Infectious Disease Control Plan - COVID-19 - Flipbook - Page 50
COVID-19 DAILY HOME HEALTH CHECK
PLEASE REVIEW THE FOLLOWING QUESTIONS DAILY.
IF YES TO ANY, PLEASE STAY HOME AND NOTIFY YOUR SUPERVISOR
Are you experiencing any of the following?
FEVER (100.4+)
COUGH
SHORTNESS
OF BREATH
SORE THROAT
HEADACHE
Have you been in close contact with anyone who has been diagnosed with COVID-19?
Yes ☐
No ☐
Having direct contact with infectious secretions of a COVID-19 case (e.g. being coughed on)
Yes ☐
No ☐
Have you been in close contact with anyone who may have COVID-19 but is yet to be confirmed?
Yes ☐
No ☐
Are you currently in close contact with anyone, such as a family member, who is experiencing
symptoms or has been confirmed as positive for COVID-19?
Yes ☐
No ☐
If YES to any of the above questions, please stay at home and notify:
Supervisor Name: Jerry Fournier
Phone: 408-287-2700
Email: jfournier@teamwrkx.com
Human Resources Name: Natasha Venzon
Phone: 408-287-2700
Email: nvenzon@teamwrkx.com
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