Social Distancing Protocol
COVID-19 Site-Specific Protection Plan
Facility Address: Click or tap here to enter text.
This Protocol was most recently updated on: Click or tap here to enter text.
Maximum number of people allowed in facility at any time:
Total Facility Square Footage:
Total Facility Square Footage Open to Public:
The Person Responsible for Implementing this Protocol
Name: Click or tap here to enter text. Title Click or tap here to enter text.
Phone number: Click or tap here to enter text. Email Address: Click or tap here to enter text.
Businesses must implement all applicable measures listed below and
be prepared to explain why any measure that is not implemented is inapplicable to the business.
Signage and Distribution:
☐ Post signage at each public entrance of the facility to inform personnel and customers of the following:
☐ Do not enter the facility if you have COVID-19 symptoms;
☐ Maintain a minimum six-foot distance from others, including when in line;
☐ Sneeze and cough into a cloth or tissue or, if not available, into your elbow;
☐ Face coverings required to enter (except if 6 years of age or under or medically inadvisable);
☐ Do not shake hands or engage in any unnecessary physical contact.
☐ Post signage at appropriate locations throughout the facility reminding customers to maintain social
☐ Post a copy of your COVID-19 PREPARED Sign and Social Distancing Protocol Visitor Information
Sheet at each public entrance to the facility where staff and customers can easily view them.
☐ Copies of this Protocol will be distributed to all personnel.
☐ Personnel are trained on COVID-19 information from the CDC, how to prevent COVID-19 from
spreading, who is especially vulnerable to the disease, and when to seek medical attention.
☐ Personnel are trained on screening themselves for COVID-19 symptoms, including temperature and/or
symptom checks using CDC guidelines.
☐ Personnel are trained on the need to stay home and get tested if they have a frequent cough, fever,
difficulty breathing, chills, muscle pain, headache, sore throat, recent loss of taste or smell, or if they or
someone they live with have been diagnosed with COVID-19.
Protocol Template Updated May 18, 2020 1