Our COVID-19 Response

Given the nature of our business and the population of residents we serve, we take steps on obtaining all the possible measures in response to the COVID-19 pandemic. The safety of our staff and residents is our utmost priority.

To keep our residents and staff from the risks of the pandemic, we implement on-site prevention and response management. These include providing competency-based training to our staff, performing infection control, adhering recommended safety practices, and most especially, promoting to boost our staff’s and residents’ immune system.

We continue to keep in touch with local, state, and health organizations for more updates about the outbreak. Rest assured that your loved ones are kept safe and healthy during these trying times.

COVID-19 GUIDELINES

Peace of Mind response to COVID-19

Since the pandemic started, we made a plan on how we can make our home safe since our resident population is more vulnerable than the general public.
Our infection control practices start with our residents/staff that includes:

• Daily COVID health screening including temperature taking
• Consistent reinforcement of proper hand washing, mask wearing
• Ongoing universal precaution for all staff including frequent disinfection of high touch surfaces.
• Enhanced and contactless COVID screening tool for staff, residents’ family, healthcare professionals etc. (designated e-form for employees and visitors with provided QR code to access the form online using mobile phone’s camera)
• Limited visitation; Outdoor visit for family and telemedicine for healthcare professionals. We allow some essential visits like home health nurses, PT/OT.

Healthcare Professional Visits
Peace of Mind Adult Family Home continue to allow essential, medically necessary visitors, including in-home physicians, hospice and home health agency personnel, and visiting nurses to enter our homes.
All healthcare professional visitors undergo a health screening with respect to Covid-19 symptoms such as fever, cough, shortness of breath, sore throat before entering our homes. Anyone exhibiting any symptoms of illness will not be permitted into our homes.

Prior to entry to our home, everyone must:

• Fill out COVID-19 e-form that can be accessed using your mobile phone’s camera (see under COVID-19 Screening Questionnaire)
• Check temperature with provided thermometer (Please ask the staff for temperature check)
• Wear face mask
• Wash hands with provided hand sanitizer
• Prepare and setup equipment/instrument, if necessary

During visit, everyone must:

• Practice social distancing from other residents and staff
• Only access resident’s room
• Fill out Nurse Visit form in resident’s room

Important: Please call our Operation Manager, Paolo, at 425-588-5183 with day and time of scheduled appointment.

Telehealth Visit

With guidelines discouraging outside visits to non-crisis medical appointments, all of our homes are promoting telehealth visits with physicians and other outside healthcare professionals.

Our homes’ Telehealth Visit requirements are:

• Date and time of the appointment
• Video software to use such as Zoom, Skype, Facetime, and Doxy.me.
• Log-in information such as username and password, and website link.
• Check-in time
• Information the doctor needs before and during the appointment such as vital signs and medication list.

Important: Please call our Operation Manager, Paolo, at 425-588-5183 with Telehealth Visit appointment information to avoid conflict with other residents’ appointments.

Medical Office Visit

Residents leaving the AFH for medically necessary trips such as routine primary care appointment, Therapy etc.

• Request the resident to practice social distancing and follow universal masking and good hand hygiene procedures while in the community/medical office.
• Request the person joining the resident to his/her appointment to wear a mask at all time while with the residents and
• We will continue to conduct daily symptoms screening with resident upon their return to the home and must at a minimum be observed for 14days.

Due to the chance patients that goes to community like medical offices were exposed to COVID-19 and could develop symptoms later on, we make extra precautionary measures to prevent exposure and possible transmission of the virus to the other residents that includes monitoring the resident for any symptoms such as fever, cough, shortness of breath, sore throat etc. and separate room quarantine. Exception applies if the resident is unable to follow due to psychosocial health issues.

Emergency Room Visit

There is a time that an emergency room visit is essential and medically necessary for an accurate evaluation of our residents’ health concerns such as:

• Chest pain
• Difficulty breathing
• Severe bleeding or trauma
• Loss of consciousness
• Loss of or blurred vision
• High uncontrolled fever
• Head injuries
• Burns
• Severe Abdominal pain
• Broken bones
• And any other urgent medically necessary health concerns

Our team will do the best they can to make an initial assessment and call 911. We will let emergency responders assess our resident if he/she needs to be transported to hospital’s Emergency room for further evaluation. We will call the resident’s family to inform of situation while medics assess our resident.

Hospitals have strict guidelines on how to protect their patients and staff during this pandemic such as health screening, mask requirement, hand-washing hygiene, and social distancing during emergency room visit.

What can you do to protect yourself in the emergency room?

• Wear face mask
• Avoid touching your nose, mouth, and eyes
• Practice social distance of six (6) feet from other people
• Clean your hands often, especially after touching any surfaces. Wash your hands with soap and water or use hand sanitizer.

Hospital Admission

As part of our efforts to protect our residents from any exposure to the virus, we have protocol that needs to follow for resident who gets admitted from the hospital and before returning to our home, which includes:

• COVID-19 Test with NEGATIVE result – it is a must on the day of hospital discharge before returning to home.
• Current or New resident that tested positive for COVID-19 will not be accepted in our home.
• Resident who tested positive for COVID-19 is required to have two (2) negative test results plus one (1) more negative result on the day of discharge before returning/moving to our home.

New Resident Admission

• We will require a recent COVID-19 test with negative result prior to move-in
• Family must follow our COVID-19 visitation protocol and pass our health screening including taking temperature
• New residents will be monitored daily as we been doing for current residents
• New resident will be self quarantined in his/her room and will be monitored for at least a week

Visitation Guidelines for Family

Starting on March 22nd, King County will be moving to Phase 3, which allow for more activities to resume including some changes on visitation guidelines for long term care facilities. But since our resident population is more vulnerable than the general public and we want to maintain a healthy and safe environment to our residents we will still have guidelines that we need to take in place. Please note that the visitation policy is subject to change at anytime based on the prevalence of the disease and State’s recommendations. We will do our best to keep you all informed.

Type of Visit

Remote Visits

• Use of technology to facilitate visits between residents and families, friends, spiritual community, healthcare workers etc using mobile phone, tablet or computer. Staff will be available to assist the resident during the virtual visit.

Window Visits

• Provide a first level room with a window with clear visibility to the resident’s visitor. We will provide a means of communication to the client, e.g., phone or tablet

Outdoor Visits

• Our outdoor visitation hours are only limited to 15 minutes per visit
• Outdoor visits are weather-permitting.
• Two visitors per resident during each visit

Limited Indoor Visits

While our home will allow limited indoor visits, outdoor visitation is still preferred even when the resident and visitor are fully vaccinated since outdoor visits generally pose a lower risk of transmission due to increase space and airflow. However, weather consideration and resident’s health status hinder outdoor visitation.

• Visitors must be fully vaccinated for indoor visit except for Compassionate care and assigned Essential support Person or ESP.

Individuals are considered “fully vaccinated” two weeks after the second of a two dose vaccine or two weeks after a single dose vaccine.

Compassionate Care Visits (Indoor) – 2 visitors per visit only
(See attached for detailed information about compassionate care visits)

• These types of visits are restricted to residents:
  • end-of-life (hospice) with “sharp decline in health status”
  • Psychosocial need situation
• Visits must occur in the resident’s room
• Staff will clean and disinfect the resident’s room and any other area used by the visitor.

Essential Support Person (Indoor) – (see attached for detailed information about ESP).

• The adult family home will consult with the resident to designate their essential support person (ESP) – 1 designated person per resident only
• ESP must wear a mask, or other face covering, during the entire visit unless medically contraindicated.
• ESP must use alcohol-based hand rub upon entering and exiting the visitation area.
• ESP should abide all home’s guidelines such as social distancing, limit contact with other residents and staff and limitation of movements within the facility

Note: if you have further questions regarding ESP please feel free to contact us.

VISITATION REQUIREMENTS

Note: These requirements must be followed to all types of visit except window and remote visit.

• Screening must be done outside the building/home using our COVID-19 Screening E-form that can be accessed using your personal mobile phone’s camera. (See under COVID-19 Screening Questionnaire)
• FOR OUTDOOR VISIT: Visitors should not walk through the facility/home to get to the outdoor visitation area and not allowed to engage with other residents.
• Visitors who bring children under the age of 12 are responsible for supervising the children and ensure they comply with hand washing, hand sanitizing, masking and social distancing requirements.
• Visitors who bring pets are responsible for supervising the pet(s) during a visit and are responsible for any associated sanitation requirements.
• All visitors must maintain 6 feet social distance.
• No eating or drinking during the visit as a mask must be worn over nose, mouth and chin at all times
• To keep resident safe, visitation should be limited to 30 minutes duration per visit and must contact the home to schedule to avoid conflict with the other resident’s visitor/s.
• Visits should not be scheduled at mealtimes and No visitation after 7PM (this applies to all visitors including ESP and Compassionate care visit)
• Visitors must stay in designated visitation locations. Visitors should limit the movement in the home. For example, visitor should not walk around the home such as kitchen, other resident’s room and part of the home where other residents stay. Rather, visitor should go directly to resident’s room or designated visitation area

Visitation Denials: Facilities/homes can deny visitation if they believe:

1. Circumstances pose a risk of transmitting COVID-19 in the facility/home because the resident/client or visitor does not comply with infection control guidance, or
2. The resident/client or visitor is at risk of abuse/harm.
3. Unscheduled visits.

What to do before the day of visit: As we try to limit the total number of visitors inside the home, scheduling a visit is a MUST.

• Please call or text Paolo/Pao at (425) 588-5183 to schedule your visit; this is to avoid conflict with other family who wants to visit their loved one.

VISITATION DAY & TIME SCHEDULES: allowed stay per visit is 30 minutes

• We will only allow families, relatives and 2 persons per visit only.
• We will only allow friends to visit for hospice resident with sharp decline.

TIME: (exception apply for ESP and compassionate care)
MORNING
10:00 AM – 10:30 AM
11:00AM – 11:30AM
AFTERNOON
2:00 PM – 2:30PM
3:00PM – 3:30PM

On the day of visit:

• Come 5 minutes before scheduled visit
• We will still ask all visitors to sanitize their hands
• Wear facemask (Please provide your own facemask).
• Fill out the COVID-19 e-Form, check your temperature with provided thermometer (Please ask the staff for temperature check)

We will also ask your cooperation to practice social distancing during your visit.
If you’re sick, please delay your visit.

We realized these guidelines place additional stress on you and your family but this is for the sake of our resident’s health and well being and we respectfully ask your cooperation and understanding during these difficult times.

Essential Support Person Attestation

STEPS IF SUSPECTED OR POSITIVE COVID-19 CASE BUT STABLE IN THE HOME

IF EMERGENT AND IN UNSTABLE CONDITION (i.e. SOB, gasping for air, high fever, if O2 saturation < 85%) CALL 911!

STEP 1: Start Protecting yourself, staff and household members
(Ensure everyone is wearing appropriate respiratory protection equipment)
Step 2: COMPLETE COVID REPORTING FORM. THIS WILL ENSURE YOU HAVE THE INFORMATION FOR DOH WHEN YOU CALL THEM.
STEP 3: Call DOH and notify them that you run an AFH and that you, staff member or resident has been exposed—request guidance and inquire when they will be out to the AFH to test everyone

STEP 4: REQUEST PPE FROM DOH AT TIME OF REPORT

• County specific public health officer: http://www.doh.wa.gov/AboutUs/PublicHealthSystem/LocalHealthJurisdiction
• Note: Make sure to notify them if you do not have health insurance so they can provide guidance accordingly

STEP 5: CALL THE PRIMARY CARE PRACTITIONER (PCP) AND ALL PHYSICIANS TO SEE WHAT STEPS THEY RECOMMEND TO TAKE.
Step 6: Call Your Personal PCP and Household Members PCP to make them aware of your exposure to the illness
Step 7: Locate testing clinics for yourself and staff if DOH does not provide onsite testing.
STEP 8: CALL THE FAMILIES AND LET THEM KNOW THE GUIDANCE YOU’VE RECEIVED FROM THE DOH AND MEDICAL PROFESSIONALS
STEP 9: CALL THE RESIDENTS REPRESENTATIVE AND CALL THOSE IDENTIFIED IN THE NEGOTIATED CARE PLAN
STEP 10: IF RESIDENT IS A DSHS CLIENT, NOTIFY THEIR CASE MANAGER
STEP 11: FILL OUT AND COMPLETE FACILITY INCIDENT LOG AND INDIVIDUAL REPORTS FOR EACH RESIDENT
STEP 12: FILL OUT AND SUBMIT AN ONLINE INCIDENT REPORT TO THE COMPLAINT RESOLUTION UNIT (CRU)

• Website: http://fortress.wa.gov/dshs/altsaapps/OCR/facilityOCR.FacRptInputFacility.executeLoad.action or
• Alternative: the CRU hotline can be contacted at 1-800-562-6078 but online form is preferred to show proof of submission

STEP 13: Report your Covid-19 status of residents and staff to the following website

• Website: https://fortress.wa.gov/dshs/adsaapps/lookup/FacilityStatus/UpdateStatus.aspx

STEP 14: DO AN INVENTORY OF CURRENT SUPPLIES ON HAND

N-95	Qty ______
Surgical Masks	Qty ______
Face Shields	Qty ______
Gowns	Qty ______
Gloves	Small QTY_____ Medium QTY _____ Large QTY _____

STEP 15: Order PPE from 3 sources –
State you have a confirmed case

1. Contact DOH
2. Call your local emergency management agency
3. Email DSHS PPE Form

STEP 16: Change your front door poster ( No Visitors Allowed)
STEP 17: START TAKING VITALS TWICE DAILY AND DOCUMENT (date, time, name, temperature, symptoms present)
STEP 18: Place door sign on door of residents that are Covid 19 Positive
STEP 19: GO OVER AND RE ENFORCE WITH STAFF PROPER PROCEDURES THAT NEED TO BE FOLLOWED WHEN CARING FOR

Covid-19 Infection Prevention Practices

We advised families to ONLY take their resident out if it is essential to their health/wellbeing. This is to decrease their chance of being exposed in the community. In dealing with the potential risk of Coronavirus (Covid-19), we have taken steps to limit exposure to our residents. The reality is that if young healthy people become ill with Coronavirus, it is generally a mild illness with a very low complication rate. If vulnerable adults with suppressed weakened or compromised immune systems become ill with Coronavirus, cause severe illness and even death. These are the type of people we care for in our long-term care settings.

What we know of the virus so far, is that it is spread three ways, an infected person gets droplets on you when talking, the person coughs or sneezes on you, or you touch something that they have coughed or sneezed on and then touch your own face (eyes, nose mouth) and infect yourself.

Be aware as you go about your day, if you are out in the community at the store, etc., wash your hands as soon as possible. Use the sanitizing wipes at grocery stores to wipe the cart handles down. Try to open doorknobs in the community with your sleeve, touch elevator buttons with back of your knuckle, do anything you can to avoid touching surfaces with your hands and avoid crowds who can cough or sneeze on or near you. If you come down with cold symptoms, you generally do not need to go to the doctor.

Currently, there is NO treatment for Coronavirus and no benefit for you to go to the doctor if you have mild symptoms. Most people will have mild viral symptoms.

You DO need to go to the doctor or hospital if you experience severe respiratory distress (you cannot breathe or are having difficulty breathing). When individuals have complications of coronavirus, there are respiratory complications and some need to be hospitalized for respiratory support (intubated, etc.). Please seek medical care from your own doctor/ARNP if you have symptoms that warrant testing for COVID-19.

IN THE AFH:
ENVIRONMENT:

• Keep common areas clean, clear and sanitized.
• Disinfect each shift and after a common area is used. Pay attention to high use/touch surfaces, walls and floors.
• Practice social distancing with residents, keeping them a minimum of 6’ apart at all times (married couples or partners use your discretion). Because isolation and social distancing is hard, try to come up with activities other than TV in their rooms. Figure out a way to video chat with Family, friends even health care professionals.
• When video chatting, doing virtual tours or inspections, ensure the privacy of the resident is maintained to the utmost, highest standard. Best practice is to ensure you have a photo consent/ video chat policy. Again, this should be limited to the scope or purpose to benefit the resident.
• Ensure that you are documenting vitals daily for Residents, Caregivers/Staff/Provider, other household members and outside Visitors (limited to essential visits and end of life death/transitioning/active dying) on each appropriate log, do screening if they have symptoms of fever, cough, SOB. SAVE INFORMATION LOGS (length of time is to be determined, keep track of records and ensure they are always accessible).
• Have hand sanitizer (60% alcohol or more) available at the door and in each bedroom. If it is safe to be around the resident it can be down, otherwise put it up high or in a lock box.
• Keep PPE (other than some gloves) outside of bedroom.
• Do laundry daily; wash separate and in HOT water, dry HOT.
• If anyone gets sick, try to isolate and quarantine for 14 days.

PPE Equipment and other supplies

Gloves	– Face masks (N95), Surgical cloth
Isolation gowns, robes, coveralls	– Eyewear, goggles or face shields
Thermometer (for temp.)
Hand sanitizer	– Disinfectant (Lysol, Pine-Sol, Bleach, etc.)
Disinfectant wipes	– Disinfectant spray
Paper towels	– Tissue paper or Kleenex
Hand soap	– Garbage Can with lid or hazardous waste bags
Clothing Hamper with lid unless using laundry bags that tie or close

Monitoring/logging

The Safe Start for Long-Term Care (LTC) plan from Washington State Department of Health (DOH) and Department of Social and Health Services (DSHS) with guidance from the Center for Disease Control (CDC), established criteria for long-term care facilities to safely permit visitation. The plan outlines visitation phases that are based on the infection rate per 100,000 people in the county and is independent of the Governor’s Healthy Washington Roadmap to Recovery. For additional information, please refer to the Safe Start for LTC plan document.

The phases in the LTC Safe Start Phases are independent of the regional phases in the Healthy WA Roadmap to Recovery. Facilities and agencies LTC Safe Start phases are based on county community case rates

These phases are as follows:
Each County calculates the number of new cases of COVID-19 per 100,000 residents and posts it to the DOH Risk Assessment Dashboard
LTC Phase 1: greater than 75 cases per 100,000
LTC Phase 2: between 25 – 75 cases per 100,000
LTC Phase 3: between 10 – 25 cases per 100,000
LTC Phase 4: less than 10 cases per 100,000

Types of visits:
This document outlines how our AFH will implement the following types of visitation:

• Virtual visits (All phases)
• Window visits (All phases)
• Outdoor visits (All phases; Phase 1 and 2 with limitations)
• Indoor visit ( All phases )

We still follow LTC phasing for all other activities that occur within the facility or outside the AFH ie Medically and Non-Medically Necessary Trips, Communal Dining, and Group Activities

Hand Washing:

• Staff/Provider: upon arrival to work, use hand sanitizer and do screening. Then all staff need to go immediately to the bathroom, hand washing station or kitchen sink and thoroughly wash your hands with soap and water for at least 20 seconds (ensuring the are washing fronts/backs, between fingers and under nails). Cough or sneeze into a tissue (available by the front door), which you immediately dispose of and then wash your hands. Wash your hands a lot; more frequently. Before and after ADL’s/caregiving of any kind, before and after preparing/serving food, before/after disinfection and cleaning.
• Visitors: REQUEST all visitors (family visitors, visiting nurses, all other household members, etc.) upon arrival to use hand sanitizer and do screening. Once cleared by staff, request they go to the sink and wash their hands upon arrival to the home. All staff and visitors should use hand sanitizer on their hands upon exiting the home. Encourage people to cough or sneeze into a tissue (available by the front door), then immediately dispose of and wash hands.
• Residents: request/assist they go to the sink and wash their hands prior to eating, every time they toilet and when they cough or sneeze (as able). Residents can use hand sanitizer on their hand’s prn. Be aware this dries out hands and they may need lotion too. Encourage Residents to cough or sneeze into a tissue, then immediately dispose of tissue and wash hands.

Disinfect/use of PPE equipment: every shift, every day, Caregivers need to sanitize frequently touched or handled surfaces. This includes but is not limited to faucets, grab bars, toilets, floors, counter tops, light switches, control panels, electronics/remotes frequently used or touched, refrigerator door handles, lock boxes, door handles, walls, door jambs, shelves, tabletops, nightstands, side tables, medical devices, durable medical equipment, telephones and other high-touch surfaces or items.

• Use common household cleaners (and sanitizing wipes) to wipe down and sanitize surfaces. in the home. We will use Lysol, Pine-sol and bleach products to disinfect. READ LABEL TO ENSURE PROPER USE FOR COMPLETE DISINFECTION.
• The proper way to do this is to spray a small amount of disinfectant onto a cleaning rag or actual surface (depending on label instructions) and use that dampened rag to wipe off solid surfaces, including inside and outside of doorknobs, toilet flushers, faucet handles, handles to fridge and oven and dishwasher, wheelchair and walker handles, and grab bars in bathrooms, etc.
• Masks/eyewear will be labeled with user’s name and hung outside of room. Disposable PPE will go in trash outside of room, reusable PPE will go in dirty linens hamper/laundry basket with lid/cover.
• Dirty linen hampers/laundry baskets and lids will be wiped down and sanitized in between laundry/washes.
• Laundry will be washed in hot water and dried with high heat.
• Any dirty/clean laundry for a quarantined resident will be carried by using a laundry bag or covered laundry basket/hamper. (hamper will be disinfected between use). All laundry will be washed separately in HOT water and HIGH heat.

Regarding how we will be triaging and dealing with a sick or potentially sick Resident or Caregiver:

Sick Resident: If a resident develops symptoms of an upper respiratory infection (fever, persistent cough, any shortness of breath and new or additional body aches) –
Contact Physician IMMEDIATELY. If physician does not return your call within 30-minutes we will call the physician again. All outbound calls will be documented with dates and times. If there are any changes in condition while waiting for the return phone call from physician call 911.

While waiting for (written) instructions we will isolate them in their room for suspected coronavirus symptoms and will place them on close observation vital signs to determine if they need advanced medical care. We will check their temperature, pulse, BP, respiratory rate (if able) and 02 sat (if able) every 2 hours. This is the same as standard care we always do.

When a resident is in isolation,
this resident is considered infectious until they are without a fever, fever reducer or symptoms for at least 24 hours. Resident will remain in their room during isolation measures. For a minimum of 14 days from the time of onset.

Staff will continue monitoring per physicians and department of health written instructions.

If resident is isolated, Staff will wear a properly fitted N-95 mask or surgical mask with face shield (follow/reference the CDC’s strategies for optimizing PPE supply), eye protection, gown/robe/coveralls, foot guards (if available) and double gloves when entering the room and during care (when PPE is available). Staff will remove PPE below the neck prior to exiting the room (this includes top layer of gloves), once out of the room remove second pair of gloves and then wash hands. Masks/eyewear will be labeled with user’s name and hung outside of room. Disposable PPE will go in trash outside of room; reusable will go in dirty linens hamper/laundry basket with lid/cover.

• All care to Residents will be delivered in their room or designated with the door closed. The resident shall not exit the room until the DOH/LHJ has determined the isolation/quarantine period has ended.
• During isolation, bed baths rather than showers. The use of a commode is recommended if the resident does not have their own designated bathroom inside their room. All soiled items carried out in tied bags or covered baskets.
• During isolation, a caregiver needs to remain in the room during meals to prevent choking, and to provide social interaction.
• During isolation, caregivers should cluster care (do all tasks at one time, eating, bathing, changing, repositioning, vitals, etc.), to provide all needed care during a period of time and prevent necessity of entering an isolated room multiple times. Cohorting of caregiver(s) when able (designated care person when able).
• Residents need excellent supportive care, extra fluids, excellent nutrition, skin care and TLC to recover from their illness.
• All things in must come out in bags and be disposed of, taken directly to outside garbage. If reusable, take directly to laundry room and follow laundry and disinfecting protocol.
• Sanitize ALL equipment and surfaces (remember doorknobs, door jams, walls, handles, shelves, nightstands, tables, and other surfaces.

Sick Caregiver: If a caregiver has a fever, new persistent cough, SOB, and muscle aches/pains that cannot be attributed to any other health condition or activity, they need to stay home, get tested, quarantine, report test results to Provider, and consult/get direction from DOH/LHJ. If a caregiver has been tested and has a confirmed COVID-19 infection, they can return to work when they have a negative COVID-19 test result or direction from the local DOH/LHJ, Provider must be informed of DOH/LHJ direction regarding caregiver. Caregiver will be requested to share testing results with facility Provider.

Reporting:

If a Resident becomes ill and tests positive for Corona virus/ Covid-19 you must report it to the CRU/DSHS Hotline by calling 1-800-562-6078 or filing an online incident report at https://www.dshs.wa.gov/…/residential-care-services-online-incident-reporting. Apply quarantine/isolation measures immediately and use PPE if we’ve got it.

If Staff become ill, we require them to go home and not return until cleared. No fever 72 hours and if tested for virus, positive then 2 proof negative Covid-19 tests prior to returning to work or a Dr. note clearing them to work. We will closely monitor or Residents and ensure their wellbeing. If a staff member has been fully vaccinated they may return to work when staff person is symptom free.

ALL OUTBREAKS WILL BE REPORTED TO THE CRU/DSHS Hotline by calling 1-800-562-6078 or filing an online incident report at https://www.dshs.wa.gov/…/residential-care-services-online-incident-reporting

Admitting/Re-admitting Residents:

• New admits/ Re-admits that have not been fully vaccinated (fully vaccinated means ≥ 2 weeks following receipt of the second dose in a 2-dose series, or ≥ 2 weeks following receipt of one dose of a single-dose vaccine) will be quarantined and monitored in a single room for evidence of COVID-19 for 14 days. Triage/screen them every day and document results as instructed above. If residents have been fully vaccinated, they do not have to be quarantined. New residents can be transferred out of a single room to a multi-resident room if they remain afebrile and without symptoms for 14 days after their last exposure (e.g., date of admission). Testing at the end of this period could be considered to increase certainty.
• A 14-day quarantine is not recommended for residents who are being admitted to a LTC facility if they are fully vaccinated (≥ 2 weeks following receipt of the second dose in a 2-dose series, or ≥ 2 weeks following receipt of one dose of a single-dose vaccine) and have not had prolonged close contact with someone with SARS-CoV-2 infection in the prior 14 days.
• Practice enhanced social distancing; universal precautions; use of protective wear or (PPE) if available. (as stated above)
• Hygiene and hand washing techniques (as stated above)
• Disinfection control and frequent sanitizing (as stated above)
• Laundry habits/protocol (as stated above)
• If a resident does show signs and symptoms follow the above protocol for continued isolation and care, remember to report to the CRU/DSHS Hotline, Social worker (if there is one), resident’s Dr, and local Health Department. As soon as possible after resident is settled.

ALL STAFF – Please remember to wash your hands, upon arriving to work, after being out in the community, and between residents. Washing your hands, avoiding shaking hands, and avoiding touching contaminated surfaces or touching your face, eyes, nose or mouth, is your best defense against this virus.

Our goal is to keep all of you, and our residents healthy/safe.