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Return to Work Screening for Niagara Region Employees - V3

Any Niagara Region employee who has been unable to work because of one or more reasons related to COVID-19 indicated below, is required to complete this return to work self-screening tool. This includes any employee attending a physical work location, or any employee working from home.
 
     ● They were tested for COVID-19 and did not receive a negative result
     ● They were self-isolating due to COVID-19 symptoms
     ● They were required to isolate due to non-essential travel
     ● They were referred to testing due to symptoms and were awaiting test results
     ● They were advised to self-quarantine due to someone who had symptoms of COVID-19, someone who tested positive for COVID-19, or someone who was tested for COVID-19 due to symptoms and is awaiting results
     ● They failed the Niagara Region Screen for COVID-19 Risk and were not able to work remotely
     ● They were advised by a licensed Health Care Professional to self-quarantine for any other reason

For any employee who may be required to immediately attend a Niagara Region physical work location or at some point in the future, completion of the return to work self-screening tool will help to ensure their ability to safely enter the location.  Completion of the self-screening tool is also required to confirm that an employee was unable to work for reasons related to COVID-19, and to support any wage continuance benefits they may have received during that time. 

Save and except as noted further below*, it is mandatory for the employees noted above to complete this screening tool following the period of time that they were unable to work for reasons related to COVID-19, and where applicable prior to re-entering a Niagara Region physical work location. Niagara Region is relying on the accuracy of information supplied by employees completing this tool in order to ensure the health and safety of all employees and permitted visitors in the workplace.  By completing this screening tool, employees acknowledge that failing to provide truthful responses may result in disciplinary action and that Niagara Region may request evidence reasonable in the circumstances to verify the period of self-isolation or self quarantine that was directed by Public Health or a physician.  Any questions in this regard should be directed to Human Resources. 

*Employees entering care-based facilities such as Long Term Care homes, Child Care Centres or Emergency Medical Services may be required to complete more enhanced return to work screening protocols specific to their work location.  If you work in one of these facilities, please contact your supervisor/manager for specific return to work instructions instead of completing this screen.

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Collection of Personal Information

Personal information collected by Human Resources pursuant to this screening tool is collected, used and disclosed under the legal authority of the Employment Standards Act and Occupational Health and Safety Protection Act, where applicable and in accordance with the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). Personal Information will be collected and used to confirm the nature of the employee’s absence from work; support their entitlement to any wage continuance benefits they may have received during the absence; and to ensure that is safe for them to return to work.

Questions about the collection of personal information pursuant to this screening tool should be directed to: Dan Miron at extension 3418.  Questions about MFIPPA and the collection of personal information generally should be directed to:

Mark Antidormi
Access and Privacy Office
Niagara Region
1815 Sir Isaac Brock Way, P.O. Box 1042
Thorold, Ontario
L2V 4T7
905-980-6000 ext. 3779