Are there more than 50 workers in one location at the same time? *
Have you observed more than four (4) workers at a time riding an Elevator?
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How many Hand Wash stations are there on site? (If none answer none)
Your answer
How many Hand Sanitizer stations are there on site? (If none answer none)
Your answer
Are Hand Wash and / or Hand Sanitizer stations properly maintained? (Refilled regularly, etc.)
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How many Flush Toilets on site? (If none answer none)
Your answer
Are Flush Toilets properly maintained? (Regularly cleaned, stocked, etc.)
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How frequently are common areas like Lunch and Break Rooms cleaned and sanitized?
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Have you observed any Worker on site who appears visibly sick?
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Are you aware of any Worker on your site who has tested positive for COVID-19 (Coronavirus)?
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If you raised any of these, or any other Health & Safety concerns with your Employer, what was their response? (Please include approx. when you raised your concerns.)
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Do you have any other comments specifically about your worksite to share?
Your answer
A copy of your responses will be emailed to the address you provided.