Fillable COVID-19 Response Team Face Shields Gloves (Schenectady County Community College)

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COVID-19 Response Team Face Shields Gloves (Schenectady County Community College)

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COVID-19 Response Team
COVID-19 Employee Return to Work - Needs Survey
Employee Name:
Title:
Work Location:
Date:
PPE and Needed Supplies:
Quantity
Item
Note:
Face Shields
For use by employees who cannot use a face mask. Limited
availability.
Gloves
Recommended for use by employees accepting materials from
others.
Disinfecting Spray
For daily self-cleaning of personal workstations.
Hand Sanitizer
For use when frequent hand washing is not an option.
Facilities Requests:
Item
Details
Note:
Furniture moves:
Work stations must be 6' apart from each other.
Personnel Relocation
When scheduling of shared offices that do not
permit social distancing cannot be worked out
Plexiglass Guard
Installation
For installation in areas with high levels of person-
to-person contact occur
Social Distance-Related
Signage:
To encourage 6' distancing in high traffic areas
Approvals Routing:
Department Head
Division VP
Human Resources
Administration/Facilities
Upon completion Form will be sent to Facilities for creation of a work order.
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COVID-19 Response Team Face Shields Gloves (Schenectady County Community College)

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Completed 3 February 2021

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