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Homeless Service Providers

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Introduction

This document is for employers who provide services to people experiencing homelessness, including emergency shelters, unsheltered homelessness, encampments, transitional housing, and other temporary situations. It provides an overview of recommended controls to help reduce the risk of exposure to COVID-19 in the workplace. It can also help workers, volunteers, clients, and visitors to understand the responsibilities of the sector to help protect them from the spread of COVID-19.

In all cases, guidance from local public health authorities and your jurisdictional OHS regulator must be followed. Cooperate with inspectors to safely accommodate their inspection activities.

Also refer to current guidance from the Public Health Agency of Canada (PHAC), specifically their “Guidance for providers of services for people experiencing homelessness (in the context of COVID-19)”. Associations such as the Canadian Alliance to End Homelessness (CAEH), the Canadian Network for the Health and Housing of People Experiencing Homelessness (CNH3), and local community agencies also provide a wealth of COVID-19 information resources.

For general COVID-19 prevention practices for both employers and workers refer to the CCOHS COVID-19 Resources documents, including “Protect Yourself and Others from COVID-19”, “COVID-19 Health and Safety Planning for Employers”, and “COVID-19 Prevention for Workers”.

Maintain existing precautions and considerations for marginalized and vulnerable groups (e.g., women, youth, LGBTQ2S+, Indigenous, chronic medical conditions, mental health, substance addictions, etc.) wherever possible.

Meet your legal occupational health and safety obligations by doing everything reasonably possible under the circumstances to protect the health and safety of your workers.

Consider the Risks

Each workplace is unique. Employers need to perform a COVID-19 risk assessment for their specific workplace, job roles, and activities (routine tasks and in-person interactions). Examples of services to review include client reception and intake, overnight shelter, hygiene facilities, food preparation and distribution, laundry, medical care, isolation and quarantine, counselling, security, mobile outreach, travel and transportation, supply pick-up and delivery, and maintenance activities.

The risk of COVID-19 transmission is increased with close proximity (less than 2 metres) and in-person interactions (close-range conversations, touching), generation of respiratory droplets (when speaking, coughing, sneezing, singing, shouting, and during strenuous activities that increase breath rate), crowded or closed spaces with poor ventilation, inadequate personal hygiene practices or facilities, and contaminated surfaces (fomites). Risk of transmission increases further when several of these risk factors are present in the same setting.

Once the risks have been identified and evaluated, the employer must implement appropriate hazard controls using the hierarchy of controls (i.e., elimination, substitution, engineering, administrative, personal protective equipment), including multiple personal preventive practices in a layered approach. Consider implementing a workplace safety plan to identify and implement solutions for COVID-19 associated risks. The plan should address as many aspects as possible in priority order.

When implementing new COVID-19 control measures, assess the potential impacts to existing infrastructure, activities, and worker or client safety. Make sure you do not create new workplace hazards. Update existing policies and procedures as needed to incorporate COVID-19 risks and control measures. Continue to evaluate how effective the controls are and make changes if needed.

Here are example questions that can be asked to help you identify COVID-19 risk factors and appropriate controls for your workplace:

  • What are the main work zones, job roles, and routine activities?
  • Where and when do workers interact with each other and other people while working?
  • How close are the interactions? Do they need to be close for certain job tasks (i.e., when and where is physical distancing not possible)? The risk of transmission increases with close and frequent contact.
  • How long are the interactions? Evidence indicates that spread is more likely with prolonged contact.
  • How crowded is the workplace? The risk of spread increases when people gather.
  • Do workers stay at one workstation or do they travel throughout the building, to other work locations, private residences, encampments, etc.?
  • Are workers using group transportation or company vehicles? Are they transporting clients?
  • Are there indoor ventilation and cooling systems? Is indoor ventilation sufficient? Poor ventilation in closed spaces can result in accumulation of virus particles.
  • Do people have easy access to personal hygiene facilities (e.g., toilets, running water, soap, and hand sanitizer)?
  • How are equipment and tools used in the workplace? Are they shared between people?
  • How often, by which method, and when are surfaces and objects cleaned and disinfected? Have the selected disinfectant products been assessed for effectiveness against the COVID-19 virus, and for potential chemical hazards to workers and clients?
  • Do people have the knowledge and resources they need to protect themselves and others from the spread of COVID-19?
  • Could language barriers impact the ability of workers and clients to understand and follow the transmission control measures?
  • Are there social factors that could make control measures more difficult to implement?
  • Are you able to assess if a person may be sick or have been exposed, and rapidly take appropriate actions?
  • Are sick leave policies adequate to support worker isolation and quarantine?

Control Measures

Elimination (including Substitution)

These types of controls eliminate exposures (at the workplace):

  • Workers whose jobs can be performed remotely should work from home e.g., office and support staff not directly involved in on-site activities.
  • Use remote communication technologies such as video/teleconferencing when possible.
  • Some services may need to be temporarily unavailable if they cannot be performed safely (e.g., indoor group social activities).

Engineering Controls

These types of controls use physical infrastructure to reduce workplace exposure. They rely on good design and maintenance to be fully effective.

Physical Barriers

  • Install appropriately sized and positioned barriers where physical distancing of at least 2 metres between people cannot always be maintained, e.g., between reception desk and client, washroom sinks, eating tables, and sleeping bunks.
  • Barriers should block respiratory droplets, extend above head height, and allow free and safe movement of the person within their enclosed zone. Refer to local public health guidance for detailed instructions on barrier design and installation.
  • Use plexiglass, plastic curtains, or other impermeable materials that are durable and easy to clean and disinfect.
  • Guide pedestrian traffic and queues using lane barriers, each lane spaced to be sure that individuals are at least 2 metres apart in all directions.

Ventilation

Poor ventilation has been linked to COVID-19 outbreaks by allowing the accumulation and transmission of virus containing aerosols in indoor spaces. Continually ventilating indoor spaces will dilute and replace the potentially contaminated air. Make sure that:

  • Any indoor work is conducted in a space that is well ventilated.
  • A licenced heating ventilation and air-conditioning (HVAC) expert is consulted before making any physical or setting alterations.
  • Existing indoor air quality requirements are not compromised.
  • Stale indoor and vehicle cabin air is not continually re-circulated, as it can contribute to increased virus accumulation.
  • Exhaust fans are fully functional, operating at maximum capacity, and remain on.
  • Air circulation or cooling fans are not directing air flow from person to person. Direct fans towards unoccupied corners or walls above people’s head height. Avoid high speed settings. Ceiling fans should also be run at low speed and in the reverse flow direction so that air is pulled up toward the ceiling.
  • Other ways can be used to help keep workspaces cool, such as shutting off heat generating equipment when not in use or allowing fewer people into closed spaces at one time.

For additional detailed information on ventilation, please refer to the Government of Canada website “COVID-19: Guidance on indoor ventilation during the pandemic” and the CCOHS document “COVID-19 Tip Sheet: Ventilation”.

Other Engineering Controls

  • Install enough handwashing stations and hand sanitizer dispensers to ensure easy access for all persons who enter the workplace and client areas.
  • If plumbing is not available, provide a spouted water container and catch basin, with water, soap, and paper towels.
  • If there are concerns about unlimited access to alcohol-based hygiene products, consider giving individual containers to workers or providing disinfectant wipes instead.
  • Reduce the number of touchpoints needed to access buildings and services:
    • Replace round doorknobs with handles and push-plates that can be operated using wrists or elbows. Install automatic doors or prop non-fire doors open. Be careful not to create new hazards (tripping or fire).
    • Install automatic touch-free lighting, water taps, sanitizer dispensers, toilet flush levers, paper towel dispensers, and waste bins.
    • Use contactless bill payment methods, such as debit or credit card tap, wireless phone payment, or e-transfers.
    • Use touch-free methods for workers to clock in, such as electronic key cards, messaging/e-mail, or rollcall by a supervisor.
  • Replace soft surfaces (carpets, seating) with hard surfaces (tile, wood, metal, plastic) that are easier to clean and disinfect.
  • Reassign room usage to provide more space. Use larger well-ventilated rooms or outdoor spaces (weather permitting) for meetings, breaks, and group activities. Rearrange, remove, or block-off extra workstations and furniture.
  • Consider closing or limiting clients indoor sit-down eating areas, while expanding outdoor areas with well-spaced seating.
  • In congregate sleeping areas, arrange bunks so that clients’ heads are distanced at least 2 metres apart, oriented head to toe or staggered. The number of bunks may need to be reduced. Bunks might need to be relocated, or additional sleeping areas may need to be re-purposed from other uses. The use of bunk beds is not recommended.
  • Restrict people from entering zones they do not perform work in or need access to (does not apply in emergency situations). Secure doors and gates if needed.
  • Establish one-way walking routes in corridors and stairways to minimize cross traffic.
  • Use signs and floor markings (at least 2 metres apart in all directions) to indicate where people should stand and walk.
  • If feasible, consider marking zones in outdoor spaces where people congregate for long periods of time. Space the zones at least 2 metres apart and make them large enough for practical use. Use weather resistant materials to mark the zone edges (e.g., painted pegs, rope, flagging tape). This may help to reduce crowding in outdoor encampments and community shelter yards.

Administrative Controls

These types of controls reduce risk through policies, procedures, and training. They rely on personnel management and compliance to be fully effective.

COVID-19 Safety Plan

A written COVID-19 safety plan may be legally required by the jurisdiction in which you operate. It may need to be posted, and available upon request from an inspector. Refer to your jurisdiction for instructions on what must be included in the plan.

It is recommended that the plan:

  • Be specific to the workplace infrastructure, activities, and job roles.
  • Lists all of the controls implemented to protect workers and visitors.
  • Outlines how to respond to suspected or confirmed cases of COVID-19.
  • Describes what to do if a person with COVID-19 requires emergency first-aid.
  • Considers what to do if large numbers of workers need to be isolated, quarantined, or will require medical care, e.g., personnel logistics and coverage for absent workers.
  • Be implemented and maintained by a designated administrator or committee.
  • Be reviewed and updated frequently to comply with evolving pandemic requirements.
  • Be communicated to supervisors and workers as part of their training.

Screening Process

  • Passive screening relies on workers to self-monitor and notify their employer if they feel sick or have possibly been exposed to COVID-19. For clients and others, self-screening could be a notice posted on the door, an automated phone message, or a website listing symptoms and entry restrictions.
  • Active screening requires the employer to ask workers questions about symptoms and potential exposure events before each work shift. For clients and others, active screening could be done by a worker posted at the shelter entrance, or over the phone.
  • Use a checklist from the Canadian Centre for Occupational Health and Safety (CCOHS), your local public health authority, or community agency.
  • Screening should be done for any workers, volunteers, clients, visitors, contractors, inspectors, or other persons who may enter the workplace. Also pre-screen participants before their attendance at individual or group programs and services.
  • Record names, contact information, times, and locations. Make sure that privacy is protected, and that the information is stored and destroyed in a safe and secure manner. If requested, provide the information to the local public health authority to assist their contact tracing efforts.
  • Screen for potential exposure to COVID-19 in the past 14 days:
    • Recent travel (international or domestic)
    • Contact with a person who tested positive for COVID-19
    • Community outbreaks
  • Screen for the most common symptoms of COVID-19.
  • If readily available and feasible, consider implementing routine rapid testing of all workers and clients as an additional active screening measure. Consider how you will manage the response to a rapid test result.
  • For clients waiting longer for confirmatory lab test results, provide separate isolation quarters if possible, or a daily check-in location with instructions to avoid contact with other persons and facilities until their results are available.
  • Consider promoting use of the national COVID Alert App.

What to do if a person is symptomatic or exposed

  • If a worker or other person in the workplace is identified as having symptoms, or has potentially been exposed to COVID-19:
    • Call 911 if symptoms are life-threatening.
    • Have them wear a medical (surgical) mask. If unavailable, they should properly wear a well-constructed, well-fitting non-medical mask.
    • Do not allow the identified worker(s) to continue with their job tasks.
    • Make every effort to keep them isolated before sending them home.
    • To reduce community spread, discourage them from using public transit, taxi, or rideshare.
    • Suggest that the worker stay home (or return home) and contact their health care provider or local public health authority if they develop symptoms or symptoms worsen.
    • Clean and disinfect any surfaces the identified person(s) may have touched.
  • If a client is identified as having symptoms, or has potentially been exposed to COVID-19, take these additional precautions:
    • Do not allow the identified client to enter the shelter, or to continue to use shared facilities if already living there.
    • The client should be isolated or quarantined in a separate designated living area. Deliver meals and necessary supplies to them.
    • Assess client health conditions daily and have a plan if transfer to a medical facility is required.
    • If your shelter does not have the means to provide separate isolation zones, co-ordinate with community affiliates (such as public health agencies, civic and community centers, recreational facilities, faith-based organizations, hotels, and modular unit agencies) to find housing, or to safely transfer the client to an isolation and treatment centre.
    • Provide secure storage and transport for personal belongings if the client must be isolated or relocated.
  • Develop procedures for contacting local public health authorities for further advice in the event of a positive COVID-19 case.
  • If the case is work-related involving a worker, additional notifications may be required, contact your jurisdictional OHS regulator and worker compensation board for guidance. Complete an incident report and begin an investigation.

Physical Distancing

  • Implement and enforce an indoor and outdoor physical distancing policy.
  • Keep essential in-person interactions few, brief, and from the greatest distance possible (at least 2 metres).
  • If there are large numbers of workers or multiple work shifts, consider implementing a cohort system (dedicated teams of workers and volunteers). Schedule the cohort to work, attend meetings and training, and take breaks together. Do not allow cohorts to mingle. The use of cohorts reduces the risk of transmission of COVID-19 and helps with contact tracing if a positive COVID-19 case is found in the workplace.
  • Workers should minimize non-essential in-person interactions with people from outside of their immediate household or work cohort.
  • Encourage workers and volunteers to only work at one job location.
  • Job tasks that require workers to be in close contact with other people and their belongings should be modified if possible. If workers must provide direct care to clients (within 2 metres), the local public health authority can provide guidance on personal protective equipment (PPE) that may need to be worn.
  • Limit the number of persons gathered at one time, indoors and outdoors. Do not exceed the occupancy limits for buildings and rooms set by your jurisdiction. Assign a worker to control entry and monitor occupancy levels.
  • Consider limiting the time each client may use the facility per day, in order to serve more clients and reduce potential exposure time.
  • Discourage workers from congregating and crowding during breaks and shift-changes, including in outdoor break areas and weather shelters. After-work gatherings should also be discouraged.
  • Request that clients stay in assigned areas and do not wander throughout the facility or visit other clients.
  • If group activities take place, do so with the smallest number of participants possible. Consider more frequent services to help maintain distancing. Provide dedicated times for more vulnerable groups such as seniors.
  • Discourage direct physical contact such as hugs and handshakes.
  • For mobile outreach services: Do not allow clients into your vehicle. Avoid entering client housing (building, vehicle, tent, or other temporary shelter). Provide services outdoors or under an open shelter where possible. Set up a waiting area. Pre-package supplies and hand them out to minimize contact.
  • Discourage use of carpooling, public transit, and rideshare services.
  • Plan for how people will maintain physical distance while evacuating or sheltering-in-place in the event of an emergency. There may be exceptions to distancing guidance, e.g., when providing emergency first aid or rescue.
  • For essential visits by specialist services (e.g., social workers, mental health, pharmacy, substance use, harm reduction, child services, police, medical response, etc.) provide a designated room or area with minimal furniture.
  • Limit or reschedule visits to your workplace by external contractors and suppliers.
  • Methods of goods delivery may vary by supplier. Consider scheduling large deliveries during hours when there are less workers and clients present or arrange for curbside pickup.

Good Hygiene Practices

  • Encourage frequent hand hygiene for all people who enter the workplace.
    When: before and after the work shift, touching shared items, using equipment and tools, touching of face mask, donning and doffing personal protective equipment (PPE), handling food, using the washroom, etc.
    How: washing with soap and water for at least 20 seconds, or if not available use hand sanitizer (more than 60% alcohol-based). If hands are visibly dirty, they must be washed with soap and water.
  • Some clients may need additional supervision and help with hygiene (e.g., children).
  • Provide basic hygiene needs supplies such as masks and hand soap.
  • Discourage singing, yelling and chanting, which can cause respiratory droplets to travel for long distances.
  • Do not allow workers to share personal protective equipment (PPE), uniforms, non-medical masks, or lunchroom eating utensils and glassware.
  • Discourage sharing of personal items such as cellphones, lighters, and water bottles.
  • Do not provide communal food or beverage services. If providing food service, offer pre-wrapped takeout meals, or contactless delivery.
  • Limit the use of items that are difficult to clean and disinfect without damage, (e.g., books and magazines, children’s soft toys), or assign them to a single user or household group for the duration of their visit. Quarantine of some items may be required between users, to allow time for virus particles to become inactive (e.g., from at least 24 hours up to 14 days depending on the material. Contact your local public health authority for further guidance.
  • Provide laundry service for uniforms or require workers wear freshly cleaned uniforms or clothes for each shift. Clothes should be bagged and washed after each shift.
  • If responsible for client laundry, ensure that linens and clothes are washed frequently. Make sure that donated items are laundered and minimally handled before distributing.
  • Do not shake dirty laundry. Use disposable gloves and perform hand hygiene after handling laundry. Clean and disinfect hampers and bins.
  • Remove communal coat storage areas. If they do not have lockers or desks, provide sealed bins or bags for workers to store their personal items, footwear, and clothing.
  • Provide clients with clean bins to store their personal items.

Cleaning and Disinfection

  • Make sure that all disinfectants used are effective against COVID-19. Refer to this Health Canada guidance for hard-surface disinfectants and hand sanitizers. Verify that selected products have a drug identification number (DIN) from Health Canada.
  • Follow the product manufacturers instructions for safe handling and effective use. Wear personal protective equipment (PPE) if required.
  • Develop a cleaning and disinfection program, with schedules and checklists for each work and visitor area.
  • Clean shared worker spaces (office, lunchroom, washroom, etc.) at least once a day.
  • Client facilities should be cleaned as frequently as possible and between users. Take into account the number of users and potential risk of transmission when planning the schedule.
  • Make sure public washrooms and showers (if open) are cleaned more frequently, have running water, and are stocked with soap, paper towels and a plastic lined no-touch waste container.
  • Frequently touched-and-shared objects and surfaces should be disinfected multiple times a day. If objects need to be shared, clean and disinfect them between users.
  • Remind workers to also clean and disinfect personal devices such as cellphones.
  • Clean and disinfect company vehicles between users (keys, steering wheel, gear shift, controls, vents, belts, seats, interior and exterior door handles, etc.).
  • If an external service contractor must visit (e.g., for construction or repairs), clean and disinfect their work area before and after their visit.
  • Refer to the CCOHS "Cleaning and Disinfecting" tip sheet for further guidance and examples of objects and surfaces.

Communication & Training

  • Use accessible formats (written, infographics, verbal) and language(s) appropriate to the audience, to make sure they can understand the instructions.
  • Use multiple communication platforms, e.g., posters, flyers, verbal reminders, texts, websites and social media, etc. to reach varied client demographics.
  • Communicate to vulnerable populations:
    • Changes to regular shelter and outreach schedules, services, and policies.
    • Updates on outbreaks in their community.
    • How to avoid exposure and prevent the spread of COVID-19.
    • How and where to access rapid testing and vaccination clinics, shelter facilities, services, safe injection sites, food and supplies, counselling, and medical care.
    • How to access government financial assistance programs.
  • Help clients understand that protective measures are necessary, and that their experience might be different than what they are used to. Remind them to be considerate of workers and other clients. Communicate what is permitted and the consequences for non-compliance.
  • Train all workers about COVID-19, including:
    • New and updated work practices and policies
    • What COVID-19 is and the common symptoms
    • What to do if they feel sick or may have been exposed
    • How the virus spreads
    • How to protect themselves and others by layering multiple hazard controls and personal preventive practices
    • How to properly wear, handle, and care for their PPE and masks
    • How to safely use cleaning and disinfection chemicals (Workplace Hazardous Materials Information System WHMIS)
    • How to stay informed about COVID-19 using reputable sources
    • The benefits of vaccination
  • Monitor compliance and repeat the communication and training as often as needed.
  • Encourage workers to report any COVID-19 concerns to their employer, supervisor, health and safety committee or representative, or union if present.
  • Ensure that managers and supervisors understand the risks, control measures, and policies. They must stay up to date on current legal requirements as the pandemic situation evolves.
  • Before they visit, communicate with external service providers about your COVID-19 controls, and also work with those services to assist with their COVID-19 precautions.

Human Resources Policies

  • Implement a mask wearing policy:
    • Follow the mask wearing requirements of your local public health agency and jurisdiction. Consider requiring that masks be worn at all times except when eating, drinking, or showering.
    • Make sure that wearing a mask does not create new hazards such as from entanglement (moving equipment) or flammability (open flame or sparks).
    • Non-medical masks are useful in reducing the spread of COVID-19 but are not considered to be personal protective equipment (PPE) as they do not meet regulated testing and certification standards. Continue to use PPE for existing occupational safety hazards and emergencies, as directed by applicable laws.
    • Update your existing heat-stress program, as mask-wearing may increase physiological stress during high-exertion tasks.
    • Masks must be well-constructed, well-fitting, and worn properly.
    • There is great variation in the quality of masks available from retail sources. Consider providing appropriate single-use medical (surgical) masks or re-useable fabric non-medical masks to workers and clients.
    • Refer to PHAC: Non-medical masks for further information and guidance.
  • Modify shift schedules to support both regular activities and COVID-19 control measures:
    • To reduce the potential daily exposure time of each worker, reduce the length of long shifts (e.g., 10+ hours), or rotate them to tasks that are not client-facing.
    • Stagger workers’ arrival, departure, and break times to avoid crowding and mingling.
    • Schedule enough time throughout the shift for workers to complete their regular tasks safely, while also meeting physical distancing, personal hygiene, and cleaning-disinfection requirements (e.g., without rushing or cutting corners).
    • Consider scheduling extra time for deep cleaning and disinfection.
    • Adjust daily staff levels to have the fewest people in the workplace (or in each area of the workplace), while making sure tasks can be completed safely. This may be challenging if there is increased need for services.
    • If there are fewer workers available, make sure essential roles such as trained supervisors, and first aid or emergency response team members are present on each shift. Make sure workers are trained to work safely including when replacing the duties of others.
  • Adopt flexible leave policies that enable sick workers to stay home:
    • Communicate firmly that sick workers should not come to work
    • Designate a process for sick workers to immediately notify their supervisor
    • Provide support to workers who are off sick
    • Do not penalize workers who must take leave to isolate or quarantine
    • Give advances on future sick leave or consider allowing workers to donate sick time to each other
    • Provide information on government economic support resources
  • Consider workers who may require an accommodation (e.g., those at higher risk of severe disease or outcomes from contracting COVID-19 due to existing medical conditions).
  • Provide mental health support and resources.

It is important that mental health resources and support are provided to all workers, including access to an employee assistance program, if available.

For further information on COVID-19, refer to the Public Health Agency of Canada.

Note that this guidance is just some of the adjustments organizations can make during a pandemic. Adapt this list by adding your own good practices and policies to meet your organization’s specific needs.

Disclaimer: As public and occupational health and safety information is changing rapidly, local public health authorities should be consulted for specific, regional guidance. This information is not intended to replace medical advice or legislated health and safety obligations. Although every effort is made to ensure the accuracy, currency and completeness of the information, CCOHS does not guarantee, warrant, represent or undertake that the information provided is correct, accurate or current. CCOHS is not liable for any loss, claim, or demand arising directly or indirectly from any use or reliance upon the information.

Document last updated April 20, 2021