EH&S Pandemic Return to Work Safety Plan
This Return to Work Safety Plan must be completed by management or designate for each department at Mount Royal University as one step in preparing for employees' return to work on campus. Overall plans are reviewed by the Planning Ahead Team (PAT) and approved by President's Executive Committee (PEC).

Submit this plan for review at least three working days before the anticipated return date of employees.

Employees cannot return to campus until EH&S has reviewed this plan, the appropriate cleaning and personal protective equipment (PPE) materials are available, and any updated occupancy limits for shared spaces are posted before employees can return to campus.

EH&S may inspect any work area on campus and has the authority to stop unsafe work.

PLEASE NOTE: Share this plan with employees on or before their return to campus, and post it in a shared, easily accessible place in the department. A copy will be kept with EH&S.

Sign in to Google to save your progress. Learn more
Email *
Name and title of person completing this form *
Your division or office *
Your department or faculty *
Unit or team manager/lead *
Office number(s) *
Expected return date *
MM
/
DD
/
YYYY
If yes, how will you maintain physical distance between people? *
What items in your shared work spaces will need to be cleaned between users? (e.g., taps, coffee maker, photocopier). Who will be responsible for cleaning the items? *
What items in your shared work spaces will need increased regular cleaning in addition to wipe-downs between users? (e.g., railings, door handles). Who will be responsible for cleaning the items and what is the schedule? *
What will be used to sterilize shared high-touch surfaces? *
Among your employees, who is the point person that others in your area can contact if they need supply refills? *
How will you manage movement and the flow of people in the work space? (e.g., directional arrows for hallways) *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mount Royal University. Report Abuse