CVE - COVID-19 Daily Health Screener
Dear CVE Community,

Thank you for your continued support of our students and each other during distance learning. As we all experience ongoing changes and impacts related to COVID-19, your efforts supporting our students and the community are truly appreciated.

The Alameda County Health Department has required additional steps to ensure our students, staff and community members remain safe during the COVID-19 pandemic. Therefore, during distance learning, CVUSD staff, students, parents and other community members will be required to complete the following COVID19 DAILY HEALTH SCREENER each day they enter any of the Castro Valley Unified School District (CVUSD) campuses.

If you answer “YES” to any of the questions you will be asked not to come onto any of the CVUSD campuses for any reason. In accordance with the Public Health Emergency Order No. 20-08 you must wear a mask while at CVUSD facilities, including outside common areas.

We appreciate your understanding and support as we continue to navigate through this unprecedented situation. We will continue to work through these challenges together.

Thank you!
Name *
Date Form Completed (Form must be completed the day you are reporting to work at a CVUSD site) *
MM
/
DD
/
YYYY
1. Within the last 10 days have you been diagnosed with COVID-19 or had a test confirming you have the virus? *
2. Do you live in the same household with, or have you had close contact* in the past 14 days with someone who has been in isolation for COVID-19 or had a test confirming they have the virus? (*NOTE: "Close Contact" is defined as living in the same house, being an intimate partner, being a caregiver, or being within 6 feet of an individual for longer than 15 minutes who has COVID-19) *
3. Have you had a fever of 100 Fahrenheit (37.8 Celsius) or higher in the past 14 days? *
4. Have you had any one or more of these symptoms today or within the past 24 hours, which is new or not explained by a reason other than possibly having COVID-19? COVID related symptoms include: Fever, cough, sore throat, shortness of breath/difficulty breathing, feeling unusually weak/fatigued, loss of taste/smell, muscle pain, headache, runny/congested nose, diarrhea, nausea and vomiting. *
Next
Never submit passwords through Google Forms.
This form was created inside of Castro Valley USD. Report Abuse