Each business or entity, including those that have been designated as essential under Empire State Development’s Essential Business Guidance, must develop a written Safety Plan outlining how its workplace will prevent the spread of COVID-19. A business may fill out this template to fulfill the requirement, or may develop its own Safety Plan.
This plan does not need to be submitted to a state agency for approval but must be retained on the premises of the business and must made available to the New York State Department of Health (DOH) or local health or safety authorities in the event of an inspection.
Business owners should refer to the State’s industry-specific guidance for more information on how to safely operate. For a list of regions and sectors that are authorized to re-open, as well as detailed guidance for each sector, please visit:
forward.ny.gov. If your industry is not included in the posted guidance but your businesses has been operating as essential, please refer to ESD’s Essential Business Guidance and adhere to the guidelines within this Safety Plan. Please continue to regularly check the New York Forward site for guidance that is applicable to your business or certain parts of your business functions, and consult the state and federal resources listed below.
COVID-19 Reopening Safety Plan
Name of Business:
Gurwin Jewish Nursing & Rehabilitation Center
Skilled Nursing Facility
68 Hauppauge Road, Commack, NY 11725
Joanne Parisi, Vice President/Administrator 631-715-2600
Owner/Manager of Business:
Not for Profit Facility
Human Resources Representative and Contact Information, if applicable:
Kristy D’Errico, Chief People Officer 631-715-2678
A. Physical Distancing. To ensure employees comply with physical distancing requirements, you agree that you will do the following:
[X] Ensure 6 ft. distance between personnel unless safety or core function of the work activity requires a shorter distance. Any time personnel are less than 6 ft. apart from one another, personnel must wear acceptable face coverings
[X] Tightly confined spaces will be occupied by only one individual at a time unless all occupants are wearing face coverings. If occupied by more than one person, will keep occupancy under 50% of maximum capacity
[X] Post social distancing markers using tape or signs that denote 6ft. of spacing in commonly used and other applicable areas on the site (e.g., clock in/out stations, health screening stations)
[X] Limit in-person gatherings as much as possible and use tele- or videoconferencing whenever possible. Essential in-person gatherings (e.g., meetings) should be held in open, well-ventilated spaces with appropriate social distancing among participants.
[X] Establish designated areas for pick-ups and deliveries, limiting contact to the extent possible.
List common situations that may not allow for 6ft. of distance between individuals. What measures will you implement to ensure the safety of your employees in such situations?
Shared offices will be arranged to maintain 6-foot separation where possible. When not practical office space will be cleaned between use and employees will wear masks when in the shared office space.
Elevators: Signage will be posted in elevators limiting occupancy
Locker Rooms: Signage to be placed in locker rooms noting social distancing.
Resident Care: Residents will be provided with masks and encouraged to use as tolerated. Staff to bundle care whenever possible to limit interaction time.
Lounge areas: Furniture has been removed to allow for social distancing.
Staff will utilize communication devices to interview residents as applicable.
How you will manage engagement with customers and visitors on these requirements (as
Conditions of entry into the facility for any customer and visitor are displayed: Including wearing a mask upon entrance to the facility, maintaining social distancing, and proper and frequent hand washing is required.
The facility will post the facility visitation policy and safety plan requirements on the website. While taking a person-centered approach and adhering to the core principals of COVID-19 infection prevention, outdoor visitation will be preferred even when the resident and visitor(s) are fully up to date with recommended vaccinations.
The core principles of COVID-19 Infection Prevention will be followed which include screening of all who enter the facility for signs and symptoms of COVID-19 which includes completing questions and observation of symptoms. Visitors will be required to complete a health screening form prior to entry and have their temperature checked. Visitors will be denied entry if they have signs of symptoms of COVID-19, have temperature of 100.0F or greater, had close contact with known COVID-19 person, are currently positive for COVID or positive in the last 10 days.
The facility will use the outside courtyard in the Weinberg and Schachne Building and Memory Care Unit weather permitting.
The facility recommends only 2 guests for in room visits to allow for social distancing. Accommodations will be made for additional visitors.
Indoor visitation may occur in closed section of dining area on Memory Care Unit, family rooms, and vacated dining rooms when residents share a room. In room visits may occur when the resident’s health status prevents leaving the room.
Visitors who are unable to adhere to these principles of COVID-19 infection prevention will not be permitted to visit or will be asked to leave.
Visitors must physically distance from facility personnel and other patients/residents/visitors that are not directly associated with the specific resident(s) being visited by that individual.
All visitors are required to receive a negative SARS-CoV-2 test result
one day prior to visitation for antigen tests and two days prior to visitation for NAAT (e.g., PCR) tests. All visitors may use either NAAT testing or antigen testing. This means, for example, that a test for a Sunday visit should be conducted no earlier than Saturday if it’s an antigen test or Friday if it’s a PCR test. Any PCR or antigen test used must either have Emergency Use Authorization by the U.S. Food and Drug Administration or be operating per the Laboratory Developed Test requirements by the U.S. Centers for Medicare and Medicaid Services. The facility will provide the rapid COVID self-testing kits if requested.
A COVID-19 visitor guidance form is available for visitors upon entrance. Visitors will be requested to complete hand hygiene with ABHS at the screening table and throughout their stay.
Educational resources will be available to all visitors on COVID-19 symptoms, testing, and measures to prevent transmission. Signage is posted in the facility
Signage will be posted at screening areas of potential for COVID-19 exposure in the facility (e.g., signage regarding current outbreaks), and adherence to the core principals of COVID-19 infection prevention, including effective hand hygiene and use of face-coverings. Signage will be noted above ABS for hand hygiene.
How you will manage industry-specific physical social distancing (e.g., shift changes, lunch breaks) (as applicable)?
Employee break rooms: Signage is posted, marking on floors noting appropriate seat placement, which is 6 feet, break times on units are staggered as applicable.
Tables and chairs in the employee dining area have been rearranged to allow for 6-foot distancing between staff.
Large meetings, resident council, and staff education will be held via zoom or conference call as practical.
All meeting rooms have decreased the capacity by 50% with social distancing signage in those areas posted
A. Protective Equipment. To ensure employees comply with protective equipment requirements, you agree that you will do the following:
[X] Employers must provide employees with an acceptable face covering at no-cost to the employee and have an adequate supply of coverings in case of replacement.
What quantity of face coverings- and any other PPE- will you need to procure to ensure that you always have a sufficient supply on hand for employees and visitors? How will you procure these supplies?
Facility is maintaining a minimum of 60 days of PPE supply in locked storage area.
The facility utilizes a PPE burn calculator to identify use.
The facility has established prime vendors for PPE procurement. Weekly deliveries are received and reconciled based upon requested orders. When par levels cannot be met by prime vendors the facility has identified alternate/3
rd party vendors. Bulk orders of PPE are placed thru these vendors.
HERDS report is completed as per regulations to identify facility PPE amounts and needs.
[X] Face coverings must be cleaned or replaced after use or when damaged or soiled, may not be shared, and should be properly stored or discarded.
What policy will you implement to ensure that PPE is appropriately cleaned, stored, and/or discarded?
Gurwin has a policy for use of PPE to address both disposable and reusable PPE items within the facility.
Staff are inserviced ongoing on the appropriate usage of PPE as well as the infection control procedures for appropriately cleaning and storing PPE for multiple uses and disposable of one time use PPE items. Competency evaluations on PPE use are done on facility staff ongoing.
Surgical Masks in are distributed to all employees, vendors, contract staff, and essential visitors upon entrance to the facility. Masks are to be removed when soiled or moist.
There is a training video for donning and doffing PPE on the facility intranet in the policy section for reference for employees.
Signage is on all units on PPE donning and doffing procedure.
Surveillance on compliance with PPE use, cleaning, and storage is being done ongoing and reported to the QAPI committee.
[X] Limit the sharing of objects and discourage touching of shared surfaces; or, when in contact with shared objects or frequently touched areas, wear gloves (trade-appropriate or medical); or, sanitize or wash hands before and after contact.
List common objects that are likely to be of shared between employees. What measures will you implement to ensure the safety your employees when using these objects?
EPA approved disinfectant wipes are located on all units, rehab gyms, office areas, and shared spaces for staff to use when equipment/materials are shared between residents/employees.
Touchless Alcohol based hand sanitizer dispensers are located adjacent to time clocks.
Computers, kiosk, telephones, desktops are wiped between use and at the beginning of the shift with EPA approved disinfectant wipes.
Disposable equipment is utilized whenever possible.
B. Hygiene and Cleaning. To ensure employees comply with hygiene and cleaning requirements, you agree that you will do the following:
[X] Adhere to hygiene and sanitation requirements from the
(CDC) and Centers for Disease Control and Prevention (DOH) and maintain cleaning logs on site that document date, time, and scope of cleaning. Department of Health
Who will be responsible for maintaining a cleaning log? Where will the log be kept?
The Chief Housekeeping Officer/ Designee will be responsible for maintaining cleaning logs. All cleaning log documents are in the housekeeping office.
[X] Provide and maintain hand hygiene stations for personnel, including handwashing with soap, water, and paper towels, or an alcohol-based hand sanitizer containing 60% or more alcohol for areas where hand washing is not feasible.
Where on the work location will you provide employees with access to the appropriate hand hygiene and/or sanitizing products and how will you promote good hand hygiene?
Alcohol based touchless hand sanitizer dispensers are located throughout the facility at the following locations: each nursing unit hallway, all entrances /exits, rehab gyms, outside dining areas, lobby areas, resident rooms, and at time clocks. Hand washing sinks are in all the resident dining rooms, at the nursing stations, medication rooms, resident rooms, meeting areas, and gyms. Hand sanitizers are in dining rooms, gyms, on medication carts and in all personal offices.
The facility promotes good hand hygiene through education and signage throughout the facility including the employee rest rooms, and at the entrance.
The facility intranet has a hand hygiene video for all staff for review.
Hand hygiene competencies are completed by all departments and reported to the QAPI Committee.
The facility will ensure the bathrooms and other hand washing areas are well stocked with hand soap and paper towels.
[X] Conduct regular cleaning and disinfection at least after every shift, daily, or more frequently as needed, and frequent cleaning and disinfection of shared objects (e.g. tools, machinery) and surfaces, as well as high transit areas, such as restrooms and common areas, must be completed.
What policies will you implement to ensure regular cleaning and disinfection of your worksite and any shared objects or materials, using products identified as effective against COVID-19?
The Chief Housekeeping Officer/Designee and Interim Director of Purchasing will procure all products for cleaning. The Chief Housekeeping Officer/Designee and Interim Director of Purchasing will review the EPA list prior to procurement of any disinfectant to ensure the product has been identified as effective against COVID-19.
EPA approved cleaning wipes are available in all departments, gyms, and on nursing units for cleaning shared items.
Employees will wipe down their assigned workspace, telephones, and computers prior to use with disinfectant wipes.
The Chief Housekeeping Officer/Designee completes random audits to inspect and validate the cleaning process on resident rooms, common areas, equipment, and high touch surfaces. Audit findings are presented to the QAPI Committee for review and evaluation.
C. Communication. To ensure the business and its employees comply with communication requirements, you agree that you will do the following:
[X] Post signage throughout the site to remind personnel to adhere to proper hygiene, social distancing rules, appropriate use of PPE, and cleaning and disinfecting protocols.
[X] Establish a communication plan for employees and visitors with a consistent means to provide updated information.
[X] Maintain a continuous log of every person, including workers and visitors, who may have close contact with other individuals at the work site or area; excluding deliveries that are performed with appropriate PPE or through contactless means.
Which employee(s) will oversee maintaining a log of each person that enters the site (excluding customers and deliveries that are performed with appropriate PPE or through contactless means), and where will the log be kept?
The facility uses the kiosk system (Accushield) to maintain an electronic log of screening questions/responses of every person that enters the facility. The electronic reports can be accessed by Administration/ICP.
[ X ] If a worker tests positive for COVID-19, employer must immediately notify state and local health departments and cooperate with contact tracing efforts, including notification of potential contacts, such as workers or visitors who had close contact with the individual, while maintaining confidentiality required by state and federal law and regulations.
If a worker tests positive for COV/D-19, which employee(s) will be responsible for notifying state and local health departments?
The Director of Nursing/ICP//Designee will be responsible for notifying state and local health departments when a worker tests positive for COVID-19.
A. Screening. To ensure the business and its employees comply with protective equipment requirements, you agree that you will do the following:
[ X ] Implement mandatory health screening assessment (e.g. questionnaire, temperature check) before employees begin work each day and for essential visitors, asking about (1) COVID-19
, (2) positive COVID-19 test in past 10 days, and/or (3) close contact with confirmed or suspected COVID-19 case in past 10 days. Assessment responses must be reviewed every day and such review must be documented with a signature. symptoms
What type(s) of daily health and screening practices will you implement? Will the screening be done before employee gets to work or on site? Who will be responsible for performing them, and how will those individuals be trained?
The facility has only one entrance open for employees, vendors, contract personnel, and visitors. There are 4 kiosks for all persons entering the facility to complete the screening questionnaire and perform temperature checks.
All visitors and staff will be screened daily prior to entering the facility. The assessment is completed on the kiosk and the assessment is electronically gathered and maintained. The information can be accessed at any time by the Director of Engineering/ICP/Administration. If the kiosk is not used the screeners will maintain a log of the visitors/staff including notation that the individual was cleared and time of entry. This log will be maintained in electronic format.
No person (employees, vendors, contract personnel, or visitor) can go past the screening area unless they have completed the mandatory assessment questions and have a temperature check. If the kiosk is unable to be used the screener will document the assessment responses on the screening log. The Infection Control Preventionist/Designee does random audits of the screening logs.
The visitor will receive a printed name tag signifying they have cleared screening.
If the visitor entering the facility identifies they have symptoms of COVID, had an exposure, tested positive for COVID in last 10 days, or have an elevated temperature an alert will be triggered, and the receptionist/security will not allow them to enter the facility.
All receptionists and security guards are trained on the screening process by ICP and Chief Engagement Officer.
Audits are done by the ICP/Designee to ensure compliance with the screening process and presented to the QAPI Committee for review and evaluation.
If screening onsite, how much PPE will be required for the responsible parties carrying out the screening practices? How will you supply this PPE?
The receptionist/Security Guards will wear surgical masks at all times while at front desk. The PPE for this function is provided by the facility and included in the established par levels.
B. Contact tracing and disinfection of contaminated areas. To ensure the business and its employees comply with contact tracing and disinfection requirements, you agree that you will do the following:
[X] Have a plan for cleaning, disinfection, and contact tracing in the event of a positive case.
In the case of an employee testing positive for COVID-19, how will you clean the applicable contaminated areas? What products identified as effective against COVID-19 will you need and how will you acquire them?
The ICP/Designee will notify the Department Head of any employee who tests positive for COVID-19. The Department Head will notify ICP/Designee if any of their staff report being positive. The Department head will notify the Housekeeping Department to complete a thorough cleaning of the employee’s office space as applicable.
In the case of an employee testing positive for COVID-19, how will you trace close contacts in the workplace? How will you inform close contacts that they may have been exposed to COVID-19?
The ICP/Designee/Department Head will notify Human Resources of any employee that tested positive for COVID-19. The ICP/Designee will contact that employee to establish if the employee is symptomatic/asymptomatic. This information and testing date will be utilized by the ICP to establish an appropriate timeline for contact tracing. The ICP/Designee will also interview the employee to establish any significant contacts amongst staff/residents. All residents and their designated representatives identified will be notified of a possible exposure to a COVID -19 positive employee. Any employee identified that had significant close contact with the confirmed positive employee will be notified by the appropriate Department Head/ICP/Designee. Human Resources will maintain list of all employees who have tested positive for COVID.
VISITATION STATED ON FIRST PAGE SECOND QUESTION
Please use this space to provide additional details about your business’s Safety Plan, including anything to address specific industry guidance.
Staying up to date on industry-specific guidance:
To ensure that you stay up to date on the guidance that is being issued by the State, you will:
[X] Consult the NY Forward website at
forward.ny.gov and applicable Executive Orders at governor.ny.gov/executive orders on a periodic basis or whenever notified of the availability of new guidance.
State and Federal Resources for Businesses and Entities
As these resources are frequently updated, please stay current on state and federal guidance issued in response to COVID-19.
New York State Department of Health (DOH) Novel Coronavirus (COVID-19) Website Centers for Disease Control and Prevention (CDC) Coronavirus (COVID-19) Website Occupational Safety and Health Administration (OSHA) COVID-19 Website
CDC Guidance for Businesses and Employers to Plan, Prepare and Respond to Coronavirus
OSHA Guidance on Preparing Workplaces for COVID-19
Personal Protective Equipment Guidance
DOH Interim Guidance on Executive Order 202.16 Requiring Face Coverings for Public and
OSHA Personal Protective Equipment
Cleaning and Disinfecting Guidance
New York State Department of Environmental Conservation (DEC) Registered Disinfectants of COVID-19
DOH Interim Guidance for Cleaning and Disinfection of Public and Private Facilities for COVID-19
CDC Cleaning and Disinfecting Facilities
Screening and Testing Guidance
DOH COVID-19 Testing
CDC COVID-19 Symptoms
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