June 17, 2020

Update on Lakes Homes and Program Development procedures and protocols for universal precautions and Preparedness plan for Covid 19

Lakes Homes’ COVID-19 Preparedness Plan follows the industry guidance developed by the state of Minnesota, which is based upon Centers for Disease Control and Prevention (CDC) and Minnesota Department of Health (MDH) guidelines for COVID-19, Minnesota Occupational Safety and Health Administration (MNOSHA) statutes, rules and standards, and Minnesota’s relevant and current executive orders.

Corona virus (Covid-19) is thought to spread mainly from person to person, who are in close contact with one another, through respiratory droplets produced when an infected person coughs or sneezes.  Symptoms of Covid-19 are fever, dry cough, shortness of breath, inability to taste or smell and fatigue.

Any person travelling to a high-risk area for Covid-19, will need to self-isolate for 14 days before returning to work/public areas of the house.

People who are ill should stay home.  Those individuals who show symptoms of cough and frequent sneezing, but not showing other signs of illness, will be asked to wear a face mask when they are around people.  eg, while providing cares, in vehicles etc.  Employees who are not sick but caring for individuals who have been diagnosed with Covid-19 will also wear a facemask and face shield.  Employees and the individuals we serve, who have been diagnosed with Covid-19 will stay isolated from others.  Continue to use personal protective equipment/supplies provided.


When the threat of Covid-19 is high, and people are encouraged to stay home, Lakes Homes will consult with medical providers about currently scheduled appointments and future appointments.  Appointments that can be postponed without ill effect will be rescheduled for a later date.  Nursing staff will work with medical providers and guardians to determine if an appointment should be made or kept.


Employees and the individuals we serve should avoid close contact with people who are ill or have been exposed to Covid-19.   This is called safe social distancing.  Stay a distance of 6 feet away when possible. Currently, all individuals will not participate in activities of more than 10 people, following CDC guidelines.  If an individual we serve is diagnosed with Covid-19, The entire house will be totally quarantined following CDC guidelines.   Currently this quarantine is 14 days. Individuals with community jobs do have the right to request to continue going to their jobs, as long as they remain healthy per this policy.  Staff and volunteers should also maintain social distance when interacting with each other

Employees will wash their hands often with soap and water for at least 20 seconds, especially after being in public places, and after blowing nose, coughing or sneezing.  Employees will coach and assist individuals we serve to do the same.  If soap and water are not easily available, hand sanitizer may be substituted as long as it is at least 60% alcohol.  Hand sanitizer should cover all services of hands and hands rubbed together until they feel dry.  Individuals we serve will receive training and prompts to follow these protocols.  Staff may need to assist individuals who struggle with this task.
All will be encouraged to avoid touching eyes, nose, mouth with unwashed hands.  Everyone should use a Kleenex or sneeze/cough into the crook of their elbow, and then immediately wash their hands.
Employees will wear a surgical mask and eye protection while working directly with an individual during activities of daily living, hygiene cares and meal time, if they are providing physical care to do so.  Masks and full-face shields will be provided.  Masks will be re-used unless/until they become soiled.  Face shields will be cleaned and sanitized after each use.  They will be stored in the home, on a hook.   If someone in the home is identified with Covid-19 virus, stronger protocols are in place for a house identified with positive case(s) of Covid-19.

Gloves will be included as daily personal protective equipment (PPE) offered to employees and individuals we serve.  Currently, gloves will be worn while performing personal care with individuals, while sanitizing surfaces and handling soiled items.  Gloves will be changed between activity, individual cares etc. and if they become soiled or damaged.  Staff will wash their hands before putting on and after removing gloves in a manner consistent with procedures taught.  Change gloves each time you are done working with an individual.  Do not wear gloves all day long.  Staff will use gloves while handling medications.  Gloves will be changed between individuals’ medications.

Due to the difficulty with procuring supplies, masks and thermometer probe covers will be re-used until damaged or overly soiled, as long as no one in the home has the Covid-19 virus.  Each employee will receive a paper bag, a mask and a face shield.  People will put their names on the outside of the paper bag and on the mask.  Thermometer probe covers should be cleaned with an alcohol swab after each use and allowed to air dry.  Resident probe covers can be stored in a Paper bag or in a med cup with their name on it and placed in a safe place to prevent tipping over.

Regular practices of cleaning and disinfecting have been implemented, including a schedule for routine cleaning and disinfecting of work surfaces, equipment, tools, vehicles and areas in the work environment, including restrooms, break rooms, and meeting rooms. Frequent cleaning and disinfecting is being conducted of high-touch areas, including, but not limited to phones, keyboards, touch screens, controls, door handles, railings, copy machines, light switches, countertops, handles, phones,  toilets, faucets, sinks, tubs, vehicle steering wheel, seats and handles of vehicles.  To disinfect, EPA registered household disinfectants can be used.  Disinfecting can also be accomplished by making bleach and water solution by mixing 5 tablespoons (1/3 cup) bleach per gallon of cold water or 4 teaspoons bleach per quart of cold water.  It must be mixed fresh each day.  People should avoid sharing phones, pens etc.  Sinks could be an infection source so residents should avoid placing toothbrushes directly on counter surfaces. Totes can be used for personal items so they do not touch the bathroom countertop
Employees must clean their hands before and after using the bio readers to clock in and out.

Prohibit food (including condiments) and beverage sharing between residents. Stagger meal times to maximize social distancing, if necessary.  Plate each meal and serve it so that multiple people are not using the same serving utensils.

Plan for the use of facemasks when providing transportation.  Take precautions when using public transportation and ride-sharing. Limit the number of individuals in the vehicle and ask them to spread out to maintain social distancing as much as possible.  Do not have air recirculated while in a vehicle. Use the vehicle’s ventilation system to exchange fresh-air in from outside the vehicle; Lower the vehicles windows as often as possible.  Pre-coordinate, schedule, and reduce and the number of trips to accommodate and allow ample time for cleaning and disinfecting in-between trips.  Remind individuals to wear a facemask or face covering, wash their hands, and follow social distancing guidelines while they are away.

Community businesses are open for business with restrictions.  Lakes Homes will follow the guidelines set forth by the state of Minnesota at the minimum.  Depending on situations, Lakes Homes may decide to follow a stronger protocol, while protecting resident rights.   Residents and staff are encouraged to use the outdoors for leisure time and exercise.  All participating in outdoor activity will follow the guideline to maintain a distance of 6 feet between people and no more than 10 people in a group.

It continues to be policy that Lakes Homes refrains from drive through at eating establishments. Resuming eating meals in dine in restaurants will be assessed on an individual basis, consulting with the individuals’ guardians.  Dining inside a restaurant will follow the guidelines set forth by the state of Minnesota.  Staff and individuals would be encouraged to use outdoor dining whenever possible.  Staff and individuals will wear masks if anticipating going to an environment that social distancing is difficult.  This would include, but no limited to farmer’s markets, flea markets etc.  Employees would be encouraged to continue this protocol even when they are off duty.

House coordinators will assign grocery shopping and other community errands.  Individuals we serve may accompany staff one at a time as long as they can maintain good safety protocols set forth in this plan.

Lakes Homes buildings will not be receiving guests indoors.   This includes employees going from house to house with the intent to visit and going to the office.   Employees will be restricted from working multiple locations whenever possible.  People entering Lakes Homes buildings shall do so for scheduled work purposes only, and utilizing personal protective equipment (PPE).  All people entering the homes and offices will wear a face mask and sanitize their hands before entering.  All people who enter the buildings who are not currently scheduled there will sign in, to facilitate contact tracing, if the need arises.

Individuals we serve may receive guests outdoors at this time.  A shaded area with seating will be provided.  Guests are asked to call ahead to coordinate their visits.  Guests are asked to consider avoiding times of day that their individual may be receiving therapies of any kind.  This would include meals and normal times of resting for that individual.  Visits should occur only on days when there are no weather warnings that would put either the visitor or individual at risk. Guests will be asked if they have any listed symptoms of Covid-19 or if they have been exposed to anyone with Covid-19 in the last 14 days.  Lakes Homes may deny face to face visit if guests answer these questions in the affirmative.  Guests must sign in and provide contact information. Guests must not enter a building for any reason without prior permission from administration.  Guests must maintain at least a six foot distance from the individual during the visit.  Guest will be required to wear a face mask and to wash their hands or use hand sanitizer upon arrival.  Hand sanitizer and instructions for its use will be provided.  Adequate staff must be present to allow for help with outdoor transition of individuals, and to assist with wiping down any visitation areas as necessary. Clean and disinfect after each visit.  Encourage individuals to wash their hands after interacting with a visitor. Staff should maintain visual observation but provide as much distance as necessary to allow for privacy of the visit conversation. 
Current COVID-19 positive individuals or individuals with COVID-19 signs or symptoms, and individuals in a 14-day quarantine or observation period are not eligible for outside visits.  Individuals who have had COVID-19 must no longer require transmission-based precautions as outlined by the CDC and MDH guidelines.  Due to the risk of exposure, holding hands, hugging, kissing, or other physical contact is not allowed during family visits.   Visitors under age 12 years must be in the control of adults who bring them and must also comply with social distancing requirements.    Pets must be under the control of the visitor bringing them in. 
Lakes Homes retains the right to deny outdoor visitation to specific individuals only if they believe circumstances pose a risk of transmitting COVID-19 to the facility because the individual or visitor does not comply with infection control guidance, or the individual or visitor is at risk of abuse/harm.

Individuals we serve are advised to plan family home visits carefully.  If there is a risk for not being able to follow safe social distancing protocols, using set protocols for handwashing and sanitizing, and wearing of face masks in close proximity, home visits should be re-evaluated, and possibly be delayed.  Home visits will be evaluated on a case by case basis with a Lakes Homes representative and guardian of the individual.  Lakes Homes is making every attempt to continue family visits via phone and internet options, such as Zoom.  Face to face visits to the homes will occur outdoors and visitors will maintain a distance of six feet and wear a face mask.   Again, the group must be smaller than 10 people or as space allows to maintain a six foot distance between people. Call Lakes Homes office if you want information on how to proceed with this.  Exceptions can be made to these protocols with express permission by the administrator.

Work to allow for the maximum amount of fresh air to be brought in (including opening windows if possible), limit air recirculation and properly use and maintain ventilation systems. Take steps to minimize air flow blowing across people, including repositioning seating and fans
Air recirculation is being limited, and ventilation systems are being properly used and maintained by Lakes Homes maintenance personnel and outside contractors, as needed.  Steps are also being taken to minimize air flow blowing across people.

Group staff meetings and training may now be reimplemented.  Staff members who are not working on shift at time of a staff meeting, will join by video/audio.  Meetings and in person training shall not consist of more than 10 people, or the ability to maintain a distance of 6 feet apart.  Lakes Homes will follow the guidelines set forth by CDC for group training. 


This COVID-19 Preparedness Plan has been certified by Lakes Homes’ management and the plan is posted throughout the workplace and made readily available to employees, guests and guardians.  It will be updated as necessary by the administrator or designee.  
Employees, individuals, families, guardians, providers and board members receive training to this plan prior to working in any of the buildings and with the individuals we serve.   Explain in plain language the parts of the plan relevant to the individuals and, as appropriate, parents, guardians, legal representatives, and case managers.  Current employees received a copy of this plan and will be trained to the plan on or before June 29, 2020.  They will be kept abreast of changes to this policy.  This plan is in accordance with Minnesota executive order 20-74.

Staff with concerns about their employer’s COVID-19 Preparedness Plan or questions about their rights should contact MNOSHA Compliance at osha.compliance@state.mn.us, 651- 284-5050 or 877-470-6742.

Individuals and their family and friends may contact Lakes Homes with questions as well as have access to the Office of Ombudsman for Long-Term Care at 651-431-2555 or 1-800-657-3591 to request advocacy services. 


Thomas Reiffenberger
Executive Administrator