COVID-19 SAFETY PLAN

Identify how you will ensure the above and any related strategies:

Prior to resuming regular day services, staff scheduled to work in the program will receive orientation/training to the new safety systems.

The agency will assigned a supervisor staff as the safety monitor and training on all aspects of the plan will be provided to this staff member. The program supervisor is also trained regarding the program plans.

This include understand and participating in pre-entry/pre-participation tests. All employees scheduled to come to work must complete a daily pre-entry screening to determine if they may have been exposed to COVID-19. If staff answers NO to the daily screening questions and have a temperature of below 100.0 degrees, they will then be authorized to work.

NOTE: All staff and essential visitors MUST comply with the temperature screening and answer the mandatory health-related questions before being cleared to work or entrance to the agency building, each day.

Individuals scheduled to attend program will follow same steps for health screening protocol daily.

1. Before staff leaves to pick up the individual, the indivdiual and or caregiver will be asked the pre-entry questions. If NO, only then will staff proceed to pick up that individual.
2. Before the individual is able to board the agency van, there temperature check will be conduct by the assigned staff/monitor, trained to use a "handheld forehead thermometor". Staff will clear the indiviudal to baord the vehicle if temperature readings are below 100.0 degrees.
3. The assigned staff/monitor will provide the individual with a face mask and hand sanitizer, before they can board the vehicle. Note: Each vehicle will have a seating protocol to ensure the safest travel routine when on the van. Staff, individual and essential visitors reponse to Pre-Entry Screening Questions and temperature will be logged and subject to saftey monitor review for compliance and accuracy each day.

For Example: Temperature and questions:

1. DO YOU CURRENTLY HAVE COVID-19 and have not yet been released from isolation/quarantine and cleared for return to work?
2. DO YOU HAVE ANY OF THE FOLLOWING NEW SYMPTOMS THAT ARE NOT EXPLAINED BY ANY PRE-EXISTING MEDICAL CONDITION: Cough, shortness of breath, difficulty breathing; or at least two of the following symptoms: Fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell?
3. OVER THE PAST 14 DAYS:
   • Has anyone you have been in contact with been confirmed with or possibly has COVID-19, including COVID-19 symptoms (listed in 2. above)?
   • Have you returned from travel to a high risk area and or state deemed high risk? if you answer “No” to all of these questions and passed the mandatory temperature check (for staff the will proceed with, client pick up is assigned as a driver or staff/monitor, for individuals they will attend program, essential visitors or staff will gain entry to the building).
   • Additionally, individuals, staff and essential visitors, must be able to answer NO that a member of their household or certified residence is being quarantined or isolated.

Training will be provided to Day Hab staff on how to recognize COVID-like symptoms, self-reporting of positive COVID-19 test results, exposure/possible exposure, and signs and symptoms to the program supervisor.

1. If symptoms occur during programs hours individual and/or staff will be isolated and contact to proper personnel/authorities.
2. Following of CDC cleaning will be followed.
3. The agency policy for document retention of medical documentation allowing an individual or staff member who was COVID-19 positive to return to program site/services will be followed and reviewed for compliance by the safety monitor.
4. The agency policy allowing the return of an individual or staff to program/services occurs only in adherence to OPWDD and NYS DOH guidance regarding quarantine periods and fever free (72 hours, without fever reducing medicaiton) durations.

Site Safety monitor and Supervisor will requently check and observed staff throughout the day to ensure health and wellbeing of all.

Familie will be reminded that individuals will not be permitted to attend program if anyone in their household is a suspected COVID-19 case.

Anyone who was COVID-19 positive must have a medical clearance to return to Day Program. The program maintains an up to date list of required DOH contacts in the event reporting of COVID-19 positive test results, exposure/possible exposure must be reported. OPWDD and 624 Regulations will be followed.

Identify how you will ensure the above and any related strategies:

Modifications to day program/service hours to allow service provision and maintaining reduced capacity and group size. Families will be offered specific pick up schedules for individuals to attend program.

Each Agency activity space used during the program day, when individuals are not participating in out door-community based (socially distanced activity) has been organized to ensure that planned group size, which will be limited to no more than fifteen (15) individuals including staff.

The agency transportation protocols will allow for only 50% capacity on agency vehicles including staff.

1. Group schedules of (15) individuals and staff working with them will be static (no floating from room to room, floating of staff and or individuals during the program week).
2. Furniture will be placed 6ft apart. Furniture that can not be moved, when using staff and individuals are required to use face mask.
3. Floor signs will be printed and placed 6ft apart on the floor to facilitate directional foot traffic.
4. Morning routine with will include support and education of individuals to learn physical and social distancing, health and hygeine and importance of wear a face mask.
5. Individuals who for medical reason or unable to tolerate a face mask will be socially distanced in the program.
6. Tabletop activities will not scheduled unless individuals can participate (bingo cards, crafts, grooming materials, art supplies, etc.) using their own supplies. Group activities utilizing recreational or gym equipment will not be scheduled.

Service Outcomes

Consideration will be given to families who prefer Telehealth service to support achieving personal outcomes, during this iniatial phase. The use of technology and innovative strategies, in the group, i.e. teaching social, ADP, communication skills, video teaching health and safey, understanding COVID-19, how to wear a mask and social distancing will be part of the daily activites.

Identify how you will ensure the above and any related strategies:

1. No more than 15 persons including individuals and staff will participate in a DH group.
2. Staff will be assigned to specific individuals (group) to work with in assigned desinated area, this group and space, the program will attempt when possible for the group remain static for the day/week. Unless critical to the heath and safety of the individual staff and or individual will not float arround during the day.
3. Food coming from home must be adequatley stored in closed disposable container, labled and must only require heating from a microwave.
4. Disposable containers will be thrown out each day. Individuals are encouradge to bring food from home to limit purchasing outside.
5. No meal time or community eatery will be buffet style dining.

Identify how you will ensure the above and any related strategies:

Groups will be minimized to 15 or less including individuals and staff, this grouping capacity which allows ample space to accommodate all individuals without compromising health and safety.

Vehicle schedules will be arranged based on the number of individuals and groups that will be transported. If needed, the hours of the program will be adjusted acomodate the transportation time of each group.

Staff will be trained not to utilize or present any materials/supplies for shared use. When possible, supplies used, they will be individualized for each individual's personal use. Prior to and after each use, the supplies will be cleaned and sanitized and then properly stored in a labeled box or Ziplock bag for that individuals' use only.

No one will use supplies unless properly disinfected and sanitized.

If an item is picked up or shared by an individual independently or accidentally, the item will be cleaned and the individuals will be encouraged to wash or sanitize their hands.

Staff will wear gloves when distributing or working with supplies. Staff will have their own supply of materials, etc. labeled for their use. Staff will not be floated unless absolutely necessary due to consumer clinical needs or staff absences.

1. The program modifications to day program/service hours to allow blocks of service provision while maintaining reduced capacity and group size.
2. The activity schedule will ensure that individuals participate in activites that focus on:
   • Health and Safety, no physical contact amonge individuals, limited sharing of equipment, individual will be assigned, personalized supplies, i.e for writing, arts and crafts, etc.
   • Activities scheduled in the outdoors in the community will be in open areas only and involve only one (1) destination each day until NYS, OPWDD and or health officials deemed other activites are safe to resume.
   • Any equipment/supplies, i.e. books, computers, iPads that must be shared as part of a planned activity, will be specific to the group that day and will be cleaned/sanitized before and after use.
   • Inidivuduals, due to ADL, social and or clinical needs will be assisted by a staff assigned to work with the individuals and or group. At all times when physical distancing (6ft) cannot be maintained individual will wear a face mask.
   • Staff working with individuals are mandated to wear a face mask. If a staff member, reports that wearing a face mask or face shield is medically contraindicated, they will not be able to work with individuals at this time.
   • All activites, groups and staff assignments will be documented/logged and filled weekly.
   • Masks and full PPE kit will be provided to staff who screens individuals/staff/visitors as well as staff who provide transportation.
   • The program safety monitor and supervisor will continously monitor, pre-entry screenings, activiites and other factors for compliance to safety rules and recommend immediate changes and or adjustment to maximize safe programming.

Identify how you will ensure the above and any related strategies:

All staff and essential visitors will be mandated to wear masks. If staff need masks or supplies, they will be accessible when needed. Individuals will be encouraged to wear masks if tolerated. Individuals, who cannot tolerate masks will be offered face shields, if tolerated.

1. All staff will be provided PPE to wear for the duration of their shift.
2. Only essential visitors are allowed at this time and must wear face masks, the agency will supply if, they have none or the face covering is not adequate and consistent with Exceutive Orders adn OPWDD guidelines.
3. Individuals will be required to wear face mask with support of the DSP staff .( the agency will provide face mask to each individual).
4. For individuals who cannot tolerate a face mask for other than medical reasons, will be continously coached and to understand the importance of its use, reinforce use, especially during transportation time and socially distanced during all activities.
5. The Agency will have ample PPE supply on site and can be requested when needed from receptionist.
6. Training will be scheduled by for DSP staff working in Day Hab upon returning to work
7. PPE will be conveniently and accessible to staff located in the vehicles, activity rooms, bathrooms, etc.
8. Staff will receive training prior to program resuming an all area of this plan, understanding COVID-19 symptons, self-reporting, health checks, on proper use of PPE including when necessary to use, donning, doffing,disposing and/or reusing and sanitizing when appropriate.
9. Supervisors and safety monitors will receive enhanced training to include: Listening to staff and respond to concerns about well-being of staff and individuals; provide transparent communication. Given the uncertainty associated with the rapidly changing crisis, staff are looking to leaders to provide reassurance and guidance; offer support where, how, and when staff need it; organization skill, ways to ease burdens on staff working with individuals with special needs.
10. All training documentation will be located in staff personal file, according to agency filing policies and be requested from HR when needed.
11. Safety logs, documentation of health checks, cleaning logs, exposure charts, DOH, OPWDD, 624 reports, activity schedules (in house and community-based) and medical documenation will be reviewed weekly and monitored for discrepancies and filed weekly by the safety monitor, in accordance with HIPAA/Privacy, OPWDD and other oversight authority guidelines.

Identify how you will ensure the above and any related strategies:

At all times Iyaho DH without walls will ensure strict adherence to hygiene requirements to reduce transmission as advised by NYS DOH and the CDC. Signage will be posted, providing reminders for hand hygeine using techniques according to NYS DOH and CDC guidance, including the conditions that require handwashing.

The DH program will provide and maintain hand hygiene items throughout the building and activity rooms to include supplies needed for activites to be carried out: Handwashing: soap, running warm water, and disposable paper towels. Hand sanitizing: alcohol-based hand sanitizer containing at least 60% alcohol for areas where handwashing facilities may not be available or practical, (i.e. the vehicle, community-based/outdoor activities), and where the need for frequent hand sanitizing is expected.

1. All staff and individuals will be advised to wash hands with soap and water for at least 20 seconds before participating in program activities, after each activity and at the end of program before leaving. If an activity is occuring outdoors at an approved place, use of hand sanitizer will be reinforced.
2. Program will utilize the cleaning and disinfecting guidelines recommended for COVID-19:
   • Vehicles will be cleaned daily before and at the end of the day.
   • Vehicles will be sanitized/disinfected between each use (i.e. after AM pick up, in between community-based out door activities and after each vehicle is used.
3. All shared objects and equipments will be sprayed/wiped (EPA Approved) sprays or wipes before and after all usage. (Any items, objects and or equipment that can be individualized by participant will be assigned) These will be will be cleaned and disinfected and placed in all abeled boxes/containers for the individual's use. No one will share this equipment.
4. Only (medically or clinically) items necessary from home will be allowed to program by individuals.

Cleaning and Disinfecting:

1. The agency will have cleaning schedule, which mandates full cleaning of the facility used by inidivduals. A typical cleaning routine will be full cleaning 2 times per day (AM and PM after use and hourly based on area and use).
2. In between all high trafic areas, bathrooms, receiption, hallways, kitchen, eating area , small high touch areas, light switched, door knobs, etc. will be cleaned hourly, by a member of the cleaning staff.
3. All high touch areas in the activities rooms and vehicles will be sanitized before and after use.
4. Equipment, objects used by individuals and/or staff during an activity of learning/teaching will be sanitized before and after use and stored according to individual's name if individualized.
5. Training and monitoring will assure cleaning staff and staff supporting individuals understand how to safely and immediately discard used gloves, paper towels or other disposable items after sanitizing or disinfecting, tied in a trash bag and removed from the environment.
6. Cleaning and maintenance staff will monitor for dwell time on products and ensure that products are stored according to use.
7. Items needed to disinfect/sanitize highly used objects and equipment will be accessible to staff, but stored to protect the health and safety of the individual.
8. All cleaing and disinfecting routines will be maintained and logged indicating the date, time, and scope of cleaning.and monitored for compliance by the stafey monitor daily.

Identify how you will ensure the above and any related strategies:

DH Supervisor will maintain logs of all individuals/ staff and essential visitors. The log will be secured in the Supervisor's office.

The Safety Monitor will check cleaning logs at the end of each day to ensure proper cleaning and sanitization of the vehicles and buildings.

We will inform families and providers that we will follow the CDC guidelines on cleaning and disinfecting the facility if someone is suspected or confirmed to have COVID-19.

Tracking

1. Signature sheet and tracker created to track COVID-19 screening for Day Hab staff, essential visitors and indivdiuals.
2. Tracking logs documenting activities, group/staff names, rooms used, out door activities, where visited, etc.
3. Day Hab Tracker logs will be completed and verified daily.
4. Staff will be trained on the necessity to self-report if symptomatic or positve test.
5. The Agency will report all positive or presume positive cases in the program to OPWDD and the local health department immiedately.
6. Documentation will be organized in a manner to enable trace of contacts, essential visitors and individuals.
7. Before an individual, staff or essential personnel can return to work after a positive result or COVID-19 symptons, medical clearance will be required before the staff and or individual may return to the program.
8. No staff member (Driver/Matron) is allowed to transport individuals or on agency vehicle if they are unable to wear a mask, whether medically or personal reasons.
9. Signature sheets of essential personnel entering site is completed and reviewed, they will be kept in the supervisor's office.
10. All reporting to health department/IRMA by the safety monitor or other designee.

All logs, medical documenation regarding COVID-19 testing and results will be maintain according to confidentiality guidelines required by federal and state law and regulations.