Restrictions Exemption Program - Millican Ogden Community ...
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Restrictions Exemption Program
CREATED Sept 22, 2021
UPDATED Sept 23, 2021Table of Contents Purpose ......................................................................................................................................................... 3 Restrictions Exemption Program .................................................................................................................. 3 Communications....................................................................................................................................... 5 Records Management .............................................................................................................................. 5 Noncompliance............................................................................................................................................. 5 Resources...................................................................................................................................................... 6 APPENDIX A – Facility Log-in Screening Form ............................................................................................. 7 Appendix B – MOCA Cleaning & Disinfecting Log ........................................ Error! Bookmark not defined.
Purpose
To allow for opportunities for recreational/ facility pursuits by following the Alberta Health/ Alberta
Government guidelines.
Restrictions Exemption Program
MOCA will be participating in the Restriction Exemption Program (REP) as of September 22, 2021, for all
individuals over the age of 12.
The following is required prior to your scheduled rental in order to participate in any program in either
of the MOCA Facilities (Community Hall & Jack Setters Arena):
• 1
Proof a vaccination provide to each team/league/organization/coordinator’s main contact for
the REP. Notification to MOCA on who the main contact is required.
o What is a valid proof of vaccination?
▪ The patron/attendee seeking entry to the business/entity/event is solely
responsible for demonstrating that they are the legitimate holder of the
vaccination record, and that the information being provided is complete and
accurate.
• If they cannot demonstrate that to the business/entity/event, the
individual must not be allowed to enter.
▪ Proof of vaccination includes:
• A picture or paper record of a valid Alberta Health Services, MyHealth
Records, pharmacy, First Nations, or physician immunization record
prominently displaying the name, type of vaccine and date of
administration, or
• Canadian armed forces immunization record, displaying the name, type
of vaccine and date of administration, or
• An immunization record from another Canadian Province or Territory,
displaying the name, type of vaccine and date of administration, or
• Valid Government of Alberta Vaccination QR code (when available).
o Proof of a negative privately-paid test result from a sample that is taken within the prior
72 hours (Results from Alberta Health Services are not eligible for consideration for this
program),
▪ The test result should be a written or printed copy that indicates the individual
has tested negative for COVID-19 on a Health Canada approved rapid antigen,
rapid PCR, or lab based PCR test approved by Health Canada or the lab
accreditation body of jurisdiction. o
• It must clearly outline the laboratory that completed the test if
applicable (e.g., DynaLIFE), the type of test, time of sample collection,
and clear indication of a negative result.
1
https://www.alberta.ca/assets/documents/covid19-restrictions-exemption-program-requirements.pdf
https://www.calgary.ca/csps/cema/covid19/safety/COVID-19-vaccine-bylaw.html• A picture of a rapid test result taken off site is not sufficient for this
purpose. o Individuals must not bring completed rapid tests or self-tests
to operators, as they can pose a communicable disease risk.
▪ Testing must not be sourced from the Alberta Health Services public COVID-19
testing system.
• This system is currently reserved for symptomatic individuals and those
in outbreak situations. If an individual has COVID-19 symptoms, they
must isolate.
o An original (non-copied) medical exemption letter
▪ A valid medical exemption is the original signed letter from a physician or nurse
practitioner that includes:
▪ The name of the person in the written documentation that matches the
identification provided.
• The physician’s or nurse practitioner’s information is complete by
including:
o Name, phone number, contact information, professional
registration number, and signature of the physician or nurse
practitioner.
o Statement that there is a medical reason for the individual’s
exemption from being fully vaccinated against COVID-19; and
o The duration that the exemption is valid.
Provide to MOCA:
• The name and the date of birth of the individual listed on the proof of immunization or
testing must be matched with the name and date of birth on the identification (for 18+).
o Driver’s License
o Health Care Card
o Citizenship card
o Metis/Treaty Card
• Verification that the proof of vaccination is appropriate (see above) OR the test result
indicates the individual has tested negative for COVID-19 within the last 72 hours (see
above), or the medical exemption letter is an original and in the prescribed form.
• Records will be stored as per below.
• This form must be completed and signed by the organizer. (form in appendix of this
document)
**In addition to providing the copy of the verification check form, a copy must be with the main
contact of your team/organization/ league/ coordinator as staff will spot check with lead
organizer to verify REP is being complied with.Communications
MOCA encourages all its staff, volunteers, and facility users to stay up to date with developments
related to COVID-19.
This document will be available to all staff, volunteers, and facility users to stay apprised on how MOCA
is taking steps to prevent the risk of transmission. This document will be posted on the MOCA website,
given to each renter and a copy available at each of its facilities.
Further communications will be in the form of signage posted throughout the facilities.
Records Management
Anyone who enters a MOCA facility will be asked to complete the MOCA Screening & Vaccine
Verification form through their team/league/organization/ coordinator main contact. The form will
contain the screening checklist and space to provide date, function, full name, address, phone number
and vaccine/ID verification.
Records will be kept in the General Managers office and only be given to AHS if there a potential
exposure occurs. Records will be kept for up to 45 days then will be shredded. At the request of renters,
a copy can be given for your program records.
Noncompliance
MOCA hopes to continue the trusting relationship it has established between all the facility users.
Should there be noncompliance with any of the policies set forth in this document, the following may
occur:
• A reminder will be given to the facility users that not following MOCA and public health orders is
against the law and puts people at risk.
• Should the facility user continue to not comply with MOCA and public health orders, the user
will be asked to leave the premises.
• Should the situation turn into an urgent matter, law enforcement may be called in.
• In the event the private function is not following procedures set forth in this document as
reference by AHS and Alberta Government (and affiliates), as per the MOCA rental agreements,
the team/ organization/ league/ coordinator will be liable for any fines of any fines, levies or law
enforcement outcomes.
MOCA does not want to be a facility reported for not abiding by public health order or be a place for an
outbreak. We appreciate your cooperation to ensure everyone, and the facility is kept safe from any
harm.Resources
RESOURCE CONTACT
MOCA Office Rentals
rentals@millicanogdencommunity.com
General Manager
generalmanager@millicanogdencommunity.com
Government of Alberta (Alberta Health) COVID-19 Info for Albertans
https://www.alberta.ca/coronavirus-info-for-albertans.aspx
Alberta Health Services Self Assessment Tool
https://myhealth.alberta.ca/journey/covid-19/Pages/COVID-Self-
Assessment.aspx
Government of Canada Coronavirus disease (COVID-19)
Information Privacy FOIP-PIPA Help Desk 780 427-5848
Toll free 310-0000 before the phone number (in Alberta)
Email sa.accessandprivacy@gov.ab.ca
Health Information Act (HIA) Help Desk 780-427-8089
Toll free 310-0000 before the phone number (in Alberta)
Email hiahelpdesk@gov.ab.ca
Office of the Information and Privacy Privacy in a Pandemic
Commissioner https://www.oipc.ab.ca/resources/privacy-in-a-pandemic-advisory.aspxAPPENDIX A – Facility Log-in Screening Form
MOCA SCREENING & VACCINE VERIFICATION FORM
If you answer *YES to any of the following, please DO NOT enter the facility, return home, and do the Self Assessment tool on the Alberta Health Services website to
determine if testing is recommended
1. Does the person attending the facility have any new onset (or worsening) of any of the following symptoms:
a. Fever, cough, shortness of breath/difficulty breathing, sore throat, chills, painful swallowing, runny nose/nasal congestion, feeling unwell/fatigued,
nausea/vomiting/diarrhea, unexplained loss of appetite, loss of sense of smell or taste, muscle/joint aches, headache, conjunctivitis (pink eye)
2. Has the attendee travelled outside of Canada in the last 14 days?
3. Has the attendee had close contact (face-to-face contact within 2 metres) with a confirmed case of COVID-19 in the last 14 days?
4. Has the attendee had close contact with a symptomatic close contact of a confirmed case of COVID-19 in the last 14 days?
ENTER *YES OR Vaccine/negative Valid ID
NAME (first & last) NO TO THE test/ exemption verification
DATE FUNCTION PHONE ADDRESS
Each person must be recorded QUESTIONS verification (main contact
ABOVE (main contact initials) initials)You can also read
