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  • Incident Report Form

  • I witnessed violations of the following checklist items:

    • 1. Daily room cleaning and disinfection  
    • 2. PPE and social distancing for ALL  
    • 3. Test and screen to prevent illness  
    • 4. Rapid response to suspected outbreak  
    • 5. No retaliation for workers who speak out about safety  
    •  -
    • 6. Other  
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