COVID-19: Health & Safety Guidelines

Last Updated: November 25, 2020

Steps Therapy’s first priority is the health, safety, and welfare of our employees and our clients. We are closely monitoring developments surrounding Coronavirus Disease 2019 (COVID-19), as well as all federal, state, and local regulations.

Steps Therapy is following the guidance of the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and the San Francisco Department of Public Health. We encourage you to stay up-to-date as well. We will resume providing in-person services when the San Francisco Shelter-In-Place order is lifted and the data indicates it is safe to gradually reopen.

Steps Therapy has implemented new health and safety measures to further protect our employees and clients. We ask for full cooperation from our employees and our clients as we all work together to help prevent transmission by minimizing contact and maintaining a healthy and safe work environment.

This policy outlines the safeguards we are requiring all employees and clients to follow until further notice. If it comes to a client’s attention that a staff member on their team is not following any of the above procedures, the client must notify the supervising BCBA immediately. Additionally, if it comes to an employee’s attention that a client is not following any of the above procedures, the employee must notify Steps Therapy Human Resources immediately.

As the situation is continuously evolving, Steps Therapy reserves the right to revise our response and guidelines periodically or as deemed appropriate. The most up to date policy information can soon be found on the Steps Therapy website at www.stepstherapy.com.

I. Limiting Contact

Social Distancing

All members of a client’s household must practice physical distancing and stay at least 6 feet (about 2 arms’ length) from our therapists where possible. This excludes the client, as well as behavior escalations or other specific circumstances that may require additional support from a parent or guardian, which would be acknowledged and consented to by both parties beforehand. Employees are not permitted to use any type of physical greeting upon arrival and upon departure (i.e. no shaking hands, hugging, high fiving, etc.

Case Assignment Limits

Our clients will receive in-home sessions from no more than two (2) Behavior Technicians. We will also ensure each Behavior Technician is assigned to no more than two (2) clients to minimize the number of cross-family interactions.

Telehealth Benefits

Our supervisors will maximize telehealth benefits and will provide services via telehealth where possible (i.e. Supervision Direction, Initial Assessments, Parent Training, etc.).

Prohibiting Substitutions & Reroutes

In the event of a caregiver cancellation, the session will be canceled and we will not provide a substitute Behavior Technician to further restrict cross-family contact. In the event of a client cancellation, we will not reroute a Behavior Technician to another client session. However, if a caregiver or a client is absent for more than two (2) weeks, Steps Therapy may reassign team members.

Smart Scheduling

In an effort to minimize cross-town travel, we will do our best to schedule Behavior Technicians with clients near their respective neighborhoods where possible. Steps Therapy will also carefully consider the health and safety of employees, clients, and their household members who are within a vulnerable population (i.e. pregnant, over 60 years of age, immunocompromised, lung or respiratory disease, heart disease, etc.).

II. Personal Health

Cancellations

Sessions must be canceled if either an employee or a member of the client’s household is exhibiting any signs of illness, no matter how minor, or if under a quarantine recommendation by a physician. Please refer to Section E of this policy for further information on the protocol Steps Therapy will adhere to.

Mandatory Client Questionnaires

Before beginning an in-person session, all clients are required to respond to a brief questionnaire pertaining to the current state of the household’s health and safety conditions of the workspace. Our Behavior Technicians will ask the following screening questions:

  1. Are you or a member of your household currently exhibiting any signs of illness, including mild symptoms such as a runny nose or a slight cough?
    1. If the answer is “no”, the Behavior Technician will proceed to the next question.
    2. If the answer is “yes”, the scheduled session will not take place.
  2. Have you or a member of your household recently tested positive for COVID-19?
    1. If the answer is “no”, the Behavior Technician will proceed to the next question.
    2. If the answer is “yes”, the scheduled session will not take place.
  3. Have you or a member of your household been instructed to remain under quarantine or isolation by a professional healthcare provider?
    1. If the answer is “no”, the Behavior Technician will proceed to the next question.
    2. If the answer is “yes”, the scheduled session will not take place.
  4. Do you have soap and paper towels/napkins in your bathroom or kitchen? May I use your bathroom or kitchen to wash my hands?
    1. If either answer is “no”, the scheduled session will not take place.
    2. If the answer is “yes”, the Behavior Technician will proceed with our guidelines.

If a session is canceled due to a client response provided in the questionnaire above, the Behavior Technician will be responsible for reporting the cancellation via Steps Therapy’s telephony system and will immediately notify the supervising Behavior Analyst (BCBA). Each cancellation will be thoroughly reviewed by Steps Therapy on an individual basis to better determine the severity of the situation and to formulate a subsequent plan of action. Please refer to Section E of this policy for further information on the protocol Steps Therapy will adhere to.

We recommend all clients review the questions above prior to the start of each scheduled session. If you already know that you will be providing an answer which will result in a canceled session, we ask that you notify the supervising Behavior Analyst (BCBA) before the scheduled session start time. This will help to prevent transmission and will keep other team members and clients safe.

Mandatory Employee Questionnaires

Before beginning an in-person session, all employees are required to respond to a brief questionnaire pertaining to the current state of their health. Our Behavior Technicians will be asked the following screening questions via Steps Therapy’s telephony system:

  1. Are you or a member of your household currently exhibiting any signs of illness, including mild symptoms such as a runny nose or a slight cough?
    • If the answer is “no”, the Behavior Technician will proceed to the next question.
    • If the answer is “yes”, the scheduled session will not take place.
  2. Have you or a member of your household recently tested positive for COVID-19?
    • If the answer is “no”, the Behavior Technician will proceed to the next question.
    • If the answer is “yes”, the scheduled session will not take place.
  3. Have you or a member of your household been instructed to remain under quarantine or isolation by a professional healthcare provider?
    • If the answer is “no”, the Behavior Technician will proceed to the next question.
    • If the answer is “yes”, the scheduled session will not take place.
  4. Please take your temperature with your provided thermometer and record the results now. Is your temperature 100.4°F/38°C or higher?
    • If the answer is “no”, the scheduled session will take place.
    • If the answer is “yes”, the scheduled session will not take place.

Please Note: As an additional measure of precaution, employees will also take their temperature when they exit the client’s home after a completed session. If the employee’s temperature is 100.4°F/38°C or higher at that time, the employee will immediately notify the Steps Therapy Office, the employee’s scheduled sessions will promptly cease, and all necessary parties will be notified. Please refer to Section E of this policy for further information on the protocol Steps Therapy will adhere to.

If a session is canceled due to an employee response provided in the questionnaire above, the Steps Therapy team will thoroughly review the cancellation on an individual basis to better determine the severity of the situation and to formulate a subsequent plan of action. Please refer to Section E of this policy for further information on the protocol Steps Therapy will adhere to.

All employees are instructed to review the questions above prior to the start of each scheduled session. If an employee already knows that he/she/they will be providing an answer which will result in a canceled session, he/she/they must notify the Steps Therapy office immediately; before arriving at the client’s home. This will help to prevent transmission and will keep other team members and clients safe.

Personal Protective Equipment (PPE)

Steps Therapy is providing all employees with PPE, as well as training for proper usage and disposal. Below is a list of the PPE items Steps Therapy will provide to all employees:

  1. Masks/Face Shields – All employees are required to put on their provided facemasks or face shields upon arrival at the client’s home (prior to beginning the client questionnaire) and must wear their facemasks for the entire duration of the session. Employees can remove their facemasks upon exiting the client’s home, once the session has been completed.
  2. Thermometers – All employees will use their provided thermometers to record their temperature prior to the start of each in-person session and upon exiting the client’s home, once the session has been completed.
  3. Gloves – All employees will put on their provided gloves immediately after washing their hands at the client’s home. Employees must wear their gloves for the entire duration of the session. Once the session has been completed, employees will properly discard their gloves at the client’s home and will immediately wash their hands with soap and water at the client’s home. After washing their hands, employees are to refrain from touching any other objects or surfaces while exiting the client’s home.
  4. Disinfectant Wipes – All employees will use their provided disinfectant wipes to sanitize their personal belongings prior to the start of each session and after each session has been completed, as well as any ABA materials used during a session.
  5. Hand Sanitizer – In addition to washing their hands with soap and water at the start and end of each session, all employees may utilize their provided alcohol-based hand sanitizer as an additional measure to sanitize their hands.
    • Please Note: Employee accommodation requests regarding specific PPE alternatives (i.e. employee latex allergy) may be submitted to Steps Therapy Human Resources for consideration. Client accommodation requests regarding specific PPE alternatives (i.e. client latex allergy) may be submitted to the client’s supervising BCBA.
  6. Hand Washing: Upon entering a client’s home, our employees are required to immediately use the client’s bathroom/kitchen to wash their hands with soap and water for a minimum of 20 seconds and to dry their hands with a paper towel/napkin. Employees will follow the same procedure at the end of each session and will refrain from touching any other objects or surfaces while exiting the client’s home.

IV. Workspace Safety

Limiting Personal Belongings

All employees will limit their personal belongings to essential items only (i.e. PPE, cell phone, wallet, keys, pen, session materials, water bottle). Employees are instructed to remove their shoes and will leave them outside of the entranceway prior to entering a client’s home, only if it is safe to do so. Employees will sanitize their limited personal belongings prior to the start of each session and after each session has been completed.

Limiting In-Home Traffic

Steps Therapy asks all clients to be mindful and considerate of our employees by restricting visitors who are outside of their immediate household from entering their home during a scheduled session time where reasonably possible. If a client must have someone outside of their immediate household in their home at the time of a scheduled session (i.e. another therapy provider for a sibling, nanny, home repair contractor, etc.), please notify your supervising BCBA immediately so we can consider alternative scheduling options if plausible for the safety of our employees.

Session Materials

Steps Therapy will ensure all ABA session materials are properly sanitized prior to mailing or delivering them to the client’s home. ABA session materials will be specific to each client’s home and will not travel to/from other client locations.

Sanitization

Steps Therapy respectfully asks all clients to share responsibility in providing a safe and healthy work environment for our employees as they provide services in your home. Clients should use their own disinfectant wipes or cleaning products (i.e. based with alcohol, bleach, or ammonia) to wipe down all surfaces, toys and in-home materials prior to the start of a scheduled session. If a client is unable to secure cleaning products or runs out of cleaning products, our employees will use their supplied PPE to sanitize the workspace.

IV. Personal Travel

Communicating Travel Plans

Steps Therapy strongly encourages all employees and clients to closely evaluate and reconsider both domestic and international travel at this time. Communication with Steps Therapy prior to, during, and upon return from personal travel is critical to keeping our employees, our clients, and our community safe.

All employees must report domestic and international travel plans to Steps Therapy Human Resources. All clients must report domestic and international travel plans to their supervising BCBA. The Steps Therapy team will thoroughly review on an individual basis to better assess the risk level and to formulate a subsequent plan of action.

V. COVID-19 Protocol for Close Contact, Symptoms and Testing Positive

COVID-19 Close Contact

Employees or clients who believe they or a member of their household have come into contact with another individual with COVID-19 should immediately contact their professional healthcare provider or the San Francisco Department of Public Health’s Nurse Triage Hotline at 855-850-2249. Employees must also notify Steps Therapy Human Resources and clients must notify their supervising BCBA as soon as possible.

All sessions will promptly cease for that particular employee or client. The Steps Therapy team will continue to remain in contact with this individual to better develop a subsequent plan of action for return and will communicate with all necessary parties accordingly.

For more information on what you should do if you have been in close contact with someone who has tested positive for COVID-19, please review COVID-19 Close Contact Advisory.

Exhibiting COVID-19 Symptoms

Employees or clients who believe they or a member of their household are exhibiting symptoms of COVID-19 should immediately contact their professional healthcare provider, stay home, closely monitor their symptoms, and follow instructions from their professional healthcare provider. Employees must also notify Steps Therapy Human Resources and clients must notify their supervising BCBA as soon as possible.

All sessions will promptly cease for that particular employee or client. Sessions may resume for that particular employee or client when the individual has been symptom-free from the original symptoms for fourteen (14) days, plus 72 hours of no symptoms. The Steps Therapy team will continue to remain in contact with this individual to better develop a subsequent plan of action for return and will communicate with all necessary parties accordingly.

For more information on what you should do if you believe you or a member of your household is exhibiting COVID-19 symptoms, please review Coronavirus Symptoms and Coronavirus Testing.

Testing Positive for COVID-19

If an employee or a member of an employee’s household has tested positive for COVID-19, the employee must immediately notify Steps Therapy Human Resources. If a client or a member of a client’s household has tested positive for COVID-19, the client must immediately notify the supervising BCBA.

All sessions will promptly cease for that particular employee or client. Sessions may resume for that particular employee or client when the individual has been symptom-free from the original symptoms for fourteen (14) days, plus 72 hours of no symptoms. The Steps Therapy team will continue to remain in contact with this individual to better develop a subsequent plan of action for return and will communicate with all necessary parties accordingly.

For more information on what you should do if you or a member of your household has tested positive for COVID-19, please review What To Do If You Are Sick.

Quarantine and Isolation

If an employee, client, or member of either household is under a professional healthcare provider’s direction to self-quarantine or isolate, all sessions will promptly cease for that particular employee or client. Sessions may resume for that particular employee or client when the individual has been symptom-free from the original symptoms for fourteen (14) days, plus 72 hours of no symptoms. The Steps Therapy team will continue to remain in contact with this individual to better develop a subsequent plan of action for return and will communicate with all necessary parties accordingly.

For more information on what you should do if you or a member of your household is directed to quarantine or isolate, please review Quarantine and Isolation.

VI. Working Together

Stop the Spread of Germs

While we have implemented additional safeguards to further protect the health, safety and welfare of our employees and our clients, we respectfully ask everyone to do their part each day, regardless of whether or not a scheduled session is occurring, so we can all continue to prevent the spread of germs and contribute to a healthy and safe work environment.

  1. Physical Distancing: Avoid group gatherings with people outside of your immediate household. Maintain 6+ foot distance from people who are outside of your immediate household (i.e. at the grocery store, bank, etc.).
  2. Stay Home When You Are Sick: When you are sick, stay home, get plenty of rest, hydrate, and check with a professional healthcare provider as needed.
  3. Wash Your Hands: Wash your hands often with soap and water for 20+ seconds. Use alcohol-based hand sanitizer if soap and water are not readily accessible.
  4. Clean Shared Surfaces: Use disinfectants to clean commonly touched items in your home, such as doorknobs, faucet handles, light switches, handrails, elevator buttons, doorbells, etc. Germs travel fast with multiple hands touching shared surfaces.
  5. Cover Your Mouth: Cough or sneeze into a tissue and immediately throw it away; use your arm or sleeve to cover your mouth if you do not have a tissue on-hand. Wear a facemask if you must be around individuals who are outside of your immediate household.
  6. Avoid Touching Your Face: Your eyes, nose and mouth are entryways for viruses to get into the human body, causing you to become infected or get sick. Make an effort to avoid touching your eyes, nose and mouth, especially without properly washing your hands or using an alcohol-based hand sanitizer first.

VII. Additional COVID-19 Resources and Infographics

  1. Local Shelter-In-Place Resources: COVID-19 Resource List
  2. Protect Yourself and Others: COVID-19 Fact Sheet
  3. Stop the Spread of Germs: Health Tips
  4. Know the Symptoms: COVID-19 Symptoms Fact Sheet
  5. If You Are Sick: Prevent The Spread of COVID-19 If You Are Sick
  6. If COVID-19 Positive: Manage Your Symptoms