Community congregate living settings toolkit
The purpose of this site is to provide you with the information necessary to respond to COVID-19 transmission at your facility. This guidance applies if one or more cases are identified at your facility, regardless of your outbreak status. See outbreak definitions below.
This toolkit is intended for all facility which follow the Community Congregate Living Settings (including assisted living, adult family homes, inpatient behavioral health facilities, supported living, and independent living) with COVID-19 cases. For skilled nursing facilities, please refer to the Skilled nursing facilities (nursing home) toolkit.
COVID-19 guidance is changing all the time, please bookmark the following sites and review them often:
- COVID-19 Resources for Healthcare Providers, Public Health – Seattle & King County
- How to Protect Yourself and Others, CDC
- Additional Information for Community Congregate Living Settings (e.g., Group Homes, Assisted Living), CDC
The current definition of a COVID‑19 outbreak at an assisted living, adult family home, or supported living agency is:
- One facility-acquired COVID 19 positive infection in a resident or client; OR
- Three or more suspect, probably, or confirmed COVID 19 cases in HCP WITH epi‑linkage AND no other more likely sources of exposure for at least one of the cases.
The current definition of a COVID‑19 outbreak at an inpatient behavioral health facility is:
- Two or more cases of confirmed COVID 19 infection in a patient four or more days after admission for a non COVID 19 condition WITH an epi‑linkage; OR
- Three or more suspect, probable, or confirmed cases of COVID‑19 infection in healthcare workers WITH epi‑linkage AND no other more likely sources of exposure for at least two of the cases.
The current definition of a COVID-19 outbreak at an independent living facility is:
- Two or more confirmed COVID-19 (staff or resident) that onset within 14 days of each other AND have no clear epidemiological linkage (“epi-link”) outside the facility. An epi-link occurs when there is known or suspected transmission (spread) between two or more positive cases (excluding household members).
Create and maintain a positive COVID-19 case list. Include all residents, clients, patients, students, employees, volunteers, and contractors at your facility who test positive for COVID-19. If you are in a confirmed outbreak, you will use this list to submit a weekly cumulative case counts to Public Health. You may be asked to submit a final case list at the end of the outbreak investigation. Download a COVID-19 Case List template (MS Excel).
Report to Public Health – Seattle & King County
- Report positive COVID cases: If there is not an ongoing investigation associated with your facility, report any positive COVID cases (including residents/patients/staff/contractors) using the Public Health COVID-19 Intake Survey. You will receive a confirmatory email with additional information and guidance links.
- Investigation start: After your report has been processed, Public Health may open an investigation for your facility. You will receive an email with follow up instructions and a COVID-19 Investigator may contact you. An investigation is a non-punitive Public Health process for collecting information about how a disease is affecting our community and for providing guidance and resources.
- Submit weekly investigation updates: Every Monday while the investigation is open, you will receive an email prompting you to submit a weekly investigation update. Use the Investigation Update Form link provided to you to report a cumulative case count, most recent symptom onset date, and any hospitalizations or deaths associated with your facility. Report every week even if your facility has no additional cases.
- Investigation closure:
- If your facility meets outbreak criteria, your investigation will close when 15 days have passed since the last positive COVID case was identified. At this time Public Health may send you an email requesting that you submit a complete COVID-19 case list. Download a COVID-19 Case List template (MS Excel).
- If your facility does not meet outbreak criteria, your investigation will close when 8 days have passed since the last positive COVID case was identified.
- Report subsequent cases: After the investigation is closed, subsequent cases should be reported using thee Public Health COVID-19 Intake Survey.
Notify all staff, residents, and applicable resident families
Notify all staff, residents, and applicable resident families of COVID-19 in your facility while maintaining confidentiality of the positive case(s).
- COVID-19 Isolation and Quarantine Guidance, Public Health – Seattle & King County
- CDC isolation guidance for those who test positive
- CDC quarantine guidance for those who have been exposed to a positive case
- Encourage residents to self-monitor for COVID-like symptoms and screen staff daily (CDC’s COVID Symptom List).
- DOH Guidance on PPE Use – What PPE to use and in what situation?
Ordering PPE Supplies
- Order PPE through your distributor or other resources.
- Ensure your facility has at least a two-week supply of PPE and other infection control supplies on hand at all times.
Please notify your investigator if your facility is having difficulty providing critical services to residents due to isolation or quarantine of staff.
Please refer to DOH guidance on staffing shortages.
- Note that local workplace safety and health requirements may differ slightly from federal guidance. Please review WA Dept. of Labor & Industries resources to ensure regulatory compliance.
- Improving indoor air, Public Health – Seattle & King County
- Ventilation and Air Quality for COVID-19, WA Dept. of Health
- Ventilation in Buildings, CDC
Cleaning and disinfection guidance
- Staff Screening Guidance and Worksheet, WA Dept. of Health
- Multi-family Housing Including Populations at Increased Risk for Complications, CDC
- Stay Up to Date with Your COVID-19 Vaccines, CDC
- Know Your COVID-19 Community Level, CDC
Signage and Posters:
Link/share our site at kingcounty.gov/covid/ILFtoolkit