Published: September 9, 2020
Sheltering in place is important for people in high-risk groups, especially older adults living in residential facilities. At the same time, social isolation poses risks to mental and physical health. In order to promote social and mental well-being, Sonoma County Public Health Division (SCPHD) is permitting some communal dining within residential facilities as long as COVID-19 mitigation measures are in place and enforced. Facilities must meet the baseline requirements outlined below, and follow the practices and measures described in the Essential Practices and Measures for Communal Dining section prior to reopening communal dining.
Health Officer Order C19-08 has been amended to allow communal dining in non-patient care residential facilities, with the requirements set forth in this guidance. Communal dining is allowed pursuant to this guidance in the following facility types:
- Residential Care Facilities for the Elderly
- Social Rehabilitation Facilities
- Adult Residential Facilities
- Continuing Care Retirement Facilities (Assisted Living)
- Residential Facilities for the Developmentally Disabled
- Residential Facilities for Substance Use Disorder Treatment and Detox
- Community Crisis Homes
- Homeless Shelters
In order to consider the reopening of communal dining, facilities must meet ALL of the baseline requirements:
- Adequate staffing: The facility must not be experiencing staff shortages; AND
- Supply of 14 days of Personal Protective Equipment (PPE) and disinfection supplies on hand: The facility must have adequate supplies of PPE for staff such that all staff wear all appropriate PPE when indicated, and have adequate supplies of essential cleaning and disinfection supplies; AND
- Case status in the residential care facility: The facility must have had no new facility-onset COVID-19 cases among their residents or staff for at least 14 days. Newly transferred residents with either known COVID-19 or who become positive during quarantine do not count as COVID-19 obtained in the facility; AND
- Access to adequate testing: The facility must maintain access to COVID-19 testing for all residents and staff at a clinical laboratory.
Essential Practices and Measures for Communal Dining
Communal dining is permitted as long as the facility adheres to the following practices and measures:
- Facility adheres to universal source control.
- All staff, including servers and kitchen staff, must wear appropriate face coverings at all times.
- All residents practice hand-hygiene and are screened for signs and symptoms consistent with COVID-19 before entering the dining room.
- All residents are signed into the dining area, or sign a roster, at each mealtime to help with contact tracing should a resident later test positive for COVID-19.
- Facility adheres to physical distancing and small groups.
- No more than 10 residents are allowed to dine in the communal dining area at one time. If space does not permit 10 persons to be 6 feet apart in the dining area, the number of residents allowed must be reduced below 10 to allow for appropriate physical distancing between residents of 6 feet or more.
- Dining is supervised to ensure physical distancing of 6 feet or more is maintained at all times. Tables and chairs should be positioned to allow for a minimum of 6 feet between residents, and a minimum of 12 feet between tables/groups of residents.
- Meals should be served in shifts, with residents assigned to a specific cohort group that eats together each mealtime, in the same area of the dining room.
- Residents should be supervised to prevent residents from sharing items during meals, such as condiments, drinks and utensils. Condiments, including salt and pepper, should be provided in individual packets or bowls upon request. No supplies should be on the table for group use.
- Buffets and self-service drinking stations are not permitted.
- Staff members assisting residents with eating should wear gloves and wash hands and change gloves prior to assisting another resident.
- Stagger entrance and exit points to minimize contact among staff and residents. If staggering is not possible, ensure that all residents have left before allowing more residents to enter.
- Facilities should be aware that anyone who leaves the facility, or has close contact with persons outside of the facility (defined as contact within 6 feet of an individual, for fifteen minutes or longer) is at higher risk of transmitting COVID-19 to the community.
- Enhanced environmental disinfection.
- All communal, high touch surfaces should be disinfected with an EPA-registered cleaning agent before and after residents and/or staff enter or vacate the dining area.
- If new resident cases are identified, communal dining and activities should cease until at least two rounds of weekly facility-wide testing are complete. During this time, the facility should review their infection control practices to prevent future infections. SCPHD is available for consultation regarding infection control measures and mitigation planning. After there have been no new positive cases (resident or staff) for 14 days, communal dining may resume with universal source control measures and physical distancing as described above.