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Acknowledgement of Responsibility to Perform Daily Health Assessment - Faculty/Staff

Please carefully read and submit your Acknowledgement prior to Monday, August 10th.

Read below for the terms of the Acknowledgement of Responsibility to Perform Daily Personal Health Assessment.

To help provide a safe environment for the students and staff at Covington Catholic High School, every school employee must share in the responsibility of minimizing the potential spread of the COVID-19 virus. Covington Catholic High School has implemented numerous precautions and safeguards to help provide a safe on-campus learning environment for the students and staff. However, achieving this goal also depends on school employees doing their part. This includes ensuring that each employee does not come to school, or attend any school-related activities, if the employee is showing signs or symptoms of potentially having the COVID-19 virus.

Accordingly, it is required that each employee complete the following daily personal health assessment each day before the employee leaves home for school or a school-related activity, as follows:

Daily Personal Health Assessment

1. Does the employee have a temperature of 100.4 or greater, as measured by a reliable and accurate home thermometer?

2. Does the employee have any COVID-19 related symptoms, including persistent non-allergy related cough, shortness of breath, difficulty breathing, chills, muscle pain not attributable to recent activity, sore throat, new rash, GI symptoms (i.e., vomiting or diarrhea), or new loss of taste or smell?

3. Has anyone in the employee’s household been diagnosed with, or showing symptoms of, COVID-19?

4. Has the employee been in recent close contact (i.e., past 48 hours) with anyone exhibiting symptoms of COVID-19 who has tested positive, not been tested, or is waiting for test results?

If the answer is “yes” to any of the foregoing questions, the employee is not permitted to report to work or attend any school-related activity, and the employee must contact the school office immediately. Depending on the circumstances, the employee may not be permitted to return to school until the employee receives authorization from a healthcare provider that it is safe for the employee to return.

Upon arrival at school, as well as throughout the day, employees may have their temperatures taken by school staff. If an employee has a temperature of 100.4 or greater, or if the employee is exhibiting any COVID-19 symptoms, the employee must leave school as soon as possible.

Each employee must sign the second sheet of this document acknowledging that they have read, understood and agree to comply with the terms of this document. The first page of this document must be kept at home for daily review before the employee leaves for school or any school-related activity.

I have received, read, understand and agree to comply with the terms of the Employee Acknowledgement of Responsibility to Perform Daily Personal Health Assessment. If I answer “yes” to any of the questions contained in the Daily Personal Health Assessment, I understand that I cannot report to work or attend any school-related activity, and that I must call the school office immediately. My attendance at work or any school-related activity on any day serves as my acknowledgment that I have completed the daily health assessment and that all answers were “no.”

Employee's Legal Name

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