NY Forward Safety Plan Template - COVID-19 Reopening Safety Plan

Sep 25, 2026

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NY Forward Safety Plan Template supports businesses in creating a written COVID-19 Safety Plan describing how the workplace will reduce the spread of infection. The plan includes guidance on people management, physical distancing, face covering and protective equipment, hygiene and cleaning practices with cleaning logs, and communication measures through posted signage. It also provides sections to capture business identity and contact information, responsibilities, and operational details needed for inspection by state or local health and safety authorities.

LanguageEnglish

CategoryForms

FormatPDF

Pages7

Reading Time3 min

AccessFree to download

COVID-19 Reopening Safety Plan

I. PEOPLE

II. PLACES

NY FORWARD SAFETY PLAN TEMPLATE Each business or entity, including those that have been designated as essential under Empire State Development's Essential Business Guidance, must develop a written Safety Plan outlining how its workplace will prevent the spread of COVID-19 . A business may ﬁll out this template to fulﬁll the requirement, or may develop its own Safety Plan. This plan does not need to be submitted to a state agency for approval but must be retained on the premises of the business and must made available to the New York State Department of Health (DOH) or local health or safety authorities in the event of an inspection. Business owners should refer to the State’s industry-speciﬁc guidance for more information on how to safely operate. For a list of regions and sectors that are authorized to re-open, as well as detailed guidance for each sector, please visit: [forward.ny.gov](forward.ny.gov. If your)[. If your](forward.ny.gov. If your) industry is not included in the posted guidance but your businesses has been operating as essential, please refer to ESD's Essential Business Guidance M]Q MQVRaRc^ cVR UdWQRZW]Rb fWcVW] cVWb EMSRch BZM ]͙ Please continue to regularly check the New York Forward site for guidance that is applicable to your business or certain parts of your business functions͜ M]Q P^]bdZc cVR bcMcRM]Q SRQRaMZ aRb^daPRb ZWbcRQ ORZ^f. COVID-19 Reopening Safety Plan Name of Business: Industry: Address: Contact Information: Owner/Manager of Business: Human Resources Representative and Contact Information, if applicable: I. PEOPLE A. Physical Distancing. To ensure employees comply with physical distancing requirements, you agree that you will do the following: ✔ Ensure 6 ft. distance between personnel, unless safety or core function of the work activity requires a shorter distance. Any time personnel are less than 6 ft. apart from one another, personnel must wear acceptable face coverings. ✔ Tightly conﬁned spaces will be occupied by only one individual at a time, unless all occupants are wearing face coverings. If occupied by more than one person, will keep occupancy under 50% of maximum capacity. STAY HOME. STOP THE SPREAD. SAVE LIVES. ✔ Post social distancing markers using tape or signs that denote 6 ft. of spacing in commonly used and other applicable areas on the site (e.g. clock in/out stations, health screening stations) ✔ Limit in-person gatherings as much as possible and use tele-or video-conferencing whenever possible. Essential in-person gatherings (e.g. meetings) should be held in open, well-ventilated spaces with appropriate social distancing among participants. ✔ Establish designated areas for pick-ups and deliveries, limiting contact to the extent possible. List common situations that may not allow for 6 ft. of distance between individuals. What measures will you implement to ensure the safety of your employees in such situations? How you will manage engagement with customers and visitors on these requirements (as applicable)? How you will manage industry-speciﬁc physical social distancing (e.g., shift changes, lunch breaks) (as applicable)? II. PLACES A. Protective Equipment. To ensure employees comply with protective equipment requirements, you agree that you will do the following: ✔ Employers must provide employees with an acceptable face covering at no-cost to the employee and have an adequate supply of coverings in case of replacement. What quantity of face coverings – and any other PPE – will you need to procure to ensure that you always have a sufficient supply on hand for employees and visitors? How will you procure these supplies? STAY HOME. STOP THE SPREAD. SAVE LIVES. ✔ Face coverings must be cleaned or replaced after use or when damaged or soiled, may not be shared, and should be properly stored or discarded. What policy will you implement to ensure that PPE is appropriately cleaned, stored, and/or discarded?

FAQs

What hygiene and cleaning documentation is required?

The plan requires adherence to CDC and DOH hygiene and sanitation requirements and maintaining cleaning logs documenting date, time, and scope of cleaning. It also calls for regular cleaning and disinfection at least after every shift (or daily and more frequently as needed), including shared objects and high transit areas such as restrooms and common areas.

Sep 25, 2026

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