COVID-19 SCREENING TOOL FOR CONTRACTORS

& THIRD PARTY SERVICE PROVIDERS

Effective September 26, 2020, in compliance with Stage 3 Regulations under the Reopening Ontario Act, each Ontario workplace is now required under O. Reg 364/20, to pro-actively screen employees entering the work environment for COVID-19-related symptoms and risk factors. Screening should occur before or when a worker enters the workplace at the beginning of their day or shift. All employees and contractors coming to the Trinity campus to perform work are required to complete a COVID-19 screening process each time they arrive on campus.

Vaccination Status:

Do any of the following statements apply to you?

• I am fully vaccinated against COVID-19
  
  
• I am partially vaccinated against COVID-19 (but not yet fully vaccinated) and I am enrolling or already enrolled in the rapid screening program
  
  
• The College has approved my request for exemption from vaccination
  
  

Fully vaccinated means 14 days following the recommended number of doses of a Health Canada-approved vaccine or 14 days after completing a Health Canada-recommended vaccination schedule for those who received non-Health Canada-approved vaccines.

          Yes                    No         

If you have answered No to this question, you have a red status. Do not come to Trinity College owned or operated property. Contact your host to determine next steps.

Screening Questions:

Please review the checklist below everyday to confirm that you do not have any symptoms or have had other exposure to COVID-19.

1. Are you currently experiencing any of these symptoms?
   
   
   • Fever and/or chills (Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higher)
     
     
   • Cough or barking cough (croup) (Continuous, more than usual, making a whistling noise when breathing (not related to asthma, post-infectious reactive airways, COPD, or other known causes or conditions you already have))
     
     
   • Shortness of breath (Out of breath, unable to breathe deeply (not related to asthma or other known causes or conditions you already have))
     
     
   • Decrease or loss sense of taste or smell (Not related to seasonal allergies, neurological disorders, or other known causes or conditions you already have)
     
     
   • Muscle aches/joint pain (Unusual, long-lasting (not related to getting a COVID-19 vaccine in the last 48 hours, a sudden injury, fibromyalgia, or other known causes or conditions you already have)
     
     
   • Extreme tiredness (Unusual, fatigue, lack of energy (not related to getting a COVID-19 vaccine in the last 48 hours, depression, insomnia, thyroid dysfunction, or other known causes or conditions you already have))
   
             Yes                    No         

2. Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms?

If you are fully vaccinated (it has been 14 or more days since your final dose of either a two-dose or a one-dose vaccine series), select “No.” If the person got a COVID-19 vaccination in the last 48 hours and is experiencing mild headache, fatigue, muscle aches, and/or joint pain that only began after vaccination, select “No.”

          Yes                    No         

3. In the last 14 days, have you travelled outside of Canada and been told to quarantine (per the federal quarantine requirements)?


          Yes                    No         

4. Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)?

This can be because of an outbreak or contact tracing.

          Yes                    No         

5. In the last 10 days, have you been identified as a "close contact" of someone who currently has COVID-19?

“Close contact” as determined or identified by a public health authority or the University of Toronto Occupational Health Nurse.

If public health has advised you that you do not need to self-isolate (for example, you are fully vaccinated or for another reason), select “No.”

          Yes                    No         

6. In the last 14 days, have you received a COVID Alert exposure notification on your cell phone?

If you are fully vaccinated (it has been 14 or more days since your final dose of either a two-dose or a one-dose vaccine series), select “No.”

If you already went for a test and got a negative result, select “No.”

          Yes                    No         

7. In the last 10 days, have you tested positive on a rapid antigen test or home-based self-testing kit?

If you have since tested negative on a lab-based PCR test, select “No."

          Yes                    No         

If you have answered Yes to the vaccination status question and No to all of the screening questions, you have a green status and may come onsite as planned. Remember to wear a mask and abide by all University/Trinity College signage and applicable public health requirements.

If you have answered No to the vaccination status questions or Yes to any of the screening questions, you have a red status. Do not come to Trinity College owned or operated property. Contact your host to determine next steps.

Contact Information:

Full Name:

Email:     and/or

Phone:

Trinity College Sponsor/Host: