Oromia Regional Health Bureau

Industrial park and factories COVID-19 prevention preparedness evaluation

checklists
PART I: - Facility Information
Name of the facility ________________________________
Name of owner; _____________________________ contact address (Mob.no) ________________
Contacted person: ________________________, Telephone: ___________________
Address of the facility:-
Zone _____________ Woreda ______________Town_________
Total number of workers: - ______, Male _______, Female _______
PART II: - Preparedness of the Facility
1. Did you have emergency Preparedness & Response Plan (EPRP)? Yes/ No (if yes, see the
document) , if no, why?
_________________________________________________________________________________
_________________________________________________________________________________
2. Did you establish technical and Task Force committee? Yes/No, if yes see its number &
composition (from different discipline/working areas) & activities performed by this committee), if
no why?
_________________________________________________________________________________
_________________________________________________________________________________
3. Health Education and Communication (Awareness Creation)
i. Means of social mobilization for the workers; - using Mass Media/ Leaflets/ Banners/public
Medias/ social Medias (Telegram/Face book/website…)
ii. IEC/BCC materials prepared, posted & distributed; Banners, Leaflets and any other education
material? _______________________
PART II: - Capacity Building
4. Does the facility have trained and assigned focal Persons on IPC, Risk communication and
surveillance? ___, if Yes; Name & contact address of the trained persons;
Name_______________________,____________________________,______________________
phone number:_______________________,_________________________,___________________
5. With whom (ZHD/THD/RHB) does this trained person communicate if the suspects fulfill the case
definition came to your facility? ____________________________________________
6. Was IPC training given for staffs and workers? Yes/ No ______________, if yes # of trainees____
PART III: - Social Distancing
7. Is your organizations/institutions/ informed to ban mass gathering and following social
distancing during their day to day activities- like;-
i. During entrance on main gate?
ii. During transportation?
iii. In the compound during refreshing, tea break, lunch time…..?
iv. Working areas?
v. Cafeterias & canteen?
vi. In the dressing/close changing room/areas?
8. Is temporary isolation room prepared in the industry park until the case is transferred to nearby
selected Isolation center? Yes / no?
9. Is body temperature of all workers taken/measured using Infrared thermometer in the main gate?
A/ Yes, b/No
PART IV: - WASH Facility
10. Is there functional Water Supplies system in your factory/Industry? 1. Yes 2. No
11. If yes, source of water supply?
a. Pipe water
b. Ground Water (Hand dug well, spring….)
c. Rain Water Harvesting
d. Specify if any other source? _________________
12. Is there Hand washing facility with soap available in each gate, entrance, working area and relevance
corners/corridors in your Organization? 1. Yes 2.No
13. Is there assigned focal person, who monitor hand washing facilities? Yes/No
14. Is the Installed hand washing facilities foot operated /pedal to reduce contamination? Yes/ No, if no
how to avoid contamination?
_________________________________________________________________________________
_________________________________________________________________________________
15. Did all the necessary sanitary equipments & materials available?
a. Ample water supply
b. Detergents/soaps
c. Hands rub alcohol/sanitizer?
PART V: - Staffing
16. Is your organization assigned relevant Health professionals for COVID-19 prevention in
your clinics? Yes/No if yes mention type of profession or professional mix :
__________________________________________________________________________
 __________________________________________________________________________
_________________________________________________________________________

PART VI: - Supply & logistics

17. Availability of supply & logistics in the facility
S.No Items Yes No If yes, number
Face Mask
N-95
1
Surgical mask
Community / household made face mask
2 Glove
Examination/disposable
Long sleeved Heavy duty/utility
3 Infrared thermometer
4 Eye Google
5 Apron
6 Gowns
7 Boots
8 Sanitizer,
9 Alcohol
10 Sprayer
11 Dustbin
12 Specify if any Others

18. Is there any transportation facility/Ambulance service assigned for this purpose to transport
suspected factory workers to nearby selected isolation centers? __________________
PART VII: - Waste Management
19. How to handle and manage used all types of PPE, liquid from hand washing?
20. How solid and liquid waste management systems of the compound looks like? ___________
21. Is Incinerator available & ready for use in the facility to manage the solid waste volume reduction?
1. Yes 2. No
22. Is your organization having Ash pit for final disposal? yes/ NO

Reported by _______________________Signature_____________________