Compassion with Excellence

FORM - HEALTH SCREENING

Health Screening Report

Due to the highly contagious nature and potential dangers associated with the Coronavirus (COVID-19), especially to seniors and individuals with weakened immune systems and respiratory issues, Agape Home Care staff MUST ALWAYS wear masks and follow safety precautions while serving clients (hand washing & social distancing as much as possible) AND confirm daily that they are healthy before reporting for duty and/or having any contact with clients (PACE Participants) by taking their temperature and answering the following questions - contact Agape Home Care Supervisor immediately by phone if showing symptoms, traveling outside Humboldt County, had contact with known COVID persons or have engaged in any large event, high-risk gatherings: