Tuesday, June 30, 2020

COVID-19 Exposure Control Plan

Jennifer Wallenfels, LMT — Spiral Massage & Bodywork
COVID-19 Exposure Control, Mitigation and Recovery Plan
Revised 6/30/20

This plan was prepared by compiling recommendations from the following organizations: the Washington State Department of Health, OSHA, the CDC, and several professional massage organizations: the ABMP, the AMTA, the WSMTA, and the FSMTB.

During Phase 2 of Safe Start, the clinic is operating at 50% occupancy by the two practitioners alternating days. Jody Ruhberg, LAc is working on Monday, Thursday, and Saturday; Jennifer Wallenfels, LMT is working Tuesday, Wednesday, and Friday.

In future phases the practitioners will attempt to stagger client arrivals and departures. In the event that this is not possible, they may take payment and reschedule in the treatment room.

The clinic will now:
  • Monitor surge capacity daily through the state’s risk assessment dashboard.
  • Encourage at-risk clients to wait longer to return to treatment.
  • Ask all clients to sign an addendum to their informed consent - see attached COVID Addendum to Informed Consent.
  • Post notices in office reminding about temperature checks, handwashing, respiratory etiquette and social distancing between clients.
  • Conduct a pre-screening the day before treatment. If client has symptoms or reason to suspect exposure, treatment will be rescheduled - see attached Screening Checklist.

During phase 2 we are taking clients one at a time, so there is no client-to-client contact, or contact between practitioners. As the county moves into further phases, and both practitioners begin to both see clients on the same day, we will implement social distancing in the office by attempting to stagger appointment times. When this is impossible, practitioners may take payment and reschedule in the treatment room, rather than bringing the clients into the shared lobby after the treatment.

  • Clients are asked to attend the appointment alone (unless the client is a minor).
  • Clients are asked to text upon arrival, and wait in their vehicles until notified to come in.
  • Clients are asked to don a mask before entry. Disposable masks are available.
  • A temperature check will be performed upon entry. If client temperature is 100.4 or above, treatment will not be performed that day. Client’s temperature is documented in the chart.
  • Clients are asked to sanitize or wash their hands before the treatment.
  • Clients are asked to sanitize their hands before leaving the treatment room.
  • The office is cleaned and disinfected after each treatment - see attached Cleaning & Sanitizing Procedures.
  • The practitioner will document in the chart that that the safety procedures were followed with the client.

  • Touchless pay systems (Apple Pay and Google Pay) are preferred.
  • If a physical card is presented, the reader should be held for the client to insert and remove their own card.
  • The signature requirement has been turned off so client does not need to touch the phone.
  • If cash or check is presented, it shall be put directly into the day’s deposit envelope.
  • After taking payments, the practitioner will perform hand hygiene.

  • Client and practitioner will both wear face masks or coverings, except when the client is prone.
  • When the client is prone, a pillowcase draping the face cradle will be used in lieu of a mask.
  • The practitioner will wear scrubs, and a cloth face covering, which are changed and washed after each client.
  • The practitioner will wear a face shield during treatment. The client is not required to wear one, but one is available upon request.
  • Face shields are disinfected with 70% alcohol after each use.
  • The practitioner will not wear gloves by default, but are available upon request.
  • The practitioner will observe proper hand hygiene before donning and doffing PPE, and don/doff in the proper order & manner.

  • Handwashing is the preferred method of hand hygiene, but if hands are not dirty, hand sanitizer is also acceptable.
  • Clients are asked to sanitize or wash hands upon entering the office, and use hand sanitizer after the treatment. Handwashing instructions are posted in the bathroom.
  • As customary, handwashing is always performed directly before and after treatment, washing up to the elbows and using a nail brush.
  • The face shield may be removed and set aside for disinfection, but the practitioner will not remove their face mask until after the client leaves and the office is ventilated. The practitioner will practice proper hand hygiene when doffing PPE.
  • The practitioner will perform office cleaning and disinfection before changing into clean scrubs and dressing the table.

  • Unnecessary items have been removed from the office for easier cleaning and disinfection.
  • 45 minutes is being allowed between treatments for thorough ventilation, cleaning and disinfection.
  • Ventilation, cleaning and disinfection with EPA-approved disinfectant will be performed on the lobby, bathroom, treatment room and laundry immediately after each client — see attached Cleaning & Sanitizing Procedure.

  • HEPA air filters have been added in the treatment room and lobby which run continuously.
  • A window will be open during treatment for increased ventilation.
  • Windows will be opened for ventilation directly after each treatment.

      Cleaning and Disinfection:
  • If surfaces are visibly soiled: clean, then disinfect. If surfaces are not soiled: just disinfection is acceptable.
  • The preferred cleaner is soap and water (or Simple Green).
  • The preferred disinfectant is 3% Hydrogen Peroxide (or commercial disinfectant wipes).
  • The preferred disinfectant for electronic items is 70% isopropyl alcohol.
  • The practitioner shall wear gloves to prevent skin irritation when sanitizing.
  • Paper towels, disinfectant, alcohol, and hand sanitizer are now stocked at the front desk and treatment room, as well as the laundry area. As customary, tissues are also available in these locations.
  • The treatment room and bathroom trash bins have been changed to foot pedal-operated, lidded cans using liners which are emptied daily.
  • As customary, dirty linens are stored in the laundry room, and washed same day in hot water with peroxide. Clean linens and scrubs are stored covered in the treatment room.
  • The practitioner will perform hand hygiene after handling dirty laundry and doing cleaning or disinfection.
  • As customary, waterproof covers are used on all pillows and heating pads.
  • As customary, linens are completely changed between each client, including any blankets used.

Practitioners will self-check their temperature at start of each day, or if symptoms develop.
If a practitioner has temperature of 100.4 or above, or develops symptoms, the practitioner shall cancel appointments, leave the premises, and refer to the Incident Response section of this document.

As this office has two solo practitioners, we have conducted our own safety training through self-education, by drawing on the resources listed at the beginning of this document. We are also continuously monitoring the latest scientific understanding of the transmission of COVID-19.

Clients are requested to contact their practitioner as soon as possible if they:
  1. Develop symptoms of COVID-19 in the two weeks after a treatment
  2. Test positive for COVID-19 in the two weeks after a treatment
  3. Get notified that they were exposed to COVID-19 in the two weeks prior to a treatment.

Clients give written consent that the Washington State Department of Health may be informed for contact tracing purposes only - see attached COVID Addendum to Informed Consent.

If clients develop symptoms and notify the practitioner, they shall be encouraged to self-isolate for 14 days, seek testing, contact their primary care physician, and notify their contacts and the DOH (or have a household member do so on their behalf).

In the unfortunate event that Jennifer Wallenfels, LMT learns she was exposed to COVID-19, or comes down with symptoms, she will self-isolate for 14 days, and get tested as soon as possible. If she tests positive, she will notify all her clients and other contacts for the prior two weeks, as well as Jody Ruhberg, LAc, as soon as possible. She must also cancel all her upcoming appointments until recovered.

Her treatment room will be closed for a minimum of three days and the lobby, bathroom and laundry areas must be thoroughly cleaned.

In the extreme case that Jennifer Wallenfels, LMT is hospitalized or too ill to notify her own clients of exposure or cancellation, Jody Ruhberg, LAc is granted permission to contact clients and the DOH on her behalf. Contact the state COVID Information line at 1-800-525-0127.


Jennifer Wallenfels, LMT

Have you or anyone in your household ever tested positive for COVID-19, or been exposed to anyone in the last two weeks who has COVID-19?

Have you or anyone in your household had any of these symptoms:
  • Cough or sore throat?
  • Difficulty breathing or shortness of breath?
  • Fever, chills or shaking?
  • Unfamiliar muscle pain or headache?
  • Sudden loss of taste and/or smell?

Have you or anyone in your household attended a large gathering? If so, what protections were employed?


If you have recovered from COVID-19,
  • Are you having any lingering symptoms or conditions related to it?
  • Are there any restrictions on your physical activity? Any new discomfort with exertion?
  • Do you have unfamiliar and severe, deep pain?
  • Do you have skin marks, rashes, or “COVID toes?”
  • Are you taking drugs to manage blood clotting?


Jennifer Wallenfels, LMT
COVID-19 Addendum to Consent for Massage Therapy

I am following guidelines from the CDC, Washington State Department of Health, and protocols from professional organizations to lessen the potential for disease transmission. I appreciate your understanding and compliance with the policies and procedures.

However, the Washington State Department of Health points out that there is no method to completely remove the risk of person-to-person spread of COVID-19 during a massage. No in-person appointment is risk-free. Telehealth sessions are an alternative to in-person appointments, and are recommended for those who are high-risk.

Please initial the following:

________ I understand that if a patient or practitioner of this facility tests positive for COVID-19 and it could have been transmitted to me, I will be informed. If this occurs, my name and contact information may be shared with the state Department of Health for contact tracing purposes only.

________ If I develop any symptoms of illness after my session, test positive for COVID-19, or discover a household member or contact has tested positive for COVID-19, I will inform Jennifer Wallenfels as soon as possible.

________ I understand no cancellation fee will be charged if I cancel an appointment due to symptoms of illness.

I have read and understand the disclosures, policies and procedures of Jennifer Wallenfels, LMT. I give my consent to receive massage treatment.

Print Name  _________________________________

Signature ___________________________________        Date _________________


Jennifer Wallenfels, LMT

If surfaces are visibly soiled: clean, then disinfect.
If surfaces are not soiled: just disinfection is acceptable.

Start of day
Empty all trashes & replace liners (mitigating exposure by leaving overnight)

After each treatment
Entry: Front door handle, countertop, phone/reader, pen/stylus, water cup, turn up air filter
Bathroom: turn on fan for ventilation, doorknob, lightswitch, toilet handle & seat, sink & dispenser handles
Treatment room: Ventilation (open windows & turn up air filter), doorknob, client chair, table, and dish; my desk & stool; dresser, vibrating massager, hot cabi, bolsters, pillow covers, table cover, table warmer switch, heater controls. Any crystals used, my glasses, pens, clipboard and client clipboard.
After cleaning protocol complete: remove scrubs, perform hand hygiene, put on new scrubs (or street clothes at end of day) and set new table linens

End of day
Do laundry
all light switches
Front desk surfaces, computer and peripherals, pens, glasses
Bathroom: include cleaning entire sink & toilet bowl
Laundry room: change laundry liner, doorknob, countertop, hamper lids, sink & dispenser handles, laundry control panels, drawer & doors, laundry bottle handles, laundry baskets, cabinet pulls

Vacuum (with HEPA filter) all floors. Vacuum at start of day to mitigate exposure
Mop hard floors
Sanitize tools after use
Dust all surfaces that have not been cleaned throughout week
Water plants

After each treatment

Turn up air filter/open window
Front door pull
Water cup

Turn on fan/clean switch
Toilet handle, lid & seat
Sink handles & soap/lotion dispenser handles

Treatment room:
Remove sheets, cups & oil bottle. Perform hand hygiene
Open windows & turn up air filter
Doorknob, heater control
Client chair & bin, table, and dish
My desk & stool
My glasses, pens, clipboard and client clipboard
Dresser drawers
Hot cabinet
Bolsters & pillow covers
Face cradle & table
Heating pad and table warmer switches
Vibrating massager, crystals, tuning forks

After cleaning complete:
Perform hand hygiene; remove scrubs
Perform hand hygiene; put on new scrubs or street clothes
Set new table linens

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