b_Employee COVID-19 Screening

Type: Policy Owner:
 Policy COVID Response Team

 Title:Document # Revision Level:  Revision Date: Approval: 
Employee COVID-19 Symptom Screening Process00031.0 12/13/2020 TBD

Employee COVID-19 Symptom Screening

Process Time: 2 Minutes

When to Use: Prior to the beginning of each shift or anytime arriving at work location

Where to Complete: All Mosaic locations and prior to entering

Performed by (Role): Employee (Self Screening)

Materials Required: 

  • Thermometer
  • Witness to Self Screening (Must be Mosaic Workforce or can it be other? Do this person man the entrance or how are they notified?)
  • Employee COVID-19 Screening Form (Note: printed version may already be available on location) (This is a temp link to the form for this example)
  • Pen or Pencil

Work Instructions:


 1. - Use thermometer to take temperature
  • Is there a specific method to use?
 2. - Review results from thermometer
  • If temperature taken is 100 degrees or higher then proceed to step 5
 3. - Review symptom list below and determine answer (yes or no) for each; If answer is yes to one or more of the listed symptoms then proceed to step 5

Symptom List:
  • New or worsening cough
  • Shortness of breath
  • Loss of taste
  • Loss of smell
 4. - Workforce person that is self screening AND Witness - sign available row of Employee COVID-19 Screening Form
  • Once all parties sign Employee COVID-19 Screening Form - proceed to step 6
(Should this step be included even if Step 3 is Yes?)
 5. - Symptoms or Fever Exists - Inform and Start Isolation:
  • Notify (in person? by phone? by email? all?) supervisor of Self Screening results (Evidence of fever and/or symptoms)
  • Return home (Qualifying Action - Go Home or at minimum Leave Mosaic premises?)
  • Start Self Isolation (Link to information?)
NOTE: Do Not Document/Record Information in Employee COVID-19 Screening Form
(Are there additional instructions/processes for witness?)
 6. - End

Who cleans area of Self-Screening once this process is complete?

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