer is used by each employee prior to entering the vehicle.

  • Reduce the number of passengers by 50% of the vehicle’s occupancy and passengers sit in locations to maximize the distance between one another.

  • Employees wear a non-medical, cloth face-covering when in vehicle containing more than one person.

  • Keep window remain open or ventilation is increased.

  • Disinfect all high-contact surfaces of the vehicle will be done at the end of each day.

Please List Any Additional Measures:

If not applicable

PROTOCOLS IN PLACE IF AN EMPLOYEE TESTS POSITIVE FOR COVID-19 OR A GUEST/PATRON HAS VISITED THE ESTABLISHMENT WHILE POSITIVE (REFER TO GUIDANCE FOUND ON https://covid19routtcounty.com/): 

Please List Any Additional Details:

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