We are preparing online training (in terms of staff and workspace preparation) which will be available at https://sheq.teachable.com very soon – please check back regularly.
Pre-Start Screening Questionnaire:
In this kit we cover how companies can return to work. The concept of returning to work especially under the conditions of a virus that has caused a lockdown in a country needs to be carefully considered.
In response to this there are a series of questions that will need to be asked of every single employee and that will include top management all the way down to labourers, contract workers, security guards, as well as visitors. It is obviously a large set of questions that need to be addressed as to what has been happening during a pandemic and how are we to respond to this as health and safety professionals.
Return to work for the Company / organisation:
- Are you getting ready to go back to work yes or no?
- Do you have a well thought out process to start up work activities again with confidence?
- Would you like a list of good questions to ask staff when screening or testing and what to do and records to keep?
Listed below are the key questions that would need to be asked with each returning employee and probably requires documented information and the important point behind documented information is that these may become a declaration or statement that can be held against an employee who makes false statements regarding their health status on returning to work.
These kind of declarations or health statements are very important, as taking on staff back into a work environment where the conditions of work have changed dramatically needs to be well thought out and considered. To do this the series of questions, in the form below is what will be attached to an induction process back into the company when the doors reopen, and is vital so it needs to be addressed.
These questions are be structured in such a way that they are easy for the employee to understand and secondly that the employee will be able to realise that this is been a serious situation and because of that they will have to respond with truthful and honest answers.
Opening questions:
# | Question: | Yes | No |
1 | Have you or any of the people in your family or friends or social circle of your neighbourhood knowingly been in contact with persons who have contracted the coronavirus illness and perhaps have been hospitalised? | ||
2 | Has any indications of illness or sickness been found inside your close family circle and circle of friends during the last 21 days? | ||
3 | Have you had any symptoms of cold or flu influenza, chest coughing, shortness of breath, or any other condition that might be an indicator that you could be affected by but not yet hospitalised through this viral disease? | ||
4 | Have you been feeling well and good over the last 70 days? | ||
5 | Have all the family members around you been well and fit and eating properly during the last 70 days? | ||
6 | Do you know whether you have been exposed to strangers that you’ve never met before and you been close to these people or in the close proximity, meaning right next to such people on an ongoing basis? It is important to understand that social distancing has been a condition that has been imposed upon South African citizens since 26 March 2020 | ||
7 | Based on social distancing have you maintained your social distancing processes where ever you have been for the last 70 days. | ||
8 | Do you believe that you might have been exposed to the virus but have not shown any symptoms of the virus at this point in time? | ||
9 | Have you been tested for coronavirus or Covid-19 over the last 70 days? | ||
10 | In terms of having been tested if your answer was yes, then have you had your results back in terms of such tests for Covid-19. | ||
11 | Were you screened at any point where similar questions like these being asked of you today were asked to establish your potential to have contracted or been in touch with this particular virus? | ||
12 | If you were screened when did that take place and can you please record the date that it happened? | ||
13 | As a follow-up to screening where were you tested for Covid-19? | ||
14 | If you have been tested have you received those results and what was the outcome of those results? | ||
15 | Have you been eating properly and maintained good nutrition during the lockdown period- good health? | ||
16 | Have you experienced any other ailment illness disease or injury during your time away from work during the lock-down. If you have been found to have any disease illness or ailment or being treated for anything during this period of time please note down what it was. | ||
17 | If you are still suffering from the effects of an ailment and illness a disease or an injury on your return to work please declare what that is and what treatment you are receiving for it? | ||
18 | Are you fit and well and ready to return to work? | ||
19 | Do you declare that all the information that you have given in this interview has been correct is truthful and that you understand that it is binding upon you under law? | ||
20 | Do you appreciate / understand that making a false declaration and returning to work where you may be a vector [source] or an initiation point for infecting other persons once we have returned to work could be a serious offence in under the laws relating to the national disaster? | ||
21 | Are you prepared to fully cooperate with your employer and any and all authorities in relation to declarations of health or illness during the next 90 days of your employment or as long as he state of emergency exists? | ||
22 | Do you agree that these questions have been asked in a fair and open manner and require fair and open answers to ensure that all parties both the organisation your colleagues your friends and your family are well protected from the effects of a deadly disease at this point in time under the conditions of a pandemic? | ||
23 | Have you provided truthful answers? | ||
24 | Do you consent that in the event that you are found to have answers or a temperature that requires further investigation that the company may share these answers to the relevant authorities to assist in contact tracing and other related steps in dealing with the spread of the virus? | ||
25 | Do you understand that the answers you have given are kept confidential by the company under both the POPI Act and our HR policies? | ||
26 | Do you understand that you may not stigmatise, call names, insult, or cause emotional or physical harm to anyone who is thought to have any symptoms for which a medical investigation is needed or who is tested positive and is receiving treatment for Covid-19? | ||
27 | Based on that question, any evidence brought to the attention of the management will be investigated whether verbal, written or in any other media whether private or the company owned systems, and may result in disciplinary processes being instituted. | ||
28 | Have you travelled from outside the province to come to work from another town or district, and if yes, which area? | ||
29 | When you travelled from the other area, which mode of transport did you use and did you practice social distancing rules during your travel? [Wore a face mask, washed hands and kept safe distances from others]? | ||
30 | Are you over 60 years of age and you agree to adhere to the precautions put in place by the Company for your protection until removed by the State? | ||
31 | Do you understand that the Government has declared Covid-19 as a notifiable disease and that the company has to ask you these questions to ensure that you are safe and that you keep your fellow workers safe by following the work guidelines you were trained on by the company as required by laws such as the OHS act and the Hazardous Biological Agents Regulations? | ||
32 | Did you receive the Covid-19 briefing on the new workplace regulations before or on returning to work? | ||
33 | Do you have someone at home who is in the vulnerable group – over 60 and sick – who you care for? | ||
34 | Do you understand that vulnerable also includes people with : HIV, Diabetes, High Blood Pressure , Hypertension, Liver disease, Kidney disease or on Kidney dialysis treatment, Heart Disease or even taking Beta Blockers or have a pacemaker fitted, any other forms of illness that cause high fever temperature – and that we must all look after such people with good care. | ||
35 | How are you feeling today? [again – confirm statement of Ok to work]. | ||
36 | Are you under financial stress or any other kind of worry right now that may affect your work? Do you need counselling? |