I. Employees
The SRJC COVID-19 Positive Exposure Incident Report was created for individuals accessing district worksites to report a suspected or confirmed case of COVID-19 at SRJC. Please complete the form if you access district worksites and have a suspected or confirmed case of COVID-19. Completing the form helps to facilitate case tracking and contact tracing, and assists the district's COVID Response Team with determining your work status.
- The online form is automatically sent to the COVID Response Team upon submission.
- District Employees will fill out this form on the behalf of:
- Any employee, volunteer, student, or visitor who informs them of a confirmed or suspected case of COVID-19.
- District Employees must notify their Supervising Administrator as soon as possible.
- No later than eight hours after learning of the reported COVID-19 exposure.
III. Filling Out the Form
Please respond to all questions to the best of your ability. To complete this form, be prepared with the following information:
- Name and contact information
- Student/employee ID number
- Role of Affected Individual (student/employee/volunteer/other)
- Building and specific locations accessed
- Classes attended while infectious
- COVID testing information and general health status
SRJC COVID Positive Exposure Incident Report
IV. Questions
- Please contact SHS by calling (707) 527-4445, or send an email to covidnurse@santarosa.edu if you are reporting a suspected or confirmed case of COVID-19 at SRJC, or need information regarding district quarantine or isolation requirements.
- Contact Linda Jay at ljay@santarosa.edu if you have questions regarding COVID sick leave.
- For additional assistance or questions, please contact the Human Resources Employee Health and Safety staff at ehsweb@santarosa.edu or call (707) 527-4803.