CoViD-19 Management Checklist

Inspection Number:
Date and Time: 2021-02-03
Item Compliant
No
Workplace Controls
(YES or NO) OBSERVATION/REMARKS PHOTO EVIDENCE

Adequate ventilation is enforced inside the workplace (Air filtration devices with high-
efficiency particulate air (HEPA) filters installed and properly maintained, air
conditioning turned off to reduce air recirculation, exhaust fans installed)

Is a drive-through window being installed in every reception area?

Engineering Control

Are the workstation, communal space (Toilet, pantry, lounge) were re-arranged
maintaining at least 1 meter apart?

Is high-efficiency filters being installed?

Are sick employees being encouraged to stay at home?

Is contact among workers, clients, and visitors minimized by replacing face-to-face

meetings with virtual communications and implementing telework if feasible?

Is alternating days or extra shifts that reduce the total number of employees in a facility
at a given time being established?

7
 Is physical distancing being observed at all times?

Is temperature checking for all employees and visitors being done before building
entry?

Has the site placed proper use instructions (avoiding touching spigot, washing hands) at
all water bottle filling stations?

10

Has the site posted instructions in a highly visible location on how to properly clean and
disinfect work stations?

11

Has the site placed informational posters in common areas describing best practices for
stopping infection spread, and/or common symptoms to be observant of?

12

Has the site posted above sinks instructions for effective hand washing practices?

13

Does the site have processes in place to ensure supplies of paper towels, soap, cleaning
agent, sanitizing agent and hand sanitizers are adequate and replenished timely?

14

Is the site regularly checking soap levels at all handwashing areas?

15
 If the site has dedicated sleeping rooms, are social distancing and enhanced cleaning
protocols in placed?

16

Is the sleeping area adheres with the health and safety protocol including fire safety?

17

Is the site ensuring cleaning is taking place between uses for the showers and social
distancing arae being applied in queue?

18

Is the site conducting daily deep cleans of the full site?

19

Are high touch frequency surfaces (like security area/reception, workstations,

countertops, and doorknobs) being cleaned to established standardst wiping clean
touch points in lockers rooms at least 4x a day, between breaks?

20

Is the site keeping a checklist of areas cleaned with signature/initials of cleaner and
time cleaned?

21

Is enhanced cleaning schedule in placed for the food services area?

22

Is non-essential travels being discouraged?

23
Admin Control
 Admin Control

Is shuttle service provided?

Is alchol/sanitizer provided in every shuttle?

Is cleaning and disinfection done before and after shuttle trip?

Are the minimum public health standards enforced inside the vehicle? (Wearing of face
mask and face shield, physical distancing observed, signages posted on no talking, no
taking of phone calles, no eating, disinfected properly before and after each use;
windows rolled down by at least 3 inches, if applicable)

Is communications plans, including a forum for answering employees' concerns and

internet-based communications being developed?

24

Is there a constant communication with the current situation of the site to all
employees including cases of COVID-19 on site ?

25

Is there a process of contact tracing if there areindividual who were confirmed with
COVID-19?

26

Is health declaration being filled up daily by the employees coming on site?

27
 Are drivers cleaning all touch surfaces of transportation vehicles at the start and end of
each use? This includes inside and outside door handles, keys, steering wheel buttons
on radio, dashboard, door, glove compartment handle, levers on the seat, belt buckle
fuel cap, and any other surfaces that may come into contact with people.

28

Is up-to-date education and training on CoViD-19 risk factors and protective behaviors
(e.g. cough etiquette and care of PPE) being provided?

29

Aside from pantry area is communal eating being discouraged?

30

Is workstation layout allow a unidirectional movement in aisles, corridors, or walkways?

31

Is there a limited number of people in enclosed space maintaining physical distancing?

(e.g. elevators, small offices, training rooms, shuttle)

32

Is use of stairs with physical distancing (unidirectional if possible) being encouraged?

33

Is there a CoViD-19 hotline and call center for employees?

34

Are there poster/signage of Maxicare CoViD-19 advisory -- Maxicare 24/7 Teleconsult

service?
 Company protocols are in place for transporting the affected employee to the nearest
health facility for proper management

Is training for workers (e.g. HK personnel, drivers) who need to use protective clothing
and equipment how to put it on, use/wear it, and take it off correctly, including in the
context of ther current duties being provided?

Trained OSH personnel to handle CoViD-19 symptomatic workers is assigned

Contact numbers of the local health office or BHERT having jurisdiction of the
workplace, CESu/MESU/PESU/RESU, DOH Hotline 1555 available and visibly posted at
conspicuous places

35

Is mask being consistently and properly worn by all employees and visitors?

36

Are masks properly removed, cleaned, and stored or disposed of, as applicable, to avoid
PPE

contamination of self, others, or the environment?

Face masks and face shields are worn by suspect COViD-19 patient inside isolation
facility

37

Physical and Mental resiliency activities to promote work-life balance undertaken

38
 Psychosocial support for workers available (ex. Presence of support group, counseling)
and/or referral mechanism to mental health specialists/facilities available (ex.
Teleconsult services or National Mental Health Crisis Hotline (09178998727 / Tel 7989
8727)

Are no-touch trash cans, soap dispenser, and sanitizer dispenser being provided?

39

Is there a roving officer (Security, Safety, or OSH Committee member) who ensures
physical distancing and observance of health protocols?

40

Is an isolation room being provided?

1. A designated isolation are is made available for every 200 workers in the
establishment.
2. Isolation area must be situated near entrance or in a nearby facility
3. Isolation area is adequately ventilated
4. Isolation area is frequently disinfected (every two hours or immediately after
occupancy)
Safe Work Practices

41

Isolation area personnel are provided by employer with single use PPEs such as
disposable gowns, faceshields, medical grade masks, and gloves and are properly
disposed every after use

Arrangements and referral to a nearby temporary provate or LGU isolation facility is in

place if provision of isolation area within workplace is not feasible

Is CoViD-19 positive cases being reported to DOH (Municipal Health Office/City Health
Office) and DOLE?

42

Is there safe ambulance transporation available for suspected COVID-19 employee?

43
 Is the necessary company policies for the prevention and control of CoViD-19 being
compiled?

44
Other Observations: