Personalizing this template ...



Healthy Return to the Workplace PlanPersonalizing this templateStep one in personalizing the template is replacing your organization’s name:Click on [Org Name] on the first page of the templateType in your organization’s nameClick anywhere else in the documentYour organization’s name should now be filled in through-out the document.Step two is replacing the logo image:Anywhere in the document, insert your logo, and resize to roughly the same height as the “Replace with LOGO” image currently present at the top of the documentHighlight your logo and hit Ctrl-c (copy) then the Delete keyGo to the Home tab in Word and select Replace. The Search and Replace pop-up will appearClick on the More button, if neededMake sure the “Find what” box is empty, and the cursor is located in the box.Click on Special, then choose Graphic. Word inserts ^g in the “Find what” boxClick into the “Replace with” box – it should be empty, and your cursor located in the boxClick on Special, then choose Clipboard Contents. Word insert ^c in the “Replace with” boxClick on the Replace All button. All images will be replaced with your logoAdapting the Template to your OrganizationOnce you have personalized the template, it’s time to make sure it fits your organization. First, look at the plan itself. Anything in this tan color is commentary and should be deleted from the final document after reading and adjusting the sections to fit your needs. Review the List of Specific Policies and Procedures, and make sure that all new policies and procedures are included on the list. Delete any that are not applicable and add and revise to meet your organizations needs and objectives. [Org Name]Healthy Return to the Workplace PlanPURPOSEThis document exists as a guide for staff and others as staff, clients, volunteers, and others enter and use the physical facilities of [Org Name]. The intent of this document is to describe the actions and expectations necessary to protect the health and well-being of all during the COVID-19 pandemic. SCOPEThis document applies to all of [Org Name]’s employees, management, contractors, interns, volunteers, clients, and visitors.Some individual policies which are attached as appendices will be in effect for specific periods, which may be referenced in absolute (date, time) terms, while others may be relative to external events or to one another. The appendices to this document may include policies that are in addition to or exceed [Org Name]’s pre-existing policies. Unless otherwise specified or superseded, all existing policies remain in effect.PRE-OPENING ACTIVITIES [Below, list individual steps that the organization must take prior to re-opening, along with responsible party(s), necessary contractors, etc. Some example steps are provided; customize to meet organization’s needs.]Set target dates and deadlines for return to workplace [may be fixed dates or relative to other markers, such as state declaration of “Phase Two”] Assess space for physical workplace modifications / physical distancingIdentify who is responsible for assessment as well as actual modificationsDetermine if markers are necessary to show appropriate distancing (for example, 6’ distancing marker lines for those approaching a reception desk, or marking off as unavailable certain seats in the waiting room or desks in an open-plan office area)Determine which, if any, common spaces (break room, etc.) will be closedEnsure signage and related resources are availableDetermine if additional hand sanitation stations or other modifications are neededDesignate the role of specific managers and employeesDeep Cleaning of FacilityIdentify who is responsible for cleaning and who is responsible for ensuring cleaning was completed to standards set by the organization. Determine if external contractors are needed for the initial or ongoing cleaningDetermine if additional supplies are needed for initial or ongoing cleaningDetermine timeline for cleaning (when will it start, how long will it take, is there a waiting period following cleaning before re-entry of employees)HR / ITIdentify who is responsible to evaluate employees for eligibility for continued remote work, determine staggered work schedules, etc.Plan effective communications so employees understand role in return to workplaceIdentify who will maintain the inventory of IT assets as they are returned to the workplace, including determining which assets remain in the possession of employees if the employee returns on a part-time / occasional basis (laptops, etc.)Clients and VisitorsIdentify procedures for clients or visitorsIf process requires additional supplies (masks for visitors, etc.), identify supply sources, stocking and re-ordering thresholds, etc. Determine post-visit cleaning requirements RE-OPENING ACTIVITIESComplete initial deep cleaning of workplace.Provide cleaning supplies, disinfecting wipes, and/or hand sanitizer as needed for high-traffic areasModify physical workplace in accordance with plan.Ensure returning employees review plan and sign that they are familiar with the plan and related policies and procedures [sample employee receipt included below]LIST OF SPECIFIC POLICIES & PROCEDURES [below, list the documents that outline specific procedures your organization will follow. Some examples are listed below, update to match your organizational needs] TOC \h \z \u \t "Heading 3,1" Appendix 1a: Policy on Cloth Face Coverings PAGEREF _Toc531186719 \h 5Appendix 1b: Policy on Clean Desks PAGEREF _Toc531186720 \h 6LIST OF ADDITIONAL APPENDICES [below, list the additional documents that are needed to make this a comprehensive plan for your organization. Some examples are listed below, update to match your organizational needs]Staff and Key Volunteer Emergency Contact List – Appendix 2Employee Staggered Work Hours Plan – Appendix 3Program-specific Alternate Operations / Recovery Plans [as developed per 3.b.3] – Appendix 4[Org Name]Employee Receipt of Healthy Return to the Workplace PlanI am aware of the potential spread of COVID-19 that could result in a range of outcomes, including severe illness and death. I acknowledge that I have been advised of, and have been given a copy of the [Org Name] Healthy Return to the Workplace Plan and related procedures that [Org Name] has created to minimize the risk to myself, to coworkers, and to others that we may encounter in the course of work activities.I understand that I am responsible for complying with all of the policies and procedures outlined in this document. I further acknowledge that I have been given the opportunity to ask any questions I may have about the application of these policies and procedures to my work.I will, to the best of my ability, practice proper social distancing at work and outside of the office as recommended by CDC and health department directives, as well as practice good hygiene (handwashing, use of hand sanitizer, wearing of a mask when appropriate, etc.) and follow other health recommendations. Should I become ill, I promise to self-report the illness and contact my supervisor at [Org Name] to let them know of my condition. I will adhere to testing guidelines and work with my own primary care providers. Finally, if I am exposed or suspected to be exposed to COVID-19, I will notify [Org Name] and self-quarantine as appropriate under CDC and [Org Name] guidelines or procedures.Print Name:______________________________Title:___________________________________Signature:_______________________________Date:___________________________________ [Org Name]Appendix 1a: Policy on Cloth Face CoveringsWe continue to monitor our workplace and add safety measures based on guidance from the Centers for Disease Control and Prevention (CDC) and other government organizations. In line with those safety measures, we are providing this guidance regarding the use of face coverings to prevent the spread of COVID-19. Unless otherwise notified by your direct supervisor, you are required to wear a cloth face covering at work. A face covering is generally a cloth, bandana, or other type of material that covers an employee’s mouth and nose. The CDC recommends that individuals wear cloth face coverings in public places or when it is impossible to practice social distancing. Remember that wearing a face covering can help prevent the spread of the disease, but only in addition to other measures that you should be taking in the workplace and at home, such as frequent hand washing, cleaning and sanitizing frequently-touched surfaces, and practicing social distancing.If you feel sick or if you are experiencing any symptoms of COVID-19 (fever, cough, difficulty breathing, chills, headache, muscle pain, sore throat, or new loss of taste or smell), let your supervisor know, go home immediately, and contact your healthcare provider for additional guidance. To get the most benefits from a face covering:Make sure it completely covers your nose and mouth.Read the directions for use (if provided).Wash your hands before and after removing it.Try not to touch your face when you adjust it throughout the day.Keep cloth coverings clean by washing daily, or more often if contamination occurs.Don’t let others wear your face covering.Keep it away from machinery that it could get caught in.If using disposable face coverings, do not reuse them, and throw them away in appropriate trash receptacles.Don’t lay your face covering on any surface that may contaminate either the covering or the surface.Don’t use it if it’s damaged or has holes, unless it is the only face covering you have access to. If you have any questions about the use of masks or face coverings in the workplace, contact Human Resources or your supervisor.[Org Name]Appendix 1b: Policy on Clean DesksAt [Org Name], we value diversity and stylistic differences and believe they help make us a stronger, more accepting organization. However, as part of our COVID-19 and Healthy Return to the Workplace policies, we have implemented a clean desk policy in our facility. The intent of the policy is to minimize the possibility of disease spread by removing unnecessary items from the desktop. This will also allow for more effective cleaning. For the period from [start date] to [end date], it is the policy of [Org Name] that desktops be maintained in a clean state, including prohibiting personal items and occasionally-used items (staplers, calculators) on the desk surface except when the employee is actually present at the desk. At the end of the work day, all files, paper, notes, etc., must be put into desk drawers or other enclosed space. ................
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