As park and recreation professionals begin to reopen facilities and reinstate programming, they should consider how they will conduct health and wellness screenings of both staff and the public. This process will help to ensure that persons showing signs of illness are not admitted to the facility or program, reducing the risk of transmission. NRPA recommends that agencies conduct screenings in all phases of reopening and that agencies establish publicly shared protocols outlining the screening process, frequency and monitoring. There are several methods and options for conducting screenings and processes should be developed in consultation with state and local public health and government officials to ensure procedures are in alignment with public health guidance and won’t result in legal implications. 

Prior to implementing screening processes, all staff should be properly trained on all protocols, policies and proper chain of command. Additionally, staff should receive customer service and de-escalation training.

Some potential screening methods are outlined below.

Screening Questions

At a minimum, staff and participants should be screened by answering a series of questions related to their health and well-being.

Download a Printable Version of the Health Screening Questionnaire

Questions may include:

1. Do you currently have a fever, cough, sore throat, shortness of breath, new loss of taste or smell, or any other COVID-19 or flu-like symptoms (nausea, vomiting, diarrhea, etc.) or have you had any of these symptoms in the last 48 hours?

2. Have you been diagnosed with COVID-19 by a medical provider in the past 14-days?

3. In the past 14-days, have you had close contact (within 6 feet for equal to or greater than a 10-minute period of time or living in your household) with a person who has been diagnosed with COVID-19 by a medical provider?

4. Have you been told by a medical provider or public health official within the past 14-days that you should self-quarantine due to potential COVID-19 exposure, or that you are suspected of having COVID-19?

If the person answers “no” to all questions, staff and visitors can proceed with participation.

If the person answers “yes” to any questions, staff should leave immediately and consult a manager to determine options. If a visitor answers “yes” to any questions, staff should review the results, not allow the visitor to enter, and refer the visitor to seek medical or public health guidance and self-isolate. See sample questionnaire for example of protocols.

Temperature Screening

Some agencies may also choose to conduct more comprehensive health and wellness screenings, including taking the temperature of staff and participants and conducting visual inspections. According to CDC, if staff or participants have a temperature of 100.4 degrees or above or appear to have symptoms of COVID-19, they should not be admitted to the facility or program.

CDC Temperature Screening at a Distance Guidance

• Ask staff or participants to take their temperature either before coming to the facility or before entering the facility. Upon arrival, stand at least 6 feet away.

• Ask staff or participants to confirm that they do not have a fever, shortness of breath or cough.

• Make a visual inspection of the staff or participant for signs of illness, which could include flushed cheeks, rapid breathing or difficulty breathing (without recent physical activity), fatigue or extreme fussiness. Ensure that staff conducting the screening undergo implicit bias training to ensure that observations are not influenced by other factors.

*You do not need to wear personal protective equipment (PPE) if you can maintain a distance of 6 feet.

If the person has a temperature or has signs of illness:

• If the person has a temperature of 100.4 degrees or above, do not allow the person to enter and refer them to seek medical and public health guidance.

• If the person appears to exhibit signs of illness, staff should review the signs with the person, not allow the person to enter and refer them to seek medical and public health guidance.

CDC Temperature Screening Behind a Barrier Guidance

• Stand behind a physical barrier, such as a glass or plastic window or partition that can serve to protect the staff member’s face and mucous membranes from respiratory droplets that may be produced if the staff or participant being screened sneezes, coughs or talks.

• Make a visual inspection of the person for signs of illness, which could include flushed cheeks, rapid breathing or difficulty breathing (without recent physical activity), fatigue, or extreme fussiness. Ensure that staff conducting the screening undergo implicit bias training to ensure that observations are not influenced by other factors.

• Conduct temperature screening (follow steps below)

    -  Perform hand hygiene

    -  Wash your hands with soap and water for 20 seconds. If soap and water are not available, use a hand sanitizer with at least 60 percent alcohol.

• Put on disposable gloves.

• Check the person’s temperature, reaching around the partition or through the window.

• Make sure your face stays behind the barrier at all times during the screening.

• If performing a temperature check on multiple individuals, ensure that you use a clean pair of gloves for each person and that the thermometer has been thoroughly cleaned in between each check.

• If you use disposable or non-contact (temporal) thermometers and you did not have physical contact with the person, you do not need to change gloves before the next check.

• If you use non-contact thermometers, clean them with an alcohol wipe (or isopropyl alcohol on a cotton swab) between each client. You can reuse the same wipe as long as it remains wet.

If the person has a temperature or has signs of illness:

• If the person has a temperature of 100.4 degrees or above, do not allow the person to enter and refer them to seek medical and public health guidance.

• If the person appears to exhibit signs of illness, staff should review the signs with the person, not allow the person to enter and refer them to seek medical and public health guidance.

CDC Temperature Screening with Personal Protective Equipment Guidance

If social distancing or barrier/partition controls cannot be implemented during screening, personal protective equipment (PPE) can be used when within 6 feet of a person. However, reliance on PPE alone is a less effective control and more difficult to implement, given PPE shortages and training requirements.

• Upon arrival, wash your hands and put on a facemask, eye protection (goggles or disposable face shield that fully covers the front and sides of the face), and a single pair of disposable gloves. A gown could be considered if extensive contact is anticipated.

• Make a visual inspection of the person for signs of illness, which could include flushed cheeks, rapid breathing or difficulty breathing (without recent physical activity), fatigue, or extreme fussiness, and confirm that the person is not experiencing coughing or shortness of breath. Ensure that staff conducting the screening undergo implicit bias training to ensure that observations are not influenced by other factors.

• Take the person’s temperature.

    - If performing a temperature check on multiple individuals, ensure that you use a clean pair of gloves for each person and that the thermometer has been thoroughly cleaned in between each check.

    - If you use disposable or non-contact (temporal) thermometers and did not have physical contact with an individual, you do not need to change gloves before the next check.

    - If you use non-contact thermometers, clean them with an alcohol wipe (or isopropyl alcohol on a cotton swab) between each client. You can reuse the same wipe as long as it remains wet.

• After each screening, remove and discard PPE, and wash hands.

• Use an alcohol-based hand sanitizer that contains at least 60 percent alcohol or wash hands with soap and water for at least 20 seconds.

• If hands are visibly soiled, soap and water should be used before using alcohol-based hand sanitizer.

• If your staff does not have experience in using PPE:

    - Check to see if your facility has guidance on how to properly put on and take off PPE. The procedure should be tailored to the specific type of PPE that you have available at your facility.

    - If your facility does not have specific guidance, the CDC has recommended sequences for donning and doffing PPE.

If the person has a temperature or has signs of illness:

• If the person has a temperature of 100.4 degrees or above, do not allow the person to enter and refer them to seek medical and public health guidance.

• If the person appears to exhibit signs of illness, staff should review the signs with the person, not allow the person to enter and refer them to seek medical and public health guidance.

NRPA will provide more guidance as available. Check this page regularly for updates.

As park and recreation professionals begin to reopen facilities and reinstate programming, they should consider how they will modify their administrative and operational practices and environments to protect staff health and safety. Professionals should adhere to all local and state public health guidance to ensure that your plans and protocols are in alignment.

The first step is to conduct a full workplace hazard assessment to identify where and how workers might be exposed to COVID-19 at work. This assessment will provide an opportunity to better understand the types of engineering controls, administrative policies and personal protective equipment (PPE) that may be needed to protect workers. Following the assessment, agencies may consider making the following modifications:

Administrative and Operational Modifications

• Encourage staff who are sick to stay home.
• Establish and clearly communicate policies for staff to report if a family member or member of their household is suspected or confirmed to have COVID-19.
• Establish and clearly communicate policies for separating sick employees and next steps for if an employee is suspected or confirmed to have COVID-19.
• Protect employees at higher risk for severe illness through supportive policies and practices.
• Establish and clearly communicate policies on wearing face coverings, hygiene requirements and PPE.
• Offer alternatives for staff who commute using public transportation.
• Create a continuity of operations plan for staff absenteeism and prioritizing essential functions.
• Establish and clearly communicate administrative policies and practices for physical distancing – telework, rotating or staggering shifts to limit the number of employees in the workplace, etc.
• Identify a workplace coordinator responsible for COVID-19 issues at each workplace.
• Consider conducting daily in-person or virtual health screenings to ensure staff are not exhibiting symptoms.
• Educate and train employees about how they can protect themselves at work and home.
• Follow CDC’s guidance for frequent cleaning and disinfection of surfaces and shared equipment between use. Provide cleaning and disinfection supplies to employees.
• Implement flexible meeting and travel options.
• Deliver services remotely.

Environmental Modifications

• Consider improving the ventilation system.
• Ensure the safety of water systems after a prolonged shutdown.
• Establish a plan for performing frequent cleaning and disinfection in accordance with CDC guidance.
• Limit the sharing of equipment when possible – phones, computers, etc.
• Increase physical space between employees at workplaces by modifying the space.
• Increase physical space between employees and customers by modifying the space (installing barriers and partitions, etc.).
• Use sign, tape, or other markings and visual cues to indicate where to stand when physical barriers are not possible.
• Close or limit access to common areas where employees are likely to congregate and interact.
• Prohibit handshaking.
• Move electronic payment devices further away from employees to reduce contact with customers.

For more detailed information, review CDC’s Guidance for Businesses and Employers.

In addition to assessing and modifying work environments and changing practices and policies to support the health of staff, establishing a plan and policy regarding the use and provision of personal protective equipment (PPE) to staff is another common workplace control. According to CDC, employers should 1) conduct a thorough workplace hazard assessment; 2) determine what PPE is needed for workers’ specific job duties based on hazards and other controls present; and, 3) select and provide appropriate PPE to the workers at no cost.

The U.S. Department of Labor, Occupational Safety and Health Administration (OSHA) outlines the cooperative efforts between employers and employees to establish and maintain a safe and healthy work environment. In general, employers are responsible for:

• Performing a “hazard assessment” of the workplace to identify and control physical and health hazards.

• Identifying and providing appropriate PPE for employees.

• Training employees in the use and care of the PPE.

• Maintaining PPE, including replacing worn or damaged PPE.

• Periodically reviewing, updating and evaluating the effectiveness of the PPE program.

In general, employees should:

• Properly wear PPE

• Attend training sessions on PPE

• Care for, clean and maintain PPE

• Inform a supervisor of the need to repair or replace PPE

What is Personal Protective Equipment (PPE)?

OSHA defines Personal Protective Equipment as “equipment worn to minimize exposure to hazards that cause serious workplace injuries and illnesses. These injuries and illnesses may result from contact with chemical, radiological, physical, electrical, mechanical, or other workplace hazards. Personal protective equipment may include items such as gloves, safety glasses and shoes, earplugs or muffs, hard hats, respirators, or coveralls, vests and full body suits.”

PPE should be safely designed, fit comfortably and properly, and stored in a safe and clean space. PPE is considered an additional workplace control to ensure the health and safety of staff, but it’s also important to ensure that engineering, work practice and administrative controls are in place to provide protection. Employers must also train staff on how to use PPE, when it is necessary, what kind of PPE is required, proper care and maintenance, and proper use, adjustment and disposal.

Common Personal Protective Equipment

Disposable Gloves

Disposable gloves are examples of PPE that are used to protect the wearer and/or the patient from the spread of infection or illness during medical procedures and examinations. Medical gloves are one part of an infection-control strategy.[i]

Disposable Gown

Gowns are examples of PPE used to protect the wearer from the spread of infection or illness if the wearer comes in contact with potentially infectious liquid and solid material. They may also be used to help prevent the gown wearer from transferring microorganisms that could harm vulnerable patients, such as those with weakened immune systems. Gowns are one part of an overall infection-control strategy.[i]

Eye Protection

Eye protection provides a barrier to infectious materials entering the eye and is often used in conjunction with other PPE. The CDC recommends eye protection for a variety of potential exposure settings where workers may be at risk of acquiring infectious diseases via ocular exposure.[i]

Face Covering

Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure. CDC also advises the use of simple cloth face coverings to slow the spread of the virus and help people who may unknowingly have the virus from transmitting it to others. CDC recommends wearing cloth face coverings in public settings where other physical distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.[i]

Medical/Surgical Face Mask

A surgical mask is a loose-fitting, disposable device that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment. [i] A surgical mask is primarily used to protect patients and healthcare workers from people who may have a respiratory infection or to protect sterilized or disinfected medical devices and supplies. *A medical/surgical mask is not the same as a face covering.

N95 Respirator

An N95 respirator is a respiratory protective device designed to achieve a very close facial fit and very efficient filtration of airborne particles. Note that the edges of the respirator are designed to form a seal around the nose and mouth. Surgical N95 Respirators are commonly used in healthcare settings and are a subset of N95 Filtering Facepiece Respirators (FFRs), often referred to as N95s.[i]

Respirator

A respirator is designed to protect the wearer from inhaling airborne contaminants such as dust, fumes, vapors, and infectious agents associated with inhaling small and large particle droplets; guidance on appropriate selection and use is covered by OSHA’s respiratory protection and PPE standards.[i]

More information on types of PPE.

*Cloth face coverings are not considered PPE, but they may prevent workers, including those who do not know they have the virus, from spreading it to others. Cloth face coverings have not been shown to protect the wearers from exposure to the virus.

PPE Needs for Common Park and Recreation Positions

OSHA has divided job tasks into four risk exposure levels. Most park and recreation workers will likely fall in the lower exposure risk (caution) or the medium exposure risk levels. In some cases, park and recreation staff who are working directly with the potentially infectious patients (at a testing site or shelter location) may fall into the high exposure risk category. PPE need will differ between categories.

High Exposure Risk: Jobs with a high potential for exposure to known or suspected sources of COVID-19. Park and recreation workers in this category may include:

• Staff deployed at testing sites

• Staff deployed at treatment sites

• Staff working at shelter sites

• Staff working at sites that provide healthcare

Medium Exposure Risk: Jobs that require frequent/close contact with people who may be infected, but who are not known or suspected patients. Park and recreation workers in this category may include:

• Janitorial and sanitation staff

• Staff who may have contact with the general public (childcare, summer camp, shelter, recreation center, senior center, events, aquatics, exercise instructors, etc.)

• Park rangers or law enforcement

• Park ambassadors

• Park service area staff

• Volunteers

Low Exposure Risk: Jobs that do not require contact with people known to be, or suspected of being, infected. Park and recreation workers in this category may include:

• Outdoor maintenance staff

• Property management staff

• Administrative staff

Sample Park and Recreation Professional PPE Needs by Risk Classification

High Exposure Risk: PPE Needs

• Respirator (N95) or medical/surgical facemask when in contact with confirmed or suspected cases of COVID-19

• Eye protection when in contact with confirmed or suspected cases of COVID-19

• Disposable gloves when in contact with confirmed or suspected cases of COVID-19 or handling belongings

• Disposable gowns when in contact with confirmed or suspected cases of COVID-19 or handling belongings

Medium Exposure Risk

• Medical/surgical face mask or face covering

• Eye protection (depending on job duties and contact with confirmed/suspected cases (e.g. cleaning staff))

• Disposable gloves (depending on job duties and contact with confirmed/suspected cases (e.g. cleaning staff))

• Disposable gowns (depending on job duties and contact with confirmed/suspected cases (e.g. cleaning staff)

Low Exposure Risk

• Face covering when in contact with others closer than 6 feet for extended periods (greater than 10 mins.)

• Additional PPE (gloves, gowns, eye protection) depending on job duties if in contact with confirmed/suspected cases

Training and Proper Use and Disposal

Park and recreation professionals should be trained on proper use of PPE, including correct use of PPE, adjustment and disposal. Employers are required to train each employee in the following areas:

• When PPE is necessary

• What PPE is necessary

• How to properly put on, take off, adjust and wear the PPE

• The limitations of PPE

• Proper care, maintenance, useful life and disposal of PPE

Employees should demonstrate an understanding of the PPE training and the ability to properly wear and use PPE before they are authorized to perform work requiring PPE. CDC provides guidance and outlines methods of putting on and taking off PPE and provides several training videos on making face coverings, proper hand hygiene and more.

• How to Put On and Take Off PPE

• Hand Hygiene

• Training videos

• How to safely put on PPE

• How to safely remove PPE

• How to make your own face covering

• ASL cloth face coverings guidance

• What you need to know about handwashing │ Spanish │ ASL

Storage and Maintenance of PPE

All PPE should be of safe design and maintained in a clean and reliable fashion. PPE should be readily available to staff and frequently inspected to ensure safety. Larger inventory of PPE should be stored in a locked area that is dry, free from temperature extremes or chemicals. If storing respirators, access should be restricted to those that have the ability to distribute higher grade gear.

PPE Supply

Shortages of PPE have been a challenge during the COVID-19 pandemic. CDC has provided guidance on how to optimize the supply of PPE, and park and recreation professionals should follow this guidance closely to ensure that healthcare providers have access to the PPE they need to treat and care for patients.

Agencies should keep an inventory of PPE to monitor the supply and anticipate restocking needs. This should be monitored frequently, and agencies should plan in advance for delays in the supply chain. The CDC PPE Burn Calculator can be used to help estimate how much PPE will be needed.