Assembly Bill 685 requires that employers notify employees of possible exposure to COVID-19 and report workplace outbreaks to the local health department. This webform is to be completed by non-healthcare employers when three or more cases of COVID-19 are identified at a workplace within a 14-day period. This information should be submitted within 48 hours. If you do not have complete information within 48 hours, you must report the information that you have obtained up to that point. If you obtain additional information after your initial report, you may submit an updated Case Information Sheet.
In accordance with HIPPA Privacy and Security Rules, all information provide in this form will remain confidential. Please provide as much information as you can. Providing this information helps our local case investigation teams identify and slow the transmission of COVID-19 in worksites throughout San Benito County.
Best viewed withGoogle Chrome and Firefox. Our Agency’s website links to Google Translation as a convenience for those who speak/read languages other than English. Please be aware that no automated or computerized translation tool produces a perfect translation. The context of the wording may be lost when translated and some translations may lose the intended meaning. Therefore, the San Benito County Health and Human Services Agency cannot guarantee the accuracy of the translated content.
If any questions arise concerning the translated version of the website, please refer to the original English version.