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Staff covid screeening forms.docx
1. HRM-EHWP/OHS Daily COVID-19 Employee Screening
Dr George Mukhari Academic Hospital
Enquiries: Ms LC Seabelo
Tel: 012 529 3374 / 0647565051
Email:Lesego.Seabelo@gauteng.gov.za
Directorate: HRM-EHWP/OHS
Ref no: Daily COVID-19 Employee Screening
HRM MEMO NO 4 OF 2020
TO: ALL DGMAH STAFF
FROM: HUMAN RESOURCE MANAGEMENT
DIRECTOR: MS O MASANGANE
DATE: 20 APRIL 2020
COVID-19 SYMPTOMS MONITORING AND MANAGEMENT OF EMPLOYEES.
1. It is mandatory that all HCWs undergo daily monitoring for COVID-19 symptoms
(cough, sore throat, shortness of breath, or fever/chills or temperature ≥ 38° C).
This process will enable:
Early and timeous identification and diagnosis of HCWs at risk of COVID-19
infection.
Early referral for appropriate treatment, care and timeous return to work of affected
workers.
Protection of other unaffected HCWs, consumers, visitors and clients of these
group of HCWs.
PROCEDURE
Screening will be at the start and prior to ending the shift for a decision to be made
for employee’s continued attendance at work.
Each HCWs will use individualiseddisposable thermometers until non-contact
thermometers are available.
Recording will be made on individualised standard daily screening tool.
The completed daily screening tool will be safely kept by the relevant Manager to
prevent risk of compromising confidentiality.
HCW with any of the above symptoms should be referred to the Screening Tent
for further clinical evaluation and COVID-19 testing.
MONITORING
Sub-directorate managers are requested to ensure that their team members are
screened daily.
Occupational Health and Safety personnel will monitor the process daily.
2. Kindly use the attached daily screening tool.
Yours sincerely
___________________
Dr LRR Lebethe
Chief Executive Officer
Date:
2. HRM-EHWP/OHS Daily COVID-19 Employee Screening
DGMAH STAFF - COVID-19 DAILY SCREENING TOOL
Surname: Name: Date of birth:
Cell number: Email address: Category:
Alternative contact details: Job title:
Next of kin (name, relationship) & contact:
Department/ Unit: Tel extension no:
Home address:
Date: DD/MM
Document morning + evening AM PM AM PM AM PM AM PM AM PM AM PM AM PM
Temperature
Symptoms (circle Y or N) Daily Daily Daily Daily Daily Daily Daily
Fever/ chills
Cough
Sore throat
Shortness of breath
Manager’s signature: