Coronavirus

What In-home Social Service Providers and Clients Need to Know about COVID-19

In-home social service providers include, but are not limited to, caregivers or aides, teachers or tutors, social workers, and resettlement agency personnel who visit the homes of their clients. They provide a wide variety of home and community-based services, including personal care, activities of daily living, and more. This guidance is not for healthcare service…

In-home social service providers include, but are not limited to, caregivers or aides, teachers or tutors, social workers, and resettlement agency personnel who visit the homes of their clients. They provide a wide variety of home and community-based services, including personal care, activities of daily living, and more.

This guidance is not for healthcare service providers. For healthcare service providers, including physical therapists, occupational therapists, and speech therapists, who are coordinating the home care and isolation of people with confirmed or suspected COVID-19 infection, visit the Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization of Coronavirus Disease 2019 (COVID-19).

For service providers, including personal care attendants, direct support professionals, paraprofessionals, and therapists, providing care to people with disabilities, visit the Guidance for Direct Service Providers.

For tips of staying safe while scheduling services or repairs, such as installation and repair of plumbing, electrical, heating or air conditioning systems, painting, or cleaning services, inside the home, visit Hiring In-home Services or Repairs.

COVID-19 is a new disease, and we are still learning about how it spreads. Here’s what is currently known:

  • It mainly spreads from person to person.
    • Between people who are in close contact (within about 6 feet).
    • Through respiratory droplets produced when a person with COVID-19 coughs, sneezes, or talks.
  • You can get the virus from infected people who don’t seem sick or show symptoms.
  • You may be able to get COVID-19 by touching a surface or object that has the virus (SARS-CoV-2) on it and then touching your mouth, nose, or eyes.
  • The more closely you interact with others and the longer that interaction, the higher the risk of COVID-19 spread.
  • The virus that causes COVID-19 can spread from people to animals after close contact. The risk of COVID-19 spreading from animals to people is considered to be low. Learn about COVID-19 and pets and other animals.

As an in-home service provider, you could be exposed to the virus during your work by:

  • Being in close contact (within 6 feet) with infected clients and others who live with them.
  • Touching or handling contaminated surfaces or items and then touching your mouth, nose, or eyes.

As an in-home service client, you could be exposed to the virus in your home by:

  • Being in close contact (within 6 feet) with your service provider who is infected.
  • Touching or handling items from outside your home and then touching your mouth, nose, or eyes.

For Service Providers

  • Stay home if you are having symptoms consistent with COVID-19.
  • Follow CDC recommended precautions and tell your supervisor that you have been exposed to a person with COVID-19 even if you are well.
    • Do not work with clients in-person until at least 14 days after your last possible exposure to the virus.
  • Take your temperature before the start of each work shift. Stay home if you have a fever of 100.4oF or greater and follow above steps.
  • Telephone screen all clients for symptoms consistent with COVID-19 or exposure to a person with COVID-19 before each visit. Ask the client:
    • “In the past two weeks have you or someone you live with had contact with someone diagnosed with COVID-19?”
    • “Do you have a fever or have you felt hot or feverish in the last two days?”
    • “Were you able to take your temperature with a thermometer?”
      • If yes, ask “What was your temperature?” and “When did you take  it?”
        Note: With COVID-19, fever can come and go, and some people might not have a fever at all. Fever is less likely in people with some underlying medical conditions, older adults, and people taking certain fever-reducing medications, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin.
      • If no, ask “Are you experiencing shaking, chills, or sweating? Do you feel warm to the touch?”
    • “Do you have a new or worsening cough today?”
    • “Do you have any of these other symptoms?
      • Shortness of breath or difficulty breathing
      • Fatigue
      • Muscle or body aches
      • Headache
      • New loss of taste or smell
      • Sore throat
      • Congestion or runny nose
      • Nausea or vomiting
      • Diarrhea”
    • If your client has been exposed, has symptoms, or tests positive for COVID-19:
      • Cancel your in-person appointment, unless you are an essential caregiver or aid. Encourage your client to contact their healthcare provider or help them contact their provider, if assistance is needed. Clients may need help accessing telehealth.
      • Essential caregivers or aides: If hospitalization for your client is not needed, your client may require assistance with home care for COVID-19.
  • Before arriving at each client’s home, evaluate yourself for symptoms.
  • Stay at least 6 feet away from clients and others in clients home, including pets, when possible.
    • Remember that people may be able to spread SARS-CoV-2 even if they do not show symptoms. Consider all close interactions (within 6 feet) as a potential source of exposure.
  • Use a mask as appropriate.
    • Masks may not protect the wearer, but may keep the wearer from spreading the virus to others.
    • Wear a mask when it is difficult to maintain a distance of at least 6-feet away from clients. When scheduling appointments with clients via telephone or online, ask them to wear a mask while the service provider is in the home.
      • Wearing masks may be difficult for people with sensory, cognitive, or behavioral issues. Masks are not recommended for children under 2 or anyone who has trouble breathing or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.
    • Learn how to put on and take off a mask
    • Change your mask after each home visit.
      • If you have more than one in-home appointment planned, it is recommended that you use a new mask for each visit.
    • Wash cloth masks after every use.
  • Wash your hands often with soap and water for at least 20 seconds. You do not need to wear gloves if you wash your hands often (unless they are already required for your job or specific job-related tasks).
    • Use a hand sanitizer with at least 60% alcohol if soap and water are not available.
    • Wash your hands or use hand sanitizer, if soap and water are not available, at these key times:
      • As soon as you enter a client’s home
      • Before, during, and after preparing food
      • Before eating food
      • Before and after physical contact with a client
      • Before putting on and after touching or removing masks
      • After using the restroom
      • After blowing your nose, coughing, or sneezing
      • After touching animals or pets, their food, or supplies
      • After changing a diaper
      • After caring for someone who is sick
      • After contact with surfaces frequently touched by multiple people
      • After cleaning surfaces frequently touched by multiple people
      • After leaving a client’s home
      • After leaving a public place
  • Do not touch your eyes, nose, or mouth.
  • Cover your coughs and sneezes when not wearing a mask.
    • Do not remove mask for coughs and sneezes.
    • When not wearing a mask, use tissues to cover your mouth and nose when you cough or sneeze.
    • Throw used tissues in the trash and wash your hands or use hand sanitizer, if soap and water are not available.
  • If at any point while in a client’s home, or after you leave, you develop a fever of 100.4oF or greater or any other symptoms consistent with COVID-19, keep your mask on, inform the client and leave the home. Make sure to inform your supervisor to arrange for medical evaluation and testing. Provide client information on cleaning and disinfecting their home.
  • If you test positive for COVID-19, you or your employer will need to notify any clients you visited during the period from two days before your symptom onset (or two days before your test if you are asymptomatic) until you meet criteria to discontinue isolation.

For Clients

  • Consider alternatives to in-person services. when possible, such as services done online or over the phone. For example, consider web-based tutoring or telehealth
  • While some children and infants have been sick with COVID-19, most illnesses have been among adults. Some reports suggest that infants under 1 year old and those with underlying medical conditions might be at higher risk of serious illness from COVID-19 than other children. If you are coordinating care for a child, talk to the child’s healthcare provider to discuss concerns and/or questions.
  • Before the service provider arrives, evaluate yourself and others in your home for symptoms consistent with COVID-19.
  • Inform the service provider if you or anyone in your home has been exposed to a person with COVID-19.
    • Keep a list of who has visited your home and when.
    • Do not allow the service provider to enter your home until at least 14 days after your (or your household member’s) last possible exposure to the virus.
  • Stay at least 6 feet away from the service provider, when possible.
    • Remember that people may be able to spread the virus that causes COVID-19 even if they do not show symptoms. Consider all close interactions (within 6 feet) as a potential source of exposure.
  • Use a mask as appropriate.
    • Masks may not protect the wearer, but may keep the wearer from spreading the virus to others.
    • Wear a mask when it is difficult to stay at least 6 feet away from the service provider.
    • When scheduling appointments with service providers via telephone or online, ask them to wear a mask when in your home.
    • Learn how to put on and take off a mask
    • Wash cloth masks after every use.
    • Wearing masks may be difficult for people with sensory, cognitive, or behavioral issues. Masks are not recommended for children under 2 or anyone who has trouble breathing or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.
  • Clean and then disinfect surfaces frequently touched by multiple people and shared objects in your home before the service provider arrives and after he or she leaves.
    • The following surfaces frequently touched by multiple people should be cleaned routinely:
      • Tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, sinks, etc.
    • Use disinfectants that meet EPA criteria for use against SARS-CoV-2external icon.
      • Always read and follow the directions on the label to ensure safe and effective use.
      • Diluted household bleach solutions or alcohol solutions with at least 70% alcohol, appropriate for surface disinfection, may also be used.
    • Wash your hands with soap and water after cleaning and then disinfecting.
  • If you are informed that a service provider who visited your home has tested positive for COVID-19, follow steps to clean and disinfect your home.
  • Wash your hands often with soap and water for at least 20 seconds.
    • Use a hand sanitizer with at least 60% alcohol if soap and water aren’t available.
    • Wash your hands or use hand sanitizer, if soap and water are not available, at these key times:
      • Before the service provider enters your home
      • Before, during, and after preparing food
      • Before eating food
      • Before and after physical contact with a service provider
      • Before putting on and after touching or removing masks
      • After using the restroom
      • After blowing your nose, coughing, or sneezing
      • After touching animals or pets
      • After changing a diaper
      • After caring for someone sick
      • After contact with surfaces frequently touched by multiple people
      • After cleaning surfaces frequently touched by multiple people
      • After the service provider leaves your home
      • After returning home after leaving a public place
  • Do not touch your eyes, nose, or mouth.
  • Cover your coughs and sneezes when not wearing a mask.
    • Do not remove mask for coughs and sneezes.
    • When not wearing a mask, use tissues to cover your mouth and nose when you cough or sneeze.
    • Throw used tissues in the trash and wash your hands or use hand sanitizer, if soap and water are not available.
  • If at any point while having the service provider in your home, or after they leave, you or anyone you live with develop a fever of 100.4oF or greater or any other symptoms of COVID-19, keep your masks on, inform the service provider, and follow CDC recommendations on What to Do If You Are Sick.
    • With COVID-19, fever can come and go, and some people might not have a fever at all. Fever is less likely in people with some underlying medical conditions, older adults, and people taking certain fever-reducing medications such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin.
  • If you test positive for COVID-19, you will need to notify any service providers who visited your home during the period from two days before your symptom onset (or two days before your test if you are asymptomatic) until you meet criteria to discontinue isolation.

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