SRJC COVID-19 Positive Exposure Incident Report

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.