all persons, regardless of symptoms or negative covid-19

Appendix A: Identification of COVID-19 Hazards All persons, regardless of symptoms or negative COVID-19 test results, will be considered potentially infectious. Particular attention will be paid to areas where people may congregate or come in contact with one another, regardless of whether employees are performing an assigned work task or not. For example: meetings, entrances, bathrooms, hallways, aisles, walkways, elevators, break or eating areas, cool-down areas, and waiting areas. Evaluation of potential workplace exposure will be to all persons at the workplace or who may enter the workplace, including coworkers, employees of other entities, members of the public, customers or clients, and independent contractors. We will consider how employees and other persons enter, leave, and travel through the workplace, in addition to addressing fixed work locations. The district has in place a robust COVID-19 Safety Plan that addresses identified potential hazards and includes measures taken to mitigate those hazards. The COVID-19 Safety Plan in its entirety is included by reference in each site’s Appendix A.

Person conducting the evaluation: Josh Costa

Date: 2/24/2021

Name(s) of employee and authorized employee representative that participated:

Alyssa Franco, Amanda Mathews, Amberlee Townsend, Andrea Sanchez, Brittney Groess, Carlos Amaya, Caroline Henrichsen, Christina Blaine, Clara Giles, Danielle Edmiston, Deanna Palacios, Debra Matson, Elle Halvorson, Eric Cortez, Erika Stewart, Ilse Lopez, Jennifer Osborne, Jill Mlinar, Jon Rogers, Josh Costa, Julia McDaniel, Julie Patton, Kelly Simmons, Kristy Hess, Kyle Madrona, Dr. La Toshia Palmer, Logan Gaming, Luci Galvan, Margaret Walsh, Mary Avery, Regina Furniss, Sarah Dillon, Scott Goehring, Shannon Faltermier, Shulawn McWhorter, Stacey Nowogurski, Susan Parker, Symphony Flores, Tamara Mahon, Terry Bryant, Todd Sanderson

Interaction, area, activity, work task, process, equipment and material that potentially exposes employees to COVID-19 hazards

Places and times

Potential for COVID-19 exposures and employees affected, including members of the public and employees of other employers

Existing and/or additional COVID-19 prevention controls, including barriers, partitions and ventilation

Staff Room Throughout the day Staff members congregate in the staff room and there could be a potential to exceed the maximum capacity creating an exposure hazard

Post room capacity =3, remove tables and chairs, post signage requiring masks, social distancing use hand gel and frequent washing hands. Staff will eat their lunches in their classroom or outdoors at the picnic tables distanced.

Front Office Throughout the day Students, Parents, and Staff members come into the office regularly which creates a potential to exceed the maximum capacity creating an exposure hazard

Post room capacity Office= 1 family at a time, use of plastic from counter to ceiling to minimize exposure for front office staff along with plexiglass barrier. Post signage requiring masks, social distancing, use of hand gel and frequent washing of hands and


Places and times



stickers on the ground as a distancing reminder.

Lobby Throughout the day Families waiting to come into the office

1 family at a time. Remove chairs in the lobby. Post signage requiring masks, social distancing and stickers on the ground as a distancing reminder. Designated areas for families to wait on the ramp just outside the lobby using stickers designating distancing on the ground.

Library Throughout the day Staff members come into the library regularly which creates a potential to exceed the maximum capacity creating an exposure hazard.

Post room capacity=6 Post signage requiring masks, social distancing, use hand gel and frequent washing of hands.

Staff Bathrooms Throughout the day Staff members use two single stall bathrooms regularly throughout the day.

Post designated areas through the use of dots in the hallway for staff members to wait their turn rather than waiting in the staff room spaced appropriately. Post signage requiring masks, social distancing, frequent cleaning per the CPP, use hand gel and frequent washing of hands.

Book Room Throughout the day Staff members used the two copy machines as well as paper cutter, die cut machine, and access to the Scholastic guided reading books.

Move the two copy machines, die cut machine, paper cuter to the Professional Development Room. 1 staff member at a time in the Book Room. Post signage requiring masks, social distancing, use hand gel and frequent washing of hands.

Professional Development Room

Throughout the day Staff members will use this room to make copies, use die cut machine, paper cutter, laminator

The professional Development room will have maximum capacity of 6 at a time. In the PD rooms move the two copy machines on opposite sides of the room and space out the die cut machine, paper cutter, laminator and paper to


Places and times



distance those in the room appropriately. Post signage requiring masks, social distancing, use hand gel and frequent washing of hands.

Student Arrival Morning Arrival As students and staff members arrive there is a potential to mix and create an exposure hazard

Students will arrive no earlier than 10 minutes prior to the start of school. As students arrive, they will go directly to class. Students will be dropped off at the front parking lot. TK, K, 3rd grade will use the Kindergarten gate to get to their classrooms. 1st grade and 2nd grade will use the main front doors to get to class. 4th and 5th grade will use the gate by the MP room and the bike rack to get to their classrooms. In the hallways stickers on the ground will direct foot traffic.

Student Dismissal Afternoon Dismissal As students and staff members are dismissed for the day there is a potential to mix and create an exposure hazard

Students will use the same routes that they entered in the morning to walk to the front of the school where there are lanes painted on the front grass with markers on the grass designating every six feet apart with 17 lanes set up designating each classroom. Students will sit on their designated dot by class waiting for their parent to arrive to pick them up.

Picnic Tables adjacent to the MP room and on the playground

Staff Lunches When teachers take their break to eat their lunch

Designate which tables can be used and can’t be used based on spacing. Can not be closer than 6 feet from one another. Post signage requiring masks when they aren’t eating, social distancing, use hand gel and frequent washing of hands.

Boiler Room Retrieving Science Materials

When staff need to retrieve Foss Science Materials

1 person at a time in the boiler room. Post signage requiring masks, social distancing, use hand gel and


Places and times



frequent washing of hands.

Appendix B: COVID-19 Inspections This form is only intended to get you started. You may need to modify this form to include issues that may be more pertinent to your particular type of workplace. Please modify accordingly. Date: Name of person conducting the inspection: Josh Costa Work location evaluated: Thomas Kelly

Exposure Controls Status Person Assigned to Correct Date Corrected

Engineering

Barriers/partitions Completion Principal 2-11-21

Ventilation (amount of fresh air and filtration maximized)

Completed Principal/M&O 2-11-21

Additional room air filtration Completed Principal/M&O 2-11-21

Administrative

Physical distancing Completed Principal 2-11-21

Surface cleaning and disinfection (frequently enough and adequate

supplies)


Hand washing facilities (adequate numbers and supplies)


Disinfecting and hand sanitizing solutions being used according to manufacturer

instructions

Completed Principal/Custodians 2-11-21

PPE (not shared, available and being worn) Completed Principal 2-11-21

Face coverings (cleaned sufficiently often) Completed Principal 2-11-21

Gloves Completed Principal 2-11-21

Face shields/goggles Completed Principal 2-11-21

Appendix C: Investigating COVID-19 Cases

THIS FORM IS NOT TO BE USED UNLESS ACCESS TO THE DISTRICT’S ONLINE COVID-19 REPORTING PROCESS IS NOT AVAILABLE. PLEASE CONTACT THE COVID-19 COORDINATOR PRIOR TO COMPLETING THIS FORM. All personal identifying information of COVID-19 cases or symptoms will be kept confidential. All COVID-19 testing or related medical services provided by us will be provided in a manner that ensures the confidentiality of employees, with the exception of unredacted information on COVID-19 cases that will be provided immediately upon request to the local health department, CDPH, Cal/OSHA, the National Institute for Occupational Safety and Health (NIOSH), or as otherwise required by law.

All employees’ medical records will also be kept confidential and not disclosed or reported without the employee’s express written consent to any person within or outside the workplace, with the following exceptions: (1) Unredacted medical records provided to the local health department, CDPH, Cal/OSHA, NIOSH, or as otherwise required by law immediately upon request; and (2) Records that do not contain individually identifiable medical information or from which individually identifiable medical information has been removed.

Date:

Name of person conducting the investigation:

COVID-19 Case Investigation Information

Employee (or non-employee*) name:

Occupation (if non-employee, why they

were in the workplace):

Location where employee worked (or

non-employee was present in the

workplace):

Date investigation was initiated:

Was COVID-19 test offered?

Name(s) of staff involved in the investigation:

Date and time the COVID-19 case was

last present in the workplace:

Date of the positive or negative test and/or

diagnosis:

Date the case first had one or more COVID-19

symptoms:

Information received regarding COVID-19

test results and onset of symptoms (attach

documentation):

COVID-19 Case Investigation Information

Results of the evaluation of the

COVID-19 case and all locations at the

workplace that may have been visited by

the COVID-19 case during the high-risk

exposure period, and who may have been

exposed (attach additional

information):

Notice given (within one business day, in a way that does not reveal any personal identifying information of the COVID-19 case) of the potential COVID-19 exposure to:

All employees who may have had COVID-19 exposure and their

authorized representatives.

Date:

Names of employees that were notified:

Independent contractors and other employers present at the workplace during

the high-risk exposure period.

Date:

Names of individuals that were notified:

What were the workplace conditions

that could have contributed to the risk

of COVID-19 exposure?

What could be done to reduce exposure

to COVID-19?

Was local health department notified?

Date:

*Should an employer be made aware of a non-employee infection source COVID-19 status.

ONLY USE THIS FORM FOR EMPLOYEES OR SUBSTITUTES WHO CANNOT ACCESS THE DISTIRCT’S PUBLIC SCHOOL WORKS TRAINING PLATFORM.

Appendix D: COVID-19 Training Roster Date: Person that conducted the training:

Employee Name Signature

all persons, regardless of symptoms or negative covid-19

Documents