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Six Step Readiness Checklist
Respiratory Viral Illness Season (2025–2026)
Step One: Complete a risk assessment including reviewing existing plans
Step Two: Create/Update Facility plans
Step Three: Create/Revise Standard Operating Procedures including outline of the:
• What: Procedures and protocols for daily operations
• When-timeline for implementation, effective timeframe for SOP duration
• Who-roles and responsibilities clearly defined
• How-documentation, training, monitoring compliance, review and revise SOP regularly
Step Five: Educate and train
Step Six: Maintain vigilance and reinforce policies
Review Guidelines
Checklist Item
Review and update respiratory illness response plan
Review Alameda County masking health advisory (2025–26)
Review vaccination and treatment guidance
Review facility outbreak control protocols (COVID, ILI)
Identify challenges in outbreak prevention to review with ACPHD
Review compliance with CalOSHA ATD/BBP standards (fit testing, immunity recordkeeping, trainings,
competencies)
Acute Respiratory Viral Infections AFL 25-01
Develop or Update Plans
💉💉 Checklist Item for Vaccination planning
Plan COVID-19, Influenza, vaccination for patients/residents and staff
Develop plan for connecting residents with RSV vaccination
Determine vaccination provider (self vs. pharmacy partner)
Schedule vaccination clinic date(s)
Prepare education for patients/families and staff
Develop and maintain vaccination tracking system (COVID-19, influenza, and RSV)
Continue to offer opportunities for vaccination for residents and staff who may initially decline
Assess if any patients/residents qualify for Pemgarda as pre-exposure prophylaxis of COVID-19. See
qualifying criteria for Pemgarda use.
����� Checklist Item for Testing, Supply & Staffing Planning
Assess rapid testing supplies (COVID-19, Influenza)
Ensure vendor (and backup) for procurement of test kits, multiplex rapid antigen preferred
Additionally, identify lab partner for PCR results (< 2 days) including RSV testing
Develop process for resolving supply shortages (2–4-week supply of PPE/tests)
Develop/update contingency plan for staffing
Develop/update sick call policy and in-service staff on the policy AFL-25-01
��� Checklist Items for Treatment & Pharmacy Coordination
Complete risk assessments for treatment eligibility, including:
assessing baseline renal function (creatinine clearance) at the beginning of respiratory viral illness
season to avoid delays in flu treatment/antiviral chemoprophylaxis. See treatment guidelines under
😷😷 Implement & Optimize Plas for Infection Prevention & Outbreak Control
Prevention & Environmental Measures Checklist Item
Promote and provide vaccination to maximize vaccine uptake
Train relevant staff on updated protocols and recommendations
Review sick-call policy with staff regularly
Promote and monitor general respiratory precautions for residents, visitors and staff
Symptom Screening
Masking
Respiratory/cough etiquette
Hand Hygiene
Maintain adequate supply and promote hand hygiene and proper use of PPE
Strengthen Isolation Procedures for symptomatic patients/residents
Optimize facility ventilation (windows, HVAC w/ MERV13+, air filters) Ventilation in Healthcare Settings
Conduct daily active surveillance for symptomatic residents and staff
Implement testing as outlined in the guidance
Offer timely treatment and post exposure prophylaxis to all residents as applicable
Regularly monitor hand hygiene and environmental cleaning and disinfection adherence and
reinforce/retrain as needed
Continually share infection control adherence monitoring data to encourage adherence and accountability
Last & Equally as Important
Review and update internal and external communication plan as needed
Ensure compliance with disease/outbreak reporting (Title 17, AFL 23-08)
Save Contact information for ACPHD for reporting and consultation support needed Alameda County Public Health Department-Acute Communicable Diseases Section
Additional Resources and References
• California Department of Public Health Healthcare-Associated Infections Program.
Recommendations for Prevention and Control of COVID-19, Influenza, and Other Respiratory
Viral Infections in California Skilled Nursing Facilities: 2025–2026
• California Department of Public Health. AFL 23-29: Coronavirus Disease 2019 (COVID-19)
Treatment Resources for Skilled Nursing Facilities (SNFs). September 26, 2023
• Infectious Diseases Society of America. 2025 Clinical Practice Guideline Update on the
Treatment and Management of COVID-19. August 4, 2025
• U.S. Food and Drug Administration. Fact Sheet for Healthcare Providers: Emergency Use
Authorization of Pemgarda
• California Department of Public Health. COVID-19 Treatment Resources for Healthcare
Providers. October 2, 2024
• The Center for Disease Control Treating Flu with Antiviral Drugs | Influenza (Flu) | CDC
• California Department of Public Health. Respiratory Virus Dashboard