Checklist template

Employee Wellness

A ready-to-use checklist with 9 items in 3 sections, covering Travel and Contact, Symptoms of COVID-19, Personal Protective Equipment (PPE). Use it as-is in Bindy, or adapt it to your own standards in minutes.

  • 3 Sections
  • 9 Items
  • 9 Yes / No checks

Use this template How audits work

1. Travel and Contact 3 items

  1. Employee has not traveled to or returned from another country within the last 14 days. Yes / No
  2. The employee has not had close contact with anyone who has traveled to or returned from another country within the last 14 days. Yes / No
  3. There has been no close contact with anyone having symptoms of or diagnosed with COVID-19 (fever, cough, difficulty breathing) within the last 14 days. Yes / No

2. Symptoms of COVID-19 4 items

  1. Employee does not have a fever. (Verify with infrared, contactless thermometer if appropriate). Yes / No
  2. The employee is not have any of the following symptoms: fever/feverish, new or existing cough, difficulty breathing. Yes / No
  3. Employee has not been diagnosed with COVID-19. Yes / No
  4. The employee has not been instructed to self-quarantine by a medical professional. Yes / No

3. Personal Protective Equipment (PPE) 2 items

  1. Employee is supplied with necessary PPE. Yes / No
  2. The employee understands how to properly use PPE as their job requires. Yes / No

About this template

This checklist is part of the Bindy template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In Bindy you can add photos, assign corrective actions, require sign-off and compare results across sites.

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