KENCREST MASK PROTOCOL

Dear KenCrest Community:

As we anticipate the relaxation of stay at home orders, KenCrest has developed plans to ensure the

safety and well-being of staff and consumers as they begin to reengage in the community. Supporting

consumers to follow guidelines for mask wearing when in public places is a priority. We recognize the variety

of medical and behavioral challenges that may impact mask wearing and want to be as prepared as possible to

address these concerns.

A Mask Medical Risk Assessment will be completed for every individual we serve to better understand medical

and/or behavioral concerns that may impact the ability to wear a mask safely or comfortably. This information

will be used to develop strategies to promote mask wearing for individuals who are medically permitted to do

so and to develop guidelines for those who cannot do so safely or willingly. A Mask Wearing History

Assessment will also be completed for each individual who has had any experiences using masks. Strategies

and resources accompany the assessment in the protocol including mask alternatives, social story and

communication resources, charts for usage tracking and medical identification cards for individuals who

choose to communicate their reason for not wearing a mask to community members. All of this and more has

been created for each team across KenCrest.

We ask that identified parties complete the assessment on assigned individuals and share them with the team

as soon as possible to set each individual up for success. We sincerely appreciate your cooperation in helping

to keep our KenCrest community healthy.

We are all in this together.

Sincerely,

The KenCrest Mask Task Force

960A Harvest Drive, Suite 100

Blue Bell, PA 19422

p: 610-825-9360 f: 610-825-4127

KenCrest.org

○ Initial Assessment

○ Re-Assessment Developed by: Latasha Williams

Mask Medical Risk Assessment Cognitive Status

Alert and Orient Knows Name Knows Day Knows Year/ Time Gesture

Method of Communication Verbal Sign Language Reads Lips Non-Verbal

Intellectual Disability Level Severe Mild Moderate Profound

Adaptive Equipment and Bodily Structure Glasses Yes No Always Wears Wears Sometimes Never Wears

Hearing Aides Yes No Always Wears Wears Sometimes Never Wears

Cochlear Implants Yes No

Ambulatory Status Yes No Independent Unsteady Needs Assist Wheelchair Bound

Contractions Yes No Arms Head/ neck Hands/fingers Wrist

Respiratory Conditions History of Asthma Yes No Mild Moderate Severe

Seasonal Allergies Yes No Mild Moderate Severe

Chronic Obstructive Pulmonary Disease Yes No Mild Moderate Severe

Emphysema Yes No Mild Moderate Severe

History of Lung Cancer Yes No Mild Moderate Severe

Cystic Fibrosis Yes No Mild Moderate Severe

Bronchitis Yes No Mild Moderate Severe

Oxygen Therapy Yes No Daily As Needed w/ BiPAP or CPAP

Has a Tracheotomy Yes No Capped Hmvt/Passy Muir Value Vent dependent

Other Respiratory Concerns Yes No List:

Medical and Behavioral Concerns Seizure Disorder Yes No Has Often Has Rarely over 5 years

History Poor Skin Integrity Yes No Explain( ie: poor nutrition etc)

History of PICA Yes No Mild Moderate Severe

Facial Reconstruction Yes No Explain:

History Skin Cancer Yes No Gets Chemo/radiation Receive topical tx No treatment

Increase Drooling Yes No Mild Moderate Severe

Behavior Issues Yes No Mild (Easily Redirect) Moderate (Difficult) Severe (Unable)

Eats by Mouth Yes No

Feeding Tube Yes No G-tube GJ/J tube NG Tube

Dysphagia Yes No Pocketing Foods Stuffing Foods

Sensory Issues Yes No (ie: texture issues)

White Coat Syndrome Yes No Increase Behaviors Incontinence Shortness of breath

Facial/ oral sexual trauma Yes No Explain:

Mask Wearing History Assessment

Has the individual worn a mask/face covering during the COVID crisis or previously as personal protective equipment?

Yes If YES, continue assessment. No If NO, move to MASK ACTION PLAN

Currently, how often is the individual trialing/wearing a mask or face covering?

○ One trial

○ More than 3 trials/week

○ Trials/wears daily

How long has the individual keep a mask/face covering on?

○ Less than a minute

○ 1-5 min

○ 5-15

○ 15-30 min

○ 30-60 min

○ More than 1 hour

○ More than 3 hours

○ Awake times with the exception of eating and grooming

What type of mask/face covering did the individual wear/trial? Mark all that apply.

○ Paper surgical mask ○ ski mask ○ Face shied

○ N95 Mask ○ Handmade cloth mask

○ Neck gaiter (neck warmer pulled over mouth/nose)

○ Bandana or other fabric tied around face/head

○ Other: (Halloween masks, fake beards, welding shields, etc.)

Please describe:

What type of help did/does the individual need to put a mask/face covering on or take it off?

○ None

○ Verbal prompting only needed for instruction

○ Minimal help (assistance to orient mask/face covering

properly and ensure secure fit, takes off independently)

○ Moderate help (assistance to fit mask/face covering over

mouth/ears or to wrap/tie, help needed to unfasten from ears, untie, or pull down)

○ Maximal help (full assistance needed to put on mask/face

covering and to remove)

Has the individual displayed any difficulty breathing when wearing a mask (breathing rate increases, shortness of breath, tearing eyes, color changes/blueish around lips and/or nail beds, new lack of coordination, look of panic-wide eyes or flapping, fearful noises)?

Yes No If Yes, describe symptoms:

Has the individual demonstrated refusal behaviors or agitation with mask wearing or attempts to trial mask?

○ Physical resistance to putting on

○ Tugging on/pulling off

○ Verbal refusal

○ Other please describe:

Has anything helped an individual to wear a mask?

○ Verbal prompts

○ Social stories/visual supports ○ Fabric/style preference

○ Theme on mask (i.e. team logo) ○ Other please describe:

Community Participation Assessment

This section is intended to collect information on locations in the community where an individual

frequents to ensure preparedness for mask wearing.

Employment and Volunteer Work:

*If the individual is not employed or engaged in volunteer work, skip to next section. Will the individual be returning to a work or volunteer location?

○ Yes ○ No

If the individual is returning to work/volunteering, indicate type of setting.

○ Grocery/retail store ○ Establishment serving or preparing food ○ Office ○ Hospital/medical center ○ Fitness center ○ Outdoor location (park, farm etc.) o Other please describe:

Has the individual received specific guidance regarding mask wearing from their employment/volunteer setting?

○ Yes ○ No If yes, please describe:

Regularly Scheduled Community Outings Please indicate places an individual often went prior to stay-at-home orders.

○ Day program Name and location: ○ Retail stores ○ Restaurants ○ Convenience food stores/coffee shops (i.e. Wawa, Dunkin Donuts) ○ Movie theaters ○ Bowling alleys or other leisure venue Please describe: ○ Doctor/clinician offices ○ Walking trails ○ Fitness center ○ Other please describe:

MASK ACTION PLAN

OPTION 1: An individual has no medical risks for mask usage & had successful experiences using a mask.

1. Make sure that the style of masks that have been successful for this individual are readily available. Try to obtain at least 3 masks at a minimum if ones are soiled, thrown away by accident, lost, or removed during an outing and need to be replaced by a clean one.

2. Offer one of these masks to the individual while at home to engage in a mask wearing game. Staff must be wearing masks during this time as well. As many individuals in the home who can wear masks should participate. A. For those who can place the masks on themselves, explain that you are going to play a game

and the point is to wear the mask the whole game without touching your face. This game can include watching a movie, playing some video games, doing a puzzle, playing board games, etc. for up to 3 total hours. Pick the activity or multiple activities you are going to do during the mask game time, pick the start time, hand everyone a mask who is not already wearing one right before the start time, and start the game.

B. For those who cannot place the masks on themselves, explain the game, but do not immediately put on the mask the individual. After you pick the activity or activities and when the game will start, then use the STEPS FOR PUTTING MASKS ON OTHERS (see below), and start the game.

C. Keep track of the progress of using this “game” at home on the FACE MASK PREPARATION FOR COMMUNITY OUTINGS CHART (see below).

3. When the individual has been able to successfully wear a mask for at least 1 hour at a time for at least 5 days; then an initial outing should be planned to figure out how successful the individual’s health and safety skills will be in public. A. Before any outing, a staff member MUST read, watch, or perform a social story about health

and safety expectations during community outings. Refer to the SOCIAL STORY AND COMMUNICATION RESOURCES list below. Each staff member must note which version was used or if a specialized social story was created for this person by a behaviorist.

B. Masks will be offered to those who can wear them securely without assistance. Staff must simply double check that the item is being worn as intended.

C. Masks – for those who need assistance with securely fitting them to their face-will be placed on the individual using the STEPS FOR PUTTING MASKS ON OTHERS (see below) protocol.

D. Each individual should start off with a one hour or less outing building up over time to up to 3 hours in the community.

E. Each outing MUST be documented on the COMMUNITY OUTING HEALTH AND SAFETY CHART (see below).

F. If there are concerns with ANY outing, the Program Manager, Personal Outcome Champion, or any other identified party must inform the team immediately upon return via email or phone so that a strategy for increased safety can be developed by the team whether that is to start with a shorter outing time, try another destination, switch to a different social story, or something else.

G. Remember to celebrate any and all successfully safe moments or full outings!

4. When the individual has successfully been able to be out in the community for 3 hours for 10 consecutive outings (no concerns for 10 outings in a row); then the Program Manager, Personal Outcome Champion, or any other identified party will inform the team and outings may be deemed safe at this time.

OPTION 2: An individual has no medical risks for mask usage & no history of using masks. 1. Make sure that at least 3 styles of masks are available to try. Check the MASK ALTERNATIVES LIST (see

below). 2. The first step is to practice mask usage at home.

A. Read, watch, or perform a social story about health and safety expectations during community

outings. Refer to the SOCIAL STORY AND COMMUNICATION RESOURCES list below. Each staff member must note which version was used or if a specialized social story was created for this person by a behaviorist.

B. Show the masks to the individual while at home to have a mask wearing game. Staff must be wearing masks during this time as well. As many individuals in the home who can wear masks should participate in this game. Allow the individual to choose which style of mask they want to try first. If the individual does not demonstrate interest in any one particular mask, it might be best to start with the material/cloth masks because they can be washed and reused.

C. For those who can place the masks on themselves, explain that you are going to play a game where the point is to wear the mask through the whole game without touching your face. This game can include watching a movie, playing some video games, doing a puzzle, playing board games, etc. for up to 3 total hours. Pick the activity or multiple activities you are going to do during the mask game time, pick the start time, hand everyone a mask who is not already wearing one right before the start time. Staff must simply double check that the item is being worn as intended then begin the game.

D. Masks – for those who need assistance with securely fitting them to their face-will be placed on the

individual using the STEPS FOR PUTTING MASKS ON OTHERS (see below) protocol. E. Keep track of the progress of using this “game” at home on the FACE MASK PREPARATION

FOR COMMUNITY OUTINGS CHART (see below). 3. When the individual has been able to successfully wear a mask for at least 1 hour at a time for at

least 5 days; then an initial outing should be planned to figure out how successful the individual’s health and safety skills will be in public. A. Before any outing, a staff member MUST read, watch, or perform a social story about health

and safety expectations during community outings. Refer to the SOCIAL STORY AND COMMUNICATION RESOURCES list below. Each staff member must note which version was used or if a specialized social story was created for this person by a behaviorist.

B. Masks will be offered to those who can wear them securely without assistance. Staff must simply double check that the item is being worn as intended.

C. Masks – for those who need assistance with securely fitting them to their face-will be placed on the individual using the STEPS FOR PUTTING MASKS ON OTHERS (see below) protocol.

D. Each individual should start off with a one hour or less outing building up over time to up to 3 hours in the community.

E. Outings MUST be documented on the COMMUNITY OUTING HEALTH AND SAFETY CHART (see below).

F. If there are concerns with ANY outing, the Program Manager, Personal Outcome Champion, or any other identified party must inform the team immediately upon return via email or phone so that a strategy for increased safety can be developed by the team whether that is to start with a shorter outing time, try another destination, switch to a different social story, or something else.

G. Remember to celebrate any and all successfully safe moments or full outings! 4. When the individual has successfully been able to be out in the community for 3 hours for 10

consecutive outings (no concerns for 10 outings in a row); then the Program Manager, Personal Outcome Champion, or any other identified party will inform the team and outings may be deemed safe at this time.

OPTION 3: An individual has at least one of the medical risks for mask usage & a history of using masks. 1. If the individual has a respiratory, seizure, or other safety consideration; please contact the doctor

associated with this health condition prior to moving forward with the mask protocol. Let them know that this person has successfully worn a mask previously and find out if there are any contraindications for the type of mask that was successful. If there are exact specifications in what should be allowed, please make sure the team gets a copy. If the doctor states that this individual cannot wear a mask, ask if there are possible alternatives.

2. If the person is dealing with any of the other conditions from the MASK MEDICAL RISK ASSESSMENT (see above), but has been successful with certain types of masks, continue to utilize those unless an issue arises during practicing usage at home.

3. Make sure that the style of masks that have been successful for this individual are readily available. Try to obtain at least 3 masks at a minimum if ones are soiled, thrown away by accident, lost, or removed during an outing and need to be replaced by a clean one.

4. Offer one of these masks to the individual while at home to have a mask wearing game. Staff must be wearing masks during this time as well. As many individuals in the home who can wear masks should participate. A. For those who can place the masks on themselves, explain that you are going to play a game and the

point is to wear the mask through the whole game without touching your face. This game can include watching a movie, playing some video games, doing a puzzle, playing board games, etc. for up to 3 total hours. Pick the activity or multiple activities you are going to do during the game, pick the start time, hand everyone a mask who is not already wearing one right before the start time, and go.

B. For those who cannot place the masks on themselves, explain the game, but do not immediately put

on the mask. After you pick the activity or activities and when the game will start, then use the STEPS FOR PUTTING MASKS ON OTHERS (see below) protocol and start the game.

C. Keep track of the progress of using this “game” at home on the FACE MASK PREPARATION FOR COMMUNITY OUTINGS CHART (see below).

5. When the individual has been able to successfully wear a mask for at least 1 hour at a time for at least 5 days; then an initial outing should be planned to figure out how successful the individual’s health and safety skills will be in public. A. Before any outing, a staff member MUST read, watch, or perform a social story about health

and safety expectations during community outings. Refer to the SOCIAL STORY AND COMMUNICATION RESOURCES list below. Each staff member must note which version was used or if a specialized social story was created for this person by a behaviorist.

B. Masks will be offered to those who can wear them securely without assistance. Staff must simply double check that the item is being worn as intended.

C. Masks – for those who need assistance with securely fitting them to their face-will be placed on the individual using the STEPS FOR PUTTING MASKS ON OTHERS (see below) protocol.

D. Each individual should start off with a one hour or less outing building up over time to up to 3 hours in the community.

E. Outings MUST be documented on the COMMUNITY OUTING HEALTH AND SAFETY CHART (see below).

F. If there are concerns with ANY outing, the Program Manager, Personal Outcome Champion, or any other identified party must inform the team immediately upon return via email or phone so that a strategy for increased safety can be developed by the team whether that is to start with a shorter outing time, try another destination, switch to a different social story, or something else.

G. Remember to celebrate any and all successfully safe moments or full outings! 6. When the individual has successfully been able to be out in the community for 3 hours for 10

consecutive outings (no concerns for 10 outings in a row); then the Program Manager, Personal Outcome Champion, or any other identified party will inform the team and outings may be deemed safe at this time.

OPTION 4: An individual has at least one of the medical risks for mask usage & no history of using masks.

1. If there is a respiratory, seizure, or other safety consideration; please contact the doctor associated with this health condition prior to moving forward with the mask protocol. Find out if there are any contraindications for different types of masks. If there are exact specifications of what should be allowed, please make sure the team gets a copy. If the doctor states that this individual cannot wear a mask, ask if there are possible alternatives.

2. If the person is dealing with any other conditions from the MASK MEDICAL RISK ASSESSMENT (see above), talk to the team about the best options for the individual using the MASK ALTERNATIVES LIST (see below). Try to have at least 3 styles of masks are available to try if at all possible.

3. The first step is to practice mask usage at home. A. Read, watch, or perform a social story about health and safety expectations during community

outings. Refer to the SOCIAL STORY AND COMMUNICATION RESOURCES list below. Each staff member must note which version was used or if a specialized social story was created for this person by a behaviorist.

B. Show the masks to the individual while at home to have a mask wearing game. Staff must be wearing masks during this time as well. As many individuals in the home who can wear masks should participate in this game. Allow the individual to choose which style of mask they want to try first. If the individual does not demonstrate interest in any one particular mask, it might be best to start with the material/cloth masks because they can be washed and reused.

C. For those who can place the masks on themselves, explain that you are going to play a game where the point is to wear the mask through the whole game without touching your face. This game can include watching a movie, playing some video games, doing a puzzle, playing board games, etc. for up to 3 total hours. Pick the activity or multiple activities you are going to do during the mask game time, pick the start time, hand everyone a mask who is not already wearing one right before the start time. Staff must simply double check that the item is being worn as intended then begin the game.

D. Masks – for those who need assistance with securely fitting them to their face-will be placed on the

individual using the STEPS FOR PUTTING MASKS ON OTHERS (see below) protocol. E. Keep track of the progress of using this “game” at home on the FACE MASK PREPARATION

FOR COMMUNITY OUTINGS CHART (see below). 4. When the individual has been able to successfully wear a mask for at least 1 hour at a time for at

least 5 days; then an initial outing should be planned to figure out how successful the individual’s health and safety skills will be in public. A. Before any outing, a staff member MUST read, watch, or perform a social story about health

and safety expectations during community outings. Refer to the SOCIAL STORY AND COMMUNICATION RESOURCES list below. Each staff member must note which version was used or if a specialized social story was created for this person by a behaviorist.

B. Masks will be offered to those who can wear them securely without assistance. Staff must simply double check that the item is being worn as intended.

C. Masks – for those who need assistance with securely fitting them to their face-will be placed on the individual using the STEPS FOR PUTTING MASKS ON OTHERS (see below) protocol.

D. Each individual should start off with a one hour or less outing building up over time to up to 3 hours in the community.

E. Outings MUST be documented on the COMMUNITY OUTING HEALTH AND SAFETY CHART (see below).

F. If there are concerns with ANY outing, the Program Manager, Personal Outcome Champion, or any other identified party must inform the team immediately upon return via email or phone so that a strategy for increased safety can be developed by the team whether that is to start with a shorter outing time, try another destination, switch to a different social story, or something else.

G. Remember to celebrate any and all successfully safe moments or full outings!

OPTION 5: An individual cannot or will not wear a mask or any alternatives. 1. KenCrest is continuing to discuss the specifics of how and when someone will be identified as not being

able to wear a mask; however-for those who are not medically restricted from wearing a face or head covering-masks must be attempted and documented using the protocol steps for a minimum of twice daily each day for 14 days. At that point, the Mask Response Team (MRT) should be contacted to formally assess the struggles that this person is having and make the recommendations for next steps. Send Email to: clinical@kencrest.org Subject: MRT Request

The response team will consist of three individuals and lead by a behavioral specialist. A single person or team cannot label a person incapable of wearing a mask without this process or a physician’s written order not to have this person wear a mask or face covering. If a person is deemed incapable of wearing a mask or is medically restricted from using a mask, do the following steps to increase community safety and awareness.

2. Make sure that the Frequently Visited Business Letter (see below) has gone out to all area businesses where this person may need or want to go.

3. Offer the individual a Medically Prohibitive Mask Usage Card (see below). The individual is the ONLY person who may show this to anyone as it contains HIPPA protected information; however, if the individual chooses to offer this card to a community member it is their information to share.

4. Make sure all staff working with this individual have a copy of the PA DEPARTMENT OF HEALTH INFORMATION FOR BUSINESSES (see below). This document states that organizations are not allowed to turn people away for not using masks. This is only to be used if identified as needed according to the GOING INTO THE COMMUNITY FLOW CHART (see below). The PA DEPARTMENT OF HEALTH INFORMATION FOR BUSINESSES document is something we would be offering for educational purposes and not to create an argument between business proprietors and our individuals.

5. Identify, using the steps from the GOING INTO THE COMMUNITY FLOW CHART (see below), what alternative locations might be included in case the individual is not interested in arguing with any business owners or offering their Medically Prohibitive Mask Usage Card (see below) to the owners.

6. Congratulate individuals on any progress made whether they choose to offer information, avoid confrontation and switch locations, or just go back home. This was their choice and it was probably not easy or fulfilling. Let them know how much you appreciate everything they are doing during this atypical time in our lives.

FACE MASK PREPARATION FOR COMMUNITY OUTINGS CHART DATE TIME

STARTED LENGTH OF TIME WORN

FACE TOUCHING?

OTHER CONCERNS OR EXPERIENCES? STAFF INITIALS

COMMUNITY OUTING HEALTH AND SAFETY CHART

DATE & TIME

DESTINATION DETAILS ON MAKS USAGE OTHER SAFETY CONCERNS

RETURN HOME

STAFF INITIALS

Kept mask on the entire time Attempted to remove mask, replaced with verbal prompt Attempted to remove mask multiple times, multiple prompts needed Removed mask and would not wear, returned home Other: __________________

Touching face Trying to touch community members Not washing hands as needed Other: _________ _________________

Time: __________ Cleaned up after outing? Yes or No Mood: ________

Kept mask on the entire time Attempted to remove mask, replaced with verbal prompt Attempted to remove mask multiple times, multiple prompts needed Removed mask and would not wear, returned home Other: __________________

Touching face Trying to touch community members Not washing hands as needed Other: _________ _________________

Time: __________ Cleaned up after outing? Yes or No Mood: ________

Kept mask on the entire time Attempted to remove mask, replaced with verbal prompt Attempted to remove mask multiple times, multiple prompts needed Removed mask and would not wear, returned home Other: __________________

Touching face Trying to touch community members Not washing hands as needed Other: _________ _________________

Time: __________ Cleaned up after outing? Yes or No Mood: ________

Kept mask on the entire time Attempted to remove mask, replaced with verbal prompt Attempted to remove mask multiple times, multiple prompts needed Removed mask and would not wear, returned home Other: __________________

Touching face Trying to touch community members Not washing hands as needed Other: _________ _________________

Time: __________ Cleaned up after outing? Yes or No Mood: ________

Kept mask on the entire time Attempted to remove mask, replaced with verbal prompt Attempted to remove mask multiple times, multiple prompts needed Removed mask and would not wear, returned home Other: __________________

Touching face Trying to touch community members Not washing hands as needed Other: _________ _________________

Time: __________ Cleaned up after outing? Yes or No Mood: ________

STEPS FOR PUTTING MASKS ON OTHERS

1. Staff and individuals should follow proper hand washing procedures before putting on or helping

individuals to put on masks.

2. When possible, allow individuals to express what they like or don’t like about a mask/face covering to help

guide choices of masks/face coverings. See Mask Alternatives List.

3. When possible, allow individuals to choose a mask to trial/wear.

4. If individuals have known interests/preferences, use those to help with motivation to wear masks such as a

favorite sports team, cartoon character, colors/embellishments, or textures. If an individual has known

sensitivity to certain textures or with touching to areas of the face, this must be taken into consideration

first.

5. Start by visually introducing the masks to create interest in them and make them less threatening. Try

hanging masks on a hook with the person’s name on a wall or door to make it feel more personalized.

6. Some individuals may need to touch a mask/face covering to accommodate to the texture before ever

securing the item over face. Offer the mask to the individual to touch over repeated trials as needed

before an individual may allow it near their face.

7. When an individual is ready to put the mask near their face, always start by having the individual in front

of the mirror so they can see everything that is happening from all angles. Staff should encourage

individuals to look in a mirror when they are putting on/receiving help with putting on a mask/face

covering so that they can see the process. A table top or hand-mirror may be helpful.

8. DO NOT place a mask on someone while standing behind them! This can create a sense of being attacked

or controlled by another person. ALWAYS offer a mask from the front or side in front of a mirror in order

to reduce anxiety.

9. Staff helping individuals should always verbalize actions/steps. For example: “May we try your mask now?”

(WAIT FOR RESPONSE OR RECOGNITION.) “May I put your mask over your mouth and nose?” (WAIT FOR

RESPONSE OR RECOGNITION.) “May I help you put the mask over your ears?” (WAIT FOR RESPONSE OR

RECOGNITION.) Steps will vary based on individual’s ability to continue.

10. If someone says no or demonstrates discomfort with a mask at any time, stop and immediately remove

the mask from this person. Thank them for trying to wear the mask and put it out of sight for a few

minutes.

11. If an individual displays any signs of breathing difficulty (breathing rate increases, shortness of breath,

tearing eyes, color changes, blueish around lips and/or nail beds, new lack of coordination, look of

panic-wide eyes or flapping, fearful noises) remove or help individual to remove mask immediately.

12. Some individuals may need to touch/have mask touched to their face before securing to head. This may

need to happen over repeated trials before an individual may allow a mask/face covering to be secured

over face.

13. Only when all other steps have been attempted and strategy is followed should a mask be secured on

someone’s face.

14. Check in with individuals regularly to make sure they are comfortable. Do not leave individuals with masks

on unattended if they are unable to remove the masks themselves!

MASK ALTERNATIVES LIST

Typical/Standard face mask options o Cloth with Velcro (can include tear-away pull that extends to a mobile body part for quick

release) o Cloth with buttons or snaps o Cloth with magnets o N95 o Paper o Filter insert cloth masks

Face shield

Hats with drop down shields

Motorcycle, bike, or skiing helmet with face shield

Neck gaiter

Face jewelry option: hand created face covering that connects to earrings, head band, and necklace

Halloween masks with cloth inserts (hot glued, snapped, sewn, or attached with Velcro)

Full face zip hoodies with mouth/nose inserts for those interested in cosplay or hero/villain scenarios

Fake beards with washable wool or yarn used in a variety of styles (Wolverine, ZZ Top, etc.)

T-shirt mask for those who have older shirts they love (use the positive memories)

Bandanas or scarves (folding techniques online depending on size)

Bedazzled fabric or paper options…cover them in washable paints, glitter, or stick on sequins for paper

Haram dancer style attached to hat or turban (potentially attached with Velcro to shirt so not open)

Snap on (or Velcro) face covering attached to eye glasses (glasses cleaned along with every use)

Fabrics to consider o Cotton (including blends with spandex or polyester) o Neoprene o Silk o Satin o Denim o Vinyl mouth area insert surrounded by other material (for those who need to read lips) o Flexible play foam (can be hand sewn for those who only tolerate this material)

Ear coverings or closures to consider o Elastic band o Hair tie o Twist ties wrapped in preferred cloth or washable o Thin fabric ties o Eye glass or sunglasses attachment option o Headband with Velcro or snaps attached to avoid “around the ears” sensory issues

SOCIAL STORY AND COMMUNICATION RESOURCES

Review all social stories, videos or communication resources to identify which items would be the most useful

for the individual. If nothing is meeting the needs of the individual, please contact the Behavior Support

person – if available – or the Enabling Technology Department if a Behaviorist is not on the team.

SOCIAL STORIES

https://www.autismresourcecentral.org/social-stories-for-young-and-old-on-covid-19/masks-soc-story/ - from HMEA’s Autism Resource Central. This is a great social story that explains why people are wearing masks. Click on the image that appears in the middle of the screen to see the full story.

http://www.texasautismsociety.org/wp-content/uploads/2020/04/Wearing-Masks-Social-Story.pdf - from Texas Autism Society. This story was designed for children but could prove useful for our individuals, as well.

Wearing a mask animated story and social story (in multiple languages) o https://paautism.wistia.com/medias/y7lc98u4lo?embedType=async&videoFoam=true&videoWidth=6

40 o https://paautism.org/resource/wearing-mask-social-story/

VIDEOS

https://www.youtube.com/watch?v=alDe9GCf8Sw – from Lifetime Psych YouTube channel. This visual aid is appropriate for all ages.

https://www.youtube.com/watch?v=lnP-uMn6q_U – from Mr. Mike YouTube channel. This visual aid was designed for children but could be beneficial for individuals with IDD.

https://www.youtube.com/watch?v=fbX0k6XJ0VU – from ABC7. This is a brief video (under 1 minute) from a surgeon explaining proper mask technique.

https://www.youtube.com/watch?v=tV-l8YkRxKQ – from KGW News. This quick video explains some of the science behind why we should wear masks right now. This may not be appropriate for everyone but could help with individuals who have questions.

https://www.youtube.com/watch?v=LxW64fBlyu4 – from NBC10 Philadelphia. Some individuals may be familiar with NBC10 and trust the information. This clip also shows regular people walking around with masks on. It also shows how to make your own and covers mask etiquette.

https://www.youtube.com/watch?v=wCVhWawGsXY – from The Children’s Hospital of Philadelphia YouTube channel. This catchy little song explains why staff are wearing masks. This may help individuals struggling with seeing so many masks in their home.

Kelly Sanders (Behavior Specialist) offered her favorite: https://www.youtube.com/watch?v=ipvbNzK4nXc

Stanley Carr’s (Trainer) offer his favorite: https://www.youtube.com/watch?v=UPhd19fjPEI

More complicated language but good https://www.youtube.com/watch?v=7QW58YIZ2iw

ASL! https://www.youtube.com/watch?v=IkHEyjPGG8A

Cute simple song about mask wearing and hand washing. Has a little lesson at the end https://www.youtube.com/watch?v=8i5wl7bZ_CM

Gloria Estefan mask song-very catchy and has a lot of fun mask related images https://www.youtube.com/watch?v=ygiDoiu4U08

COVID RESOURCES & NOTES

Communication Assistant Core Board: Includes symbols and words for those familiar with using low-tech

versions of PECS https://techowlpa.org/news/aac-covid19-core-board/

It is highly recommended that you use words/phrases that are meaningful to your individual(s). For

example, the word “mask” may mean “Halloween mask” to your individual(s). It may be better to say

“face covering” or “PPE” when asking an individual to wear a mask. Instead of: “Put on your mask.” Try:

“Let’s cover our faces to stay safe.” Contact the individual’s behavior specialist or your supervisor if you

are uncertain about the best words/phrases

Here is an example for the standard adult face mask.

o https://www.inquirer.com/resizer/oZ-oVzcCHaIAHfPohVADbP2T2eU=/1400x932/smart/arc-anglerfish-

arc2-prod-pmn.s3.amazonaws.com/public/IBYH3H7OKNFLFP54V2LMMZGJRQ.png

https://paautism.org/resource/coronavirus-resources/

o Social distancing animated story and social story (in multiple languages) https://paautism.wistia.com/medias/fabtvup2ua https://paautism.org/resource/social-distancing-social-story/

o Isolation animated story and social story (in multiple languages) https://paautism.wistia.com/medias/3nlgtzlmkt https://paautism.org/resource/isolation-social-story/

o Staying Home animated story and social story (in multiple languages) https://paautism.wistia.com/medias/n7649m4slt https://paautism.org/resource/stay-home-social-story/

o Washing Hands social story (in multiple languages) https://paautism.org/resource/hand-washing-social-story/

o Getting Tested for COVID: https://paautism.org/resource/testing-covid-social-story/ o Quarantine: https://paautism.org/resource/quarantine-social-story/ o Wearing Gloves: https://paautism.org/resource/wearing-gloves-social-story/

PA DEPARTMENT OF HEALTH INFORMATION FOR BUSINESSES

Order of the Secretary of the Pennsylvania Department of Health Directing Public Health

Safety Measures for Businesses Permitted to Maintain In-person Operation

Recognizing that certain life-sustaining businesses in the Commonwealth must remain open

despite the need for strong mitigation to slow the spread of the 2019 Corona virus (COVID-19),

the Secretary of Health has ordered certain actions to be taken by employers and the employees

of life-sustaining businesses (employees) to protect their health and lives, the health and lives of

their families, and the health and lives of the residents of the Commonwealth who depend upon

their services.

Q. If the customer refuses to wear a mask will they be turned away or will the customer be

refused service?

A. Yes, with the exception for businesses that provide medication, medical supplies, or food,

which must offer another means for the customer to purchase goods if they the customer is

unable to wear a mask. Those means could include home delivery or contactless curbside pickup.

However, individuals who cannot wear a mask due to a medical condition (including

children under the age of 2 years per CDC guidance) may enter the premises and are not

required to provide documentation of such medical condition. If that occurs, and if the business is not

able to provide a mask, the business should consider providing information on mask

making, distributing ”how to” flyers, or sharing locations to purchase masks.

Q. What if someone does not come in with a mask and the business cannot offer an

alternative means of serving the customer?

A. Businesses should consider providing masks to their customers or offering resources to

customers information on how to make masks. Consider sharing mask making on social media,

distributing” how to” flyers, or sharing locations to purchase masks. Customers can also be

reminded to wear a scarf or bandana as a mask. However, individuals who cannot wear a mask

due to a medical condition (including children under the age of 2 years per CDC guidance) may

enter the premises and are not required to provide documentation of such medical condition.

Q. How do businesses avoid confrontation with customers who do not wear a mask?

A. Businesses should consider how they would deal with a customer who came into their

business without a shirt or shoes. Businesses should consider giving customers resources on

how to make their own mask, provide a mask, or ask the customer to wear a scarf or bandana

in addition to reminding them of the Secretary’s Order.

960A Harvest Drive, Suite 100

Blue Bell, PA 19422

p: 610-825-9360 f: 610-825-

4127

KenCrest.org

FREQUENTLY VISITED BUSINESSES LETTER

Dear Community Friends,

Your business/organization has been identified as a favorite place of someone who looks

forward to reengaging with your services when the social isolation restrictions are lifted. We can only

imagine how challenging this time has been on your company and its employees. We appreciate that

everyone has to do their part to keep others safe in order to minimize the spread of COVID-19.

We wanted to let you know that we are practicing safe hand washing for a minimum of 20

seconds at a time at home so that we can continue this when we are out in the community. We have

also been making sure to check for any of the CDC symptoms of COVID-19 and take the necessary

precautions to get tested or self-quarantine as needed. We have even completed an assessment for

whether or not it is safe to wear a mask or face covering.

There are some folks; however, that have been recommended not to wear a mask for medical

reasons. We want to keep everyone safe, but we put our own lives at risk if we were to go outside of

these recommendations. There are so many reasons why someone could not wear a mask including

respiratory concerns, seizure disorders, or even the inability to physically remove a mask in an

emergency. Please know that if we could, we would wear a face covering because we care about

you. We hope that you understand that we will continue to keep a social distance of at least 6 feet

for our own safety and yours. We really can’t wait to see you again and thank you for being a valuable

part of the community.

Sincerely,

Your Friend at KenCrest

P.S. If you have any questions, feel free to email safety4kc@kencrest.org. We made this email

address just for you and anyone in the KenCrest community to ask questions about COVID-19!

Medically Prohibitive Mask Usage Card

NAME: NAME:

I understand that it is recommended by the CDC that everyone wear a mask. I have a medical diagnosis that prohibits

me from safely being able to use a mask or other face covering. I will be using social isolation standards of at least 6

feet of space to keep myself and others safe during this time. Thank you for

understanding.

I understand that it is recommended by the CDC that everyone wear a mask. I have a medical diagnosis that prohibits

me from safely being able to use a mask or other face covering. I will be using social isolation standards of at least 6

feet of space to keep myself and others safe during this time. Thank you for

understanding.

DATE: DATE:

GOING INTO THE COMMUNITY FLOW CHART

Created by Katharine Croce, Ed. D., BCBA-D