Employee Reporting Agreement

The purpose of this Agreement is to inform employees of their responsibility to notify their manager (or Manager On Duty) when they experience any of the symptoms or conditions listed below, so that appropriate steps can be taken to prevent the transmission of foodborne illness, and protect the safety and health of our Guests and other Team Members.

I AGREE TO IMMEDIATELY REPORT:

Any Onset of the Following Symptoms: either while at work or outside of work, including the date of onset:

1. Diarrhea

2. Vomiting

3. Jaundice

4. Sore throat with fever

5. Infected cuts or wounds, or lesions containing pus on the hand, wrist, and exposed body part, or other body part and the cuts, wounds, or lesions are not properly covered (such as boils and infected wounds, however small)

Medical Diagnosis:

Whenever diagnosed as being ill with Norovirus, typhoid fever (Salmonella Typhi), shigellosis (Shigella spp. infection), Escherichia coli O157:H7 or other EHEC/STEC infection, or hepatitis A (hepatitis A virus infection).

 Future Exposure to Foodborne Pathogens:

1. Exposure to or suspicion of causing any confirmed disease outbreak of Norovirus, typhoid fever, shigellosis,

E. coli O157:H7 or other EHEC/STEC infection, or hepatitis A

2. A household member diagnosed with Norovirus, typhoid fever, shigellosis, illness due to EHEC/STEC, or hepatitis A

3. Either the Team Member or household member attending or working in a setting experiencing a confirmed disease outbreak of Norovirus, typhoid fever, shigellosis, E. coli O157:H7 or other EHEC/STEC infection or hepatitis A

3. Good hygienic practices.

I have read (or had explained to me) and understand these requirements concerning my responsibilities under health department regulation and safe food handling guidelines and agree to comply with:

1. Reporting requirements specified above involving symptoms, diagnoses, and exposure specified;

2. Work restrictions or exclusions that are imposed upon me; and

I understand that failure to comply with the terms of this Agreement could lead to disciplinary action up to and including termination of my employment.