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:

1. Program will post signage in highly visible locations; including site entrances, doors, restrooms. 

2. Signage will include CDC guidelines and other safe practices (i.e. proper handwashing, coughing, and sneezing etiquettes, use of mask or face covering, COVID-19 signs and symptoms, social distancing/capacity limitations, prohibition of nonessential visits).

3. Program will post signage and show videos on how to mitigate the spread of COVID-19.

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:
  • per infection control standards for protection of screener and screened person,
  • 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:
  • Facilitating departure as soon as possible, and
  • 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:

1. Agency will designate a licensed nurse to provide training on COVID-19 signs and symptoms, vital sign/temperature monitoring, and proper use of PPE. Designated nurse will also provide program support as needed.

2. Program will designate staff to conduct daily temperature checks and to ensure completion of health questionnaire for staff, individuals and essential visitors. The program will keep a log of all screenings, which will be reviewed by a supervisory staff and securely locked.

3. Temperature checks for individuals will be conducted 3x daily at a minimum. Checks will be conducted just before entering the van during pick-up, before entering the hub location/designated site for the day, and just before exiting the van at drop off.

4. Program will use non-contact/touch-less thermometers when performing temperature checks. Staff conducting temperature checks must have adequate PPE; at minimum, masks/face covering and gloves.

5. Program will actively encourage staff and individuals who are sick or who have recently tested positive for COVID-19 or had close contact with a person who tested positive to stay home. Staff and/or individuals who have a temperature and don’t successfully meet the initial health screening will be sent home or not picked up. They will be required to remain home until they are fever free for 72 hours without the use of fever-reducing medications (e.g. Advil, Tylenol). If any staff or person supported test positive for COVID-19, they will be required to adhere to the OPWDD and DOH guidelines regarding quarantine periods and fever free durations before they will be allowed to return to the program. Close contacts will also be required to stay home. Program will require clearance from a medical professional prior to returning to work or program.

6. All staff, individuals and essential visitors will be regularly monitored for signs and symptoms of COVID-19. Program will identify a dedicated room or space to isolate symptomatic staff or individuals until they can return home or to a health facility. Program will ensure cleaning and disinfecting between use.

7. Program will maintain a visitor’s log to record person’s name and telephone number for the purpose of contact tracing in the event of a suspected case.

8. Provider will notify the Local Health Department of any positive COVID-19 test results of individuals served and any staff member employed by the agency. (If Program /Services fall under the Justice Center Jurisdiction, the Justice Center will also receive notification. If program does not fall under the Justice Center Jurisdiction, phone notification will be reported to OPWDD’s IRMA Unit).

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:

1. Program will limit human presence on site by initially maintaining the Telehealth modality and providing day services in the home for those living in ARC residences. There will be a phased return to site based/in-person programming as appropriate.

2. Most meetings will continue to be conducted virtually. Meetings that warrant in-person attendance will be limited to 5 people at maximum.

3. No non-essential visitors will be permitted at the site.

4. Floor markings will be placed throughout the site; especially where lines or groups can potentially form or need to form. A distance of 6 feet will be maintained whenever possible.

5. Consideration is being given to blocking off some fixtures in restrooms to support social distancing.

6. Furniture/Chairs will be spaced six feet apart. Consideration is being given to arrange seating to face the same direction (rather than facing each other) to reduce transmission of droplets (e.g. from talking, coughing, or sneezing).

7. Arrival and dismissal times will be staggered to avoid crowding.

8. Vans will load and unload on a staggered schedule so that individuals are not entering or exiting a site at the same time.

9. To the extent possible, routes will report directly to a site in the community to avoid congestion at the hub location.

10. Volunteer opportunities must meet social distancing requirements and masks must be used. Interaction with other volunteers and the public will be limited.  

11. Restrictions on the number of employees in shared spaced; including break rooms and offices, will be enforced.

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:

1. Van capacity will not exceed 6 (including staff and individuals).

2. To the extent possible, program will create consistent groupings of the same individuals and same staff. The maximum number of participants per group will be dependent upon the location of an activity, with a maximum number of 15 people per group.

3. To the extent possible, program will refrain from intermixing groups. 4. Program will limit volunteer and recreational activities/events in closed spaces. Whenever possible, program will hold activities in outdoor locations that have space to appropriately social distance

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:

1. Program will limit human presence on site by initially maintaining the Telehealth modality and providing day services in the home for those living in ARC residences. There will be a phased return to site based/in-person programming as appropriate.

2. When possible, routes will report directly to a site to avoid congestion at the hub location.

3. Program will limit volunteer and recreational activities/events in closed spaces. Whenever possible, program will hold activities in outdoor locations that have space to appropriately social distance.

4. Program will implement stagger meal times to minimize the number of people dining inside at one time.

5. Weather permitting, groups will dine in separate outdoor and/or alternative indoor locations that support social distancing.

6. Program will prohibit the sharing of food and water bottles. Use of water coolers will be prohibited.

7. Program will encourage staff and individuals to bring meals that require minimal or no preparation. Program will also encourage the use of disposable utensils.

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:

1. Program will ensure adequate supply of PPE supplies including masks and gloves.

2. Program will provide masks for its employees, the individuals we support and visitors (as needed). Individuals and staff who choose to wear their own masks/face coverings will be reminded to clean and/or replace them as needed.

3. Staff, individuals, and visitors will be required to wear a mask or face covering however, consideration will be given when a person is unable to tolerate wearing a mask or face covering because of a medical condition, mental health condition, or disability. Temporary removal will permitted when eating or drinking or when staff are alone in an office or enclosed or separated work area or alone in a vehicle.

4. An extra supply of masks and gloves will be kept on each program van for emergency use.

5. Agency nurse will provide training on appropriate use of PPE. Program will ensure ongoing training as needed. 

F.   Hygiene and Cleaning

• 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:
    • 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, 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:
    • Frequent cleaning and rigorous disinfection of high-risk areas/high touch surfaces;
    • Use of only EPA registered products for disinfecting non-porous surfaces;
    • Adhere to proper dwell times for all cleaners, sanitizers and disinfectants per manufacturer recommendations as indicated on the product label; and
    • Ensure adequate ventilation to prevent inhaling toxic fumes.
    • Maintain site cleaning logs indicating the date, time, and scope of cleaning.
    • Keep cleaning products, sanitizers and disinfectants secure and out of reach of individuals who may misuse;
    • 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.
    • 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.
    • PPE use and hand hygiene when cleaning and disinfecting causes safety hazards.
    • 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:

1. Program will teach and reinforce proper handwshing.

2. Use signage to encourage frequent handwashing.

3. Program will keep sinks and bathrooms stocked with soap and paper towels.

4. Program will teach and encourage staff and individuals to use proper cough/sneeze etiquette and to immediately discard tissue.

5. Program will utilize step-on trash cans for touch control.

6. Program will do its best to provide hand sanitizers (based on availability).

7. Adequate cleaning solution and paper towels will be kept on site to clean and disinfect areas and will be placed in a secured area (accessible to staff).

8. The cleaning and disinfecting of high touch surface areas (such as door and refrigerator handles, copying machines, phones, microwave, sinks, table tops, etc.) will be conducted throughout the day. A log will be kept to document cleanings.

9. Work stations will be supplied with cleaning supplies for employees to sanitize their work area at the beginning of each day (at minimum).

10. Additional cleaning measures will be taken if a staff/individual is/was at the program with symptoms or a positive diagnosis of COVID-19.

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 from the same facility will be transported together; preventing individuals or staff from other residences to be intermingled whenever possible;
  • Reduce capacity on buses, vans, and other vehicles to 50% of total capacity;
  • As possible, stagger arrival and departure times to reduce entry and exit density.
  • To the extent possible, restrict close contact of individuals and staff 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. Ensure staff who cannot medically tolerate the use of a face covering are not assigned to transport individuals.
  • To the extent they can medically tolerate one, support individuals to wear masks in vehicles.
  • 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:

1. Temperature checks will take place prior to getting on the van. Each van will be equipped with a touchless thermometer.

2. Staff and individuals will be encouraged to wear a mask. However, consideration will be given when a person is unable to tolerate wearing a mask or face covering because of a medical condition, mental health condition, or disability. Temporary removal will permitted when eating or drinking or when staff are alone in an office or enclosed or separated work area or alone in a vehicle.

3. Where appropriate and safe, windows will be rolled down to permit airflow.

4. Reduced capacity on each van- no more than 6 passengers.

5. To the extent possible, individuals who are transported together will be kept together at the day program.

6. Vans will load and unload on a staggered schedule to so that individuals are not entering or exiting the site at the same time.

7. Program will use different entry and exit rather than funneling everyone through the same entry/exit space.

8. Vans will be cleaned and disinfected after each use. A cleaning log will be kept and reviewed by the Fleet Advisor. The cleaning log will indicate the date, time, and scope of cleaning.

9. Adequate supply of disinfectant, paper towels and PPE will be kept on each vehicle and monitored daily.

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:

1. Program will identify a dedicated room or space to isolate symptomatic staff or individuals until they can return home or to a health facility; cleaning and disinfecting appropriately between use.

2. Program will maintain a visitor’s log to record person’s name and telephone number for the purpose of contact tracing in the event of a suspected/confirmed case.

3. Provider will cooperate with the Local Health Department and notify them of any positive COVID-19 test results of individuals served and any staff member employed by the agency. (If Program/Services fall under the Justice Center Jurisdiction, the Justice Center will also receive notification. If program does not fall under the Justice Center Jurisdiction, phone notification will be reported to OPWDD’s IRMA Unit). 

ADDITIONAL SAFETY PLAN MEASURES:

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

Anticipated Re-opening Date: September 28, 2020     

      Upon the program’s soft re-opening, the total number of individuals and staff will not exceed 35 (25 individuals and 10 staff). Staff will be assigned to a cohort size of 5 individuals. Programming will ensure that there’s no intermixing or floating of staff and groups/cohorts. The program is subject to a temporary re-closure should the number of cases reach 5%.

      The Adult Resources Center, Inc. will ensure that all Day Services operated by ARC resume operations safely and consistently with Centers for Disease Control and Prevention (CDC), United States Department of Labor’s Occupational Safety and Health Administration (OSHA), Environmental Protection Agency (EPA), Americans with Disabilities Act (ADA), New York State Department of Health (DOH) and OPWDD requirements and guidelines. Processes and practices will be modified as information changes.