Oak View Union Elementary School District COVID-19 Daily Self-Screening Assessment

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Individuals that are fully vaccinated against COVID-19; that is those who have received:
*2 doses of Moderna Vaccine and 14 days have past since their last vaccine; or
*2 doses of Pfizer Vaccine and 14 days have past since their last vaccine; or
*1 does of Johnson and Johnson/Janson and 14 days have past since their last vaccine; and
*who do not have signs and symptoms of COVID-19 no longer need to complete daily COVID-19 screening.

Fully vaccinated individuals that come into close contact (less than 6 feet for more than 15 minutes) with someone that has COVID-19 need to monitor for symptoms of COVID-19. If symptoms appear after exposure to someone with COVID-19, complete the checklist below, self quarantine for 10 following the appearance of symptoms and notify the school superintendent.

Individuals that are not fully vaccinated (do not meet the above criteria) must continue to complete daily screening prior to coming to work.

Under the order of the San Joaquin County Public Health Officer and CDPH:
• If you are COVID-19 positive, you must isolate for 10 days after symptoms first appeared and until you are fever-free for 24 hours without fever-reducing medication and see improvement in symptoms. If you have been diagnosed with COVID-19 and have no symptoms (asymptomatic), you must stay home for 10 days from the date of your positive COVID-19 test.
• If you have had close contact, less than 6 feet for 15 minutes or more, with someone who is COVID-19 positive or has been told by a health care provider to get tested for COVID-19, you must quarantine for 10 days from your last exposure to the COVID -19 positive person.
• If you have signs and symptoms of COVID-19 but test negative and you have had no known exposure to someone COVID-19 positive, you may return to work 3 days after symptoms resolve.

In answering yes, you may be contacted by the nurse.

Email *

First and Last Name *

Please share your phone number

Do you have any of the following COVID-19 symptoms in the past 48 hours? (Mark all that apply) *

I have no COVID-19 symptoms

Temperature of 100.4 degrees or higher

Shortness of breath or difficulty breathing (unexplained)

Cough (unexplained and unrelated to existing allergies or underlying chronic condition)

Runny nose or congestion (unexplained and unrelated to existing allergies or underlying chronic condition)

Chills

Fatigue (unexplained)

Headache, muscle aches, or body aches (unexplained)

New loss of taste or smell

Nausea or vomiting (unexplained)

Diarrhea (unexplained)

Sore Throat (unexplained)

Required

Are you isolating or quarantining because you tested positive for COVID-19, came into close contact (less than 6 feet for 15 minutes) with someone with COVID-19 or someone with COVID-19 symptoms? *

Yes

If you indicated YES to any of the above questions, stay home, contact your health care provider, notify the Superintendent, and follow established leave procedures. If you indicated NO to all of the above questions and do not have any COVID-19 symptoms, you may report to your worksite. All employees must follow SJC Public Health protocols for physical distancing and face coverings, and practice general safety precautions while at Oak View Union Elementary School District worksite. If you feel ill or exhibit COVID-19 symptoms at any time during your shift, please put your mask on, notify your supervisor, and go home. By submitting this form, you attest to the accuracy of the information provided. Thank you for completing this form.

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