CoVID-19 SafeTY Plan

                                                        SAFETY PLAN COMPONENTS 

NOTE: Guidance bullets below are not a substitute for provider review and adherence to content of Interim Guidance Regarding the Reopening of Day Services Certified by the Office for People With Developmental Disabilities 

Signage – applies to certified sites and other locations controlled by the provider 

• Ensure program building entrances have signs that alert that non-essential visitors are not allowed.
   
• Ensure signs are posted throughout the program building to provide instruction on the critical COVID-19 transmission prevention and containment activities identified in the companion document Interim Guidance Regarding the Reopening of Day Services Certified by the Office for People With Developmental Disabilities. 

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

Modern Guidance have installed safety signs that inform visitors are not allowed. Posted signs how to prevent the transmission prevention and containment of COVID-19. Signs notifying that mask wearing is required in the program. Corridoring an area with red tape around the facility entrance to prevent any direct contact when entering the facility was also completed.

Signs are being posted to encourage social distancing and observe COVID 19 safety procedures to prevent and stop the spread.

The Program Director will conduct checks and any damage or missing will be replaced. A staff will be assigned to monitor and report any missing sign. The Program Director will ensure compliance. 

A. Entrance to Site Based Programs Pre-Entry/Pre-Participation Screening: 

• Screen all individuals, staff, and essential visitors prior to entry into the day program site
  and/or participation in services/service delivery:
  o per infection control standards for protection of screener and screened person,
  o to include temperature check and required questions on exposure and COVID-19
  Symptoms, per NYS DOH and OPWDD guidance documents.
   
• Maintain daily documentation of all screening of individuals, staff and visitors in
  compliance with OPWDD and NYS guidance and policy. 

                 Response to Signs and Symptoms and Departure:
 

• Safe management of any individual, staff or visitor who fails initial/pre-program screening or is exhibiting signs or symptoms during service delivery, to include:
  o Facilitating departure as soon as possible, and
  o Safely manage separation from people not exhibiting symptoms, until they depart.
   
• Ensure instruction is provided to any individual or staff sent home due to symptoms to contact their health care provider and written information on healthcare and testing resources.
   
• Ensure the day program immediately notifies the local health department and OPWDD about the suspected case.
  

                 Participation and Return to Program/Service:
  

• Ensure staff members know to report and how to report positive COVID-19 test results, exposure/possible exposure, and signs and symptoms to their supervisor.
   
• Ensure individuals do not participate in day services while they or a member of their household or certified residence is being quarantined or isolated.
   
• Maintain medical documentation allowing an individual or staff member who was COVID-19 positive to return to program site/services.
   
• Ensure any return of an individual or staff to programs/services occurs only in adherence to OPWDD and NYS DOH guidance regarding quarantine periods and fever free durations. 

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

On a daily basis staff will answer the pre screening test prior to work. They will do a daily temperature test prior to starting their shift. Staff are encourages to monitor their temperature at home and asked to stay home with any slight elevation in temperature for 24 hours. Elevation lasting more than 24 hours requires medical clearance up to COVID 19 testing as determine by medical professional. 

Families or other representatives will also be required to answer the screening questions for individuals served prior to daily pick up. Each individual temperature check and observe for sign of illness prior to entering the van. For any sign of illness and or temperature above 98.6 individuals will be asked to stay home for observation and medical clearance up to COVID 19 testing as determine by medical professional.

B. Social Distancing Requirements:
Ensure effective practices to facilitate social distancing when distancing is not possible, including the following: 

• Reduction of total number of individuals served at one time, in order to reduce congestion
  and facilitate easier social distancing;
   
• Plans to maintain no more than 50% occupancy in small/confined spaces within a
  program, such as a staff break room;
   
• Potential use of physical barriers within site-based spaces;
   
• Planned use, capacity and arrangement of furniture and/or work equipment in program
  rooms, workspaces and meal and seating areas to allow for social distancing of at least six feet apart in all directions (i.e. 36 square feet) and limit density. (Note an individual’s needs may require individual to staff distance to be less than six feet);
   
• Use of signage and floor markers/distance markers denoting spaces of six feet throughout program area spaces, common spaces, waiting areas, entry, exits and other areas of travel;
   
• Facilitate one directional foot traffic where necessary in narrow spaces, using tape or signs with arrows;
   
• Install physical barriers, as appropriate, especially when physical distancing is not feasible between program/workspaces;
   
• Support and education of individuals to learn physical distancing/use of markers, patterns of movement, and other program strategies;
   
• Maintain a staffing plan to prevent employees who should need to “float” between different rooms or different groups of individuals, unless such rotation is necessary to safely support individuals due to unforeseen circumstances (e.g. staff absence).
   
• Provide adequate space and operational practices (e.g. staggered break times) for staff to adhere to social distancing while completing independent tasks (i.e. paperwork) and when taking breaks (i.e. eating or smoking). 

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

A reorganization of the facility has resulted in desk assignment to individuals who will be required to adhere to their assigned seats. Protective barriers have been installed to desk using six feet markers for social distancing. Each desk will have the name of the individual assigned. 

Floor markers are installed to maintain social distancing. Individuals going to their desk will follow the clearly marked path. Individuals exiting their desk area will be taught to wait for direction to proceed. This will be monitored by staff working with the individuals.

Individuals will snack at their desk and staff will either eat in the kitchen or go out for breaks. The facility has adequate space for social distancing. In situations when social distancing cannot be maintained for short period, everyone will be wearing masks. 

C. Gatherings in Enclosed Spaces 

• Modifications to day program/service hours as needed, to allow blocks of service
  provision while maintaining reduced capacity and group size.
   
• Planned group size, which will be limited to no more than fifteen (15) individuals who
  receive services. The restriction on group size does not include employees/staff.
   
• Ensure the group (≤15) of individuals receiving services and staff working with them are
  as static as possible.
   
• Ensure that different stable groups individuals and staff, have no or minimal contact with
  one another and do not utilize common spaces at the same time, to the greatest extent
  possible.
   
• Stagger staff and/or individual meal and break times to maintain social distancing.
   
• Adhere to social/physical distancing practices identified in the safety plan.
   
• Prohibit shared food and beverages and buffet style dining.
   
• Require that food brought from home must require limited preparation (i.e. heating in
  microwave) during day services and be packed appropriately.
   
• Ensure reusable food utensils and storage containers are washed in the dishwasher on
  the hottest wash and dry setting.

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

MGS day program is a small group. Individuals are assigned their own areas where they will be required to carry on their activities for the day. Common spaces such as computer room and conference room will temporarily be reassigned for isolation and storage. There will be no agency sponsored activity involving food (birthday celebration and holidays) and individuals will continue to bring their own snack. Families will be asked to fit smaller containers in a zip lock should the food require microwaving. Only one staff will assist individuals with heating food daily utilizing gloves to do so. Disposable utensils will be provided. In our facility the heating of foods and distribution of utensils was a function of the individuals served. These activities will now be the responsibility of program staff. Additionally staff will now have the responsibility to put coats away in the closet.(This activity to put coats together is under review and will be determine prior to cooler weather) 

D. Day Program Schedules and Activities

• Modifications to day program/service hours as needed, to allow blocks of service 

provision while maintaining reduced capacity and group size. 

• Focus on activities with little or no physical contact and which do not rely on shared equipment, to the extent possible.
   
• Schedule individual’s activities to reduce density and allow for social distancing. 

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

Day program schedule will be modified from 9 am to 1.15pm for individuals living with families. Individuals living in residences with additional support will have services from 1.30 pm to 5.30pm.

All individuals will have their own desk assignment and each individual will have a tablet provided by MGS to complete their goals and other activities to participate. 

Community outings are temporarily suspended. Group exercise dancing will be modified and will take place in assigned space twice weekly instead of daily if the new arrangement allows.

The schedule will include educating individuals on COVID 19, and the protocols put in the facility for prevention.

consideration will be given to families who are not confident sending individuals by working with families to provide alternate service for the next 2 to 3 months 

E. Personal Protective Equipment: 

• Ensure all staff wear an appropriate cloth or disposable face mask/covering that covers
  both the mouth and nose, at all times while providing services, consistent with all current Executive Orders and OPWDD guidelines (unless medically contraindicated / not tolerated.
   
• Ensure all essential visitors wear a face mask or covering, providing a facemask onsite at no cost, if visitors do not have their own which meets requirements.
   
• Support individuals receiving services to wear face coverings, as tolerated, whenever social distancing cannot be achieved.
   
• Maintain an adequate supply of required PPE on site (and available to staff for when needed for community-based services) to minimally include masks and gloves, and with gowns and face shields as needed.
   
• Train all staff on proper use of PPE including when necessary to use, donning, doffing, disposing and/or reusing and sanitizing when appropriate.
   
• Retain documentation of trainings in the employees’ personnel files and per agency procedures.
  

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

Staff will be trained on the proper use of PPE and procedures including disposing and sanitizing. There will be no visitors to the facility. Staff and Individuals are required to use a mask. A supply of face mask are readily available free of cost and face shield will be available onsite.

Mask, glove face shield and gowns are available on site for staff in adequate supply

A record of staff who have participated in the training will be made available onsite. 

F. Hygiene and Cleaning
Personal Hygiene to Reduce Transmission: 

• Ensure strict adherence to hygiene requirements to reduce transmission as advised by NYS DOH and the CDC.
• Provide and maintain hand hygiene stations at each location to include: 

o Handwashing: soap, running warm water, and disposable paper towels.
o Hand sanitizing: alcohol-based hand sanitizer containing at least 60% alcohol for 

areas where handwashing facilities may not be available or practical, and where the 

need for frequent hand sanitizing is expected;
• Train staff to wash their hands frequently with soap and water for at least 20 seconds using techniques per NYS DOH and CDC guidance, including the conditions that require handwashing.
• Support individuals to wash their hands frequently/when needed, with soap and water, for at least 20 seconds using appropriate techniques as tolerated.
• Encourage and facilitate use of hand sanitizers by staff and individuals upon arrival to and departure from program and through the day, providing supervision/support of use by individuals as needed.
• Address any individualized needs affecting the unsupervised availability of hand sanitizer. 

Cleaning and Disinfection of Environment, Equipment and Supplies: 

• Strictly adhere to sanitation requirements as advised by NYS DOH guidance documents.  
• Implement the following minimum standards regarding cleaning and sanitizing: 

o Frequent cleaning and rigorous disinfection of high-risk areas/high touch surfaces; o Use of only EPA registered products for disinfecting non-porous surfaces;
o Adhere to proper dwell times for all cleaners, sanitizers and disinfectants per 

manufacturer recommendations as indicated on the product label; and
o Ensure adequate ventilation to prevent inhaling toxic fumes.
o Maintain site cleaning logs indicating the date, time, and scope of cleaning.
o Keep cleaning products, sanitizers and disinfectants secure and out of reach of 

individuals who may misuse;
o 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. o Clean and disinfect all areas and equipment used by a person exhibiting symptoms 

upon their departure from the area and prior to use of the area or equipment by other 

individuals or staff.
o PPE use and hand hygiene when cleaning and disinfecting causes safety hazards. o Provide ventilation with outside air safely and when possible. 

• Limit use of shared objects/equipment. Ensure shared items are cleaned and/or sanitized after each use. Require hand hygiene before/after contact and glove use when feasible.
• Prohibit use of items/objects that cannot be cleaned and sanitized (i.e. soft object, cloth placemats, etc.) unless clinically required. 

• Prohibit bringing personal items from home, except when clinically necessary, then have a plan for regular cleaning and disinfection including immediately prior to departure. 

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

Disinfecting wipes, sprays and other approved cleaning products are available on site. Disinfecting wipes will be used to maintain the area clean during programming hours with full scale cleaning after each session and as needed. Windows will be open during when cleaning to allow proper ventilation. Sanitizers will be places around the facility and at the door to ensure proper sanitization. Gloves are readily available for use. To the extent possible items will not be shared. Individuals will have their own. Supervisor will ensure compliance. Director will monitor  

G. Transportation 

Ensure that the following measures are implemented for the transport of individuals to/from day services to reduce COVID-19 transmission risk, when providing or contracting for transportation: 

• Ensure only individuals and staff traveling to and from the same day program be transported together; individuals or staff from other day programs should not be
  intermingled for purposes of transportation at this time; individuals transported together are encouraged to be cohorted for purposes for day programming also, in order to reduce further intermingling;
   
• Reduce capacity on buses, vans, and other vehicles transporting individuals from multiple residences to 50% of total capacity;
   
• Individuals and staff who reside/work together in the same home may be transported together to day program(s) in the same vehicle without a vehicle capacity reduction;
   
• As possible, stagger arrival and departure times to reduce entry and exit density.
   
• To the extent possible, restrict close contact of individuals and staff from different
  households  by not sitting near each other or the driver.
   
• If there are multiple doors in a bus or van, utilize one-way entering and exiting. Provide
  instruction for individuals to exit the vehicle one at a time and wait for driver or staff
  instruction before doing so.;
   
• Ensure staff and the driver always wear face coverings in the vehicle. Social
  distancing must be maintained for individuals who cannot tolerate wearing a mask and, when possible, such individuals should be transported alone or with members of the same household. Ensure staff who cannot medically tolerate the use of a face covering are not assigned to transport individuals.
   
• After each trip is completed, clean and disinfect the interior of the vehicle before additional individuals are transported; and
   
• Where appropriate and safe, roll windows down to permit air flow. 

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

No more than four individuals and two staff are permitted on the agency van. Van will have seating assignment away from the driver. All staff and individuals will be required to wear mask. Weather permitting windows will be rolled down to allow air flow. Prior to entering the van all individuals and staff will sanitize their hand and have temperature checks. A screening log will be maintained daily.

The van will be cleaned and disinfected after each trip.The driver will be sign off verifying van cleaning.

Alternate arrangement will be made for individual who are not able to tolerate the mask for long periods of time  

H. Tracing and Tracking 

• Notify the local health department and OPWDD immediately upon being informed of any
  positive COVID-19 test result by an individual or staff at their site.
   
• If a staff or visitor test positive, procedures for day service cooperation with the local
  health department to trace all contacts in the workplace and notify the health department of all staff, individuals and visitors who entered the facility dating back to 48 hours before the positive person began experiencing COVID-19 symptoms or tested positive, maintaining confidentiality as required by federal and state law and regulations. 

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

Any positive test result:

Program Director/Nurse will immediately notify OPWDD and Health Department

Will trace back 48 hours all who entered the facility and provide appropriate notification with positive COVID TESTor symptoms.

Maintain and treat with confidentiality of the positive person.

Notify all contacts.

ADDITIONAL SAFETY PLAN MEASURES: 

Please use this space to provide additional details about your program’s Safety Plan, if appropriate. 

Opening will be phased in beginning with one third individuals at the time of opening.

AMMENDMENT TO SAFETY PLAN: 9/4/2020

Program Schedule: The second group of individuals will be brought in from 10.30 am to 2pm. Based on location and choice individuals maybe given the opportunity to switch their time