Staff COVID-19 Health & Safety Agreement Staff COVID-19 Health & Safety Agreement It is our shared responsibility to ensure a safe workplace. JVS Toronto has developed safety guidelines in line with all Public Health recommendations to minimize the likelihood of transmission of COVID-19. It is critical that all staff comply with the following prevention practices in order to work on-site at a JVS Toronto office. It is critical that, if any of the following circumstances apply to you, you inform your manager immediately and do not come into the office: (Please note, "close contact" refers to being within 2 metres for a prolonged period of time, living with, caring for, being in a relationship with, etc.) You have tested positive for COVID-19 and have not yet been cleared by Human Resources to return to work. You have been recently tested for COVID-19 and are awaiting results. You have cold or respiratory symptoms: such as, fever/feverish or NEW cough or sore throat or difficulty breathing, headache or congestion etc. (A fever is a temperature of 38 degrees Celsius or 100.4 degrees Fahrenheit or greater.) In the past 14 days, you have been symptomatic and had close contact with someone who has a confirmed case of COVID-19. You have had close contact with a person with acute respiratory illness (new or worsening cough or shortness of breath and often fever). A member of your household, or someone you've had closed contact with, is being tested and waiting for their results for COVID 19. (Note, this does not apply if the person is someone that is being tested as part of the provincially mandated testing of LTCH staff and Emergency Childcare staff) You or a close contact has travelled outside of Canada within 14 days prior to working at a JVS Toronto site. If you are on-site and you begin to experience symptoms you will inform the on-site manager. The on-site manager will isolate you in a pre-assigned location to conduct an online assessment for COVID-19 as per the Isolation policy. Based on the outcome of the assessment you may be directed to leave the workplace, self-isolate, and get tested for COVID-19. If you are/were on-site and it is confirmed by a health care provider that you are/were infected with COVID-19 this may constitute a workplace hazard under Ontario’s Occupational Health and Safety Act. As such, you have a duty to report this hazard to management. This information helps JVS Toronto determine the time period that you were in the workplace before self-isolation and if other staff or visitors may have been exposed. In addition, while working on-site, all staff must adhere to the following health and safety protocols: Wear a cloth or disposable face mask at all times Wash your hands whenever possible Use hand sanitizer when hand washing is not feasible Wipe down and disinfect surfaces after each use Maintain physical distancing standards of 6 feet (about 2 arms’ length) from others I confirm that I have read and understand all JVS Toronto health and safety protocols. I agree to abide by these protocols while working on-site at a JVS Toronto location. Full Name * Manager’s Name * Allen Stern Allison Steinberg Amy Plourde Ana Bernstein Anca G. Cucu Anna Eskin Bill Sims Deborah Worboys Gina Lillico Ilia Shapira Irene Vaksman Jason Tooral Kaitlin Murray Kim Coulter Lucy Lu Marina Ayvazyan Matthew Rodrigues Nazreen Yousuf Neda Farahmandpour Nelly Teitelbaum Philip Hollett Robert Gauthier Sharvari Jois Sumika Takahashi Tamara Novik Trina Charles Vasthi Carrasco Yahav Barnea Zeri Zigeta Date * Signature * Clear Submit If you are human, leave this field blank.