Richland Public Health Business Reporting Form (COVID-19)
Please use this form to report a concern regarding a business in Richland County during the COVID-19 pandemic.
* Required
Are you contacting us to determine if a business is essential or non essential?
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Yes
No
What is the name of the business you want us to know about?
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Your answer
Are you an employee at this business?
Yes
No
Clear selection
Have you contacted a member of the management team or HR division about your concern at the business you want us to know about?
*
Yes
No
Could you please provide us the contact information (name and phone number) of someone at this business (for example: owner, manager, head of HR, Union representative)?
Your answer
Please answer "Yes" or "No" to the following statements to help us better serve you with this concern. Is the business you are contacting us about....
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Yes
No
Don't Know
A nonessential business that is open
Not maintaining "social distancing" (i.e., a 6 foot distance between all people in the establishment including employees and patrons)
Not sanitizing high touch surfaces like doorknobs, tables, equipment, etc.
Not allowing employees to take sick leave
Not providing hand sanitizer
Has an employee who might be COVID-19 positive, but not taking any precautions (i.e., other employees still coming in, no self-isolation)
Requiring high risk employees (i.e., individuals over the age of 60, individuals with underlying health issues) to report to work
Not providing appropriate Personal Protective Equipment (PPE). This includes items such as gloves, masks, gowns, etc.
Yes
No
Don't Know
A nonessential business that is open
Not maintaining "social distancing" (i.e., a 6 foot distance between all people in the establishment including employees and patrons)
Not sanitizing high touch surfaces like doorknobs, tables, equipment, etc.
Not allowing employees to take sick leave
Not providing hand sanitizer
Has an employee who might be COVID-19 positive, but not taking any precautions (i.e., other employees still coming in, no self-isolation)
Requiring high risk employees (i.e., individuals over the age of 60, individuals with underlying health issues) to report to work
Not providing appropriate Personal Protective Equipment (PPE). This includes items such as gloves, masks, gowns, etc.
Can you please provide us details regarding the concern you have with this business?
*
Your answer
Could you please provide your name and contact information so we can follow-up with you if needed?
Your answer
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